BACKGROUND: The purpose of this research was to compare one hospital family practise residents' diagnostic and therapeutic behavior with a Dupont et al described Guidelines on acute infectious diarrhea in adults and HARRISON'S PRINCIPLES OF INTERNAL MEDICINE 15th edition's algorithm for the management of acute diarrheal patients. METHODS: From March 1, 2003 to April 30, 2003, we reviewed 82 acute diarrheal patients (3.19% of the total patients) who had visited one hospital's emergency room which was located in Jeonju district. Doctor's diagnostic and therapeutic approaches were reviewed on the basis of history and physical exam. Then we compared with the standard algorithm referred above. RESULTS: Inpatients were 36.6% (30 patients) among the total of 82 and 63.4% (52 patients) returned home after symptomatic treatment. Among the 52 return home patients, doctors did not entirely conduct stool exam. Among the 30 hospitalized patients, doctors conducted stool exam in 25% among 4 of 16 high fever patients, in 25% among 2 of 8 moderately dehydrated who had diarrhea more than 10 times per day, and in 60% among 6 of 10 patients whose symptom duration was more than 48 hours. Doctors did not use antibiotics in 76.9% (40 patients) of 52 return home patients. Quinolone and Augmentin tablets were administered to each 6 patients of 12 return home patients. Among the 30 inpatients, Augmentin injection were given to 80% (24 patients) and second-generation cephalosporin with aminoglycoside combination injection to 13.3% (4 patients) and quinolone injection to 6.7% (2 patients). CONCLUSION: Compared with standard algorithm, doctors neglected testing stool examination that may be the most important way to diagnose the specific etiology of acute diarrhea. If we actively utilize the stool exam, it may help in providing the correct diagnosis and suitable treatment.
Adult ; Amoxicillin-Potassium Clavulanate Combination ; Anti-Bacterial Agents ; Diagnosis ; Diarrhea ; Emergency Service, Hospital ; Fever ; Humans ; Inpatients ; Internal Medicine ; Jeollabuk-do ; Tablets

Cervicogenic headache (CGH) is not universally accepted as terminology used to discuss headaches associated with disorders of the cervical spine. Sjaastad was the first to describe CGH that its definition and diagnosis relied entirely on clinical features. Pain is often triggered by irritation of nociceptors from structures in the cervical spine, and so diagnostic criteria of CGH have been established with agreement that these headaches start in the neck or occipital region and are associated with tenderness of cervical paraspinal tissues. Past history and clinical features are important to detect and diagnose the disease because the significance of radiological findings and advanced diagnostic testing is unclear. Gunn's intramuscular stimulation (IMS) is a treatment modality of CGH upon radiculopathic model. We tried IMS for treatment of 3 patients with CGH. After IMS, the patients were well respond the therapy and the results were satisfactory. Therefore we recommend the IMS for the treatment of CGH.
Diagnosis ; Diagnostic Tests, Routine ; Headache ; Humans ; Neck ; Nociceptors ; Post-Traumatic Headache* ; Spine

PURPOSE: This study is used to investigate and understand types of meaning in life of matriarch. Methods: This study is based on a Q-methodological approach. Thirty nine statements concerning meaning in life were selected. Twenty seven women were chosen as a subject group for this study. Their opinions were shown in 39 statements divided into 9 scales by forced distribution. Results: TypeIwas named "self-transcendental and future- oriented types". In this types a one pursued attitudinal value by religion. Type II was named "Realistic and responsibility fulfilling types". This type pursued creative and experiential value. Type III was named "Encounter and relationship oriented type". This types pursued experiential value. Type IV was named "Realistic self-actualizing type". This types pursued creative value. Type V was named "Altruistic and commitmental types". This type pursued creative, experiential, and attitudinal value. CONCLUSION: Considering the structure of finding the meaning in life of matriarchs, all types had responsibility and self-control in their lives and lived for present however, only typeI lived for the future. It seem necessary to understand each matriarchs meaning in life and nursing needs to develop appropriate nursing interventions based on the type matriarch she is.
Female ; Humans ; Nursing ; Weights and Measures

No abstract available.
Humans

A 20-year-old woman was admitted because of intractable seizures, myoclonus, gait ataxia, and severe intellectual deterioration with age of onset at 16 years. She had no family history of neurological disease. A thorough laboratory investigation was unremarkable. Brain MRI showed generalized cerebral and cerebellar atrophy. Interictal EEG showed intermittent generalized polyspike and waves, maximum on the bilateral parieto-occipital areas, and MNSEP showed giant cortical SEP. Brain biopsy revealed intraneuronal accumulation of granular osmiophilic deposits (GROD), which is characteristic of electromicroscopic findings of neuronal ceroid lipofuscinosis (NCL). We report biopsy-proven adult NCL, which is one of the rare neurodegenerative diseases. (J Korean Neurol Assoc 19(1):45~48, 2001
Adult* ; Age of Onset ; Atrophy ; Biopsy* ; Brain* ; Electroencephalography ; Female ; Gait Ataxia ; Humans ; Magnetic Resonance Imaging ; Myoclonus ; Neurodegenerative Diseases ; Neuronal Ceroid-Lipofuscinoses* ; Neurons* ; Seizures ; Young Adult

No abstract available.
Angiomyolipoma* ; Tuberous Sclerosis*

PURPOSE: The aim of this study was to investigate the potential effects of mild hypoxia in the mature and immature brain. METHODS: We prepared organotypic slice cultures of the hippocampus and used hippocampal tissue cultures at 7 and 14 days in vitro (DIV) to represent the immature and mature brain, respectively. Tissue cultures were exposed to 10% oxygen for 60 minutes. Twenty-four hours after this hypoxic insult, propidium iodide fluorescence images were obtained, and the damaged areas in the cornu ammonis 1 (CA1), CA3, and dentate gyrus (DG) were measured using image analysis. RESULTS: In the 7-DIV group compared to control tissue, hypoxia-exposed tissue showed decreased damage in two regions (CA1: 5.59%+/-2.99% vs. 4.80%+/-1.37%, P=0.900; DG: 33.88%+/-12.53% vs. 15.98%+/-2.37%, P=0.166), but this decrease was not statistically significant. In the 14-DIV group, hypoxia-exposed tissue showed decreased damage compared to control tissues; this decrease was not significant in the CA3 (24.51%+/-6.05% vs. 18.31%+/-3.28%, P=0.373) or DG (15.72%+/-3.47% vs. 9.91%+/-2.11%, P=0.134), but was significant in the CA1 (50.91%+/-5.90% vs. 32.30%+/-3.34%, P=0.004). CONCLUSION: Although only CA1 tissues cultured for 14 DIV showed significantly less damage after exposure to hypoxia, the other tissues examined in this study showed a tendency towards less damage after hypoxic exposure. Therefore, mild hypoxia might play a protective role in the brain.
Anoxia* ; Brain ; Dentate Gyrus ; Fluorescence ; Hippocampus ; Neuroprotective Agents* ; Oxygen ; Propidium

Adrenal cysts are rare lesion that usually present themselves as an incidental finding during surgery, or at the time of autopsy. The cysts are usually small, seldom exceeding 10cm in diameter, and are generally asymptomatic. However, they present a difficult problem in differentiation between benign and malignant lesions of the adrenal gland. In the differential diagnosis, other cystic lesions of the upper abdomen must also be considered, including hepatic, splenic, renal and pancreatic cysts. Herein we report a case of endothelial cyst of lymphangiomatous type of the adrenal gland which was detected in a 44-year-old male patient during a routine health examination by ultrasonography as a pancreatic pseudocyst. Gross examination revealed multiple separate but continuous cysts, measuring 10.6x8x7cm in dimension. Within the wall, compressed adrenal cortex was noted. Microscopically, fibrous wall containing hypertrophied smooth muscle lined by endothelial cells was also noted. We reviewed literatures of the adrenal cyst and report a case.
Male ; Humans ; Cysts

Diatomology has provided important evidences for diagnosis of drowning in forensic practice. However, conflicting opinions about the reliability of diatom test still exist. As a part of efforts to end this controversy, it is very important to secure the diatom profile in the water sample of drowning site. Our results obtained in this study show the characteristics of temporal and spatial distribution of diatom collected from the main drowning sites of Han river in Korea. During spring, 111 taxa (98 species and 13 varieties) were identified from 31 genera, and 87 taxa (77 species and 10 varieties) were identified from 22 genera during summer. At the level of genus Achnanthes, Cyclotella, Cymbella, Fragilaria, Navicula, Nitzschia, and Stephanodiscus represented the highest numbers, and were the most widely occurred during two seasons. The centric diatoms, Stephanodiscus hantzschii f. tenuis and Cyclotella atomus were typical of spring and summer, respectively, and identified as dominant indicator species. The commonly occurred species, including dominant species in the seasonal cluster analysis influenced the formation of site - specific groups. As a result, our results will be able to be used not only as the comparison data of diatom found in the drowning victim's tissue but also a reference data to rule out the possibility of contamination.
Diatoms ; Drowning ; Korea ; Rivers ; Seasons ; Water

BACKGROUND: The recent studies shows that LV relaxation abnormalities are the important factors of heart failure in elders. To determine the association between LV diastolic functions and heart failure, we assessed LV diastolic functions in elderly patients with pulmonary congestion and in asymptomatic elders by using pulsed doppler echocardiography. METHODS: In order to assess LV diastolic function, we performed pulsed doppler echocardiography to elderly patients with pulmonary congestion and asymptomatic elders from Mar.2001 to Sep.2001. The following parameters were used as indices of LV diastolic function; Mitral E wave(E), Mitral A wave(A), Deceleration time(DT), Isovolumic relaxation time(IVRT), Systolic pulmonary venous flow(PVs), Diastolic pulmonary venous flow(PVd). RESULTS: In elderly patients groups, there was significant increase in deceleration time compared with asymptomatic elders(255.83+/-54.41 vs 210.80+/-48.53, p<0.05). There was significant increase in isovolumic relaxation time in elderly patient group compared with asymptomatic elders(123.06+/-25.07 vs 98.78+/-15.12, p<0.01). Although there was no significant difference, decreased E/A ratio and increased PVs/PVd were noted in both groups. CONCLUSIONS: The results shows that the impairments of LV diastolic function were noted in both groups. Especially DT and JVRT were significant increase in elderly patient group with pulmonary congestion. Therefore these parameters, such as DT, IVRT, can be helpful as predictive indices of diastolic heart failure in elders.
Aged* ; Deceleration ; Echocardiography, Doppler, Pulsed ; Estrogens, Conjugated (USP)* ; Heart Failure ; Heart Failure, Diastolic ; Humans ; Relaxation