No abstract available.
Breast Neoplasms* ; Breast*

PURPOSE: This study aimed to develop an in-depth and comprehensive understanding of the experiences of critical care nurses caring for dying patients.METHOD: Eleven critical care nurses with experience in caring for dying patients were recruited from four tertiary hospitals. Semi-structured face-to-face interviews were conducted between November 2016 and March 2017. The transcribed data were analyzed using qualitative content analysis to identify major themes and sub-themes that represented the experiences of critical care nurses.RESULTS: The following six themes, and twelve sub-themes, were identified: (1) the gap between expectation and reality, (2) a distorted meaning of death, (3) repeated emotional pain and stress, (4) finding a solution alone, (5) sublimation into mission and calling, and (6) integration into one's own life.CONCLUSION: This study found that critical care nurses experience various psychological difficulties while caring for dying patients, and they made efforts on their own to overcome them. These findings are expected to inform the development of specialized programs to support critical care nurses to tackle these challenges, create guidelines on caring for dying patients, and help promote death education.
Critical Care ; Education ; Humans ; Intensive Care Units ; Methods ; Sublimation ; Tertiary Care Centers

A ‘collision’ tumor refers to the existence of two different neoplasms within the same tumor. Sometimes, the term ‘biphasic tumor’ is also used. However, a ‘collision’ tumor is defined as the occurrence of two neoplasms within proximity of each other yet maintaining distinctly defined, separate boundaries. In contrast, a ‘biphasic’ tumor demonstrates two or more phenotypically distinct neoplastic cell populations merging within the same space. Here, we report a case of collision tumor associated with sarcomatoid eccrine porocarcinoma and basal cell carcinoma arising in a 57-year-old male patient.
Carcinoma, Basal Cell* ; Eccrine Porocarcinoma* ; Humans ; Male ; Middle Aged

Fine needle aspiration of the breast is an important diagnostic tool in malignant lesions, but is also useful in differentiation of inflammatory breast diseases mimicking carcinoma clinically and radiologically. Recently. the authors have experienced eight biopsy-proven cases of chronic inflammatory diseases of the breast, which consisted of 4 cases of duct ectasia, 2 cases of fat necrosis, and a case of tuberculous mastitis and granulomatous mastitis respectively, Their cytologic features mainly based on the components and the relative frequency of inflammatory cells were evaluated for differential diagnosis of chronic inflammatory breast diseases. The results are as follows: 1. In cases of duct ectasia, varying amount of neutrophils, mononuclear leukocytes, histiocytes and multinucleated giant cells were intermixed with benign epithelial cell clusters. 2. Abundant fat tissue fragments were diagnostic for fat necrosis. Histiocytes and mononuclear cells were main components but not rich, and neutrophils and giant cells were infrequently observed. 3. Characteristic granulomas composed of epithelioid cells, mononuclear leukocytes and Langhans} type giant cells and lymphocytic infiltrates were conspicuous in tuberculous mastitis, and occasionally neutrophils, necrotic materials and epithelial cell clusters were found. 4. In granulomatous mastitis, epithelioid cell granulomas were also noted but numerous neutrophils and histiocytes were intermingled within or outside the granulomas.
Biopsy, Fine-Needle* ; Breast Diseases* ; Breast* ; Diagnosis, Differential ; Dilatation, Pathologic ; Epithelial Cells ; Epithelioid Cells ; Fat Necrosis ; Female ; Giant Cells ; Granuloma ; Granulomatous Mastitis ; Histiocytes ; Leukocytes, Mononuclear ; Mastitis ; Neutrophils

No abstract available.
Humans ; Scalp*

The prenatal diagnosis of spina bifida includes the combined use of maternal serum alpha-fetoprotein (MSAFP) screening and fetal sonography. On ultrasonogram, spina bifida is characterizd by visualization of the spinal defect and associated cranial abnomalities: the Lemon sign, the Banana sign, ventriculomegaly, small biparietal diameter, and obliteration of the cisterna magna. We should now be able to rely on ultrasound as the main technique for diagnosis of spina bifida when MSAFP is elevated. Recently, we have experienced three cases of spina bifida diagnosed with meningomyelocele, lemon sign, banana sign and ventriculomegaly on ultrasonogram at respectively 18+3, 18, and 18+6 weeks of gestation. We present these cases with a brief review of literatures.
alpha-Fetoproteins ; Cisterna Magna ; Diagnosis ; Mass Screening ; Meningomyelocele ; Musa ; Pregnancy ; Prenatal Diagnosis ; Spinal Dysraphism* ; Ultrasonography*

PURPOSE: In Kyung Hee East-West Neo Medical Center, Seoul, Korea, efforts to raise rooming-in care success rate have been undertaken since when the hospital was established in 2006. We intended to analyze our experience over the past 3 years of period and to discuss the advantages of rooming-in. METHODS: We analyzed the rooming-in practice rate, failure rate, and the breast feeding rate. Subjects were 860 normal healthy neonates from June 2006 to June 2009. RESULTS: Among these 860 cases, 83 babies were required separation out of rooming-in in the middle of the course. Among these 83 cases, 70 cases had to stop the course due to poor condition of babies and 13 cases due to maternal condition. 70 cases of infant's causes consist of 68 cases of NICU admission and 2 cases of poor feeding support. The other 13 cases of separation include refusal by maternal condition. Therefore the success rate of rooming-in for the last 3 years was 90.3%, that is 777 cases among the total 860 cases. The percentage of exclusive breast feeding was 64%, that of mixed feeding with breast and formula feeding was 25%, and formula feeding only was 11%. CONCLUSION: We experienced successful rooming-in care for the last 3 years. Nursery facilities should educate and encourage the advantages of rooming-in, including the good formation of attachment between mother and infant, emotional stability, protection from infection, and increased breast feeding rate so that rooming-in care can be fully established.
Breast ; Breast Feeding ; Disulfiram ; Humans ; Infant ; Infant, Newborn ; Korea ; Mothers ; Nurseries ; Rooming-in Care

Gasritis cystica profunda (GCP) is a rare disease in which hyperplasia of mature glandular epithelium extends into the tissues beneath the submucosa. It shows multiple small cysts in the mucosa and submucosa of the stomach. It was firstly reported by Littler and Gleibermann on 1972. GCP is mainly observed at the site of gastroenterostomy but, it may occur in the stomach without a previous history of surgery. The proposed pathogenesis of the these abnormalities are related to ischemia, chronic inflammation and the presence of a foreign body. GCP may present not only as a submucosal tumor or as solitary or diffuse polyps but also as a giant gastric mucosal fold rarely. It should be differentiated from Menetrier's disease, Zollinger-Ellison syndrome, inflammatory disease and malignancy. We present a case of gastritis cystica profunda without having had any previous surgery, suspiciously caused by gastric foreign body. We made a diagnosis based on findings from the esophagogastroduodenoscopy, endoscopic ultrasonography and histologic findings after surgery.
Diagnosis ; Endoscopy, Digestive System ; Endosonography ; Epithelium ; Foreign Bodies* ; Gastritis* ; Gastritis, Hypertrophic ; Gastroenterostomy ; Hyperplasia ; Inflammation ; Ischemia ; Mucous Membrane ; Polyps ; Rare Diseases ; Stomach ; Zollinger-Ellison Syndrome

BACKGROUND/AIMS: The effective and reproducible diagnostic parameters for differentiating benign from malignant gastrointestinal stromal tumors (GISTs) are still not clear. In this study, GISTs were diagnosed and classified by immunohistochemistry and their clinical and pathologic features were investigated. GISTs were re-evaluated by Amin's and NIH's criteria, and prognostic relevance of these two criteria were compared. METHODS: Fifty cases of gastrointestinal mesenchymal tumor diagnosed from May 1990 to February 2000, were evaluated by immunohistochemical staining for CD117, CD34, smooth muscle actin, and S-100 protein. GISTs were diagnosed according to Amin's and NIH's criteria. The relationship between the prognosis and diagnosis based on Amin's or NIH's classification were analyzed. RESULTS: Thirty cases of gastrointestinal mesenchymal tumors were diagnosed as GISTs. The stomach (40%) and small bowel (40%) were the most common origin for GISTs. Immunophenotypically, null, myoid, neural, combined type were 70.0%, 10.0%, 16.7% and 3.3%, respectively. Seven cases showed metastasis and one case showed recurrence. According to Amin's criteria, 5 benign, 8 borderline and 17 malignant tumors were diagnosed. The NIH's criteria showed 2 very low risk, 6 low risk, 7 intermediate risk, and 15 high risk tumors. Metastasis or recurrence of GISTs had no significant relationship with malignancy according to Amin's criteria (p=0.4069) but had significant correlation with high risk tumor based on NIH's criteria. (p=0.0352). CONCLUSIONS: GISTs showing local invasion, distant metastasis or recurrence were related with high risk tumors based on NIH's criteria. NIH's criteria might be better reliable scheme than Amin's for predicting the prognosis of GISTs.
Adult ; Aged ; Diagnosis, Differential ; English Abstract ; Female ; Gastrointestinal Neoplasms/*diagnosis/pathology ; Gastrointestinal Stromal Tumors/*diagnosis/pathology ; Humans ; Male ; Middle Aged ; Prognosis

BACKGROUND: Hypercholesterolemia is a risk factor of cardiovascular diseases and metabolic syndrome. Cholesterol level in childhood is related to the development of cardiovascular diseases in adulthood. This study aimed to investigate cholesterol levels of first grade students in elementary school, to analyze the relationship between the children's cholesterol levels and those of parents' and to evaluate the factors influencing children's cholesterol levels. METHODS: In 2004, a sample of 108 first-graders in elementary school in Gwacheon city and their 216 parents were included in this study. Height, weight, body mass index, waist and hip circumference and blood pressure were measured and bio-chemical data were obtained. The children's birth weight, eating habits, physical activity, occupation, educational background, married status, mean monthly income of each family were obtained by questionnaire. RESULTS: The correlation coefficient between children's cholesterol and fathers' cholesterol was 0.331 (P<0.001). The correlation coefficient between children's cholesterol and mothers' cholesterol was 0.364 (P<0.001). The mean total cholesterol level in children differed significantly according to mother's smoking status, mother's overeating due to stress and mother's diet restriction tendency for weight control. In multiple linear regression analysis of children's cholesterol as dependent variable, the explanation power (R(2)) of the model including children's sex, father's age and cholesterol levels, mother's age and cholesterol levels was 0.281. The explanation power (R(2)) of the other model including variables of the previous model and children's fruit consumption, parent's eating out tendency, mother's smoking status, mother's other behavior during mealtime, mother's overeating due to stress and mother's diet restriction tendency for weight control was 0.388. In final model, only the parent's cholesterol levels had significant effect on children's cholesterol levels. CONCLUSION: It was parent's cholesterol level that affected significantly on the children's cholesterol level.
Birth Weight ; Blood Pressure ; Body Weight ; Cardiovascular Diseases ; Child* ; Cholesterol* ; Diet ; Eating ; Fruit ; Gyeonggi-do* ; Hip ; Humans ; Hypercholesterolemia ; Hyperphagia ; Linear Models ; Meals ; Motor Activity ; Occupations ; Parents* ; Risk Factors ; Smoke ; Smoking ; Surveys and Questionnaires