Midline malignant reticulosis is a relentlessly progressive, localized, destructive inflammatory process of upper respiratory tract including the nose, nasopharynx, palate, paranasal sinuses, and midface. Histologically, it is characterized by a dense aceumulation of pleomorphic mononuclear cells with an admixture of inflammatory cells. We report a case of midline malignant reticulosis developed in a 64-year-old man, who showed a serosanguineous nasal discharge, perforation of nasal septum, persistent ulceration of hard palate, and disseminated lesions on the abdominal skin, which was confirmed by histopathalogical examination. In addition we studied infiltrated cells with atypical nuclei by immunohistochemical staining with a pannel of monoclonal antibodies. The results revealed that the atypical cells expressed the T-cell marker, but not the macrophage and B-cell marker.
Antibodies, Monoclonal ; B-Lymphocytes ; Humans ; Macrophages ; Middle Aged ; Nasal Septum ; Nasopharynx ; Neoplasm Metastasis* ; Nose ; Palate ; Palate, Hard ; Paranasal Sinuses ; Respiratory System ; Skin* ; T-Lymphocytes ; Ulcer

There are few reports in the literature on how to care and manage bi!ateral congenital dislocation of the hip. Six patients have been encountered at this hospital from June 1979, of them four children had operative treat ment and the other two conservative. As a result of our experience about the management of bilateral congenital dislocation of the hip. The authors obtained the following conceptions; 1. The patient with bilateral dislocation was rather delayed in diagnosis. Therefore, in comp the treatment of bilateral cases was poorer than that of unilateral case. 2. In the case of the dislocated hip that might be easily reduced and maintained in the stab servative care was usually recommeded even in the older child. Unstable, unreduced hip,; hip in old children, the more definitive operation and internal & external rigid immobilization mandatory to get good result. 3. It might be beneficial to operate the more deformed and resistive hip first, and then to p with the same procedure 2 weeks after the first operation.
Child ; Diagnosis ; Dislocations ; Fertilization ; Hip ; Humans ; Immobilization

We report two cases of hyperkeratosis of the nipple and areola which occurred in 22-year-old woman and 13-year-old girl. The former was suffered from mild pruritic, verrucous thickening and brownish discoloration of both nipples and areolae for 5 years. The latter had asymptomatic, verrucous thickening and dark brownish hyper- pigmentation of the right nipple and areola for 3 years. Both showed mild to marked hyperkeratosis and papillomatosis with increased pigmentation in the basal cell layer histopathologically. In both cases, the lesions were not responsive to the topical medications including steroids and keratolytic agents. Therefore we recommended surgical excision because the patients are greatly disturbed by the appearance of the lesions.
Adolescent ; Female ; Humans ; Keratolytic Agents ; Nipples* ; Papilloma ; Pigmentation ; Steroids ; Young Adult

Gardner's syndrome is a familial disease consisting of gastrointestinal adenomatous polyposis, osteomas of the mandible, skull, and long bones, and a variety of sol tissue lesions, including sebaceous cysts, fibromas, lipomas, and desmoid tumors. The colon is the most common site for polyposis, but the stomach, duodenum, small bowel, and periampullary area may also be involved. The diagnostic evaluation, malignant potential, and management is identical to that for familial adenomatous polyposis. The extracolonic manifestations of Gardner's syndrome are frequent and varied. Gardner's syndrome is inherited as autosomal dominant traits. Authors experienced one case that is a 32 year old female patient who had colonic and duodenal multiple polyposis, desmoid tumor in abdominal wall and right mesocolon and odontoma on mandible.
Abdominal Wall ; Adenomatous Polyposis Coli ; Adult ; Colon ; Duodenum ; Epidermal Cyst ; Female ; Fibroma ; Fibromatosis, Aggressive ; Gardner Syndrome* ; Humans ; Lipoma ; Mandible ; Mesocolon ; Odontoma ; Osteoma ; Skull ; Stomach

A total of 14 children underwent 29 treatments with EDAP-LT01 extracorporeal shock wave lithotripsy for urinary tract stones between February, 1987 and ugust, 1988. The results were obtained as follows : 1. The sex ratio was about A 2:1, 9 (64.3%) in male and 5 (35.7%) in female patients. The average patient age was 7.1 years with a range of 2 to 16 years. 2. Treated stone locations were kidney in 8 children (57.1% ) ; calyx in 6 (42.8% ) and renal pelvis in 2 (14.3% ) and ureter in 6 (42.9% ) ; upper ureter in 2 (14.3% ) and lower ureter in 4 (28.6 %). There were multiple renal stone in 4 (28.6% ) and bilateral renal stone in 1 (7.1%), the average stone size was 1.6cm with a range of 0.7 to 3.1cm. 3. The average numbers of treatment were 1.8 sessions and the average treatment time was 38.7 minutes. The average storage required was 107 in one session. 4. Of the 11 patients whose age was less than 10 years, 10 (71.4% ) required caudal anesthesia. Three patients whose age was more than 10 years treated without any type of anesthesia. 5. The total average success rate of treatment-ended 11 patients was 81.8% in stones of 0.7-3.0cm. The cause of failed ESWL were stone component in 1 and impacted stone in 1. 6. All or the patients were not required the pre and post-ESWL additional manipulation. ESWL complications were not required admission and surgical management. Therefore, we confirmed that EDAP-LT01 ESWL is a safe, effective and easily applicable technique for treatment of urinary stones in children.
Anesthesia ; Anesthesia, Caudal ; Child* ; Female ; Humans ; Kidney ; Kidney Pelvis ; Lithotripsy* ; Male ; Sex Ratio ; Shock* ; Ureter ; Urinary Calculi

PURPOSE: This study aimed to investigate the degree of role conflict and its ambiguity, and fatigue in clinical nurses and to analyze the effect of these on their self-resilience in order to provide fundamental data for improving their working environment after the Middle East Respiratory Syndrome outbreak. METHODS: After the collection of data from 258 clinical nurses in five general hospitals, t-test, ANOVA, Pearson's correlation coefficient, and multiple regression were performed using IBM SPSS Statistics 20.0. RESULTS: A significant positive correlation was found between nurses' role conflict and ambiguity and fatigue; while a negative correlation was found between nurses' role conflict and ambiguity and self-resilience. A significant negative correlation was found between fatigue and self-resilience. According to the study results, the factor that affected clinical nurses' self-resilience the most was role conflict and its ambiguity, followed by marital status, fatigue, educational level, religion, and related tasks, which together accounted for 38% of self-resilience in clinical nurses. CONCLUSION: To improve weaknesses in nursing care after the Middle East Respiratory Syndrome outbreak, the scope of nursing care was changed upon the expansion of integrated nursing and care-giving services. Therefore, in the rapidly changing environment of nursing, policies to improve nursing performance, as well as successful reaction capability, are suggested.
Coronavirus Infections ; Fatigue ; Hospitals, General ; Marital Status ; Nursing ; Nursing Care

Femoral Head fracture associated with posterior dislocation of the hip was once considered a rare industrial injury. However, the advant of high-speed travel has contributed to its increased incidence. Ten cases of fractured femoral head with posterior dislocation of the hip were treated at the Busan Paik Hospital between June 1979 and June 1982. During the same period, a total of 38 posterior hip dislocations were treated. The patients were followed for the average of 19.3 months, the range being 6 months to 3 years. There were 9 men and 1 woman the age ranged from 25 to 56 years. The fractures were classified according to Pipkin and the results were evaluated by Epsteins criteria. 1. The incidence of femoral head fracture was 26.3%, 10 cases of 38 posterior hip dislocations. 2. The better result was noted in open method than in closed method. 3. The absolute surgical indications were considered as followings. a. inadequate closed reduction of head fragment especially the large one. b. the involvement of weight bearing portion of femoral head. c. the hip joint pain caused by impingement of small fragment between joint space. 4. Arthrogram was helpful to find the concealed small fragment when the hip joint pain persisted with negative findings in ordinary x-ray.
Busan ; Dislocations ; Female ; Head ; Hip Dislocation ; Hip Joint ; Hip ; Humans ; Incidence ; Joints ; Male ; Methods ; Weight-Bearing

The purpose of this study is to make an emphasis the necessity of the dynamization after interlocking intramedullary nailing. We reviewed 75 cases of the fractures of the shaft of femur or tibia fixed with static interlocking intramedullary nailing. We excluded the cases in whom the locking screws were removed for the purpose of the relief of pain from the irriataion by those screws. The parameter we reviewed were the type of fracture, postoperative gap between the major fragments. Early callus formation, the union time, postoperative dynamization and controlled weight bearing. In those cases in which the contact surface between the major fragments was more than 50% and there noticed no early callus within 6 weeks after operation, the union time was shortened after dynamization, when the contact surface was less than 50% and there noticed no early callus, the union time was shortened after bone graft and dynamization which resulted in some shortening in the length in acceptable ranges. In cases with a major gap of more than 2mm, the union time was shortened after dynamization. The rate of early callus formation was a little higher in cases with postoperative controlled weight bearing than those to whom we did not permit a controlled weight bearing.
Bony Callus ; Femur ; Fracture Fixation, Intramedullary ; Tibia ; Transplants ; Weight-Bearing

PURPOSE: This study aimed to investigate the degree of role conflict and its ambiguity, and fatigue in clinical nurses and to analyze the effect of these on their self-resilience in order to provide fundamental data for improving their working environment after the Middle East Respiratory Syndrome outbreak. METHODS: After the collection of data from 258 clinical nurses in five general hospitals, t-test, ANOVA, Pearson's correlation coefficient, and multiple regression were performed using IBM SPSS Statistics 20.0. RESULTS: A significant positive correlation was found between nurses' role conflict and ambiguity and fatigue; while a negative correlation was found between nurses' role conflict and ambiguity and self-resilience. A significant negative correlation was found between fatigue and self-resilience. According to the study results, the factor that affected clinical nurses' self-resilience the most was role conflict and its ambiguity, followed by marital status, fatigue, educational level, religion, and related tasks, which together accounted for 38% of self-resilience in clinical nurses. CONCLUSION To improve weaknesses in nursing care after the Middle East Respiratory Syndrome outbreak, the scope of nursing care was changed upon the expansion of integrated nursing and care-giving services. Therefore, in the rapidly changing environment of nursing, policies to improve nursing performance, as well as successful reaction capability, are suggested.

BACKGROUND: Aging is associated with increased cardiovascular risk and firmly established as a risk factor for the development of atherosclerosis. However the exact mechanism of age-related damage to the arterial wall and its relation to the atherosclerotic process are not well known.The endothelium plays an important role for the regulation of vascular tone and the endothelial function is impaired in the presence of risk factors early in the process of atherosclerosis. Assessment of endothelial function appears to be a valuable tool for the diagnosing and therapeutic monitoring of coronary artery disease. Anti-oxidants are known to improve endothelial dysfunction in atherosclerosis patients. The aim of this study was, (1) to evaluate the endothelial function in elderly, (2) to investigate whether vitamin C administration has benefit on the endothelial function in elderly. METHODS: The endothelial function was estimated using venous occlusion plethysmography(VOP) in 7 elderly and 7 young healthy volunteers. The strain guage was connected to plethysmograph to record the forearm volume change. A rapid cuff inflator was used to inflate the arm cuff to 40 mmHg instantaneuosly thus occluding venous return from the forearm. The measurement of forearm volume change was repeated for 7 times each stage. The change of the forearm blood flow(FBF) was measured with the acetylcholine infusion through brachial artery and also with intra-arterial vitamin C. RESULTS: Endothelium-dependent vasodilatation was significantly impaired in the elderly group compared to the young group(321 +/-17% in elderly group vs 509 +/-81%, mean+/-SEM) Forearm blood flow response to acetylcholine was significantly enhanced with inraarterial infusion of vitamin C in elderly group(321+/-17% in elderly group vs 78% in vitamin C) Coinfusion of L-NMMA, an inhibitor of nitric oxide synthase, blunted forearm blood flow response to acetylcholine. CONCLUSIONS: Even though the mechanisms leading to drpressed endothelial function in elderly remains to be elucidated, our study shows that vitamin C result in demonstrable improvement by a mechanism that is probably related to antioxidant activity.
Acetylcholine ; Aged* ; Aging ; Arm ; Ascorbic Acid* ; Atherosclerosis ; Brachial Artery ; Coronary Artery Disease ; Endothelium ; Forearm ; Healthy Volunteers ; Humans ; Nitric Oxide Synthase ; omega-N-Methylarginine ; Risk Factors ; Vasodilation* ; Vitamins*