PURPOSE: To describe HRCT findings in five patients with pathologically proved acute interstitial pneumonia MATERIALS AND METHODS: This study included 5 patients with pathological and clinical diagnosis of acute interstitial pneumonia. Mean age of the patients was 40(range, 31-53 years). CT scans were reviewed by two chest radiologists retrospectively. CT scans were assessed for the presence and distribution of ground-glass attenuation, air-space consolidation, interlobular septal thickening, honeycombing, and pleural effusion. RESULTS: The area of ground-glass attenuation and air-space consolidation were seen at HRCT in all 5 patients. These lesions were distributed diffusely in both lungs, but involved predominantly subpleural lungs in 2 patients and posterior lungs in 3 patients. Three patients had mild interlobular septal thickening. None of them showed honeycombing. Three of the 5 patients died within 52 days of initial manifestation. CONCLUSION: Acute interstitial pneumonia differs from the more chronic form of idiopathic interstitial pneumonia in their HRCT findings.
Diagnosis ; Humans ; Idiopathic Interstitial Pneumonias ; Lung ; Lung Diseases, Interstitial* ; Pleural Effusion ; Retrospective Studies ; Thorax ; Tomography, X-Ray Computed

Pathologists and others have been calling the serous cystadenoma of the pancreas "microcystic cystadenoma", following Compagno and Oertel's proposal in l978 because it usually consists of innumerable small cysts (less than 2cm). However, unilocular or predominantly macrocystic types of serous cystadenoma have been occasionally reported. Therefore, they present a difficulty in precise preoperative and intraoperative diagnosis for their simi1ar gross appearance to other cystic lesions of the pancreas. We discovered two cases of macrocystic and unilocular serous cystadenomas of the pancreas which were lined by cuboidal to flattened epithelial cells. They contained PAS positive and D-PAS negative intracytoplasmic glycogen granules. The unilocular, macrocystic and microcystic patterns may represent a morphologic spectrum of a pancreatic neoplasm. So we propose to use the term "serous cystadenoma" rather than microcystic cystadenoma.
Cysts

Purpose: This descriptive study investigated the effects of nurses’ knowledge of withdrawalof life-sustaining treatment, death anxiety, and perceptions of hospice care on their attitudes toward withdrawal of life-sustaining treatment. Methods: Data were collected from 262 nurses at tertiary hospitals, general hospitals, or primary hospitals in Busan, Korea, and statistically analyzed using the t-test, analysis of variance, the Scheffé test, Pearson correlation coefficients, and hierarchical regression analysis. Results: The participants’ scores were 3.68±0.45 (out of 5) for attitudes toward withdrawal of life-sustaining treatment, 0.65± 0.15 (out of 1) for knowledge of withdrawal of life-sustaining treatment, 2.61±0.26 (out of 4) for death anxiety, and 4.06±0.43 (out of 5) for perceptions of hospice care. Furthermore, knowledge of withdrawal of life-sustaining treatment and perceptions of hospice care showed positive correlations with attitudes toward withdrawal of life-sustaining treatment, while death anxiety showed a negative correlation. The most significant factors influencing attitudes toward withdrawal of life-sustaining treatment were perceptions of hospice care, followed by having experienced caring for patients who withdrew life-sustaining treatment, death anxiety, having a spouse, and ethical values, and the overall explanatory power was 43.0%. Conclusion This study showed that perceptions of hospice were an important fac-tor influencing nurses’ attitudes toward withdrawal of life-sustaining treatment. Therefore,it is necessary to develop and validate educational intervention programs that can improve perceptions of hospice care.

Intracranial vasculitis is a rare and disastrous complication of tuberculous meningitis if not treated properly. Focal neurologic deficits according to the vessels involved are common manifestation. Here, we report a 29-year-old man who suffered abrupt, bizarre behavioral changes caused by vasculitis complicating tuberculous meningoencephalitis. The diagnosis of tuberculous meningitis is based upon both the CSF findings and a chest X-ray. His systemic symptoms disappeared by after being administered antituberculous medication but various psychotic features such as hypersomnia, hyperphagia and aggressivebehavior continued. A brain MRI showed multiple small parenchymal tuberculous nodules, and the brain MR angiography revealed a narrowing of the proimal middle cerebral arteries and a reduced visualization of the cerebral vessels, suggesting widespread vasculitis. Intravenous dexamethasone successfully ameliorated his behavioral changes. In addition both the follow up brain MRI and angiography showed a normalization of the previous findings.
Adult ; Angiography ; Brain ; Dexamethasone ; Diagnosis ; Disorders of Excessive Somnolence ; Follow-Up Studies ; Humans ; Hyperphagia ; Magnetic Resonance Imaging ; Meningoencephalitis* ; Middle Cerebral Artery ; Neurologic Manifestations ; Thorax ; Tuberculosis ; Tuberculosis, Meningeal ; Vasculitis

OBJECTIVE: Immunofluorescence microscopy including confocal laser scanning microscopy and electron microscopy were used to study the production of fibronectin, tenascin, and laminin in the cumulus-corona (CC) cells surrounding mature, unfertilized oocytes after ovulation in view of their presumptive importance in the coordination of the processes leading to fertilization and early embryo cleavage, including the final maturation of the ovum, the sperm-egg interaction, and the complex biochemical mechanism between the ovum and the oviduct. METHODS: Mature oocyte-cumulus complex (OCC) was cultured for 24 and 48 hour and fixed in 3.7% formaldehyde. Specimens were incubated with a mixture of primary monoclonal antibodies recognizing different epitopes of fibronectin, tenascin, and laminin, and then with a mixture of secondary antibodies containing FITC, TRITC, and Cy-5 conjugated antibodies. Observation was made by confocal laser scanning microscope equipped with epifluorescece optics. Transmission electron microscopy were used to observe the OCC at 24 and 48 hours after cultrue. RESULTS: The immunocytochemical date demonstrated that CC masses are capable of producing fibronectin and tenascin but their production is heterogeneous in the CC population. Immunoreactivity to fibronectin and tenascin was shown mostly by inner corona cells, and the intensity of immunofluorescence decreased from the central corona cells to the peripheral cumulus cells. Colocalization of fibronectin and tenascin was evident in most CC cells. Moreover, fibronectin and tenascin immunoreactive material was observed in the intracytoplasmic areas, at the plasma membrane level as well as in the extracellular matrix. Whereas, laminin immunofluorescence was found around plasma membrane and extracellular area, but a intracytoplasmic reaction was rarely observed. The distribution of laminin immunofluorescence was similar to that of fibronectin and tenascin, but in some cumulus cells, colocalization between them was not found. Ultrastructurally, cumulus cells projected numerous long, thin microvilli into the intercellular area and some micovilli penetrated into zona pellucida. The inner layer of the cumulus mass was loose arrangement of relatively uniform, small cells with widened intercellular spaces, whereas in the outer layer, cumulus cells are rather larger in size and compact arrangement by narrow, irregular spaces. A small and large linear gap junctions were easily found at cell contacts. The cytoplasm of most cells had abundant organelles typical of steroidogenesis: numerous mitochondrias, a well-developed smooth endoplasmic reticulum, electron dense lipid droplets, and bundles of microtubules and microfilaments. Rudimentary disrupted basal lamina along the cytoplasmic border was rarely seen in a few inner conora cells. CONCLUSION: Even though the functional role of these extracellular matrix proteins remains still unclear, it is reasonable to suggest that they are necessary in various steps of the reproductive process. Cumulus cells appears to be a heterogeneous and dynamic system for suitable microenviroment of fertilization. And functional differences between corona and cumulus cells during the oocyte denudation may be accounted for particular distribution of these adhesive proteins and steroidogenesis-related organelles.
Actin Cytoskeleton ; Adhesives ; Animals ; Antibodies ; Antibodies, Monoclonal ; Basement Membrane ; Cell Membrane ; Cumulus Cells ; Cytoplasm ; Embryonic Structures ; Endoplasmic Reticulum, Smooth ; Epitopes ; Extracellular Matrix ; Extracellular Matrix Proteins ; Extracellular Space ; Female ; Fertilization ; Fibronectins* ; Fluorescein-5-isothiocyanate ; Fluorescent Antibody Technique ; Formaldehyde ; Gap Junctions ; Immunohistochemistry ; Laminin* ; Microscopy, Confocal ; Microscopy, Electron* ; Microscopy, Electron, Transmission ; Microscopy, Fluorescence ; Microtubules ; Microvilli ; Mitochondria ; Oocytes ; Organelles ; Oviducts ; Ovulation ; Ovum ; Sperm-Ovum Interactions ; Tenascin* ; Zona Pellucida

PURPOSE: The purpose of this study was to determine subjective happiness related factors in Korean nursing students. METHODS: A purposive sample of 200 nursing students was recruited for the cross-sectional survey design. The instruments were perceived stress scale, major satisfaction scale, resilience scale, and subjective happiness scale. Data were analyzed using descriptive statistics, hierarchical linear regression, and the Sobel test for testing mediating effects. RESULTS: The mean score of stress, major satisfaction, resilience and subjective happiness was 2.21, 3.95, 3.60 and 5.03, respectively. Perceived health status, stress_positive perception, stress_negative perception, resilience_self confidence, resilience_positivity, resilience_social support had significant effects on subjective happiness. Explained variance for the subjective happiness was 53.4%. Resilience had a partial mediating effect in the relationship between stress and subjective happiness (Sobel test: Z=-5.67, p<.001). Also, resilience had a mediating effect in the relationship between major satisfaction and subjective happiness (Sobel test: Z=5.65, p<.001). CONCLUSION: Based on the findings of this study, nursing intervention programs focusing on improving resilience are recommended to improve subjective happiness in nursing students.
Cross-Sectional Studies ; Happiness* ; Humans ; Linear Models ; Negotiating ; Nursing* ; Students, Nursing*

This study is to find out changes in medical practice at a university hospital before and after covering intraocular lens (IOL) from the health insurance benefit. The coverage started on March 1, 1993 and a total of 596 cases who were discharged from July 1 to December 31, 1992 and 580 cases who were discharged from July 1 to December 31, 1993 were analyzed. Since the standard reimbursement scheme was changed from March 1, 1993, the charges for 1992 were transformed into 1993 scheme. Major findings are as follows: Average length of stay was statistically significantly decreased from 8.24 days in 1992 to 6 86 days in 1993. Charges except IOL has been statistically significantly decreased from 501,000 won in 1992 to 444,000 won in 1993. Charges for drugs and injection have been reduced. However, charge per day for them was not much different. This is due to decrease in length of stay. Charges for laboratory tests and radiologic examination were quite the same. charges which are not covered by the insurance remained the same. The revenue of the hospital was reduced as expected. However, the hospital reduced the length of stay and increase the turnover rate in order to compensate the potential loss of revenue due to the difference of reimbursement between the out-of-pocket expense and the insurance coverage. By introducing the IOL benefit in the insurance, the insured pays less, hospital generates more revenue through shortening the hospital stay, and the total medical care cost becomes less nationwidely.
Health Care Costs ; Insurance ; Insurance Coverage ; Insurance, Health* ; Length of Stay ; Lenses, Intraocular*

No abstract available.
*Bile Duct Diseases/diagnosis ; *Bile Ducts, Intrahepatic ; Female ; *Hamartoma/diagnosis ; Humans ; Liver Diseases/diagnosis ; Middle Aged

PURPOSE: The purpose of this study was to compare knowledge level of those clinical nurses who received HPV vaccine and those who did not and their perception of the relatedness of HPV vaccine to causes of cervical cancer. METHODS: A total of 249 clinical nurses were surveyed from June to July, 2009. The questionnaire originally developed by Kim & Ahn (2007) examined HPV-related knowledge originally and the tool for perception of the causes of cervical cancer was originally developed by Kim (1993). The total number of subjects equaled to: vaccination group of 52 (20.9%) and non-vaccination group of 197 (79.1%). RESULTS: Vaccination group showed significantly higher score of both knowledge of HPV vaccination and the perception of the cause of cervical cancer in comparison to the nonvaccination group at (p<.05). Among 4 subscales of the perception of causes of cervical cancer, destiny and constitution subscale scores were significantly different between the two groups at (p<.05). CONCLUSION: Clinical nurses need to constantly update with current knowledge of HPV and be prepared with currently changing cancer prevention strategies, especially in cervical cancer.
Constitution and Bylaws ; Humans ; Nurse Clinicians ; Papillomavirus Vaccines ; Surveys and Questionnaires ; Uterine Cervical Neoplasms ; Vaccination

Eight cases of combine hepatocellular-cholangiocarcinoma(HCC-CC) of the liver were analysed along with their growth patterns and histologic subtypes to draw a possible implication in understanding of their histogenesis. The relative incidence of combined HCC-CC among the surgically resected primary carcinomas of the liver(485 cases) was 1.6%. The combination patterns varied and were classified as follows; the multinodular tumor, each consisting of HCC or CC element(type 1) was found in 1 case, the single tumor mass with two distinct compartments of HCC and CC(type 2) in 3, and the single tumor with random mixture of two elements(type 3) comprised the remaining 4 cases. Of the 7 cases of single tumor mass(type 2 and 3) HCC and CC comprised the major component in 5 and 2 cases, respectively. The histologic features of both HCC and CC elements were not different from those of isolated HCC and CC, except for two of CC element in type 3 which disclosed the intermediated differentiation or socalled cholangiolocellular carcinoma in part. We conclude that there is no significant difference in the relative incidence of combined HCC-CC among primary carcinomas of the liver and their subtypes compared to that in other countries, regardless of high incidence of both HCC and CC in Korea. Also, we discussed a possible histogenisis along a hypothesis that some of the combined HCC-CC be the consequence of interposition of different cell type from a new subclone into the growth of an initial single cell type of primary carcinoma of the liver.
Incidence ; Carcinoma, Hepatocellular