Atypical condyloma is a variant of flat condyloma characterized by the presence of atypical koilocytes having large hyperchromatic, smudged and often bizarre nuclei. Atypical condyloma can be frequently misdiagnosed on cytologic smear and on tissue sections by its marked cellular atypia, as high grade dysplasia, in situ or even invasive squamous cell carcinoma. We described two cases of atypical condyloma of the female genital tract. The cytologic features and histologic changes were reminiscent of those of invasive squamous cell carcinoma and severe degree of dysplasia of the uterine cervix. The differential findings between atypical condyloma and squamous cell carcinoma were discussed in detail.
Female ; Humans

PURPOSE: The purpose of this study was to examine the effects of resilience and job satisfaction on organizational commitment in Korean-American registered nurses. METHODS: A cross-sectional study was conducted using a structured questionnaire survey with 203 Korean-American registered nurses living in New York State and New Jersey State. Data were collected from May 8 to August 25, 2012. Collected data were analyzed using t-test, ANOVA, Scheffe test and hierarchical multiple regression. RESULTS: The mean organizational commitment of Korean-American registered nurses was 3.34+/-0.59 out of a possible 5.00. The resilience and job satisfaction were significant variables predicting the level of organizational commitment among Korean-American registered nurses, accounting for 50% of the variability. CONCLUSION: The results of the study indicate that it is necessary to identify factors influencing job satisfaction and develop programs to strengthen personal resilience in order to increase organizational commitment.
Cross-Sectional Studies ; Humans ; Job Satisfaction* ; New Jersey ; Surveys and Questionnaires

PURPOSE: To quantitatively evaluate by MRI brain atrophy and abnormal parenchymal signal intensity onT2-weighted spin echo image in alcoholics. MATERIALS AND METHODS: MRI of 24 alcoholic patients were retrospectively evaluated to measure brain atrophy (cerebral sulcal width, bifrontal horn distance, third ventricular width, fourth ventricular width, ambient cistern width, cerebellopontine angle cistern width, number of cerebellar sulci, and number of vermian sulci) and abnormal high signal lesions of brain parenchyma onT2-weighted spin echo image, and were compared with age matched controls (n=29). The alcoholics and controls were divided into two age groups, younger (30 - 49 years) and older (50 - 72 years), and statistical analysis was then performed. Axial and sagittal T1- and T2-weighted spin echo images were obtained using a 0.5 Tesla superconductive system. RESULTS: Statistical significant parameters in the supratentorial region were cerebral sulcal width, distance between lateral ends of frontal horns of both lateral ventricles, and third ventricular width (p<0.05),and in the infratentorial region were fourth ventricular width, ambient cistern width, cerebellopontine angle cistern width, number of cerebellar sulci, and number of vermian sulci (p<0.05). In the younger age group, statistical significant parameters were cerebral sulcal width, third ventricular width, ambient cistern width, cerebellopontine angle cistern width, number of cerebellar sulci, and number of vermian sulci (p<0.05) and in the older group were cerebral sulcal width, bifrontal horn distance, third ventricular width, fourth ventricular width, number of cerebellar sulci, and number of vermian sulci (p<0.05). Abnormal high signal intensity onT2-weighted spin echo images were seen in 46% of alcoholics (11/24) and in 13% of controls (3/29). High signal lesions in the older group were statistically significant (p<0.05). CONCLUSION: Atrophic brain changes and periventricular high signal foci on T2-weighted spin echo image are significantly higher in chronic alcoholics than in age-matched normal controls.
Alcoholics* ; Alcoholism ; Animals ; Atrophy* ; Brain* ; Cerebellopontine Angle ; Horns ; Humans ; Lateral Ventricles ; Magnetic Resonance Imaging* ; Retrospective Studies

PURPOSE: This study is to investigate the job stress and presenteeism of nurses with work shift. METHODS: The data were collected through questionnaires from 281 clinical nurses working for a university hospital located in D city from 13 to 28 of February, 2009. The data were analyzed by descriptive statistics, t-test, ANOVA, Scheffe verification test, Pearson correlation coefficient and multiple linear regression using SPSS/WIN 16.0. RESULTS: The mean score of job stress was 3.47. Work overload and psychological burden scored the highest point as the sub-category of work stress factor. Work performance loss out of presenteeism showed 26.89 and perceived productivity, 79.79. Also 94.7% of respondents answered they had health problems. A significantly positive correlation was found among job stress, work performance loss and health issue. To determine the factors affecting persenteeism, work performance loss was associated with work overload and perceived productivity with interpersonal relationship conflict. CONCLUSION: Based on the findings of the study, job stress is positively correlated with work performance loss, and health problems. Therefore, health problems of nurses with work shift need to be considered and plans to manage their job stress affecting presenteeism need to be developed at an earlier stage.
Surveys and Questionnaires ; Efficiency ; Linear Models

No abstract available.

Tetralogy of Fallot constitutes the highest proportion of cyanotic congenital heart disease and has four basic abnormal anatomical pictures including ventricular septal defect, pulmonary stenosis, aortic overriding and right ventricular hypertrophy. The work of Edward, et al(1965), Guntheroth, et al(1965) and Lev and Eckner(1964) has shown that the anatomical picture in a combination of just first two morphological characteristics, the aortic overriding and right ventricular hypertrophy being a consequence of the ventricular septal defect and pulmonary stenosis. Basic signs involve two categories, one is change of shunt rate depending on pulmonary stenosis, ventricular septal defect and systemic vascular resistance, and the other is physiological response to the chronically lowered PaO2. Thus the pathophysiological status presents to us more problems than other congenital heart disease in the care of patients during operation and anesthesia. Therefore, the anesthesiologist must understand the basic pathophysiology, various findings of examination, symptoms and signs, the problems during anesthesia and postoperative care. The purpose of this study was to evaluate the anesthetic management in total corrective surgery of tetralogy of Fallo which was performed at Severance Hospital. Out of consecutive 160 cases of tetralogy of Fallot in our past ten years experiences from 1971 to 1980, we selected the clinical results on anesthetic care of 12 cases which received total corrective surgery under hypothermia and extracorporeal circulation. The results were as follows: 1) Out of 121 cases, 82 cases were male(67.8%) and female was 39 cases(32.2%). The group aging from 6 to 10 year old was the highest proportion (44.6%) and the next proportion was the group aging from 11 to 15(22.3%). 2) Out of 121 cases, 91 cases were cyanotic(75.2%). On the diagnostic distribution, tetralogy of Fallot without any other anomaly was the most common(66.9%). 3) As for premedicants, secobarbital was the highest proportion(28.1%). For anesthetic maintenance, methoxyflurane with nitrous oxide was the most common(43.8%). 4) During cardio-pulmonary bypass, high flow perfusion was commonly used and the highest mean arterial pressure was 89.09+/-1.21 mmHg and the lowest mean arterial pressure was 36.33+/-1.21mmHg. 5) The major complications after operation and anesthesia were dysrhythmia(13.1%), pleural effusion(10.3%), main wound infection(10.3%), hemorrhage(8.3%), acute renal failure(8.3%), heart failure(6.9%), low output syndrome(4.1%) and cerebral infarction due to air emboliam(2.7%). 6) Out of 121 cases were expired and hospital mortality was 23.1%. The causes of death were heart failure(50%), acute renal failure(14.3%) and cerebral infarction(14.3%). in conclusion, anesthetic care for total corrective surgery of teralogy of Fallot should be based upon the understanding of the pathophysiology of disorder itself.
Female ; Humans ; Mortality

PURPOSE: The purpose of this study was to identify the effects of meridian massage on menopausal symptoms and Shin-Hur in middle-aged menopausal women. METHOD: The research design was a nonequivalent control group pre-post experimental design. The subjects of the study were middle-aged women who had had no menstruation in the last 12 months after the last menstrual bleeding. Cards of invitation on bulletin boards of several apartments were placed to recruit the subjects. The cards of invitation included: purpose of the study, eligibility criteria, method and period. Eighteen women in the experimental group and 16 women in the control group were conveniently assigned, respectively. The experimental group received 20 min meridian massage 3 times per week for 4 weeks. The menopausal symptoms and Shin-hur were measured and compared between the two groups before and after the intervention. Data were analyzed with the SPSS program by Fisher's exact test, Wilcoxon Sign Rank test, Mann Whitney U-test and Spearman's rank correlation. RESULT: The experimental group showed a significant decrease of menopausal symptoms (U=77.00, p=.020) and Shin-Hur (U=76.00, p=.017). There was a significantly positive correlation between menopausal symptoms and Shin-Hur (r=.497, p=.003). CONCLUSION: Meridian massage was effective in improving menopausal symptoms and Shin-Hur in middle-aged menopausal women. Thus it can be useful as a nursing intervention for menopausal women.
Abdomen ; *Acupressure ; Acupuncture Points ; Female ; Humans ; Massage/*methods ; Meridians ; Middle Aged ; *Postmenopause ; Women's Health

We retrospectively analyzed 54 patients with esophageal cancer treated surgically between 1992 and 1996. They composed of 51(94.4%)men, 3(5.6%)women, and the age ranged from 42 to 78, the mean was 58.7+/-8.37. Symptoms were varied with dysphagia(72.2%), epigastric discomfort(16.6%), chest pain (5.6%), and so on(5.6%). Transthoracic esophagectomy(TTE) with esophagogastrostomy was done in 36 case, TTE with esophagocologastrostomy in 4 case, and transhiatal esophagectomy(THE) with esophagogastrostomy in 14 case. The operative mortality was 12.9%(7/54); 6 underwent TTE with esophagogastrostomy, and 1 underwent TTE with esophagocologastrostomy. Postoperative complications were of anastomotic leakage in 7 case, wound infection in 10 case, anastomotic stricture in 9 case, vocal cord paralysis in 2 case, bronchial tearing in 1 case, and pneumothorax in 3 case. Locations of esophageal cancer were upper thoracic esophagus in 4 case, middle thoracic esophagus in 34 case and lower thoracic esophagus in 16 case. Histological types were adenocarcinoma in 1 case and squamous cell carcinoma in 53 case. During the follow-up period, 25 cases died. Cumulative survival rate was 52.7% in 1 year, 45.5% in 2 year, 45.5% in 3 year, 45.5% in 4 year, 45.5% in 5 year.
Adenocarcinoma ; Anastomotic Leak ; Carcinoma, Squamous Cell ; Chest Pain ; Constriction, Pathologic ; Esophageal Neoplasms* ; Esophagus ; Follow-Up Studies ; Humans ; Mortality ; Pneumothorax ; Postoperative Complications ; Retrospective Studies ; Survival Rate ; Vocal Cord Paralysis ; Wound Infection

In the field of the experimental lung transplantation, we analyzed the CT findings of acute rejection, infection in the left single allotransplanted lung of adult mongrel dogs, and the CT findings were compared with the histological findings obtained by the lung biopsy. Twenty two adult mongrel dogs were divided into two groups(Donor and recipient group). Donor lungs were flushed with LPDG(low potassium dextran glucose) solution(n=4) or modified Euro-collins solution(n=7) and preserved over 20 hours with 10degrees C(1 case preservation for 4hours). After left single lung transplantation, the chest X-ray and sequential computed tomogram were performed with concomitant hemodynamic study and arterial blood gas analysis on immediate postoperative period, postoperative 3rd day and postoperative 7th day. Two of eleven transplanted lungs had acute rejection which was represented as moderate infiltration at immediate or 1st postoperative day but became extensive infiltration at postoperative 3rd day on CT. There were showed one case of bronchopleural fistula, six cases of pneumonia and two cases of pulmonary infarction. In one rejection cases, the opacity of transplanted lung was improved by injection of methylprednisolone 500mg daily during 3 days. We concluded that CT was a useful noninvasive evaluation parameter after lung trans- plantation and the serial CT scan enabled early detection of acute rejection.
Adult ; Allografts* ; Animals ; Biopsy ; Blood Gas Analysis ; Dextrans ; Dogs* ; Fistula ; Hemodynamics ; Humans ; Lung Transplantation* ; Lung* ; Methylprednisolone ; Pneumonia ; Postoperative Period ; Potassium ; Pulmonary Infarction ; Thorax ; Tissue Donors ; Tomography, X-Ray Computed

OBJECTIVE: The elderly population is rapidly growing, and the population over age 65 is expected to increase. To evaluate factors that determine recovery in this population, we report a clinical analysis of 77 elder patients of mild head trauma over 65 years of age. METHODS: The medical records were reviewed retrospectively for 77 head-injured patients aged 65 to 85 years who were admitted to our institution between March, 1995 and December, 1999. The outcome was compared with age, sex, Glasgow Coma Scale score, and radiologic characteristics. RESULTS: As in all age groups, males predominated and motor vehicle accidents accounted for a highest proportion(35%). Of the traffic accidents, pedestrian injuries were more common. The single most common lesion was subdural hematoma. The initial radiologic findings were not correlated with outcome. The GCS score was statistically correlated with prognosis. Sixty-one patients(79.2%) had favorable outcome. Ten of seventy-seven patients(13%) died whereas cerebral injury accounted for 5 deaths. Non-cerebral causes of death were composed of pneumonia, multi-organ failure and sepsis. The mean hospitalization was 52.3+/-12.6 days. CONCLUSION: The mortality rate after injury is higher in elderly patients. It is therefore the factors of intracranial and extracranial cause which influence survival and outcome be carefully treated. Neurologic deficits, even though mild, are the risk factor of poor prognosis in the elderly. Earlier identification of risk and aggressive support may be needed for decreasing the morbidity and the mortality in the elderly.
Accidents, Traffic ; Aged ; Cause of Death ; Craniocerebral Trauma* ; Glasgow Coma Scale ; Head* ; Hematoma, Subdural ; Hospitalization ; Humans ; Male ; Medical Records ; Mortality ; Motor Vehicles ; Neurologic Manifestations ; Pneumonia ; Prognosis* ; Retrospective Studies ; Risk Factors ; Sepsis