Status epilepticus has been occasionally reported as a cause of acute disseminated intravascular coagulation(DIC), but little is known regarding the pathogenesis of this uncommon association. The occurrence of DIC in status epilepticus may be related to widespread endothelial damage secondary to seizure-induced hyperpyrexia or status epilepticus due to high fever. We experienced two cases of status epilepticus accompanying fever in which laboratory data demonstrated activation of coagulation and fibrinolytic systems in a 3-year-old girl and a 12-month-old boy. There was no evidence of infection, trauma, brain damage, or toxic ingestion as alternative explanations for the consumptive coagulopathy. Hematologic parameters did not improve despite multiple transfusions of red blood cells, pletelets, and fresh frozen plasma. Body temperature should be monitored closely in patients with status epilepticus and efforts directed toward prompt lowering of body temperature to prevent the development of consumption coagulopathy.
Body Temperature ; Brain Injuries ; Child, Preschool ; Dacarbazine ; Disseminated Intravascular Coagulation* ; Eating ; Erythrocytes ; Female ; Fever* ; Humans ; Infant ; Male ; Plasma ; Status Epilepticus*

PURPOSE: Convulsive status epilepticus induces disturbance in acid-base homeostasis. It is known that metabolic acidosis is common after status epilepticus. A recent, discovery indicates respiratory acidosis is common after status epilepticus. This study is to analyze the acid-base disturbances in patients with status epilepticus. METHODS: Retrospectively, we reviewed twenty-five patients with status epilepticus, who were admitted to the pediatric department of Chosun University Hospital between January 1995 and August 2000. We have analyzed the clinical correlation among the acid-base disturbance, the incidence of pulmonary infiltration, and the type and duration of convulsions. RESULTS: Acid-base disorders in the status epilepticus were revealed in 17(68%) of 25 patients. Respiratory acidosis with or without metabolic acidosis was most common(N= 13; 52%). There was no significant correlation between the pulmonary infiltration(N=8; 32%) and the acid-base disorders(P>0.05). The most common seizure type in status epilepticus was generalized tonic clonic(72%). In that type, the most common acid-base disorder was respiratory acidosis(11/18). The mean serum pH was significantly decreased with duration of seizures(P<0.05). CONCLUSION: This study finds that respiratory acidosis with or without metabolic acidosis was most common in status epilepticus. There was no significant correlation between pulmonary infiltration and acid-base disorders. Respiratory acidosis was most common in generalized tonic clonic seizure.
Acidosis ; Acidosis, Respiratory ; Homeostasis ; Humans ; Hydrogen-Ion Concentration ; Incidence ; Retrospective Studies ; Seizures ; Status Epilepticus*

PURPOSE: The advantages of air reduction are the ease of performing the procedure, reduced radiation time and lower morbidity rate if perforation occurs. But, patients who fail air reduction undergo a laparotomy at which 10% have spontaneously reduced. The first enema decreases the edema and venous congestion of bowel wall, thus repeated reduction may succeed. The aim of this study is to evaluate the efficacy of delayed repeated pneumatic reduction of intussusception in patients with failure of an initial attempt. METHODS: Between January 1998 and December 1999, 21 patients with proven intussusception received repeated delayed reduction 1 to 3 hours following the first failed attempt. These patients were in stable condition and did not have peritonitis, shock or toxic sign. RESULTS: Before reduction, the patients had symptoms and signs for 6 to 48 hours (median 24 hr). The interval from the first reduction to the repeated was 1 to 3 hours (median 2.2 hr). The success rate of repeated reductions was 76.2% (16 of 21 patients), and 23.8% (5 of 21 patients) required surgery. Four of 5 patients requiring surgery were manually reduced and 1 spontaneously reduced in the operating room. CONCLUSION: We recommended a repeated reduction in patients with intussusception who are in stable clinical condition after an unsuccessful initial reduction attempt.
Edema ; Enema ; Humans ; Hyperemia ; Intussusception* ; Laparotomy ; Operating Rooms ; Peritonitis ; Shock

No abstract available.
Amniotic Fluid* ; Female ; Meconium* ; Zinc*

OBJECTIVES: To investigate the relationship between the Helicobacter pylori (H. pylori) colonization and the grade of gastritis in the antrum and in the body of patients with duodenal ulcer (DU) or benign gastric ulcer (BGU). METHODS: This study was performed in H. pylori-positive 220 DU patients and 180 BGU patients. H. pylori density was evaluated by modified Giemsa staining and CLO test, and gastritis grade was graded by H+ACY-E staining in the antrum and in the body. RESULTS: H. pylori grade by Giemsa staining was 1.24 in the antrum and 0.82 in the body for DU group (p +ADw- 0.01), and those of BGU group were slightly reversed, 0.83 and 0.87, respectively, but without statistical significance. Similarly H. pylori grade by CLO test was 3.1 in the antrum and 2.8 in the body for DU group (p +ADw- 0.01), and those of BGU group 2.3 and 2.6 (p +ADw- 0.05), respectively. In contrast, gastritis grade was 1.7 in the antrum and 1.2 in the body for DU group (p +ADw- 0.01), and those of BGU group 1.6 and 1.3 (p +ADw- 0.01), respectively, similar to those of DU. However, there was a correlation between H. pylori grade and gastritis grade in the antrum and in the body, not only in DU but also in BGU group (p +ADw- 0.01). CONCLUSION: In spite of different distribution patterns of H. pylori between DU group and BGU group, gastritis grade of the antrum was significantly higher than that of the body in both DU and BGU. However, gastritis is correlated with H. pylori density not only in DU but also in BGU patients. It looks like the inflammatory reaction to H. pylori is stronger in the antrum than in the body.
Adult ; Aged ; Colony Count, Microbial ; Comparative Study ; Duodenal Ulcer/pathology+ACo- ; Duodenal Ulcer/microbiology ; Female ; Gastric Fundus/pathology ; Gastric Fundus/microbiology ; Gastritis/pathology+ACo- ; Gastritis/microbiology+ACo- ; Helicobacter Infections/pathology ; Helicobacter Infections/diagnosis+ACo- ; Helicobacter pylori/isolation +ACY- purification+ACo- ; Human ; Male ; Middle Age ; Probability ; Pyloric Antrum/pathology ; Pyloric Antrum/microbiology ; Severity of Illness Index ; Stomach Ulcer/pathology+ACo- ; Stomach Ulcer/microbiology

PURPOSE: The purpose of this study was to identify experiences of nurses who served as preceptors in clinical education for senior student nurses in a college of medicine in Wonju city. METHOD: Data was collected from 20 preceptors instructing senior student nurses in 2001 using a self-completion questionnaire. To analyze data, content analysis was done using an analysis scheme developed by the investigators. RESULT: The analysis scheme consisted of 7 categories and 25 subcategories. 135 significant statements were analyzed and categorized. Preceptors indicated that they were role models, socialization facilitators and educators while instructing students in the clinical practicum. In performing the preceptors' role, preceptors reported that their most important change was self-enhancement,and positive experience was a constructive work atmosphere. The most important factor facilitating the preceptors' role performance was support from head nurses, and the most discouraging factor was work loads. CONCLUSION: This study suggests that interventions for encouragement and socialization of preceptors should be developed to promote clinical education for senior student nurses.
Adult ; *Education, Nursing ; Female ; Humans ; Korea ; *Preceptorship/methods

PURPOSE: The purpose of this study was to identify experiences of nurses who served as preceptors in clinical education for senior student nurses in a college of medicine in Wonju city. METHOD: Data was collected from 20 preceptors instructing senior student nurses in 2001 using a self-completion questionnaire. To analyze data, content analysis was done using an analysis scheme developed by the investigators. RESULT: The analysis scheme consisted of 7 categories and 25 subcategories. 135 significant statements were analyzed and categorized. Preceptors indicated that they were role models, socialization facilitators and educators while instructing students in the clinical practicum. In performing the preceptors' role, preceptors reported that their most important change was self-enhancement,and positive experience was a constructive work atmosphere. The most important factor facilitating the preceptors' role performance was support from head nurses, and the most discouraging factor was work loads. CONCLUSION: This study suggests that interventions for encouragement and socialization of preceptors should be developed to promote clinical education for senior student nurses.
Adult ; *Education, Nursing ; Female ; Humans ; Korea ; *Preceptorship/methods

Vertically aligned, laterally spaced nanoscale titanium nanotubes were grown on a titanium surface by anodization, and the growth of chondroprogenitors on the resulting surfaces was investigated. Surfaces bearing nanotubes of 70 to 100 nm in diameter were found to trigger the morphological transition to a cortical actin pattern and rounded cell shape (both indicative of chondrocytic differentiation), as well as the up-regulation of type II collagen and integrin beta4 protein expression through the down-regulation of Erk activity. Inhibition of Erk signaling reduced stress fiber formation and induced the transition to the cortical actin pattern in cells cultured on 30-nm-diameter nanotubes, which maintained their fibroblastoid morphologies in the absence of Erk inhibition. Collectively, these results indicate that a titanium-based nanotube surface can support chondrocytic functions among chondroprogenitors, and may therefore be useful for future cartilaginous applications.
Animals ; Apoptosis ; Cell Differentiation/*drug effects ; Cells, Cultured ; Chick Embryo ; Chickens ; Chondrocytes/cytology/drug effects/metabolism ; Chondrogenesis/*drug effects ; Collagen Type II/metabolism ; Immunohistochemistry ; Integrin beta4/metabolism ; Mesenchymal Stem Cells/*cytology/*drug effects/metabolism ; Nanotubes/*chemistry ; Titanium/*chemistry/*pharmacology

OBJECTIVES: We aimed to investigate the prevalence of Extrapyramidal signs (EPS) and the associations between EPS and cognitive subdomains in patients with Alzheimer disease (AD). METHODS: We recruited 1,324 patients with AD from the Clinical Research of Dementia of South Korea (CREDOS), a hospital based cohort study with fifty-six participating hospitals. We estimated cognitive subdomain using the Seoul Neuropsychological Screening Battery-Dementia version (SNSB-D). Dementia severity was measured by Clinical Dementia Rating Sum of Boxes (CDR-SB) and Korean version of Mini-Mental Status Examination (K-MMSE). The EPS group was defined by the presence of at least one EPS based on a focused neurologic examination. RESULTS: The prevalence of patients with EPS was 11%. These had higher CDR-SB scores than non-EPS group. After controlling for demographic, radiological, and dementia severity (CDR-SB) factors, EPS group showed lower cognitive ability in the subdomains for visuospatial and frontal-executive function than non-EPS group. The patients with EPS were showed significantly higher scores in the subdomain for memory function. CONCLUSION: The presence of EPSs in patients with AD was associated with lower visuospatial, frontal-executive function and higher memory function.
Alzheimer Disease ; Cohort Studies ; Dementia ; Humans ; Mass Screening ; Memory ; Neurobehavioral Manifestations ; Prevalence ; Republic of Korea

BACKGROUND: Most chronic hemodialysis units select heparin doses on an empirical basis. Too little heparin causes clotting in the extracorporeal circuit and too much heparin may lead to excessive bleeding. We conducted a prospective, randomized, repeated cross over study to evaluate the effect of two different heparin regimens. The empirical standard dose regimen (empirical heparinization, EH) was used for all patients, and the individualized dose regimen (individualized heparinization, IH) determined by measuring the activated clotting time (ACT) was performed for more adequate heparinization during hemodialysis. METHODS: Twenty-four outpatients with systemic heparinization who had been on hemodialysis for more than 3 months were enrolled. In both METHODS, anticoagulation was achieved with a loading dose and a continuous infusion of heparin. Each regimens were prescribed alternately, and repeated after 2 weeks later. The study evaluated pre-post dialytic Hgb, Hct, Platelet and predialytic albumin, heparin loading dose and infusion rate, ACT, total blood compartment volume (TBCV), visible blood clots, bleeding, pre-post dialytic and next predialytic BUN, predialytic Cr, URR, Kt/Vurea. RESULTS: Twenty-two patients were analyzed in this study. Pre-post dialytic Hgb, Hct, Platelet and predialytic albumin, heparin loading dose were not significantly different between two methods. But heparin infusion rate were significantly increased in individualized heparinization than in empirical heparinization. Activated clotting times were prolonged and maintained adequately in individualized heparinization during hemodialysis. The loss of TBCV and visible blood clots were significantly decreased in individualized heparinization than in empirical heparinization. There was no bleeding complication in two methods. Pre-post and next predialytic BUN, predialytic Cr, URR, Kt/Vurea were not significantly different between two methods.0.CONCIUSION: We concluded that the individualized heparinization can maintain adequate anticoagulation than the empirical heparinization without any other problems and compromising the delivery dose of dialysis.
Blood Platelets ; Dialysis ; Hemorrhage ; Heparin* ; Humans ; Outpatients ; Prospective Studies ; Renal Dialysis*