This study was performed to observe the therapeutic effects of interferon-gamma(IFN-gamma) and gamma-globulin(gamma-globulin) in experimental Pneumocystis carinii pneumonia of immune suppressed mice. After 9 weeks, trimethoprim-sulfamethoxazole(TMP-SMZ; 10-50 mg/mouse/day), mouse IFN-gamma(5 x 10(4) units/mouse/day) and mouse gamma-globulin(20 mg/mouse/day) were administered to the mice for 3 weeks by the experimental group. The therapeutic efficacy was evaluated by body weights, histopathologic and electron microscopic findings of the lungs, and number of P. carinii cysts by Gomori's methenamine silver stain. Body weights of the mice were significantly increased in the group of combination therapy of TMP-SMZ with IFN-gamma or gamma-globulin, and in the group of TMP-SMZ treatment (p < 0.05), however, little effect was found in the group of gamma-globulin alone. Histopathologic findings of P. carinii pneumonia were much improved in the group of combination therapy of TMP-SMZ with IFN-gamma. Treatment with either TMP-SMZ or IFN-gamma significantly reduced the number of cysts in the P. carinii pneumonia, but gamma-globulin alone was ineffective. In electron microscopic findings of P. carinii pneumonia, the number of trophozoites and cysts were reduced by treatment with either TMP-SMZ or IFN-gamma, and most of the cysts were empty or containing one or two intracystic bodies. The present results suggested, that combination therapy of TMP-SMZ with IFN-gamma had synergistic effects in treatment of P. carinii pneumonia in experimental mice.
Drug-Synergism ; Drug-Therapy,-Combination ; English-Abstract ; Gamma-Globulins-administration-and-dosage ; Interferon-Type-II-administration-and-dosage ; Mice- ; Trimethoprim-Sulfamethoxazole-Combination-administration-and-dosage ; *Gamma-Globulins-therapeutic-use ; *Interferon-Type-II-therapeutic-use ; *Pneumonia,-Pneumocystis-carinii-therapy ; Gamma-Globulins ; Trimethoprim-Sulfamethoxazole-Combination ; Interferon-Type-II

BACKGROUND: This study was conducted to explore the prevalence of and the factors affecting constipation in elementary school students in urban and rural areas. METHODS: Study subjects were 585 grade 5 and 6 students. We conducted self-administered questionnaires during October, 2009. Outcome measure was the prevalence of constipation evaluated by the Rome III Diagnostic criteria for functional constipation. Independent variables were gender, grade, residence, mother's employment status, self-rated health status, number of family members, bowel movement habit, and health behavior (nutrition, exercise, and stress). RESULTS: The multiple logistic regression analysis showed that females, grade 5 students, those with working mothers, and those physically inactive reported having constipation significantly more often. CONCLUSIONS: Our study revealed that the female gender, increasing age, mother's employment status, and physical inactivity were risk factors for constipation in elementary school students. To improve bowel function in children, health education programs and school health promotion programs targeting healthy life habits should be implemented.
Child ; Constipation* ; Employment ; Female ; Health Behavior ; Health Education ; Humans ; Logistic Models ; Mothers ; Outcome Assessment (Health Care) ; Prevalence* ; Risk Factors ; School Health Services ; Surveys and Questionnaires

No accepted standard currently exists to classify asphyxia and define its subtypes. Sauvageau and Boghossian proposed an asphyxia classification system in 2010 that divided asphyxia into suffocation, strangulation, mechanical asphyxia, and drowning. Here, we present a modification of this classification system. We propose to classify asphyxia into four main categories: suffocation, strangulation, mechanical asphyxia, and complicated asphyxia. Suffocation includes smothering and choking as well as confined spaces, entrapment, and vitiated atmosphere. Strangulation is subdivided into hanging, ligature strangulation, manual strangulation, and other unspecified strangulation. Mechanical asphyxia includes positional and traumatic asphyxia. Finally, complicated asphyxia is defined as cases with two or more identifiable mechanisms of asphyxia. In this study, we review autopsy cases from 2012 diagnosed as asphyxia and classify them according to our proposed asphyxia classification system. In 24.7% of cases, the age range was 40-49 years, and 51.9% were men. The most common method of asphyxia was hanging (245 cases, 55.1%), followed by ligature or manual strangulation (53 cases, 11.9%). Most hangings were suicides; smothering, ligature, and manual strangulation were usually homicides. Eighteen cases were complicated asphyxia. This classification provides a simplified, unified, and useful tool to classify and understand deaths due to asphyxia.
Airway Obstruction ; Asphyxia* ; Atmosphere ; Autopsy* ; Classification* ; Confined Spaces ; Drowning ; Homicide ; Humans ; Korea* ; Ligation ; Male ; Suicide

PURPOSE: To evaluate the incidence and CT findings of the medial depression and bony dehiscence of lamina papyracea as an anatomic variation. MATERIAL AND METHODS: 1472 PNS CTs of the patients with symptoms of chronic sinusitis were retrospectively evaluated. RESULTS: The total incidence of depressed lamina papyracea as an anatomic variation was 3.5%(52/1472) on PNS CT. There was a statistically significant correlation between the increasing age and the incidence of delamina papyracea. Depression of lamina papyracea anterior to the basal lamella were more common those of the posterior depression. Associated findings were herniation of adjacent fatty tissue in all cases and the roedial bowing and hypertrophied configuration of the medial rectus muscle without significant herniation in 19 cases(34%). CONCLUSION: Nontraumatic, asymptomatic depression with bony dehiscence of lamina papyracea as an anatomic variation is not uncommon with the incidence of 3.5%. Recognition of its existence and degree may helpful in avoiding various ocular complication during ethmoid surgery.
Adipose Tissue ; Anatomic Variation* ; Depression* ; Humans ; Incidence ; Retrospective Studies ; Sinusitis

PURPOSE: To evaluate the incidence and the site of osteomas and their relation to sinonasal inflammation. MATERIALS AND METHODS: 1578 PNS computed tomography (CT) of patients with symptoms of sinusitis were evaluated and correlation with plain radiographic finding was done. RESULTS: The total incidence of osteomas was 0.82%(13/1578) on plain radiography and 3.29% (52/1578) on CT. Fifty-seven osteomas were found in 1578 PNS CT, including 2 osteomas in 5 cases. The most common site was the ethmoid sinus(54%, 31/57) and the next was the frontal sinus(35%, 20/57) on CT. Forty-five osteomas (78.9%) were associated with the sinonasal inflammatory change. CONCLUSION: The total incidence of osteomas from our results was higher than previous reports. And based on the analysis of CT, the most common site was not the frontal sinus as all the previous reports stated, but the ethmoid sinus, probably by virtue of high resolution of CT and/or higher prevalence of inflammation in the ethmold sinus.
Ethmoid Sinus ; Frontal Sinus ; Humans ; Incidence ; Inflammation ; Osteoma* ; Prevalence ; Radiography ; Sinusitis ; Virtues

Here we report an autopsy case of diabetic ketoacidosis (DKA) with severe hypertriglyceridemia (12,900 mg/dl). A 29-year-old woman with a history of type 1 diabetes was found dead at a motel. There was no injury on external inspection, but a lump of cheese-like material was noted in the heart at autopsy and peripheral blood plasma had a creamy appearance. After postmortem biochemical analysis, we made a diagnosis of DKA with severe hypertriglyceridemia and concluded that these unusual autopsy findings were caused by DKA and postmortem change. Uncontrolled diabetes often causes DKA and hypertriglyceridemia. To the best of our knowledge, this is the first report in Korea of DKA with severe hypertriglyceridemia diagnosed by autopsy.
Adult ; Autopsy* ; Diabetic Ketoacidosis* ; Diagnosis ; Female ; Heart* ; Humans ; Hypertriglyceridemia* ; Korea ; Plasma ; Postmortem Changes

BACKGROUND: We evaluated the clinical usefulness of the quick Sepsis-Related Organ Failure Assessment (qSOFA) score (based on the 2016 definition of sepsis) at intensive care unit admission in Korean patients with bacteremia. METHODS: We retrospectively analyzed clinical data from 236 patients between March 2011 and February 2016. In addition to the qSOFA, the Modified Early Warning score (MEWS) and systemic inflammatory response syndrome (SIRS) criteria were calculated. RESULTS: The patients' median age was 69 years, and 61.0% were male. Of the patients, 127 (53.8%) had a qSOFA score ≥2 points. They had significantly higher rates of septic shock, thrombocytopenia, and hyperlactatemia, and increased requirements for ventilator care, neuromuscular blocking agents, vasopressors, and hemodialysis within 72 hours after intensive care unit admission. They also had a significantly higher 28-day mortality rate. When analyzed using common thresholds (MEWS ≥5 and ≥2 SIRS criteria), patients with a MEWS ≥5 had the same results as those with a qSOFA score ≥2 (P < 0.05). However, patients with ≥2 SIRS criteria showed no significant differences. CONCLUSIONS: Our results show that a qSOFA score ≥2 at admission is a useful screening tool for predicting disease severity and medical resource usage within 72 hours after admission, and for predicting 28-day mortality rates in patients with bacteremia. In addition, qSOFA scores may be more useful than SIRS criteria in terms of prognostic utility.
Bacteremia* ; Critical Care* ; Humans ; Hyperlactatemia ; Intensive Care Units* ; Korea* ; Male ; Mass Screening ; Mortality ; Neuromuscular Blocking Agents ; Prognosis ; Renal Dialysis ; Retrospective Studies ; Sepsis ; Shock, Septic ; Systemic Inflammatory Response Syndrome ; Thrombocytopenia ; Ventilators, Mechanical

PURPOSE: A number of drugs are capable of changing body weight as a side effect. A number of neurotransmitter systems acting in several hypothalamic nuclei are pivotal to the storage regulation of body fat. Leptin is a protein encoded by the ob gene that is expressed in adipocyte. It regulates eating behavior by activating the action to the satiety center in the hypothalmus. The purpose of this study is to investigate the changes of serum leptin in children with epilepsy. METHODS: Serum leptin levels were measured in 43 epileptic patients (30 males, 13 females) receiving valproate or carbamazepine by radioimmunoassay. Thirty patients (19 males, 11 females, 10.0+/-5.0 years of age) were treated with valproate (VPA group) and 13 patients (11 males, 2 females, 9.1+/-4.0 years of age) were treated with carbamazepine (CBZ group). Obesity index and body mass index were calculated before and during anticonvulsant medications. RESULTS: 1) Body mass indices were significantly increased after VPA or CBZ medication; from 17.24+/-2.74 to 18.47+/-2.60 in VPA group, from 16.77+/-1.69 to 17.43+/-3.01 in CBZ group. 2) Obesity indices were increased without statistical significance after medication in both group. 3) Serum leptin levels were significantly higher in VPA group (4.54+/-4.77ng/ml) than CBZ group (2.47+/-2.26ng/ml). CONCLUSION: Body weight gain after VPA medication in susceptible individual might be related to a certain mechanism that elevates serum leptin level.
Adipocytes ; Adipose Tissue ; Body Mass Index ; Body Weight ; Carbamazepine ; Child* ; Epilepsy ; Feeding Behavior ; Female ; Humans ; Leptin* ; Male ; Neurotransmitter Agents ; Obesity ; Radioimmunoassay ; Valproic Acid ; Weight Gain

PURPOSE: The purpose of this study was to describe nurses' experiences of accidents in patient safety. METHODS: Data were collected from October 8, 2011 to January 31, 2012 through in-depth interviews with seven nurses who had worked on wards or in the ICU in a university hospital. Data were analyzed by applying Colaizzi's phenomenological methodology. RESULTS: The following six categories were extracted: Fear of the patient's condition caused by the accident, Conflict in the accident report, Blame on others and circumstances, Feeling guilty and sorry as the patient's condition is improving, Being disappointed with the unfavorable atmosphere in dealing with the accident, After the accident, being sensitive in performing nursing duties and being faithful to the principles. CONCLUSION: The results indicate that the organizational culture in the hospital related to accidents in patient safety is still closed and punitive, and such an atmosphere causes nurses to feel seriously hurt, but through this experience nurses are likely to mature as nursing professionals. Programs on prevention of accidents in patient safety and a system to guard against these accidents should be established. Also the organizational safety culture should be improved.
Atmosphere ; Humans ; Methods ; Nursing ; Organizational Culture ; Patient Safety*

PURPOSE: Simulation-based learning has become a powerful method to improve the quality of care and help students meet the challenges of increasingly complex clinical practice settings. The purpose of this study was to identify the learning effects using high-fidelity SimMan and multi-mode simulation. METHODS: Participants in this study were 38 students who were enrolled in an intensive course for a major in nursing at R college. Collected data were analyzed using Chi-square, t-test, and independent t-test with the SPSS 18.0 for Windows Program. RESULTS: There were no statistically significant differences in learning effects between high-fidelity SimMan and multi-mode simulation group. However, skills in clinical performance in the high-fidelity SimMan group were higher than in the multi-mode group (p=.014), communication in clinical performance in multi-mode simulation group was higher than in the high-fidelity SimMan group (p<.001). CONCLUSION: Multi-mode simulation with a standardized patient is an effective learning method in many ways compared to a high-fidelity simulator. These results suggest that multi-mode simulation be offered to students in nursing colleges which cannot afford to purchase a high-fidelity simulator, or offered as an alternative.
Adult ; Education, Nursing, Baccalaureate ; Emergency Medical Services ; Female ; Heart Arrest/*nursing ; Humans ; Learning ; Male ; Manikins ; *Patient Simulation ; Students, Nursing/psychology