Pigmentary dermarcation lines are boundaries between more deeply pigmented skin and areas of lighter pigmentation. We report 4 cases of pigmentary demarcation lines of pregnancy associated with erythema which developed in the third trimester of pregnancy and were symmetrically located in the buttock and posteromedial portion of the lower extremities. After delivery, the erythema disappeared within 3-7 days, followed by slow resolution of the brownish pigmentation.
Buttocks ; Erythema* ; Female ; Humans ; Lower Extremity ; Pigmentation ; Pregnancy Trimester, Third ; Pregnancy* ; Skin

PURPOSE: Occupational stress can have a negative effect on the worker such as physical, emotional, and psychological health. Although it is well reported that health service staff tend to have a high level of minor psychiatric disorder, only a few studies have been reported in Korea. Intern and Residency (residents) are very vulnerable periods of stress and other psychiatric disorders. In this study, we describe occupational stress of interns and residents and relationship between occupational stress and depression. METHODS: The participants of this study were interns and residents trained in a tertiary hospital in Korea. The occupational stress scale was used for measurement of occupational stress. In addition, the Korean version of the Beck depression scale was used to evaluate the prevalence of depression. Statistical analyses were performed using SPSS v. 18.0; p-value less than 0.05 was considered statistically significant. RESULTS: Female doctors showed higher occupational stress than male. Interns and chief residents demonstrated higher occupational stress than other grades. Astonishingly, most participants showed depressive mood. Compared with the general population, job demand and culture of the workplace are in the first upper quartile. It is indicated that compared with general populations, physicians have a higher workload and patience is required in order to cope with the harsh culture of the workplace. Depressive mood was evaluated with various factors and only occupational stress was statistically significant. CONCLUSION: Overwhelming occupational stress of residents could result in both medical and social problems. Therefore, recognition of occupational stress is essential and aggressive interventions are required.
Burnout, Professional ; Depression ; Female ; Health Services ; Humans ; Internship and Residency ; Korea* ; Male ; Prevalence ; Seoul* ; Social Problems ; Tertiary Care Centers*

Cyclic Neutropenia is a benign, unusual hematologic disorder characterized by regularly recurring episodes of severe neutropenia occurring approximately every 21 days. Beside neutrophils, monocytes, lymphocytes, platelets and reticulocytes all cycle with strict periodicity suggest that this disease should be viewed as cyclic hematopoiesis, not merely as cyclic neutropenia. During neutropenic periods, patients regularly experience aphthous stomatitis, fever, malaise, cervical lymphadenitis, cutaneous infections and occasional pneumonia and otitis media. The exact cause of cyclic neutropenia is unknown. But it is strongly suggested that cyclic neurtopenia is due to an abnormality in the regulation of early hematopoietic precursor cells. We have documented a case of cyclic neutropenia for a period of 2.5 years in a 11 year-old boy who had suffered from recurrent fever, stomatitis, gingival swelling, cervical lymphadenitis and skin infections at 3 weeks intervals since 5 years of age. A brief review of the related literatures is presented.
Child ; Fever ; Hematopoiesis ; Humans ; Lymphadenitis ; Lymphocytes ; Male ; Monocytes ; Neutropenia* ; Neutrophils ; Otitis Media ; Periodicity ; Pneumonia ; Reticulocytes ; Skin ; Stomatitis ; Stomatitis, Aphthous

Purpose: To evaluate the efficacy of the preventive abduction brace in dementia patients after bipolar hemiarthroplasty of the hip. Materials and Method: A review of 30 patients who had dementia prior to bipolar hemiarthroplasty of the hip. 20 females and 10 males were evaluated and their mean age was 80.4 years old (range, 68 to -92 years old). The average MMSE-K in dementia patients was 14.2 (range, 8 to 20). The reasons for the bipolar hemiarthroplasties were femoral neck fractures in all the cases. We analyzed the dislocation rates of those who had preventive abduction braces applied prospectively. Results: The average follow-up period after hemiarthroplasty was 2.2 years. All 30 patients had preventive abduction braces and no dislocations occurred after the bipolar hemiarthroplasties. Conclusion: Hip dislocations were not detected in those patients who preventive abduction braces applied. The present findings suggest that having a preventive abduction brace will definitely reduce the dislocation rate in dementia patients who have difficulties with rehabilitation after their operations.
Braces* ; Dementia* ; Dislocations ; Female ; Femoral Neck Fractures ; Follow-Up Studies ; Hemiarthroplasty* ; Hip Dislocation ; Hip* ; Humans ; Male ; Prospective Studies ; Rehabilitation

BACKGROUND: The cardiac troponin I (cTnI), one of the subunits of the troponin regulatory complex, binds to actin and inhibits interactions between actin and myosin. cTnI is highly sensitive and specific marker for myocardial injury and is useful in diagnosis and detection of reperfusion in acute myocardial infarction (AMI). In this study, we measured the serum concentration of cTnI according to serial time after chest pain in patients with AMI and compared serum concentration of cTnI with CK-MB and echocardiographic data to evaluate the significance of measuring serum concentration of cTnI in AMI. SUBJECTS AND METHODS: The study was carried out on 16 patients with first attack of AMI within 6 hours of chest pain. All patients were performed thrombolytic therapy and reperfusion was confirmed by coronary angiography. Blood samples for measuring of CK-MB and cTnI were collected at 4-h intervals during the first 24 h, 12-h intervals until 48 h, and 24-h intervals until fourth days after hospitalization. Echocardiography were performed before thrombolytic therapy in all patients. RESULTS: 1) The mean age of subjects was 63.6+/-11.5 years (range:44 - 84 years) and 11 patients were men and 5 patients were women. The site of infarction was anterior in 11 patients and inferior in 5 patients. 2) The peak concentrations of CK-MB and cTnI were reached from 4-h to 12-h after admission in all patients (7.3+/-2.6-h, and 9.0+/-3.1-h, respectively), but there was no significant difference in peak time. 3) Serum concentration of CK-MB was normalized at 72-h after admission, but cTnI was remained in increased state until 96-h after admission. The numbers of the patients with above cutoff value of CK-MB and cTnI at different time after admission were significantly different after 72-h (p<0.05). 4) The peak cTnI and sigma cTnI level were significantly correlated with peak CK-MB and sigma CK-MB level, respectively (r 2 =0.7955, p<0.0001 and r 2 =0.6378, p=0.0002, respectively). 5) The ejection fraction was not correlated with peak cTnI concentration (r 2 =0.0948, p=0.2461) and sigma cTnI (r 2 =0.1867, p=0.0946). 6) The wall motion score index was not correlated with peak cTnI concentration (r 2 =0.2135, p=0.0716), but significantly correlated with sigma cTnI (r 2 =0.2540, p=0.0465). CONCLUSION: The serum concentration of cTnI was useful in late diagnosis of AMI and cTnI release in patients with AMI was correlated with myocardial infarct size.
Actins ; Chest Pain ; Coronary Angiography ; Delayed Diagnosis ; Diagnosis ; Echocardiography ; Female ; Hospitalization ; Humans ; Infarction ; Male ; Myocardial Infarction* ; Myosins ; Reperfusion ; Thrombolytic Therapy ; Troponin I* ; Troponin*

Prurigo pigmentosa(PP) is a rare dermatosis with an unknown cause characterized by intensely pruritic papules that resolve with reticulate pigmentation. It is a disease entitity commonly reported in Japan but seemingly rare in other parts of the world. We report 5 cases that clinically and histopathologically fulfilled the characterisitics of PP and were treated with dapsone resulting in significant clinical improvement.
Dapsone ; Japan ; Pigmentation ; Prurigo* ; Skin Diseases

PURPOSE: In most emergency department (ED), sedation is required before carrying out an invasive procedure on a pediatric patient. In the ED setting, it is essential to determine the optimal dose and administration route of CH for successful sedation. The aim of this study was to determine the optimal dose of CH for an invasive procedure and to examine the effectiveness of the drug's different administration routes. Furthermore, in this study, we performed simple survey using questionnaire which composed of Likert-scale to evaluate satisfaction of medical staffs in ED with administration routes. METHODS: This study was conducted prospectively. The study participants were pediatric patients under 8 years old who visited the ED in two tertiary hospitals in South Korea within a period of 12 months. RESULTS: Overall, 300 patients were included in this study. The age, sex, and weight of the patients were not shown to influence the sedation time. Chloral hydrate dosage is the independent factor to influence the both sedation and discharge time (p<0.01). In the comparison of the groups, groups 1, 2, and 5 showed no significant difference. On the other hand, groups 3 and 4 were shown to be statistically significantly different from group 1. CONCLUSION: Up to 100 mg/kg CH is safe to use in the emergency department for pediatric patients, but the initial dose of 50 mg/kg for oral administration should be considered in advance because it can provide safe and effective sedation with a lower possibility of causing an adverse effect.
Administration, Oral ; Chloral Hydrate* ; Deep Sedation ; Emergency Service, Hospital ; Hand ; Humans ; Korea ; Medical Staff ; Prospective Studies ; Tertiary Care Centers

This study was carried out to investigate foodservice management practices of 100 child care centers nationwide, and to provide background information for developing foodservice management policies at child care centers. Approximately 20% of the child care centers had a separate dining room; most of the centers were vulnerable to sanitation or safety problems. The percentage of the centers that planned menus was about 60% and 10% established standardized recipes. Fourteen percent of the centers kept records for distribution and menu evaluation and 33% kept sanitation management records. Since only 7% of the centers employed a dietitian, foodservice in most centers were not managed by professionals. The results of menu assessment revealed that 56.5% of the national/public child care centers received 19 points or higher out of 21 points, whereas 5.6% of the private child care centers received the same scores. Proper usage and storage of raw food, sanitary management of equipment and facilities, waste management/leftover food treatment, and basic facility of cooking zones were performed well by many centers. The overall scores of foodservice performance were only 31.2 out of 60 points, representing relatively poor safety management, food procurement management, and facilities and equipment management. These results indicate that the foodservice management of the child care centers are in a relatively poor state. Since nutrition management of the most centers was performed by non-professionals, it may not be possible to provide proper nutrition for health and normal growth of preschool children and to perform efficient nutrition education programs. The following suggestions are strongly recommended in order to improve foodservice performance at child care centers. First, foodservice administration should be performed by a dietitian, and second, efforts should be focused on strengthening nutrition and sanitation management.
Child ; Child Care* ; Child* ; Child, Preschool ; Cooking ; Education ; Humans ; Nutritionists ; Safety Management ; Sanitation

PURPOSE: The purpose of this study was to evaluate the role of glucose transporter in peritoneal glucose and fluid transport. METHODS: Male Sprague-Dawley rats were used. 5mL normal saline with(CB) and without(C) Cytochalasin B(1 muM) was intraperitoneally injected once. From the next day 25 mL commercial dialysis solutions containing 4.25% glucose was injected into the peritoneal cavity twice a day for 8 weeks in a half of each group(CB-IP, n=6 and C-IP, n=8). The other half of each group served as control without IP(C- Control, n=7 and CB-Control, n=7). A 2 hour dwell study was performed using dialysis solutions containing 4.25% glucose. Intraperitoneal volume(IPV) after 2 hours of dwell was measured and peritoneal fluid absorption rate(Qa) was calculated as RISA disappearance rate. Dialysate glucose amount remaining after 2hour dwell(DGA) was calculated and expressed as % of the initial value. RESULTS: IPV was significantly higher in CB than in C in both IP and Control. IPV was significantly lower in C-IP than in C-Control and CB-IP while it was similar between CB-Control and CB-IP. Qa was significantly higher in IP than in Control. DGR was significantly higher in CB than in C and in control than in IP. CONCLUSION: Longterm peritoneal exposure to high glucose dialysis solution increased peritoneal glucose absorption and decreased ultrafiltration volume in rat. A single IP use of glucose transporter inhibitor attenuated increased glucose absorption and decreased ultrafiltration after longterm peritoneal exposure to dialysate.
Absorption* ; Animals ; Ascitic Fluid ; Dialysis ; Dialysis Solutions ; Glucose Transport Proteins, Facilitative* ; Glucose* ; Humans ; Male ; Peritoneal Cavity ; Peritoneal Dialysis, Continuous Ambulatory ; Rats ; Rats, Sprague-Dawley ; Ultrafiltration

Biliary atresia is a surgical disease of infancy with a very poor prognosis usually attributed to the rarity of surgically correctable case. This paper presents a case of incorrectable type of biliary atresia 50 days old Direan female infant who were subjected to the Modified Kasai Operation She had shown good bile excretion after surgery but developed recurrent fever, severe hypocalcemia and roentgenographically prover rickets during the follow up periods. She died 7 months after the operation.
Bile ; Biliary Atresia* ; Female ; Fever ; Follow-Up Studies ; Humans ; Hypocalcemia ; Infant ; Prognosis ; Rickets