Multiple primary tumors are defined as cases involving primary malignant tumors of different histologic origins in one person. The absolute number of reported cases of double primary malignant tumors has increased in recent years diagnostic procedures. Primary adenocarcinoma of duodenum is a rare disease and represents less than 0.5% of all gastrointestinal malignancies. Therefore, synchronous multiple primary cancers of the stomach and duodenum are very rare. Recently, we experienced a case of triple primary malignant tumors of different site originating from the stomach, duodenum and cervix in 71- year-old woman. She had had radiation therapy and chemotherapy for squamous cell carcinoma of the uterine cervix 8 years previously. We performed subtotal gastrectomy and pancreaticoduodenectomy with radical lymph node dissection. She remained healthy without any evidence of recurrence 12 months after the operation.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Cervix Uteri ; Drug Therapy ; Duodenal Neoplasms* ; Duodenum ; Female ; Gastrectomy ; Humans ; Lymph Node Excision ; Pancreaticoduodenectomy ; Rare Diseases ; Recurrence ; Stomach ; Stomach Neoplasms* ; Uterine Cervical Neoplasms*

Strongylodiasis is universal in distribution but is most abundant in countries with a tropical climate. Although infestation by Strongyloides stercoralis is usually limited to the intestines, dessemination of this helminth in debilitated host can be lead to death with various clinical disorders. characterized by profound malabsorption, diarrhea, electrolyte imbalance, gram negative or opportunistic fungal sepsis, coma and death. Cell-mediated immunity contributing significantly to the control of helminthic infections, may be suppressed by carcinoma, immunosuppressive chemotherapy and use of corticosteroids. Diagnosis of Strongyloidiasis is achieved by an examination of samples of feces, duodenal aspirates and sputum of patients for Strongyloides stercoralis. Treatment of strongyloidiasis is twofold : correction of the immunosuppressive state by withdrawal of immunosuppressive drug, if possible, and vigorous treatment with thiabendazole. Testing for strongyloidiasis is especially recommanded before treating a patients should be monitored for infection by Strongyloides stercoralis and other opportunistic infection. We are reporting a case patient with Strongyloides stercoralis hyperinfection and pulmonary tuberculosis who had been. used corticosteroid for persisting polyarthritis.
Adrenal Cortex Hormones ; Arthritis ; Coma ; Diagnosis ; Diarrhea ; Drug Therapy ; Feces ; Helminths ; Humans ; Immunity, Cellular ; Intestines ; Opportunistic Infections ; Sepsis ; Sputum ; Strongyloides stercoralis* ; Strongyloides* ; Strongyloidiasis ; Thiabendazole ; Tropical Climate ; Tuberculosis, Pulmonary

BACKGROUND: In these days of increasing need for medical treatment, and the trend of changing lifestyles for personal health care, the position of medical treatment has led to the increase of careful and various services to every member of the community. But the reality of medical treatment, including the present situation of the emergency room in general hospital is recognized as the cause of those dissatisfactions and complaints of both patients and their caregivers. So this study aims at contributing to the harmonious relation between doctor and patient. METHODS: This study has been carried out by the questionnaire method on the basis of the relatively reasonable 331 papers among 430 questionnaire papers of the patients and their caregivers hospitalized by way of the emergency room in Cheonju Yeong Dong Hospital from Sep. 1994 to Apr. 1995. RESULTS: Among 331 subjects of this questionnaire, there were 121 male patients(36.6%), 76 female patients(23.0%), 80 male caregivers(24.2%), 54 female caregivers. The subjects were compaced of 23 teenagers(7.8%), 74 in their twenties(22.4%), 135 in their thirties(40.8%), 52 in their fourties(15.7%), 29 in their fifties(8.8%), 12 in their sixties(3.6%), 6 in their seventies(1.8 %). Both patients and their caregivers seemed to have a great dissatisfactions and complaints, which can be extraneous to medical treatment. Many patients complained of the unbearable situations such as delayed pain control before after a first-aid treatment, as well as various poor condition of medical treatment in emergency room. Their caregives complained of the lack of a thought explanation of diagnosis and prognosis, as well as the tedious waiting time before taking medical teratment. There were many cases where the emergent patients took medical treatment with some dissatisfa'ctions and complaints of medical staffs or medical donditions. CONCLUSIONS: When using the emergency room in a general hospital, both patients and their caregivers experiance a great deal of dissatisfactions and complaints, which can be followed by a distrust of the hospital and an obstacle of medical treatment. The medical staff, such as the hospital authorities, doctors, and nurses should make various improvements upon the medical conditions of the emergency room in general hospital.
Caregivers ; Delivery of Health Care ; Diagnosis ; Emergencies* ; Emergency Service, Hospital* ; Female ; Hospitals, General ; Humans ; Life Style ; Male ; Medical Staff ; Prognosis ; Surveys and Questionnaires

Dermatomyositis is a severe, idiopathic systemic disorder with predominant involvement of skin and skeletal muscle. The association of adult dermatomyositis and malignancy in particular has generated much attention. The reported prevalence of cancers in this disease varies from 6.7% to 52.2%. We experienced a concurrent case of transverse colon cancer and dermatomyositis on 67 year old female patient and report with review of literatures.
Adult ; Aged ; Colon* ; Colon, Transverse ; Colonic Neoplasms* ; Dermatomyositis* ; Female ; Humans ; Muscle, Skeletal ; Prevalence ; Skin

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

PURPOSE: This study was conducted to investigate the factors that affect subjective well-being in nursing students. METHODS: A total of 236 nursing students participated in the study. Data was collected from November through December 2013 using a self-reporting questionnaire that surveyed the level of gratitude, interpersonal relationship ability, subjective happiness, and life satisfaction. Data was analyzed by descriptive analysis, t-test, ANOVA, Pearson correlation coefficients and multiple regression with the SPSS/WIN 18.0 program. RESULTS: Subjective happiness positively correlated with gratitude (r=.41, p<.001) and interpersonal relationship ability (r=.55, p<.001). Life satisfaction positively correlated with gratitude (r=.53, p<.001) and interpersonal relationship ability (r=.37, p<.001). Significant predictors of subjective happiness included gratitude (beta=.38, p<.001), interpersonal relationship ability (beta=.28, p<.001) and major satisfaction (beta=.17, p=.002). The regression model explained 39.3% of subjective happiness. Significant predictors of life satisfaction included gratitude (beta=.42, p<.001), academic achievement (beta=.15, p=.006), interpersonal relationship ability (beta=.16, p=.008) and major satisfaction (beta=.12, p=.035). The regression model explained 35.3% of life satisfaction. CONCLUSION: To improve subjective well-being among nursing students, nurse educators should develop educational intervention programs to promote gratitude and interpersonal relationships.
Happiness ; Humans ; Interpersonal Relations ; Surveys and Questionnaires ; Students, Nursing*

We report a case of squamous cell carcinoma arising in porokeratosis of Mibelli in a 32-year-old male who presented with a large, slowly extending, erythematous patch with central ulceration on the left lateral side of the neck. Histopathologic examination of the periphery of the patch and central tumor showed porokeratosis and squamous cell carcinoma, respectively.
Adult ; Carcinoma, Squamous Cell* ; Epithelial Cells* ; Humans ; Male ; Neck ; Porokeratosis* ; Ulcer

The secondary implantation has gradually increased year by year. The authors conducted a study on eighty-two patients(92 eyes) recieving secondary intraocular lens implantation from Jan 1989 to Jan 1993. Sulcus fixation of posterior chamber IOL implantation was done in cases of intact or small posterior capsule rupture(56 cases). Anterior chamber intraocular lens(8 cases) and posterior chamber intraocular lens implantation by scleral fixation(28 cases) was done in eyes with large posterior capsule rupture or no zonular support. Final postoperative visual acuity of 0.5 or better was acquired in 77 eyes(83.7%) and didn't show statistically significant difference in three groups. The postoperative complications induced IOL decent ration(9.8%), uveitis(6.7%), cystoid macular edema(3.3%), vitreous hemorrhage(3.3%), and retinal detachment(3.3%). The causes of postoperative decreased visual acuity were cystoid macular edema(2.2%), fibrous membrane on IOL(2.2%), IOL decentration(1.1%) and IOL dislocation(1.1%), No statistically significant difference was noted in postoperative central corneal endothelial cell loss in three groups.
Anterior Chamber ; Aphakia* ; Corneal Endothelial Cell Loss ; Lens Implantation, Intraocular* ; Lenses, Intraocular* ; Membranes ; Postoperative Complications ; Retinaldehyde ; Rupture ; Visual Acuity

BACKGROUND: This study purposed to analyze and understand how spatial accessibility of patients influenced the number of outpatient visits for the internal medicine of a hospital. METHODS: A hospital with 100 beds in Seoul, South Korea provided data from 2013 January 1 to 2013 June 30. Euclidean distance and road ares were used to represent the spatial accessibility. Patient level data and dong level data were collected and used in spatial analysis. Dong level data was converted into grid level (500×500 m) for the multivariate analysis. Hot-spot analysis and generalized linear model were applied to the data collected. RESULTS: Hot-spots of outpatient visits were found around the study hospital, and cold-spots were not found. Number of outpatient visits was varied by the distance between patient resident and hospitals, and about 80% of total outpatient visits was occurred in within the 5 km from study hospital, and 50% was occurred in within 1.6 km. Spatial accessibility had significant influences on the outpatient visits. CONCLUSION: Findings provide evidences that spatial accessibility had influences on the patients' behaviors in utilizing the outpatient care of internal medicine in a hospital. Results can provide useful information to health policy makers as well as hospital managers for their decision making.
Ambulatory Care ; Decision Making ; Health Policy ; Humans ; Internal Medicine* ; Korea ; Linear Models ; Multivariate Analysis ; Outpatients* ; Seoul ; Spatial Analysis

Polycythemia vera (PV) is a rare myeloproliferative disease that causes elevated absolute red blood cell (RBC) mass due to uncontrolled RBC production. Moreover, this condition has been associated with a high risk of ischemic stroke and large vessel stenosis or occlusion, with many studies reporting cerebral infarction in PV patients. Despite these findings, there have been no reports on the vessel wall MRI (VW-MRI) findings of the narrowed vessels in PV-associated ischemic stroke patients. To the best of our knowledge, this is the first report in English regarding the carotid VW-MRI findings of a 30-year-old male diagnosed with PV after being hospitalized due to stroke.