PURPOSE: The accuracy of CT in the detection of injuries of the solid visceral organ is well established, but the value of CT in diagnosing small bowel rupture after abdominal trauma is controversal. This study was conducted to ascertain CT finding of small bowel rupture result from abdominal trauma. MATERIALS AND METHODS: A retrospective analysis of preoperative abdominal CT findings in 40 patients was performed. Small bowel rupture was confirmed by surgery. Precontrast and postcontrast enhanced CT images were obtained in all patients. RESULTS: Diagnostic findings of small bowel rupture including pneumoperitoneum or retroperitoneal air, discontinuity of the bowel wall and extravasation of oral contrast materials were observed in 33 cases(83%). Intraperitoneal or retroperitoneal free air was seen in 31 cases(78%) and intraperitoneal or retroperitoneal free fluid collection was seen in 38 patients(95%). Small bowel wall was thickened in 31 cases(78%), bowel wall was enhanced in 12 cases(30%) and bowel wall discontinuity and extravasation of oral contrast material was seen in 5 cases, respectively. CONCLUSION: The CT scan is sensitive and effective modality for evaluation of small bowel rupture after abdominal trauma, because of high detectability of diagnostic and suggestive CT findings.
Contrast Media ; Humans ; Pneumoperitoneum ; Retrospective Studies ; Rupture* ; Tomography, X-Ray Computed

Purpose: This study aims to examine differences in experiences of violence and hospital violence attitude according to gender and gender-role identity of clinical nurses. Methods: The quota sampling method, was used to select the research subjects. They were divided into two groups male and female nurses who worked for three general hospitals or higher level-hospitals in Incheon and Gyeongbuk. The data of 219 subjects was used for final analysis. The IBM SPSS 22.0 was used to analyze the data t-test and ANOVA. Results: According to gender, the hospital violence experience of female nurses was oserved frequently when the verbal violence came from guardians, and when the physical threats came from others. For male nurses, the experiences of hospital violence was obserbed. According to gender, the hospital violence attitude revealed significant differences in female nurses that the negative attitude was higher (t=-4.69, p<.001). According to gender-role identity, the undifferentiated and femininity showed significant differences (F=4.86 p=.003). Conclusion The differentiated strategies of coping measures and violence preventive education considering the gender and gender-role identity of clinical nurses would help formulate measures for the effective management of hospital violence.

Steroids are widely used for the treatment of a variety of diseases, including autoimmune and allergic diseases. Immediate hypersensitivity reactions can occur within 1 hour after administration of steroids and are regarded as IgE-mediated hypersensitivity presenting as urticaria, angioedema, bronchospasm, and anaphylaxis. Steroid hypersensitivity is rare, but can be life-threatening. Therefore, it is important to find implicated drugs and to choose safe alternative agents. A 44-year-old female was diagnosed with steroid hypersensitivity after intralesional steroid injection. She underwent a skin prick test and an intradermal test for methylprednisolone, triamcinolone, hydrocortisone, and dexamethasone. The results were positive to triamcinolone and methylprednisolone. The patient was educated to avoid culprit agents in order to prevent recurrence. Herein, we report a rare case of steroid hypersensitivity that showed positive reactions to triamcinolone and methylprednisolone. A review of the literature for steroid hypersensitivity is also provided.
Adult ; Anaphylaxis ; Angioedema ; Bronchial Spasm ; Dexamethasone ; Drug Hypersensitivity ; Female ; Humans ; Hydrocortisone ; Hypersensitivity ; Hypersensitivity, Immediate* ; Intradermal Tests ; Methylprednisolone ; Recurrence ; Skin ; Skin Tests ; Steroids* ; Triamcinolone ; Urticaria

To discover genetic markers for autism spectrum disorder (ASD), we previously applied genome-wide BAC array comparative genomic hybridization (array-CGH) to 28 autistic patients and 62 normal controls in Korean population, and identified that chromosomal losses on 8p23.1 and on 17p11.2 are significantly associated with autism. In this study, we developed an 8.5K ASD-specific BAC array covering 27 previously reported ASD-associated CNV loci including ours and examined whether the associations would be replicated in 8 ASD patient cell lines of four different ethnic groups and 10 Korean normal controls. As a result, a CNV-loss on 8p23.1 was found to be significantly more frequent in patients regardless of ethnicity (p<0.0001). This CNV region contains two coding genes, DEFA1 and DEFA3, which are members of DEFENSIN gene family. Two other CNVs on 17p11.2 and Xp22.31 were also distributed differently between ASDs and controls, but not significant (p=0.069 and 0.092, respectively). All the other loci did not show significant association. When these evidences are considered, the association between ASD and CNV of DEFENSIN gene seems worthy of further exploration to elucidate the pathogenesis of ASD. Validation studies with a larger sample size will be required to verify its biological implication.
Autistic Disorder ; Cell Line ; Child ; Clinical Coding ; Coat Protein Complex I ; Comparative Genomic Hybridization ; Ethnic Groups ; Genetic Markers ; Humans ; Sample Size ; Autism Spectrum Disorder

BACKGROUND: Hantaan (HTN) and Seoul (SEO) viruses, harbored by the striped-field mouse(Apodemus agrarius) and the Norway or common rat (Rattus rattus & Rattus norvegicus), respectively, were known to cause hemorrhagic fever with renal syndrome(HFRS) in Korea. We evaluated the seroepidemiologic patterns of hantaviral infections and detect the hantaviral antigens from patients' sera. METHODS: Total 8,102 HFRS patients' sera were collected from 1994 to 1996, and examined by indirect immunofluorescent antibody technique (IFA), hemagglutination inhibition test (HI), IgM emzyme-linked immunosorbent assay (IgM-ELISA) and nested reverse transcription-polymerase chain reaction(RT-PCR). RESULTS: The seropositive rate against hantaviral antigen was 12.0% (973/8102) with the high incidence rate (68.3%) in the period from October to January, and males in the thirties were mostly affected. HTN viral infections were detected 3.5 and 5.2 times higher than SEO viral infections by HI and RT-PCR, respectively, and patients in the fifties were the mostly affected age-group in SEO viral infections, IgM antibodies were detected in the 717 sera of the 905 IFA positive cases (79.2%), and the antigen detection rate of HTN and SEO viruses was 7.7% (56/724). Interestingly, 40 sera (4.4%), showed higher antibody titers against the Puumala (PUU) virus than those against HTN or SEO viruses. CONCLUSION: The results showed HTN and SEO viruses were the main causative agents of HFRS in Korea, and also suggested the possible presence of PUU-related hantaviral infections.
Animals ; Antibodies ; Fever ; Hantaan virus ; Hantavirus ; Hemagglutination Inhibition Tests ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Immunoglobulin M ; Incidence ; Korea ; Male ; Norway ; Puumala virus ; Rats ; Seoul ; Seoul virus ; Seroepidemiologic Studies

Complex regional pain syndrome (CRPS) is a painful and disabling disorder that can affect one or more extremities. Unfortunately, the knowledge concerning its natural history and mechanism is very limited and many current rationales in treatment of CRPS are mainly dependent on efficacy originated in other common conditions of neuropathic pain. Therefore, in this study, we present a case using a total spinal block (TSB) for the refractory pain management of a 16-year-old male CRPS patient, who suffered from constant stabbing and squeezing pain, with severe touch allodynia in the left upper extremity following an operation of chondroblastoma. After the TSB, the patient's continuous and spontaneous pain became mild and the allodynia disappeared and maintained decreased for 1 month.
Adolescent ; Chondroblastoma ; Extremities ; Humans ; Hyperalgesia ; Male ; Natural History ; Neuralgia ; Pain, Intractable ; Upper Extremity

BACKGROUND: The principal acute febrile diseases reported in autumn, Korea, have been hemorrhagic fever with renal syndrome (HFRS), scrub typhus, murine METHODS: To evaluate the seroepidemiologic patterns of acute febrile illness in Korea, sera were collected from 5330 patients from 1994 to 1995, and examined for antibodies against Hantaan virus, Orientia tsutsuga-mushi, Rickettsia typhi, and Borrelia burgdorf eri by indirect immunofluorescent antibody technique(IFA) and by macroscopic agglutination test for Leptosp ira intero-gans. RESULTS: Of 640 seropositive cases against O. tsutsu-gamushi, 60% were female; age group of the seventh decade occupied 30%; 89% were reported during October and November. By IFA test, the seropositive rate of murine typhus was 3.5% (187/5330) with high incidence rate (44%) in the period from October to December, and males in their forties and fifties were mostly affected. Cases seropositive for leptospirosis consisted 1% of 5330 acute febrile illness cases. Of 55 seropositive cases, 71% were male; 71% were in their sixties; 78% occurred during the period from August to October. Hantavirus seropositive rate was 12.2% (649/5330) with a high incidence rate (70%) in the period from October to January and males in the thirties were mostly infected. No seropositive case of Lyme disease was present. CONCLUSION: The above results indicate that hantavirus, O. tsutsugamushi, R. typhi, and L. interogans were the main causative agents of acute febrile diseases during autumn season in Korea.
Agglutination Tests ; Antibodies ; Borrelia ; Female ; Hantaan virus ; Hantavirus ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Incidence ; Korea* ; Leptospirosis ; Lyme Disease ; Male ; Rickettsia typhi ; Scrub Typhus ; Seasons ; Typhus, Endemic Flea-Borne

Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis affecting medium- or small-sized arteries. Its diagnosis may be delayed because it is a rare disease, and patients presenting with PAN demonstrate variable clinical manifestations and non-specific laboratory abnormalities. Gastrointestinal involvement occurs in 14~65% of patients with PAN and is a significant cause of morbidity and mortality. Thus, early diagnosis is very important in PAN with gastrointestinal involvement. We report two cases of rapidly progressive PAN presenting with abdominal pain, having failed conservative treatment.
Abdominal Pain* ; Arteries ; Diagnosis ; Early Diagnosis ; Humans ; Mesenteric Artery, Superior* ; Mortality ; Polyarteritis Nodosa* ; Rare Diseases ; Vasculitis

Systemic capillary leak syndrome (SCLS) is an unusual entity characterized by hypovolemic shock, hemoconcentration, and hypo-albuminemia associated with paraproteinemia as a result of marked capillary hyperpermeability. Complications of this syndrome can include compartment syndromes, pulmonary edema, thrombosis, and acute kidney injury. This paper reports a case of severe SCLS accompanied by acute tubular necrosis caused by hypoperfusion and myoglobinuria secondary to rhabdomyolysis, which resulted in chronic kidney disease that necessitated hemodialysis. However, there have been rare data of residual end-organ damage after acute attacks in Korea. Therefore, this paper reports a case of complicated SCLS enough to hemodialysis and that developed into chronic kidney disease.
Acute Kidney Injury ; Capillaries ; Capillary Leak Syndrome ; Compartment Syndromes ; Kidney Failure, Chronic ; Korea ; Myoglobinuria ; Necrosis ; Paraproteinemias ; Pulmonary Edema ; Renal Dialysis ; Renal Insufficiency, Chronic ; Rhabdomyolysis ; Shock ; Thrombosis

STUDY DESIGN: Retrospective study. PURPOSE: To more accurately determine the incidence and clarify risk factors. OVERVIEW OF LITERATURE: Superior mesenteric artery syndrome is one of the possible complications following correctional operation for scoliosis. However, when preliminary symptoms are vague, the diagnosis of superior mesenteric artery syndrome may be easily missed. METHODS: We conducted a retrospective study using clinical data from 118 patients (43 men and 75 women) who underwent correctional operations for scoliosis between September 2001 and August 2007. The mean patient age was 15.9 years (range 9~24 years). The risk factors under scrutiny were the patient body mass index (BMI), change in Cobb's angle, and trunk length. RESULTS: The incidence of subjects confirmed to have obstruction was 2.5%. However, the rate increased to 7.6% with the inclusion of the 6 subjects who only showed clinical symptoms of obstruction without confirmative study. The BMI for the asymptomatic and symptomatic groups were 18.4+/-3.4 and 14.6+/-3, respectively. The change in Cobb's angle for the asymptomatic and symptomatic groups were 24.8+/-13.6degrees and 23.4+/-9.1degrees, respectively. The change in trunk length for the asymptomatic and symptomatic groups were 2.3+/-2.1 cm and 4.5+/-4.8 cm, respectively. Differences in Cobb's angle and the change in trunk length between the two groups did not reach statistical significance, although there was a greater increase in trunk length for the symptomatic group than for the asymptomatic group. CONCLUSIONS: Our study shows that the incidence of superior mesenteric artery syndrome may be greater than the previously accepted rate of 4.7%. Therefore, in the face of any early signs or symptoms of superior mesenteric artery syndrome, prompt recognition and treatment are necessary.
Body Mass Index ; Humans ; Incidence ; Male ; Mesenteric Artery, Superior ; Retrospective Studies ; Risk Factors ; Scoliosis ; Superior Mesenteric Artery Syndrome