OBJECTIVE: To evaluate the changes of bladder management methods after the discharge from hospital, and to identify the problems associated with their method changes of bladder management after the discharge. METHOD: The subjects of this study were 128 spinal cord injury patients with a neurogenic bladder dysfunction who were admitted to the hospital and received the neurogenic bladder management and training. We reviewed the medical records of these patients for the management methods of neurogenic bladder and interviewed the patients whether they are still using the same methods after the discharge. RESULTS: The number of patients who were doing the intermittent catheterization at the time of discharge from hospital was markedly reduced after the discharge and most of the patients in this group have switched to the external collecting device method, using Cred, Valsalva or tapping method. The reasons of this change were that the intermittent catheterization method was not only difficulty and complicated but also restricted their social activities. CONCLUSION: We concluded that a long term close follow up and continuous encouragement are very important in the management of neurogenic bladder patients who are discharged with the intermittent catheterization method.
Catheterization ; Catheters ; Follow-Up Studies ; Humans ; Medical Records ; Spinal Cord Injuries ; Spinal Cord* ; Urinary Bladder ; Urinary Bladder, Neurogenic*

PURPOSE: The purpose of this study is to identify the epidemiologic and clinical characteristics of respiratory adenovirus infections in children, and to investigate the difference in the clinical features between single adenovirus infection and coinfection with adenovirus and other respiratory viruses. METHODS: A retrospective study was performed in 470 children hospitalized with respiratory adenovirus infections in Gwangmyeong Sungae Hospital between January 2013 and December 2013. RESULTS: The mean age of the patients was 46.2 months and the peak incidence was in the 12- to 24-month age group. The mean duration of hospitalization and fever were 4.5+/-1.1 and 4.5+/-9.2 days, respectively. Seasonally it had occurred throughout the year, but showed the highest prevalence in August and high prevalence in July, September, and October. The frequency of viral coinfection with other respiratory viruses was 39.6%. The age was significantly younger in coinfection group than in the single adenovirus infection group (P<0.001). The prevalence rates of bronchiolitis (P<0.001) and pneumonia (P=0.042) were significantly higher in the respiratory syncytial virus coinfection group. The coinfection rate was significantly higher in children aged less than 2 years (P<0.001), and the prevalence rates of bronchiolitis (P<0.001) and pneumonia (P<0.001) were also higher in the group aged less than 2 years than other age groups. CONCLUSION: Adenovirus is an important viral agent in hospitalized children with acute respiratory tract infection. Lower respiratory tract infections, such as bronchiolitis and pneumonia, and coinfection with other respiratory viruses were more frequently occurred in patients under 2 years of age. Further studies are needed to clarify whether coinfection with other respiratory viruses would increase the rate of lower respiratory tract infections in patients with respiratory adenoviral infections.
Adenoviridae Infections* ; Adenoviridae* ; Bronchiolitis ; Child ; Child, Hospitalized ; Coinfection ; Fever ; Hospitalization ; Humans ; Incidence ; Inpatients* ; Pneumonia ; Prevalence ; Respiratory Syncytial Viruses ; Respiratory Tract Infections ; Retrospective Studies ; Seasons

PURPOSE: This study was conducted to identify risk factors for new onset diabetes after transplantation (NODAT) among renal transplant recipients treated with tacrolimus-based immunosuppressant. METHODS: We selected renal transplant recipients who underwent surgery at Samsung Seoul Hospital between May 2001 and July 2009. Exclusion criteria were as follows: recipients <18 years old, history of diabetes mellitus (DM) or impaired glucose tolerance. Analysis of possible risk factors for NODAT included age, gender, body mass index, co-morbid diseases, family history of DM, infection of hepatitis B or polyomavirus, type of donors (cadaver or living) and acute rejection. Overall incidence and median value of NODAT onset day were analyzed with Kaplan-Meier curve. We calculated crude incidence rate and relative risk (RR) and 95% confidence interval (CI) for independent risk factors of NODAT using Cox proportional hazard analysis. RESULTS: A total of 278 patients were included and the incidence of NODAT was 13.3% (5.6/100 person-year) and the median duration of NODAT onset was 28 days. In Cox analysis, risk factors for NODAT were age (45-59 years: RR=1.41, 95% CI 1.09-1.83, 60> years: RR=4.36, 95% CI 2.00-9.49), family history of DM (RR=1.62, 95% CI 1.12-2.34) and polyomavirus infection (RR=1.40, 95% CI 1.08-1.81). CONCLUSION: The risk factors for NODAT among renal transplant recipients treated with tacrolimus-based regimen were age (>45 years old), family history of DM and polyomavirus infection.
Body Mass Index ; Diabetes Mellitus ; Glucose ; Hepatitis B ; Humans ; Incidence ; Kidney Transplantation ; Polyomavirus ; Polyomavirus Infections ; Rejection (Psychology) ; Risk Factors ; Tacrolimus ; Tissue Donors ; Transplants

Laribacter hongkongensis is an emerging pathogen in patients with community-acquired gastroenteritis and traveler's diarrhea. We herein report a case of L. hongkongensis infection in a 24-yr-old male with liver cirrhosis complicated by Wilson's disease. He was admitted to a hospital with only abdominal distension. On day 6 following admission, he complained of abdominal pain and his body temperature reached 38.6degrees C. The results of peritoneal fluid evaluation revealed a leukocyte count of 1,180/microL (polymorphonuclear leukocyte 74%). Growth on blood culture was identified as a gram-negative bacillus. The isolate was initially identified as Acinetobacter lwoffii by conventional identification methods in the clinical microbiology laboratory, but was later identified as L. hongkongensis on the basis of molecular identification. The patient was successfully treated with cefotaxime. To the best of our knowledge, this case is the first report of hospital-acquired L. hongkongensis bacteremia with neutrophilic ascites.
Acinetobacter/isolation & purification ; Acinetobacter Infections/complications/diagnosis/microbiology ; Bacteremia/complications/*microbiology ; Cefotaxime/therapeutic use ; Diagnosis, Differential ; Gastroenteritis/complications/*diagnosis/*microbiology ; Hepatolenticular Degeneration/complications/microbiology ; Humans ; Liver Cirrhosis/complications/microbiology ; Male ; Neisseriaceae/*isolation & purification ; Phylogeny ; Republic of Korea ; Young Adult

PURPOSE: The education for self-management of asthma is considered as an essential component to control asthma and improve outcomes. This study aimed to develope an educational game for increasing knowledge of asthma management among children and their caregivers. METHODS: Three subspecialists of pediatric allergy and respirology, 1 pediatrician, 3 pediatric residents and 15 medical students conducted this study. An instructional systemic design using analysis, design, development, implementation and evaluation (ADDIE) model was applied in the entire process of game production. We surveyed the demands of asthma education in 19 caregivers of children who were in the treatment of asthma in Korea University Anam Hospital and reflected its results on the construction of game. For the evaluation of the objective effects of developed game, the comparison study was performed between the patients who had experienced the game (n=20) and those who had not (n=22) by using questionnaire about the knowledge of asthma. RESULTS: The game was developed as a form of board game and had contents including precipitating factors, symptoms and treatment of asthma. The patients older than elementary student easily understood the mode and substances of game, and participated with their concentrations throughout approximately 2 hours' operating time. In analysis of the knowledge level of asthma, the patients who had experienced board game showed significantly higher knowledge level than those who had not (74.0+/-17.6 vs. 55.0+/-17.1, P=0.006). CONCLUSION: We developed a family board game for the asthma education through the systematic production process. The board game may increase the knowledge level in asthmatic children, which would improve the ability of self-management.
Asthma ; Caregivers ; Child ; Humans ; Hypersensitivity ; Korea ; Precipitating Factors ; Surveys and Questionnaires ; Self Care ; Students, Medical

Intestinal lymphangiectasia is characterized by protein- losing enteropathy, and is diagnosed by a small bowel biopsy demonstrating dilated lymphatics in the mucosa, submucosa and serosa in the absence of coexistent inflammation. We report a case of primary intestinal lymphangiectasia that occurred in a 2-year-6-month-old girl who was treated successfully with antiplasmin and octreotide. Initially, the patient was treated with a lipid restriction diet with medium chain triglyceride oil, but her symptoms were not relieved. This case shows that antiplasmin and octreotide therapy might be useful for treating refractory primary intestinal lymphangiectasia.
Biopsy ; Diet ; Female ; Humans ; Inflammation ; Mucous Membrane ; Octreotide* ; Serous Membrane ; Triglycerides

PURPOSE: Colorectal cancer is regarded as preventable with routine checkups. The purpose of this study was to evaluate the usefulness of each test performed during routine checkups and to assess the clinicopathological characteristics of colorectal cancer detected at the Health Promotion Center (HPC). RESULTS: We recruited 120 colorectal cancer patients identified on routine checkup at the HPC. The control group was composed of 3,829 colorectal cancer patients who underwent surgery during the same period. Clinicopathological variables were compared using the chi-square test. RESULTS: The male-to-female ratio was 79:41; the mean age was 57.9 (30~78) years. The incidence of right colon cancer was 16.7%, and that of left colon cancer was 83.7%. Sigmoidoscopy (55.5%), colonoscopy (28.3%), and fecal occult blood tests (FOBT, 10.8%) were used for detecting colorectal cancer. The overall positive rates of FOBT and serum carcinoembryonic antigen (CEA) were 28.3% and 20.8%, respectively, but were higher in advanced colon cancer (49.0% and 31.4%) and right colon cancer (60% and 25%). Early colorectal cancer was more frequent in the study group (54.9%) than in the control group (16.9%, P<0.001). Right colon cancer was significantly associated with advanced colon cancer (80%), and left colon cancer was associated with early colon cancer (62.3%, P=0.001). CONCLUSIONS: Endoscopy, including sigmoidoscopy and colonoscopy, played a crucial role in detecting early colorectal cancer at the HPC. Including endoscopy in basic routine checkup programs should help to increase early detection of colorectal cancer.
Carcinoembryonic Antigen ; Colonic Neoplasms ; Colonoscopy ; Colorectal Neoplasms* ; Endoscopy ; Health Promotion* ; Humans ; Incidence ; Occult Blood ; Sigmoidoscopy

Congenital bronchial stenosis is a rare condition with variable symptoms of presentation. Affected patients are usually asymptomatic, but because of the reduced airway, cough, cyanosis and respiratory distress may be presented. We report a 19 month-old girl with a recurrent history of severe wheezing, dyspnea and cyanosis accompanied by lower respiratory tract infections. Young children with severe respiratory symptoms and no immunological abnormalities must be suspected of airway structural abnormalities.
Child ; Constriction, Pathologic ; Cough ; Cyanosis ; Dyspnea ; Humans ; Organic Chemicals ; Respiratory Sounds ; Respiratory System ; Respiratory Tract Infections

PURPOSE: Neuroblastoma is a malignant neoplasm which arises from primitive sympathetic neuroblasts, and occasionally can matured from a malignant neuroblastoma into a benign ganglioneuroma. It has the highest rate of spontaneous regression of any pediatric tumor. We performed a retrospective study of pathologic features after combination therapy in advanced neuroblastoma. Prognostic effects of the individual morphologic feature and prognostic groupings according to modified Shimada classification systems were analyzed. METHODS: The treatment results for six patients with neuroblastoma seen at Keimyung University from Jan. 1991 to June 2000 were analyzed. Patients were treated with a combination of chemotherapy, radiation therapy, and surgery, and classified by two major prognostic criteria based on morphological features of neuroblastoma, such as modified Shimada classification and histologic grading. RESULTS: Three cases were classified to a good histologic group; among them, two cases survived, but one case was lost in follow-up. There were three cases classified in a poor histologic group. All of these patients expired due to sepsis and hemorrhagic pancreatitis. CONCLUSION: Prognostic classification due to pathologic findings had significant value in evaluating the survival rate of neuroblastoma patients.
Classification ; Drug Therapy ; Follow-Up Studies ; Ganglioneuroma ; Humans ; Neuroblastoma* ; Pancreatitis ; Prognosis* ; Retrospective Studies ; Sepsis ; Survival Rate

OBJECTIVE: The aims of this study were to evaluate the level of job stress in subway workers and to determine the main factors that aggravated their PTSD(Post-Traumatic Stress Disorder) symptom, which were due to having fallen under a train, and to verify the effectiveness of the intervention program. METHODS: The questionnaires utilized in the survey were composed of the Korean Occupational Stress Scale (the short form, 24 items), the depression scale, the coping scale II, the PTSD scale and the life style, health status and occupational properties. The intervention program for PTSD symptoms was executed for 18 subway operators who had experienced deadly accidents in their service from June 2004 to May 2006. The intervention programs included exercise, meditation and deep breathing for 8 weeks and a written message was sent twice per week. RESULTS: Compared with pre-intervention, the post-intervention group showed significantly lower scores for the KOSS, depressive symptom and the PTSD. CONCLUSION: This study showed the intervention program was effective to lower the job stress, the PTSD symptoms and depressive symptoms, and to improve the coping skills. It was suggested that the mental health promotion program should be implemented for subway workers to prevent occupational mental diseases.
Adaptation, Psychological ; Depression ; Humans ; Life Style ; Meditation ; Mental Health ; Questionnaires ; Railroads ; Respiration ; Stress Disorders, Post-Traumatic