PURPOSE: Mycoplasma pneumoniae pneumonia is one of the most common community- acquired pneumonias in childhood. Recently, it has tended to occur at a young age. We reviewed clinical manifestations of M. pneumoniae pneumonia in the young. METHODS: A total of 378 children who were admitted to the Bundang Jesaeng Hospital due to M. pneumoniae pneumonia from 2003 to 2006 were retrospectively analyzed. M. pneumoniae infection was confirmed by mycoplasma antibody titer >1:320 or four-fold increase of titer. The children were divided into an infant group (Group A, 0-4 years) and an older children group (Group B, 4-14 years). We analyzed the differences between the two groups according to incidence, clinical manifestations, laboratory and radiologic findings. RESULTS: The number of patients in Group A was 147 (38.9%) and in Group B, 231 (61.1%), respectively. Seasonal distribution showed the highest frequency in autumn and the lowest frequency in spring in both groups. The most common symptom was cough (98.6% and 96.5%, respectively) and fever (85.7% and 91.3%, respectively). The most common physical findings were crackle (72.8% and 73.3%, respectively). The common radiologic findings were lobar pneumonia in both groups (55% and 76.1%, respectively), followed by bronchopneumonia (29.2% and 11.6%, respectively). Group A had a lower incidence of high antimycoplasma antibody titer (>1:5,120) and severe pulmonary complication than Group B. CONCLUSION: Group A had the more incidence of sputum production, leukocytosis, bronchopneumonia and duration of fever less than 7days. Group B had the more incidence of weak breathing sound, lobar pneumonia and duration of fever more than 7days.
Bronchopneumonia ; Child ; Cough ; Fever ; Humans ; Incidence ; Infant ; Leukocytosis ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia* ; Pneumonia, Mycoplasma* ; Respiratory Sounds ; Retrospective Studies ; Seasons ; Sputum

Malignant peripheral nerve sheath tumor (MPNST) is a rare entity of all soft tissue sarcomas. It has four different types of glandular, melanocytic, rhabdomyoblastic, and epithelioid. Epithelioid MPNST is composed of predominantly epithelioid cells. In contrast, typical MPNST is consisted of spindle cells, which is arranged in a fascicular or whirling pattern. A 33-old man showed two skin-color to reddish brown protruding nodules on the left thigh. Microscopically, one nodule was made up of epithelioid cell, primarily. In addition, the other nodule was composed of epithelioid cells and spindle cells, which also showed Antoni A and B. Immunohistochemical study showed the cells being positive for S-100 protein (weak and focal) and neuron-specific enolase, and negative for HMB-45, smooth muscle actin. Herein, we report a case of two different forms of malignant nerve sheath tumor on the left thigh, which was not associated with neurofibromatosis-1.
Actins ; Epithelioid Cells ; Muscle, Smooth ; Nerve Sheath Neoplasms ; Neurilemmoma ; Neurofibromatoses ; Peripheral Nerves ; Phosphopyruvate Hydratase ; Prognosis ; S100 Proteins ; Sarcoma ; Thigh

OBJECTIVES: To determine changes in the incidence and pattern of eclampsia in Il Sin Christian Hospital over a 46-year period. METHODS: Information was collected from medical records of the 1910 eclamptic patients among 233,613 deliveries in Il Sin Christian Hospital from Jan. 1 1953 to Dec. 31 1998. Incidence, presentation, and management of eclampsia were reviewed retrospectively, and maternal mortality rate and perinatal mortality rate were calculated. Statistical analysis was done by Chi-squared and Fisher's exact test through two by two tables looking at relative changes between each study period. RESULTS: The overall incidence of eclampsia was 81.8 per 10,000 deliveries. The incidence of eclampsia had increased from 137.3/10,000 in 1953-1962 to 278.4/10,000 in 1963-1972, but the rate had reduced to 6.5/10,000 in 1993-1998. There was a statistically significant fall in the rate of eclampsia every decade between 1973 and 1992, but there has been steady decrease in the last study period. Convulsion occurred antepartum in 54% of patients, intrapartum in 29% and postpartum in 17%. With the reduction in the proportion of antepartum eclampsia, there has been a relative increase in that of intrapartum and postpartum eclampsia. Maternal death occurred in 59 cases among eclampsia, and maternal mortality rate was 3.1%. Maternal mortality rate had significantly decresed from 11.1% in 1953-1962 to 3.8% in 1963-1972, and there has been no maternal death from eclampsia since 1986. Postpartum eclampsia had increased death risk compared with antepartum or intrapartum eclampsia. There were 280 cases of perinatal death and overall perinatal mortality rate was 144.1 per 1000 deliveries. There was a significant decrease in the rate from 243.2/1000 in 1953-1962 to 141.5/1000 in 1963-1972, but the rate has risen steadily since 1983. CONCLUSIONS: With the improvement in antenatal care and management of eclampsia, the incidence of eclampsia and its associated maternal mortality has decreased over the last 46 years. But eclampsia still remains a significant complication of pregnancy with high maternal and perinatal mortality.
Eclampsia* ; Female ; Humans ; Incidence ; Maternal Death ; Maternal Mortality ; Medical Records ; Perinatal Mortality ; Postpartum Period ; Pregnancy ; Retrospective Studies ; Seizures

PURPOSE: This study is to investigate the job stress and presenteeism of nurses with work shift. METHODS: The data were collected through questionnaires from 281 clinical nurses working for a university hospital located in D city from 13 to 28 of February, 2009. The data were analyzed by descriptive statistics, t-test, ANOVA, Scheffe verification test, Pearson correlation coefficient and multiple linear regression using SPSS/WIN 16.0. RESULTS: The mean score of job stress was 3.47. Work overload and psychological burden scored the highest point as the sub-category of work stress factor. Work performance loss out of presenteeism showed 26.89 and perceived productivity, 79.79. Also 94.7% of respondents answered they had health problems. A significantly positive correlation was found among job stress, work performance loss and health issue. To determine the factors affecting persenteeism, work performance loss was associated with work overload and perceived productivity with interpersonal relationship conflict. CONCLUSION: Based on the findings of the study, job stress is positively correlated with work performance loss, and health problems. Therefore, health problems of nurses with work shift need to be considered and plans to manage their job stress affecting presenteeism need to be developed at an earlier stage.
Surveys and Questionnaires ; Efficiency ; Linear Models

OBJECTIVES: This study was performed to identify the relations between the old's participation in voluntary service activities and health-related quality of life. METHODS: The subjects of the study were 318 elderly people aged over 65 years. They were interviewed with the use of a questionnaire from May 1 to June 30, 2012 to collect data. To verify the data collected, this study carried out a linear regression analysis. RESULTS: The health-related quality of life of the elderly who were participating in voluntary service activities was statistically significantly higher than that of those who were not. CONCLUSIONS: This study has meaning in that it discovered that the elderly people's participation in voluntary service activities had a positive effect on their health-related quality of life.
Aged* ; Humans ; Linear Models ; Quality of Life*

PURPOSE: The purpose of this study was to determine factors that affect poor quality of life (QOL) of older adults who received home health service. METHOD: The sample 492 older adults participated in the study. The QOL was measured using the scale of QOL of Ware and other data were collected through face-to-face interviews from September to August, 2009. RESULTS: The level of QOL was moderate (Mean 24.4, SD 7.4). The QOL was poorer in older adults (p<.05) and in those living alone (p<.01) compared to older adults and those living with couple or family respectively. The QOL was positively correlated with a sense of mastery (r=.213, p<.05), connection of health (r=.160, p<.05) and a cognitive function (r=.119, p<.01), and negatively correlated with Activities of Daily Living (r=-.266, p<.01) and Instrumental Activities of Daily Living (r=-.339, p<.01). Sense of mastery, connection of health & welfare, and IADL were significant predictors of QOL. CONCLUSION: Finding suggest that home health service program should incorporate strategies for increasing sense of mastery and capability of performing IADL, and strengthening connection of health service that may improve QOL of older home health service recipients.
Activities of Daily Living ; Adult ; Health Services ; Humans ; Quality of Life

Mitomycin C(MMC) is one of the alkylating agents, which is commonly used adjunctively to inhibit the over-growth of the fibroblasts in high-risk filtering surgery. However, it increases the incidence of the complications including persistent postoperative hypotony. The hypotony may be caused by the toxic effect of MMC on the ciliary epithelium. The morphological changes of the ciliary epithelium were evaluated using transmission electron microscope four and twelve weeks after the application of balanced salt solution(BSS) and MMC on the exposed sclera against the ciliary body in the rabbit eyes. There was no specific change in the ciliary epithelium four and twelve weeks after the application of BSS. Four weeks after the application of 0.2mg/ml of MMC, the mitochondria in the nonpigmented epithelium of the applied region were swollen mildly. The mitochondria of both pigmented and nonpigmented epithelia were swollen moderately in the region applied with 0.5mg/ml of MMC. Twelve weeks after the application of either 0.2 or 0.5mg/ml of MMC, the mitochondria were swollen markedly, the nuclear membranes in the pigmented and nonpigmented epithelia were wrinkled, and the heterochromatins of the nuclei faded in both applied and contralateral ciliary epithelia. These findings indicate that mitomycin C causes degenerative changes in the ciliary epithelium decrease aqueous production.
Alkylating Agents ; Ciliary Body ; Epithelium* ; Fibroblasts ; Filtering Surgery ; Heterochromatin ; Incidence ; Mitochondria ; Mitomycin* ; Nuclear Envelope ; Sclera

BACKGROUND: Cutaneous angiosarcoma (AS) is a rare malignant tumor of endothelial origin with a very poor prognosis, frequent recurrences, and high metastatic potential. Clinical suspicion is often raised too late, but histological findings and immunohistochemical assays have proved to be very helpful in the diagnostic process. OBJECTIVE: The purpose of this study was to evaluate the clinical and histopathologic features of angiosarcoma. METHODS: We retrospectively analyzed 12 patients with angiosarcoma who had visited our department of dermatology in Gyeongsang National University Hospital between 1998 and 2013. The clinical features, evolution, treatment, and outcome were examined, and biopsy specimens were reviewed by a trained dermatologist, with subsequent immunohistochemical assessment. RESULTS: Cutaneous AS was clinically diagnosed in 3 of 12 patients. There were many clinical misdiagnoses including lupus erythematosus, metastatic cancer, and infectious granuloma. The male to female ratio was 1:0.71 and the mean age of the patients was 66.25 years. The most frequent site of angiosarcoma was the scalp, in 8 of 12 patients. Histopathologically, well-differentiated angiosarcoma was composed of vascular channels, lined by flattened atypical endothelial cells that could be distinguished from their benign counterparts. Variable differentiation may be observed even in the same tumor. Immunohistopathologic analysis showed that the tumor cells were positive for CD31, CD34, Ki 67, and Factor VIII-related antigen. CONCLUSION: This study provides useful data on the clinical and histopathologic characteristics of angiosarcoma in the Korean population.
Biopsy ; Dermatology ; Diagnostic Errors ; Endothelial Cells ; Female ; Granuloma ; Hemangiosarcoma* ; Humans ; Male ; Prognosis ; Recurrence ; Retrospective Studies ; Scalp ; von Willebrand Factor

BACKGROUND: Angiokeratomas are vascular malformations that usually appear as multiple or solitary cutaneous papules, nodules, or plaques. Several clinical variants of angiokeratoma exist. The differential diagnosis of angiokeratoma can be difficult and some cases that are clinically suggestive of angiokeratoma are found to be caused by other diseases following skin biopsy. OBJECTIVE: The purpose of this study was to examine the diagnostic yield following analysis of clinically diagnosed angiokeratomas, which presented as multiple or solitary cutaneous papules, nodules, or plaques. METHODS: We retrospectively reviewed 36 patients who had visited the department of dermatology between January 2004 and December 2013, and who, following biopsy, had a clinical diagnosis of angiokeratoma or a differential diagnosis of angiokeratoma. We compared the clinical and histopathologic diagnoses, and analyzed the rate of concurrence and clinical features, including age, sex, location, and duration. RESULTS: The angiokeratoma patients accounted for 61.1% of all new patients and their mean age was 32.2 years. The most common subtype was solitary angiokeratoma (11 cases, 50%). Histopathologic analysis showed that 38.9% of patients had a different type of disease and their mean age was 31.4 years. The most common causes of disease for this latter group were pyogenic granuloma (21.4%) and hemangioma (21.4%), followed by calcinosis cutis, dermatofibroma, neurofibroma, pilomatricoma, verruca vulgaris, and herpes viral infection. CONCLUSION: Lesions suggestive of angiokeratoma need further examination and a biopsy is useful to determine the correct differential diagnosis between angiokeratoma and other diseases, to avoid erroneous management.
Angiokeratoma* ; Biopsy ; Calcinosis ; Dermatology ; Diagnosis ; Diagnosis, Differential ; Granuloma, Pyogenic ; Hemangioma ; Histiocytoma, Benign Fibrous ; Humans ; Neurofibroma ; Pilomatrixoma ; Retrospective Studies ; Skin ; Vascular Malformations ; Warts

BACKGROUND: With the advancement of socioeconomic and medical sciences, the number of elderly patients with skin diseases significantly increased. Therefore, the epidemiologic survey of dermatologic disease is in need for the elderly population. OBJECTIVE: The purpose of this study was to evaluate the prevalence of dermatologic diseases in elderly patients and to compare the results with the previous reports in malignant and benign skin tumors. METHODS: We retrospectively reviewed the clinical records of 2,678 outpatients older than 65 years of age, who visited the Department of Dermatology from January 2010 to December 2013. We compared the clinical diagnoses and analyzed the distribution of dermatologic diseases and clinical features, including the factors of age and sex. Among them, 575 patients who received biopsy for skin tumors were pathologically analyzed, confirmed, and classified as malignant or benign tumor. RESULTS: The incidence of skin disease in the group of patients older than 65 years of age was 15.6% (2,678). The ratio of men to women was 1 : 1.13 (1,257 : 1,421). The types of skin diseases in the group were as follows: infectious skin disease (26.1%); eczema (23.2%); epidermal and adnexal nevi and tumors (17.5%); drug eruption, erythema, and urticaria (7.0%); pruritus, psychocutaneous disorder, and neurocutaneous dermatoses (6.6%); papulosquamous disease (3.3%); diseases of the skin appendages (3.2%); disorders of pigmentation (2.5%); diseases of the mucous membrane (2.3%); cutaneous vascular diseases (2.2%); and skin tumors (21.5%). The most common malignant tumors were as follows: squamous cell carcinoma (33.9%), basal cell carcinoma (31.2%), Bowen's disease (19.0%), keratoacanthoma (7.2%), malignant melanoma (5.0%), and lymphoma (1.8%). The most common benign tumors were as follows: actinic keratosis (48.0%), seborrheic keratosis (17.2%), epidermal cyst (12.7%), melanocytic nevus (6.2%), hemangioma (3.7%), milia (2.0%), and hypertrophic scar and keloid (2.0%). The incidence of malignant tumors in women was much higher than in men, with a ratio of 1 : 1.96. CONCLUSION: This study provides useful data on the incidence and the characteristics of elderly skin diseases. Compared to the previous studies, the frequency of malignant tumors was relatively higher and variable. We advise physicians to make the appropriate diagnosis and treatment for the early detection of skin tumor, especially the squamous cell carcinoma and basal cell carcinoma, which are caused by long-term exposure to the sun.
Aged* ; Biopsy ; Bowen's Disease ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cicatrix, Hypertrophic ; Dermatology ; Diagnosis ; Drug Eruptions ; Eczema ; Epidermal Cyst ; Erythema ; Female ; Hemangioma ; Humans ; Incidence ; Keloid ; Keratoacanthoma ; Keratosis, Actinic ; Keratosis, Seborrheic ; Lymphoma ; Male ; Melanoma ; Mucous Membrane ; Nevus ; Nevus, Pigmented ; Outpatients ; Pigmentation ; Prevalence ; Pruritus ; Retrospective Studies ; Skin ; Skin Diseases* ; Skin Diseases, Infectious ; Solar System ; Urticaria ; Vascular Diseases