No abstract available.
Emergencies* ; Emergency Service, Hospital* ; Emergency Treatment* ; Humans

PURPOSE: To investigate the efficacy of percutaneous embolization of hypervascular VX-2 carcinoma in the retroorbital area of the rabbits using Histoacrylic Blue(N-butyl 2-cyanoacrylate, NBCA) and to establish as an experimental model. MATERIALS AND METHODS: Retroorbital VX-2 carcinoma was made in 10 rabbits by injection of carcioma cells. At 2 and 4 weeks following the tumor cell injection, carotid angiography was performed before and after percutaneous embolization using 50% NBCA diluted with Lipiodol. Doppler ultrasonography was also performed to evaluate the vascularity of the mass. Light microscopic examination was used to evaluate the effect of embolization on the tumor mass. RESULTS: Angiography following percutaneous embolization showed filling of embolic materials in the tumor beds. Ultrasonographic findings showed tumor necrosis and increased Doppler signal in the tumor. Histopathological examinations showed extensive necrosis of tumor cells with remaining viable cells surrounding the capillaries. There were no NBCA emboli in arterioles and capillaries of tumor beds in multiple sections. CONCLUSION: Since 50% diluted NBCA used as percutaneous embolus into the retroorbital VX-2 carcinoma dose not get into small blood vessels of tumor beds. using NBCA in lower concentration in the hypervascular tumor would be the next step to figure out its usefulness. This study also serves as an experimental model of percutaneous embolization of hypervascular tumor.
Angiography ; Arterioles ; Blood Vessels ; Capillaries ; Embolism ; Enbucrilate* ; Ethiodized Oil ; Models, Theoretical ; Necrosis ; Orbit* ; Rabbits* ; Ultrasonography, Doppler

PURPOSE: The purpose of this study was to analyze factors affecting burnout among clinical nurses according to Positive Psychological Capital. METHODS: The study design was a descriptive survey and questionnaires were collected from 412 clinical nurses who worked in a general hospital in "J" city. Data were analyzed using frequency, percentage, mean, standard deviation, independent t-test, One-way ANOVA, Scheffe test, Pearson Correlation, and hierarchical multiple regression. RESULTS: In Model individual characteristics accounted for 27.8% of the influence on burnout. In model II with the addition of the 4 factors; Self-efficacy, Hope, Resilience, Optimism, individual characteristics accounted for 48.5% of the influence on burnout. Optimism and Resilience of the Positive Psychological Capital sub-variables were statistically useful as factors influencing burnout. CONCLUSION: The results indicate that it is necessary to develop active human resource management and educational programs to decrease burnout and strengthen the Positive Psychological Capital of the nurses.
Hospitals, General ; Humans ; Surveys and Questionnaires

The purpose of this study was to describe outcome indicators of nursing education including critical thinking, professionalism, leadership, and communication and to evaluate differences among nursing programs and academic years. A descriptive research design was employed. A total of 454 students from four year baccalaureate (BS) nursing programs and two three-year associate degree (AD) programs consented to complete self-administered questionnaires. The variables were critical thinking, professionalism, leadership and communication. Descriptive statistics, chi2-test, t-tests, ANOVA, and the Tukey test were utilized for the data analysis. All the mean scores of the variables were above average for the test instruments utilized. Among the BS students, those in the upper classes tended to attain higher scores, but this tendency was not identified in AD students. There were significant differences between BS students and AD students for the mean scores of leadership and communication. These findings suggested the need for further research to define properties of nursing educational outcomes, and to develop standardized instruments for research replication and verification.
Education, Nursing ; Humans ; Korea ; Leadership ; Research Design ; Statistics as Topic ; Students, Nursing ; Thinking ; Surveys and Questionnaires

PURPOSE: The corneas obtained from 38 donor eyeballs were examined whether corneal guttata was present or not by flat preparation(15 eyeballs) and scanning electron microscopy(23 eyeballs) in order to investigate the relationship between age and the incidence of corneal guttata. METHODS: The corneal endothelial cells with Descemet's membrane were prepared on slides flat and examined by light microscope. The surface of the corneal endothelial cells was examined by scanning electron microscopy. RESULTS: The endothelial excrescences with pigment deposit were shown at the corneal periphery near the trabecular meshwork. The oval to round shaped corneal warts were isolated or confluent in shape. The corneal endothelial cells were variable in size. The cytoplasmic processes were observed on the surface of the bare Descemet's membrane. The fibrillar structure of the degenerating cytoplasm of the corneal endothelial cells over the corneal warts was shown with central pit. The fibrillar excrescences over Descemet's membrane was in banded structures. CONCLUSIONS: In normal cornea, corneal guttata was observed by flat preparation in all cases over 43 years. The endothelial edema was noted in two eyes combined with corneal guttata with the degeneration or loss of corneal endothelial cell.
Cornea ; Cytoplasm ; Descemet Membrane ; Edema ; Endothelial Cells ; Humans ; Incidence ; Microscopy, Electron ; Microscopy, Electron, Scanning ; Tissue Donors ; Trabecular Meshwork ; Warts

PURPOSE: Using transmission electron microscopy (TEM), we studied the ultrastructures of rapidly proliferating preretinal membranes of young patients with very extensive ischemic proliferative diabetic retinopathy and diabetes with uncontrollable blood sugar level. METHODS: Nine cases of preretinal membranes were obtained from six eyes of five patients with rapidly progressed proliferative diabetic retinopathy (mean age, 35 years) during vitrectomy. We obtained each preretinal membrane bimanually as one single sheet membrane using intraocular scissors and forceps. Each tissue was fixed in 3% glutaraldehyde in the operating room. All specimens were prepared and studied using TEM. RESULTS: The preretinal membranes were composed of blood vessels and some interstitial cells. The blood vessels within the preretinal membranes varied in developmental stages, from the immature stage to the mature stage. The blood vessels were highly active, in that primitive cells showed a large nucleus and prominent chromatin clumping with abundant cytoplasm. Highly active fibroblast-like cells were also noted. CONCLUSIONS: We observed highly active angiogenesis in preretinal membranes, which rapidly proliferated in cases of severe retinal ischemia in young diabetes patients. This is the first report of such a finding, which may help to explain the poor prognosis of this disease modality.
Blood Glucose ; Blood Vessels ; Chromatin ; Cytoplasm ; Diabetic Retinopathy ; Eye ; Glutaral ; Humans ; Ischemia ; Membranes ; Microscopy, Electron, Transmission ; Operating Rooms ; Prognosis ; Retinaldehyde ; Surgical Instruments ; Vitrectomy

No abstract available.
Female ; Humans

PURPOSE: To evaluate whether soft tissue surrounding the celiac axis, as seen on abdominal CT imaging after gastrectomy for gastric carcinoma, should be considered as the recurrence of carcinoma or postoperative change. MATERIALS AND METHODS: One hundred and forty-one abdominal CT examinations of 71 patients who had undergone subtotal or total gastrectomy for gastric carcinoma were included in our study. Conventional CT scans were obtained with 1 cm thickness and interval from the diaphragm to the kidneys after contrast enhancement. It was considered that carcinoma had not recurred if findings were negative on UGI series, endoscopy with biopsy and a normal level of carcinoembryonic antigen except for soft tissue surrounding the celiac axis on abdominal CT. We then divided subjects into a recurrence group (N = 20) and normal group (N = 51) and on initial follow-up CT (FU-CT), analyzed the incidence, margin, shape, extent, degree and pattern of attenuation of the soft tissue surrounding the celiac axis in both groups. Since the second FU-CT examination, we observed changes in the soft tissue surrounding the celiac axis. RESULTS: On initial follow-up CT, at mean 308 days after surgery, fifty-five percent(39/71) of total patients (70% (14/20) of the recurrence group and 49% (25/51) of the normal group) showed soft tissue surrounding the celiac axis. The margin was distinct in 12 (86%) of the recurrence group and indistinct in 21 (84%) of the normal group (P < 0.001). Twelve (86%) of the recurrence group showed a nodular or confluent nodular shape and 21 (84%) of the normal group showed a permeative shape (P < 0.001). Extent was unilateral in eight (57%) of the recurrence group and bilateral in 16 (64%) of the normal group. Attenuation was similar to that of the spleen and muscle in seven (50%) of the recurrence group and was similar to that of muscle in 18 (72%) of the normal group. The pattern of attenuation was homogeneous in 13 (93%) of the recurrence group and 21 (84%) of the normal group. There was no significant difference in extent, degree and pattern of attenuation between the two groups. Since the second FU-CT examination, soft tissue surrounding the celiac axis was seen to have changed. In one patient in the recurrence group it had a distinct margin, was nodular in shape, unilateral in extent and showed attenuation similar to that of the spleen. In one patient in the normal group, it had changed and had an indistinct margin, three patients showed a decrease in the amount of soft tissue and eight showed decreased attenuation. CONCLUSION: Follow-up abdominal CT is useful in the differentiation of cancer recurrence and postoperative change, and for observing changes in soft tissue surrounding the celiac axis.
Axis, Cervical Vertebra* ; Biopsy ; Carcinoembryonic Antigen ; Diaphragm ; Endoscopy ; Follow-Up Studies ; Gastrectomy* ; Humans ; Incidence ; Kidney ; Recurrence ; Spleen ; Tomography, X-Ray Computed

PURPOSE: To recognize foraminal variants of the foraminae of the skull base in the middle cranial fossa, and to thus understand and distinguish normal and potentially abnormal structures. MATERIALS AND METHODS: We analysed 163 patients without intracranial disease who had undergone CT scanning. These comprised 82 men and 81 women with a mean age of 39 years (range, 4|73 years). HRCT was performed, using a GE 9800 scanner. All CT scans were obtained 6-7 slices at the base of the skull, with 1.5 mm collimation at 1.5 mm intervals parallel to the infraorbital line. We analysed the foraminae by closesly correlating imaging findings and established anatomic knowledge. RESULTS: In 45 cases (27.6 %) the foramen ovale was 5-10 mm in diameter and asymmetrical. Deficiency of the medial bony wall including persistent foramen lacerum medius was seen in five cases (3.1 %). Confluence of the foramen ovale and the foramen spinosum was seen in 13 cases (8 %) and confluence of the foramen ovale and the foramen of Vesalius in 23 (14.1 %). Posterolateral groove for the accessory meningeal artery was observed in 36 cases (22 %). The foramen spinosum was asymmetrical in 42 cases (25.8 %). A small or absent foramen spinosum with a larger ipsilateral foramen ovale was observed in 11 cases (6.7 %). Medial bony defect was seen in 16 cases (9.8%). The foramen spinosum was absent in four cases (2.5 %). In 74 cases (45.4 %), the foramen of Vesalius was absent ; it was present unilaterally and bilaterally in 55 (33.7 %) and 34 cases (20.9 %), respectively. Five cases showed duplicated foramina. Canaliculus innominatus was seen in 14 cases (8.9 %) and was present bilaterally in three (1.8 %). CONCLUSION: HRCT clearly delineates bony structure and is well able to display the rich spectrum of anatomic variation found in the base of the skull. The recognition of these normal variants will result in a better understanding of skull base neurovascular anatomy and diminish speculation as to their true nature during the interpretation of CT images.
Anatomic Variation ; Cranial Fossa, Middle* ; Female ; Foramen Ovale ; Humans ; Male ; Meningeal Arteries ; Skull ; Skull Base ; Tomography, X-Ray Computed

PURPOSE: The objective of the study was to determine the anatomical and functional changes of the left ventricle (LV) in obese children less than 10 years old using the conventional echocardiography and tissue doppler. METHODS: A total of 45 children were enrolled for the study of which all including 12 obese children whose body mass index (BMI) exceeded 95th percentile for age and sex adjusted standard BMI of Korean children were screened by conventional echocardiographic and tissue doppler imaging examinations at Kangneung Asan hospital during June 2005 to October 2005. RESULTS: There was no statistical difference in age between control and obese group (CG vs. OG: 7.1+/-1.2 yr. vs. 8.0+/-1.5 yr). The average BMI in OG was 22.6+/-2.4 kg/m2. The conventional echocardiographic indices of LV including the diastolic LVID (LV Internal Dimension), LVPWT (LV Posterior Wall Thickness), the systolic IVST (Interventricular Septal Thickness), LVID and LVPWT were higher in OG compared to CG. Also, the LV mass (LVm), LV mass index (LVmI), fractional shortening (FS) and ejection fraction (EF) were higher in OG than CG. however, the early and late diastolic mitral inflow velocities (E, A) and their ratios (E/A) showed no differences between the two groups. The myocardial performance index (MPI) was higher in OG than CG: 0.42+/-0.09 vs. 0.35+/-0.07. The isovolemic relaxation time (IVRT) was prolonged in OG compared to CG: 55+/-8 ms vs. 46+/-9 ms. The indices of TDI including the systolic peak velocity (s') and late diastolic peak velocity (a') at mid-IVS were higher in OG than CG, but the early diastolic peak velocity (e'), e'/a', E/e' at mid-IVS showed no differences between the two groups. The indices of TDI at the lateral portion of mital annulus showed no differences between the two groups. CONCLUSION: This study showed that increased LVm, LVmI, EF, FS, MPI, IVRT and a' in obese children less than 10 years old. This result showed anatomical and functional early change of LV due to obesity similar to adult and adolescence more than 10 years old.
Adolescent ; Adult ; Body Mass Index ; Child* ; Chungcheongnam-do ; Echocardiography* ; Gangwon-do ; Heart Ventricles ; Humans ; Obesity ; Relaxation