An analysis of echocardiograms was made in 50 patients with pericardial effusion of various origins, diagnosed by clinical and M-mode echocardiographic examinations. In these cases the estimated volume of pericardial effusion ranged between 40 ml and 999 ml. The width of echo-free space behind the left ventricular wall which reflect the amount of effusion showed a significant positive correlation with the systolic excursion and the diastolic mean velocity of both right and left ventricular epicardial surfaces. The echocardiographic patterns of so-called pseudo-mitral valve prolapse and a notch on the right ventricular epicardial surface during systole were found more frequently in patients with large pericardial effusion. Thus, in pericardial effusion, and echocardiographic examination is useful for the visualization of the abnormal motions of cardiac structures as well as for its diagnosis.
Diagnosis ; Echocardiography* ; Humans ; Pericardial Effusion* ; Prolapse ; Systole

No abstract available.
Cataract* ; Chlorpromazine* ; Skin Pigmentation* ; Skin*

Disseminated intravascular coagulation (DIC) is a pathological syndrome in which activation of coagulation cascade leads to fibrin clot formation, consumption of platelets and coagulation factors, and secondary fibrinolysis. We report a case of severe postoperative hemorrhagic diathesis due to DIC. A 59-year-old man was scheduled for reduction of tibia fracture and anatrophic nephrolithotomy of staghorn calculi. On the fifth postoperative day, second operation was performed for nephrectomy due to perirenal hematoma. Two days later, third operation was performed for hemostasis because of the continuous bleeding. Coagulation tests showed positive DIC profiles of thrombocytopenia, hypofibrinogenemia, increased fibrin degradation products, and prolonged prothrombin time and thrombin time. The patient recovered uneventfully and discharged on the 59th postoperative day.
Blood Coagulation Factors ; Calculi ; Dacarbazine ; Disseminated Intravascular Coagulation* ; Fibrin ; Fibrin Fibrinogen Degradation Products ; Fibrinolysis ; Hematoma ; Hemorrhage* ; Hemorrhagic Disorders ; Hemostasis ; Humans ; Middle Aged ; Nephrectomy ; Postoperative Complications ; Prothrombin Time ; Thrombin Time ; Thrombocytopenia ; Tibia

BACKGROUND: Superior migration of humeral head has been conventionally determined by measuring the acromiohumeral distance (AHD), We sought to devise a novel measurement system more reliably and accurately than AHD. We described a structural landmark called 'C-line'. In this study, we investigated the clinical usefulness of 'step-off of the C-line (SOC)' compared to that of AHD. METHODS: The C-line formed from the medial margin of the proximal humeral head continuing up to the inferior margin of the articular glenoid and then to the lateral border of the scapula. The superior migration of the humeral head triggered by a rotator cuff tear introduces a discontinuity in this C-line. We measured the distance of this discontinuity. We enrolled 144 patients who underwent a rotator cuff repair. We selected 58 controls who didn't have any cuff lesions apparent on magnetic resonance imaging. Using radiographs derived from standardized true anteroposterior views of the shoulder, we measured the SOC and the AHD. We used t-tests for statistical analyses. RESULTS: A rotator cuff tear was associated with an increase in SOC and a decrease in AHD. In control group, the mean SOC was 1.29 ± 1.71 mm and AHD was 9.71 ± 2.65 mm. In cuff tear group, the mean SOC was 3.15 ± 3.41 mm and AHD was 8.28 ± 1.76 mm. The mean SOCs of the patient group in relation to the mean SOC of the control group according to tear size, the SOCs of medium tear and lager groups showed statistically significant increase (p<0.05). CONCLUSIONS: The SOC may be a similarly effective to diagnose cuff tears of medium size and larger compared with AHD.
Humans ; Humeral Head* ; Magnetic Resonance Imaging ; Methods* ; Rotator Cuff ; Scapula ; Shoulder ; Tears

PURPOSE: This study was aimed to evaluate the methodological issues and comprehensiveness of workplace bullying instruments and to suggest a taxonomy of psychological abuse. METHODS: Nineteen instruments applied in health care organizations and 469 questionnaire items mainly regarding psychological abuse were collected through a literature review. Three researchers classified the questionnaire items according to a “taxonomy of psychological abuse in the workplace.” RESULTS: Many instruments of workplace bullying were developed in the 2000s using a reflective measurement model, but their psychometric property was not sufficient and the measurement model is questioned. Based on the questionnaire items, the “taxonomy of psychological abuse in the workplace” was modified by adding two new subcategories (unachievable work and unfair treatment) and clarifying some operational definitions. According to the modified taxonomy of 11 (sub)categories, the reviewed instruments assessed 6.5 (sub)categories on average. No instrument measured all (sub)categories. Category 4.2 (disrespect, humiliation, and rejection of the person) was measured in all instruments, followed by Categories 5 (professional discredit and denigration) and 1.2 (social isolation) behaviors. CONCLUSION: The current instruments are not comprehensive enough. It is suggested that the modified taxonomy is verified and guide more reliable and inclusive instruments in the future. Furthermore, a formative measurement model, which defines a bullying as an inventory of different types of behaviors, should be used.
Aggression ; Bullying* ; Classification* ; Delivery of Health Care* ; Hostility ; Psychometrics ; Surveys and Questionnaires

The antihypertensive effect of trimazosin was studied in 24 cases of essential hypertension, which include 9 cases with pretreatment diastolic pressure of 114mmHg or more, for a period of 4 weeks. The average pretreatment systolic and diastolic blood pressures were approximately 175mmHg and 114mmHg, respectively. The treatment was started with 100mg of trimazosin daily in 2 divided doses and and the drug was titrated upward at weekly interval by 100mg up to 400mg/day depending on the response of the blood pressures. Routine blood counts, urinalyses, liver and kidney function tests, electrolyte balance, total serum cholesterol and triglyceride were determined before and at the end of treatment. The diastolic blood pressure fell 10mmHg or more in 20 out of 24 cases(83.3%), and in 12 cases out of 20 favorable responders it fell to 90mmHg or below. The pretreatment diastolic blood pressure in 4 nonresponders was all 115mmHg or more. The antihypertensive effect appeared during the first week of therapy and progressively increased until the end of treatment week without causing postural hypotension. Unpleasant symptoms appeared in 12 cases during treatment, which include dizziness, headache, numbness in the extremities and tinnitus in the decreasing order of frequency. However, these symptoms were mild and transient in all cases disappearing spontaneously despite continued medication. No significant biochemical changes in the blood were recorded after treatment. We conclude that trimzosin seems to be a safe and effective antihypertensive drug particularly useful for the treatment of mild to moderate hypertension.
Blood Pressure ; Cholesterol ; Dizziness ; Extremities ; Headache ; Hypertension* ; Hypesthesia ; Hypotension, Orthostatic ; Kidney Function Tests ; Liver ; Tinnitus ; Triglycerides ; Urinalysis ; Water-Electrolyte Balance

PURPOSE: This study aimed to identify and compare hospice care research topics between Korean and international nursing studies using text network analysis. METHODS: The study was conducted in four steps: 1) collecting abstracts of relevant journal articles, 2) extracting and cleaning keywords (semantic morphemes) from the abstracts, 3) developing co-occurrence matrices and text-networks of keywords, and 4) analyzing network-related measures including degree centrality, closeness centrality, betweenness centrality, and clustering using the NetMiner program. Abstracts from 347 Korean and 1,926 international studies for the period of 1998–2016 were analyzed. RESULTS: Between Korean and international studies, six of the most important core keywords-“hospice,”“patient,”“death,”“RNs,”“care,” and “family”-were common, whereas “cancer” from Korean studies and “palliative care” from international studies ranked more highly. Keywords such as “attitude,”“spirituality,”“life,”“effect,” and “meaning” for Korean studies and “communication,”“treatment,”“USA,” and “doctor” for international studies uniquely emerged as core keywords in recent studies (2011~2016). Five subtopic groups each were identified from Korean and international studies. Two common subtopics were “hospice palliative care and volunteers” and “cancer patients.” CONCLUSION: For a better quality of hospice care in Korea, it is recommended that nursing researchers focus on study topics of patients with non-cancer disease, children and family, communication, and pain and symptom management.
Child ; Hospice Care* ; Hospices* ; Humans ; Korea* ; Nursing ; Nursing Research ; Palliative Care ; Semantics

Forty cases of infiltrating duct carcinoma of the breast were examined immunohistochemically for expression of TGF-beta and angiogenesis in order to analyze significant correlation with prognostic parameters including tumor size, axillary lymph node metastasis, clinical stage, histologic grade, estrogen receptor and progesterone receptor status. The TGF-beta expression was observed in tumors center and advancing edges of tumors. To determine microvessel density for angiogenesis, we stained endothelial cells for Factor VIII related antigen and counted microvessel within tumor. The results were as follows: 1) The strong immunohistochemical expression of TGF-beta and higher counts of microvessels were observed in advancing edges of tumors (p<0.05). 2) The TGF-beta expression in the advancing edges of tumors was closely related to clinical stage and presence of axillary lymph node metastasis (p<0.05). 3) The mean microvessel counts were significantly higher in tumors from patients with axillary lymph node metastasis and increased with increasing clinical stage (p<0.05). 4) The TGF-beta expression was not related to histologic grade, estrogen receptor and progesterone receptor status(p>0.05). Therefore, the results suggested that the TGF-beta expression and angiogenesis in infiltrating duct carcinoma of the breast may play an important part in prognostic factors, closely related to the lymph node metastasis and clinical stage.
Neoplasm Metastasis

The cardiac dimensions and functions were studied by analyzing simultaneously recorded M-mode echocardiograms and phonocardiograms in 24 cases of essential hypertension with no evidence of heart faliure, and also in 20 healthy adults for comparison. Thirteen hypertensives out of 24 had findings consistent with left ventricular hypertrophy on either routine chest roentgenograms or electrocardiograms or both(group II) and the remaining 11 had no such findings(group I). The posterior wall and septal thickness, and isovolumic relaxation time were significantly was increased even in the group I as well as in the group II. The isovolumic relaxation time was correlated well with the septal thickness in both groups. In contrast, a significant increase in left atrial and left ventricular systolic dimensions was noted only in the group II, and so was a significant reduction in the fractional shortening and mean velocity of circumferential fiber shortening. These findings suggest that the echocardiographic examination is useful in patients with essestial hypertension for the early dagnosis of the increased thickness of the posterior wall and the septum, and the abnormality during early diastolic relaxation of the left ventricle, prior to the appearance of the ventricular hypertrophy on the routine chest films amd/or electrocardiograms, and also that echocardiograms enable early detection of the systolic dysfunction of the hypertrophied left ventricle in the absence of apparent failure.
Adult ; Echocardiography* ; Electrocardiography ; Heart ; Heart Ventricles ; Humans ; Hypertension* ; Hypertrophy ; Hypertrophy, Left Ventricular ; Relaxation ; Thorax

Hong Seok-hoo, who took charge of Jejungwon, was successful in translating Jiro Tsuboi's book titled "Sinpyeonsaengnigyogwaseo (1897)" and publishing it with a title of "New Edition of Physiology Textbook" in 1906. Jiro Tsuboi, the original author of that book, was a doctor having majored in Hygienics in Germany and was also known to have done pioneering work in Hygienics and Occupational and Environmental Medicine in Japan. At that time, he wrote that book for the purpose of teaching his students at Ordinary Middle School and Normal School. Therefore, it was not intended as a Physiology textbook for medical students, but an introductory book explaining Physiology with a wide range of subjects including hygienic matters in a broader sense. Hong Seok-hoo made an almost complete translation of the "New Edition of Physiology Textbook." While editing the book, however, he changed some of the most Japanese-style contents to meet the Korean conditions then, and made up for some insufficient contents with reference to the original author's other books. Although it was not included in an original version of that book, he also compiled a physiology dictionary in order to help Korean readers acquire medical terms in a more systematic way. Just like other textbooks of Jejungwon, the "New Edition of Physiology Textbook" was also put into Korean only. Hong Seok-hoo accepted Japanese-style medical terms, but also changed some of them or coined new words, considering the Korean circumstances then. He seemed to do so in an effort to introduce Western medicine in a more independent way while overcoming his limitations of translation. In particular, this book criticized that a long-term use of cosmetics might cause a serious lead poisoning from a Christian viewpoint, saying that a God-created human body should be kept intact as it is. In addition, in the course of reediting premodern books, the term "Lord" was changed into "God," which is considered a kind of fusion between traditional values and missionary medicine. While translating books, Jejungwon could put such fusion into practice because it was a hospital established under the banner of the propagation of Christianity. Besides the "New Edition of Physiology Textbook," at least five physiology textbooks were also translated into Korean in the last years of Daehan Empire for the purpose of teaching students modern subjects like Physiology, Health and Hygienics in educational institutions including Boseong School, Hwimun School and Soongsil School. On the other hand, the "New Edition of Physiology Textbook" was first translated at the end of Daehan Empire in order to foster more professional doctors in medical schools compared to those schools. In this respect, by translating the "New Edition of Physiology Textbook," Jejungwon can be considered as playing a pioneering role in translating Physiology textbooks in the late Daehan Empire.
Cosmetics ; Environmental Medicine ; Fees and Charges ; Germany ; Hand ; Human Body ; Humans ; Japan ; Lead Poisoning ; Missions and Missionaries ; Numismatics ; Schools, Medical ; Students, Medical ; Translating