Diffuse alveolar hemorrhage (DAH) is associated with severe outcomes. We report a case of acute respiratory failure that required mechanical ventilation and was clinically and pathologically diagnosed as DAH related to exposure to organic dust. A 39-year-old man, who had visited a warehouse to grade beans for purchase, was referred to our hospital for impending respiratory failure. His initial radiographic examinations revealed diffuse bilateral ground-glass opacities in his lungs and bronchoalveolar lavage resulted in progressively bloodier returns, which is characteristic of DAH. He underwent bedside open lung biopsy of his right lower lobe in the intensive care unit. Biopsy results revealed DAH and organization with accumulation of hemosiderin-laden macrophages and a few fibroblastic foci. The patient was treated with empirical antibiotics and high-dose corticosteroids and successfully weaned from mechanical ventilation. DAH might be considered in the differential diagnosis of patients with acute respiratory failure after exposure to organic particles.
Adrenal Cortex Hormones ; Adult ; Anti-Bacterial Agents ; Biopsy ; Bronchoalveolar Lavage ; Diagnosis, Differential ; Dust* ; Fibroblasts ; Hemoptysis ; Hemorrhage* ; Humans ; Intensive Care Units ; Lung ; Macrophages ; Respiration, Artificial ; Respiratory Insufficiency*

We found an title error in our published article.

PURPOSE: The study was conducted to investigate the effect of career barrier, satisfaction, and career decision making pattern on career search behaviors in male nursing students. METHODS: Data were collected through structured questionnaires that included general characteristics, career barrier, satisfaction, career decision making pattern and career search behaviors and were analyzed by descriptive statistics, ANOVA, t-test, Pearson correlation coefficient and multiple regression using SPSS/PC+ program. RESULTS: The results of the research suggest the two aspects of career search behaviors as being self-exploration and environmental exploration. The rational pattern, among the types of satisfaction and career decision making pattern, was found to have a meaningful effect on self-expression. On the other hand, dependent pattern, among the satisfaction and career decision making pattern, was found to have an effect on career search patterns. CONCLUSION: It is considered that, based on the results of this study, diversified approaches that consider individual career decision making patterns such as rational pattern and dependent pattern as well as the methods to enhance the satisfaction of male nursing college students for career guidance are needed.
Decision Making* ; Hand ; Humans ; Male* ; Nursing* ; Students, Nursing*

No abstract available.
Neoplasm Metastasis* ; Neuroblastoma*

PURPOSE: This study was conducted to investigate nursing students' knowledge and beliefs about Kangaroo care (KC). METHODS: A cross-sectional descriptive design was used. Undergraduate students enrolled in departments of nursing (n=322) from three universities in D city participated. Knowledge and beliefs about KC were measured using the Kangaroo Care Questionnaire (KCQ). RESULTS: The overall level of nursing students' knowledge about KC was very low with a mean score of 6.9 out of 17. The mean score for nursing students' beliefs about KC was 87.4 out of 100, indicating relatively positive beliefs. The students who had both education and exposure to KC had higher scores for knowledge and more positive beliefs about KC compared to students with no experience or exposure to KC. There was a positive correlation between knowledge and beliefs about KC (r=.371, p<.001). CONCLUSION: The results suggest that there is a need to develop educational programs for nursing students in order to increase their knowledge and develop positive beliefs about KC.
Education ; Humans ; Infant, Newborn ; Infant, Premature ; Kangaroo-Mother Care Method ; Macropodidae* ; Nursing* ; Students, Nursing*

The effects of vitamin D3 supplementation on bone mineral density and bone mineral content in ovariectmized rats were investigated. Forty female Sprague-Dawley rats (body weight 180 g) were divided into two group, ovariectomy and Sham groups, which were each randomly divided into two subgroups that were fed casein and casein supplemented with vitamin D3 diets. Bone mineral density (BMD) and bone mineral content (BMC) were measured using PIXImus (GE Lunar Co, Wisconsin, USA) in spine and femur on 6 weeks after feeding. Osteocalcin and urinary DPD crosslinks value were measured as markers of bone formation and resorption. The body weight gain and food efficiency ratio (FER) were higher in OVX groups than in Sham groups regardless of diets. Serum Ca concentration and urinary Ca excretion were higher in vitamin D3 supplemented group than in casein group in Sham and OVX. Crosslinks values were higher in OVX groups than in Sham groups. Spine BMD and femur BMD of ovariectomy group were significantly lower than Sham groups, however vitamin D3 supplemented groups were significantly higher than control groups in Sham and OVX. In conclusion, dietary vitamin D3 supplementation on ovariectimized rats were significantly increased bone mineral density and bone mineral content in spine and femur.
Animals ; Body Weight ; Bone Density ; Caseins ; Cholecalciferol ; Compensation and Redress ; Diet ; Female ; Femur ; Humans ; Osteocalcin ; Osteogenesis ; Ovariectomy ; Rats ; Rats, Sprague-Dawley ; Salicylamides ; Spine ; Vitamin D ; Vitamins ; Wisconsin

Paraneoplastic pemphigus is a distinct and rare autoimmune disease characterized by extensive and painful mucosal ulcerations and polymorphic desquamated skin lesions in the setting of an underlying neoplasm, typically of lymphoreticular origin. Thus difficulties in the management of anesthesia can be expected. A 66-years-old man was scheduled for removal of intraabdominal sarcoma associated with paraneoplastic pemphigus. Physical examination showed multiple erythematous bullae, crusts, plaques and target-like lesions on the whole body and desquamated erythematous skin lesions on the back and extremities. In the operating room, his right femoral artery was cannulated with a 20 G, 12.7 cm CVP catheter and left femoral and subclavian veins with 14 G, 20 cm CVP catheters, respectively. After application of 4 % lidocaine spray, his oropharynx and supraglottic area were evaluated under direct laryngoscopy and revealed multiple ulcerations on oral mucosa, but no distinct lesion on supraglottic area. Anesthesia was induced by rapid-sequence method with fentanyl, thiopental sodium and succinylcholine followed by endotracheal intubation. The endotracheal tube was held by a roll gauze around the neck and its cuff was minimally inflated to avoid overpressure against his tracheal wall. After the end of surgery, his oral cavity was suctioned with no remarkable bleeding, and tracheal wall including cuff-contacted area was evaluated under fiberoptic bronchoscopy, revealed intact wall without any bulla or ulceration. The patient was transferred to intensive care unit for proper postoperative management after extubation of endotracheal tube.
Anesthesia ; Autoimmune Diseases ; Bronchoscopy ; Catheters ; Extremities ; Femoral Artery ; Fentanyl ; Hemorrhage ; Humans ; Intensive Care Units ; Intubation, Intratracheal ; Laryngoscopy ; Lidocaine ; Mouth ; Mouth Mucosa ; Neck ; Operating Rooms ; Oropharynx ; Pemphigus* ; Physical Examination ; Sarcoma ; Skin ; Subclavian Vein ; Succinylcholine ; Suction ; Thiopental ; Ulcer

PURPOSE: This study aimed to assess the prevalence of asthma, allergic rhinitis, and atopic dermatitis in elementary school students according to thebody mass index. METHODS: This study was conducted as cross-sectional descriptive research using a structured questionnaire. Data were collected from 6,398 students at 15 elementary schools located in Y City in Korea. The cross-sectional survey used the Korean version of International Study of Asthma and Allergies in Childhood questionnaire. Logistic regression analysis was performed to estimate the odds ratios of body mass index. RESULTS: The symptom prevalence of asthma, allergic rhinitis, and atopic dermatitis in the last 12 months was 12.4%, 49.5%, and 24.5%, respectively. The symptom prevalence of asthma was significantly higher in the obesity group. The number of those without any asthma symptom in lifetime was significantly smaller in the overweight (OR=0.70, p=.004) and obesity (OR=0.57, p=.005) groups than in the healthy weight group. CONCLUSION: These results suggest that asthma, allergic rhinitis, and atopic dermatitis prevention programs for elementary school students should include weight control intervention.
Asthma* ; Body Mass Index* ; Cross-Sectional Studies ; Dermatitis ; Dermatitis, Atopic* ; Humans ; Hypersensitivity ; Korea ; Logistic Models ; Obesity ; Odds Ratio ; Overweight ; Prevalence* ; Rhinitis*

The uterine cervical cancer is the rnost common tumor of malignant gynecologic tumors and complete remission of the cancer has been possible through early diagnosis and treatment. To evaluate the efficacy of tumor markers SCCA and CEA in patients with uterine cervical cancer as markers for monitoring, we analyzed serum SCCA and CEA crncentrations of 43 patients wit.h uterine cervical caner as a study group and 73 patients with benign pelvic disease as a contrnl group, were admitted to depar tment of Obstetncs & Gynecology, College of Medicine, Kyung Hee University from May 1991 to January 1993. The results were as follows ; 1. The distrihution of the clinical stages of 43 cervical cancers were : CIS 9, stage I 11, stage II 12, stageg III 5, stage lV 6. 2. The positive rate of SCCA of control group was 17%, and that of CEA nf control group was 12%. And the positive rate of SCCA of study group was 46.5% and that of CEA of study was 27.9%. 3. The average concentration of SCCA of control group was 0.71ng/ml and that of SCCA of study group was 8.25ng/ml(p<0.05). 4. The average concentration of CEA of control group was 1.95ng/ml and that of CEA of study group was 8.33ng/ml(p<.0.05). 5. The average concentration of SCCA by stage were 1.15ng/rnl for C1S, 1.14ng/ml for stage I, 9.72ng/rnl for stage III, 16.75ng/rnl for stage III, 21.95ng/ml for stage IV. Here, the mean value of SCCA was increased stepwise through cliinical stage, there was a correlation between the clinical stage and the concen tration of serum SCCA (p>0.05). 6.The average concentration of CEA by stage were 3.11ng/ml for CIS, 1.96ng/ml for stage I, 8.11ng/rnl for stage II, 18.92ng/ml for stage III, 19.44ng/ml for stage IV. There was not a correlation between the clinical stage and the concentration of serm CEA. 7. When the cervical cancer was divided by histologic subtypes, the average concentration of SCCA in squamous cell carcinoma of uterine cervix was 11.86ng/ml and the positive rate of SCCA in squamous cell carcinoma was 53.6%(9.46ng/ml & 58.8% in large keratinizing cell type, 15.56ng/ml & 45.5% in large nonkeratinizing cell type). And the average concentration of SCCA in adenocarcinoma was 1.32ng/ml positive rate was 40.0%. The tumor marker SCCA was more sensitive to squamous cell carcinoma rather than adenocarcinoma. 8. The sensitivities of SCCA in preinvasive cancer and invasive cancer were 22.2% and 52.9%, respectively. The average concentration of SCCA in invasive cancer was 10.04ng/ml and was more significantly elevated than of SCCA in preinvasive cancer. 9. Using SCCA & CEA together as markers for monitoring, the positive rate significantly incresaed to 70.6%(p<0.05). But measuring the two tumor marker alone, that not significantly increased. 10) . The diagnostic efficacy of SCCA in cervical cancer was 59.0%, that was higher as compaired with that of CEA. These results suggest that the serum concentration of SCCA is significantly increased stepwise by clinical stage and concomitant measurements of serum SCCA & CEA are more useful in diagnosis of cervical cancer. However measurements of SCCA and/or CEA have little efficacy in the detection of early cervical cancer considering it's low rate of positivity in early cervical cancer. We will evaluate the efficacy of two tumor markers in determining prognosis, therapeutic response and early detection of recurrence for the posttreatment patients in the future.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Cervix Uteri ; Diagnosis ; Early Diagnosis ; Female ; Gynecology ; Humans ; Prognosis ; Recurrence ; Selective Estrogen Receptor Modulators ; Biomarkers, Tumor* ; Uterine Cervical Neoplasms*

BACKGROUND: Although enriched broth cultures have been recommended as an adjuvant to the direct plating of tissue and body fluid specimens, the cost-effectiveness of broth cultures has been questioned in regard with the clinical significance of "broth only isolates(BOI)". The purpose of this study was to investigate the usefulness of thioglycollate broth(THIO) cultures. METHODS: We reviewed retrospectively results in the culture specimens of body fluids, tissue biopsies, and puses received during the month of July 1997. All specimens were inoculated into THIO in addition to agar plates. We reviewed the medical records of culture-positive patients to determine the clinical significance and relevance of their isolates. Clinically significant isolates were defined as those for which an appropriate antimicrobial therapy was done except one judged as contaminants by clinicians and clinically relevant isolates as the clinically significant one isolated first. RESULT: Of 2,008 specimens, 512(25.4%) from 365 patients grow 561 isolates 464 plate isolates and 97 BOI. Two hundred eighty nine(62.3%) of the 464 isolates from plate cultures were clinically significant, compared to only 12(12.4%) of 97 BOI (P<0.05). Only four (4.1%) BOI were clinically relevant, including one Pseudomonas aerugiosa from ascites. one Klebsiella pneumoniae and two Staphylococcus aureus from tissue specimens. CONCLUSION: A routine use of enriched broth culture rarely recover clinically relevant isolates. Considering the laboratory and medical costs of the recovery of contaminants and clinically irrelevant isolates, the enrichment broth cultures should be used more selectively.
Agar ; Ascites ; Biopsy ; Body Fluids ; Humans ; Klebsiella pneumoniae ; Medical Records ; Pseudomonas ; Retrospective Studies ; Staphylococcus aureus