Closed loop onstruction represent a surgical emergency, because this lesion leads to small boweel infarction, perforation, and peritonitis if not treated in time. We analyzed the CT and ultrasonographic findings of 4 patients prospectively and 2 patients retrospectively with surgically proven closed loop obstruction of the small boweel to evaluate the characteristic findings, the cause of the closed loop obstruction and predictive criteria for the viablity of the involved bowel loop. The characteristic CT and sonographic features of the closed loop obstruction of the small bowel included; dilated fluid-filled bowel loops, the thickened bowel wall, absence of peristalsis, and ascites. In one case, closed loop obstructio originating from umbilical hernia was documented by CT and sonography. The possible criteria for the gangrenous changes could be the maximal thickness of bowel more than 7mm, and infiltration in the mesentery/omentum.
Ascites ; Emergencies ; Hernia, Umbilical ; Humans ; Infarction ; Peristalsis ; Peritonitis ; Prospective Studies ; Retrospective Studies ; Ultrasonography*

PURPOSE: The purpose of the study was to compare CT with scintigraphy in the detection of parenchymal lesionsof acute pyelonephritis in children, and to assess the diagnostic value of CT. MATERIALS AND METHODS: This studyinvolved 32 children with acute pyelonephritis ; their ages ranged from 1 month to 10 years. Renal CT , TC-99mDMSA planar and SPECT images, and medical records were retrospectively reviewed. We evaluated the number, size,shape, density, and location of pyelonephritic lesions, as seen on CT and scintigraphic images. RESULTS: In 43involved kidneys, 193 parenchymal lesions of acute pyelonephritis were identified. The results of CT were abnormalin 42 kidneys (98%), and those of scintigraphy, in 39(91%). CT showed single or multiple hypoenhancing parenchymallesions ; these were streaky(n=151), wedge-shaped (n=34), or oval (n=8), and ranged from about 3-30mm in maximumdiameter. Abscess (n=5), renal fascial thickening (n=6) and thickening of the bridging septae (n=7) wereassociated. Scintigraphic findings were diffuse or localized area of varying degrees of diminished corticalactivity, and these were more precisely identified on SPECT than on planar images. For the detection of 55 of 193pyelonephritic lesions, CT was more sensitive than scintigraphy ; 29 of the 55 lesions were less than 5 mm indiameter. CONCLUSION: For the detection of pyelonephritic lesions, particularly smaller ones, and for theevaluation of complications such as abscess formation, CT is more sensitive than Tc-99m DMSA scintigraphy. Weconclude that in children with subtle scintigraphic findings who are in serious clinical condition or in whomcomplications are suspected, CT is a useful tool for assessing a therapeautic plan and the prognosis of acutepyelonephritis.
Abscess ; Child* ; Humans ; Kidney ; Medical Records ; Prognosis ; Pyelonephritis* ; Radionuclide Imaging* ; Retrospective Studies ; Succimer* ; Tomography, Emission-Computed, Single-Photon

Real-time ultrasonogram was performed in 31 Pt. with CHPS, who was admitted at the pediatric department of Wonkwang University hospital from January 1991 to June 1993. Those who had positive results of pyloric volume for diagnosis of CHPS and were confirmed by surgery. The results were at follows: 1) The average ultrasonographic measurements of pyloric muscle thickness, pyloric diameter, pyloric length were 4.9+/-1.09mm, 14.42+/-2.69mm, 19.17+/-2.37mm, and pyloric volume was 3.26+/-1.39ml. 2) The diagnostic reliabilities with the ultrasonographic measurements of muscle thickness (>4mm), pyloric diameter (>12mm) and pyloric length (>15mm) by Stunden's criteria in 31 cases were compared, which were not significant difference among them. 3) In ultrasonographic measurements of 31 cases for diagnosis of CHPS, positive results with 3 parameters were 80.6% and with 2 parameters and double tract signs were 87.1%. So. we conclude pyloric volume greater than 1.4ml was the most reliable parameter, which was satisfied 100% with diagnosis of CHPS.
Diagnosis* ; Pyloric Stenosis, Hypertrophic* ; Ultrasonography

Black adenoma is known to be a rare variant of adrenal cortical adenoma containing characteristic abundant lipofuscin pigments in the cytoplasm. Almost all of them are nonfunctioning and only occasionally they are associated with Cushing's syndrome or primary hyperaldosteronism. We present two cases of black cortical adenoma of the adrenal gland associated with Cushing's syndrome in a 24-year-old woman and a 64-year-old man. This report dealt with clinical and pathologic presentation including ultrastructural identification of lipofuscin pigment.
Female ; Male ; Humans ; Adenoma

PURPOSE: The purpose of this study was to compare the rehabilitation nursing services what nurses recognize to be important and what they do in practice of the industrial workers. METHOD: The subjects were 150 nurses who were working at the industrial hospital. The questionnaire was made up with 43 items about the perception on importance and performance of rehabilitation services. RESULT: The highest services in the perception on importance and performance subscale were physical and therapeutic services. The highest difference between perception on importance and performance was the social and occupational services. The perception on importance of rehabilitation services had positive correlation with performance. The group take care of general patients had a higher level of perception on importance than the other group, and level of performance had significant difference with age and position. CONCLUSION: We need to develop the strategy for promoting the performance of services that recognize it will be important services, but not to do. Further study on system for promoting the nurse practitioner who responsible for rehabilitation nursing.
Humans ; Nurse Practitioners ; Occupational Health ; Surveys and Questionnaires ; Rehabilitation Nursing

INTRODUCTION: The purpose of this study was to investigate the changes in the concern and attitudes of Nursing students toward the disabled before and after the disability experience program. METHOD: 151 Nursing students with clinical practice in National rehabilitation hospital were conveniently selected as the subject. All subjects had experience the disability program, and their attitudes toward the disabled were measured before and after the 3hours' program. Collected data were analyzed by SPSS 11.0 with paired t-test. RESULTS: 1. The concern toward the disabled after their disability experience program was more positive than before(t= -4.930, p= .000). 2. The attitudes toward the disabled after their disability experience program was more positive than before(t=5.892, p=.000). 3. The appreciation of daily life after their disability experience program was higher than before(t=- -8.563, p= .000). CONCLUSION: In summary, the disability experience program should be effective in order to promote the positive attitude toward the disabled. Therefore expansion of this program is of profound significant.
Humans ; Nursing* ; Rehabilitation ; Students, Nursing*

Recently it is known that Turner's syndrome is frequently associated with hypothyroidism. We report a case of Turner's syndrome associated with subclinical hypothyroidism. A 23-year-old female was admitted to the hospital with complaints of amenorrhea and short stature. She had a mosaicism of 45, X0/46, Xi(X_q) in the cell, cultured from the peripheral blood. The plasma thyroxine and triiodothyronine were normal and there was no clinical symptom of hypothyroidism. But the thyroid-stimulating hormone(TSH) concentration was unusually higher(184 uU/L). She has been treated with the cyclic therapy of conjugated estrogen and medroxyprogesterone, in addition to the thyroxine replacement therapy. After 2 months, the menstruation was restored and TSH was normalized.
Amenorrhea ; Cells, Cultured ; Estrogens ; Female ; Humans ; Hypothyroidism ; Medroxyprogesterone ; Menstruation ; Mosaicism ; Plasma ; Thyroxine ; Triiodothyronine ; Turner Syndrome ; Young Adult

Bronchoalveolar lavage (BAL) has emerged as a useful technique for the study of pulmonary interstitial disorders. Several types of information are provided by the evaluation of lavage fluid. Identification of cellular constituents helps to separate inflammatory process. Recently we have studied cellular constituents of BAL from three cases with histologically confirmed pulmonary sarcoidosis, idiopathic pulmonary fibrosis and hypereosinophilic syndrome. Pulmonary sarcoidosis showed a marked increase in lymphocytes, idiopathic pulmonary fibrosis revealed a predominance of neutrophils, and hypereosinophilic syndrome presented a marked increase in eosinophils in the lavage fluids.
Bronchoalveolar Lavage ; Child* ; Eosinophils ; Humans ; Hypereosinophilic Syndrome ; Idiopathic Pulmonary Fibrosis ; Lymphocytes ; Neutrophils ; Sarcoidosis ; Sarcoidosis, Pulmonary ; Therapeutic Irrigation ; Urinary Tract Infections* ; Urinary Tract*

PURPOSE: To assess long-term changes in intraocular pressure (IOP) and the development of glaucoma after early phacoemulsification in acute primary angle closure. METHODS: Retrospective chart review of acute primary angle closure patients treated with phacoemulsification in attack eyes versus fellow eyes. Within a month after the angle closure attack, all subjects underwent cataract surgery and were divided into two groups: group A received cataract surgery on their attack eyes. Group B also received cataract surgery on their fellow eye after phacoemulsification of the attack eyes. Study outcomes were the prevalence of IOP rise (occurrence of IOP >21 mmHg) and the incidence of newly developed glaucoma. RESULTS: Eighty-nine eyes were included, with 62 attack eyes in group A and 27 fellow eyes in group B. Group A (14 eyes, 22.58%) had a higher cumulative rate of IOP rise than group B (3 eyes, 11.11%) at 12 months (p = 0.001). Newly developed glaucoma was not observed in group B; however, 6 patients in group A developed glaucoma during the 12-month follow-up period (p < 0.001). CONCLUSIONS: The attack eyes treated with phacoemulsification showed a significantly higher prevalence of IOP rise and newly developed glaucoma than fellow eyes that received phacoemulsification. These findings suggest that there is a possibility of IOP rise and development of glaucoma even when angle closure and successful IOP control have apparently been achieved after phacoemulsification.
Cataract ; Follow-Up Studies ; Glaucoma ; Glaucoma, Angle-Closure ; Humans ; Incidence ; Intraocular Pressure* ; Phacoemulsification* ; Prevalence ; Retrospective Studies

PURPOSE: RKIP (Raf kinase inhibitor protein) is a novel candidate tumor suppressor, known to inhibit the MAPK signaling by interfering with the MEK phosphorylation by Raf-1. The aim of this study was to investigate the expression of RKIP and analyze the pattern of inactivation and mutation of the RKIP gene in human gastric cancer. METHODS: To explore if RKIP inactivation is implicated in gastric tumorigenesis, an expression analysis on the transcription and protein expression levels and a mutational analysis of RKIP were performed in 15 human gastric cancer cell lines and 92 primary carcinoma tissues. RESULTS: Abnormal reduction of the level of RKIP expression was frequently detected in the cancer cell lines and primary tumor tissues, at both the transcript and protein levels. Moreover, the expression level of RKIP in the tumor cells was inversely correlated with the level of Erk phosphorylation, indicating that RKIP plays a key role in the regulation of the Raf-MEK-Erk signaling pathway in human gastric cells. While the expression of the RKIP transcript was not re-activated in low expressor cells by treatment with the demethylating agent 5'Aza-dC, the genomic RKIP was detected at low levels in many cancer cell lines, suggesting that an abnormal reduction of level of RKIP expression in tumors might be caused by allelic deletion of the gene rather than transcriptional silencing due to aberrant DNA hypermethylation. A loss of heterozygosity study, using an intragenic polymorphic marker, revealed that approximately 21% of the gastric cancers harbored allelic loss of the RKIP gene. CONCLUSION: Collectively, this study has demonstrated that RKIP is a tumor suppressor, whose expression is frequently downregulated by allelic deletion in human gastric cancers. This study also suggests that an altered expression of RKIP might contribute to the development of gastric cancer via abnormal elevation of the Raf-Erk signaling pathway.
Carcinogenesis ; Cell Line ; DNA ; Humans* ; Loss of Heterozygosity ; Phosphorylation ; Phosphotransferases* ; Stomach Neoplasms*