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

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

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

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

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

Citrullinemia is a rare inborn error of metabolism of the urea cycle, and was first reported by McMurray, et al. in 1962. It is inherited as an autosomal recessive trait. The normal synthesis of argininosuccinic acid is blocked in this disease due to a deficiency of argininosuccinic acid synthetase(AS), which has been demonstrated in liver cells and fibroblasts. The clinical symptoms are vomiting, lethargy or irritability, convulsion and mental retardation. The diagnosis is made by the finding of an increased plasma citrulline level. Every effort should be made to reduce the blood ammonia level as rapidly as possible before irreversible brain damage occurs. This report describes a case of citrullinemia that was diagnosed through organic acid analysis and amino acid analysis, and reviews the related literatures.
Ammonia ; Argininosuccinic Acid ; Brain ; Citrulline ; Citrullinemia* ; Diagnosis ; Fibroblasts ; Intellectual Disability ; Lethargy ; Liver ; Metabolism ; Plasma ; Seizures ; Urea ; Vomiting

OBJECTIVES: The aim of this study was to identify the association between insight and neuropsychiatric symptoms in patients with Alzheimer's dementia (AD). METHODS: We examined 2607 patients with AD in the Clinical Research Center for Dementia of South Korea study and designed a cross-sectional study. Each patient underwent psychiatric, neurological, and medical examination, interview for caregivers, laboratory tests, neuropsychological tests, and brain MRI. Cognitive function was measured using the Korean version of the Mini-Mental State Examination, Global Deterioration Scale, and Clinical Dementia Rating. Behavioral and psychological symptoms were measured using the Korean version of the Neuropsychiatric Inventory. Daily Living was measured using the Barthel Index for daily living activities and Seoul-Instrumental Activities of Daily Living. Insight was classified according to 'with insight', 'partial insight', and 'without insight' by interview with caregivers. RESULTS: Among the 2607 patients, 990 were included in the 'with insight' group, 1191 were included in the 'Partial insight' group, and the 'without insight' group included 426 patients. The 'without insight' group had a significantly higher aggression level than the 'with insight' group, but not the 'partial insight' group [odds ratio (OR)=1.46, 95% confidence interval (CI) : 1,14-1.88]. A significantly lower prevalence of depression was observed in the 'Partial insight' group and the 'without insight' group, compared to the 'with insight' group (OR=0.51, 95% CI : 0.43-0.61/OR=0.61, 95% CI : 0.48-0.78). The 'partial insight' group showed a lower anxiety level than the 'with insight' group (OR=0.63, 95% CI : 0.53-0.75). CONCLUSION: Findings of this study confirmed that insight level was associated with aggression, depression, and anxiety in patients with Alzheimer' dementia.
Activities of Daily Living ; Aggression ; Anxiety ; Brain ; Caregivers ; Cross-Sectional Studies ; Dementia ; Depression ; Humans ; Neuropsychological Tests ; Prevalence ; Republic of Korea