Paragonimiasis is prevalent in Far East and a kind of endemic Korean disases. The primary site of humanparagonimiasis is the lung, but hte ectopic infection of lung fluke has been reported by many authors. Weexperienced one case of abdominal paragonimiasis in a 44 year old male with a complaint of left lowerquadrantpain. Physical examination, barium enema, and other data suggested the possibility of tumor originating from thewall of descending colon. (intramural tumor). Postoperative specimen taken from the solid tumorous lesion showedparasitic granuloma, characteristic of Paragonimus Westermani. Here, we report a case of very peculiar ectopicparagonimaisis involved descending colon wall simulating neoplastic tumor, and also review the literaturesbriefly.
Barium ; Colon ; Colon, Descending ; Enema ; Far East ; Granuloma ; Humans ; Lung ; Male ; Mesocolon ; Paragonimiasis ; Paragonimus westermani ; Physical Examination ; Trematoda

No abstract available.
Hemolytic-Uremic Syndrome* ; Mycoplasma Infections* ; Mycoplasma*

The purpose of this study is to estimate cesarean section rate in Korea and analyze the socioeconomic variables and health resources which affect regional variation in the rate. Samples were drawn from the record of vaginal and cesarean section deliveries based upon insurance claim bills which have been submitted to the National Federation of Medical Insurance for the first three months, January through March, 1991. The results are obtained as follows: It was found that, cesarean section rate was increasing rapidly up to 23.1% in 1991. Cesarean section per 10 thousand insured people was 4.8 and the number of cesarean section per 10 thousand insured eligible(15-49 years old) female was 7.6. The fee for normal delivery was 109,489 won and that for cesarean section was 390,024 won. The average days of hospitalization in normal delivery was 2.3 days, and those in cesarean section was 7.6 days. On the average cesarean section has a longer of stay as much as by 4.3 days and cost 3.6 times more than normal deliveries. Cesarean section rates vary among medical facilities: 19.8% at clinics 37.6% in small-scale hospitals, and 29.1% in general hospitals. The regional variation of cesarean section rates was also fairly prominent. The South Cheju Gun has the highest rate of cesarean section, 56.2%. Meanwhile no cesarean section cases has been reported in Sunchang Gun during the period of this study. The variation is noted among provinces. The rate for Cheju province has been 3.4 times higher than that for Chunnam. The number of cesarean section per 10 thousand insured people vary greatly among regions, too. This study has found that there exists significant regional variations among various geographic units in terms of average length of stay, average cost, number of obsretricians and number of beds. Multiple regression analysis was done to identify factors explaining the regional variance of various cesarean section rates: In the urban areas, no significant explaining variables were noted except the number of beds for the dependent variable of cesarean section cases per 10 thousand insured eligible females. The smaller the number of bed, the more cases of cesarean section was noted for an urban area. The is mostly because the rate of cesarean section is higher in medium-size hospitals than in large general hospitals. In the rural areas, the factor of education has been found significant for all three dependent variables. The higher the educational level, the rate of cesarean section is most likely to rise. An income variable measured by the amount of monthly insurance contribution has been identified a powerful predictor in explaining the variance of cesarean section rates. The same has been noted for the number of obstetricians. Similar findings are observed for the country as a whole. The income level has been found as the most powerful explaining factor in the regional variance of cesarean section rates. In general the rate is higher in the urban areas, and lower in the area with more small hospitals. As this is the initial attempt to identify the factors relevant to the regional difference in the rates of cesarean section, more elaborated study is urgently required.
Cesarean Section* ; Education ; Fees and Charges ; Female ; Health Resources ; Hospitalization ; Hospitals, General ; Humans ; Insurance ; Jeju-do ; Korea* ; Length of Stay ; Pregnancy

PURPOSE: To evaluate the efficacy and stability of AcrySof Toric intraocular lens (IOL) implants and to analyze the miscorrection that resulted after implantation. METHODS: This retrospective study included 422 eyes of 348 patients who underwent cataract surgery with implantation of the AcrySof toric IOL between December 2011 and June 2013. We evaluated uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), keratometry and refraction preoperatively and 3 months postoperatively. The axis of implanted AcrySof Toric IOL was measured using the KR-1W aberrometer before mydriasis. At 3 months postoperatively, patients with a residual cylindrical power of 0.50 diopters (D) or more, and having an IOL rotation of 10 degrees (degrees) or more were considered having miscorrection. RESULTS: UCVA (log MAR) improved from 0.58 +/- 0.35 to 0.18 +/- 0.26. Preoperative corneal astigmatism was 1.46 +/- 0.72 D and postoperative refractive cylindrical power was 0.45 +/- 0.30 D. The postoperative miscorrection was 50.5% in the T3 group, 35.7% in the T4 group, and 27.2% in the T5 group. The incidence of overcorrection was significantly higher in the T3 group than in the T4 and T5 group. In eyes with with-the-rule (WTR) astigmatism, overcorrection was found in 36.4% (32/88 eyes), while in eyes with against-the-rule (ATR) astigmatism, undercorrection was found in 37.6% of cases (44/117 eyes). There were five cases of IOL rotation at 3 months postoperatively. CONCLUSIONS: AcrySof Toric IOL was effective in correcting corneal astigmatism and had good rotational stability. However, the incidence of miscorrection, especially for overcorrection, was higher with lower power toric IOL. Patients with WTR astigmatism tend to have overcorrection, while those with ATR show a tendency toward undercorrection, suggesting that these changes considered at the time of cataract surgery.
Astigmatism ; Axis, Cervical Vertebra ; Cataract ; Humans ; Incidence ; Lenses, Intraocular* ; Mydriasis ; Retrospective Studies ; Visual Acuity

Severe congenital neutropenia (SCN) is a heterogeneous group of disorders with a defect in granulopoiesis causing marked neutropenia and severe bacterial infections. A 17-month-old girl (patient 1) was admitted due to cervical lymphadenitis caused by methicillin-resistant Staphylococcus aureus, with neutropenia. She had Pseudomonas aeruginosa sepsis and peritonitis with perforated appendicitis at 8-month of age. Her sister, a 37-month-old girl (patient 2), had recurrent stomatitis with profound neutropenia, and her mother, a 32-yr-old woman (patient 3), had had recurrent stomatitis until her early 20s with neutropenia. We found an ELANE gene mutation (c.597+1G > A) from them in direct DNA sequencing analysis. Patients 1 and 2 did not respond to granulocyte colony stimulating factor and patient 1 was treated with prolonged antibiotics and excision. We demonstrated inherited SCN cases showing different severity even with the same mutation of the ELANE gene in a family.
Adult ; Child, Preschool ; DNA Mutational Analysis ; Female ; Granulocyte Colony-Stimulating Factor/therapeutic use ; Humans ; Infant ; Leukocyte Elastase/*genetics ; Methicillin-Resistant Staphylococcus aureus/isolation & purification ; Mutation/genetics ; Neutropenia/*congenital/diagnosis/drug therapy/genetics ; Pedigree ; *Phenotype ; Polymorphism, Single Nucleotide ; Recurrence ; Staphylococcal Infections/diagnosis/microbiology ; Stomatitis/diagnosis ; Tomography, X-Ray Computed

Angiogenesis is essential for tumor growth and metastasis, however, the prognostic value of neovascularization is undetermined. The aim of this study is to evaluate the prognostic significance of microvessel density (MVD) and vascular endothelial growth factor (VEGF) expression in breast carcinomas. An immunohistochemical stains for CD 31 (DAKO) to estimate MVD and VEGF (Santa Cruz) were done on 40 cases of invasive breast carcinoma. MVD was calculated as an average count of vessels per 200 power field in the most vascularized areas. VEGF expression was interpreted according to staining intensity and number of positive cells. Mean MVD was 35, and MVD was not correlated with lymph node metastasis or histologic grade, but high MVD (mean MVD>35) showed an increasing tendency in cases with larger size, negative ER/PR, and positive cathepsin D. All of the cases showed VEGF expression, but VEGF expression was not correlated with tumor size, histologic grade, lymph node metastasis, ER/PR status, and cathepsin D expression. These results suggest that MVD and VEGF expressions are not reliable prognostic factors.
Breast Neoplasms* ; Breast* ; Cathepsin D ; Coloring Agents ; Lymph Nodes ; Microvessels* ; Neoplasm Metastasis ; Vascular Endothelial Growth Factor A*

PURPOSE: The purpose of this study was to determine the effects of simulation based training using a post-operating rehabilitation case on learning outcomes in nursing students. METHODS: A quasi-experimental research design (one group pretest and posttest design) and a questionnaire for measuring learning outcomes were used in this study. The participants were 35 students in a college of nursing. Data were collected before the program and immediately after the program that applied simulation based training using a post-operating rehabilitation case consisted of 4th running and debriefing for 26 hours. With SAS 9.2 program, descriptive statistics and paired t-test were used to analyze the data. RESULTS: There were statistically significant increases in necessity (p=.001) and performance of learning outcome (p<.001) of simulation based training using a post-operating rehabilitation case among students in a college of nursing. CONCLUSION: The findings of this study demonstrate that simulation based training using a post-operating rehabilitation case for nursing students may increase performance of learning outcomes on clinical reasoning and critical thinking.
Humans ; Learning* ; Nursing ; Surveys and Questionnaires ; Rehabilitation* ; Research Design ; Running ; Students, Nursing ; Thinking

PURPOSE: The purpose of this study was to investigate the perception and satisfaction of cancer patients participating in clinical trials of anticancer drugs and the factors affecting their satisfaction. METHODS: The participants were cancer patients who participated in more than two cycles of clinical trials at a tertiary hospital in Seoul, Korea. Questionnaires were used to assess the perception and satisfaction of clinical trials of anticancer drugs. RESULTS: A total of 106 patients participated. The average perception and satisfaction regarding clinical trials among patients on a 5 point scale was 3.99±0.45 and 4.09±0.55 respectively. There was a significant difference in the correlation among participants' perception and their satisfaction (r =.67, p<.001). Regression analysis revealed that satisfaction was explained by, perception of clinical trials (β =.67, p<.001), participation period 30~59 days (β =.21, p=.009), and participation period over 60 days (β=.20, p=.013). These variables explained 48.7% of the variance of clinical trial satisfaction. CONCLUSION: The results of this study suggest that changes in perceptions of clinical trials are needed to improve satisfaction of anticancer drug clinical trials. This can be used as a basis for improving the quality of clinical trials and education programs for cancer patients participating in clinical trials.
Education ; Humans ; Korea ; Personal Satisfaction ; Seoul ; Tertiary Care Centers

PURPOSE: The purpose of this study was to determine the current status of obesity intervention programs, and its effects on endothelium function in adolescents. METHOD: This was a descriptive research study, that investigated domestic and international literature 2009–2018. Using databases inside and outside of Korea to search for ‘adolescent’, ‘obese adolescent’, ‘exercise’, ‘program’, or ‘intervention’, and ‘endothelium function’, a total of 14 literature have been selected for 6 domestic research and 8 international research, excluding overlapping, case studies, literature reviews, and unrelated studies. RESULTS: Interventions for enhancing endothelium function were exercise program, diet, vitamin D3 treatment, and Orlistat intake relative to international research, and combined exercise and purple sweet potato intake, in most domestic research. Dependent variables included FMD, RHI, NMD, EPCs, and EMPs, for measuring endothelium function in international research, and PWV, FMD and RHI, in domestic research. CONCLUSION: Results of this study confirmed that application of obese intervention programs, may improve endothelium function in adolescents. Further studies are required, to develop nursing intervention, that would enhance endothelium function in adolescents.
Adolescent ; Cholecalciferol ; Diet ; Endothelium ; Humans ; Ipomoea batatas ; Korea ; Methods ; Nursing ; Obesity

Angiosarcoma is a very rare malignant tumor of endothelial cell origin. We experienced a case of angiosarcoma presented with massive pleural effusion, which was considered as a metastasis from right kidney. A 44-year-old male patient was admitted due to dyspnea for one month. He had a history of transient hematuria 3 months before admission, which disappeared spontaneously Chest roentgenography showed total haziness in left hemithorax with multiple nodular shadows in right lung. Abdominal ultrasonogram showed a single heterogeneous hyperechoic mass, measuring about 7.3×7.1×6.5cm in size in the upper and mid-pole of the right kidney, involving. renal sinus. Computed tomography of the chest revealed highly enhanced multiple pulmonary and subpleural nodules with loculated pleurisy. In bronchoscopic finding, a fungating, hypervascular tumor mass was noticed at the orifice of anterior basal segment of left lower lung after removal of tenaceous mucus Pleural and bronchoscopic biopsies showed findings of angiosarcoma confirmed by immunochemical stains with factor VIII related antigen(+), laminin(+) and vimentin(+), and by characteristic electronmicroscopic findings. Massive pleural effusion was controlled with several times of pleurodesis in both pleural spaces.
Adult ; Biopsy ; Coloring Agents ; Dyspnea ; Endothelial Cells ; Factor VIII ; Hemangiosarcoma* ; Hematuria ; Humans ; Kidney ; Lung ; Male ; Mucus ; Neoplasm Metastasis ; Pleural Effusion* ; Pleurisy ; Pleurodesis ; Radiography ; Thorax ; Ultrasonography