Hyperkeratosis of the renal pelvis and ureter is a rare condition and is explained by the metaplastic change from transitional to cornified squamous epithelium. This lesion is frequently associated with, and perhaps caused by chronic urinary infection, but potentially premalignant, accompaning with carcinoma in about 10 to 20 per cent of the cases at the time of diagnosis. A case of hyperkeratosis of renal pelvis & ureter which was clinically suspected of carcinoma in a 49-year old woman with a long history of chronic pyelonephritis is presented with review of literature.
Female ; Humans

PURPOSE: This study was done to compare breast feeding rates and factors influencing feeding practice between late preterm (34< or =GA<37) and preterm infants (GA<34). METHODS: A survey was done of 207 late preterm and 117 preterm infants in neonatal intensive care units (NICU) of 4 university hospitals in D city. Data were collected from July 2009 to June 2010 from 324 medical records in the NICU. Breast-feeding at home was checked either by telephone survey or questioning during hospital visits. RESULTS: Rate of breast feeding for late preterm infants was significantly lower than for preterm infants. There was no significant difference in breast-feeding at home. We found differences in factors influencing breast feeding between the two groups. Factors influencing feeding for late preterm infants were type of delivery, mothers' occupation, feeding type during hospitalization, time elapse from hospital discharge, total admission days, infant's body weight at first feeding and length of NPO (nothing by mouth). Factors influencing feeding for preterm infants were birth order, maternal disease and obstetric complications, and one-minute Apgar score. CONCLUSION: Results of the study show low rates of breast-feeding for late preterm infants indicating a need for breast-feeding education for mothers of these infants.
Body Weight ; Breast Feeding/*statistics & numerical data ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature ; Intensive Care Units, Neonatal ; Interviews as Topic ; Length of Stay ; Male ; Mothers/*psychology ; Occupations ; Time Factors

PURPOSE: The role of MRI in the detection of cholangiocarcinoma of the common hepatic duct has rarely been described. This study was attempted to ascertain characteristic MR features of cholangiocarcinoma. MATERIALS AND METHODS: The T1(500/30, TRs/TEs) and T2 weighted(200/80, TRs/TEs) MR images were obtained from nine patients with cholangiocarcinoma of the common hepatic duct. The common hepatic lesions were detected in seven cases. MR features of cholangiocarcinoma were analysed according to the signal intensity and associated findings. RESULTS: The seven cases showed lower signal intensity than the surrounding normal liver parenchyma on T1 weighted image. On T2 weighted image, the tumor showed isosignal intensity and hyperintensity in four and three patients, respectively. T2 image also revealed diffusely increased signal intensity in some hepatic lobe or segment in four cases, and Intrahepatic periductal high signal intensity in one case. Other associated MR findings were intrahepatic metastasis, and intratumoral hemorrhage, each noted in a different case. CONCLUSION: T2 weighted Image appears to be effective in the detection of cholangiocarcinoma of the common hepatic duct and evaluation of its associated intrahepatic lesions.
Cholangiocarcinoma* ; Hemorrhage ; Hepatic Duct, Common* ; Humans ; Liver ; Magnetic Resonance Imaging ; Neoplasm Metastasis

PURPOSE: The purposes of the study were to determine the effects of AIDS education which includes discussion on knowledge, prejudice, social interaction, and intention for AIDS prevention in college students. METHOD: A convenience sampling method was used to collect data, and 136 university students participated in the study. One group pretest-post test design was used and questionnaire for measuring knowledge about AIDS and attitude to AIDS were administered before and after 100 minutes of AIDS education, The education program consisted of a 50-minute lecture with video aids and 50 minutes of small group discussion. Means, SD, and paired t-test with the SPSS program were used to analyze the data. RESULTS: There were significant increases in knowledge (p= .000) and social interaction (p= .002) after the education, but no significant changes in prejudice (p= .832) nor in intention for AIDS prevention (p= .074). CONCLUSION: AIDS education including discussion was found to be an effective method for improving knowledge and social interaction of college students. The results suggest that education which includes discussion sessions should be used with college students to improve social interaction with people who are HIV positive and enhance knowledge about AIDS.
Education* ; HIV ; Humans ; Intention* ; Interpersonal Relations* ; Prejudice* ; Surveys and Questionnaires

Purpose: This study was conducted to determine the factors affecting a hypothetical model of testing for general hospital nurses’ job embeddedness. Methods: Data were collected from August 20 to September 19, 2021, by a self-administered questionnaire answered by 428 general hospital nurses. The data were analyzed by SPSS and AMOS. Results: Nine of the hypothetical model’s 12 hypotheses were supported by the data collected from all participants. The test results indicate that ego resilience, subjective career success, and recovery experience from job stress directly affect participants’ job embeddedness. Nurses’ work environments were reported to affect ego resilience and subjective career success, while at the same time ego resilience and subjective career success affected the participants’ job embeddedness. Work-life balance was found to affect ego resilience and ego resilience affected subjective career success, and at the same time subjective career success directly affected participants’ recovery experiences from job stress and job embeddedness. Of these variables, subjective career success had the strongest direct effect on participants’ job embeddedness. Work-life balance affected the participants’ recovery experiences from job stress, and their recovery experiences from job stress were found to directly affect job embeddedness. Conclusion These results suggest that different management strategies to enhance hospital nurses’ job embeddedness should address nurses’ ego resilience, subjective career success, and recovery experiences from job stress.

PURPOSE: We aimed to determine whether head elevation during combined spinal-epidural anesthesia (CSE) and Caesarean section provided improved hemodynamics and appropriate sensory block height. MATERIALS AND METHODS: Forty-four parous women undergoing CSE for elective Caesarean section were randomly assigned to one of two groups: right lateral (group L) or right lateral and head elevated (group HE) position, for insertion of the block. Patients were positioned in the supine wedged position (group L) or the left lateral and head elevated position (group HE) until a block height of T5 to light touch was reached. Group HE was then turned to the supine wedged position with maintenance of head elevation until the end of surgery. Hemodynamics, including the incidence of hypotension, ephedrine dose required, and characteristics of the sensory blocks were analyzed. RESULTS: The incidence of hypotension (16 versus 7, p=0.0035) and the required dose of ephedrine [24 (0-40) versus 0 (0-20), p<0.0001] were greater in group L compared to group HE. In group L, the time to achieve maximal sensory block level (MSBL) was shorter (11.8+/-5.4 min versus 20.1+/-6.3 min, p<0.0001) and MSBL was also higher than in group HE [14 (T2) versus 12 (T4), p=0.0015]. CONCLUSION: Head elevation during CSE and Caesarean section is superior to positioning without head elevation in the lateral to supine position, as it is associated with a more gradual onset, appropriate block height, and improved hemodynamics.
Adult ; Anesthesia, Epidural/*methods ; Anesthesia, Obstetrical/*methods ; Anesthesia, Spinal/*methods ; Blood Pressure/physiology ; Cesarean Section/*methods ; Elective Surgical Procedures/methods ; Female ; Head ; Hemodynamics ; Humans ; Hypotension ; Patient Positioning/*methods ; Pregnancy ; Treatment Outcome

We studied ninety cases of thyroid glands both histopathologically and by immunohistochemical methods in patients with Graves' disease using B and T cell markers to evaluate the role of lymphocytic subpopulation. Females were affected more frequently than males with a ratio of 6.5:1, and usually the females were younger than the males at the time of surgery. The heavier the lymphocytic infiltration, the higher was the percentage of germinal center formation or fibrosis. The degree of lymphocytic infiltration was also related to the titers of antithyroglobulin or antimicrosomal antibodies. T cells were mostly scattered individually or in small groups between the follicles; however, in the severely infiltrated group, the major pattern was in clusters. T8 positive cells were more abundant than T4 positive cells, and their distribution pattern was accordant with T11 positive cells. Immunoglobulin synthesizing B cells were positively stained in 47 of 94 cases tested and IgG was the most predominant. In the mild and moderate lymphocytic infiltration groups, IgM was mostly stained at the mantle zone or in the lymphoid cluster of the interfollicular stroma, whereas IgM positive cells were present exclusively in the germinal center of the severely infiltrated group. The results of our study indicate that the major lymphocyte subpopulation in Graves' disease is B lymphocytes, and the degree of T lymphocytic infiltration correlated better with titers of antimicrosomal antibody than antithyroglobulin.
Adolescent ; Adult ; Child ; Female ; Graves' Disease/immunology/*pathology ; Human ; Immunoglobulins/metabolism ; Lymphocytes/immunology/pathology ; Male ; Middle Age ; Support, Non-U.S. Gov't ; Thyroid Gland/immunology/pathology

PURPOSE: The purpose of this study was to identify status and characteristics of patients who have been readmitted to ICU, and to analyze risk factors associated with the readmission to ICU within 48hours.METHODS: Data were collected from patient's electronic medical reports from one hospital in B city. Participants were 2,937 patients aged 18 years old or older admitted to the ICU. Data were analyzed using odd ratios (ORs) from multivariate logistic regressions.RESULTS: 2.2% of the 2,937 patients were early readmitted to ICU. Risk factors for early readmission to ICU were existence of respiratory disease, use of mechanical ventilator, and duration of hospitalization (longer).CONCLUSION: The assessment on the respiratory system of the patient who will be discharged from the ICU was identified as an important nursing activity. Therefore, the respiratory system management and education should be actively conducted. In addition, early ICU readmission may be prevented and decreased if a link was built to share the information on patient condition between the ICU and general wards.
Critical Care ; Education ; Hospitalization ; Humans ; Intensive Care Units ; Logistic Models ; Nursing ; Patient Readmission ; Patients' Rooms ; Respiratory System ; Risk Factors ; Ventilators, Mechanical

PURPOSE: The purpose of this study was to identify the extent to which intensive care unit (ICU) nurses' perceptions of life-sustaining treatment decisions and “a good death” affect attitudes toward terminal care.METHOD: Participants included 109 ICU nurses from three university hospitals. Data were collected using structured questionnaires, and collected data were analyzed using a t-test, ANOVA, the Scheffé test, Pearson correlation coefficients, and a multiple regression analysis (SPSS 24.0 program).RESULTS: Perceptions of life-sustaining treatment decisions and a sense of closeness (a constituent for the awareness of “a good death”) were positively correlated with terminal care attitudes. The factors affecting terminal care attitudes were a clinical career in ICU (β=.20, p=.035), a sense of closeness(β=.19, p=.041), and the perception of a life-sustaining treatment decision (β=.22, p=.017). This finding indicates that more than 10 years of experience in ICU, a greater sense of closeness, and a higher view of life-sustaining treatment decisions results in more positive attitudes toward terminal care. The explanatory power of these variables on terminal care attitudes was 14% (F=6.84, p < .001, Adj R2=.140).CONCLUSION: A sense of closeness and the perception of life-sustaining treatment decisions were identified as the factors affecting terminal care attitudes. Thus, various programs must be developed to raise awareness among ICU nurses of “a good death” and perceptions of life-sustaining treatment decisions.
Critical Care ; Hospitals, University ; Intensive Care Units ; Methods ; Terminal Care

Identifying tumors or wounds on the scalp is difficult because hair blocks the vision during surgery and suturing. In the meantime, we have commonly used hairpins to hold the hair for a clearer view; however, we would like to suggest a new method, a “hair-fixing sheet,” consisting of hook-like surface. We applied the two methods, hair-fixing sheets and hairpins, assuming several situations. In these situations, it was possible to fix a wider range or various shapes more conveniently using a hair-fixing sheet than using several hairpins at a similarly low cost. In addition, it was easy to change the hair to be fixed, remove it postoperatively, and prevent the hair from being pulled out, thereby preventing additional postoperative pain.