A 68-year-old man was refered for evaluation and treatment of advanced esophageal cancer. He complained of substernal dysphagia for solid and liquid foods. He did not remember episodes about ingesting something that correlated with symptoms. The single-contrast esophagogram revealed subtotal obstruction of the cervical esophagus with barium outlining the polypoid-filling defect irregularly. After 18 hours later, the patient underwent endoscopic examination and at the direct esophagoscopic finding, the food materials mainly consisted of packed rice was filled in the cervical esophagus. After saline irrigation, a fish bone, which was about 50X9 mm, and looked like a knife was lodged just distal to the impacted food materials. The fish bone was removed successfully from the esophagus. The patient experienced dramatic relief of symptoms shortly after procedure.
Aged ; Barium ; Deglutition Disorders ; Esophageal Neoplasms ; Esophagus ; Humans

PURPOSE: This study was done to identify and compare nursing performance including job stress, emotional labor and burnout between nurses who work in comprehensive nursing care service wards and general wards. METHODS: Participants were 187 nurses working in a general hospital in Busan which provides comprehensive nursing care service (comprehensive nursing care service ward: 95, general ward: 92). Data were collected using questionnaires and analyzed using descriptive statistics, χ² test, t-test, ANOVA, and multiple regression with the SPSS/WIN 23.0 program. RESULTS: There was no significant difference in the variables between comprehensive nursing care service ward nurses and general ward nurses. Factors influencing burnout were emotional labor in comprehensive nursing care service ward nurses while job stress and emotional labor were the factors influencing burnout in general ward nurses. CONCLUSION: The findings of this study indicate that comprehensive nursing care service can be a positive delivery system for nurses. Therefore, there is a need for strategies to integrate comprehensive nursing care service systematically.
Busan ; Hospitals, General ; Nursing Care* ; Nursing* ; Patients' Rooms* ; Stress, Psychological*

Monilethrix is a rare hereditary disorder of hair which was described by smith in 1879. The scalp hair is most frequently affected but the body or sexual hair are rarely affected. The affected hair shows periodic constrictions that break easily, so the hair could not grow more than a few millimetere long. It is thought that the node of the affected hair is normal and the thin internodal segment is deficient in hair matrix. Keratosis pilaris is generally an associated feature. We experienced a case of monilethrix with keratosis pilaris. The 4 years old male patient with monilethrix affected only scalp hair with keratosis. The family history was non-contributory.
Child, Preschool ; Constriction ; Hair ; Humans ; Keratosis* ; Male ; Monilethrix* ; Scalp

Developmental venous anomalies are congenital anomalies of the intracranial venous drainage and clinically asymptomatic. Cavernous hemangiomas are vascular malformations composed of dilated vascular channels lined with a single layer of endothelial cells without any intervening normal neural tissue. Although, cavernous hemangioma may be clinically silent, but frequently cause variable neurologic manifestations; intracranial hemorrhage, seizures, and focal neurologic deficits. Frequent association of these two diseases has already been reported and it has been suggested that cavernous hemangiomas not the developmental venous anomalies that cause the acute clinical symptoms. A 4 year old girl with sudden onset of headache, vomiting, gait disturbance and signs of unilateral cerebellar dysfunction 2 days before admission showed a 2.5x2.5cm sized hematoma with heterogenous signal intensity both in CT and MRI in the left cerebellar hemisphere. Four-vessel cerebral angiography revealed characteristic findings of developmental venous anomalies. Pathologic findings of the surgically removed hematoma disclosed typical feature of cavernous hemangioma. Based on the findings in this case and review of the literatures, we concluded that the possibility of other diseases such as cavernous hemangiomas must be considered in patients who has intracranial hemorrhage due to the developmental venous anomalies.
Cerebellar Diseases ; Cerebral Angiography ; Child, Preschool ; Drainage ; Endothelial Cells ; Female ; Gait ; Headache ; Hemangioma, Cavernous* ; Hematoma ; Hemorrhage* ; Humans ; Intracranial Hemorrhages ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Seizures ; Vascular Malformations ; Vomiting

The Carneys complex is a multisystemic tumorous disorder that features myxoma(heart, skin, and breast), spotty skin pigmentation(cutaneous and mucocutaneous), endocrine tumors(adrenal, testicular, and pituitary) and peripheral nerve tumors. The criteria far diagnosis of the complex is the presence of two or more of the above conditions. The condition is transmitted as an autosomal dominant trait. The most serious components of the syndrome are cardiac myxoma and psammomatous melanotic schwannoma. The cutaneous manifestations are a major clue in the disorder. We report a case of Carneys complex in a 19-year-old woman. She had spotty pigmentation on her face, left atrial myxoma, and myxoma on her right nipple. Her mother and sister had left atrial myxoma.
Diagnosis ; Female ; Humans ; Mothers ; Myxoma* ; Neurilemmoma ; Nipples ; Peripheral Nervous System Neoplasms ; Pigmentation ; Siblings ; Skin ; Young Adult

Fisting is an uncommon sexual activity, and death due to fisting is very rare. In the present report, we describe a case of a woman who died from fisting by her male partner. A 38-year-old woman went to a motel with a man after consuming alcohol, and there they kissed each other. As desired by woman, the man inserted his fingers into her vagina and anus, and later inserted his fist and forearm into her vagina and anus. After 20-30 minutes of fisting, the woman became unconscious and died. The autopsy confirmed the presence of perineal and vaginal lacerations with massive internal pelvic soft tissue injury with uterine artery rupture. A partial tear was noted at the rectosigmoid junction. The cause of death was hypovolemic shock due to uterine artery rupture. Following court trials, the assailant was sentenced to 4 years of imprisonment for the felony of inflicting bodily injury resulting in death.
Anal Canal ; Autopsy ; Cause of Death ; Female ; Fingers ; Forearm ; Humans ; Lacerations ; Male ; Rupture ; Sexual Behavior ; Shock ; Soft Tissue Injuries ; Unconscious (Psychology) ; Uterine Artery ; Vagina

BACKGROUND: Respiratory atopy (RA) is frequently associated with atopic dermatitis (AD) and the age of onset is usually later than that of the dermatitis. OBJECTIVE: The aim of this study was to investigate the prevalence, the onset, and the duration of RA associated with AD in Korea. We also tried to correlate the existence of RA with the severity and prognosis of AD. METHODS: One hundred and eighty one patients with AD were studied. Information about the age at onset and the duration of RA were obtained from the medical history of patients or from the medical records. The severity of AD was graded. RESULTS: RA was found in 66 cases of AD (36.5%). The average age at onset of asthma was 6 years and the average duration of asthma was 6 years. The average age at onset of allergic rhinitis (AR) was 12.4 years and the average duration of AR was 6.8 years. The prevalence of asthma with AD was the most common in the age group between 8 and 11 years while the prevalence of AR was the most common in the age group between 20 and 23 years. The higher occurrence of RA in the older age group was considered to represent persistence of AD in-to adult life. We could not find any difference in the severity of AD between pure AD patients and AD patients with RA. CONCLUSION: The prevalence of RA in AD in Korea was considered to be similar to that of other reports. The average onset of asthma in Korea was a little later, whereas the average on-set of AR was a little earlier than that in the other reports. The duration of RA, which has hardly been mentioned in the literature, was considered to be about 6 years in Korea. It is likely that RA is a poor prognostic factor for AD, but does not affect severity of dermatitis.
Adult ; Age of Onset ; Asthma ; Dermatitis ; Dermatitis, Atopic* ; Humans ; Korea ; Medical Records ; Prevalence ; Prognosis ; Rhinitis, Allergic

The origin of the stromal cell of cerebellar hemangioblastoma has long been studied electron microscopically and immunohistochemically. The results and theories about the stromal cell origin are variable and plentiful. However, the exact origin of the stromal cell remains controversial. The present study is aimed to elucidate the nature of the stromal cell of cerebellar hemangioblastoma. Ten cases of hemangioblastoma in Severance Hospital were used for immunohistochemical analysis of the stromal cell. The immunohistochemical staining of GFAP, S-100 protein, NSE, alpha-l-antichymottypsin, cytokeratin, CD 68, factor VIII related antigen, and synaptophysin were performed. The results were as follows; GFAP and S-100 protein were stained mainly but weakly in bellar capillary spindle cell and cellular process. NSE was stained mainly in foam cells, and 6 cases among them revealed strong reaction. ct-l-antichymotrypsin was stained in a few foam cells of 5 cases. Cytokeratin, CD 68, factor VIII related antigen, and synaptophysin showed negative reaction. Based on these results, it is considered that the origin of the stromal cell is histiocytic or neurogenic rather than glial. The weak positivity of GFAP and S-100 protein may support the neurogeriic origin but ct-l-antichymotrypsin positivity does not support the possibility. The positivity of GAP and S-100 protein supports the phagocytic action of histiocytic cell and suggests histiocytic origin rather than neurogenic.

PURPOSE: The purpose of this study was to explore the effects of head nurses' authentic leadership and empowerment on job satisfaction, and nursing performance of nurses and to identify the mediating effect of empowerment in the relationships of head nurses' authentic leadership, with nurses' job satisfaction, and nursing performance. METHODS: The sample for this study was 149 nurses from 2 general hospitals located in Busan. Data were collected using self-administered questionnaires and the SPSS/WIN 23.0 program was used for analysis. Mediation analysis was performed according to the Baron and Kenny method and Sobel test. RESULTS: Head nurses' authentic leadership showed positive correlations with empowerment, job satisfaction, and nursing performance. Empowerment showed partial mediating effects in the relationship between head nurses' authentic leadership and nurses job satisfaction, and a perfect mediating effect in the relationship between head nurses' authentic leadership and the performance of nursing. CONCLUSION: The results indicate that it is necessary to develop strategies and applications to enhance nurses' empowerment for improved job satisfaction and nursing performance.
Busan ; Head ; Hospitals, General ; Job Satisfaction ; Leadership ; Methods ; Negotiating ; Nursing ; Power (Psychology) ; Work Performance

Changes in CTB labeled motor neurons of the spinal cord were observed after the induction of peripheral neuropathy by ligation of the tibial nerve. Rats were anesthetized and the tibial nerve was ligated with 3-0 silk. The rats were separated into three groups based on the length of time the tibial nerve was ligated (1, 2, or 4 weeks). After the ligation procedures were complete, the tibial nerve stumps were soaked in CTB solution. Tibial nerve segments and the spinal cord were then observed. In the control and experimental groups, CTB-labeled neurons formed a discrete population that was concentrated primarily at the L5 level, while the contributions from L4 and L6 were minor. According to the distributions, CTB-labeled neurons were divided into rostral and caudal groups. A selective decrease of CTB-labeled neurons was observed only in the caudal group, extending from the rostral L5 to one-half of the rostral L6. The total numbers of CTB-labeled motor neurons were 2,160+/-169.3, 1,002+/-245.1, 587.5+/-346.5, and 1,728+/-402.6 in the control group, 1 week group, 2 week group, and 4 week group, respectively. The selective decrease of CTB-labeled neurons in the caudal division was responsible for the decrease in the total number of labeled neurons in all groups. Following peripheral neuropathy caused by ligation of the tibial nerve, CTB-labeled neurons in the spinal cord decreased selectively. These results may provide important neuroanatomical data regarding the effects of peripheral neuropathy by ligation of the tibial nerve.
Animals ; Ligation ; Motor Neurons ; Neurons ; Peripheral Nervous System Diseases ; Rats ; Silk ; Spinal Cord ; Tibial Nerve