Gestational trophoblastic disease associated with the tubal pregnancy is uncommon, and the incidence has been described as 1/5000 tubal pregnancy. We have experienced a case of metastatic gestational trophoblastic disease(GTD) in the lung occuring with complete hydatidiform mole arising in tubal pregnancy. The patient was a 39-year-old, G4P2A2L2 woman with amenorrhea for 5 weeks. Ectopic pregnancy in the right fallopian tube was suspected on transvaginal ultrasonogram. A right adnexectomy was performed. The fallopian tube was markedly dilated and ruptured. The right ovary and a round hematoma had adhered to the external surface of the fallopian tube. On gross examination, no molar tissue was identified. On microscopic examination, the lumen of the dilated fallopian tube was filled with blood clots admixed with several chorionic villi showing hydropic swelling and marked proliferation of atypical trophoblasts. Proliferating syncytio-and cytotrophoblasts invaded the wall of the blood vessels of the fallopian tube and sheets of trophoblasts and some villi were identified in the lumen of blood vessels. Multiple pulmonary nodules thought to be metastatic nodules were identified in the chest X-ray and serum beta-HCG had increased 2 weeks later. This case indicates that a careful pathological examination in the ectopic pregnancy is mandatory, because tubal GTD is not clinically distinguishable from ordinary tubal pregnancy.
Pregnancy ; Female ; Humans ; Neoplasm Metastasis

PURPOSE: This study was to verify the effects of spiritual care module education programs by applying it to nurses. METHOD: The study employed a non-equivalent control group pretest-posttest design in a quasi-experimental basis. Subjects were 93 nurses (46 in an experimental group and 47 in a control group) with more than two years clinic experience, attending a bachelor program of K University, in I city, Korea. The program consists of courses with 2.5 hours per week for seven weeks. RESULT: Scores of spiritual needs and spiritual nursing competence increased significantly in the experimental group. The score of spirituality and spiritual well-being also increased in the experimental group, but not significantly. CONCLUSION: The spiritual care module education program was considered to be an effective nursing intervention education course. Nurses educated with this program seemed to perform better nursing interventions for subjects facing difficulties or confusion by helping them restore and cope with those problems by themselves. Therefore, it is recommended that spiritual care module education should be settled as a regular course of nursing college with consideration to the corrections and supplements mentioned in this study.
Education* ; Korea ; Mental Competency ; Nursing ; Spirituality

No abstract available.
Humans*

PURPOSE: To identify current status of university health care program. METHODS: Data and information from homepages of 309 colleges or universities in South Korea were collected. The data was analyzed by frequencies, t-test, chi2 test with SPSS Ver. 18.0. RESULTS: 117(37.9%) universities had organization of health care. Whether university had health care program or not had shown significantly depended on number of students, types of school (university or college), region, and existence of medical and nursing course. Medical course was shown as a strong predictor for facilitating university health care program limitedly focusing on diseases treatment. Health promotion programs have been operated in 15 universities, vaccination programs in 10 universities, and health screening in 20 universities. CONCLUSION: It is strongly recommended to revise the School Health Law for constructing a comprehensive university health care program consolidating health counseling and physical training.
Counseling ; Delivery of Health Care* ; Health Promotion ; Humans ; Jurisprudence ; Korea ; Mass Screening ; Nursing ; School Health Services ; Vaccination

The purpose of this study was to investigate the displacement of and the stress distribution on the prosthesis, abutment, and its supporting tissues under functional load, and the effect of alteration in root length of 2nd abutment. The 3-dimensional finite element method was used and the finite element models were prepared in which the abutments of left mandibular 5 unit fixed partial denture were canine, the 1st premolar and the 2nd molar, and the root lengths of canines were as follows. Model I: Root length of canine was 2mm longer than the 1st premolar Model II: Root length of canine was 2mm shorter than the 1st premolar Static compressive force of 300N was applied to connector between 2nd premolar & 1st molar, and then von Mises stress, displacement and reaction force were obtained. The results were as follows : 1. In fixed partial denture, prosthesis under load on pontic was rotated around mesio-distal long axis of it from longual side to buccal, and simultaneously bended in buccal and gingival direction with mesial end deformed in gingival direction and distolingual end in occlusal 2. Clinical crowns of abutments were bended in the same directions with those in which prosthesis deforms. Due to that, roots of anterior abutments were twisted in counterclockwise with concentration of shear stress on distal or distobuccal sides of their cervices, and that of posterior was in clockwise with concentration of shear stress on mesiobuccal side of it in the same level with anterior abutments. 3. In case that root length of the 2nd abutment was longer than that of the 1st abutment, its displacement and reaction force which means the force tooth exerts on the surrounding periodontal tissues were smaller but shear stress on itself was larger than in the case root length of 2nd abutment was shorter.
Axis, Cervical Vertebra ; Bicuspid ; Crowns ; Denture, Partial, Fixed* ; Finite Element Analysis* ; Molar ; Prostheses and Implants ; Tooth

BACKGROUND: Cyclosporine is an immunosuppressant that acts on T-cells and cytokines. Although the efficacy of systemic cyclosporine in the treatment of psoriasis has been established, the relationship between response to cyclosporine and systemic inflammation using the high sensitivity C-reactive protein (hs-CRP) immunoassay is still unclear. OBJECTIVE: The aim of this study is to investigate whether systemic inflammation with clinical and laboratory findings indicate a response after 8 weeks of oral 3 mg/kg cyclosporine therapy in patients with psoriasis. METHODS: Thirty-five patients with psoriasis were treated with oral cyclosporine for 8 weeks. The clinical response to oral cyclosporine was determined using the PASI score. The correlation between hs-CRP and the treatment response to cyclosporine was analyzed. Also, descriptive characteristics of psoriatic patients with psoriatic arthritis, metabolic syndrome, and high BMI (BMI> or =25) were investigated. RESULTS: Hs-CRP levels and PASI scores were significantly reduced after 8 weeks of oral cyclosporine treatment. Eight patients showed excellent response, fifteen a good response, and twelve a moderate response. The baseline hs-CRP levels in excellent and good response groups (1.35+/-0.59 mg/L and 1.32+/-0.86 mg/L, respectively) to oral cyclosporine were significantly higher than the moderate response group (0.51+/-0.20 mg/L, p=0.004). Psoriatic patients with psoriatic arthritis, metabolic syndrome, and high BMI demonstrated higher levels of baseline hs-CRP. Patients with psoriatic arthritis and metabolic syndrome showed greater response to cyclosporine treatment. CONCLUSION: Patients with greater inflammatory burden, as demonstrated by elevated baseline hs-CRP, have better treatment responses to cyclosporine compared to patients with lesser inflammation.
Arthritis, Psoriatic ; C-Reactive Protein ; Cyclosporine ; Cytokines ; Humans ; Immunoassay ; Inflammation ; Psoriasis ; T-Lymphocytes

It has been known that the immunological functions against cancer cells were diminished, and these phenomena result from the inhibition of cell-mediated immunity by substance(s) secreted from cancer cells. It was also reported that the immunological functions decreased in patients with stomach cancer, which is the most frequent cnacer in Korean. However, the nature and function of the inhibitory factor(s) orignated from stomach cancer have not been identified. To elucidate effects of immuological inhibitory factor(s) secreted from cancer cells, SNU-1 (stomach cancer) and SW480 P109/R3P2 (colon cancer) were used in this study. Jurkat T cell line, an acute T cell leukemia, was pre-incubated with fractionated cancer cell culture supernatant for 3 days, then was stimulated with PMA, PWVanti-CD28 mAb or PMA/ionomycin for 8 hrs respectively. Fraction of SNU-1 (3 - 10 kDa) and above 10 kDa of SW480 P109/R3P2 inhibited the expression of IFN-r mRNA when Jurkat T cell was stimulated with PMA. However, there were no difference in IL-2 and IL-4 gene expression response to either PMA/anti-CD28 mAb or PMA/ionomycin. These results show that cancer cells secret some inhibitory factor(s) acting on the immune response, especially IFN-r gene expression of the Jurkat T cells response to PMA. Therefore, it suggests that the inhibitory factor(s) secreted from cancer cells influences on. the PKC-dependent pathway related to the signal transduction by PMA.
Cell Culture Techniques ; Cell Line ; Gene Expression ; Humans ; Immunity, Cellular ; Interleukin-2 ; Interleukin-4 ; Leukemia, T-Cell ; RNA, Messenger ; Signal Transduction ; Stomach Neoplasms ; T-Lymphocytes

PURPOSE: To evaluate the outcome of coronary lesions for efficacy of dexamethasone therapy after additional immunoglobulin(IVIG) retreated in initial IVIG-resistant Kawasaki disease(KD). METHODS: Retrospective studies were performed on 438 cases of KD treated with one or two episode of high-dose IVIG and 24 cases with dexamethasone therapy after additional immunoglobulin(IVIG) retreated in initial IVIG-resistant Kawasaki disease(KD) at this hospital from June 2000 to January 2004. 2D echocardiogram was done at admission, 2 months later and every 2 or 3 months when coronary lesion had improved more than 2 months later. RESULTS: In 108(24.7%) of 438 cases with IVIG therapy only, 10(41.7%) of 24 cases with dexamethasone therapy after additional immunoglobulin(IVIG) retreated in initial IVIG-resistant Kawasaki disease(KD), coronary abnormality had been shown by initial 2D-echocardiogram examined at acute stage. In 10(2.3%) of 438 patients with IVIG therapy only, and in 3(12.5%) of 24 cases with additional IVIG retreatment, coronary lesions were still remained at follow-up echocardiogram. Even though it had tendency to increase the coronary lesions in the group with dexamethasone therapy after additional immunoglobulin(IVIG) retreated in initial IVIG-resistant Kawasaki disease(KD), there was no significant differences about the incidence of coronary lesions between two groups. There was no significant differences in age, sex, and other clinical findings between two groups. CONCLUSION: The combination therapy with high doses of IVIG and aspirin in KD is the standard treatment but not always effective. The dexamethasone therapy may be another treatment of choice after additional immunoglobulin(IVIG) retreated in IVIG- resistant Kawasaki disease(KD).
Aspirin ; Dexamethasone* ; Follow-Up Studies ; Humans ; Immunoglobulins, Intravenous ; Incidence ; Mucocutaneous Lymph Node Syndrome* ; Retreatment ; Retrospective Studies

PURPOSE: The purpose of this study is to evaluate the role of plasma brain natriuretic peptide(BNP) concentraion in Kawasaki disease(KD) and to evaluate the relationship of BNP and Tissue doppler imaging(TDI) in ventricular function. METHODS: Plasma BNP concentration was obtained in the acute phases of KD(n=49) and non-KD(n=36). TDI and conventional echocardiography were performed in 49 patients in acute phase of KD. E' velocity, A' velocity at the lateral mitral annulus, interventricular septum, lateral tricuspid annulus were measured. RESULTS: The mean plasma BNP concentration in patients with KD in the acute phase was significantly higher than non-KD(61.1+/-100.9 pg/mL vs 13.2+/-9.5 pg/mL, P<0.05). There was significant negative correlation with BNP and E' velocity, E/E' ratio at lateral mitral annulus in the aucte phase of KD. CONCLUSION: The level of plasma BNP significantly increased in aucte phase of KD. But, there was no definite level of plasma BNP to diagnosis of KD. Diatolic ventricular function was decreased in acute phase of KD which BNP is elevated by TDI.
Brain* ; Diagnosis ; Echocardiography ; Humans ; Mucocutaneous Lymph Node Syndrome* ; Natriuretic Peptide, Brain* ; Plasma* ; Ventricular Function

Gastrointestinal stromal tumors (GISTs) constitute the most common primary mesenchymal tumors of the digestive tract and characteristically express c-kit (CD117). GISTs are the most common non-epithelial tumor of the GI tract and frequently originate from the stomach and small bowel. Specifically, the synchronous occurrence of a GIST with other epithelial tumors is rarely reported. Recently, we discovered one case of a concurrent gastric cancer and a small bowel GIST that was initially suspected to be peritoneal seeding from gastric cancer. The patient was initially admitted with epigastric pain. Gastric cancer with peritoneal seeding was suspected after an evaluation. Following a laparoscopic examination, a distal gastrectomy with D2 lymph node dissection and small-intestine segmental resection was performed. The final pathologic diagnosis was early gastric cancer and high-risk small bowel GIST. The patient refused adjuvant therapy for the GIST, and currently shows no other marked indisposition. He has been disease-free for 14 months.
Gastrectomy ; Gastrointestinal Stromal Tumors ; Gastrointestinal Tract ; Humans ; Lymph Node Excision ; Seeds ; Stomach ; Stomach Neoplasms