BACKGROUND: In the most of emergency department, the diagnosis of appendicitis has been carried by clinical history, physical examination and plain X-ray. But the diagnostic accuracy by these methods was so low that unnecessary operation was common performed, and sometimes the operation was delayed till the physicians could confirm the acute appendicitis clinically. Although many kinds of diagnostic tools such as CT scan, laparoscope, and etc, we believe that ultrasonography(US) would be a quick and sensitive diagnostic method for the evaluation of acute appendicitis in the Emergency Department. METHODS: Forty-seven patients who were clinically suspected as acute appendicitis were evaluated with the grayscaled US by emergency physician. The probe of US was placed on maximal tender point of abdomen, and the appendix image was evaluated while probe was pressed deeply and gentry. When the blind loop was fecund at maximal tender point of abdomen, we evaluated the diameter of appendix, the presence of compressibility, peri-aspen-diceal fluid collection and other mass effect. As soon as the ultrasonographic evidences of the appendicitis were noticed, the operations were done and pathologic report were reviewed later. RESULTS: Among the forty-seven patients, forty patients were diagnosed as a appendicitis by US, and most common ultrasonic findings were as follows; 1) non-compressible blind loop larger than 5 mm in diameter, 2) wall thickening more than 3 mm, 3) peri-appendiceal fluid collection, 4) periappendiceal mass. Among remaining 7 patients in whom we could not get any positive findings of appendicitis, abdominal CT scan was carried in 2 cases who had direct and rebound tenderness on right lower abdomen, and CT scan showed the evidences of the appendicitis. The other 5 cases without rebound tenderness were observed far 2 hours, and abdominal pain was disappeared lately. Finally forty-two patients were operated and confirmed as acute appendicitis by pathologic reports; 24 were reported as suppurative appendicitis, and 12 cases of gangrenous appendicitis, 3 cases of perforated appendicitis, and 3 cases were peri-appendiceal abscess. The specificity of US in the diagnosis of acute appendicitis was 71.4%, and the sensitivity was 95.2%. CONCLUSIONS : In some patients suspected appendicitis, emergency physicians could diagnosis acute appendicitis accurately and rapidly by use of ultrasonography. Although the US was an actuate imaging modality to diagnosis acute appendicitis and evaluate its complications, we recommend a laparotomy or abdominal Cf scan in the patients with negative US findings in spite of presence of peritoneal irritation signs such as rebound tenderness and/or muscle guarding on right lower abdomen.
Abdomen ; Abdominal Pain ; Abscess ; Appendicitis* ; Appendix ; Diagnosis ; Early Diagnosis* ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Laparoscopes ; Laparotomy ; Physical Examination ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; Ultrasonics ; Ultrasonography*

BACKGROUND: Autoimmune hemolytic anemias are characterized by autoantibodies recognizing antigens on the Individual's own red blood cells, resulting in immune- mediated hemolysis. Blood transfusions have been regarded as hazardous in patients with autoimmune hemolytic anemia (AIHA) because of potential intensification of hemolysis and a presumed high incidence of alloimmunization. METHODS: We examined the pretransfusion and posttransfusion hemoglobin levels in 6 patients with autoantibodies in their sera, which showed panagglutinations with all bloods tested in the compatibility testing. They received 'least' incompatible blood because of inability to find compatible blood. RESULTS: When we compared pretransfusion hemoglobin level with posttransfusion hemoglobin level, in 5 of 6 patients with AIHA, the hemoglobin levels were increased after red cell transfusion. 4 patient who did not respond to transfusion therapy initially had an increase in hemoglobin level after steroid treatment. Any signs or symptoms indicating hemolytic transfusion reaction were not observed ducting the transfusion period in all patients. CONCLUSIONS: The decision to transfuse in AIHA should consider multiple factors including the patient's clinical status, the potential benefit of transfusion, the potential response to other therapeutic modalities, but must never be regarded as contraindicated, even though the compatibility test may be strongly incompatible.
Anemia, Hemolytic* ; Anemia, Hemolytic, Autoimmune ; Autoantibodies ; Blood Group Incompatibility ; Blood Transfusion ; Erythrocyte Transfusion* ; Erythrocytes* ; Hemolysis ; Humans ; Incidence

BACKGROUND: Autoimmune hemolytic anemias are characterized by autoantibodies recognizing antigens on the Individual's own red blood cells, resulting in immune- mediated hemolysis. Blood transfusions have been regarded as hazardous in patients with autoimmune hemolytic anemia (AIHA) because of potential intensification of hemolysis and a presumed high incidence of alloimmunization. METHODS: We examined the pretransfusion and posttransfusion hemoglobin levels in 6 patients with autoantibodies in their sera, which showed panagglutinations with all bloods tested in the compatibility testing. They received 'least' incompatible blood because of inability to find compatible blood. RESULTS: When we compared pretransfusion hemoglobin level with posttransfusion hemoglobin level, in 5 of 6 patients with AIHA, the hemoglobin levels were increased after red cell transfusion. 4 patient who did not respond to transfusion therapy initially had an increase in hemoglobin level after steroid treatment. Any signs or symptoms indicating hemolytic transfusion reaction were not observed ducting the transfusion period in all patients. CONCLUSIONS: The decision to transfuse in AIHA should consider multiple factors including the patient's clinical status, the potential benefit of transfusion, the potential response to other therapeutic modalities, but must never be regarded as contraindicated, even though the compatibility test may be strongly incompatible.
Anemia, Hemolytic* ; Anemia, Hemolytic, Autoimmune ; Autoantibodies ; Blood Group Incompatibility ; Blood Transfusion ; Erythrocyte Transfusion* ; Erythrocytes* ; Hemolysis ; Humans ; Incidence

No abstract available.
Humans ; Hypothyroidism* ; Siblings*

PURPOSE: The purpose of this study was to investigate the relationships among variables of somatic attribution, chronic pain, depression and chronic fatigue in the elderly. METHODS: Empirical data for testing hypothetical models was collected from 311 people over 65 years old in a community settings in Seoul, Korea in June and July, 2000. Data were analyzed by descriptive statistics and correlational analysis using pc-SAS program. The Linear Structural Modeling(LISREL) 8.0 program was used to find the best fit model which explained causal relationship of variables. RESULT: According to Accepted model, the relation of variables is that the somatic attribution is the influencing variable to chronic pain and depression and chronic pain and depression is the influencing variable to chronic fatigue. CONCLUSION: The findings of this study give useful information to construct intervention program relating chronic pain, depression and chronic fatigue for the elderly.

No abstract available.
Humans ; Quintuplets*

The purpose of this study was to evaluate a nutrition education program designed to reduce sugar intake in preschool children. The nutritional knowledge, dietary attitude, dietary behavior, and food intake with a sweet taste in preschool children were tested before and after 4 weeks of nutrition education from March 8 to April 1, 2016. The preschool children were recruited in Dobong-gu, Seoul. The subjects were divided into two groups; educated (N=59) and non-educated group (N=40). Statistical analyseis were performed using SPSS 22. The nutritional knowledge about sweet tasting food was significantly increased (P<0.01) in the educated group and significantly decreased (P<0.01) in the non-educated group. The dietary attitude toward sweet tasting food was significantly decreased (P<0.05) in the educated group but not significantly changed in the non-educated group. The dietary behavior toward sweet tasting food was significantly decreased (P<0.05) in the educated group and significantly decreased (P<0.01) in the non-educated group. The major food sources of sugar intake were not significantly changed in either groups. The major food sources of sugar intake in the 5 years old children were yogurt products>sweetened breads>cookies/biscuits>chocolate>cereals>beverages>sweetened milk>sweet spicy chicken>Tteokbokki. Although there are some limitations in this study, due to the short length of the nutrition education and lack of active participation by the parents, the results suggest that effective nutrition education on sweet tasting food can bring about changes in nutritional knowledge as well as dietary attitude.
Child ; Child, Preschool* ; Eating ; Education* ; Humans ; Parents ; Seoul ; Yogurt

No abstract available.
Female ; Perinatal Mortality* ; Pregnancy ; Pregnancy, Multiple*

We herein report a case of occupational contact urticaria syndrome induced by cefotiam di-hydrochloride in a nurse. She had generalized pruritic wheals accompanied by palpitations and tachypnea during the preparation of cefotiam solution. A scratch patch test with cefotiam di-hydrochloride, a major component of cefotiam ingredient showed multiple erythema and wheals within 5 minutes, accompanied by palpitations and tachypnea. No delayed type reaction was observed. Based on her clinical history and scratch test result, we diagnosed her condition as contact urticaria syndrome caused by cefotiam.
Cefotiam* ; Erythema ; Patch Tests ; Tachypnea ; Urticaria*

Picky eating behavior is a significant factor in causing unhealthy eating and disturbing the growth of children. This study examined picky eating behaviors and food intake of 112 preschoolers aged 3∼5 year, picky eaters (n=41) and non-picky eaters (n=71), living in Dobong-gu, Seoul metropolitan area, South Korea.Picky eating questionnaires and three consecutive 24-hour dietary recalls were collected from their caregivers.The difference between the two groups was verified using a Chi-square test or t-test and Pearson’s correlation. Compared to the non-picky eaters, fussiness, satiety responsiveness, and refusal of food variety were significantly higher in picky eaters (P＜0.001). Compared to the non-picky eaters, an assessnent of the preschooler’s behavior and the caregivers’ perception were positively correlated in picky eaters (r=0.749, P＜0.001). The intakes of shellfish (P＜0.05), vegetables (P＜0.001), fiber, vitamin E (P＜0.01), vitamin A, and folate (P＜0.05) were significantly lower in picky eaters than the non-picky eaters. The major food sources of vitamin A and folate were vegetables, of which grains were the source of fiber, fats and oils were the source of Vitamin E, and root vegetables were source of vegetables in both picky and non-picky eaters. In conclusion, picky eating behaviors are related to different fussiness and slowness in eating. Therefore, it is suggested to increase the amount of meal and vegetable intake in picky eaters.