No abstract available.
Male ; Penis* ; Xanthogranuloma, Juvenile*

Purpose: The study aimed to investigate the relationship between moral distress and the quality of nursing care. Methods: This cross-sectional correlation study included nurses working at oncology nursing units of two secondary general hospitals in Seoul and Gyeonggi-do, Korea. A total of 207 nurses participated. Moral distress was measured by the Moral Distress Scale-Revised Nurse Questionnaire and quality of nursing care was evaluated by the Quality of Oncology Nursing Care Scale. Data were collected from October 5 to 31, 2018. Data analysis included descriptive statistics, independent t-test, ANOVA, Pearson’s correlation coefficient and multiple regression analysis. Results: The quality of oncology nursing care showed a negative correlation with moral distress (r=-.19, p=.007). The factors affecting the quality of oncology nursing care were religion (β=-.22, p=.001), clinical experience in oncology units (β=.27, p=.007), and moral distress (β=-.16, p=.018). Moral distress showed a statistically significant predictive power of 13% in the regression model (F=8.70, p=<.001). Conclusion The findings of this study suggest that management of moral distress is important to increase the quality of oncology nursing care.

BACKGROUND: Epinephrine is commonly used to reduce bleeding by constriction of nasal vessels in endoscopic sinus surgery. However, when it absorbs to other organs systemically, tachycardia and hypertension may occur and result in more bleeding. This study is performed to evaluate the dose response effects of remifentanil infusion to suppress these adverse responses without delaying emergence. METHODS: Sixty healthy patients who scheduled for endoscopic sinus surgery were randomly allocated into three groups by the dose of remifentanil infusion. For induction and maintenance of anesthesia, 0.05, 0.15, 0.25microgram/kg/min of remifentanil and 3.5microgram/ml of intravenous propofol by TCI were infused to each group. Systolic and diastolic blood pressure, heart rate and bispectral index were measured for 15 minutes at the 1 minute intervals after nasal packing of epinephrine. RESULTS: Systolic and diastolic blood pressure in R0.15 and R0.25 group were significantly lower compared to R0.05 group during 9 to 12 minutes after epinephrine packing, but heart rate and bispectral index were not significantly different among the groups. The frequency of hypotension and bradycardia were significantly higher in R0.25 than R0.05 and R0.15. CONCLUSIONS: Continuous infusion of 3.5microgram/ml of propofol with 0.15microgram/kg/min of remifentanil attenuate hypertension and tachycardia induced by epinephrine with little side effects.
Anesthesia ; Blood Pressure ; Bradycardia ; Constriction ; Epinephrine* ; Heart Rate ; Hemodynamics* ; Hemorrhage ; Humans ; Hypertension ; Hypotension ; Propofol ; Tachycardia

Amelanotic maliganat melanoma is a comparatively rare disease. It accounts for 1.8~8.1% of all malignant melanoma. It is sometime difficult to diagnose amelanotic malignant melanoma because there is no pigmentation, clinically. Polypoid melanoma is a variant of nodular melanoma, which in depth seldom reaches the reticular dermis. The main part of the tumor is located above the nearby epidermis, raised in the form resembling cauliflower. We report a rare case of amelanotic malignant melanoma with polypoid feature in a 78-year-old woman who presented a single bright red nodule on the left thigh.
Aged ; Brassica ; Dermis ; Epidermis ; Female ; Humans ; Melanoma ; Melanoma, Amelanotic ; Pigmentation ; Rare Diseases ; Thigh

No abstract available.
Cryptococcosis* ; Humans

BACKGROUND: Although many laboratories use automated blood culture systems, adequate skin disinfection and optimal blood volume are still critical for successful culture. The authors undertook a nationwide survey to understand the current situation and problems of blood culture in Korea. METHODS: A survey of blood culture was performed in March and April 2010, including disinfectants, blood collection intervals, and recommended blood volumes. The laboratory physicians described the storage condition of culture bottles before delivery to the equipment. For quality control, the positive rate and skin contamination rate were studied. RESULTS: Replies to the survey were collected from 74 Korean hospitals. Povidone iodine after either isopropyl alcohol or ethanol application was the most common means of skin disinfection. Sampling of a second set of cultures was performed simultaneously in 38% of hospitals and after a 30-min interval in 50%. The recommended blood volume was 10 mL in most cases (69%), but was 20 mL in 24% of cases. The bottles were stored at 37degrees C before installation in 23% of cases and at room temperature in 16%, whereas 57% were placed directly in the equipment during the night shift. Positive rates ranged 8-10% in 32% of hospitals, 5-8% in 23%, and <5% in 12%. Skin contamination rates were 2-3% in 32% of hospitals, 1-2% in 27%, and >3% in 13%. CONCLUSION: Skin disinfection methods were rather variable. Sampling interval, blood volume, and storage of bottles should be standardized. More than 10% of the hospitals require quality improvement in terms of positive rate and skin contamination rates.
2-Propanol ; Bacteremia ; Blood Volume ; Disinfectants ; Disinfection ; Ethanol ; Povidone-Iodine ; Quality Control ; Quality Improvement ; Sepsis ; Skin

We evaluated the clinical results of the combined keratoplasty and cataract surgery. Fifty nine patients were devided into 3 groups according to the operation type: Group I; penetrating keratoplasty, cataract extraction and intraocular lens implantation (triple procedure), Group II; penetrating keratoplasty and cataract extraction, Group III; penetrating keratoplasty and intraocular lens implantation. The most common cause of corneal opacity was infection in group I and II, and aphakic bullous keratopathy in group III. The preoperative best corrected visual acuity was less than 20/200 in almost all patients. The postoperative corrected visual acuity of 20/100 or better was obtained in 70%(14 eyes), 53%(9 eyes) and 33.3%(5 eyes) in group I, II and III and 12 months. Clarity of the graft cornea was maintained 90.9% in group I, 55% in group, and 64.7% in group III. The two most common complication were graft rejection and glaucoma. From above results, combined keratoplasty and cataract surgery could be an available procedure which obtain a good visual outcome in patients who have both corneal opacity and cataract. Especially, the triple procedure offers patients the chance of an early visual rehabilitation after graft and cataract surgery with a little risk of complication. However, more careful preoperative examinations and postoperative managements should be necessary for a higher success-rate.
Cataract Extraction ; Cataract* ; Cornea ; Corneal Opacity ; Corneal Transplantation* ; Glaucoma ; Graft Rejection ; Humans ; Keratoplasty, Penetrating ; Lens Implantation, Intraocular ; Rehabilitation ; Transplants ; Visual Acuity

Neutrophils and eosinophils, 2 prominent granulocytes, are commonly derived from myelocytic progenitors through successive stages in the bone marrow. Our previous genome-wide transcriptomic data unexpectedly showed that genes encoding a multitude of neutrophil primary granule proteins (NPGPs) were markedly downregulated during the end period of eosinophilic terminal differentiation when cord blood (CB) cluster of differentiation (CD) 34+ cells were induced to differentiate toward the eosinophil lineage during a 24-day culture period. Accordingly, this study aimed to examine whether NPGP genes were expressed on the way to eosinophil terminal differentiation stage and to compare their expression kinetics with that of genes encoding eosinophil-specific granule proteins (ESGPs). Transcripts of all NPGP genes examined, including proteinase 3, myeloperoxidase, cathepsin G (CTSG), and neutrophil elastase, reached a peak at day 12 and sharply declined thereafter, while transcript of ESGP genes including major basic protein 1 (MBP1) attained maximum expression at days 18 or 24. Growth factor independent 1 (GFI1) and CCAAT/enhancer-binding protein α (C/EBPA), transactivators for the NPGP genes, were expressed immediately before the NPGP genes, whereas expression of C/EBPA, GATA1, and GATA2 kinetically paralleled that of eosinophil granule protein genes. The expression kinetics of NPGPs and ESGPs were duplicated upon differentiation of the eosinophilic leukemia cell line (EoL-1) immature eosinophilic cells. Importantly, confocal image analysis showed that CTSG was strongly coexpressed with MBP1 in differentiating CB eosinophils at days 12 and 18 and became barely detectable at day 24 and beyond. Our results suggest for the first time the presence of an immature stage where eosinophils coexpress NPGPs and ESGPs before final maturation.
Bone Marrow ; Cathepsin G ; Cell Line ; Eosinophils* ; Fetal Blood ; Granulocytes ; Hypereosinophilic Syndrome ; Kinetics ; Leukocyte Elastase ; Myeloblastin ; Neutrophils* ; Peroxidase ; Trans-Activators

TLR6 forms a heterodimer with TLR2 and TLR4. While proinflammatory roles of TLR2 and TLR4 are well documented, the role of TLR6 in inflammation is poorly understood. In order to understand mechanisms of action of TLR6 in inflammatory responses, we investigated the effects of FSL-1, the TLR6 ligand, on expression of chemokine CCL2 and cytokine IL-1beta and determined cellular factors involved in FSL-1-mediated expression of CCL2 and IL-1beta in mononuclear cells. Exposure of human monocytic leukemia THP-1 cells to FSL-1 resulted not only in enhanced secretion of CCL2 and IL-1beta, but also profound induction of their gene transcripts. Expression of CCL2 was abrogated by treatment with OxPAPC, a TLR-2/4 inhibitor, while treatment with OxPAPC resulted in partially inhibited expression of IL-1beta. Treatment with FSL-1 resulted in enhanced phosphorylation of Akt and mitogen-activated protein kinases and activation of protein kinase C. Treatment with pharmacological inhibitors, including SB202190, SP6001250, U0126, Akt inhibitor IV, LY294002, GF109203X, and RO318220 resulted in significantly attenuated FSL-1-mediated upregulation of CCL2 and IL-1beta. Our results indicate that activation of TLR6 will trigger inflammatory responses by upregulating expression of CCL2 and IL-1beta via TLR-2/4, protein kinase C, PI3K-Akt, and mitogen-activated protein kinases.
Butadienes ; Chemokine CCL2 ; Chromones ; Humans ; Imidazoles ; Indoles ; Inflammation ; Leukemia ; Macrophages ; Maleimides ; Mitogen-Activated Protein Kinases ; Morpholines ; Nitriles ; Phosphatidylcholines ; Phosphorylation ; Protein Kinase C ; Pyridines ; Toll-Like Receptor 6 ; Toll-Like Receptors ; Up-Regulation

Diabetic ketoacidosis (DKA) is a medically fatal condition in poorly controlled hyperglycemia or newly diagnosed diabetes mellitus. Severe hypertriglyceridemia (HTG) is an uncommon complication of DKA and can be associated with acute pancreatitis (AP). We present the clinical manifestations, laboratory findings, and management of AP associated with HTG in a 14-year-old girl with DKA. The patient, with a 7-year history of type 2 diabetes presented with epigastric pain, 1 month after stopping insulin injection. DKA, severe HTG, and AP were diagnosed based on the laboratory and imaging tests. She recovered from DKA after conventional treatment for DKA, and her triglyceride (TG) level was reduced from 10,867 mg/dL to the normal range after 7 days of admission without antilipid medication. Given that her C-peptide level was not too low and considering her negative diabetes-related antibodies and high TG level, targeted gene panel sequencing was performed on the genes associated with diabetes and HTG. We identified a heterozygous mutation, c.4607C>T (p. Ala1537Val), in ABCC8 related to maturityonset diabetes of the young (MODY) 12. To our knowledge, this is the first reported case of HTG-induced AP with DKA in a patient with MODY. In addition, we reviewed the literature for pediatric cases of HTG with DKA. In patients with DKA, timely awareness of severe HTG related to insulin deficiency is crucial for improving the consequences of AP. We recommend considering AP in all DKA patients presenting with severe HTG to ensure early and proper management.