Purpose: This study aimed to describe the meaning of spiritual care as perceived by nursing students. Methods: This study used a descriptive research design, and the participants were 126 fourth-year nursing students from three nursing colleges. Data were collected from August to September 2019, and were analyzed using the content analysis method. Results: Four themes of spiritual care with 15 sub-themes were extracted from the content analysis: 1) “promoting spiritual well-being” (sub-themes: “providing religious help”, “caring for the patient as a spiritual being”, and “presupposing human dignity regardless of religion”); 2) “taking place in actual nursing practice” (representative sub-themes: “considering the perspective of the patient”, “reducing suffering”); 3) “caring for the multifaceted needs of human beings” (representative sub-themes: “providing physical, mental, and spiritual care”, “caring for both the mental and physical health of the patient”), and 4) “growing together”(sub-themes: “positively affecting patient well-being”, “beginning with the nurse’s self-transcendence”). Conclusion These results suggest that nursing students consider spiritual care to be a highly positive and practical form of nursing care. However, because few students have been exposed to religion and spirituality, more systematic training should be provided.

Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disorder of unknown etiology. Inflammation may usually extend beyond the joints and involve other organs. Clinically detectable splenomegaly is present in 5~10% of RA. Methotrexate (MTX) is a structural analog of folic acid that inhibits the enzyme dihydrofolate reductase, so cellular proliferation is reduced. MTX has been proven to be effective in treating RA and is believed to be nononcogenic at low, weekly dose employed in the patients with RA. However, recently there has been increased concern about the oncogenic potential of MTX because of several case reports describing the occurrence of non-Hodgkin's Lymphoma (NHL) in the patients with RA treated with MTX. A 65-year-old woman with RA was treated with low dose MTX (i.e. 10 mg/week) for 3 years. Because of prolonged left upper abdominal pain and thrombocytopenia associated with huge splenomegaly, splenectomy was performed. Biopsy revealed splenic B-cell NHL. We report a case of RA with splenomegaly who developed B-cell NHL in spleen during low dose MTX therapy.
Abdominal Pain ; Aged ; Arthritis, Rheumatoid* ; B-Lymphocytes ; Biopsy ; Cell Proliferation ; Female ; Folic Acid ; Humans ; Inflammation ; Joints ; Lymphoma, Non-Hodgkin* ; Methotrexate ; Spleen ; Splenectomy ; Splenomegaly ; Tetrahydrofolate Dehydrogenase ; Thrombocytopenia

Granular cell tumors involving the esophagus are rare tumors. Since Abrikossoff first reported five cases of granular tumor of the tongue in 1926, fewer than 200 cases of esophageal granular cell tumors have been reported in the world. The granular cell tumors usually were seen in tongue, skin & breast. it has rarely been noted in the esophagus. The treatment of this tumor was not established well. Therefore, we report a case of granular cell tumor of the low esophagus, which was resected by polypectomy following 'O'-band ligation. This 56-year-old male patient was transferred to our hospital because of abnormal endoscopic finding on the esophagus at local clinic. There was esophageal polypoid lesion on the low esophagus. After polypectomy, the lesion was revealed as granular cell tumor in histopathologic examination.
Breast ; Endoscopes ; Esophagus ; Granular Cell Tumor* ; Humans ; Ligation* ; Male ; Middle Aged ; Skin ; Tongue

BACKGROUND: The balances of the proteinases and antiproteinases system have been implicated in the pathogenesis of various exudative pleural effusions. The aim of this study was to examine the matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of metalloproteinase-1 (TIMP-1) levels in exudative pleural effusions. METHODS: The study included 33 tuberculous effusions, 17 malignant, and 5 transudates. The pleural levels of MMP-1 and TIMP-1 were determined using a commercially available ELISA assay. RESULTS: The group of tuberculous effusions showed higher pleural MMP-1 levels than the malignant and transudates. The pleural TIMP-1 levels of the tuberculous and malignant effusions were higher than the transudates. CONCLUSION: Elevated pleural MMP-1 and TIMP-1 levels were found in tuberculous effusions.
Enzyme-Linked Immunosorbent Assay ; Exudates and Transudates ; Matrix Metalloproteinase 1* ; Peptide Hydrolases ; Pleural Effusion* ; Tissue Inhibitor of Metalloproteinase-1*

We present a case of intradural extramedullary capillary hemangioma of the thoracic spine with a long segment of transient cord edema. Spinal capillary hemangiomas are extremely rare vascular tumors and only a few cases have been reported. On the MR images, the mass showed hypointensity on the T1-weighted images, hyperintensity on the T2-weighted images relative to the spinal cord, and strong homogeneous enhancement on the contrast-enhanced T1-weighted images. The T2-weighted images showed a long segment of ill-defined hyperintense area in the spinal cord which was completely resolved after surgery.
Capillaries* ; Edema* ; Hemangioma ; Hemangioma, Capillary* ; Spinal Cord ; Spine

A 17-year-old male patient complained of acutely developed severe paresthesia, pain, and weakness of the right lower extremity. He fell to the ground during performance of hand-stand physical exercise. Despite administration of conservative treatment for two weeks in a private clinic, motor function of the hip flexor and knee extensor were measured as poor grade. EMG showed femoral nerve and lateral femoral cutaneous nerve injury. Findings on MRI and CT revealed a mass measuring 8x5x7 cm in the iliac fossa. After evacuation of the hematoma(400 cc), neurologic dysfunction and thigh circumference were fully recovered, compared with the contralateral side, after one and half year follow up. This condition rarely occurs in individuals without coagulopathy. We reported on a rare case of iliacus hematoma and femoral neuropathy treated by surgical decompression in a patient with no coagulopathy.
Adolescent ; Decompression, Surgical ; Exercise ; Femoral Nerve ; Femoral Neuropathy ; Follow-Up Studies ; Hematoma ; Hip ; Humans ; Knee ; Lower Extremity ; Male ; Neurologic Manifestations ; Paresthesia ; Thigh

PURPOSE: Computed tomography (CT) has been the most informative imaging in renal trauma. Despite the good sensitivity of magnetic resonance (MR) imaging to the presence of hematuria, edema and ischemia, MR imaging has not been widely studied in patients with renal trauma. This present study was initiated to evaluate the role of MR imaging in patient with renal trauma. MATERIALS AND METHODS: We prospectively reviewed the imaging of CT and MR imaging of 13 patients who suffered from renal trauma. RESULTS: The presence and size of perirenal hematoma could be detected in both CT and MR imaging. However, MR imaging provided additional information about the onset of hematoma and could differentiate subcapsular hematoma from perirenal hamatoma more accurately. Focal renal infarction that was differentiated difficultly from perirenal hematoma on CT could be easily identified on MR imaging. CONCLUSIONS: MR imaging determine the extent of parenchymal laceration and the status of perirenal hematoma, renal infaction and renal fragment more accurately than CT. Moreover, MR imaging has advantages including lack of ionizing radiation and no routine need for intravenous contrast medium. Therefore, we suggest that MR imaging can alternate CT in selected cases.
Edema ; Hematoma ; Hematuria ; Humans ; Infarction ; Ischemia ; Lacerations ; Magnetic Resonance Imaging* ; Prospective Studies ; Radiation, Ionizing

Background: Few studies have classified chest computed tomography (CT) findings of coronavirus disease 2019 (COVID-19) and analyzed their correlations with prognosis. The present study aimed to evaluate retrospectively the clinical and chest CT findings of COVID-19 and to analyze CT findings and determine their relationships with clinical severity. Methods: Chest CT and clinical features of 271 COVID-19 patients were assessed. The presence of CT findings and distribution of parenchymal abnormalities were evaluated, and CT patterns were classified as bronchopneumonia, organizing pneumonia (OP), or diffuse alveolar damage (DAD). Total extents were assessed using a visual scoring system and artificial intelligence software. Patients were allocated to two groups based on clinical outcomes, that is, to a severe group (requiring O2 therapy or mechanical ventilation, n = 55) or a mild group (not requiring O2 therapy or mechanical ventilation, n = 216). Clinical and CT features of these two groups were compared and univariate and multivariate logistic regression analyses were performed to identify independent prognostic factors. Results: Age, lymphocyte count, levels of C-reactive protein, and procalcitonin were significantly different in the two groups. Forty-five of the 271 patients had normal chest CT findings. The most common CT findings among the remaining 226 patients were groundglass opacity (98%), followed by consolidation (53%). CT findings were classified as OP (93%), DAD (4%), or bronchopneumonia (3%) and all nine patients with DAD pattern were included in the severe group. Uivariate and multivariate analyses showed an elevated procalcitonin (odds ratio [OR], 2.521; 95% confidence interval [CI], 1.001–6.303, P = 0.048), and higher visual CT scores (OR, 1.137; 95% CI, 1.042–1.236; P = 0.003) or higher total extent by AI measurement (OR, 1.048; 95% CI, 1.020–1.076; P < 0.001) were significantly associated with a severe clinical course. Conclusion CT findings of COVID-19 pneumonia can be classified into OP, DAD, or bronchopneumonia patterns and all patients with DAD pattern were included in severe group. Elevated inflammatory markers and higher CT scores were found to be significant predictors of poor prognosis in patients with COVID-19 pneumonia.