Steroid cell tumor, not otherwise specified (NOS), are rare ovarian tumor, in addition, it is more rare in children. The majority of these tumors produce several steroid hormones, particularly testosterone. Estrogen also secreted by steroid cell tumor, NOS, but it is uncommon. Furthermore, hypertension is an infrequent sign in steroid cell tumor, NOS. An 8.5-yr-old girl with hypertension and frequent vaginal spotting visited at our clinic. On laboratory evaluation, secondary hypertension due to an elevated plasma renin level and isosexual pseudoprecocious puberty was diagnosed. Right solid ovarian mass was detected in radiologic tests. She underwent a right ooporectomy and it revealed renin and progesterone receptor positive steroid cell tumor, NOS. After operation, her blood pressure returned to normal level and vaginal bleeding disappeared. Even though this case is very rare, when hypertension coincides with virilization or feminization, a renin-secreting ovarian steroid cell tumor, NOS, should be considered.
Child ; Female ; Humans ; Hypertension/*etiology ; Ovarian Neoplasms/complications/*diagnosis/pathology ; Puberty, Precocious/enzymology/*etiology ; Receptors, Cell Surface/metabolism ; Receptors, Progesterone/metabolism ; Renin/blood ; Sex Cord-Gonadal Stromal Tumors/complications/*diagnosis/pathology ; Steroids/biosynthesis ; Tomography, X-Ray Computed ; Vacuolar Proton-Translocating ATPases/metabolism

PURPOSE: This study was to develop and prove the effects of aself management compliance promotion program for primary hypertension patients who reside in rural communities. METHOD: The content of the self management compliance promotion program developed by this study was as follows: A leader trains patients as a group or individually, in walking, education and green tea therapy from the first to twelfth week. From the thirteenth to twenty fourth week, the patients should perform walking and green tea therapy by themselves. One hundred twenty subjects volunteered to participate in the study, who were among those registered as hypertension patients in the 14 community health clinics located in Chungcheongbuk-do. RESULT: Systolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, triglyceride, step width, and degree of obesity decreased significantly. High-density lipoprotein cholesterol, step length, knowledge of hypertension, and self management compliance significantly increased. CONCLUSION: A self management compliance promotion program for primary hypertensive patients enhances biophysical index and knowledge on hypertension, thus ultimately suggesting a nursing intervention for promoting self management compliance.
Adult ; Aged ; Aged, 80 and over ; Female ; Health Promotion ; Humans ; Hypertension/psychology/*therapy ; Life Style ; Male ; Middle Aged ; Patient Compliance ; *Patient Education as Topic ; Rural Population ; *Self Care

Objective: Low tidal volume ventilation (LTVV) is one of the strategies to prevent ventilator-induced lung injuries. This study aimed to investigate the use of LTVV among endotracheally intubated patients who received mechanical ventilation (MV) in emergency departments (EDs). Methods: We conducted a retrospective, standardized chart review of all adult patients who received MV in 6 EDs between July 2020 and June 2021. The data of a total of 766 patients who had an initial application of MV in the ED were analyzed. The primary outcome was exhaled tidal volume. Logistic regression analyses were conducted to develop a multivariate model identifying the factors associated with conventional tidal volume ventilation (CTVV), defined as the exhaled tidal volume of >8 mL/kg predicted body weight. Results: Of the 766 patients, 483 patients (62.8%) were male. Respiratory failure (37.8%) was the most common indication for MV. In the initial ventilator setting, pressure control ventilation was preferred to volume control ventilation (80.4% vs. 19.0%). LTVV was used in 418 patients (54.6%). In the multivariate logistic regression analysis, the factors associated with the CTVV were female sex (adjusted odds ratio [OR], 2.62; 95% confidence interval [CI], 1.03-6.69), height (adjusted OR, 0.92; 95% CI, 0.89-0.94), and respiratory rate (adjusted OR, 0.93; 95% CI, 0.87-0.99). Conclusion About half of the adult patients undergoing MV received LTVV in the ED. The female sex, height, and respiratory rate were associated with CTVV. The use of predicted body weight based on sex could increase the usage of LTVV.

BACKGROUND: This prospective phase II study assessed the efficacy and toxicity of the combination of carboplatin, ifosfamide and etoposide for previously untreated patients with extensive-disease small cell lung cancer (ED-SCLC). METHODS: Patients with ED-SCLC received a combination chemotherapy with carboplatin AUC 6.0 on day 1, ifosfamide 1200 mg/m2 on day 1-3, and etoposide 100 mg/m2 on day 1-3. RESULTS: Forty-one patients received a median of six cycles of chemotherapy. A complete response was seen in 5 patients and a partial response was seen in 33 patients (overall response 95%). The median duration of the response was 5.1 months (95% CI; 3.4-6.8 months). The median time to progression and overall survival were 7.4 months (95% CI; 6.1-8.6 months) and 10.7 months (95% CI; 6.9-14.6 months), respectively, providing the one-year survival rate of 43.9%. Grade 3~4 anemia, neutropenia and thrombocytopenia occurred in 14%, 7% and 6% in a total of 212 cycles, respectively. Non-hematologic toxicities were generally mild and manageable. No treatment related death was observed. CONCLUSIONS: The combination chemotherapy of carboplatin, etoposide and ifosfamide showed an effective response rate and acceptable toxicity.
Anemia ; Area Under Curve ; Carboplatin* ; Drug Therapy* ; Drug Therapy, Combination ; Etoposide* ; Humans ; Ifosfamide* ; Neutropenia ; Prospective Studies ; Small Cell Lung Carcinoma* ; Survival Rate ; Thrombocytopenia