Lipoma is one of the unusual benign breast neoplasms and usually manifests at fatty breast of women at the age of 40 to 60. We experienced a case of large breast lipoma nearly replacing the whole left breast parenchymal tissue with mammographic finding of well-defined radiolucent mass, sonographic finding of hyperechoic mass with disorganized echopattern and computerized tomographic finding of very low attenuation mass, characteristic to adipose tissue, in a young woman of her dense breast.
Adipose Tissue ; Breast Neoplasms ; Breast* ; Female ; Humans ; Lipoma* ; Ultrasonography

PURPOSE: The purpose of the study was to describe the experiences of do-not-resuscitate (DNR) among nurses. METHODS: Data were collected by in-depth interviews with 8 nurses in 8 different hospitals. Conventional qualitative content analysis was used to analyze the data. RESULTS: Eight major themes emerged from the analysis: DNR decision-making bypassing the patient, inefficiency in the decision-making process of DNR, negative connotation of DNR, predominance of verbal DNR over written DNR, doubts and confusion about DNR, least amount of intervention in the decision for DNR change of focus in the care of the patient after a DNR order, and care burden of patients with DNR. Decision-making of DNR occurred between physicians and family members, not the patients themselves. Often high medical expenses were involved in choosing DNR, thus if choosing DNR it was implied the family members and health professionals as well did not try their best to help the patient. Verbal DNR permission was more popular in clinical settings. Most nurses felt guilty and depressed about the dying/death of patients with DNR. CONCLUSION: Clearer guidelines on DNR, which reflect a family-oriented culture, need to be established to reduce confusion and to promote involvement in the decision-making process of DNR among nurses.
Adult ; Attitude to Death ; Critical Care ; Decision Making ; Family/psychology ; Humans ; Interviews as Topic ; Korea ; Nursing Staff, Hospital/*psychology ; Professional-Family Relations ; *Resuscitation Orders/psychology ; Social Support ; Tape Recording

PURPOSE: This study was to developed to create a CD-ROM and an educational program for the prevention of sexual harassment and violence and to contribute to the perception and add to the coping of the victims of sexual harassment and violence as well as the child, parents, and teachers. METHOD: The study's methods were literature reviews, surveys, and assessments of the negotiation process for educational needs of sexual harassed and abused children. RESULT: The sexual harassment and violence prevention program will contain four subjects : 1) sexual development of a preschool child, 2) characteristics of sexual harassment and violence of a preschool child, 3) safe sex, early detection of sexual violence syndrome, and coping strategies. The CD-RON was composed from three sites. The first was a child site, the second was a parent/teacher site, and the third was a game site for evaluations. The child site consisted of 10 possible scenarios of sexual harassment and violence that a child could experience. The parent/teacher site consisted of knowledge and information for prevention and coping strategies for sexual harassment and violence. At the end of each situation question and answer sections that were used for formative evaluation. Also, the game site could be a summative evaluation. CONCLUSION: The effects of this program and the CD-ROM were based of the promotion of reverence for humanity and gender equality for preschool childen. Eventually, children, parents, and teachers will have prevention and coping ability that will reduce the occurrence of sexual harassment and violence in Korea.
CD-ROM* ; Child ; Child, Preschool* ; Humans ; Korea ; Negotiating ; Parents ; Safe Sex ; Sex Offenses* ; Sexual Development ; Sexual Harassment* ; Violence

PURPOSE: Experience of chest pain may be different in women from that of men and this discrepancy may cause misdiagnosis of angina contribute to mortality by this disease in women. The purpose of this study was to analyze the characteristics of chest pain and responses to the symptoms in women. METHOD: A content analysis was conducted with interviewed data obtained from women who underwent the treadmill test RESULT: Seven major categories were identified from this content analysis: attributes of chest pain; accompanied symptoms; precipitating factors; relief strategies; family support; communication with physicians; and effects of chest pain on their lives. Characteristics of pain were described as heaviness, tightness, heating sensation, tearing, and others. Duration and intensity of pain varied in a wide range. Radiating pain presented in 9 patients, and the locations of radiation were throat, neck, shoulder arm and fingers. Women tended not to respond actively to their chest pain, and didn't get appropriate support either from their family or from their physicians when they reported chest pain. CONCLUSION: Women express non-typical as well as typical patterns of pain when they experience chest pain. Clinicians have to consider the variability of symptoms when they assess women with suspicions of angina.
Angina Pectoris* ; Arm ; Chest Pain* ; Diagnostic Errors ; Exercise Test* ; Female ; Fingers ; Heating ; Hot Temperature ; Humans ; Male ; Mortality ; Neck ; Pharynx ; Precipitating Factors ; Sensation ; Shoulder ; Thorax*

PURPOSE: The purpose of this study was to describe quality of life (QOL) in Korean school-age children by identifying dimensions and attributes of QOL from the child's point of view. METHOD: In-depth interviews with focus questions were used for the study. Twelve children, aged 10 to 13 years, were recruited from Seoul and rural areas. The interviews were audio-taped and transcribed before content analysis. The data were analyzed for themes and attributes. The researchers read the data together and discussed their conclusions until a consensus was reached. RESULTS: Eight dimensions, 57 subdimensions and 101atttributes were identified for QOL in school-age children. The eight dimensions of QOL were physical, social, emotional, learning, leisure, family, self-value, and material aspects. CONCLUSION: The study results can be utilized in developing reliable instruments to measure quality of life specific to school-age children. It is proposed that a consistent and unified policy should be established by school, family, and community for the purpose of improving the QOL of school-age children.
Child* ; Consensus ; Humans ; Learning ; Leisure Activities ; Quality of Life* ; Seoul ; Child Health

PURPOSE: To assess the efficacy of ancillary CT findings other than the obstructive lesion per se for the differential diagnosis of extrahepatic biliary obstruction. MATERIALS AND METHODS:CT findings of 49 patients with extrahepatic bile duct obstruction(22 benign and 27 malignant lesions) were assessed with emphasis on the patterns of ductal dilatation, contrast enhancement, and diffuse thickening of the extrahepatic ductal wall. Degree of central and peripheral intrahepratic ductal dilatation was graded by comparing with the adjacent portal radicles and hepatic parenchymal thickeness. RESULTS: Diffuse circumferential thickening and contrast enhancement of the extrahepatic ductal wall were more frequent in benign cases, but only thickening was statistically significant(p < 0.01). Peripheral intrahepatic ducts were more severely dilated by malignant causes(p < 0.01). With the same degrees of extrahepatic and central ductal dilatations, peripheral intrahepatic ducts were more severely dilated in malignant than in benign cases. CONCLUSION: These results may help to interpret the CT findings of extrahepatic biliary obstruction, particularly when the cause of biliary obstruction is uncertain.
Bile Ducts, Extrahepatic ; Diagnosis, Differential ; Dilatation* ; Humans

BACKGROUND: This study was doned to evaluate the rate of awakening after desflurane or isoflurane anesthesia in pediatric tonsillectomy patients. METHODS: Sixty patients, aged 5 10 years undergoing a tonsillectomy with or without an adenoidectomy were randomly assigned to receive either desflurane-N2O (group D) or isoflurane-N2O (group I). A recovery profile was assessed by a 3 point scale for the first 0, 15 and 30 min in the recovery room. RESULTS: It was statistically significant that group D had a shorter extubation time and eye opening time and a less apprehensive score than group I at 0, 15 and 30 min. CONCLUSIONS: We conclude that desflurane-N2O may offer clinical advantages over isoflurane when used for maintenance of anesthesia during a pediatric tonsillectomy.
Adenoidectomy ; Anesthesia ; Humans ; Isoflurane ; Recovery Room ; Tonsillectomy*

PURPOSE: The purpose of this study is to evaluate the characteristics of parotid gland tumors to help in the differentiation between benign and malignant lesions. MATERIAL AND METHODS: The CT findings of 22 patients with surgically proven parotid gland tumors were reviewed. Analysis was focused on the density and margin characteristics of the tumors, and the relationahip between the tumor and surrounding structures. RESULTS: Those tumors were pleomorphic adenoma (n=8), Warthin's tumor (n=5), basal cell adenoma (n=l), lipoma (n=l), dermold cyst (n=l), adenold cystic carcinoma (n=2), mucoepidermoid carcinoma (n=l), epidermold carcinoma (n=l), and carcinoma in pleomorphic adenoma (n=l). Most of benign and malignant tumors were heterogeneous in denstiy on contrast enhanced CT scans. In 5 of 6 malignant cases, the tumors had irregular or ill-defined margin and a tendancy to involve or cross the superficial layer of deep cervical fascia with obliteration of subcutaneous fat. Two malignant tumors invaded surrounding structures. CONCLUSION: Although the heterogeneous density of tumor is not a specific finding for malignancy at CT, following findings, such as, irregular or blurred margin of the lesion, the involvement of fascial plane, and the infiltration of surrounding structures may suggest the possibility of malignant parotid tumor.
Adenoma ; Adenoma, Pleomorphic ; Carcinoma, Mucoepidermoid ; Fascia ; Humans ; Lipoma ; Parotid Gland* ; Subcutaneous Fat ; Tomography, X-Ray Computed

BACKGROUND: Splenectomy is often performed for the patients with refractory chronic immune thrombocytopenic purpura (ITP). Still, there are no generally accepted guidelines for the minimum level of platelet count and the average requirement of platelet transfusion so that the patients can safely undergo splenectomy. We evaluated the changes of platelet count and transfusion requirements around the splenectomy in patients with chronic ITP. METHODS: We reviewed the medical records of 25 patients with chronic ITP. We compared the platelet counts at admission, immediately pre-op and several post-op days. We also investigated the number of platelet concentrates transfused around splenectomy. We determined the effect of splenectomy according to Difino's classification. RESULTS: The median platelet counts of the patients was 18x109/L (7-238x109/L) on admission and recovered to 108x109/L (22-460x109/L) on preoperation day by platelet transfusion and immunosuppressive treatment. The platelet counts were rapidly recovered after splenectomy from the day of operation. Only 3 patients needed platelet transfusion after splenectomy. Thirteen among twenty five patients (52%) underwent operation without platelet transfusion support. Most transfusions were done before the surgery and 80% (12/15) of the patients required transfusion of more than 10 units of random donor platelet concentrate. Twenty one patients (84%) showed the complete remission after splenectomy. CONCLUSION: Splenectomy can lead to rapid remission even in most cases of refractory chronic ITP. Many cases can undergo the operation only with treatment modalities other than transfusion such as immunosuppressive agents and/or immunoglobulin. The minimum level of platelet counts for splenectomy may be safe over 50x109/L and about 10 units of platelet concentrate may be enough for preparation of splenectomy.
Blood Platelets* ; Classification ; Humans ; Immunoglobulins ; Immunosuppressive Agents ; Medical Records ; Platelet Count ; Platelet Transfusion* ; Purpura, Thrombocytopenic, Idiopathic* ; Splenectomy* ; Tissue Donors

PURPOSE: The purpose of the study was to explore how hospital nurses decide to quit working as professional nurses using the grounded theory method. METHOD: The data was collected by individual in-depth interviews with 12 hospital nurses who recently resigned from work and it was analyzed using 'constant comparative analysis.' RESULT: The core category that emerged was "in search of new balance with self, work, and family". Three stages were identified: 1) "unconditionally accepting the working situation of itself," 2) "weighing advantages and disadvantages of working as a hospital nurse", and 3) "redesigning a future". Each stage contains three major strategies. The major strategies of the first stage are "maintaining a learning attitude", "enduring physical burnout," and "enduring unfair interpersonal relationships". The second stage contains "identifying advantages of working", "identifying disadvantages of working", and "comparing the advantages with the disadvantages". Lastly, the third stage includes "reassessing the aim of life", "beginning to construct an alternative life", and "deciding to quit working at a certain point". CONCLUSION: The results of the study will help nursing administrators in designing and implementing an effective turnover prevention program for nurses by understanding more deeply the process of turnover phenomenon among hospital nurses.
Administrative Personnel ; Humans ; Korea* ; Learning ; Nursing