Typhlitis or neutropenic enterocolitis is a life-threatening, necrotizing process of the cecum whose incidence is increasing. Typhlitis presents as fever, abdominal pain, and diarrhea in neutropenic patients. As the incidence of typhlitis increases, emergency physicians must be aware of this rapidly progressive and potentially fatal disease. The definitive management of typhlitis is controversial. The most prudent course for the emergency physician is to initiate aggressive medical management early in the ED. We describe a 25-year-old man with severe neutropenia presented to the emergency department with fever, abdominal pain, diarrhea that began 2days earlier. Abdominal computerized tomography(CT) demonstrated diffuse concentric thickening of the cecal wall, intramural edema, inflammatory bowel changes but no free air and abscess formation. He was recovered by early diagnosis and aggressive medical therapy. We report a case of typhlitis with literature reviews.
Abdominal Pain ; Abscess ; Adult ; Cecum ; Diarrhea ; Early Diagnosis ; Edema ; Emergencies* ; Emergency Service, Hospital ; Enterocolitis, Neutropenic ; Fever ; Humans ; Incidence ; Neutropenia ; Typhlitis*

BACKGROUND: We compared factors associated with self-reported depression and, in particular, diagnosis and treatment of depressive symptoms in Korean adults. METHODS: The sample included 13,306 adults aged 19 years or older from the 2010 and 2011 Korea National Health and Nutrition Examination Survey (KNHANES V). Data were applied to the chi2 test and multivariate logistic regression analysis. RESULTS: The following characteristics of individuals are significantly associated with self-reported depression: female (vs. male, OR [odds ratio]=3.35), ages 50-59 years (vs. 60+, OR=1.45), economic status (low vs. high, OR=1.35; middle-low vs. high OR=1.29), unemployed (vs. employed, OR=1.23), education (elementary vs. college, OR=1.18; middle school vs. college, OR=1.27; vs. high school vs. college, OR=1.18), current smoking (vs. no, OR=1.19), high-risk alcohol consumption (vs. no, OR=1.18), perceived health (good vs. very good/excellent, OR=1.156; poor/fair vs. very good/excellent, OR=2.65), chronic disease (vs. no, OR=1.26), activity limitation due to health problems (vs. no, OR=1.74), and being in a sickbed during the past month (vs. not in a sickbed, OR=1.69). Living in a metropolitan area (vs. rural, OR=1.40) is significantly associated with greater odds of being diagnosed with depression. The odds of being treated for depression are lower for female (vs. male, OR=0.53). Greater odds of being treated for depression was seen for those with chronic conditions (vs. no, OR=1.73) and activity limitation due to health problems (vs. no, OR=2.05), as well as, those in a sickbed (vs. not, OR=1.88). CONCLUSIONS: Applying our findings, policy makers should address the lower rates of depression diagnosed in non-metropolitan areas to reduce regional variations, and also promote treatment in females.
Administrative Personnel ; Adult* ; Alcohol Drinking ; Chronic Disease ; Depression* ; Diagnosis* ; Education ; Female ; Humans ; Korea ; Logistic Models ; Male ; Nutrition Surveys ; Smoke ; Smoking

Isolated infernal iliac artery aneurysms and rupture are relatively infrequent, often difficult to detect and therefore rarely considered in the differential diagnosis for abdominal pain. The consequences can be grave, The incidence of isolated iliac artery aneurysm is 1~2% of that of abdominal aortic aneurysm(AAA). The natural history is of gradual enlargement, with rupture the most common clinical presentation. The signs and symptoms of such an aneurysm are influenced by its concealed location within the bony pelvis. Awareness of these special characteristics improves the chances of early diagnosis and proper surgical treatment before possible rupture. Here is a case of ruptured aneurysm of left internal iliad artery. A 73-year-old man was presented to our emergency center with severe abdominal pain and voiding difficulty Abdominal Computed Tomography(Cf) and angiography showed ruptured aneurysm of left infernal iliad artery. Emergency operation was successfully performed for the ruptured internal iliad artery aneurysm.
Abdominal Pain ; Aged ; Aneurysm* ; Aneurysm, Ruptured ; Angiography ; Arteries ; Diagnosis, Differential ; Early Diagnosis ; Emergencies ; Humans ; Iliac Artery* ; Incidence ; Natural History ; Pelvis ; Rupture ; Rupture, Spontaneous*

No abstract available.
Career Choice* ; Humans

BACKGROUND: Hypothermia is a condition that can lead to serious complications and even to death in newborn. Although the temperature control is essential in neonatal care, it is often neglected during urgent transfer from local private hospitals. The purpose of this study is to evaluate the incidence and clinical outcomes of transfer induced neonatal hypothermia. SUBJECTS AND METHOD: In this retrospective study, subject is limited to transferred outborn babies with age less than 24 hours from June 1996 to May 1999. A total of 3,086 patients were admitted in NICU during the study period and inborn and outborn babies were 1,743(56%) and 1,343(44%) respectively. Among the 1,343 outborn babies, 212 babies were transferred from the private hospital within 24 hours of birth and were eligible for the study. Rectal temperature on arrival, transfer time, birth weight, gestational age, initial arterial gas study, and clinical outcome were compared. Statistical analysis has been done with chi-sqaure test and multiple logistic regression analysis. RESULTS: There were 84 cases(39.6%) hypothermia(<36degrees C> among the 212 babies and the rate of hypothermia in transfered babies have not decreased over the study period. There were significantly more hypothermia in lower gestational age (less than 28 weeks) and lower birth weight (less than 2,000gm) caused hypothermia significantly more than normal gestational age or normal range of birth weight. And time interval (less than 12 hour) from birth to arrival at emergency department was also significant factor in hypothermia. The mortality rate was three fold higher in hypothermia than normothermic or hyperthermic babies. CONCLUSION: This study shows that hypothermia during neonate transportation is a major cause of neonatal mortality and morbidity in prehopital care. Body temperature control during transport of neonates under 24 hours of age should be emphasized for the better outcome of treatment.
Birth Weight ; Body Temperature ; Emergency Service, Hospital ; Gestational Age ; Hospitals, Private ; Humans ; Hypothermia* ; Incidence ; Infant ; Infant Mortality ; Infant, Newborn* ; Logistic Models ; Mortality ; Parturition ; Reference Values ; Retrospective Studies ; Transportation*

No abstract available.
Fetal Development* ; Pregnancy*

No abstract available.
Asthma*

Total anomalous pulmonary venous return(connection) is a congenital heart disease. Especially, the reports of the patients with double connections of all pulmonary veins were rare. An infant who underwent operation for total anomalous pulmonary venous return had double drainge of all pulmonary veins to both left vertical vein and anomalous descending vein. This second lesion was not diagnosed preoperatively, but in operative field. Operative treatments were performed by ligation of left vertical vein and central pulmonary vein-to-left atrium anastomosis without ligation of the descending anomalous vein. For these less common variants fo total anomalous pulmonary venous return,a more detailed and precise understanding of morphology can facilitate accurate surgical repair. And also, early detection of the disease is an another issue for a good prognosis.
Heart Defects, Congenital ; Humans ; Infant ; Ligation ; Prognosis ; Pulmonary Veins ; Scimitar Syndrome* ; Veins

OBJECTIVES: The present study was intended to assess the mental health of nurses working for university hospitals and to establish which factors determine their mental health. METHODS: Self-administered questionnaires were given to 1,486 nurses employed in six participating hospitals located in Daejeon City and Chungnam Province between July 1st and August 31st, 2006. The questionnaire items included sociodemographic, job-related, and psychosocial factors, with job stress factors (JCQ) as independent variables and indices of mental health status (PWI, SDS and MFS) as dependent variables. For statistical analysis, the Chi-square test was used for categorical variables, with hierarchical multiple regression used for determining the factors effecting mental health. The influence of psychosocial and job-related factors on mental health status was assessed by covariance structure analysis. The statistical significance was set at p<0.05. RESULTS: The factors influencing mental health status among subject nurses included sociodemographic characteristics such as age, number of hours of sleep, number of hours of leisure, and subjective health status; job-related characteristics such as status, job satisfaction, job suitability, stresses such as demands of the job, autonomy, and coworker support; and psychosocial factors such as self-esteem, locus of control and type A behavior patterns. Psychosocial factors had the greatest impact on mental health. Covariance structure analysis determined that psychosocial factors affected job stress levels and mental health status, and that the lower job stress levels were associated with better mental health. CONCLUSIONS: Based on the study results, improvement of mental health status among nurses requires the development and application of programs to manage job stress factors and/or psychosocial factors as well as sociodemographic and job-related characteristics.
Adult ; Age Factors ; Health Behavior ; *Hospitals, University ; Humans ; Job Satisfaction ; Korea/epidemiology ; *Mental Health ; Nurses/*psychology ; Socioeconomic Factors ; Stress, Psychological/*psychology ; Workplace/psychology

: In order to observe the antigenic fractions in saline extract of adult Paragonimus westermani, proteins in the crude extract were separated by sodium dodecyl sulfate-polyacylamide gel electrophoresis (SDS-PAGE) in reducing conditions. The separated protein fractions were transferred to nitrocellulose paper on which 20 sera from human paragonimiasis were reacted and immunoblotted. Out of 15 stained protein bands in SDS-PAGE, 7 reacted with the sera. Of 14 reacted bands, 30 kilodalton(kDa) band was the most frequently reacted (95%) and was a strong antigen. Protein bands of 23 and 46 kDa were also strong antigens. Bands of over 150 kDa, 120 kDa, 92 kDa, 86 kDa, 74 kDa, 62 kDa, 51 kDa, 32 kDa, 28 kDa, 16.5 kDa and 15.5 kDa were also reactive but their frequencies of the reaction were variable.
parasitology-helminth-trematoda ; Paragonimus westermani ; immunology ; antigen ; electrophoresis