Primary sclerosing cholangitis is a chronic disease of unknown cause, characterized by inflammation and fibrosis of the biliary tree with diffuse multifocal stricture formation. With increasing knowledge of primary sclerosing cholangitis, it is now recognized that in the setting of inflammatory bowel disease, cholangiocarcinoma is a complication of primary sclerosing cholangitis. We recently experienced a case of 41 year old female patient who had Crohns disease associated with primary sclerosing cholangitis and cholangioearcinoma. We report a case of primary sclerosing cholangitis with cholangiocarcinoma with literature review.
Adult ; Biliary Tract* ; Cholangiocarcinoma* ; Cholangitis, Sclerosing* ; Chronic Disease ; Constriction, Pathologic ; Crohn Disease ; Female ; Fibrosis ; Humans ; Inflammation ; Inflammatory Bowel Diseases ; Pancreas*

No abstract available.
Aneurysm, Infected* ; Endocarditis* ; Mesenteric Artery, Superior*

PURPOSE: The aim of this study was to determine the prevalence of asymptomatic nasopharyngeal carriages in children using a multiplex reverse transcriptase-polymerase chain reaction (mRT-PCR) assay kit. METHODS: We obtained nasopharyngeal swabs from 33 children without any underlying disease from July 25 to July 28, 2008. The children were free from the signs of respiratory tract infections at the time of sampling. DNA was extracted from the swabs and subjected to multiplex RT-PCR using a primer set for the detection of pneumococci (Seeplex(R) PneumoBacter ACE Detection Seegene, Seoul, Korea). The amplified PCR products were separated on 2% agarose gels and stained with either ethidium bromide or screen tape system (Lab901 Scotland, UK). RESULTS: A total of 33 children (male, 15 female, 18) aged between 3.2 and 16.3 (median, 8.2) years were included in this study. The mRT-PCR detected colonized bacteria (Streptococcus pneumoniae, Hemophilus influenzae, Chlamydia pneumoniae, and Bordetella pertussis) in 30 children (90.9%). Of these, 13 children (39.4%) showed more than 2 bacteria: 12 children were positive for 2 bacteria (S. pneumoniae and H. influenzae) and 1 child was positive for 3 bacteria (S. pneumoniae, H. influenzae, and C. pneumoniae). CONCLUSION: mRT-PCR was found to be a sensitive tool for the detection of asymptomatic nasopharyngeal carriages. Clinical significances of the bacteria detected by mRT-PCR will have to be evaluated in the future.
Aged ; Bacteria ; Bordetella ; Child ; Chlamydophila pneumoniae ; Colon ; DNA ; Ethidium ; Female ; Gels ; Haemophilus influenzae ; Humans ; Influenza, Human ; Nasopharynx ; Pneumonia ; Polymerase Chain Reaction ; Prevalence ; Respiratory Tract Infections ; Scotland ; Sepharose ; Streptococcus pneumoniae

BACKGROUND: Etanercept is a recombinant human soluble tumor necrosis factor-alpha (TNF-alpha) receptor fusion protein that inhibits TNF-alpha, a major mediator in the pathogenesis of graft-versus-host disease (GVHD). The purpose of our study was to evaluate the safety and efficacy of etanercept therapy in children with steroid-refractory acute GVHD (aGVHD) (n=5) and chronic GVHD (cGVHD) (n=3). METHODS: Five males and 3 females were enrolled and their median age was 14.4 years (range, 2.1~18.8). Etanercept 0.4 mg/kg per dose (maximum dose, 25 mg) was given subcutaneously twice weekly for 4 weeks followed by 0.4 mg/kg per dose (maximum dose, 25 mg) weekly for 4 weeks. At the time of initiation of etanercept, 5 patients had aGVHD grade III to IV (III=4, IV=1) and 3 patients had moderate to severe cGVHD (moderate=1, severe=2). RESULTS: Overall, 6 of 8 patients (75%) responded to the treatment with etanercept, including 5 patients with aGVHD [n=3 complete response (CR), n=2 partial response (PR)] and 1 patient with cGVHD [n=1 PR, n=2 no response (NR)]. Clinical responses were most commonly seen in patients with refractory gut aGVHD. CMV reactivation occurred in 2 patients, bacterial infection in 1 patient, and fungal infection in 1 patient. CONCLUSION: Our preliminary data indicate that etanercept is well tolerated and can induce a high response rate in patients with steroid refractory aGVHD, particularly in the setting of intestinal involvement.
Bacterial Infections ; Child ; Female ; Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; Humans ; Immunoglobulin G ; Male ; Receptors, Tumor Necrosis Factor ; Tumor Necrosis Factor-alpha ; Etanercept

Purpose: The purpose of this program is to develop an educational program to improve the nursing management competency of middle-level nursing managers. Methods: The program outline is based on the results of the Importance Performance Analysis (IPA) and Systematic Review (SR). Also performed the content validity accordingly. Results: The result of the concepts are derived from 6 competencies for planning process, 4 competencies for organizing process, 4 competencies for staffing process, 26 competencies for directing process, and 12 competencies for controlling process by integrating IPA and SR. This outline of the program was constructed according to the derived integrated concept and both content validity and structured outline were interpreted as valid. Conclusion This suggests that middle-level managers need a systematic program and support to effectively lead the organization by recognizing the importance rather than performance.

Magnetic Resonance image(MRI) is used as the diagnostic modality for evaluation of suspected intramedullary tumors and differential diagnosis of these tumors at the spinal cord. We experienced intramedullary astrocytoma of cerviced cord with large syrinx and multiple peritumoral cysts consisted of subacute and chronic hemorrhage at the margin and within the syrinx and cysts on MRI.
Astrocytoma* ; Diagnosis, Differential ; Hemorrhage* ; Magnetic Resonance Imaging ; Spinal Cord*

PURPOSE: Since 1997, private postnatal care facilities (San-hu-jo-ri-won in Korean) have emerged to take the role of the family. As a result, neonates are now exposed to many people and are very vulnerable to infection. However, there has been no study on the influence of postnatal care facilities on neonatal infection. The aim of this study was to determine the risk factors of neonatal infection in full-term babies in Korea. MATERIALS and METHODS: We followed up 556 pregnant women and their babies for 4 weeks after their births at 2 hospitals in Seoul and Daejeon from October 2004 to September 2005. Among 512 full-term babies, 58 had infectious diseases. To determine the risk factors for infection, 53 infected neonates at 4-28 days of life and 413 healthy neonates were compared. RESULTS: The incidence of neonatal infection at 4 to 28 days after birth was 10.5%. After adjusting the related factors, the number of siblings (OR = 2.05, 95% CI = 1.13-3.71 for 1 or more) and postnatal care facilities or home aides (OR = 1.91, 95% CI = 1.07-3.45) were significant risk factors. Formula or mixed feeding (OR = 1.66, 95% CI = 0.91-3.04) increased the risk of neonatal infection but it was not statistically significant. CONCLUSION: When the newborns had siblings, stayed at postnatal care facilities, or were cared for by home aides, the risk of neonatal infections significantly increased. Further research on the feeding effect on neonatal infection and evaluation of prevention efforts are needed.
Communicable Diseases/*epidemiology ; Female ; Humans ; Infant, Newborn ; Korea/epidemiology ; Mothers ; Risk Factors ; *Term Birth

BACKGROUND: Adolescent girls are interested in weight reduction, but effective and adequate education for weight reduction is not done in Korea. And so much information is accepted via mass media. We investigated body image perception, weight control activities and their side effects among adolescent girls. METHODS: We used questionnaire about body image and weight control activities of middle and high school girls in Seoul in Sep. 1995. RESULTS: 88.6% of girls were not satisfied with their own height and 85.1% of girls with their own weight. 66.3% underweight students(BMI<20kg/m2) thought they were too fat and 98% acceptable weight students(20kg/m2<_KBMI<25kg/m2) thought they were too fat. So most girls had body image disturbance. 42.4% of girls were trying to lose weight and 85.1% were trying to lose weight reason for attractiveness and 16.6% were trying to lose for health. Self reported weight reduction methods were exercise(31.6%), fasting(21.9%), diet(21.5%), monodiet(10.8 %), laxatives(2.3%), very low calorie diet(1.8%) etc. Students who tr ied to lose weight for attractiveness selected more undesirable methods than who tried to lose weight for health(P<0.01). Most common route is via magazine, TV and newspaper. 43.4% of girls who tried to lose weight experienced side effects after weight reduction, those were dizziness(71.3%), general weakness(51%), apathy(26.S%) etc. CONCLUSIONS: Most girls had body image distortions. Useless weight reduction activities were done or planned and most of information was accepted via mass media. It is important to educate the girls to get adequate body image and effective weight reduction program is needed for health in adolescent girls.
Adolescent* ; Body Image* ; Education ; Female* ; Humans ; Korea ; Mass Media ; Periodicals ; Periodicals as Topic ; Self Report ; Seoul ; Thinness ; Weight Loss ; Weight Perception ; Weight Reduction Programs ; Surveys and Questionnaires