With the improvements, during recent years, in the control of the infections and nutritional diseases thesubject of congenital malformation becomes of increasing importance. The radiologic signs are crucial for promptdiagnosis of anomalies of alimentary tract and with early identification of resulting complication, surgicaltherapy is usually life-saving. 30 cases of congenital anomalies of alimentary tract in infants were reviewed inrespect of age, sex, incidence and radiological findings. 1. The most common lesion was hypertrophic pyloricstenosis, followed by congenital megacolon and anorectal anomaly, tracheoesophageal fistula, intestinal atresia.2. Male outnumbered female in most congenital anomalies of alimentary tract. 25 cases were under the age of 1month. 3. Common symptoms of upper gastrointestinal tract obstruction are vomiting and abdominal distention. Inthe obstruction of lower gastrointestinal tract, abdominal distention and failure of meconium passage were noted.4. Roentgenologic finding were as follows, a. Chest A-P and lateral view; In tracheoesophageal fistula, sacculardilatation of upper esphagus and displacement of trachea anterolaterally were the most common finding. b. Simpleabdomen: Obstructive pattern of proximal portion of duodenum shows in 11 cases, of distal bowel shows in 16 cases.Duodenal atresia showed “double bubble” sing, hypertrophic pyloric stenosis showed marked gastric distention,paucity of air in small bowel and increased gastric peristalsis were the most common finding. Hirschsprung'sdisease showed absence of rectal gas almostly. The variable length between blind hindgut to anus was seen inanorectal anomalies. c. Esophagogram: Blind sac of upper esophagus was seen at the 4th thoracic spinal level anddisplacement of trachea anteriolaterally. 1 case of tracheoesophageal fistula had an intact esophageal lumen. d.Upper G-I series; In hypertrophic pyloric stenosis, delayed gastric emptying, string or double tract sign were themost common finding and catapiller sign, tit sign, shoulder sing or open umbrella sign were noted. e. Bariumenema; In congenital megacolon, transitional zone and irregular bizzar contraction, “choppywave” were noted.Radiograph made 24 hours after barium enema showed retained barium in the colon. f. Selective retrogradefistulogram, distal loopgram & voiding cystogram: In anorectal anomalies, 3 cases showed rectourethral fistula and2 cases showed rectovaginal fistula and 1 case showed rectovesical fistula. And membranous imperforate anus is in1 case.
Anal Canal ; Anus, Imperforate ; Barium ; Colon ; Duodenum ; Enema ; Esophagus ; Female ; Fistula ; Gastric Emptying ; Gastrointestinal Tract ; Hirschsprung Disease ; Humans ; Incidence ; Infant ; Lower Gastrointestinal Tract ; Male ; Meconium ; Peristalsis ; Pyloric Stenosis, Hypertrophic ; Rectovaginal Fistula ; Shoulder ; Thorax ; Trachea ; Tracheoesophageal Fistula ; Upper Gastrointestinal Tract ; Vomiting

OBJECTIVES: The purpose of this study was to assess the objective and universal attitudes toward mentally-disabled defendants. The authors examined the criminal characteristics of the mentally-disabled defendants and clarified the differences between psychiatric opinions about the criminal responsibilities of mental patients and the final judicial decisions. METHODS: The subjects consisted of 75 mentally-disabled defendants. They had been referred to Seoul Eunpung Municipal hospital during the period of Jan. 1990 to Mar. 1997. We examined them through psychiatric interview, clinical psychological tests and other tests. The data obtained were analyzed in several aspects: demographic factors, characteristics of crime, psychiatric opinions and legal opinions. RESULTS: Regarding the demographic background, most commonly met subjects were males, single, in their twenties and thirties, with educational background of about 11 years, unemployed, and living in urban districts. Approximately one third(37.5%) of all subjects were diagnosed as schizophrenia, 10.8% an mood disorder and 9.3% as personality disorder. The most frequent criminal act was assault and battery(28.0) and the mental states at the time of the criminal act could be inferred as delusion/hallucination(52.0%) and paroxysmal emotional uncontrollable state(33.3%),etc. About forty perecnt(39.4%) of victims were strangers, 25.3% were public servants 21.3% were family members. According to the psychiatric report out of 75 defenddants, defendants were classified as followes:44 defendants were evaluated to be totally free of criminal responsibility, 22 defendants to be partially responsible, and 5 defendants to be fully responsible. However, the psychiatric evaluation was found to be in contrast with the final judicial decisions by the court:16 defendants were totally free of criminal responsibility, 44 of restricted criminal responsibility and 15 fully responsible. In case of no responsibility, the agreement rate between the judge's opinions and the psychiatric ones was 36.3%, for partial responsibility it was 73.0%, and for full responsibility it was 100%. DISCUSSION: The judges do not completely agree to psychiatric opinions. Therefore, the authors suggest that more facilitated communication between psychiatrists and judges should be necessary for the benefiit of mentally-disabled defendants.
Crime ; Criminals ; Demography ; Disability Evaluation* ; Hospitals, Municipal ; Humans ; Male ; Mentally Ill Persons ; Mood Disorders ; Personality Disorders ; Psychiatry ; Psychological Tests ; Schizophrenia ; Seoul

PURPOSE: This study was done to examine the influence of nursing service quality and medical service satisfaction on intent to revisit the hospital, and to identify mediating effects of medical service satisfaction between nursing service quality and intent to revisit the hospital. METHODS: This study was a cross-sectional survey. Participants were 390 hospitalized patients at one general hospital in Gyeonggi Province. Data were collected from July 21 to September 10, 2010 and analyzed using SPSS/PC version 18.0. RESULTS: The score for nursing service quality continuously improved but the scores for medical service satisfaction and intent to revisit the hospital did not changed significantly after estimated. Factors influencing intent to revisit the hospital were nursing service quality, medical service satisfaction, 'same religion', and 'Christian', and the explanation power of these four factors was 79.7%. Medical service satisfaction had a partial mediating effect between nursing service quality and intent to revisit the hospital. CONCLUSION: Findings indicate that nursing service quality is a very important factor to improve both medical service satisfaction and intent to revisit the hospital. Nursing managers should develop strategies to improve nursing service quality.
Consumer Satisfaction ; Cross-Sectional Studies ; Hospitals, General ; Humans ; Negotiating ; Nursing Services

Kimura's disease is a benign, uncommon, chronic inflammatory condition that usually presents with painless subcutaneous nodules or plaques. Head and neck are the most frequently involved sites in Kimura's disease. Mandible is the most commonly involved, followed by neck, cheek, scalp and forehead. Other possible sites are oral cavity, inguinal area and extremities, but there have been no reports involving the nose, especially the one that looks like a rhinophyma. We describe a case of Kimura's disease presenting like a rhinophyma.
Cheek ; Extremities ; Forehead ; Head ; Mandible ; Mouth ; Neck ; Nose ; Rhinophyma ; Scalp

BACKGROUND: Angioleiomyoma of the skin is a rare smooth muscle tumor and may develop anywhere in the body. Comprehensive clinicopathological analysis of angioleiomyomas developed in Korean has not been reported in domestic dermatological journals. OBJECTIVE: The purpose of this study was to evaluate the clinical and pathological characteristics of angioleiomyoma and the relationship between the tumor and the nerve with immunohistochemical stains. METHODS: Fifty nine cases of angioleiomyoma were reappraised from the files of the pathology of Seoul National University, Green Cross Reference Laboratory Center and Korea Veterans Hospital. Brief clinical histories of all cases were examined and microscopic findings in 35 cases were classified according to subtypes. Paraffin blocks were recut and stained in 16 cases for desmin, smooth muscle actin and S-100 protein. RESULTS AND CONCLUSION: 1. Male to female ratio was 1:1.27. 2. The age of the patients was mostly over 20 years and the mean age was 51 years in men and 40 years in women. 3. Tumors occurred most frequently in the lower extremity(38 cases), and followed by upper extremity(18 cases), head(2 cases), and trunk(1 case). Women had predominance of the legs in location site and men showed equal distribution in the lower and upper extremities.
Actins ; Angiomyoma* ; Coloring Agents ; Desmin ; Female ; Hospitals, Veterans ; Humans ; Korea ; Leg ; Male ; Muscle, Smooth ; Paraffin ; Pathology ; S100 Proteins ; Seoul ; Skin ; Smooth Muscle Tumor ; Upper Extremity

With the dynamically changing environment of society, managing change is the vital element of organizations's survival and growth. Health care organizations have expended enormous resources to restructure patient care delivery. Despite the growing literature describing these organizational innovations, there is a paucity of credible data that reflects systematic measurement and evaluation of such changes. This study examined the nurses' psychological response toward the work process redesign, newly introduced by the nursing department in a acute care hospital. The aim of the study was to figure out how nurses's general perception of change and perceived attributes of change affected their acceptance of change during the organizational transition. This was descriptive-correlational. The sample for the study included 50 head nurses and 135 staff nurses. Data was analyzed using SPSS PC+, version 10.0. The major findings of the study were as follows: First, the mean score of the perception of change was 71.2 (SD=13.8) with the range of 0-100, which means nurses generally perceived change positively. There were significant differences in perception of change by gender and education level. Head nurses perceived change more positively than staff nurses. The higher education level showed the more positive view of change. Second, among the perceived attributes of change, trialability had the highest mean score, which means nurses perceived the change more positively if it is testable on a limited basis. Relative advantage was perceived the most negatively. Finally, factors influencing the acceptability of the work-process redesign were perceived comparability, complexity, relative advantage, and observability, which accounted for 43.7% of the variance in the acceptability of change.This study evaluated the preliminary effects of the nursing process for reengineering, focusing on nurses' acceptability towards change. The usefulness of this research study was to determine the factors influencing acceptance of organizational members during transitional periods of change and to suggest effective strategies for increasing adoption as well as for decreasing resistance to change.
Delivery of Health Care ; Education ; Nursing ; Nursing Process ; Nursing, Supervisory ; Organizational Innovation* ; Patient Care

Pulmonary artery sling is a rare congenital cardiovascular anomaly which presents clinical obstructive symptoms and signs of trachea, right main bronchus and esophagus due to left pulmonary artery abnormaly arises from proximal part of right pulmonary artery. Aberrant left pulmonary artery courses to the right above right main bronchus and then turns to the left, and courses to between the anterior of the esophagus and the posterior aspect of trachea. One of important clinical significances of the pulmonary artery sling is associated with intracardiac anomalies, and with tracheal stenosis and bronchomalacia due to press tracheobronchial tree by the aberrant pulmonary artery. It has been thought that embryological malconnection between the pulmonary artery bud from left sixth arch and the pulmonary posterior branchial plexus in the left lung bud. We had experienced 21 months old male infant with left pulmonary artery sling associated with persistent left superior vena cava and dextropostioned heart. The heart seems to move to right hemithorax due to hypoplasia or segmental atelectasis of right lung.
Bronchi ; Bronchomalacia ; Esophagus ; Heart* ; Humans ; Infant ; Lung ; Male ; Pulmonary Artery* ; Pulmonary Atelectasis ; Trachea ; Tracheal Stenosis ; Vena Cava, Superior*

An unusual case of glroependymal cyst involving the lateral ventricle, 3rd ventricle, cerebellopontine angle cistern and prepontine cistern, simultaneously, is reported. The glroependymal cyst is benign developmental cyst that mainly occurs in the cerebrospinal axis in relation to ventricle, but occasionally occurs in relation to extraventricular system, such as subarachnoid space, brain stem and cerebral parenchyme. The histological characteristics of ependymal cyst wall are ependyma-like epithelium and neuroglial tissue.
Axis, Cervical Vertebra ; Brain Stem ; Cerebellopontine Angle ; Epithelium ; Lateral Ventricles ; Subarachnoid Space

A study of effect of local hypothermia upon the spinal cord was performed in cats. With a cuff, a cooler, to which was attached connecting tubes to a refrigerator, the experimental technique was deviced to cool the spinal cord locally at midthoracic level. Cold liquid, saline at a temperature of +/-1.1 degrees C, was circulated in closed system through the tubing into the cuff which was snugly rested on the dorsal surface of the spinal cord as a heat exchanger. The temperatures were measured with thermocouples at various sites in the spinal cord before, during, and after the cooling every two minutes upto twenty minutes. In the cord underneath the cuff, the mean precooling temperature of 35.4 degrees C in normal control group was lowered to 11.0 degrees C during the first two minutes of cooling. After this in initial rapid drop in temperature, there was a further gradual reduction of 4.5 degrees C upto 20 minutes cooling to be 6.5 degrees C. The lowest mean temperatures recorded throughout cooling were 4.3 degrees C at dorsal surface and 6.9 degrees C at center of the cord. And the temperature lowering was nearly not noted beyond the cord 1 cm apart from an edge of cuff in rostral and caudal directions. For comparison, the temperature in the cord that had not been injured was also measured. The rate of cooling in the cord underneath the cuff seemed to be faster than in the control group of animal in which the cord was not injured. Another design of this experiment was an evaluation of the protective effect of local hypothermia with respect to cord edema and injury associated cord hemorrhage. Immediately after intravenous administrations of fluorescin the spinal cords were contused with impaction injury. These injured cords were removed ar different time intervals after trauma, and spread or distribution of fluorescin in frozen sectioned specimens was observed under ultraviolet illumination with fluorescence microscope. In all cooling groups, pathological pictures were reduced in its degree and extent more than those in the control group, and that, earlier the cooling after the injury to the cord, better the result was outcome. It would be well to say that local hypothermia might be within the margin of safety and beneficial in the management of spinal cord injury in this experiment.
Administration, Intravenous ; Animals ; Cats ; Edema ; Fluorescence ; Hemorrhage ; Hot Temperature ; Hypothermia* ; Lighting ; Spinal Cord Injuries ; Spinal Cord*

BACKGROUND: In November 2016, an outbreak of scombroid fish poisoning occurred among elementary school students in Seoul, Korea. An epidemiological investigation was conducted to identify the cause and source of the illness. METHODS: A case-control study was conducted among school members who had eaten lunch in the school. The histamine level in the suspect food item (yellowtail steak) was measured. RESULTS: Fifty-five (5.4%) of 1,017 school members who consumed fish for lunch fell ill. The principal symptoms were flushing (100%) and headache (72.7%); the median incubation period was 40 minutes. All had consumed yellowtail steak (odds ratio, 9.24; 95% confidence interval, 1.22–69.91). Leftover steak had an elevated histamine level (293 mg/kg), higher than the allowed 200 mg/kg. CONCLUSION: An outbreak of scombroid fish poisoning was confirmed; this is the first such report in Korea. Detailed food safety guidelines must be established.
Case-Control Studies ; Flushing ; Food Safety ; Foodborne Diseases ; Headache ; Histamine ; Humans ; Korea* ; Lunch ; Poisoning* ; Seoul*