Mllerian adenosarcoma of uterus usually present as pedunculated endometrial masses in postmenopausal women with vaginal bleeding. Extraendometrial variants are much less common. A 50-year-old woman, after total abdominal hysterectomy with bilateral salpingo-oophorectomy due to adenomyosis and benign ovarian mass, presented with protruding mass through vagina. The mass, originated from vaginal stump, was diagnosed as Mllerian adenosarcoma. We report a case of extrauterine Mllerian adenosarcoma with a review of literatures.
Adenomyosis ; Adenosarcoma* ; Female ; Humans ; Hysterectomy* ; Middle Aged ; Uterine Hemorrhage ; Uterus ; Vagina

BACKGROUND/AIMS: Liver biopsy has been used to evaluate the degree of hepatic fibrosis in patients with chronic liver diseases. It is important to assess liver fibrosis when following the course of chronic liver diseases. Histopathological examination of percutaneous biopsy specimens is invasive and is also of questionable value because of the heterogenous distribution of pathological changes in the liver. Therefore, non-nvasive methods to determine the progress of liver fibrosis are needed. Serum hyaluronic acid and type IV collagen are known to be related to hepatic fibrosis. This study was performed to evaluate the clinical usefulness of serum hyaluronic acid and type IV collagen measurement as a differential point in patients with chronic liver diseases and early cirrhosis. METHODS: This study included 109 patients with chronic liver diseases caused by various etiologies. Liver biopsy and histopathological classification were done in all patients. Serum hyaluronic acid and type IV collagen were measured by one-tep sandwich binding protein assay and one-tep sandwich enzyme immunoassay. RESULTS: The concentrations of hyaluronic acid and type IV collagen in the early cirrhosis group (208.5+/-186.4 ng/mL, 242.1+/-162.8 ng/mL) were significantly higher (p<0.01) than those in the normal and fatty liver group (26.3+/-21.7 ng/mL, 79.2+/-28.8 ng/mL), mild chronic hepatitis group (22.8+/-15.4 ng/mL, 125.5+/-79.7 ng/mL), moderate to severe hepatitis group (66.3+/-60.5 ng/mL, 148.5+/-78.7 ng/mL). At the cutoff value of 100 ng/mL for hyaluronic acid and 200 ng/mL for type IV collagen, the sensitivities were 66.7% and 55.6%, and specifities were 82.9% and 89%, and diagnostic efficiencies were 78.9% and 80.7% respectively for discriminating patients with cirrhosis (4 points) from the mild to severe fibrosis (0~3 points). CONCLUSIONS: The serum levels of hyaluronic acid and type IV collagen may be sensitive markers of fibrotic process in chronic liver diseases and useful biochemical markers in differentiation of the patients with early cirrhosis from those with chronic liver diseases.
Biomarkers ; Biopsy ; Carrier Proteins ; Classification ; Collagen Type IV* ; Fatty Liver ; Fibrosis ; Hepatitis ; Hepatitis, Chronic* ; Humans ; Hyaluronic Acid* ; Immunoenzyme Techniques ; Liver Cirrhosis* ; Liver Diseases ; Liver*

PURPOSE: The purpose of this study was to identify international students' use of university health centers by individual characteristics and seasons. METHODS: This was a retrospective descriptive study using data obtained from the electronic record system of one university health center. The study participants were international undergraduate students who registered for any of two semesters between March 1, 2014 and February 28, 2015 and visited the university health center during their registration period. RESULTS: The most common reasons for visits were problems of head, eye, nose and throat systems, followed by respiratory system. Their visits mostly occurred in the fall and spring. The most frequently used services were distribution of oral medication followed by wound treatment. The number of visits per individual was statistically different by gender (u=-3.307, p=.001), but not by their major (chi2=.543, p=0.762) or nationality (chi2=5.518, p=.271). CONCLUSION: Further study is necessary to better define health needs and related factors for this unique population. The electronic record system provides great opportunities in development and application of need based health services for international students and for research in this area.
Ethnic Groups ; Head ; Health Services ; Humans ; Nose ; Pharynx ; Respiratory System ; Retrospective Studies ; Seasons ; Student Health Services ; Wounds and Injuries

PURPOSE: This study investigates the current situation and future trends in the field of cataract and refractive surgery in Korea. METHODS: Since 1995, the members of the Korean Society of Cataract and Refractive Surgery (KSCRS) have been surveyed annually on cataract and refractive surgery. The 2005 annual survey, consisting of 74 multiple-choice questions, was mailed in February 2005 to 364 KSCRS members. Seventy-six (20.8%) members answered. Current data were compared with those of previous annual surveys and with those of annual surveys of ASCRS (American Society of Cataract and Refractive Surgery) members. RESULTS: The duration of hospitalization has decreased annually and the use of topical anesthesia (49%) has hemained stationary. Self sealing wound construction was the main wound closure technique in phacoemulsification (66%). Acrylic intraocular lenses are the most preferred (75%) for small incisioncataract surgery. The implantation of phakic IOL was performed by 30% of respondents and interests in the value added by IOL has increased annually. CONCLUSIONS: This survey summarized current trends and changes in cataract and refractive surgery in Korea.
Anesthesia ; Cataract* ; Surveys and Questionnaires ; Hospitalization ; Korea* ; Lenses, Intraocular ; Phacoemulsification ; Postal Service ; Refractive Surgical Procedures ; Wound Closure Techniques ; Wounds and Injuries

PURPOSE: The study purposes were to describe the process of developing the Korean versions of the Six Dimension Scale of Nursing Performance (Six-D) and Student Nurse Stress Index (SNSI) and psychometric evaluation of the two measurements. METHODS: This was a methodology study using a descriptive cross-sectional design with 51 nursing students in 4th year of university. Internal consistency reliability was assessed using Cronbach alphas. Construct validity was determined by exploring correlations among Six-D, SNSI, objective structured clinical examination (OSCE), self-efficacy and grade point average (GPA). RESULTS: Internal consistency reliability of Six-D and SNSI was acceptable with Cronbach's alpha of .95 and .82. Correlation analysis to determine construct validity revealed that Six-D presented positive correlations with OSCE (r=.109~.272) and self-efficacy (r=.005~.161) and negative correlation with GPA (r=-.246~-.394), although all were not statistically significant. SNSI presented all negative correlations with OSCE (r= -.007~-.238), self-efficacy (r=-.246~-.394), and GPA (r=-.092~-.426) and were mostly statistically significant except OSCE. CONCLUSION: Six-D needs more evidence to confirm validity to predict observed clinical competency and theoretical relationships with self-efficacy and GPA. However, SNSI presented trends of expected relationships with relevant variables. Therefore, further research is recommended in testing validity of Six-D with other student populations.
Asthma ; Humans ; Psychometrics ; Students, Nursing

BACKGROUND AND OBJECTIVES: The renin-angiotensin system (RAS) is a major regulator of blood pressure. The angiotensin II receptor type 1 (AGTR 1) A1166C has been extensively studied in searching for their involvement in the development of hypertension. The aim of this study was to determine the association of the AGTR 1 A1166C marker with essential hypertension in Korean adolescents. SUBJECTS AND METHODS: Forty hypertensive adolescents were included in this study. The obesity index (OI) and body mass index (BMI) of the subjects were calculated. Blood pressure was measured at the resting state by oscillometric methods. The serum aldosterone, renin, insulin, angiotensin converting enzyme (ACE), homocysteine, vitamin B12 and folate levels were measured. The carotid intima-media thickness (IMT) and diameter and the brachial-ankle pulse wave velocity (baPWV) were evaluated by ultrasound. Polymerase chain reaction (PCR) was conducted to amplify the DNA of each of the study subjects to analyze the polymorphism of AGTR 1 A1166C. RESULTS: The genotypic frequency of AA was 87.5%, that for adenylate cyclase (AC) was 12.5% and no CC type was detected. The serum homocysteine level was higher in the subjects with the AC genotype than that in the subjects with the AA genotype (11.9+/-2.9 umol/L vs 17.1+/-4.2 umol/L, respectively). The carotid IMT of the subjects with the AA genotype was greater than that of the subjects with the AC genotype (5.0+/-0.1 mm vs 8.0+/-0.2 mm, respectively). CONCLUSION: In conclusion, the A1166C mutation group had a significantly greater carotid IMT and higher homocysteine levels than the group with the normal genotype of AGTR 1. The AC genotype of A1166C may be useful to predict the presence of early coronary artery disease in hypertensive adolescents. More investigation is necessary to clarify the relation between the A1166C gene and its involvement with coronary artery disease in hypertensive Korean adolescents.
Adenylyl Cyclases ; Adolescent ; Aldosterone ; Angiotensin II ; Angiotensins ; Blood Pressure ; Body Mass Index ; Carotid Intima-Media Thickness ; Coronary Artery Disease ; DNA ; Folic Acid ; Genotype ; Homocysteine ; Humans ; Hypertension ; Insulin ; Obesity ; Peptidyl-Dipeptidase A ; Polymerase Chain Reaction ; Pulse Wave Analysis ; Receptor, Angiotensin, Type 1 ; Receptors, Angiotensin ; Renin ; Renin-Angiotensin System ; Vitamin B 12

We report a rare case of spindle cell/pleomorphic lipoma of the oropharynx. A 45-year-old woman presented with a 9-month history of a lump in 2001. A well demarcated polypoid, rubbery mass was found in the left vallecula and was surgically removed. The mass was diagnosed as a spindle cell lipoma. She revisited with the same complaint in 2008. Examination revealed another polypoid mass at the left aryepiglottic fold, near the previous excision site. The excised mass histologically consisted of mature fat cells, numerous bizarre giant cells, and bland spindle cells, features of a typical pleomorphic lipoma. This is the first case of recurrent oropharyngeal spindle cell/pleomorphic lipoma, showing histologic changes during the recurrence. Complete removal and follow-up are necessary for the treatment of this uncommon neoplasm.
Adipocytes ; Female ; Follow-Up Studies ; Giant Cells ; Humans ; Lipoma ; Middle Aged ; Oropharynx ; Recurrence

This study was conducted to develop job standards for clinical dietitian administering clinical nutrition therapy to diabetic patients in hospitals. Based on DACUM (Developing A Curriculum) analysis of 17 members including clinical dietitians, professors majoring in clinical nutrition and researchers, information on duties, tasks and task elements of clinical dietitians for diabetes care were derived and applied to diabetes mellitus-specific clinical nutrition care in hospitals for evaluation. The final developed job standards for clinical dietitians for diabetes care included four duties, 19 tasks and 56 task elements. The duties consisted of nutrition assessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring . evaluation. For application of diabetes mellitus-specific job standards in clinical nutrition care, 108 work activities were developed and classified into 90 basic and 18 recommended types. Performance rates of standardized jobs were 80.2% at nutrition assessment, 99.6% at nutrition diagnosis, 78.5% at nutrition intervention, and 32.9% at nutrition monitoring . evaluation. These results can be applied as guidelines to implement jobs for diabetes mellitus-specific clinical nutrition services in clinical settings. In addition, they would be useful for education standards in educational institutions for education and training of clinical dietitian.
Diabetes Mellitus ; Diagnosis ; Education ; Humans ; Job Description ; Nutrition Assessment ; Nutrition Therapy* ; Nutritionists*

The present study was conducted to provide the basis for improvement of clinical nutrition services through development of job standards of clinical dietitian for the clinical nutrition therapy to cancer patients in hospitals. Developing A Curriculum (DACUM) method was used for job analysis and development of job standards for clinical dietitians for cancer care. Based on DACUM analysis, information about duties, tasks, and task elements of clinical dietitians for cancer care was collected. Developed job standards were applied to clinical nutrition care for cancer patients in hospitals for evaluation. Based on DACUM analysis, consultations from professionals, and field application tests, the final job standards were composed of four duties, 18 tasks, and 56 task elements. The duties consisted of nutritional assessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring.evaluation. For cancer nutrition care, 109 work activities were developed. They were composed of 75 basic and 34 recommended work activities. The application of developed job standards for clinical dietitians for cancer care at 10 hospitals showed a performance rate of 72.3%. In conclusion, job standards for clinical dietitians for cancer care developed in this study might be effectively used as guidelines for providing clinical nutrition services for cancer patients in hospitals.
Curriculum ; Diagnosis ; Humans ; Nutrition Assessment ; Nutrition Therapy* ; Nutritionists* ; Referral and Consultation

Dyslipidemia has significantly contributed to the increase of death and morbidity rates related to cardiovascular diseases. Clinical nutrition service provided by dietitians has been reported to have a positive effect on relief of medical symptoms or reducing the further medical costs. However, there is a lack of researches to identify key competencies and job standard for clinical dietitians to care patients with dyslipidemia. Therefore, the purpose of this study was to analyze the job components of clinical dietitian and develop the standard for professional practice to provide effective nutrition management for dyslipidemia patients. The current status of clinical nutrition therapy for dyslipidemia patients in hospitals with 300 or more beds was studied. After duty tasks and task elements of nutrition care process for dyslipidemia clinical dietitians were developed by developing a curriculum (DACUM) analysis method. The developed job standards were pretested in order to evaluate job performance, difficulty, and job standards. As a result, the job standard included four jobs, 18 tasks, and 53 task elements, and specific job description includes 73 basic services and 26 recommended services. When clinical dietitians managing dyslipidemia patients performed their practice according to this job standard for 30 patients the job performance rate was 68.3%. Therefore, the job standards of clinical dietitians for clinical nutrition service for dyslipidemia patients proposed in this study can be effectively used by hospitals.
Cardiovascular Diseases ; Curriculum ; Dyslipidemias* ; Humans ; Job Description ; Nutrition Therapy* ; Nutritionists ; Professional Practice