BACKGROUND: Isolated lung perfusion (ILP) was developed as a new treatment approach to non-resectable primary or metastatic lung cancer, because of its ability to reduce systemic toxicity while delivering high-dose chemotherapeutic agents to the target organs. This research was planned to evaluate the direct toxic effect of high-dose cisplatin to the lung tissue during isolated lung perfusion. MATERIAL AND METHOD: Fifteen mongrel dogs were divided in the perfusate for 40 minutes. The second group was composed of 5 mongrel dogs which underwent ILP with cisplatin 2.5 mg/Kg added to the perfusate for 30 minutes and 10 minutes with washing solution without cisplatin. The third group underwent the same procedure as the second group except cisplatin 5.0 mg/Kg in the perfusate. Activities of serum angiotensin converting enzyme (ACE), tumor necrosis factor-alpha (TNF-alpha), and concentration of serum lactate dehydrogenase (LDH) and blood urea nitrogen/creatinine (BUN/Cr) were analyzed in each groups at the time of pre-perfusion, 1 hour, 1 day, 1 week, and 2 weeks after ILP. RESULT: Serum ACE activities before and 1 hour, 1 day, 1 week, and 2 weeks after ILP in control group were 45.1+/-6.3, 44.6+/-9.3, 46.7+/-9.5, 50.8+/-9.1, 46.1+/-4.3 U/L. Those in cisplatin 2.5 and 5.0 mg/Kg groups were 49.4+/-12.6, 39.0+/-8.6, 42.3+/-15.9, 50.0+/-2.6, 53.8+/-8.3 and 55.5+/-12.3, 47.0+/-6.3, 45.1+/-6.9, 74.8+/-19.5, 60.2+/-12.0 U/L, respectively. Serum TNF-alpha activities in each group before and after ILP were 5.0+/-1.5 / 7.7+/-2.2 / 6.6+/-2.5 / 4.3+/-1.3 / 5.2+/-1.1 (control), 8.7+/-1.6 / 9.9+/-2.2 / 7.9+/-1.5 / 6.3+/-2.2 / 7.4+/-2.4 (cisplatin 2.5 mg/Kg), and 6.9+/-0.7 / 8.9+/-3.4 / 7.9+/-4.0 / 3.3+/-0.9 / 5.8+/-1.3 pg/ml (cisplatin 5.0 mg/Kg). Mean LDH levels of each group were 225.7 / 271.3 / 328.9 / 350.8 / 255.7(control), 235.7 / 265.7 / 336.0 / 379.5 / 299.2 (cisplatin 2.5 mg/Kg), and 259.6 / 285.2 / 340.6 / 433.4 / 292.4 IU/L (cisplatin 5.0 mg/Kg). So there was no significant difference in serum ACE, TNF-alpha, and LDH activity changes after ILP between the 3 groups. And, there was no significant changes in BUN/Cr in each groups, which was independent of ILP and perfused concentration of cisplatin. In addition, all dogs survived the ILP and there was no significant evidence of pulmonary vascular injury after 2 weeks of ILP with cisplatin. CONCLUSION: There was no harmful effect of cisplatin to the lund tissue of the mongrel dog up to 5.0 mg/Kg in perfusate. Therefore, it is perceived to be safe and effective to deliver high-dose cisplatin to the lung without pulmonary toxicity and renal damage with ILP.
Animals ; Cisplatin* ; Dogs* ; L-Lactate Dehydrogenase ; Lung Neoplasms ; Lung* ; Peptidyl-Dipeptidase A ; Perfusion* ; Tumor Necrosis Factor-alpha ; Urea ; Vascular System Injuries

PURPOSE: This study was conducted to identify the influence of trauma experiences and social adjustment on health-related quality of life in North Korean defectors. METHODS: The subjects were 117 North Korean defectors living in B and Y city. The data were collected from September 1 to September 20, 2014, and analyzed by the SPSS/WIN 18.0 program. RESULTS: Significant differences were found in the health-related quality of life with respect to the subjects' education, marriage status, types of dwelling, family types, duration of residence in South Korea, jobs in South Korea and in North Korea, families left in North Korea or other surrounding countries, and subjective health status. Health-related quality of life is negatively related to trauma experiences during escape from North Korea and during their life in South Korea. Health-related quality of life positively is related to social adjustment. The meaningful variables which influenced the subjects'health-related quality include social adjustment, job in South Korea, job in North Korea, current family structure, and trauma experiences in South Korea. Total explanatory power of these factors for health-related quality in North Korean Defectors is 43.0% and social adjustment is the most influential factor. CONCLUSION: Therefore, in order to enhance health-related quality of life in North Korean defectors, it is necessary for them to increase social adjustment and decrease trauma experiences. In addition, methods are needed to provide job opportunities, better education and family services for North Korean defectors.
Democratic People's Republic of Korea ; Diagnostic Self Evaluation ; Education ; Humans ; Korea ; Marriage ; Psychological Trauma ; Quality of Life ; Social Adjustment ; United Nations

PURPOSE: The purpose of this study was to explore the subjective experiences of those who are abstinent from alcohol to recover from alcoholism. METHODS: A qualitative descriptive study design was used. RESULTS: In this study, 3 clusters of themes and 7 themes were derived: 1. Decision for abstinence - 1) an unavoidable choice and 2) choice due to insight to alcoholism; 2. Difficulties to endure - 1) difficulty with giving up and 2) difficulty with handling; 3. Adaptation to a new lifestyle - 1) satisfaction with trivial rounds of daily life, 2) finding new values, and 3) restoration of broken relationships. CONCLUSION: Abstinence experience among people with alcohol use disorder is decided with a variety of personal motives. Abstinence experience includes giving up relationships with people and pleasure with alcohol as well as difficulties with enduring stress without alcohol. However, participants who were abstinent from alcohol were satisfied with their new lifestyles, had new life values, and were respected by their family and others. Therefore, healthcare providers needed to understand abstinence experience to support people with alcohol use disorder who have passed through a difficult process of alcohol abstinence.
Alcohol Abstinence ; Alcoholics ; Alcoholism ; Health Personnel ; Humans ; Life Style ; Male ; Pleasure ; Qualitative Research

No abstract available.
Airway Management* ; Humans ; Neck*

PURPOSE: The purpose of this study is to understand nursing college life experiences of North Korean Defectors and identify their meanings. METHODS: The study collected data through individual in-depth interviews among six undergraduates or graduates from nursing colleges, using phenomenological research methodology of Colaizzi-one of qualitative research approaches. RESULTS: Six categories drawn as a result of research include ‘Be bumped against hard reality wall’, ‘Bondage of discrimination and prejudice’, ‘Endure and stand with strength of faith’, ‘Myself grown up along with work’, ‘Becoming one amid differences’, and ‘Stepping towards unification’. CONCLUSION: The result of this study would contribute to understanding academic and interpersonal difficulties North Korean defectors might experience at nursing colleges. And it may also help people to learn that they would play an important role in integration of the nursing fields of South and North Korea as well as the nation's unification. Along the way, the results of the study could be basic data to establish national policy helping North Korean defectors adapt to nursing college life, and develop the supporting system of colleges as well as setting up appropriate supports and measures from the perspective of the nursing field.
Democratic People's Republic of Korea ; Discrimination (Psychology) ; Life Change Events ; Nursing ; Qualitative Research ; Research Design

Melanosis can affect various parts of the gastrointestinal tract. Melanosis of the colon is not uncommon, while melanosis of the ileum is extremely rare. We report a case of melanosis ilei associated with chronic ingestion of oral iron (256 mg of ferrous sulfate once or twice daily for approximately 5 years) in a 32-year-old woman with end-stage renal disease. The findings of a colonoscopy, which was performed as a part of her medical checkup, were normal up to the cecum; however, numerous brownish-black punctuate pigmentations of the ileal mucosa were observed. Microscopic examination revealed hemosiderosis in the lamina propria of the ileal mucosa, particularly at the tips of villi. The diagnosis of melanosis (hemosiderosis) ilei was made based on the endoscopic and histological findings.
Adult ; Colon ; Colonoscopy ; Eating ; Female ; Ferrous Compounds ; Gastrointestinal Tract ; Hemosiderin ; Hemosiderosis ; Humans ; Ileum ; Iron ; Kidney Failure, Chronic ; Melanosis ; Mucous Membrane ; Pigmentation

Eosinophilic gastroenteritis (EG) is characterized by eosinophilic infiltration of the bowel wall and variable gastrointestinal manifestations. Clinicians should have a high index of suspicion for EG when faced with gastrointestinal symptoms and peripheral eosinophilia to avoid incorrect diagnosis and inappropriate treatments. A 24-year-old woman was admitted to our hospital complaining of acute right lower quadrant abdominal pain and a laparoscopic appendectomy performed for a presumed diagnosis of an acute appendicitis. However, the procedure revealed bowel edema and a moderate amount of ascites without evidence of a suppurative appendicitis. Postoperatively, she showed persistent and progressive eosinophilia, exudative eosinophilic ascites, eosinophilic infiltration of the resected appendix wall, and eosinophilic infiltration of gastroduodenal mucosa. A punch biopsy of the abdominal skin also revealed inflammation with marked eosinophilic infiltration of the skin. She recovered after the treatment with a low dose of steroid for the EG with eosinophilic dermatitis. EG with eosinophilic dermatitis has not been reported yet and is considered fortuitous in this case.
Adult ; Dermatitis/*diagnosis/drug therapy/pathology ; Eosinophilia/*diagnosis/drug therapy/pathology ; Female ; Gastroenteritis/*diagnosis/drug therapy/pathology ; Humans ; Steroids/therapeutic use ; Young Adult

Among chemical agents in herbicides, dioxin(2,3,7,8-tetrachloro dibenzo-rho-dioxin: a chemical contaminant in herbicides sprayed during the vietnam war has been known to be the major agent causing toxic effects. Approximately 320,000 korean soldiers participated the vietnam war from 1964 to 1974. Although the potential hazards of the herbicides among Korean veterans exposed were implicated, the problem had not been a public issue until 1991 when Korean veterans were informed U. S. companies, the herbicides manufacturer payed fund, from which a trust fund for New Zealand and Australian Class members were established in 1985. After a series of appeals and demonstration by the korean veterans demanding medical care and compensation for their serious health damages, a bill of medical care and compensation for herbicides victims was promulgated in March 1993 and become effective from May 1993. This study was carried out with two major objectives: the first to understand the health problems caused from the herbicides by reviewing literatures published, and the second to examine the nature and extent of health impacts among Korean veterans exposed and to develop valid study methods for the major study by interviewing and reviewing records on a part of veterans (638 persons) registered and completed medical examination in Seoul Veterans Administration Hospital from June to october 1993. The results obtained are as follows: 1. The literature review of 107 papers revealed that: l) Dioxin is teratogenic, carcinogenic and affects almost all organs including nertous, endocrine, and reproductive systems in animal experiments. 2) The diseases showing evidence of causal association were Hodgkin's disease, non-Hodgkin's disease, lung cancer, lymphoma, soft tissue sarcoma, chloroacne and polyneuropathy when judged on the basis of consistency in study results and biological plausibility. 2. Interview and medical record review study on 638 veterans, though limited validity owing to lack of control group, crude estimates of dioxin exposure levels (no biomarkers measurable), and uncertainty of diagnosis, showed that: 1) Most of the study subject's were in their 40's of age and had been dispatched to vietnam during the period from 1965-1970 around one year. 2) Most frequently complained symptoms in medical examination were motor weakness(32%), sensory abnormalities in extremities(23%), skin diseases(22%), and pain in extremities(20%) whereas in interview they were more frequent in order of skin problem(44%), motor weakness (38%), sensory abnormalities and pain in extremities(l7% and 19% each). Kappa indices on the same category of complaints between two sources of information were variable and relatively low. 3) On medical examination, only a part of the 638 subjects had initial impression (442 pts) and final diagnosis (218 pts) suggesting decision making on diagnosis appeared to be difficult even with all available modern medical technologies; in initial impression disorders from peripheral and central neuropathy were predominant whereas in final diagnosis various types of skin disorder were most frequent. 4) when dose-response relationship between several conditions (from questionnaire) and arbitrary exposure scores were examined by CMH linear trend test, spontaneous abortion, sexual problems and health problem of offsprings showed statistically significant linear trends. However, pregnancy, accident and suicidal attempts did not show any relationship in this study capacity. 5) Among complaints, psychosis and neurosis(anxiety, phobia) in interview study, and memory disorder and psychosis in medical record study revealed linear trend. 6) Skin disorder was the only condition showing linear trend in initial impression and none in final diagnosis on medical examination. Even though objective to select out dioxin-related disease or group of diseases from this study was not achieved the research experiences provided firm basis for developing various methodological approaches. 3. From this preliminary study we concluded that a larger scale major epidemiologic study on health impacts of herbicides among Korean veterans exposed is not only indispensible but also well designed study with more valid exposure information and diagnosis may be able to establish causal relationship between certain groups of diseases and exposure to the herbicides among Korean veterans.
Abortion, Spontaneous ; Animal Experimentation ; Biomarkers ; Compensation and Redress ; Decision Making ; Diagnosis ; Epidemiologic Studies* ; Female ; Financial Management ; Herbicides* ; Hodgkin Disease ; Humans ; Lung Diseases ; Lymphoma ; Medical Records ; Memory Disorders ; Military Personnel ; New Zealand ; Polyneuropathies ; Pregnancy ; Psychotic Disorders ; Sarcoma ; Seoul ; Skin ; Uncertainty ; United States Department of Veterans Affairs ; Veterans* ; Vietnam*

PURPOSE: The purpose of this study was to investigate the effects of emotional labor, emotional intelligence and social support on job stress in clinical nurses. METHODS: Participants were 123 clinical nurses and data were collected from October to December, 2011 and analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients and multiple regression with SPSS 18.0. RESULTS: A positive correlation was found between job stress and emotional labor. Emotional labor showed a significant negative correlation with emotional intelligence and social support, whereas a positive correlation was found between emotional intelligence and social support. The strongest predictor of job stress was emotional labor. In addition, institution satisfaction (dissatisfaction) and the reason for selecting the job (opportunities for service) accounted for 21% of variance in job stress. CONCLUSION: The results of this study suggest that it is important to manage emotional labor as well as to improve job satisfaction in order to reduce job stress in clinical nurses.
Emotional Intelligence ; Job Satisfaction

Despite a thorough history, physical examination, and complete diagnostic workup, the correct diagnosis of small-intestinal malignancy is established preoperatively in only 50% of cases; an exploratory laparotomy is often required. However, recent advances in endoscopic technologies, such as double-balloon enteroscopy (DBE), have been shown to facilitate the preoperative diagnosis of these tumors. Confirmation of malignancy using DBE in equivocal cases may greatly increase both patients' acceptance of surgery and the confidence of the physician planning a surgical resection. We describe herein the case of a 53-year-old woman with a stage I jejunal adenocarcinoma that was diagnosed by DBE and treated by laparoscopic jejunectomy. Histopathological examination revealed a stage I jejunal adenocarcinoma (T2N0M0) without muscularis propria invasion, lymphovascular invasion, or lymph-node metastasis.
Adenocarcinoma ; Double-Balloon Enteroscopy ; Female ; Humans ; Jejunum ; Laparotomy ; Middle Aged ; Neoplasm Metastasis ; Physical Examination