Mutation of p53 tumor suppressor gene is now recognized as the most frequent genetic alteration in human neoplasms. Although meningiomas are common intracranial tumors, little is known about the clinical significance of p53 abnormalities in meningiomas. We studied 31 cases of meningioma to investigate the significance of p53 protein expression in meningiomas and its relationships with histological and clinical parameters and proliferative activity. Classical and atypical meningiomas were 16 (51.6%) and 15 cases (43.4%), respectively. p53 protein expression was detected in 4 (25.0%) of 16 classical, and 12 (80.0%) of 15 atypical meningiomas. p53 protein expression was correlated with Ki-67 staining index, atypical type, high histologic score, sheet pattern of the neoplastic cells, vascular proliferation, and male patient (p<0.05). In conclusion, immunohistochemical evaluation of p53 protein and histologic score of meningiomas are useful in assessing the prognosis.
Genes, Tumor Suppressor ; Humans ; Male ; Meningioma* ; Prognosis

PURPOSE: The purpose of this study was to identify the impact of workplace bullying experience and resilience on organizational commitment in general hospital nurses. METHODS: Participants were 250 nurses of a general hospital in Seoul, Gyeonggi-do and Gangwoen-do. Data were collected using the structured questionnaires and analyzed using descriptive statistics, t-test, ANOVA, pearson's correlation coefficient, and multiple regression analysis. RESULTS: As a result of multiple regression analysis, workplace bullying, resilience, clinical career, and work unit turned out to be variables that explained general hospital nurses' organizational commitment (Adj. R²=0.17, p<.001). CONCLUSION: These findings suggest that bullying and resilience were defined as the influential variables on organizational commitment of nurses. Therefore strategies and programs about workplace bullying and resilience are needed to be developed.
Bullying* ; Gyeonggi-do ; Hospitals, General* ; Seoul

No abstract available.
Child* ; Humans ; Infant* ; Intussusception*

Cardiac arrest associated with hyperkalemia during red blood cell transfusion is a rare but fatal complication. Herein, we report a case of transfusion-associated cardiac arrest following the initiation of extracorporeal membrane oxygenation support in a 9-month old infant. Her serum potassium level was increased to 9.0 mEq/L, soon after the newly primed circuit with pre-stored red blood cell (RBC) was started and followed by sudden cardiac arrest. Eventually, circulation was restored and the potassium level decreased to 5.1 mEq/L after 5 min. Extracorporeal membrane oxygenation (ECMO) priming is a relatively massive transfusion into a pediatric patient. Thus, to prevent cardiac arrest during blood-primed ECMO in neonates and infants, freshly irradiated and washed RBCs should be used when priming the ECMO circuit, to minimize the potassium concentration. Also, physicians should be aware of all possible complications associated with transfusions during ECMO.
Blood Transfusion ; Death, Sudden, Cardiac ; Erythrocyte Transfusion ; Erythrocytes ; Extracorporeal Membrane Oxygenation* ; Heart Arrest* ; Humans ; Hyperkalemia* ; Infant* ; Infant, Newborn ; Potassium

We herein report a case of AIDS-related Kaposi's sarcoma (KS) in a 36-year-old male patient, who had a solitary nodular skin lesion on the left supraclavicular area. The histopathologic findings showed typical features of KS as spindle cell proliferation and vascular spaces lined with endothelial cells. The patient's serum was positive for antibodies to the human immunodeficiency virus (HIV) and he had opportunistic infection of Pneumocystis carinii pneumonia and pulmonary tuberculosis. The WBC count was 1,200/mm3 and CD4 count was 50/mm3 with decreased CD4/CD8 ratio to 0.06. He died due to an aggravated respiratory infection.
Adult ; Antibodies ; CD4 Lymphocyte Count ; Cell Proliferation ; Endothelial Cells ; HIV ; Humans ; Male ; Opportunistic Infections ; Pneumonia, Pneumocystis ; Sarcoma, Kaposi* ; Skin ; Tuberculosis, Pulmonary

The Q-switched ruby laser has been used in clinics since the early 1980s. It was tried to remove tattoos at first with good effects. Thereafter, some physicians reported the usefulness of the laser in the treatment of some kinds of pigmented lesions such as nevus of Ota, freckles and lentigines. The reason why the Q-switched ruby laser has a lot of effect on tattoos and some pigmented lesions is that the laser has the function of selective photothermolysis on those cutaneous lesions. The authors have treated 185 patients with tattoos and cutaneous pigmented lesions using the Q-switched ruby laser during last 4 years ago. Patients had tattoos, nevus of Ota, freckles, lentigines, melasma, postinflammatory hyperpigmentation, and were followed up over 5 months after the end of the laser treatment. The authors analysed the results and compared them with other's results in Caucasians, and we intended to present a guide of the treatment using Q-switched ruby laser in Koreans. The results were as follows 1. Tattoos showed good results after the treatment because the most of tattoos are black or dark blue in color and cheated by amateur. We repeated the laser treatments with the interval of 2 weeks. 2. Nevus of Ota, freckles and lentigines showed good results after treatment of the Q-switched ruby laser 3. Melasma showed no improvement after the treatment. 4. The treatment of postinflammatory hyperpigmentation using the Q-switched ruby laser must be confined within a part of the lesion at the first visit of patient, because the therapeutic effects were observed in some patients only and the degree of depigmention after treatment was diverse. 5. The most common complication after Q-switched ruby laser treatment was pigmentary change, including hyperpigmentation in most of the cases and hypopigmentation in some cases. However, there was no visible scar or remarkable change of skin texture in all of the cases.
Asian Continental Ancestry Group ; Cicatrix ; Humans ; Hyperpigmentation ; Hypopigmentation ; Lasers, Solid-State* ; Lentigo ; Melanosis ; Nevus of Ota ; Skin

One of the most important prognostic factors in LCP disease is the extent of epiphyseal involvement. Magnetic resonance imaging is considered to be the technique of choice for early diagnosis of Legg-Calve-Perthes disease. Gadolinium-enhanced spin-echo MR images were obtained after nonenhanced Tl-weighted(spin-echo) and T2-weighted(gradient-echo) images. Four different areas were identified in the femoral epiphysis(necrosis, regenerative, cartilaginous and normal fatty bone tissue). The histological evolution of LCP is well described by Catterall and others. Comparing their description with our MRI finding, we suggest classification of LCP into three phases: (I) necrosis, (II) regeneration(IIa-early and IIb-late) and (III) reossification and sequale. T2 weighted image was useful in the early stage and Tl weighted image was useful in the later stage for evaluation of involved extent of the disease. With MRI, we think that we can find out the stage of LCP more early and rationally, pathological factors more easily and appropriate time for operation exactly. we believe that MRI is more adequate method to decide the stage of LCP disease.
Classification ; Early Diagnosis ; Legg-Calve-Perthes Disease ; Magnetic Resonance Imaging* ; Necrosis

Operative reduction is not essential for mild to moderate spondylolisthesis, but some authors agree that reduction of spondylolisthesis is beneficial for widening of intervertebral canal and consequently for decompression of neural tissue even though the degree of slippage is grade I or II. In our institute, we sometimes reduced the slippage for these reasons. But at follow up study we would find redisplacement and the degree of it seemed to be associated with the kind of instruments. So we analyzed redisplacement rate according to the kind of instruments in 59 cases of spondylolisthesis that were followed more than one year. The conclusions were as follow; 1. There was no significant correlation between reduction and redisplacement rate with pathologic type, lesion site, age,iscectomy and clinical result at least in grade I or II spondylolisthesis (P>0.05). 2. The pedicle screw system was more useful in reduction and its maintenance than the Luque ring system (P<0.001). 3. Redisplacement was occurred mainly within 2 months after operation, 4. The cause of redisplacement after reduction seems to be associated with mechanical insecurity before consolidation of the grafted bone takes place.
Decompression ; Follow-Up Studies ; Spondylolisthesis* ; Transplants

BACKGROUND: Tsutsugamushi disease is an acute, rashed febrile disease that shows widely varying prognoses from unsymptomatic infection to death. Early diagnosis and treatment lead to speedy recovery. Otherwise, many complications develop. This research was carried out to analyze the factors that affect the development of complications by comparing Tsutsugamushi patients with complicaions with those without complications. METHODS: Among the acute febrile disease patients who visited the emergency center of Chosun University Hospital from January to December 2000, 41 patients were clinically and serologically confirmed as having Tsutsugamushi disease. They were divided into two groups; 14 patients with complications and 27 patients without complications. We analyzed the two groups for correlations between complications and sex, age, period of occurrence, transfer or not, vital signs, laboratory findings, period before treatment, and checks for the existence of underlying disease, eschar, eruption, chest Xrays, and early diagnosis. RESULTS: 1) The aged have a high incidence of the disease, but there was no correlation between age and complications. Also, there was no correlation based on sex. 2) Although fall has a high incidence of the disease, the other seasons have higher complication rates. 3) The complication incidence rate has no correlation with either blood pressure or heart rate, also it does no correlate with eschar and skin rashes. 4) In the laboratory findings, hemoglobin and platelet, and Bun/Cr correlate with the complicaton incidence rate, but the white blood cell count and AST/ALT do not. 5) The complication incidence rate was high when treatment was started 10 days after the onset of Tsutsugamushi disease and no early diagnosis had been given. CONCLUSION: Early diagnosis and treatment are most important in preventing complications of Tsutsugamushi disease because the factors that affect the developement of complications of Tsutsugamushi disase are found during early diagnosis. Patients with doubtful clinical symptoms and abnormal lab findings should be started on a program of antibiotic treatment.
Blood Platelets ; Blood Pressure ; Early Diagnosis ; Emergencies ; Exanthema ; Heart Rate ; Humans ; Incidence ; Leukocyte Count ; Prognosis ; Scrub Typhus ; Seasons ; Thorax ; Vital Signs

Methemoglobinemia results from the oxidation of ferrous iron (Fe++) to ferric iron (Fe+++) within hemoglobin. It is caused by various etiologies, including the herbicide Propanil. Patients with low levels of methemoglobin (metHb) are asymptomatic but symptomatic patients and patients with high levels of metHb require treatment. Methylene blue is the first choice for the treatment of methemoblobinemia, but has some complications such as hemolytic anemia and rebound methemoglobinemia. We report the case of a 91-year-old woman who died of aniline herbicides poisoning. The level of metHb in her blood was initially 20.7% and her mental status was drowsy. She was intravenously treated with methylene blue within a therapeutic range for methemoglobinemia. After treatment with methylene blue, the level of metHb decreased but later increased above 20%. Methylene blue treatment was repeatedly attempted, but the patient suffered from hemolytic anemia and rebound methemoglobinemia. The patient finally died from renal failure and cardiopulmonary collapse. We must be careful because methemoglobinemia can occur even when treated pesticides such as propranil.
Anemia, Hemolytic ; Female ; Herbicides ; Humans ; Iron ; Methemoglobin ; Methemoglobinemia* ; Methylene Blue ; Pesticides ; Poisoning ; Propanil* ; Renal Insufficiency