Dermoid tumors of tbe corneal limbus are failYly common congenital lesions. They are noted -at birth and may grow slowly in size and encroach upon the pupillary area occupying a site partly over the cornea and partly over the sclera. The tumors are yellowish, elevated and variable in size. Histologically the tumor consists of fibrofatty tissue covered by epidermoid epithelium and are invaded by ectodermal derivatives such as hair follicle, sebaceous and sweat glands. Trauma, irritation and puberty may hasten their growth. About 30% of patients with. corneal dermoid exhibit other congenital anomalies of ocular tissue, face, teeth, jaw, ear, spine, skull, and so on. Recently two cases of limbal dermoids were seen in our clinic. Histologically hair follicles and sebaceous glands are shown in one specimen, and cartHage and sebaceous glands in the other specimen.
Adolescent ; Cornea ; Dermoid Cyst* ; Ear ; Ectoderm ; Epithelium ; Hair Follicle ; Humans ; Jaw ; Limbus Corneae ; Parturition ; Puberty ; Sclera ; Sebaceous Glands ; Skull ; Spine ; Sweat Glands ; Tooth

The ectopic bone formation is a condition in which mature lamellar bone is formed in tissues that do not normally ossify, which was first described by Riedel in 1883. It has been observed at sites of chronic infection, hemorrhage, fibrous scarring or contracture. The pathophysiology of ectopic bone formation is not clearly identified but has complex and multifaceted causes, which resulted to differentiate the non-circulating pluripotent mesenchymal cells to osteoblastic stem cells. The local environment conditions of trauma, disruption of soft tissues and periostium, bone debris, hematoma, damaged muscle, uncommitted fibroblasts are suspected to be one of the causes of this condition. Comparing to simple soft tissue calcification, the ectopic bone has all the morphologic and biochemical characteristics of orthotopic bone, which is subjected to turnover and even has the ability for bone marrow formation. A case of late occlusion in a femoro-post. tibial PTFE graft about 5 months after vascular reconstruction due to ectotopic bone formation, which is confirmed by pathology around the graft is presented. After excision of the ectopic bone around the inflow vascular anastomosis site with re-vascularization, the patient was free from the ischemic leg symptoms. We reported a case of occlusion of vascular anastomosis site by ectopic bone formation with review of literature.
Bone Marrow ; Cicatrix ; Contracture ; Fibroblasts ; Hematoma ; Hemorrhage ; Humans ; Leg ; Osteoblasts ; Osteogenesis ; Pathology ; Polytetrafluoroethylene ; Stem Cells ; Transplants

PURPOSE: The purpose of this study was to identify the major trends in research studies in the Journal of Korean Academy of Nursing Administration from 2010 to 2012. METHODS: A review using analysis criteria developed by researchers was done of 132 studies published between 2010 and 2012. Research design, participants, research domain, and keywords were analyzed from the Journal of Korean Nursing Administration. RESULTS: Job satisfaction, stress, organizational commitment, safety, turnover, nursing education, and performance were found to be major keywords. Of the research in the Journal, quantitative methods were used in 93.2% of studies. The major setting and participants were hospitals (58.2%) and nurses (65.5%) respectively. Prevalent analysis methods used were t-test, ANOVA, correlation, regression, chi-square, AMOS, and factor analysis. Major domains in the articles were: controlling, directing, staffing, nursing management education, and professionalism & legal principles. CONCLUSION: Through this study, the research trends in nursing administration were identified, but there is a need to include more of the following topics in future research: new concepts in nursing policy, enhanced deliberations of IRB, rationalization of the effects in sample size calculations, theoretical development of planning and organizing, and development of interventions for management support of the nursing management process.
Education ; Education, Nursing ; Ethics Committees, Research ; Job Satisfaction ; Methods ; Nursing Research ; Nursing* ; Rationalization ; Research Design ; Sample Size

PURPOSE: This study was conducted to develop a nursing leadership program outcome evaluation system, required for accreditation of nursing education. METHODS: A methodological design was used. To ensure the theoretical validity of the evaluation system, learning objectives for nursing education programs and job descriptions for nurses in Korea were verified by analyzing the relationships in the five attributes of the nursing leadership concept. The nursing leadership program outcome evaluation system was developed based on the Kim & Park's developmental model (2008). RESULTS: The nursing leadership program outcome evaluation system was established, including implementation level, education curriculum, level of performance, evaluation method, rubrics, and Close-the-Loop. CONCLUSION: The developed evaluation system can be actively used in nursing education, and contribute to enhancing the leadership competencies of nursing students and graduate nurses.
Accreditation ; Curriculum ; Education ; Education, Nursing ; Humans ; Job Description ; Korea ; Leadership* ; Learning ; Methods ; Nursing* ; Students, Nursing

BACKGROUND: The hemodynamic responses to endotracheal intubation are associated with sympathoadrenal activity. Polymorphisms in the beta1-adrenergic receptor (beta1AR) gene can alter the pathophysiology of specific diseases. The aim of this study is to investigate whether the Ser49Gly and Arg389Gly polymorphism of the beta1AR gene have different cardiovascular responses during endotracheal intubation under sevoflurane anesthesia. METHODS: Ninety-one healthy patients undergoing general anesthesia were enrolled. Patients underwent slow inhalation induction of anesthesia using sevoflurane in 100% oxygen. Vecuronium 0.15 mg/kg was given for muscle relaxation. Endotracheal intubation was performed by an anesthesiologist. The mean arterial pressure (MAP), heart rate (HR), and the corrected QT (QTc) interval were measured before induction, before laryngoscopy, and immediately after tracheal intubation. Genomic DNA was isolated from the patients' peripheral blood and then evaluated for the beta1AR-49 and beta1AR-389 genes using an allele-specific polymerase chain reaction method. RESULTS: No differences were found in the baseline values of MAP, HR, and the QTc interval among beta1AR-49 and beta1AR-389, respectively. In the case of beta1AR-49, the QTc interval change immediately after tracheal intubation was significantly greater in Ser/Ser genotypes than in Ser/Gly genotypes. No differences were observed immediately after tracheal intubation in MAP and HR for beta1AR-49 and beta1AR-389. CONCLUSIONS: We found an association between the Ser49 homozygote gene of beta1AR-49 polymorphism and increased QTc prolongation during endotracheal intubation with sevoflurane anesthesia. Thus, beta1AR-49 polymorphism may be useful in predicting the risk of arrhythmia during endotracheal intubation in patients with long QT syndrome.
Anesthesia ; Anesthesia, General ; Arrhythmias, Cardiac ; Arterial Pressure ; DNA ; Genotype ; Heart Rate ; Hemodynamics ; Homozygote ; Humans ; Inhalation ; Intubation ; Intubation, Intratracheal ; Laryngoscopy ; Long QT Syndrome ; Methyl Ethers ; Muscle Relaxation ; Oxygen ; Polymerase Chain Reaction ; Vecuronium Bromide

PURPOSE: The purpose of this study was to provide a concept analysis of nursing leadership. METHODS: The concept analysis process of Walker and Avant (2011) was used. A review of the literature was conducted using several databases, including PubMed, CINAHL, Ovid-Medline, DBpia, and KISS. The databases were searched using the following terms 'nursing leadership', 'nursing' & 'leadership', and 'nurse & 'leadership', and for studies published from January 2000 to March 2015. Strict inclusion and exclusion criteria were applied. RESULTS: Analysis of these studies indicated nursing leadership attributes were individual growth, collaboration, nursing excellence, creative problem solving, and influence. The antecedents of nursing leadership were the individual maturity level, construction of mutual trust and confidential relationships, and a job requirement. The consequences were improvement in nursing productivity, development of a supportive work environment, and satisfaction with the nursing profession. CONCLUSION: The findings in this study provide a definite concept of nursing leadership. The findings also provide the theoretical evidence for the development of nursing leadership competencies in nursing students and professional nurses.
Cooperative Behavior ; Efficiency ; Humans ; Leadership* ; Nursing* ; Problem Solving ; Students, Nursing ; Walkers

Spontaneous thrombosis of the subclavian vein, termed "effort thrombosis" or the Paget-Schroetter Syndrome, has long been considered a primary thrombotic process, but recent experience suggests that it may commonly result from repeated mechanical compression. This syndrome is unusual and is frequently considered inconsequential compared with thrombosis of the iliac or femoral vein. However, pulmonary embolism has been documented in up to 15% of patients with subclavian thrombosis. Many patients with this disorder are offlicted by disabling symptoms of upper extremity venous congestion. It is now recognized that the morbidity of this condition is significant and its traditional treatment needs serious reconsideration. Presumed to be a primary thrombotic disorder, its treatment has traditionally consisted of arm elevation and anticoagulation. Increased awareness of the pathophysiology of this symdrome can allow timely, improved diagnostic screening and use of specific surgical intervention to relieve the venous consequences. During the 44 months we have treated 5 patients with the thrombosis of subclavian vein. There were two men and three women with an average of 50 years(range from 40~61 years). And all patients presented with pain, swelling, and cyanosis of the upper extremity. Venous congestion worsened especially with abduction of the arm. Three of five patients were originally treated with arm elevation and anticoagulation; two also underwent surgical intervention.
Arm ; Cyanosis ; Female ; Femoral Vein ; Humans ; Hyperemia ; Male ; Mass Screening ; Pulmonary Embolism ; Subclavian Vein ; Thrombosis ; Upper Extremity ; Upper Extremity Deep Vein Thrombosis

PURPOSE: In Korea, the entire population must enroll in the national health insurance system, and those who are classified as having a lower socioeconomic status are supported by the medical aid system. The aim of this study was to evaluate the association of the medical insurance status of gastric cancer patients with their survival after gastrectomy. MATERIALS AND METHODS: A total of 247 patients who underwent surgical treatment for gastric cancer between January 1999 and December 2010 at the Seoul Medical Center were evaluated. Based on their medical insurance status, the patients were classified into two groups: the national health insurance registered group (n=183), and the medical aid covered group (n=64). The survival rates were calculated using the Kaplan-Meier method. RESULTS: The median postoperative duration of hospitalization was longer in the medical aid covered group and postoperative morbidity and mortality were higher in the medical aid group than in the national health insurance registered group (P<0.05). The overall 5-year survival rate was 43.9% in the medical aid covered group and 64.3% in the national health insurance registered group (P=0.001). CONCLUSIONS: The medical insurance status reflects the socioeconomic status of a patient and can influence the overall survival of gastric cancer patients. A more sophisticated analysis of the difference in the survival time between gastric cancer patients based on their socioeconomic status is necessary.
Gastrectomy* ; Hospitalization ; Humans ; Insurance Coverage* ; Insurance* ; Insurance, Health ; Korea ; Methods ; Mortality ; National Health Programs ; Seoul ; Social Class ; Stomach Neoplasms* ; Survival Rate

This case series study demonstrates the possibility of successful implant rehabilitation without bone augmentation in the atrophic posterior maxilla with cystic lesion in the sinus. Sinus lift without bone graft using the lateral approach was performed. In one patient, the cyst was aspirated and simultaneous implantation under local anesthesia was performed, whereas the other cyst was removed under general anesthesia, and the sinus membrane was elevated in a second process, followed by implantation. In both cases, tapered 11.5-mm-long implants were utilized. With all of the implants, good stability and appropriate bone height were achieved. The mean bone level gain was 5.73 mm; adequate bone augmentation around the implants was shown, the sinus floor was moved apically, and the cyst was no longer radiologically detected. Completion of all of the treatments required an average of 12.5 months. The present study showed that sufficient bone formation and stable implantation in a maxilla of insufficient bone volume are possible through sinus lift without bone materials. The results serve to demonstrate, moreover, that surgical treatment of mucous retention cyst can facilitate rehabilitation. These techniques can reduce the risk of complications related to bone grafts, save money, and successfully treat antral cyst.
Anesthesia, General ; Anesthesia, Local ; Dental Implants ; Humans ; Maxilla ; Maxillary Sinus* ; Membranes* ; Osteogenesis ; Rehabilitation* ; Sinus Floor Augmentation ; Transplants

Diabetic neuropathy is one of the most common complications of diabetic mellitus and has myriad clinical presentations. Amitriptyline is an effective drug for painful diabetic neuropathy, but has a wide variety of cardiovascular effects. We report a case of amitriptyline-induced ventricular tachycardia in a patient with painful diabetic neuropathy. A 48-year-old man with no history of heart disease was treated with amitriptyline for the past 2 months. The dosage of this drug was gradually increased and the maximal dose was 170 mg per day. Prior to administration of this drug, his chest X-ray and electrocardiogram were normal. On admission he complained of chest discomfort and palpitation for 3 days, but his vital sign was stable. The electrocardiogram showed a wide QRS complex with a rate of 170 beats per minute. The ventricular tachycardia was successfully treated with electrical cardioversion.
Amitriptyline* ; Diabetic Neuropathies* ; Electric Countershock ; Electrocardiography ; Heart Diseases ; Humans ; Middle Aged ; Tachycardia, Ventricular* ; Thorax ; Vital Signs