The purpose of the study is to minimize the incidence of glaucoma and ocular hypertension caused by using corticosteroids during induction chemotherapy for acute lymphoblastic leukemia in children. We have periodically observed the intraocular pressure and the variation of C / D ratio of two 7 years old boys with chemotherapy in our pediatric department. We observed the increase in intraocular pressure using applanation tonometer, and we managed by beta- blockers, carbonic anhydrase inhibitor and etc. Increased intraocular pressure has been normalized after chemotherapy. The frequency of occurrence of the ocular hypertension and glaucoma can be controlled with the quantity of corticosteroids used.
Adrenal Cortex Hormones ; Carbonic Anhydrases ; Child ; Drug Therapy ; Glaucoma* ; Humans ; Incidence ; Induction Chemotherapy* ; Intraocular Pressure ; Leukemia ; Ocular Hypertension ; Precursor Cell Lymphoblastic Leukemia-Lymphoma*

Fluid resuscitation is a basic treatment in hemorrhagic shock. We compared the circulatory responses to fluid resuscitation of 10% pentastarch with those of fresh whole blood and plasmanate in hemorrhagic shock. Eighteen mongrel dogs were bled 24 ml/kg and replaced by equivalent amounts of fresh whole blood(n=6, group B), pentastarch(n=6, group P) and plasmanate(n=6, group PL). Hemodynamic measurements and calculations were performed before and after bleeding and after volume therapy. The decrease of hematocrit and platelet count after volume replacement indicate that hemodilutional effect was maximum 30 min after volume therapy and significantly greater in group P than PL(p<0.05). Central venous pressure(CVP), pulmonary capillary wedge pressure(PCWP) and cardiac index(CI) were increased to 146-189%, 146-172% and 146-175% in group P, respectively during 60 min. These changes were significantly greater than group B and PL(p<0.05). There was delayed recovery of mean arterial pressure in group PL(92% 30 min after volume therapy) compared with group B and P(92% and 93% 5 min). Also group P and PL showed significant prolongation in prothrombin time and partial thromboplastin time during experiment(120 min) and these were significantly more prolonged in group P than PL(P<0.05). And group P showed similar O transport and O extraction ratio to those of group B. The increases in plasma catecholamine were observed after hemorrhage, but no significant changes 5 and 30 min after volume therapy. This suggests that the neurohumoral response to hemodilution was not marked. Mixed venous O2 saturation(SvO2) was directly proportional to CI during experiment(r=0.69, p<0.01), indicating that SvO2 can represent CI during shock and volume therapy. In conclusion, l0% pentastarch is useful as a substitute for fresh whole blood or plasmanate.
Animals ; Arterial Pressure ; Blood Transfusion, Autologous* ; Capillaries ; Dogs* ; Hematocrit ; Hemodilution ; Hemodynamics ; Hemorrhage ; Hydroxyethyl Starch Derivatives ; Partial Thromboplastin Time ; Plasma ; Platelet Count ; Prothrombin Time ; Resuscitation* ; Shock ; Shock, Hemorrhagic*

We report a rare case of carcinosarcoma arising in the stomach. The tumor is presented in the posterior wall of the gastric lower body and antrum of a 56-year-old man. Grossly the tumor has polypoid appearance with diffuse surface ulceration and measures 5.5 cm in diameter. The tumor is accompanied with three separate well differentiated early gastric adenocarcinomas (two EGC type IIc & IIa). Microscopically, the tumor consists of moderately well differentiated adenocarcinoma in the periphery, and lobulated sarcomatous areas in the center, which shows chondroid differentiation. Transitional areas between adenocarcinoma and chondrosarcoma are evident. Immunohistochemical studies show positivity for cytokeratin and carcinoembryonic antigen in the epithelial component, and for vimentin and S-100 in the sarcomatous component. The transitional areas are positive in carcinoembryonic antigen, vimentin, S-100, and cytokeratin. The tumor extended to the subserosa and showed metastasis of only adenocarcinomatous component in six out of 47 dissected perigastric lymph nodes.
Adenocarcinoma ; Carcinoembryonic Antigen ; Carcinosarcoma* ; Chondrosarcoma ; Humans ; Keratins ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis ; Stomach* ; Ulcer ; Vimentin

Chronic perineal pain is an often encountered problem, which produces a great degree of functional impairment and frustration to the patient and a challenge to the treating physician. The reason for this problem is that the region contains diverse anatomic structures with mixed somatic, visceral and autonomic innervations affecting bladder and bowel control and sexual function. A blockade of nociceptive and sympathetic supply to the perineal region, supplied through the ganglion impar has been shown to benefit patients with chronic perineal pain. Several options to this block have been described that chemical neurolysis, radiofrequency ablation etc. Although the analgesic effect of Botulinum toxin type A (BoNT-A) has long been considered secondary to its action for muscle relaxation, BoNT-A also affects the release of the neurotransmitters that are involved in pain perception. We describe a patient who was successfully given ganglion impar block with BoNT-A.
Botulinum Toxins ; Botulinum Toxins, Type A ; Frustration ; Ganglion Cysts ; Humans ; Muscle Relaxation ; Nerve Block ; Neurotransmitter Agents ; Pain Perception ; Urinary Bladder

Nerve conduction study has been an important part of electrodiagnosis and has been utilized as a clinical diagnostic technique in diabetic neuropathy. But conduction study of the more proximal segment has been a few reports. This study demonstrated segmental method for obtaining orthodromic motor nerve conduction and mixed nerve conduction, and antidromic distal sensory nerve conduction in diabetic group and normal group. The purpose of the study was to determine diagnostic value of segmental nerve conduction in diabetic neuropathy. The results were as follows: 1. Significant difference at P<0.01 between diabetic group and normal group; in median motor terminal latency, median motor nerve conduction velocity at axilla-elbow segment and elbow-wrist segment, median sensory nerve conduction velocity at wrist-elbow segment, ulnar motor and sensory conduction velocity at wrist-elbow segment, posterior tibial motor nerve conduction velocity at popliteal fossa-ankle segment, peroneal motor nerve conduction velocity at fibula head-ankle segment. 2. No significant difference at P>0.05 between diabetic group and normal group; in ulnar motor terminal letency, ulnar sensory nerve conduction velocity at axilla-Erb's point segment and finger-wrist segment, peroneal motor terminal latency and peroneal motor nerve conduction velocity at popliteal fossa-fibula head segment, posterior tibial motor terminal latency, sural sensory nerve conduction velocity. 3. The nerve conduction of proximal segment is more statistically significant than that of distal segment.
Diabetic Neuropathies ; Electrodiagnosis ; Fibula ; Head ; Neural Conduction*

No abstract available.
DiGeorge Syndrome*

The purpose of this study was to assess the hygiene status of 145 child-care foodservices, which were newly registered in the Center for the Children's Foodservice Management (CCFSM) in Changwon, Gyeongnam. Sanitary inspection checklist (40 food safety items) of Korea Food and Drug Administration (KFDA) was used by the CCFSM in Changwon, Gyeongnam. Average score from the total safety items in 145 child-care foodservices was 21.41 points out of 40 points. Score gaps between the lower group (71 foodservices, 13.92 points) and higher group (74 foodservices, 28.61 points) showed a significant difference (P<0.001). The top five priorities of sanitary measures needing corrective actions for child-care foodservices were as follows: 'provide hand washing and sanitizing tools, and supply manuals on how to wash hands properly', 'supply record form for access/inspection', 'conduct education for cooks on standards in the selection of sanitizer for raw vegetables and proper methods to wash and sanitize raw vegetables', 'provide a refrigerator and a freezer with installed thermometers and temperature record monitoring logs', 'encourage separation of contamination operating zone and clean zone or conduct training for cooks on ways to prevent cross-contamination by performing work separately by the hour'. For the higher group, most were national/public facilities (83.3%), whereas in the lower group, private facilities (62.1%) were more common than national/public ones (37.9%). Therefore, a significant difference (P<0.001) was detected in the two groups. These private facilities should be supported.
Checklist* ; Education ; Food Safety ; Gyeongsangnam-do ; Hand ; Hand Disinfection ; Hygiene ; Korea* ; Thermometers ; United States Food and Drug Administration* ; Vegetables

This study has been attempted using the Q methodology to clarify leader type of nurse managers that head nurses and general nurses recognize, and to clarify its relative relation. Sixty-three statements were extracted through interviews with general and professional people interested in the subject of nurse leaders to extract the Q population. Atotal of 314 Q population was formed added with 251 questions extracted from related documents. Final 32 Q samples were selected by reorganization of 314 Q population after reexamining statements through inquiry of 1 professor of the nurse department, 2 students in course of nurse science masters degree and 2 students in course of doctoral degree. The P sample selection standard of this study were 25 nurses and 30 head nurses. Examination subjects themselves filled out 32 statements classified in a measure of 9 points from agreeable items to disagreeable items, Principal component factors were analyzed using the QUANL pc program after grading the contents of the P sample. Nurses recognizing subjective structure for leader behaviors of nurse manager were analyzed to be 3 factors: vision presentation type, self-capability consideration type, relationship consideration type, and head nurses recognizing subjective structure were analyzed to be 2 types ; task pursuit leader type, and concord pursuit type. Nursing manager's leader behavior, expected by staff nurse are more complex and higher level which may combined with task pursuit leader type in concord pursuit leader of head nurse. Also according to Hersey and Blanchard theory(1977), the effectiveness of leadership becomes to be larger as the accordance rate between the behaviors of nurse leaders and followers reaction increase. Two suggestions have been made based on the conclusion. 1. Studies on creating strategies in relation to development, management, selection of nurse leaders should be made based on this study. 2. There is a need for relative study of production and degree of similarity of leadership types based on this study.
Humans ; Leadership* ; Nurse Administrators* ; Nursing ; Nursing, Supervisory

BACKGROUND: Today, the eradication of H. pylori represents a generally accepted and beneficial therapeutic strategy for treatment and prevention of peptic ulcer relapse. Major factors that have affected H. pylori eradication are eradication rate of regimen, compliance of patients and complications of drugs. Recently, the combination of omeprazole, amoxicillin and clarithromycin has been accepted as one of the most effective treatment for the eradication of H. pylori. The primary aim of this study was to evaluate the efficacy of this therapeutic modality in Korean patients. METHODS: Two hundred twenty three patients with peptic ulcer and H. pylori infection were taken two types of triple therapy. Group A were treated with omeprazole 20 mg bid, amoxicillin 500 mg tid, clarithromycin 500 mg tid daily for 14 days. Group B were treated with omeprazole 20 mg bid, amoxicillin 1g bid, clarithromycin 500 mg bid daily for 7 days. Endoscopy with H. pylori tests was repeated 4 weeks after the end of treatment and then biopsy specimens were taken in antrum and body. CLO test and Warthin Starry silver stain were conducted concordantly. RESULTS: The H. pylori eradication rate was 92.5% in group A, 90.4% in group B. There was no significant difference in eradication rate. More than 50% of ulcer size reduction was observed 90.5% in group A, 86.3% in group B. There was no significant difference in ulcer healing(p > 0.05). The incidence of all side effects in both group were as follows; 22.6% in group A, 19.1% in group B. But major side effect was found only group A, of whom the symptom was too serious for the treatment to continue. CONCLUSION: We concluded that the seven days regimen was more favorable, because the eradication rate was almost the same as the 14 days regimen. And drug compliance and cost effectiveness were better than 14 days treatment regimen.
Amoxicillin* ; Biopsy ; Clarithromycin* ; Compliance ; Cost-Benefit Analysis ; Endoscopy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Incidence ; Omeprazole* ; Peptic Ulcer ; Recurrence ; Silver ; Ulcer

OBJECTIVES: The purpose of this study was to examine the characteristics and the psychosocial factors associated to the referral to psychiatric care in the suicide attempters visiting emergency center. METHODS: We conducted a systematic chart review of 377 suicidal attempters visiting emergency center of the Korea University Ansan Hospital between January 2008 and December 2011. We gathered a data contain 20 items including psychosocial characteristics and factors related to suicide and factors related to psychiatric treatment. Multivariate logistic regression models were fitted to data to estimate the unique effects of sex, drunken status, companion, suicidal methods, place of suicide and current use of psychiatric medication on the referral to psychiatric care. RESULTS: The female gender(OR=1.63, 95% CI=0.99-2.69), suicidal attempts at home(OR=3.40, 95% I=1.21-9.56) and drunken state at visit(OR=2.34, 95% CI=1.10-5.01) are the factors that predict the risk of the non-referral of the patients to psychiatric intervention. Place of suicidal attempt was the most important factor do play a role in determining whether referral to psychiatric care will take place or not. Current use of psychiatric medication showed a trend toward significance(p=0.08, OR=1.67, 95% CI=0.95-2.95). CONCLUSIONS: These results suggest that when deciding whether to adapt or to refuse the referral to psychiatric care, the factors such as suicidal intent, lethality of suicide methods, familiar factors and alcohol may contribute onto the referral to psychiatric care. Additional research is required to investigate an association of these factors with referral to psychiatric care.
Emergencies* ; Epidemiology ; Female ; Friends ; Gyeonggi-do ; Humans ; Korea ; Logistic Models ; Methods ; Psychology ; Referral and Consultation* ; Suicide*