PURPOSE: It was to identify the relationship with the health beliefs, self-efficacy and medical care utilization in nurses in order to provide basic data for program development to actively help nurses' health practice. METHODS: The subjects were 360 hospital nurses in P city, K Province. Instruments were health belief developed by Walker, Sechrist & Pender (1987), self-efficacy by Sherer, Maddux & Mercandante(1982), and medical care utilization by Korean National Health & Nutrition Examination Survey(2006). The data were analyzed as descriptive statistics, Chi-square, t-test, and ANOVA using SPSS 11.5. RESULTS: There were significant differences in medical care utilization depending on age(p=.008), marital status(p=.019), education level(p=.005), types of work(p=.017), nursing units(p=.018), and period of work(p=.001). Use of outpatient clinic was significantly different depending on perceived susceptibility(F=2.463, p=.045). Nurses who consulted to doctor in other hospital had higher perceived severity(F=2.759, p=.028). Nurses who used complementary medicine had higher perceived barrier(F=2.278, p=.047). The score of self-efficacy was significantly different in medical care service frequency (F=3.030, p=.018) and to whom their health problems consulted(F=3.092, p=.010). CONCLUSION: Medical service utilization was different depending on the demographic characteristics, perceived susceptibility, severity, and barrier, and self efficacy. It is needed to give health promotion program considering these factors for nurses.
Ambulatory Care Facilities ; Complementary Therapies ; Health Promotion ; Program Development ; Self Efficacy

No abstract available.
Hospitals, General* ; Humans

Choroid plexus tumors are uncommon brain tumors that primarily occur in children. Most of these tumors originate from the intraventricular area, and the most common clinicalpresentation is increased intracranial pressure. Dissemination through the cerebrospinal fluid space is the inevitable natural course of the disease. Here, we present 2 rare cases of adult choroid plexus carcinoma (CPC), each with distinct clinical presentation and progression. The first case was a 40-year-old male who presented with multiple intraventricular masses. After surgical biopsy, radiation and intrathecal chemotherapy failed to elicit any response. The patient progressed with spinal cord dissemination and expired 1 year later. The second case presented with visual disturbance, and brain MRI revealed a large ovoid juxtaventricular mass with peritumoral edema. This 49-year-old female patient underwent craniotomy for what was thought to be a high-grade glioma; however, the mass was connected to the choroid plexus at the operative field. Her pathology specimen was diagnosed as CPC, and adjuvant systemic chemotherapy was administered. She has now been free of recurrence for 10 months. The description of the presentation and progression of these rare adult-onset CPC provides insight for the diagnosis and treatment of other rare instances of choroid plexus tumors.
Adult ; Biopsy ; Brain ; Brain Neoplasms ; Cerebrospinal Fluid ; Child ; Choroid Plexus Neoplasms ; Choroid Plexus ; Choroid ; Craniotomy ; Diagnosis ; Drug Therapy ; Edema ; Female ; Fourth Ventricle ; Glioma ; Humans ; Intracranial Pressure ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pathology ; Recurrence ; Spinal Cord

PURPOSE: To investigate the effects of transplantation of a circumferentially-trephined autologous oral mucosal graft using a vacuum trephine on ocular surface reconstruction in patients with limbal stem cell deficiency. METHODS: Patients with a limbal stem cell deficiency who underwent transplantation of autologous oral mucosal graft performed by a particular surgeon in Seoul National University Hospital were included. The medical records of these five patients were retrospectively reviewed. The lower labial mucosal graft inside the inferior lip was trephined to a depth of 250 µm using a donor vacuum trephine with a 9-mm diameter. Outside markings were made using a 14-mm intraoperative keratometer. The oral mucosal graft was dissected under a microscope using a Beaver mini-blade as either a ring or a crescent-shaped strip with a 5-mm width. The mucosal graft was transplanted onto the limbus in the limbal-deficient eye. Best-corrected visual acuity and corneal status were measured during the follow-up period. RESULTS: Four patients were diagnosed with Stevens-Johnson syndrome and one was diagnosed with atopy-associated immune keratitis. The mean follow-up period was 10.4 ± 2.9 months. After 4 months, visual acuity improved in all patients, and the mean improvement in logarithm of the minimum angle of resolution visual acuity was 0.526 ± 0.470 (range, 0.15 to 1.10). Corneal surface erosion and neovascularization decreased in four patients, and stromal opacity decreased in two patients. The engraftments maintained ocular surface stabilization in four of the five patients at the last follow-up. CONCLUSIONS: Transplantation of circumferential autologous oral mucosal grafts may be effective for the treatment of limbal stem cell deficiency.
Follow-Up Studies ; Humans ; Keratitis ; Lip ; Medical Records ; Reconstructive Surgical Procedures ; Retrospective Studies ; Rodentia ; Seoul ; Stem Cells ; Stevens-Johnson Syndrome ; Tissue Donors ; Transplants ; Vacuum ; Visual Acuity

Diffuse sclerosing papillary carcinoma(DSPC), a variant of papillary carcinoma of the thyroid, is characterized by diffuse involvement of one or both thyroid lobes, and histologic features such as prominent sclerosis, intense lymphocytic infiltrate, num erous psammoma bodies, and squamous metaplasia together with the charac teristic cytoarchitectural pattern of classical papillary carcinoma. We experienced a case of fine needle aspiration cytologic(FNAC) findings of DSPC, which was con firmed by histologic examination of the thyroidectomy specimens. The patient was 26 years old female who presented with diffuse firm enlargement of the thyroid gland with enlargement of many cervical lymph nodes. FNAC smears showed numerous psammoma bodies, many lymphocytes, metaplastic squamous cells, absence of stringy colloid, and epithelial cells showing classical features of papillary carcinoma, such as nuclear grooves, intranuclear inclusions, and ground glass chromatin pattern.
Adult ; Biopsy, Fine-Needle* ; Carcinoma, Papillary* ; Chromatin ; Colloids ; Epithelial Cells ; Female ; Glass ; Humans ; Intranuclear Inclusion Bodies ; Lymph Nodes ; Lymphocytes ; Metaplasia ; Sclerosis ; Thyroid Gland* ; Thyroidectomy

PURPOSE: Postoperative pancreatic fistula (POPF) is one of the most common and clinically relevant complications after distal pancreatectomy. Some aspects of POPF management remain controversial. Therefore, the aim of this study was to determine the natural course of POPF and fluid collection after distal pancreatectomy and to reappraise the necessity of intraoperative abdominal drainage insertion. METHODS: For recent 10 years, 264 distal pancreatectomies were performed at Seoul National University Hospital. Clinicopathologic data including POPF and postoperative fluid collection (POFC), and its treatment modality were reviewed retrospectively. During follow-up, the location, size, and clinical impact of the POFC were determined on the basis of CT images. RESULTS: Clinically relevant POPFs were identified in 72 patients (27.3%). Therapeutic interventions were performed in 40 patients (55.6%), and conservative management was successful in 32 patients (44.4%). POFC was detected in 191 cases (72.3%) on the first postoperative CT. During follow-up, spontaneous regressions were observed in 119 cases (93.0%). Only thick pancreatic stump increased the risk of clinically relevant POPF (≥17.3 mm, P = 0.002) and the occurrence of POFC (≥16.0 mm, P < 0.001) in multivariate analysis. CONCLUSION: Intraoperative abdominal drainage insertion could be selectively indwelled in patients with a thickness of pancreas ≥17.3 mm. Since radiologically-proven POFC after distal pancreatecomy showed a 93.0 rate of spontaneous regression, POFC without signs of infection can be safely monitored.
Drainage ; Follow-Up Studies ; Humans ; Multivariate Analysis ; Pancreas ; Pancreatectomy* ; Pancreatic Fistula* ; Retrospective Studies ; Seoul

Smith-Lemli-Opitz syndrome (SLOS) is a rare, autosomal recessive disease caused by an inborn error in cholesterol synthesis. Patients with this disease suffer from multiple malformations due to reduced activity of 7-dehydrocholesterol reductase (DHCR7), which increases 7-dehydrocholesterol (7DHC) and 8-dehydrocholesterol (8DHC) concentrations and decreases cholesterol concentration in body fluids and tissue. The SLOS phenotypic spectrum ranges from a mild disorder with behavioral and learning problems to a lethal disease characterized by multiple malformations. Here, we describe a newborn male with ambiguous genitalia who was diagnosed to have type II SLOS during the neonatal period. A clinical examination revealed low levels of unconjugated estriol in the maternal serum, and a variety of fetal ultrasound anomalies, including prenatal growth retardation. After birth, the infant was diagnosed to have congenital heart disease (Tetralogy of Fallot with severe pulmonary artery stenosis), cleft lip and palate, micrognathia, postaxial polydactyly, ambiguous genitalia, and cataracts. Clinical investigation revealed extremely low plasma cholesterol levels and the presence of mutation (homozygote of p.Arg352Gln) in the DHCR7 gene. The patient underwent palliative heart surgery (to widen the pulmonary artery) and received intravenous lipid supplementation. Cholesterol levels increased slightly, but not to normal values. The patient died from cardiopulmonary failure and sepsis 72 days after birth. This report provides the first description of a Korean patient with SLOS confirmed by verification of DHCR7 gene mutation and illustrates the need for early recognition and appropriate diagnosis of this disease.
Body Fluids ; Cataract ; Cholestadienols ; Cholesterol ; Cleft Lip ; Dehydrocholesterols ; Disorders of Sex Development ; Estriol ; Heart Diseases ; Humans ; Infant ; Infant, Newborn ; Learning ; Male ; Oxidoreductases ; Oxidoreductases Acting on CH-CH Group Donors ; Palate ; Parturition ; Plasma ; Polydactyly ; Pulmonary Artery ; Reference Values ; Sepsis ; Smith-Lemli-Opitz Syndrome ; Thoracic Surgery

Adenomyoepithelioma (AME) is a rare breast lesion with balanced proliferation of both epithelial and myoepithelial cells. Patients usually present with a solitary mass without pain and nipple discharge. Although the tumor is generally considered benign, it has potential for local recurrence, metastasis, or malignant change. Approximately 150 cases have been reported in the medical literature, of which 40 cases were malignant or potentially malignant. But among them, elastographic findings have been reported in only two cases and still remain unclear. Herein, we now present a case of breast AME with emphasis on elastography.
Adenomyoepithelioma ; Breast Neoplasms ; Breast ; Elasticity Imaging Techniques ; Humans ; Neoplasm Metastasis ; Nipples ; Recurrence ; Ultrasonography

High-intensity focused ultrasound (HIFU) has been regarded as a non-surgical, minimally invasive therapeutic option for patients who prioritize uterus-conservation. Although many studies have shown that HIFU therapy is a safe and effective treatment of uterine fibroid, not all fibroids are suitable for HIFU due to risks of serious complications. We experienced three cases of complications after the HIFU ablation for huge uterine fibroids, including two cases of rapid myoma enlargement and one case of heavy vaginal bleeding.
Female ; Humans ; Leiomyoma ; Myoma ; Single Person* ; Ultrasonography* ; Uterine Hemorrhage

BACKGROUND: It has been hypothesized that genetic alteration at the cellular level may have a significant effect on cellular mechanisms controlling the proliferation and apoptosis of Langerhans cells (LCs). METHODS: We examined whether p16 protein expression can be used to predict the outcome of Langerhans cell histiocytosis (LCH). Archival paraffin blocks from children diagnosed with LCH and followed at the Asan Medical Center and Chungnam National University Hospital between March 1998 and February 2008 were studied. RESULTS: Slides were stained with p16 antibody and evaluated semi-quantitatively using the following scale: negative, no staining; +/-, weakly positive; 1+, staining similar to lymphocytes surrounding the LCs; 2+, stronger staining than lymphocytes; 3+, much stronger staining than lymphocytes. Negative and +/- groups were assigned to a lower expression group (LEG) and the 1+, 2+, and 3+ groups were assigned to a higher expression group (HEG). The median age of the 51 patients (24 girls, 27 boys) was 49 (range, 0.6-178) months, and LCH was diagnosed based on CD1a positivity. p16 protein was expressed to varying degrees in all but one specimen. There was a greater tendency toward multisystem disease, risk organ involvement, and relapse in the HEG than in the LEG. CONCLUSION: The p16 protein may have a significant effect on cellular mechanisms controlling the proliferation and apoptosis of LCs, and thus may influence the clinical outcome and prognosis of LCH.
Apoptosis ; Child ; Histiocytosis ; Histiocytosis, Langerhans-Cell ; Humans ; Immunohistochemistry ; Langerhans Cells ; Lymphocytes ; Paraffin ; Prognosis ; Recurrence