Clavicular fracture is common injury in the upper extremity, but ipsilateral proximal, distal or middle-third clavicular fractures which occur simultaneously are an extremely rare. Seven cases have been reported in the English and Japanese literatures, but it has never been reported in Korea. We report a case of ipsilateral proximal and distal clavicular fracture caused by fall from height and describe its presumed mechanism, diagnosis, treatment with a review of literatures.
Asian Continental Ancestry Group ; Clavicle ; Humans ; Korea ; Upper Extremity

Acupuncture with gold needle insertion is utilized in Oriental medicine, and the effect of therapy is represented by anti-inflammatory and analgesic function, But sometimes the needle is erroneously inserted into abdominal organs, and then it may cause dangerous complications. We report a case of multiple gold needles in the abdominal organs without having definete clinical symptoms.
Acupuncture* ; Medicine, East Asian Traditional ; Needles* ; Radiography*

Purpose: The purpose of this study was to investigate the effects of nursing workplace spirituality, job embeddedness, and the nursing work environment on the organizational commitment of clinical nurses. The findings of the study will serveasafoundational resource for designinginterventions to improvenurses' organizational commitment. Methods: The samples of this study comprised 170 nurses working at general hospitals in B City. Data were analyzed through the SPSS 25.0 program using ANOVA, t-test, Scheffé́ test, Pearson's correlation coefficient, and multiple regression. Results: The primaryfactors impactingparticipants' organizational commitment were nursing workplace spirituality (β=.388, p<.001), nursing work environment (β=.232, p=.001), position (β=.145, p=.009),and pay satisfaction (β=.143, p=.012). These factors had an explanatory power of 51.4% with regard to organizational commitment. Conclusion To improve nurses’ organizational commitment, it is necessary to implementand developintervention programs aimed atincreasingtheir sense of workplace spirituality. Moreover, organizational management and policy initiatives are needed to foster apositivenursing work environment and pay satisfaction.

Colorectal cancer consists of 8.2 percent of all malignancy in korea, and shows more increaing tendency. Despite the advances in the detection of calorectal cancer no single screening technique has achieved both high degree of diagnostic accuracy and minimal patient morbidity. We studied 24 patients, who underwent colonoscopy, with clinical suspicious colon cancer at Presbyterian Medical Center between Jan and Sep.1995, and evaluated the diagnostic feasibility of colon lavage cytology using oral cleansing solution.(continue...)
Colon* ; Colonic Neoplasms* ; Colonoscopy ; Colorectal Neoplasms ; Diagnosis* ; Humans ; Korea ; Mass Screening ; Protestantism ; Therapeutic Irrigation

Colorectal cancer consists of 8.2 percent of all malignancy in korea, and shows more increaing tendency. Despite the advances in the detection of calorectal cancer no single screening technique has achieved both high degree of diagnostic accuracy and minimal patient morbidity. We studied 24 patients, who underwent colonoscopy, with clinical suspicious colon cancer at Presbyterian Medical Center between Jan and Sep.1995, and evaluated the diagnostic feasibility of colon lavage cytology using oral cleansing solution.(continue...)
Colon* ; Colonic Neoplasms* ; Colonoscopy ; Colorectal Neoplasms ; Diagnosis* ; Humans ; Korea ; Mass Screening ; Protestantism ; Therapeutic Irrigation

Pancreas lipomatosis is definde as fatty replacement of pancreatic acinar cells. Of the nine cases evaluated, seven cases (77.8%) of lipomatosis were limited inbody and tail, one case (11.1%) showed total lipomatosis excluding uncinate process and the remaining one case (11.1%) only in tail. As to the severity of lipomatosis, complete fat replacement in body and tail was found in four cases (44.4%), incomplete body and complete tail involvement in two (22.2%), incomplete body and tail, complete all except uncinate process, and complete tail involvements were found in one case (11.1%) each. Associated or predisposing factors included three diabetes mellitus (33.3%) combined with pancreas divisum, pancreas lithiasis and cholelithiasis respectively, hepatitis (22.2%) in two, and pseudocyst (11.1%) in one case, but in three cases (33.3%) nothing was found. In conclusion, pancreas lipomatosis was easily diagnosed by the abdominal CT and it was associated or predisposed by several e tities but had no major clinical symptoms, such as pancreatic insufficiency.
Acinar Cells ; Causality ; Cholelithiasis ; Diabetes Mellitus ; Exocrine Pancreatic Insufficiency ; Hepatitis ; Lipomatosis* ; Lithiasis ; Pancreas* ; Tail ; Tomography, X-Ray Computed

Twenty seven patients with known rectal cancer were evaluated with CT and CT findings were correlated with surgical and pathologic results on the aspect of perirectal fat infiltration and lymph node involvement. The accuracy in assessment of perirectal fat infiltration was 77.8% (21 of 27); sensitivity, 73.3% (11 of 13); specificity, 83.3% (10 of 12). In the detection of lymph node involvement, lymph nodes were divided into five groups according to the arterial teritories. Overall accuracy in the evaluation of lymph node involvement was 86.7%. Accuracy of peritumoral lymph node involvement was 51.9% (14 of 27); sensitivity, 42.9%(9 of 21); specificity 83.3% (5 of 6). Accuracy of internal iliac lymph node involvement was 88.9% (24 of 27); sensitivity, 85.7% (6 of 7); specificity, 90.0% (18 of 20). Of the common and external iliac lymph node, accuracy was 100% (27 of 27); sensitivity, 100% (2 of 2); specificity, 100% (25 of 25). Of the aortic bifurcation and mid sacral lymph node, accuracy was 92.6% (25 of 27); sensitivity, 50% (2 of 4); specificity, 100% (23 of 23). In regard to the inferior mesenteric lymph node, no lymphadenopathy was found on CT and pathologic results. In conclusion, CT has limited value in evaluating rectal cancer but with the satisfactory outcome in assessment of perirectal fat infiltration and lymph node, involvement except peritumoral node preoperative CT is useful in the evaluation of rectal cancer.
Humans ; Lymph Nodes* ; Lymphatic Diseases ; Rectal Neoplasms* ; Sensitivity and Specificity

No abstract available.
Cardiomyopathy, Hypertrophic* ; Humans ; Twins, Monozygotic*

Baerobic, spore forming, and rod-shaped bacterium. Anthrax spores are introduced into macrophage by phagocytosis and multiply after germination. The anthrax spores infected in macrophage produce lethal toxin eventually caused cell death. In this study, we analyzed apoptosis and cytokine TNF-alpha and IL-12 secretion after the infection of spores of B. anthracis Sterne in the murine macrophage RAW264.7 cells and in the primary human macrophages. In murine macrophage RAW264.7 cells infected by spore of B. anthracis Sterne, the cells were markedly changed in secretion of TNF-alpha (482~6,213 pg/ml) by lethal toxin, and induced apoptosis. In case of RAW264.7 cells infected by formalin-inactivated spores of B. anthracis, the cells were not able to produce lethal toxin, which released lower level concentration of TNF-alpha (7.7~97.2 pg/ml), and rarely induced apoptosis. When primary human macrophage cells infected with spores of B. anthracis Sterne, they secreted TNF-alpha (5~16 pg/ml), and induced apoptosis about 1% of total cells. We presented that inducing apoptosis by spores of B. anthracis Sterne capable of expressing lethal toxin is related with the secretion of TNF-alpha in murine macrophage RAW264.7 cells. These studies revealed that human and murine macrophages has affected differently by anthrax lethal toxin produced by spores of B. anthracis Sterne.
Anthrax ; Apoptosis ; Bacillus anthracis* ; Bacillus* ; Cell Death ; Germination ; Humans ; Interleukin-12* ; Macrophages* ; Phagocytosis ; Spores* ; Tumor Necrosis Factor-alpha*

Angiomyofibroblastoma is a distinctive, hitherto uncharacterized, benign soft tissue tumor of the vulva with histology similar to an aggressive pelvic angiomyxoma. It can be distinguished from an aggressive angiomyxoma by its circumscribed borders, higher cellularity, more numerous blood vessels, the frequent presence of plump stromal cells, minimal stromal mucin, and rarity of erythrocyte extravasation. We experienced a case of angiomyofibroblastoma of the vulva occurring in a 45-year-old woman. The lesion was a well-defined but not encapsulated mass, 4.5x4.2 cm. Histologically the mass was characterized by alternating hypercellular and hypocellular edematous zones in which abundant blood vessels were irregularly distributed. Immunohistochemically, the spindled, plump spindled, and oval stromal cells were reactive for vimentin and desmin, but not for cytokeratin, or S-100 protein.
Female ; Humans