No abstract available.
Femur* ; Osteoporosis*

No abstract available.
Leukemia, Plasma Cell* ; Plasma Cells* ; Plasma*

PURPOSE: This study was done to identify the relationship between nurses' compliance with safety guidelines for the use of antineoplastic agents, observable symptoms, and stress from occupational exposure. METHODS: The participants were 172 nurses from six general hospitals in a metropolitan area. They had administered antineoplastic agents at least three months prior to the study. Data were collected using self-report questionnaires, and then analyzed using SPSS/WIN 23.0 for descriptive statistics, t-test, one-way ANOVA, Scheffé method, and Pearson correlation coefficient. RESULTS: The average score on the guideline for safety compliance was 87.75 points out of a total of 100. The average score for observable symptoms of exposure to antineoplastic agents was 30.12 (28~56) points, and that for mean stress was 33.52 (15~60) points. Observable symptoms and stress from occupational exposure showed a statistically significant positive correlation (r=0.34, p < .001). CONCLUSION: To increase the degree of compliance with safety guidelines for antineoplastic agents, hospitals should lower the chance of exposure to antineoplastic agents, as well as minimize the observable symptoms and stress from occupational exposure. Periodic education and policy support are needed to improve compliance with safety guidelines for antineoplastic agent use.
Antineoplastic Agents* ; Compliance* ; Education ; Hospitals, General ; Methods ; Occupational Exposure*

No abstract available.
Myelodysplastic Syndromes*

The coexistence of adrenal cortical tumor and pheochromocytoma was extremely rare. A total of 25 reported cases showing evidence of hyperfuction of the adrenal cortex and pheochromocytoma were noted in the literature. Of those twenty cases were coexistence of pheochromocytoma and adrenocortical hyperplasia and only five cases were coincident pheochromocytoma and adreno-cortical adenoma. Recently, we experienced a case of adrenocortical adenoma associated with incidental pheochrmocytoma. A 55-year-old woman complained of progressive weight gain and epigastric discomfort. Hormonal and radiologic studies revealed Cushings syndrome with a left adrenal tumor. Adrenalectomy was performed and the gland actually had two nodules on its surface, one pheochromocytoma and the other cortical adenoma. This patient was the first case of pheochromocytoma with adrenocortical adenoma in Korea. We report the case with a review of literature.
Adenoma ; Adrenal Cortex ; Adrenalectomy ; Adrenocortical Adenoma ; Female ; Humans ; Hyperplasia ; Korea ; Middle Aged ; Pheochromocytoma ; Weight Gain

BACKGROUND: It is known that QT dispersion represents asynchronous repolarization of ventricle which is related to ventricular fibrillation. The incidence of ventricular arrhythmia is increased after acute myocardial infarction. So this study compared QT dispersion and other repolarization indexes for detection of asynchronous repolarization in acute myocardial infarction. We also investigated which portion of repolarization is the key portion of the asynchrony. METHODS: In 37 acute myocardial infarction patients and 38 angina patients dispersion of QT, JT, JTpeak and QTpeak were measured. We also measured maximum adjacent dispersion of same parameters in precordial leads. In 20 survived patients and 17 dead patients after acute myocardial infarction were also compared. We also investigated correlation of PVC's on Holter monitoring with these repolarization parameters. RESULTS: 1) All ventricular repolarization indexes(QT, QTc, JT, JTpeak, QT peak and TpeakTend dispersion) were significantly increased in acute myocardial infarction group than compared with those of angina group(p<0.05). 2) Maximal precordial dispersion(QT, QTc, JT, JTpeak and QTpeak) were also significantly increased in acute myocardial infarction group than angina group(p<0.05). 3) Dead patient group after myocardial infarction showed significantly increased QTc and TpeskTend dispersion compared with those of survived patient group(p<0.05). 4) Multivariate linear correlation showed that TpeakTend dispersion and JT dispersion was correlated with QT dispersion. CONCLUSIONS: There were asynchronous myocardial repolarization changes in acute myocardial infarction. Our study demonstrated that T wave change was major determinant of dispersion of myocardial repolarization.
Arrhythmias, Cardiac ; Electrocardiography, Ambulatory ; Humans ; Incidence ; Myocardial Infarction* ; Ventricular Fibrillation

BACKGROUND: In the United States, the Centers for Disease Control and Prevention recorded a 20-fold increase in the incidence of vancomycin-resistant enterococci (VRE) associated with nosocomial infections between 1989 and 1991. Although VRE has been reported in Korea since 1992, infections caused by these organisms are still extremely rare in Pusan, Korea. Therefore, a point prevalence culture survey was carried out to investigate the prevalence of intestinal colonization with VRE among patients admitted to Kosin Medical Center, which can predict the appearance of clinical infections with VRE. METHODS: Between July 1997 and August 1997, stool specimens were obtained from 303 patients. Specimens were placed in bile esculin azide broth containing vancomycin (64 microgram/mL) and aatreonam (60 microgram/mL). Cultures were done for 48 hours at 37degrees C, and turbid solutions were subcultured on blood agar. Minimal inhibitory concentrations (MIC) of vancomycin and teicoplanin to Enterococcus isolates were determined by Etest on Mueller-Hinton agar. For amplification of the vanA, vanB, and vanC genes, polymerase chain reactions were performed. RESULTS: VRE isolates were isolated from 6 of the patients (2%). Four of them were identified as E. faecium, and 1 was identified as E. avium, and 1 was identified as Enterococcus spp. All of them were highly resistant to vancomycin (MICs >256 microgram/mL), and they were also resistant to teicoplanin (MICs 32-->256 microgram/mL). All of 6 VRE strains carried vanA gene. CONCLUSION: The colonization of VRE was not infrequent among the patients of a university hospital in Pusan, Korea. Moreover, a large proportion of the colonizing VRE was revealed Enterococcus faecium with vanA gene, which implies quite a possibility of a sudden rising of infections by this organism in the near future. So we propose that the vancomycin susceptibility test should be done for every enterococcal isolate from clinical specimens and the intestinal colonization rate of VRE should be closely monitored at regular intervals for the purpose of surveillance 50 that proper establishment of plans for the prevention of this troublesome pathogen's spread can be promptly made.
Agar ; Bile ; Busan ; Centers for Disease Control and Prevention (U.S.) ; Colon* ; Cross Infection ; Enterococcus ; Enterococcus faecium ; Esculin ; Humans ; Incidence ; Korea ; Polymerase Chain Reaction ; Prevalence ; Teicoplanin ; United States ; Vancomycin

This study examined foodservice management performance in child-care centers and suggests ways in which meal service quality can be improved. Questionnaires were distributed to 51 child-care facilities. The majority of respondents were facility directors (dietitians) and their facility type was tax-paid (92.2%). The dietitian response rate was 51.0%, and the majority (96.2%) were hired with co-management status, visiting a facility once a week (76.0%). Only 52.1% of the facilities had menu planning by a dietitian, and improvements were needed in terms of planning menus with standardized recipes, especially for infant meals. The monthly food cost per child was 47,394 won, and the labor cost for a co-management dietitian was 3,670 won per child, indicating 21.8% and 1.8% of the tuition fee, respectively. Other necessary improvements included: more reliable food purchasing management, securing additional foodservice equipment, and better sanitation management. In addition, respondents rated the following as requirements to ensure high quality meal service: 'modernized foodservice equipment and facilities', 'government financial support', and 'information on nutrition and foodservice management provided by dietitians'. Based on the study results, the following are recommendations for improving meal service quality in child-care centers: Dietitian placement should be extended to facilities of over 50-capacity in addition to their current placement in facilities of over 100-capacity, and co-management dietitians should have their control span restricted to two facilities instead of five. Finally, nationwide nutrition support plans and nutrition education programs should be developed and implemented by dietitians, and their roles should be extended to foodservice mangers as well as nutrition teachers.
Child ; Surveys and Questionnaires ; Dietary Sucrose ; Fees and Charges ; Humans ; Infant ; Meals ; Menu Planning ; Sanitation

Proliferating trichilemmal tumor is one of rare benign tumors of the skin appendages, considering as hamartoma of the terminal hair follicle, isthmic segment of the outer root sheath. We report a case of numerous proliferating trichilemmal tumors admixed with ordinary trichilemmal cysts with femilial history in 64-year-old man. He has total 157 lesions, which are chiefly located in scalp (48), back (32), and also face, neck, trunk, extremities. Histologically, the tumor is composed of irregularly arranged and ansatomosed trabeculae, lobules, or sheets of proliferated trichilemmal squamous epithelium with peripheral palisading of the basaloid cells. Several layers of squamoid or ovoid cells have PAS-positive clear cytoplasm. And it also shows abrupt amorphous, trichilemmal keratinization. Some squamous eddies with mild cellular atypism are associated, but definite invasion or other evidence of the malignancy is not found. usual multiple trichilemmal cysts are admixed with tumor and occasionally exhibit connection between them.
Cysts ; Hamartoma

Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive procedure carrying potential complication such as pancreatitis, hemorrhage, perforation and cholangitis. Most of those complications are mild and usually need a short additional hospitalization periods. Perforation, however, often requires surgical intervention and in this case, the rate of mortality is up to 10%. Prompt diagnosis and proper management are key determinants for successful outcome. For this, endoscopist should be aware of possibility of perforation before procedure especially in high risk patients with altered anatomy such as prior Billroth II or Roux-en-Y anastomosis. After diagnosis of perforation, multidisciplinary approach involving medical, surgical and radiologic interventional subspecialties, is essential. Usually, surgical treatment is needed for type I free wall perforation and medical and endoscopic treatments are recommended for type II-IV perforation. Recently, several anecdotal studies reported successful endoscopic treatment using new devices for type I duodenal wall perforation but it is not warranted that endoscopic treatments can substitute the surgical intervention.
Anastomosis, Roux-en-Y ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Diagnosis ; Gastroenterostomy ; Hemorrhage ; Hospitalization ; Humans ; Mortality ; Pancreatitis