Purpose: This study reviewed screening and assessment tools that are used to measure delirium in patients with cancer in hospice and palliative care settings and examined their psychometric properties. Methods: Four databases were searched for studies using related search terms (delirium, tools, palliative care, cancer, and others). The inclusion criteria were a) studies that included screening/assessment tools for measuring delirium in cancer patients receiving hospice/palliative care, and b) studies published in English or Korean. The exclusion criteria were a) studies that were conducted in an intensive care setting, and b) case studies, qualitative studies, systematic reviews, or meta-analyses. Results: Out of the 81 studies identified, only 10 examined the psychometric properties of tools for measuring delirium, and 8 tools were ultimately identified. The psychometric properties of the Memorial Delirium Assessment Scale (MDAS) were the most frequently examined (n=5), and the MDAS showed good reliability, concurrent validity, and diagnostic accuracy. The Delirium Rating Scale had good reliability and diagnostic accuracy. The Delirium Rating Scale-Revised 98 also showed good reliability and structural validity, but its diagnostic performance was not examined in hospice/palliative care settings. The Nursing Delirium Screening Scale showed relatively low diagnostic accuracy. Conclusion The MDAS showed evidence of being a valid assessment tool for assessing delirium in patients with cancer in palliative care. Few studies examined the diagnostic performance of delirium tools. Therefore, further studies are needed to examine the diagnostic performance of screening/assessment tools for the optimal detection of delirium in patients with cancer in hospice/palliative care.

Adenoid cystic carcinoma (ACC) of the breast is an uncommon carcinoma accounting for less than 1% of the breast carcinoma. This type of carcinoma has a distinctive histology, such as cylindromatous, cribriform, glandlike space and solid pattern in the variable proportion. Prognosis is favorable with rare recurrence or metastasis and the guideline for therapy is not well established. We experienced a case of ACC of right breast in the 48 year-old woman. Cytologically, it showed numerous three-dimensional, well outlined cell clusters with central core of homogeneous, eosinophilic material. The mass was well demarcated, firm and measured 2.5 2.5 2 cm. Cut surface was yellowish white and granular with focal necrosis. Histologically, the tumor was composed of cylindromatous, adenoid and solid area with marked cellular atypia. Focal invasion was identified in the adipose tissue around the tumor. Histologic and nuclear grade was III by Kleer's grade. Nodal metastasis was not found.
Adenoids* ; Adipose Tissue ; Breast Neoplasms ; Breast* ; Carcinoma, Adenoid Cystic* ; Eosinophils ; Female ; Humans ; Middle Aged ; Necrosis ; Neoplasm Metastasis ; Prognosis ; Recurrence

Herpes simplex esophagitis has been recognized with increased frequency as an opportunistic infection in immunosuppressed or debilitated patients. However, it is also documented as self-limited esophagitis in apparently healthy patients. We report two cases of herpetic esophagitis diagnosed by biopsies. One case was noted in an immunocompetent patient having gastric peptic ulcer who had clinical improvement with symptomatic treatment. And the other was noted in an immunosuppressed patient having chemotherapy for gastric carcinoma who had resolution of symptoms with acyclovir therapy. Histologically, esophageal mucosa exhibited erosion and inflammatory cellular exudate with intranuclear eosinophilic inclusions in the epithelial cells. These were confirmed by the PCR and immunohistochemical stain for herpes simplex virus using a biopsy material.
Acyclovir ; Biopsy ; Drug Therapy ; Eosinophils ; Epithelial Cells ; Esophagitis* ; Exudates and Transudates ; Herpes Simplex* ; Humans ; Mucous Membrane ; Opportunistic Infections ; Peptic Ulcer ; Polymerase Chain Reaction ; Simplexvirus

No abstract available.
Tenosynovitis*

A 52-year-old woman was admitted with a palpable mass on the abdominal wall. This tumor had developed at the same site of a previously resected dermatofibrosarcoma protuberans. The biopsy specimen from the recurrent tumor revealed malignant fibrous histiocytoma. Immunohistochemistry with anti-CD34 antibody revealed diffuse linear positivity on the tumor cells of dermatofibrosarcoma protuberans and negativity on malignant fibrous histiocytoma. Anti CD34 antibody was valuable for a differential diagnosis of these two lesions.
Abdominal Wall ; Biopsy ; Dermatofibrosarcoma* ; Diagnosis, Differential ; Female ; Histiocytoma, Malignant Fibrous* ; Humans ; Immunohistochemistry ; Middle Aged

Background: Gastric juice volume and acidity are influenced by food, drugs, and patient factors such as age, sex, weight, and fasting time. But almost studies were performed without controlling of these confounding variables. This study was designed to determine the change of gastric juice volume and acidity in relation to the fasting time within a constant food intake. Methods: Fifty-seven healthy patient randomly allocated to one of two groups. Group I was instructed to ingest 200 ml of milk up to 8 hours before anesthesia and Group II was instructed to drink 200 ml of water up to 1~2 hours before anesthesia. After the endotracheal intubation the volume and acidity of gastric juice were measured. Relationships between gastric volume or acidity and fasting time were analysed using correlation analysis. The data were analyzed using Wilcoxon rank sum test, comparing Group I with Group II. Results: There is no significant relationship between gastric juice volume or acidity and the fasting time within the same food intake. Gastric juice volume and acidity of the patients who ingested milk at 8~9 hours before anesthesia were similar to that of those patients who drank water at 1~2 hours before anesthesia. Conclusion: It is necessary to individualize the fasting time of the patients and it seems that water ingestion up to 1~2 hours before anesthesia may be safe.
Anesthesia ; Confounding Factors (Epidemiology) ; Eating ; Fasting* ; Gastric Juice* ; Humans ; Intubation, Intratracheal ; Milk ; Water

A 16-year-old girl developed pyoderma gangrenosum without underlying disease at first. She was treated with local cutaneous dressing and systemic oral prednisolone and minocycline for 10 months, imtermittently. After that, acute leukemia, which was undeterminated type, was developed 4 years after first onset. Since pyoderma gangrenosum may be a preindication of underlying disease, continual follow up check for systemic disease is required.
Adolescent ; Bandages ; Female ; Follow-Up Studies ; Humans ; Leukemia* ; Minocycline ; Prednisolone ; Pyoderma Gangrenosum* ; Pyoderma*

No abstract available.
Lower Extremity*

Any type of urticaria may affect as many as 20% person during their lifetimes, yet the causes of this disorder is established in no more than 20% of cases. So, 308 patients with urticaria(acute ; 73, factitial; 120, chronic;115) were evaluated for results of historical and laboratory tests. The results were summerized as follows,' 1. The disesse primarily affected 2nd % 3rd decade(46.2%) with predominance of woman than man (M: F=1: 1.4). 2. Ninety-seven(31.5%) had at least one abnormal finding in the laboratory tests but, may be twenty-three(7.5%) would have causal relationship. 3. We sought serologic markers of Hepatitis B virus infection in serum from 8(14%) of 57 patients with urticaria. Of these, 4 were found to have abnormal liver function. 4. Sixty-five had taken at least one sort of drug previously or just before urticaria developed, but, may be forty-six(14.9%) would have a causal relationship and the predisposing drugs were analgesics, antibiotics, common cold medication & vitamin etc. 5. The predisposing conditions were as follows ; pulmory tuberculosis, viral hepatitis, hyperthyroidism, tonsillitis & ascariasis, etc. Of these, eleven(3.6%) of this patients were newly found to have underlying diseases. 6. This study showed inciting factors of urticaria in 27.2%(84/308).
Analgesics ; Anti-Bacterial Agents ; Ascariasis ; Common Cold ; Female ; Hepatitis ; Hepatitis B virus ; Humans ; Hyperthyroidism ; Liver ; Palatine Tonsil ; Tonsillitis ; Tuberculosis ; Urticaria* ; Vitamins

No abstract available.
Hand Injuries* ; Hand*