An ipsilateral supraclavicular lymph node recurrence of breast cancer after surgery has been considered a predecessor to distant metastases. There still is a debate as to whether breast carcinoma patients with the isolated supraclavicular lymph node recurrence should be considered to have disseminated disease or if aggressive treatment, with curative intent, is justified. We report two cases of an isolated ipsilateral supraclavicular lymph node recurrence following modified radical mastectomy, and multimodality treatments with modified radical neck dissection, systemic chemotherapy and involved field radiotherapy. These patients have lived without locoregional recurrence or distant metastases for 3 and 2 years, respectively. Conclusively, we recommend aggressive combined multimodality treatments, including surgery, such as modified radical neck dissection or complete excision of the involved lymph nodes, systemic chemotherapy, and involved field radiotherapy, in patients with isolated supraclavicular lymph node recurrence, but with no other evidence of distant metastases.
Breast Neoplasms ; Drug Therapy ; Humans ; Lymph Nodes ; Mastectomy, Modified Radical ; Neck Dissection ; Neoplasm Metastasis ; Radiotherapy ; Recurrence

Left ventricular hypertrophy(LVH) is one of common cardiovascular complications in hypertensive patients and it is well known that hypertensive cardiac disease accompained by LVH is still common cause of congestive heart failure in spite of treatment of hypertension. The authors assessed the prevalence of anatomical and functional abnormalities of left ventricle by EKG, chest X-ray and echocardiography in 45 essential hypertensive patients and also in 20 normal controls. Average values of left ventricular posterior wall thickness(LVPWd), interventricular septal thickness(IVSd), left ventricular mass(LVM), and left ventricular mass index(LVM/BSA) by echocardiography in hypertensive groups with LVH by EKG or chest X-ray were significantly higher than those of hypertensive groups without LVH by EKG or chest X-ray(P<0.005). Among 27 hypertensive patients with LVH by EKG and chest X-ray increased LVPWd was found in 24 patients(18%) and increased LVH in 26 patients(19%). Increased LVPWd and LVM were found in 3 patients(23%) among 13 hypertensives without LVH by EKG and chest X-ray. Hypertensive patients with increased LVH showed LVH by EKG and chest X-ray more frequently than those with increased LVPWd. Also, hypertensive patients without increased LVM showed MVH by EKG and chest X-ray less frequently than those without increased LVPWd. Therefore, echocardiography appears to be superior to routine chest X-ray and EKG for defecting LVH in hypertensive patients, especially without LVH by these tests. In conclusion, even though estimation of LVM by echocardiography seems to be a better method than single measurement of LVPWd, it seems thant estimation of LVM together with LVPWd will be more valuable in diagnosis of LVH in hypertensive patients.
Diagnosis ; Echocardiography* ; Electrocardiography ; Heart Diseases ; Heart Failure ; Heart Ventricles ; Humans ; Hypertension* ; Hypertrophy, Left Ventricular* ; Prevalence ; Thorax

A total of 47 preoperative CT scans in patients with renal cell carcinoma were retrospectively reviewed and compared with surgical findings to assess the accuracy of CT for determining the perinephric tumor extension. CT criteria for perinephric extension were hazy ill-defined tumor margin, perirenal nodule and fascial thickening. Regardless of the tumor stage, the accuracy of CT in detecting perinephric extension was 76.6%(36/47), with a sensitivity of 88.9% (16/18) and specificity of 68.9% (20/29). The cause of understaging (n=2) was microscopic infiltration of the perinephric space. The causes of overstaging were tumor infiltration to the renal capsule (n=5), partial adhesion with the perinephric fat (n=3) and renal vein thrombosis (n=1). A smooth clear tumor margin is highly reliable sign for stage I but infiltrative findings onto renal capsule and perirenal fat could be considered stage I.
Carcinoma, Renal Cell ; Humans ; Renal Veins ; Retrospective Studies ; Sensitivity and Specificity ; Thrombosis ; Tomography, X-Ray Computed

A total of 47 preoperative CT scans in patients with renal cell carcinoma were retrospectively reviewed and compared with surgical findings to assess the accuracy of CT for determining the perinephric tumor extension. CT criteria for perinephric extension were hazy ill-defined tumor margin, perirenal nodule and fascial thickening. Regardless of the tumor stage, the accuracy of CT in detecting perinephric extension was 76.6%(36/47), with a sensitivity of 88.9% (16/18) and specificity of 68.9% (20/29). The cause of understaging (n=2) was microscopic infiltration of the perinephric space. The causes of overstaging were tumor infiltration to the renal capsule (n=5), partial adhesion with the perinephric fat (n=3) and renal vein thrombosis (n=1). A smooth clear tumor margin is highly reliable sign for stage I but infiltrative findings onto renal capsule and perirenal fat could be considered stage I.
Carcinoma, Renal Cell ; Humans ; Renal Veins ; Retrospective Studies ; Sensitivity and Specificity ; Thrombosis ; Tomography, X-Ray Computed

No abstract available.
Chest Pain* ; Emergencies* ; Emergency Service, Hospital* ; Thorax*

PURPOSE: This study aimed to compare work-related musculoskeletal symptoms, occupational stress and nursing work environments of nurses working in patient-sitter wards and general wards. METHODS: The study surveyed 240 nurses with more than one year of experience working in both patient-sitter wards and general wards. The collected data then was analyzed by SPSS statistics version 22. RESULTS: As for the musculoskeletal symptoms, the survey showed that 85.2% and 67.8% of the nurses had such symptoms respectively in patient-sitter wards and general wards. In terms of occupational stress, no significant difference was observed between the patient-sitter ward and the general ward (t=-0.23, p=.821). Lastly, the study showed that there is a significant difference in terms of work environment considering the scores recorded 2.65 and 2.55 points respectively in patient-sitter ward and general ward (t=2.53, p=.012). CONCLUSION: Follow-up research should look at ways to lower the rate of experiencing work-related musculoskeletal symptoms; analyze work performances and establish work standards to lower occupational stress; and devise measures to improve the work environment for the nurses working in patient-sitter wards.
Follow-Up Studies ; Musculoskeletal Diseases ; Nursing* ; Patients' Rooms*

PURPOSE: The purpose of this study was to explore the relationships among preschoolers' smartphone addiction tendency, problem behaviors, and parenting efficacy of the mothers of these children. METHODS: A cross-sectional, descriptive study design was used with self-administered questionnaires. A total of 83 mothers of preschoolers aged 4-6 years and their preschool teachers from a kindergarten participated in the study. RESULTS: Mean daily time spent by the preschoolers on smartphones was about 45 minutes/day. About 40% spent more than 60 minutes/day on smartphones. The majority (69.8%) used smartphones without adult supervision. The level of smartphone addiction tendency among the preschoolers was 1.52+/-0.45 on a 4-point scale. Preschoolers whose mothers use smartphones for more than 60 minutes/day showed a higher level of smartphone addiction tendency than preschoolers whose mothers use smartphones for less than 60 minutes/day. Also smartphone addiction tendency among preschoolers had a positive correlation with hyperactive-distractible behavior (r=.228, p=.038) and a negative correlation with parenting efficacy of their mothers (r=-.299, p=.006). CONCLUSION: Our findings demonstrated that preschooler's smartphone addiction tendency is significantly associated with hyperactive-distractible behaviors of the children and low parenting efficacy among their mothers. Therefore well-designed care plans for these populations should be provided to decrease smartphone addiction tendency.
Adult ; Cellular Phone ; Child ; Child, Preschool ; Humans ; Mothers* ; Organization and Administration ; Parenting* ; Parents* ; Smartphone ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to explore the relationships among preschoolers' smartphone addiction tendency, problem behaviors, and parenting efficacy of the mothers of these children. METHODS: A cross-sectional, descriptive study design was used with self-administered questionnaires. A total of 83 mothers of preschoolers aged 4-6 years and their preschool teachers from a kindergarten participated in the study. RESULTS: Mean daily time spent by the preschoolers on smartphones was about 45 minutes/day. About 40% spent more than 60 minutes/day on smartphones. The majority (69.8%) used smartphones without adult supervision. The level of smartphone addiction tendency among the preschoolers was 1.52+/-0.45 on a 4-point scale. Preschoolers whose mothers use smartphones for more than 60 minutes/day showed a higher level of smartphone addiction tendency than preschoolers whose mothers use smartphones for less than 60 minutes/day. Also smartphone addiction tendency among preschoolers had a positive correlation with hyperactive-distractible behavior (r=.228, p=.038) and a negative correlation with parenting efficacy of their mothers (r=-.299, p=.006). CONCLUSION: Our findings demonstrated that preschooler's smartphone addiction tendency is significantly associated with hyperactive-distractible behaviors of the children and low parenting efficacy among their mothers. Therefore well-designed care plans for these populations should be provided to decrease smartphone addiction tendency.
Adult ; Cellular Phone ; Child ; Child, Preschool ; Humans ; Mothers* ; Organization and Administration ; Parenting* ; Parents* ; Smartphone ; Surveys and Questionnaires

The hypotensive effect and side reactions of Buterazine were evaluated in 21 patients with essential hypertension. The results were as follows; 1) Before medication and after 2 and 4 weeks of medication, the over all average systolic and diastolic pressure were 188+/-23/112+/-7, 168+/-13/101+/-17, and 158+/-12/95+/-8mmHg, respectively. After 2 and 4 weeks of medication, the over all average systolic pressure decreased by 20 and 30mmHg(P<0.005, P<0.001), and the over all average diastolic pressure decreased by 11 and 17mmHg(P<0.025, P<0.001), respectively. In 69% of all cases, marked or moderate degree of hypotensive effect was observed. 2) There was no significant changes in heart rates before and after treatment. 3) In 84% of all cases, improvement of symptoms were observed. 4) There was no side effects which required discontinuing the treatment, except 2 cases which discontinued the medication.
Blood Pressure ; Heart Rate ; Humans ; Hypertension

Purpose: The purpose of this study was to systematically review and conduct meta-analysis on factors affecting career preparation behavior of Korean nursing students. Methods: Related articles published in Korean and English were collected based on search terms and converted into a numerical database. Data extraction, quality assessment and analysis including a systematic review and meta-analysis were completed. Results: The review included 27 studies. There were 25 factors influencing career preparation behavior of Korean nursing students. Factors were categorized into four sub-factors: personal, contextual, cognitive-emotional, and goal-related. In the meta-analysis of 27 articles the total effect size (ESr) was .34. The effect sizes of the four sub-factors were .37 for individual factors, .25 for situation factors, .34 for cognitive and emotional factors, and .41 for target factors. The main factors were .53 for career-related efficacy, .43 for self-leadership, and .43 for career decision level. Conclusion Nursing students with high career-related efficacy and self-leadership are more likely to demonstrate career preparation behavior. Based on these results, educational institutions for nursing students must improve students’ self-leadership and career effectiveness through education so that they can set career goals.