Undifferentiated carcinoma with osteoclast-like giant cells (OGCs) is the least common type of gallbladder carcinoma. Here, the author presents a case of undifferentiated gallbladder carcinoma with OGCs in an 81-year-old male patient. Grossly, the tumor was a 10x7 cm sized, polypoid, lumen-filling mass with extensive hemorrhage and necrosis. Microscopically, the tumor was composed of pleomorphic ovoid to spindle cells admixed with numerous OGCs. There was a minute focus of mucosal dysplasia and carcinoma in situ. Immunohistochemically, the mononuclear cells were positive for cytokeratin, p53 and Ki-67, while the OGCs were negative for these markers but positive for CD68. These findings support an epithelial origin for the ovoid to spindle cells and the nonneoplastic reactive histiocytic lineage of the OGCs.
Aged, 80 and over ; Carcinoma ; Carcinoma in Situ ; Gallbladder* ; Giant Cells* ; Hemorrhage ; Humans ; Keratins ; Male ; Necrosis ; Osteoclasts

Suffering is a human burden that may not be truly avoidable. In order to put that view in perspective we must examine suffering in a form as isolated from self-inflicted behavior as possible. The suffering of a child is one such example. The purpose of this study is to understand the meaning of suffering in the teenager and is to analyze difference of suffering in children and adult. The subjects of this study were 6 children (12year-17year) including in-patients and out-patients of a general hospital who were diagnosed as having cancer. The data was collected from October 10,1996 to April 15, 1997. Qualitative research methods of in-depth interview and participant observation were used for data collection. Data analysis progressed according to the fieldwork phases suggested by the Hybrid Model. According to the results of the study, the meaning of suffering in the teenager can be described as follows: Suffering is an inevitable experience of all human beings. When each child experiences pain and destroying child-adult relationship, suffering in which threaten one's personal integrity is perceived differently among each child depending on their personal inner factors, one's significant others, exterior circumstances and stimuli. Suffering brings severs and unendurable distress which accompany anguish, depression, anxiety and fear. This findings provide data for new insights of suffering. When caring for teenager who experience suffering, nurse need to consider the influence of suffering. Moreover, appropriate nursing interventions aimed at relieving suffering need to be developed.
Adolescent ; Adult ; Anxiety ; Child ; Data Collection ; Depression ; Hospitals, General ; Humans ; Nursing ; Outpatients ; Qualitative Research ; Statistics as Topic ; Stress, Psychological ; Child Health

No abstract available.
Nephrolithiasis* ; Uric Acid*

No abstract available.

PURPOSE: The present study purposed to investigate Korean adults health status, smoking perception. and self-efficacy of smoking cessation according to whether smoking or not. METHODS: This study conducted a questionnaire survey of 694 adults at D County in Korea during the period from the 10th of June to the 10th of July 2004. The instruments used for this study were scales on health status, smoking perception and self-efficacy: of smoking cessation. Data was analyzed by frequency and percentage, mean and SD, chi2-test, t-test, ANOVA using SPSS 11.0 program. RESULTS: The subjects of this study were 503 men and 191 women, and 60.8% of the male subjects and 6.8% of the female subjects were smokers. With respect to health status (t=-2.58, p=0.010), smoking perception (t=10.59. p<0.000) and the self-efficacy of smoking cessation (t=-23.04, p<0.000), there were significant differences according to whether smoking or not. CONCLUSIONS: It is necessary to make repeated study to find other variables that affect adults smoking and to develop smoking cessation programs that enhance the self-efficacy of smoking cessation.
Adult ; Female ; Humans ; Korea ; Male ; Smoke* ; Smoking Cessation* ; Smoking* ; Weights and Measures ; Surveys and Questionnaires

Tumors of the ceruminous gland are rare. However, careful histologic evaluation and classification are necessary for the proper treatment and ultimate prognosis. We present 5 cases of ceruminous gland tumors. Case l (73/M) and case 2 (52/M) were adenoid cystic carcinoma. They presented with protuding masses in the left external auditory canal for several months. Case 3 (76/M) was a mucoepidermoid carcinoma of auditory canal, who presented with right ear swelling. The mass recurred 3 years after the surgical resection and combined radiation therapy. Case 4 (60/F) and case 5 (2l/F) were ceruminous adenoma, which showed diffuse or focal areas of glandular structures with one-or two-layer of eosinophilic columnar to cuboidal cells and sometimes with myoepithelial cells. These tumors showed non-infil-trative growth pattern and lack of mitosis, and had no capsule.

No abstract available.
Dyspnea* ; Humans ; Male* ; Middle Aged*

This study was conducted to investigate the effect of the NutriPlus+ Program and to observe how the improved statuses were maintained after the program's termination. The subjects were infants and their parents, who have participated in the NutriPlus+ Program conducted by South Healthcare Center in Po-hang for longer than six months, during the period 2007 - 2010. The survey was conducted with questionnaires, and scores were tabulated from each question. After the intervention of the program, scores representing degrees of nutrition knowledge and nutrition attitude increased. The rate of nutritional risk by anthropometric measurement decreased, and the prevalence rate of anemia was significantly decreased as well. The number of subjects lacking any nutrients, except for iron and vitamin C, decreased, which indicates that the NutriPlus+ Program was effective. After enough time had passed after the intervention's completion; however, the scores of nutrition knowledge and nutrition attitude decreased. The number of subjects with low height and weight (proportional to their age) relatively decreased, and the prevalence rate of anemia increased slightly. The number of subjects lacking in energy and calcium consumption increased as well, which indicates that the effect of the NutriPlus+ Program was not maintained after the program's termination.
Anemia ; Ascorbic Acid ; Calcium ; Delivery of Health Care ; Humans ; Infant ; Iron ; Parents ; Prevalence ; Surveys and Questionnaires

OBJECTIVE: Although cor pulmonale due to chronic lung disease was not uncommon, there was uncertainty in its diagnosis due to the difficulty in measuring functional and anatomical changes of right heart and pulmonary vascular system. Among various non-invasive diagnostic methods presented so far, no ideal standard diagnostic criterion has been established. The authors attempted to know positive diagnostic ratio of cor pulmonale and to study the presence of the relationship between these diagnostic criteria when electrocardiographic and echocardiographic diagnostic criteria for cor pulmonale were applied to the patients with chronic lung disease. And we investigated the usefulness of echocardiogaphic diagnostic criteria for the diagnosis. METHODS: One electrocardiographic and two echocardiographic diagnostic criteria were applied to 38 patients with chronic lung disease(21 pulmonary emphysema and 17 chronic advanced pulmonary tuberculosis) for the diagnosis of cor pulmonale. Comparison was also made in their relationship. Then pulmonary artery diameter, measurement of pulmonary function test and echocardiographic examination and radio-nuclear right ventricular ejection faction were compared between the groups to ensure each criterion was satisfied. RESULTS: 1) When the three diagnostic criteria for confirming the cor pulmonale, electrocardiographic rriterion(right ventricular hypertrophy), right ventricular dimension criterion(right ventricular end-diastolic dimension>25mm, RVDd>25mm), and right ventricular wall thickness criterion (right ventricular wall thickness>6mm, RVWT>6mm) were applied to the patients, the positive rate were 32%(12/37), 30%(10/33) and 17%(6/36) respectively. A statistically significant correlation between electrocardiographic criterion and right ventricular wall thickness criterion was found to exist. 2) Various parameters of pulmonary function test and echocardiographic examination were compared in the patient groups with and without cor pulmonale when each non-invasive diagnostic criterion was applied to all patients. Followings are the results. (1) In the positive group on electrocardiographic criteria, vital capacity, forced vital capacity, and arterial oxygen tension were significantly smaller than in the negative group on electrocardiographic criterion(p<0.05), and the echocardiographic parameters of right ventricle, ie. end-diastolic area, end-systolic area, end-diastolic dimension, end-systolic dimension, mid-ventricular short axis and maximal short axis in positive group were significantly larger than in the negative group. (2) In the positive group on right ventricular diastolic dimension criterion(RVDd>25mm), percentage forced expiratory volume in 1 second and forced expiratory flow 25-75% were significantly smaller than in the negative group on right ventricular diastolic dimension criterion. (3) In the positive group on right ventricular wall thickness criterion(RVWT>6mm), vital capacity, forced vital capacity, forced expiratory volume in 1 second, forced expiratory flow 25-75% and arterial oxygen tension were significantly smaller than in the negative group on right ventricular wall thickness criterion. CONCLUSION: When several non-invasive diagnostic criteria for cor pulmonale were applied to the patients with chronic lung disease, there were some differences in its positive diagnostic ratio depending on the applied diagnostic criteria. There was also a statistically significant correlation between electrocardiographic criterion and right ventricular wall thickness criterion. When each diagnostic criterion was applied to the patients, significant differences were found in several parameters resulted from pulmonary function test and echocardiographic examination based on presence or nonpresence of cor pulmonale. But no difference in the ejection fraction measured by radio-nuclear method was shown between cor pulmonale group and non cor pulmonale group. Consequently it was suggested that applying echocardiographic criteria in addition to electrocardiographic criterion for the diagnosis of cor pulmonale in the patients with chronic lung disease is clinically useful.
Axis, Cervical Vertebra ; Diagnosis ; Echocardiography* ; Electrocardiography ; Forced Expiratory Volume ; Heart ; Heart Ventricles ; Humans ; Lung ; Lung Diseases ; Oxygen ; Pulmonary Artery ; Pulmonary Emphysema ; Pulmonary Heart Disease* ; Respiratory Function Tests ; Uncertainty ; Vital Capacity

The cytologic heterogeneity of the tumor cells in gastric signet ring cell carcinoma was studied with 13 surgically early gastric carcinoma specimens by means of histochemical stainings on mucin(periodic acid Schiff-alcian blue at pH 2.5, paradoxical concanavalin A, high iron diamine) and electron microscopy. Of the 13 cases of early gastric cell carcinomas, 6 were mucosal type and 7 were submucosal type. Eleven cases consisted of mixture of gastric and intestinal type signet ring cells and the remaining 2 of the mucosal type were entirely made of gastric type. The colonic goblet cell type was found in 4 of the submucosal type. Within the mucosa the tumor cells showed a layering phenomenon; type A signet ring cells were distributed at the central zone and type B and C at the superficial or deeper zone. Each type of signet ring cell showed variable mucin histochemical stainability of gastric and/or intestinal nature. Above finding strongly suggest that the variable phenotypes of signet ring cells result from a heterogeneity of cytoplasmic mucin as well as different stages of differentiation of signet ring carcinoma cells.