PURPOSE: We studied CT findings of bronchioloalveolar carcinoma that manifestated varied clinical and radiologic characteristics. MATERIALS & METHODS: We studied presenting radiographic patterns and their characteristics and secondary findings of histologically proven 30 cases of bronchioloalveolar carcinomas on chest CT scan. RESULTS: Bronchioloalveolar carcinoma appeared radiologically as a solitary nodule(19 cases), consolidation (7 cases), and multinodules(4 cases). A solitary nodular type shows irregular or spiculated borders, peripheral or subpleural location, heterogenous density, pleural tags, pseudocavitation, and sometimes rim-enhancement of mass. A consolidation type shows air-brochogram, pseudocavitation and CT anglogram within homogenous low attenuated consolidated lung. Hilar and mediastinal lymphadenopathy as secondary findings of bronchioloalveolar carcioma appeared frequently(43.3%). Even in a solitary nodular form, hilar & mediastinal lymphadenopathy was noted in 36.8% and follow-up study in 6 cases showed lung-to-lung metastasis with 14.7 months in mean metastasis duration. CONCLUSION: It is difficulty in diagnosis of bronchioloalveolar carcioma with clinical or plain radiographic features alone because of theis variability. We found that CT scan can help the diagnosis of this tumor. We also found out that a solitary form of bronchioloalveolar carcioma as well as diffuse form does not have a good prognosis.
Adenocarcinoma, Bronchiolo-Alveolar* ; Diagnosis ; Follow-Up Studies ; Lung ; Lymphatic Diseases ; Neoplasm Metastasis ; Prognosis ; Tomography, X-Ray Computed

PURPOSE: Kimura's disease is an inflammatory condition of unknown etiology which usually occurs in salivary glands and cervical lymph nodes. This study was undertaken to evaluate the radiologic characteristics of Kimura's disease using CT and MRI. MATERIALS & METHODS: We evaluated CT & MR of 10 patients with histologically proved Kimura's disease in the head and neck. Six males and four females between 16 and 58 years old (mean age, 37.6 years) were included. Contrast enhanced CT scan was performed in all, and spin-echo MRI was performed in 2 patients. RESULTS: Both CT and MRI demonstrated the distinctive sites of involvement that were major salivary glands (4 cases) and lacrimal gland (1 case), periglandular soft tissue (8 cases), and cervical lymph nodes (8 cases). Majority of soft tissue lesions were ill-defined with infiltration to adjacent fascial planes, but nodal lesions were relatively well-defined and homogenous. The lesions were iso-intense on Tl-weighted image and hyper-intense on T2-weighted image. All but a few nodal lesions showed variable degree of contrast enhancement on CT and MRI. CONCLUSION: In diagnosis of Kimura's disease, CT & MRI of head & neck, especially salivary glands, are useful. In cases of recurrent periglandular soft tissue mass with contrast-enhancing cervical lymphadenopathy in adult patients, Kimura's disease should be included in the differential diagnosis.
Adult ; Diagnosis ; Diagnosis, Differential ; Female ; Head* ; Humans ; Lacrimal Apparatus ; Lymph Nodes ; Lymphatic Diseases ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neck* ; Salivary Glands ; Tomography, X-Ray Computed

Angiokeratoma circumscriptum is present at birth or early childhood and is an uncommon dermatosis characterized by papules and small nodules that may coalesce to form plaques. Histopathologically, there are varying degrees of hyperkeratosis, papillomatosis, and irregular acanthosis. In the papillary dermis, greatly dilated capillaries are observed, The acanthotic epidermis encircles the vascular spaces(blood cysts) where, occasionally, organized thrombi may be found. The use of pulsed-dye lasers to treat cutaneous vascular lesions is based on the theory of selective photothermolysis. We report a case of an angiokeratoma circumscriptum in an 48-year-old woman for whom the flashlamp pulsed tunable dye laser proved to be a highly successful means of treatment.
Angiokeratoma* ; Capillaries ; Dermis ; Epidermis ; Female ; Humans ; Lasers, Dye* ; Middle Aged ; Papilloma ; Parturition ; Skin Diseases

PURPOSE: To evaluate the effectiveness of intralesional triamcinolone acetonide injection for chalazia in pediatric patients. METHODS: We performed a retrospective chart review of 58 patients (70 lesions) under fifteen years of age and 40 patients (50 lesions) aged fifteen and over, who underwent intralesional triamcinolone acetonide injections and performed follow-ups for at least three months between January 2007 and October 2008. Data regarding age, sex, lesion size, location, number of injections, treatment success, surgery, and complications were evaluated. RESULTS: Cumulative treatment success of TA was 64.3% with the first injection, 82.9% with a second injection, and 88.6% with a third injection in patients under fifteen years of age. The average number of TA injections was 1.67+/-1.03 in primary chalazia and 1.48+/-0.87 in recurrent chalazia, while the cumulative treatment success until third TA injection was 89.8% in primary chalazia and 85.7% in recurrent chalazia inpatients under fifteen years old. The average number of TA injections was 1.95+/-1.18 in primary chalazia and 1.80+/-1.14 in recurrent chalazia, while the cumulative treatment success until the third TA injection was 82.5% in primary chalazia and 70.0% in recurrent chalazia in patients aged fifteen and over. No complications were noted with TA injections. CONCLUSIONS: Intralesional triamcinolone acetonide injection in chalazia is an effective and safe treatment in pediatric patients.
Aged ; Chalazion ; Follow-Up Studies ; Humans ; Injections, Intralesional ; Inpatients ; Retrospective Studies ; Triamcinolone Acetonide

No abstract available.

PURPOSE: This study was conducted to expand nurse's experience of harmful work environments. METHODS: Data were collected through in-depth dividual interviews and analyzed using Colaizzi phenomenological analysis methodology. RESULTS: Harmful work environments experienced by nurses were categorized as followed: ‘Neglect concerning infections’, ‘Being thrown into a violent working environment’, ‘The hard times of being alone’, ‘Struggling with the harmful work environments’. CONCLUSION: The results of this study provide a deep understanding of the harmful work environments. It is necessary to create safe work environments and it is important to improve awareness in the system of organizations as well as individuals. Also, it is necessary to develop tools to measure work environment including risk factors.
Risk Factors

Purpose: This study aimed to develop a nursing work environment scale for clinical nurses and to verify its validity and reliability. Methods: The initial items comprised individual interviews with eleven clinical nurses. The content validity of the initial items was evaluated twice by nine experts, while 37 preliminary items were reviewed through pilot tests with 20 nurses and cognitive interviews with five nurses. The survey data were collected from 353 clinical nurses working at general hospitals. Results: In the exploratory factor analysis, the number of factors was determined through parallel analysis, scree test, and cumulative variance ratio. Consequently, 23 items and three factors were thus composed, yielding a total cumulative variance ratio of 91.3%. The finalized 20 items of the final three factors were subjected to a confirmatory factor analysis, which led to the validation of the three subscales model. The three sub-factors were composed of nurse manager competency, nurse safety management system, and a nurse support system. Conclusion This scale is expected to be useful for evaluating the nursing work environment of clinical nurses by verifying its reliability and validity through various methods.

No abstract available.
Osteoporosis* ; Radionuclide Imaging*

PURPOSE: To analyse the causes and radiologic findings in patients with mediastinitis and to evaluate theefficacy of chest CT scanning in patients with delayed diagnosis. MATERIALS AND METHODS: Seventeen patients withhistopathologically(n=15) or cliniclly diagnosed(n=2) mediastinitis were involved in this study. Eleven of theformer group underwent surgery, and in four, tube drainage was performed. All underwent chest radiography and CTscanning, and in seven patients, the causes of delayed diagnosis were analysed. RESULTS: The most common cause ofmediastinitis was esophageal rupture (n=11). Others were extension from neck abscess to the mediastinum(n=3),complications after a Benthall procedure(n=1), tuberculous lymphadenitis (n=1) and mycotic aneurysm(n=1). Patientswith esophageal rupture suffered from underlying diseases such as esophageal cancer(n=2), iatrogenic esophagealrupture(n=2), Boerhaave's syndrome(n=2), and esophagitis(n=1). In patients with neck abscess(n=3), each wassecondary to infected cystic hygroma, Ludwig angina, or deep neck infection, respectively. On chest CT, patientswith esophageal rupture(n=11) had an abscess in the posterior mediastinum; nine abscesses extended to the cervicalarea along the retropharyngeal space, and the patient with Ludwig angina had an abscess involving all compartmentsof the mediastinum. Among the total of 17 patients, diagnostic delays were found in seven, while five hadspontaneous esophageal ruptures and two suffered complications after a Benthall procedure and Tbc lymphadenitis,respectively. The causes of diagnostic delay varied. Among seven patients, pnevmonia was initially diagnosed intwo, who were treated ; one had multiorgan failure, and one was suffering from pericardial effusion and lungabscess. In three other patients, chest radiographs initially showed non-specific findings, leading to delayed CTexamination. CONCLUSION: The most common cause of mediastinitis was esophageal rupture, and in these patients,chest radiographs and clinical symptoms were sometimes not specific. CT was valuable for the detection ofmediastinitis, and for early diagnosis can be the modality of choice.
Abscess ; Delayed Diagnosis* ; Drainage ; Early Diagnosis ; Humans ; Ludwig's Angina ; Lymphangioma, Cystic ; Mediastinitis* ; Mediastinum ; Neck ; Pericardial Effusion ; Radiography ; Radiography, Thoracic* ; Rupture ; Thorax* ; Tomography, X-Ray Computed ; Tuberculosis, Lymph Node

PURPOSE: To compare the effect of breast milk containing fortifier with preterm formula on bone mineral metabolism in premature infants, we evaluated the state of bone mineralization, biochemical alteration and the frequency of rickets during the first five months of life. METHODS: Fourteen fortified breast milk-fed infants and eleven preterm formula-fed infants who were born at Il-Sin Christian Hospital from August, 1996 through July, 1997, were studied. The breast milk-fed group received human milk fortifier. The intake of Ca, P, Mg, protein, and fat was calculated at one month of age. Birth weight and weight at one, two and five months of age were measured. Serum Ca, P, alkaline phosphatase and 25-hydroxyvitamine D were measured at one month of age, and the wrist received X-ray examinations monthly. Total body bone mineral content was measured by Dual energy X-ray absorptiometry (Lunar WI) at two and five months of age. RESULTS: The two groups were similar in birth weight, gestational age, and weight at one, two and five months of age. Enteral Ca, P, protein, Mg, and fat intake, and urinary excretion of Ca, P were similar among the two groups. Serum Ca, P, ALP and 25-hydroxyvitamin D were not different. Occurrence of rickets and bone mineral content were similar among the two groups. CONCLUSION: Fortified breast milk-fed infants and preterm formula-fed infants showed no difference in total body bone mineral content and occurrence of rickets. Ultimately, we could enhance the advantage of breast milk fed to premature infants by adding fortifier.
Absorptiometry, Photon ; Alkaline Phosphatase ; Birth Weight ; Bone Density ; Breast ; Calcification, Physiologic ; Gestational Age ; Humans* ; Infant ; Infant, Newborn ; Infant, Premature ; Metabolism* ; Milk, Human* ; Rickets* ; Wrist