To determine effects of the direction of the rotational work shifting on the circadian rhythm and adaptation of physiological and psychological components were investigated with nursing students. Two groups of seven volunteers participated as experimental subjects, and eight nursing students participated as a control group. The directions of rotation work shift were as follows : CW(clockwise)-shift system rotation in the direction of day shift(3 lays), evening shift(3days), off duty(1day) and night shift(5days). and CCW(counterclockwise)-shift system rotation in the reverse direction. Urinary free cortisol and 17-hydroxycorticoster oids in the urine were measured by the solid-phase radioimmunoassay and the colorimetry methods, re spectively. Plasma melatonin was measured by radioimmunoassay. The urinary free cotisol rhythm changed to ir-regular on the evening and night shift in the CCW shift system, whereas the rhythm seems to adapt on night shift in the CW shift system. The daily rhythms of urinary 17-OHCS indicate that they are well synchronized to shift work. These results show that the rotation of shift in the CW direction is more acceptable in terms of the adaptation of hormonal rhythms. These results indicate that the CCW rotation of shift work makes it more difficult for the workers to adapt on a physiological level, and has many more negative effects on nurses when compared with the CW rotation. Thus, a clockwise rotating shift systern seems to be more desirable for the optimal health and performance of nurses.
Circadian Rhythm* ; Colorimetry ; Humans ; Hydrocortisone* ; Melatonin ; Plasma ; Radioimmunoassay ; Students, Nursing ; Volunteers

A 70 year old male patient experienced a sudden visual acuity decrease in his left eye below 0.1 with preretinal, retinal and subretinal hemorrhage after excessive sexual activity. Four months later, his vision improved in the affected eye without any treatment. Eight months later, there was an area of organized sugbretinal hemorrhage remained around vascular arcade. We report this case with case review.
Aged ; Hemorrhage ; Humans ; Male ; Retinaldehyde ; Sexual Behavior* ; Visual Acuity

The clinical entity of Dysplasia Epiphyseal Multiplex was first descrihed by Fairbank in 1935, characterized by the disturbance of endochondral ossification in hoth epiphyseal centers and regions of physeal growth. It manifests itself radiologically as late appearance and mottling of the ossification centers and clinically as short stature, stubby digits and painful stiffness of multiple joints. It is typically transmitted as an autosomal dominant trait though recessive forms have been described. The spine is normal apart from a mild increased lumbar lordosis. Many patients are referred to an orthopaedic surgeon for bilateral Perthes disease, as was one of the authors cases. This Paper reports four cases of multiple epiphyseal dysplasia which affected one family.
Animals ; Hip ; Humans ; Joints ; Knee ; Legg-Calve-Perthes Disease ; Lordosis ; Osteochondrodysplasias* ; Spine

No abstract available.
Shock, Septic*

PURPOSE: The modified triple test (MTT; physical examination, ultrasonography, and fine-needle aspiration cytology) for palpable breast masses yielded 100% diagnostic accuracy when all 3 components were concordant (all benign or all malignant) in our previous study. However, about 30% of cases were discordant and required open or core needle biopsy. This study is designed to evaluate the modified triple test by scoring system, based on our experience, and to develop a method to further limit the need for surgical biopsy of discordant cases. METHODS: The MTT was performed in 175 palpable breast masses of 166 female patients between August 1998 and June 2001 at the Outpatient Clinic, Department of Surgery, Chungbuk National University Hospital. Each component of the MTT was assigned 1, 2, or 3 points for a benign, suspicious, or malignant result, respectively, yielding a total modified triple test score (MTTS) from 3 to 9 points, and 25 cases with 3 points of MTTS were clinically followed up without histological confirmation. RESULTS: Among 175 cases, concordant cases were 120 (68.6%); benign cases was 66 (37.7%), and malignant cases were 54 (30.8%). Concordant cases had 100% of diagnostic accuracy, sensitivity, and specificity. Among the 25 cases of benign concordant (MTTS 3 points), no case was proved to be malignant through clinical follow-up observation. Total discordant cases were 55 (31.4%); 15 cases of 4 points (8.6%), 11 cases of 5 points (6.3%), 4 cases of 6 points (2.3%), 18 cases of 7 points (10.3%), 7 cases of 8 points (4.0%). In each discordant group, 0 cases of 4 points (0%), 2 cases of 5 points (18.2%), 3 cases of 6 points (75%), 15 cases of 7 points (83.8%), and 7 cases of 8 points (100%) were proved to be malignant by histologic confirmation. Aspiration cytology has the highest specificity and positive predictive value of the 3 MTT components. CONCLUSION: Palpable breast masses that score 3 or 4 points by MTTS are benign and could be clinically followed up, and masses that score 8 or 9 points are malignant and should undergo defiitive therapy. Confirmatory biopsy might be applied on only 20% of the masses the reserve MMTTS of 5, 6, and 7 points.
Ambulatory Care Facilities ; Biopsy ; Biopsy, Fine-Needle ; Biopsy, Large-Core Needle ; Breast* ; Chungcheongbuk-do ; Diagnosis* ; Female ; Follow-Up Studies ; Humans ; Physical Examination ; Prospective Studies* ; Sensitivity and Specificity ; Ultrasonography

Fusariosis is a rare infectious disease caused by species of the genus Fusarium that has been increasingly documented as an emerging agent of opportunistic infections in immunocompromised patients and, occasionally, immunocompetent hosts. We describe an 18-year-old Korean male, previously diagnosed as acute lymphocytic leukemia, presented with 2~4 cm-sized erythematous to necrotic papulonodules on the trunk and extremities for a week. White blood cell count was 200 cells/L and biopsy specimen showed structures resembling fungal elements in the dermis and subcutaneous fat. Cultures from a biopsy sample growing whitish cottony colonies contained fusoid multiseptated macroconidia. He was diagnosed as fusariosis and treated with intravenous amphotericin B. But white blood cell count and clinical symptoms didn't improve and he was expired after 6 days of treatment.
Adolescent ; Amphotericin B ; Biopsy ; Communicable Diseases ; Dermis ; Extremities ; Fusariosis ; Fusarium* ; Humans ; Immunocompromised Host ; Leukocyte Count ; Male ; Opportunistic Infections ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Subcutaneous Fat

Malignant schwannoma is a relatively rare malignant neoplasm arising from schwann cell of neuroectodermal origin that infiltrate locally and widely, and metastases. Inreaosseous bone involvement or retroperitoneal location of this tumor is extremely rare. A rare case of solitary malignant schwannoma which originated in the sacrum and extended to the retroperitoneal space in a 34 year-old male without neurofibromatosis reported. Simple X-ray showed not sclerotic, smooth marginated lytic defect in the right sacral bone. Computed tomography(CT) of sacrum revealed homogenous soft mass with intraosseous and dumbel shaped retroperitoneal extension without enhancement after were appeared in serial iliac artery angiogram. We could remove the tumor mass without specific technical difficulty with the help of CT and angiographic findings.
Adult ; Humans ; Iliac Artery ; Male ; Neoplasm Metastasis ; Neural Plate ; Neurilemmoma* ; Neurofibromatoses ; Retroperitoneal Space ; Sacrum*

Central retinal vein occlusion(CRVO) and branch retinal vein occlusion(BRVO) are the most common retinal vascular diseases. Althouht the pathogenesis of these two dieseases are different, the clinical features are similiar. In this paper, we studied on several factors such as sex, age, laterality, refractive error, intraocular pressure(IOP) and, systemic diseases(56 eyes of CRVO group and 128 eyes of BRVO group). In BRVO hroup, female, above 50 years old, bilaterality and hyperopia(above +3.0D) are more frequent than in CRVO group. In CRVO group, high IOP and below 40 years old are more frequent than in BRVO group. The hing incidence of female in BRVO group(P=0.034) and the high incidence of high IOP in CRVO group(P=0.011) are statistically significant. Diabetes melitus, glucose intolerance, tuberculosis, and syphilis are more frequently associated in CRVO group than in BRVO group, whereas hypertension and heart disease are more frequently associated in BRVO group. An abnormal level in CRP, VDRL and PTT are higher in CRVO group than in BRVO. On the other hand, the incidences of abnormal lipid profile, Hb A2 fraction and RA are higher in BRVO group than in CRVO. In cases of CRVO, the incidence of hypertension is higher in patients of 50 years old or older than in patients do 49 years old or younger, In cases of BRVO, the incidence of heart disease in patients of 50 years old or older is higher than in patients of 49 years old or younger, which both diseases are statistically significant(P<0.05).
Adult ; Female ; Glucose Intolerance ; Hand ; Heart Diseases ; Humans ; Hypertension ; Incidence ; Middle Aged ; Refractive Errors ; Retinal Vein* ; Retinaldehyde* ; Risk Factors* ; Syphilis ; Tuberculosis ; Vascular Diseases

The combination of an intradermal nevus with epidermal cyst or other adnexal tumors has often been described since 1952. Most of these reports have involved the coexistence of common epidermal cysts and melanocytic nevi. Herein, we report a 21-year-old Korean male, who initially presented to our department with a rapidly enlarging preexisting nevus on his back. The mass was surgically excised and histopathologically showed intradermal nevus combined with epidermal cyst.
Epidermal Cyst ; Humans ; Male ; Nevus ; Nevus, Intradermal ; Nevus, Pigmented ; Young Adult

BACKGROUND: Both the Korean Society of Infectious Diseases and The Korean Center for Diseases Control recommended MMR (measles, mumps, rubella) vaccination to health care workers (HCWs) but this had rarely been applied mainly due to economic reasons. In this paper, we report a measles outbreak initiated by two inpatients and then spread to other nine infants and three HCWs. We also report that this outbreak was successfully contained by active infection control measures. METHODS: Measles cases were determined according to CDC clinical criteria and confirmed by the level of the measles-specific IgM antibody. Suspected patients were isolated in aeration-limited areas. After measles cases in HCWs were detected, people in 26 pediatric wards were screened for measles-specific IgG antibody. MMR (measle, rubella, mumps) vaccination was applied to HCWs who were negative for measles-specific antibodies or HCWs who were exposed but not sure of their vaccination status. RESULTS: From April 21 to June 4 in 2007, measles-infected patients consisted of eleven infants (11 months old in median age) and three HCW women. Antibody screening revealed that only 73% (19 out of 26) in pediatric wards were positive for measles-specific IgG. After a medical doctor was confirmed as measles-infected, health care worker exposed to measles patients were all vaccinated without antibody test. CONCLUSION: The precise level of anti-measles antibody in adults has to be revealed by further studies involving multiple organizations. This result could be helpful for establishing a proper health care policy of MMR vaccination.
Adult ; Antibodies ; Centers for Disease Control and Prevention (U.S.) ; Communicable Diseases ; Delivery of Health Care ; Disease Outbreaks ; Female ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Infant ; Infection Control ; Inpatients ; Mass Screening ; Measles ; Mumps ; Rubella ; Tertiary Care Centers ; Vaccination