We report an autopsy case of secondary hemochromatosis associated with multiple frequent blood transfusion for the treatment of aplastic anemia. A 23-year-old man had been diagnosed as having aplastic anemia at the age of 13. He received a whole blood transfusion, about 1280 ml, every month during the past 10 years. Recently he developed diabetes mellitus and a congestive heart failure. The autopsy revealed that multiple organs were affected by secondary hemochromatosis, including the liver, heart, pancreas, spleen, bone marrow, stomach, thyroid gland, adrenal glands, and testes. The lungs and liver showed gross and microscopic findings consistent with a congestive heart failure in addition to hemochromatosis. The details are presented. This is a case of rare secondary hemochromatosis occurring in a young man and presenting the classic histopathologic changes indistinguishable from those of primary hemochromatosis.
Adrenal Glands ; Anemia ; Anemia, Aplastic* ; Autopsy* ; Blood Transfusion ; Bone Marrow ; Diabetes Mellitus ; Heart ; Heart Failure ; Hemochromatosis* ; Humans ; Liver ; Lung ; Pancreas ; Spleen ; Stomach ; Testis ; Thyroid Gland ; Young Adult

PURPOSE: This study was performed to measure nursing professionalism, organizational communication, and intent to stay, and investigate the relationship among these three variables in geriatric hospital nurses. METHODS: A cross-sectional survey was done with the participation of 195 nurses working at 23 geriatric hospitals in B city of Gyeongsangnam-do, Korea. Data were collected from January 19 to 25, 2018 using structured questionnaires and were analyzed using SPSS/WIN program. RESULTS: The geriatric hospital nurses' scores for nursing professionalism, organizational communication, and intent to stay were relatively lower than those of general hospital nurses. Each of these three variables was differently perceived according to participants' general characteristics but there was a positive correlation between them. The factors influencing intent to stay were organizational communication, age and through newspapers/advertising (one of motivations for working at geriatric hospitals). These three variables explained 47% of intent to stay. CONCLUSION: To increase intent to stay in geriatric hospital nurses, nursing or hospital managers must develop and apply programs that help improve nurses' professionalism and organizational communication. Especially geriatric hospital nursing managers should try to provide organizational communication enhancement programs for young and inexperienced nurses.
Cross-Sectional Studies ; Gyeongsangnam-do ; Hospitals, General ; Korea ; Nursing ; Professionalism

PURPOSE: This methodological study was conducted to test the reliability and validity of an instrument that measures attitudes of advance directives (ADs) among nurses. METHODS: 1) Sixteen items related to attitudes in the English version of the Knowledge, Attitudinal, and Experiential Survey on Advance Directives (KAESAD) were forward/backward translated into Korean. 2) The content was validated by an expert panel (three nursing professors and eight hospice nursing specialists). 3) The preliminary 12 items were selected as a tool to assess the Korean version of Nurses' Attitudes towards Advance Directives (NAAD-K). 4) The instrument was validated by a survey (n=216). 5) It was confirmed to use the 12 items for the final version of the instrument. RESULTS: NAAD-K was shown to be valid in terms of factors, items and content. The three factors extracted from the factor analysis were named as follows: Caring for patients with an AD (factor 1), nurses' role in informing patients (factor 2) and patient right (factor 3). The three factors explained total variance 57.796%. Factor loadings of the 12 items ranged from 0.47 to 0.93. For the 12 items, Cronbach's alpha was 0.81, and Guttman split-half coefficient was 0.78. CONCLUSION: This instrument was identified to be applicable with satisfactory reliability and validity for further use in measuring nurses' attitudes towards ADs in hospice and palliative care.
Advance Directives ; Hospice and Palliative Care Nursing ; Hospices ; Humans ; Methods ; Nursing ; Palliative Care ; Patient Rights ; Reproducibility of Results

This study was conducted to measure the difference in levels of cerebral metabolites in the right and left hemispheres, gray (GM) and white matter (WM), imaging planes, and anatomical regions of healthy dogs to establish normal variations. Eight male Beagle dogs (1 to 4 years of age; mean age, 2 years) with no evidence of neurologic disease were studied. Using the multi-voxel technique on a 1.5 Tesla magnetic resonance imaging scanner, metabolite values (N-acetyl aspartate [NAA], choline [Cho], creatine [Cr]) were obtained from the frontoparietal WM, parietal GM, temporal GM, occipital GM, thalamus, cerebellum, mid-brain, and pons. There was no significant difference in levels of these metabolites between the right and left in any locations or between the GM and WM in the cerebral hemispheres. However, there were significant differences in metabolite ratios within imaging planes. The NAA/Cr was lower in the cerebellum than other regions and the thalamus had a higher Cho/Cr and lower NAA/Cho ratio than in other regions. The spectral and metabolic values will provide a useful internal reference for clinical practice and research involving multi-voxel magnetic resonance spectroscopy. Measurement of metabolite values in the transverse plane is recommended for comparing levels of regional metabolites.
Animals ; Aspartic Acid ; Cerebellum ; Cerebrum ; Choline ; Creatine ; Dogs* ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy* ; Male ; Pons ; Rabeprazole ; Thalamus ; White Matter

Nuchal fibroma (NF) is a rare, benign soft tissue tumor of the posterior neck, but can also occur extranuchally. Usually, it is a slow-growing, asymptomatic solitary mass that occurs more frequently in middle-aged males. Histologically, hypocellular dense collagens in the dermis and subcutaneous layer are characteristic. Careful total excision is necessary for the treatment and accurate diagnosis. We report an unusual case of a NF occurring at the lateral neck deeply under platysma muscle. This lesion should be included in the differential diagnosis of soft tissue masses arising in the posterior neck or rarely in the lateral neck as in our case, especially when the diagnosis is not definite.
Collagen ; Dermis ; Diagnosis, Differential ; Fibroma ; Humans ; Male ; Muscles ; Neck

PURPOSE: The aim of this study was to identify an adequate chest compression site with measurement of the sternal length of young Korean adults. METHODS: We measured the distance from the suprasternal notch to the lower end of the sternum by palpation and width of heel above the carpal bone end 1 cm (H1), 2 cm (H2) in young Korean adults. We also measured weight, height, and BMI of participants. We then compared correlation of each collected variant to sternal length and heel length. RESULTS: A total of 200 young adults (100 men, 100 women) were enrolled. In measurement of the mean sternal length (SL), no difference was observed between men (19.9 cm) and women (19.6 cm) (p<0.05). However, height, weight, and BMI showed positive correlation with SL (R2 value, BMI=6.7, height=9.2, weight=10.4). After participants were divided into four groups based on gender and mean height, we calculated mean H2 and SL/2 of each group. The mean H2 and SL/2 of the group composed of men above mean height was 8.5 cm and 10.2 cm. The same value for the group of men below mean height was 8.5 cm and 9.7 cm. The mean H2 and SL/2 of the group composed of women above mean height was 7.5 cm and 10.1 cm. The same values for the group of women below mean height were 7.3 cm and 9.6 cm. The mean SL/2 was always higher than the mean H2 in different height groups. CONCLUSION: Compression just above the lower end of the sternum by heel on the hand is appropriate in men. In contrast, when performing chest compression in women, chest compression at the level of the sternum away from the width of the index finger of the sternal end is recommended.
Adult* ; Cardiopulmonary Resuscitation ; Carpal Bones ; Female ; Fingers ; Hand ; Heel ; Humans ; Male ; Palpation ; Sternum ; Thorax* ; Young Adult

OBJECTIVE: This study aimed to analyze the expression pattern of glycogen synthase kinase 3β (GSK3β) and its phosphorylated forms, GSK3β phosphorylated at Ser9 (pS9GSK3β), and GSK3β phosphorylated at Tyr216 (pY216GSK3β), in cervical squamous cell carcinoma (SCC) and adenocarcinoma (AC). METHODS: We performed immunohistochemical staining for GSK3β, pS9GSK3β, and pY216GSK3β in 64 SCC and 20 AC cases and compared their expression patterns between the 2 tumor types. RESULTS: Increased GSK3β and pS9GSK3β expression but decreased pY216GSK3β expression compared with that in the normal cervix were observed in both SCC and AC specimens. Specifically, the levels of GSK3β and pS9GSK3β were significantly increased in SCC and AC, respectively. GSK3β was localized in the nucleus and/or cytoplasm of SCC and AC cells. However, pS9GSK3β was predominantly localized in the membrane of AC cells, whereas it was present in the nucleus and/or cytoplasm of SCC cells. CONCLUSION: The results suggest that the phosphorylation status of GSK3β changes during cervical cancer development and the different expression levels and patterns of GSK3β and pS9GSK3β are associated with the specific histologic phenotype of cervical cancer.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Cervix Uteri ; Cytoplasm ; Epithelial Cells ; Female ; Glycogen Synthase Kinases ; Membranes ; Phenotype ; Phosphorylation ; Uterine Cervical Neoplasms

OBJECTIVE: The purpose of this study was to identify the factors that influence the consent of case management for suicide prevention. METHODS: This study included 232 suicide attempters from September 1, 2015 to August 31, 2016 at the Emergency Medical Center of Soonchunhyang University Bucheon Hospital, Korea. A retrospective chart analysis was performed using a chi-square test or Fisher exact test, as well as univariate and multivariate logistic regression analysis (R ver. 3.3.3). RESULTS: The positive factors affecting case management consent were direct face-to-face counseling with a case manager, patient's age, suicide attempt without alcohol, first suicide attempt, and no psychiatric history. In addition, suicide attempters who underwent follow-up case management were more likely to participate in outpatient mental health care. Through the case manager, continuous emotional support and encouragement were provided to the suicide attempt, which proved to be effective. CONCLUSION: This study emphasizes the importance of case management for suicide attempters visiting the emergency medical center and suggests that the cooperation of national and regional systems should be expanded to increase the case participation rate.
Case Management* ; Counseling ; Emergencies* ; Emergency Service, Hospital* ; Follow-Up Studies* ; Gyeonggi-do ; Humans ; Korea ; Logistic Models ; Mental Health ; Outpatients ; Retrospective Studies ; Suicide* ; Suicide, Attempted

A five-year-old spayed female Labrador retriever presented with right forelimb lameness one day earlier. Radiographs and computed tomography of the right shoulder joint revealed conspicuous enthesophytes, bone cyst, and bone fragment at the intertubercular groove. Magnetic resonance imaging showed a loss of continuity of the biceps tendon and inhomogeneous hyperintense signal of the surrounding soft tissue and moderate synovial fluid on T2- and proton density-weighted images with contrast enhancement on the postcontrast T1-weighted images. The dog was diagnosed with tenosynovitis and biceps tendon rupture with osteoarthritis based on a comprehensive evaluation of the computed tomography and magnetic resonance imaging features.

A seven-year-old, castrated male, Korean domestic shorthair cat was referred because of a kidney abnormality. Radiography revealed left renal agenesis and right kidney enlargement. Ultrasonography and computed tomography (CT) showed amorphous calcified materials in a cyst-like lesion of the right kidney. In the excretory phase of the CT images, the lesion was opacified with contrast material, indicating communication with the collecting system. Based on these findings, the cat was diagnosed with a calyceal diverticulum. A calyceal diverticulum may cause various clinical symptoms related to the urinary system. The excretory phase of CT is useful for diagnosing a calyceal diverticulum.