A Study on Personality Characteristics According to Suicide Risk Reporting of Students in the 2nd Step Evaluation of the Emotional-Behavioral Characteristic Test in One Region / 생물치료정신의학

Objectives@#The purpose is to investigate personality characteristics according to reports of suicide risk among students in the 2nd step evaluation of the Student Emotional Behavior Test conducted in one district of Daegu in 2022. @*Methods@#A total of 99 students’ school level, gender, and rate of suicide risk reporting were investigated, and sub-factors of Personality Assessment Inventory-Adolescent (PAI-A) were compared according to suicide risk reporting. We also analyzed the factors that have the most significant influence on suicide risk reporting among PAI-A. @*Results@#There was no gender difference in suicide risk reporting, but there was a significant difference at the school level. Among the PAI-A clinical scales, significant differences between groups were found in somatic complaints (SOM), anxiety (ANX), anxiety-related disorder (ADR), depression (DEP), paranoia (PAR), borderline features (BOR), suicide ideation (SUI), nonsupport (NON) and treatment rejection (RXR). Suicide risk reporting was higher in high school students than middle school, and students with high scores of NON on the PAI-A. @*Conclusions@#Reports of suicide risk show differences in internalization factors of personality traits. This means that adolescents are more likely to report suicide risk as they frequently experience inherent negative emotions such as depression and anxiety or as their interpersonal relationships become strained. In addition, it can be said that identifying social networks and forming support resources are important factors in preventing self-harming or suicidal ideation that occur during early adolescence.

Epidemiologic Characteristics and Case Fatality Rate of Vibrio vulnificus Infection: Analysis of 761 Cases From 2003 to 2016 in Korea

Background@#Vibrio vulnificus infection is a highly fatal disease resulting from the consumption of raw or undercooked seafood and exposure to seawater containing the organism. It has been a nationally notifiable disease since 2000 in Korea. The aims of this study were to assess the trends in the incidence of V. vulnificus infection and its case fatality rate and to determine the epidemiologic characteristics to effectively prevent infection and lower mortality. @*Methods@#We analyzed the incidence trends of V. vulnificus infection by year, month, and region in 913 cases reported to the Korea Centers for Disease Control and Prevention (KCDC, currently Korea Disease Control and Prevention Agency) by the National Infectious Disease Surveillance System from 2001 to 2016. We analyzed the number of patients with V. vulnificus infection who were under the National Health Insurance Service (NHIS) and whose coastal seawater temperature data were provided by the Korea Oceanographic Data Center of the National Institute of Fisheries Science. Epidemiological investigations were followed up and analyzed for 761 patients from 2003 to 2016. A total of 152 patients who were not followed up were excluded from the analysis. The case fatality rate was analyzed for 325 cases reported to the KCDC from 2011 to 2016. @*Results@#The mean incidence of V. vulnificus infection was 0.12 per 100,000 people, and the highest incidence was reported in September (41.1%) during the study period. The incidence rate per 100,000 people was the highest in Jeonnam (8.23). The number of patients who claimed to the NHIS was the highest in September (105 patients). The average seawater temperature was the highest at 24.1°C in August, and the average seawater temperature from August to October, when many cases occurred, was 22.4°C. The male-to-female ratio was 6:1, and 96.4% of the patients were aged ≥ 40 years. Of the patients, 96.1% had underlying diseases, the most common of which was liver cirrhosis (56.3%). The case fatality rate was 48.9%. @*Conclusion@#The occurrence of V. vulnificus infection showed distinct seasonality, with a large number of cases occurring in the months when the seawater temperature was high;there were also distinct geographical characteristics. The incidence of V. vulnificus infection and mortality rates have not decreased for decades, and it is still an important public health problem with a high fatality rate.

A Study on Evaluation System for Nursing Bachelor Degree Program Outcomes: Focus on Improvement in Nursing Leadership Ability / 간호행정학회지

PURPOSE: This study was conducted to develop a nursing leadership program outcome evaluation system, required for accreditation of nursing education. METHODS: A methodological design was used. To ensure the theoretical validity of the evaluation system, learning objectives for nursing education programs and job descriptions for nurses in Korea were verified by analyzing the relationships in the five attributes of the nursing leadership concept. The nursing leadership program outcome evaluation system was developed based on the Kim & Park's developmental model (2008). RESULTS: The nursing leadership program outcome evaluation system was established, including implementation level, education curriculum, level of performance, evaluation method, rubrics, and Close-the-Loop. CONCLUSION: The developed evaluation system can be actively used in nursing education, and contribute to enhancing the leadership competencies of nursing students and graduate nurses.

Clinical Dimensions of Bloating in Functional Gastrointestinal Disorders

BACKGROUND/AIMS: Bloating is common bothersome symptoms and most studies conducted in the Western countries found that bloating was frequently associated with lower gastrointestinal (GI) symptoms but many patients complaint bloating as upper GI symptoms in the clinical setting. This study was conducted to assess the prevalence of bloating, and to identify symptom grouping and finally document the impact of bloating in the diagnosis of functional GI disorders. METHODS: Participants in a comprehensive health-screening cohort were enrolled. They were asked about demographic, medical, and social history and upper and lower GI symptoms by using a validated questionnaire. Factor analysis with principal component analysis method with varimax rotation was used. RESULTS: Among the total of 1050 subjects (mean age, 44.6 ± 10.2 years; females, 46.4%), significant bloating symptoms were found in 282 (26.9%); the prevalence of functional bloating was 6.9%. Factor analysis revealed a 5-component structure with upper GI symptoms, constipation, diarrhea-predominant irritable bowel syndrome (IBS), constipation-predominant IBS, and fecal incontinence. Abdominal bloating loaded on both the upper GI symptoms (0.51 of loadings) and constipation (0.40). On logistic regression analysis, bloating was more predictable for IBS (OR, 7.5; P < 0.001) than functional dyspepsia (FD; OR, 3.7; P = 0.002). Bloating was more frequently combined with IBS according to their severity, but this association was not detected in patients with FD. CONCLUSIONS: Abdominal bloating is common symptom in about a quarter of patients and appears as upper as well as lower GI symptoms. However, abdominal bloating is more predictable for IBS, especially constipation-predominant IBS, than FD.

Concept Analysis of Nursing Leadership / 간호행정학회지

PURPOSE: The purpose of this study was to provide a concept analysis of nursing leadership. METHODS: The concept analysis process of Walker and Avant (2011) was used. A review of the literature was conducted using several databases, including PubMed, CINAHL, Ovid-Medline, DBpia, and KISS. The databases were searched using the following terms 'nursing leadership', 'nursing' & 'leadership', and 'nurse & 'leadership', and for studies published from January 2000 to March 2015. Strict inclusion and exclusion criteria were applied. RESULTS: Analysis of these studies indicated nursing leadership attributes were individual growth, collaboration, nursing excellence, creative problem solving, and influence. The antecedents of nursing leadership were the individual maturity level, construction of mutual trust and confidential relationships, and a job requirement. The consequences were improvement in nursing productivity, development of a supportive work environment, and satisfaction with the nursing profession. CONCLUSION: The findings in this study provide a definite concept of nursing leadership. The findings also provide the theoretical evidence for the development of nursing leadership competencies in nursing students and professional nurses.

Development and Long Term Evaluation of a Critical Pathway for the Management of Microvascular Decompression / 간호행정학회지

PURPOSE: In order to provide a systematic and standardized treatment course for MVD patients, a critical pathway (CP) program was developed and the results of its long term application were analyzed. METHODS: This was a methodological study. The CP was established and applied to 75 (step I) and 1,216 (step II). Another group of 56 with similar features was used as a control group. RESULTS: The application of CP turned out to be useful in many regards: the rate of hearing loss was reduced from 1.8% to 0% (step I) and 0.5% (step II), and low cranial nerve palsy was reduced from 1.8% to 1.3% and 0.7%, respectively. The length of hospitalization decreased by 2.56 days (25.2%) for step I and 3.05 days (30.0%) for step II. Days of ICU stay were reduced by 7.9% and 1.8%. The total cost per patient was reduced by 14.8% (step I). The cost per day was increased by 13.7% and 52.4%. An increase in the patient satisfaction index was noted, as shown in the ICU information guide (p=.002). CONCLUSION: The development and application of CP was found to improve the quality of medical treatment and the efficacy of hospital management in MVD patients. Well organized and efficient system and multidisciplinary teamwork are the key component of the successful application of CP.

Analysis of Research Articles Published in the Journal of Korean Academy of Nursing Administration for 3 Years (2010~2012) / 간호행정학회지

PURPOSE: The purpose of this study was to identify the major trends in research studies in the Journal of Korean Academy of Nursing Administration from 2010 to 2012. METHODS: A review using analysis criteria developed by researchers was done of 132 studies published between 2010 and 2012. Research design, participants, research domain, and keywords were analyzed from the Journal of Korean Nursing Administration. RESULTS: Job satisfaction, stress, organizational commitment, safety, turnover, nursing education, and performance were found to be major keywords. Of the research in the Journal, quantitative methods were used in 93.2% of studies. The major setting and participants were hospitals (58.2%) and nurses (65.5%) respectively. Prevalent analysis methods used were t-test, ANOVA, correlation, regression, chi-square, AMOS, and factor analysis. Major domains in the articles were: controlling, directing, staffing, nursing management education, and professionalism & legal principles. CONCLUSION: Through this study, the research trends in nursing administration were identified, but there is a need to include more of the following topics in future research: new concepts in nursing policy, enhanced deliberations of IRB, rationalization of the effects in sample size calculations, theoretical development of planning and organizing, and development of interventions for management support of the nursing management process.

Effect of Optimal Humidification for Extremely Low Birth Weight Infants During Nasal Continuous Positive Airway Pressure

PURPOSE: To evaluate the efficacy of Optimal humidification during Nasal Continuous Positive Airway Pressure (nCPAP) for Extremely Low Birth Weight Infant (ELBWI). METHODS: The study design was a pre-test-post-test nonequivalent nonsynchronized quasi-experimental design. The participants were 218 ELBWI on nCPAP (experimental group: 102 and control group: 116). Data collection was conducted from January 2005 to April 2010. In order to measure and analyze the nCPAP duration, reintubation and nasal condition, Chi-square test and t-test were used. RESULTS: Hypothesis 1, that the duration with nCPAP in the experimental group is longer than that of the control group and hypothesis 2-3, that the rate of reintubation and nasal problems in the experimental group are lower than the control group, were all supported as there were statistically significant differences between two groups. CONCLUSION: The findings suggest that the Optimal humidification in this study is an efficient intervention because it helps increase the last time of nCPAP with ELBWI and minimize complications. It is expected that Optimal humidification is beneficial and helpful in preventing and caring for respiratory problems in these infants.

Development of a Critical Pathway of Barbiturate Coma Therapy in the Management for Severe Brain Damage / 간호행정학회지

PURPOSE: This study is a descriptive research to analyze prognostic factors of barbiturate coma therapy (BCT) for severe brain damage patients, to develop a critical pathway (CP) based on the results of analysis and to examine the effect of its clinical application. METHOD: We analyzed medical records of 76 patients who received BCT for more than three days between January 1999 to July 2005. Based on the results of the analysis, we developed a CP and applied it to 12 people during August-December of 2005. RESULT: By application of BCT CP, the mortality rate decreased from 31.6% to 16.7%. It was found that the period of staying at ICU and total period of hospitalization were shortened by 2.78 (13.9%) days and 16.43 (29.4%) days, respectively. The Glasgow coma scale of the recovery group by CP application was 9.03 (4.64) at 72 hours post of BCT and 14.28 (1.82) at discharge from hospital, and DRS was 6.62 (6.38) points. CONCLUSION: By verifying clinical validity of the suggested CP, we believe that we have obtained visible effects standardizing the treatment pathway of BCT for brain damage patients.

Development of a Critical Pathway of Barbiturate Coma Therapy in the Management for Severe Brain Damage / 간호행정학회지

PURPOSE: This study is a descriptive research to analyze prognostic factors of barbiturate coma therapy (BCT) for severe brain damage patients, to develop a critical pathway (CP) based on the results of analysis and to examine the effect of its clinical application. METHOD: We analyzed medical records of 76 patients who received BCT for more than three days between January 1999 to July 2005. Based on the results of the analysis, we developed a CP and applied it to 12 people during August-December of 2005. RESULT: By application of BCT CP, the mortality rate decreased from 31.6% to 16.7%. It was found that the period of staying at ICU and total period of hospitalization were shortened by 2.78 (13.9%) days and 16.43 (29.4%) days, respectively. The Glasgow coma scale of the recovery group by CP application was 9.03 (4.64) at 72 hours post of BCT and 14.28 (1.82) at discharge from hospital, and DRS was 6.62 (6.38) points. CONCLUSION: By verifying clinical validity of the suggested CP, we believe that we have obtained visible effects standardizing the treatment pathway of BCT for brain damage patients.

Effects on Changes in Femoral Vein Blood Flow Velocity with the Use of Lower Extremity Compression for Critical Patients with Brain injury

PURPOSE: This study was done to evaluate the mean venous velocity (MVV) response with knee and thigh length compression stockings (CS) versus intermittent pneumatic compression (IPC) devices in immobile patients with brain injuries. METHODS: We carried out a randomized controlled study. We analyzed both legs of a randomly chosen sample of 43 patients assigned to one of 4 groups (86 legs). The patients were sequentially hospitalized in the intensive care unit (ICU) in "S hospital" from November 2005 to December 2006. The base line and augmented venous velocity was measured at the level of the common femoral vein. We applied leg compression 42 times over 7 days (for 2 hours at a time at 2 hour intervals). RESULTS: There was a statistical difference among the 4 groups. The difference for the "IPC" group was more significant than the "CS" group. CONCLUSION: These results indicate that the application of IPC can be considered as an effective method to prevent deep vein thrombosis for immobile patients with brain injury.

Clinical Analysis of Prenatal Cytogenetic Diagnoses: Four-year Experience at Asan Medical Center / 대한산부인과학회잡지

OBJECTIVE: To review and evaluate a total of 2,372 cases of prenatal cytogenetic diagnoses at Asan Medical Center from 1999 to 2002. METHODS: We reviewed the medical records of the patients in whom the procedure for prenatal cytogenetic diagnosis was performed. A total of 1780 cases of amniocentesis, 455 cases of cordocentesis, and 137 cases of chorionic villus sampling were analyzed. The cytogenetic results, indications for prenatal cytogenetic diagnoses, maternal ages, and the profiles of abnormal karyotypes were reviewed. We calculated the positive predictive value of each indication for abnormal fetal karyotypes and evaluated a factor that was the most sensitive marker for abnormal fetal karyotypes. RESULTS: Among the 2,372 cases of prenatal cytogenetic diagnoses, abnormal karyotypes were identified in a total of 158 cases (6.7%). The most frequent indication for prenatal cytogenetic diagnosis was abnormal maternal serum screening (33.9%), followed by ultrasonographic abnormality (22.9%) and old age (20.0%). No significant difference was found between mean maternal age with and without abnormal fetal karyotypes after excluding balanced rearrangements and polymorphisms (31.9 +/- 5.3 vs. 32.1 +/- 4.5 years). Among the 92 cases of abnormal fetal karyotypes after excluding balanced rearrangements and polymorphisms, the most frequent indication for prenatal cytogenetic diagnosis was ultrasonographic abnormality (58.7%), followed by abnormal maternal serum screening (10.9%). The positive predictive value of ultrasonographic abnormality for abnormal fetal karyotype was 9.9%. CONCLUSION: Among the several indications for prenatal cytogenetic diagnosis, ultrasonographic abnormality could be the most predictive marker for abnormal fetal karyotypes.

Effects of a Closed Endotracheal Suction System on Oxygen Saturation, Ventilator-Associated Pneumonia, and Nursing Efficacy / 간호학회지

PURPOSE: The purpose of this study was to examine the effects of a closed endotracheal suction system(CES) on oxygen saturation, ventilator associated pneumonia(VAP), and nursing efficacy in mechanically ventilated patients. METHOD: This study was conducted in the intensive care unit of a University Hospital in Gwangju City. Data was collected from July to October, 2003. Seventy mechanically ventilated patients were randomly divided into two groups; 32 for CES and 38 for open endotracheal suction system(OES) protocol. Twenty one nurses were also involved to examine the nurses' attitude of usefulness about CES. RESULT: SaO2 was significantly different between CES and OES. The incidence of VAP in CES was lower than that of OES. Nursing efficacy was related to time, cost, and usefulness of the suction system. Time of suctioning in CES was shorter than that of OES. CES also contributed significantly to lower the cost of treatment than OES. The usefulness score of CES increased after 6 months of use. CONCLUSION: CES prevented VAP, was cost effective, and a safe suctioning system. CES ncan be used with patients with sensitivity to hypoxygenation and with a high risk of VAP.

Pulmonary Complications in Major Burn Patients: Differences in Radiologic and Clinical Findings between Inhaled and Non-inhaled Burn

PURPOSE: To analyze differences in the radiologic and clinical findings of pulmonary complications between an inhalation and non-inhalation group of major burn patients, and to apply the findings to the specific diagnosis of pulmonary complications. MATERIALS AND METHODS: This study involved 45 major burn patients (18 with inhalation injury, and 27 without) in whom pulmonary complications ensued. Follow-up studies were based on chest radiographs obtained between initial burn day and postburn (PB) 57 (mean, day 27). Types, times of onset, underlying causes, and changes at follow-up study of pulmonary complications between the inhalation and the non-inhalation group were assessed. RESULTS: In the inhalation group, the most frequent complication was air-borne pneumonia (n=7, 39%); others were hydrostatic pulmonary edema (n=5, 28%), ARDS (n=5, 28%), atelectasis (n=5, 28%), inhalation pneumonitis (n=3, 17%), pleural effusion (n=3, 17%), and hematogenous pneumonia (n=1, 6%). In the non-inhalation group, airborne pneumonia (n=8, 30%) was also the most common complication; other were hydrostatic edema (n=6, 22%), ARDS (n=5, 19%), atelectasis (n=5, 19%), pleural effusion (n=5, 19%) and hematogenous pneumonia (n=2, 7%). The average times of onset were as follow: for airborne pneumonia, PB day 13.1 (range, 5-27) in the inhalation group, and PB day 21.7 (10-49) in the non-inhalation group; for hematogenous pneumonia, more than one month, regardless of inhalation; for ARDS, PB day 4.9 (2-15) and PB day 13 (7-20) in the inhalation and non-inhalation group, respectively; and for inhalation pneumonitis, PB day 1.7 (1-3). The most common probable cause of ARDS in the inhalation group was inhalation injury (3/5), and in the noninhalation group, sepsis (4/5). CONCLUSION: In major burn patients, pulnonary complications differed in terms of their onset time and causes between the inhalation group and the non-inhalation group. In such cases, awareness of the presence or absence of inhalation injury and the onset time of pulmonary complications is necessary if complications are to be specifically diagnosed.

Clinical Usefulness of Diffusion-weighted MRI in Various Stages of Ischemic Stroke

PURPOSE: Diffusion-weighted MRI (DWI) is well known to be sensitive in the detection of hyperacute infarct, but has not been systematically investigated in patients with acute or subacute infarct. We evaluated the usefulness of diffusion-weighted MRI in assessing the various stages of brain infarct. MATERIALS AND METHODS: Fifty-five consecutive patients with symptoms of brain infarct underwent fast spinecho T2-weighted MRI (T2W1) and DWI. Using only a brief clinical history, two radiologists first attemptelto detect the lesion using T2W1, which was then compared with DWI. The usefulness of the latter was then evaluated in terms of the following criteria: 1) Its abilility to detect a lesion not seen at T2WI (detection); 2) localization of the responsible ischemic focus among multiple high-signal intensities seen at T2WI (localization); 3) conspicuity of a lesion which was subtle at T2WI (conspicuity); 4) detection of multiple lesions (multiplicity). RESULTS: DWI was useful in 44 of 55 patients (80%), including 9 of 9 (100%) with hyperacute infarct (<6 hours), 20 of 27 (74%) with acute infarct (<48 hours), and 15 of 19 (79%) with subacute infarct (<2 weeks). Among the nine patients at the hyperacute stage, DWI was useful for detection of the lesion in six (67%), for localization, 4 (44%) in one (11%), for conspicuity in four (44%), and for multiplicity in five (56%); at the acute stage (20 patients), for detection in three (15%), for localization in ten (50%), for conspicuity in eight (40%), and for moltiplicity in five (25%); and at the subacute stage (15 patients), for detection in three (20%), for localization in nine (60%), for conspicuity in two (13%), and for multiplicity in three (20%). CONCLUSION: DWI is very sensitive for the diagnosis of hyperacute infarct. In the assessment of this, it is useful during the acute or subacute period for the detection of small lesions, the localization of ongoing lesions among multiple high signal intensities seen at T2WI, and the determination of lesion conspicuity.

The Clitoral Size of the Korean Female Newborn / 영남의대학술지

BACKGROUND: To determine mean clitoral and glans size of Korean female newborn. MATERIALS AND METHODS: The size of glans and clitoris of 68 Korean female newborns born at Yeungnam University Medical Center were measured from May in 1999 to August in 1999. RESULTS: The mean size of the 68 newborns were 2.38+/-1.14 mm in glans length, 2.55+/-1.48 mm in glans width and 4.66+/-1.93 mm in clitoral length. In the premature infants the mean clitoral size was 1.92+/-1.58 mm in glans length, 1.78+/-1.24 mm in glans width and 3.86+/-2.16 mm in clitoral length. In the full term infants 2.53+/-1.12 mm in glans length, 2.75+/-1.58 mm in glans width and 4.94+/-1.89 mm in clitoral length. In low birth weight infants clitoral size was measured 1.55+/-1.10 mm in glans length, 2.04+/-2.03 mm in glans width and 3.29+/-1.87 mm in clitoral length. In normal birth weight infants 2.53+/-1.13 mm in glans length, 2.68+/-1.48 mm in glans width and 4.92+/-1.91 mm in clitoral length. In high birth weight infants 1.54+/-0.50 mm in glans length, 1.63+/-0.53 mm in glans width and 3.18+/-1.04 mm in clitoral length. CONCLUSION: There was no significant correlation between gestational age and clitoral size or glans size, but significant negative correlation was found between birth weight and clitoral size or glans size.

The Conceptual Structure of Coping : Based on Patients receiving Hemodialysis / 기본간호학회지

This study was done to analyze and develop the concept of coping in patients receiving hemodialysis. The Hybrid Model of concept development was applied to develop a conceptual structure of coping in patients receiving hemodialysis, which included a field study carried out using an in-dept interview with 18 patients in the hemodialysis room of one general hospital in Seoul. Data-analysis was done in three phases as suggested by the Hybrid Model. Finally, by summarizing the results from each case, the attributes of coping, its dimensions, definition and structure were outlined. According to the results of the study, a conceptual structure of coping which centers around stressors, stress-appraisal, strategy of coping and new definitions of coping in patients receiving hemodialysis was suggested: The coping of patients receiving hemodialysis is a process that deals with physical, emotional, inter-personal, and role stress caused by hemodialysis due to renal failure. It has a series of phases which include a phase that appraises the stressful situation based on past experience of chronic disease management, one's remaining years, the extent of family support, the extent of economic dependency, inter-personal support, education and uncertainty, and a phase of developing coping strategies that con be affected by social support and self esteem. As a result of coping, patients adapt or not to the life situation of receiving hemodialysis.

A Case of Allergic Bronchopulmonary Aspergillosis During Childhood

Allergic bronchopulmonary aspergillosis(ABPA) is an inflammatory disease which causes a hypersensitivity to Aspergillus spores growing in the bronchi. The clinical syndrome is characterized by asthma, recurrent pulmonary infiltrations or mucoid impaction, eosinophilia, and central bronchiectasis. A 12-year-old boy was admitted to our hospital because of right lower chest pain and cystic mass-like shadows on a chest X-ray film. He had asthma as an infant, but had no asthmatic symptoms on admission. Chest CT scan showed low density cystic mass of the right lower lobe. The total eosinophil count and IgE level were abnormally high. Test for immediate skin reaction to Aspergillus fumigatus was positive but precipitating antibody to Aspergillus antigen was negative. After steroid treatment, he became asymptomatic. Radiologic abnormalities including mass-like shadows were resolved by two months after the start of treatment and a follow-up high resolution CT scan obtained after clinical improvement revealed central saccular bronchiectasis. We report one case of ABPA with review of literature.

99mTc-MIBI scan in mammary Pagets disease: a case report

Technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) uptake is known to be increased in breast cancer because of increased blood flow from angiogenesis and heightened metabolism. We performed a 99mTc-MIBI scan in a patient with mammary Paget's disease. The patient had underlying invasive cancer in the same side of the breast. 99mTc-MIBI scan exhibited a scintigraphic image of the uptake from the invasive cancer lesion located deeply in the breast toward the epidermis. 99mTc-MIBI showed an uptake in the deeply located invasive cancer lesion as well as nipple lesion. Especially, the delayed phase of Tc-MIBI scan demonstrated the tumor site more accurately. In conclusion, 99mTc-MIBI scan could be a useful adjunct to clinical decision making in the management of Paget's disease of the breast.

A Case of Chylous Ascites Secondary to Congenital Ileal Atresia / 대한주산의학회잡지

Chylous ascites in neonates is an unusual and etiologically poor understood entity. We report a male newborn who suffered from abdominal distension and respiratory distress after birth. Paracentesis was performed and ascitic fluid was obstained. Analysis of the fluid revealed cell count (RBC 10,000/mm3, WBC 800/mm3: segmented form-72%, lymphocyte form- 28%), protein 4,100 mg/dl, glucose 57 mg/dl, cholesterol 53 mg/dl, triglyceride 28 mg/dl. Culture of ascitic fluid grew no bacteria. A plain film of abdomen and abdominal sonogram showed massive ascites. On the 4th hospital day, gastrografin enema showed microcolon and ileal atresia. On the 6th hospital day, ileocolostomy has been performed and operative findings sho- wed blind pouch in terminal ileum, massive inflammation and extensive adhesion on peritoneum. After operation, he gained weight by continuous gavage feeding. He discharged on the 36th hospital day.