This study presents the cytologic features of peritoneal washings, with particular emphasis on the cytologic discrimination among serous, mucinous, and endometrioid adenocarcinoma of the ovary. We selected histologically confirmed 27 cases of peritoneal washing : 8 cases of serous cystadenocarcinomas, 5 cases of mucinous cystadenocarcinomas, and 14 cases of endometrioid adenocarcinomas. The most frequent cytologic pattern of three tumors was clusters. Ball pattern was found in serous cystadenocarcinoma(36%) and acinar pattern in endometrioid adenocarcinoma (36%). Mucinous adenocarcinoma showed mucoid background(100%) and endometrioid adenocarcinoma revealed inflammatory background(43%). The cytoplasmic vacuoles were noted in 80%, 13%, and 43% of mucinous, serous, and endometrioid adenocarcinoma, respectively. The endometrioid adenocarcinoma showed prominent nucleoli(64%). In conclusion, the cytologic findings of mucinous cystadenocarcinoma were different from that of serous and endometrioid carcinomas, such as mucoid background, abundant cytoplasm with vacuolated cytoplasm, and peripherally located cytoplasm. Although endometrioid carcinoma showed acinar pattern and prominent nucleoli, the differential diagnosis between serous cystadenocarcinoma and endometrioid adenocarcinoma in peritoneal washing cytology was not always possible.
Adenocarcinoma, Mucinous ; Carcinoma, Endometrioid* ; Cystadenocarcinoma, Mucinous ; Cystadenocarcinoma, Serous ; Cytoplasm ; Diagnosis, Differential* ; Discrimination (Psychology) ; Female ; Mucins* ; Ovary ; Vacuoles

Purpose: This study aimed to develop a nursing clinical judgment scale (NCJS) and verify its validity and reliability in assessing the clinical judgment of nurses. Methods: A preliminary instrument of the NCJS comprising 38 items was first developed from attributes and indicators derived from a literature review and an in-depth/focus interview with 12 clinical nurses. The preliminary tool was finalized after 7 experts conducted a content validity test based on a data from a preliminary survey of 30 hospital nurses in Korea. Data were collected from 443 ward, intensive care unit, emergency room nurses who voluntarily participated in the survey through offline and online for the verification of the construct validity and reliability of the scale. Results: The final scale comprised 23 items scored on a 5-point Likert scale. Six factors – integrated data analysis, evaluation and reflection on interventions, evidence on interventions, collaboration among health professionals, patient-centered nursing, and collaboration among nurse colleagues – accounted for 64.9% of the total variance. Confirmatory factor analysis supported the fit of the measurement model, comprising six factors (root mean square error of approximation = .07, standardized root mean square residual = .04, comparative fit index = .90). Cronbach’s α for all the items was .92. Conclusion The NCJS is a valid and reliable tool that fully reflects the characteristics of clinical practice, and it can be used effectively to evaluate the clinical judgment of Korean nurses. Future research should reflect the variables influencing clinical judgment and develop an action plan to improve it.

Purpose: The purpose of this study was to investigate the association between nurses’ positive psychological capital, self-leadership, relational bonds, and organizational commitment, and to identify factors influencing organizational commitment. Methods: The participants in this study were 199 nurses conveniently selected at one general hospital in Seoul. Data collection was conducted between January 1st and March 31st, 2019, and was analyzed using the SPSS/WIN 23.0 program. Results: The mean score for positive psychological capital was 3.31±0.44, for self-leadership, 3.44±0.40, for relational bonds, 3.54±0.79, and for organizational commitment, 3.81±0.76. Positive psychological capital (r=.40, p<.001), self-leadership (r=.33, p<.001) and relational bonds (r=.51, p<.001) showed significant correlation with organizational commitment. Stepwise multiple regression analysis showed that positive psychological capital and relational bonds were included in the factors affecting the organizational commitment of clinical nurses. These variables explained 29.0% of organizational commitment. Conclusion Findings indicate that it is necessary to build effective strategies to enhance positive psychological capital and relational bonds for nurses. Such strategies will result in improved organizational commitment.

BACKGROUND AND OBJECTIVES: Recurrent vestibulopathy is defined a disease characterized by more than a single episode of vertigo of duration characteristic of endolymphatic hydrops but without auditory or clinical neurological symptoms or signs. To investigate the clinical characteristics and the efficacy of combination therapy, we analyzed the clinical records of the patients diagnosed as recurrent vestibulopathy. MATERIALS AND METHOD: Clinical records of sixty four patients diagnosed as recurrent vestibulopathy were retrospectively reviewed. The data on age, sex distribution, natural history, family history of recurrent vestibulopathy, concurrent headache, caloric response was analyzed. The efficacy of combination therapy for vertigo control in the patients with a minimum 24-month follow-up was also evaluated. RESULTS: Mean onset age of recurrent vestibulopathy was 43 years and there was a female preponderance. Concurrent headache and elevated SP/AP ratio in electrocochleogram was frequently observed in these patients. After the combination medical therapy, patients with severe recurrent vestibulopathy showed significant decrease in the number of vertigo spells with 37.5% of complete control of vertigo. CONCLUSION: As a distinctive clinical disorder with unknown cause, recurrent vestibulopathy should be always considered to the patients complaining recurrent episodic vertigo. Combination therapy individualized to the symptoms and signs of the patients with recurrent vestibulopathy might be effective in reducing the frequency of vertigo attacks. Further case-control studies with large population should be necessary.
Age of Onset ; Case-Control Studies ; Endolymphatic Hydrops ; Female ; Follow-Up Studies ; Headache ; Humans ; Natural History ; Retrospective Studies ; Sex Distribution ; Vertigo ; Vestibular Neuronitis*

Familial juvenile polyposis is a rare intestinal polyposis characterized by the occurrence of multiple juvenile polyps in the gastrointestinal tract. We report a case of familial juvenile polyposis in a 17-year-old man with a review of the literature. This patient underwent total colectomy due to a 6 years history of rectal bleeding. Grossly, the colon showed 36 variable sized pedunculated polyps, measuring 2.5cm x 2cm from the largest size and 0.2cm x 0.2cm to the smallest size. Histologically, the polyps consisted of cystically dilated glands, lined by normal colonic epithelial cells, scattered in loose, edematous stroma containing inflammatory cell infiltration. There were no areas of tubular adenoma or malignancy in any of the polyp.
Adenoma ; Adolescent ; Colectomy ; Colon ; Epithelial Cells ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Intestinal Polyposis ; Polyps

Objective tinnitus originates from the para-auditory structures of the head and neck and can be heard or documented by examiner. Three representative forms of objective tinnitus, according to the causal organs are myoclonic tinnitus, vascular tinnitus and tinnitus caused by the patulous Eustachian tube. Etiologies, pathologic mechanisms, diagnostic approaches, and proper treatment methods of objective tinnitus are comprehensively discussed with a review of literatures. Objective tinnitus can be cured in many cases. Clinicians need to be well aware of the clinical characteristics of objective tinnitus since early, correct diagnosis with proper management are mandatory for its cure.
Diagnosis ; Eustachian Tube ; Head ; Neck ; Tinnitus*

The prevalence and related diseases of otitis media with effusion(OME) which is a very common disease in infants and young children were investigated in a group of 3 to 6 year old children. The study population includes 374 children with 185 boys and 189 girls enrolled in 7 kindergartens in Puchun city. The middle ear status was assessed by combination of findings of otomicroscope, pneumatic otoscope, impedence audiometry. The related diseases were evaluated by radiologic findings and questionnare with statistic analysis. Fifty-nine children were considered to have OME(prevalence: 15.8%) with peak at 3 years of age(30.6%). Of the 59 children with OME, fifty-four percent had bilateral involvement and all the remainder had unilateral involvement. The risk for otitis media with effusion increased in children with adenoid enlargement, tonsillar enlargement, and paranasal sinusitis, and this was confirmed to be statistically significant(p<0.01).
Adenoids ; Audiometry ; Child* ; Cross-Sectional Studies* ; Ear, Middle ; Female ; Gyeonggi-do* ; Humans ; Infant ; Otitis Media with Effusion* ; Otitis Media* ; Otitis* ; Otoscopes ; Prevalence* ; Sinusitis

BACKGROUND AND OBJECTIVES:Prevention of mucosal changes induced by experimental pneumococcal otitis media with antibiotics was reported in the previous studies. But the effects of combined therapy with antibiotics and steroid on middle ear mucosa in acute otitis media is not determined yet. The purpose of this study was to investigate the treatment effects of antibiotics and steroid on the middle ear mucosa of experimental acute otitis media. MATERIALS AND METHOD: The right middle ear of 27 rats was inoculated with log phase type 3 streptococcus pneumoniae, and the left ear served as control. Penicillin G was administered to 9 rats, penicillin G and dexamethasone were administered to 9 rats after bacterial challenge. The animals were killed at day 4, 7 or 14 after challenge. Tympanic membrane and middle ear mucosa were examined under the surgical microscope and light microscope. RESULTS: Untreated pneumococcal AOM has been shown to cause persistent structural changes of the middle ear mucosa. Both in antibiotics-treated group and in antibiotics and steroid-treated group, the structural changes were diminished, as compared with those of untreated infected controls. The antibiotics and steroid-treated group showed marked decrease of structural changes, especially in mucosal metaplasia to secretory epithelium. CONCLUSION: The results suggest that the combination treatment of antibiotics and steroid in acute otitis media would seem to be almost as effective in reducing treatment period and preventing the persistence of mucosal changes, which may decrease development of serous otitis media as a sequale of acute otitis media.
Animals ; Anti-Bacterial Agents* ; Dexamethasone ; Ear ; Ear, Middle* ; Epithelium ; Metaplasia ; Mucous Membrane* ; Otitis Media with Effusion ; Otitis Media* ; Otitis* ; Penicillin G ; Rats* ; Streptococcus pneumoniae ; Tympanic Membrane

No abstract available.

OBJECTIVES: Baso-apical gradients exist in various cochlear structures including medial olivocochlear (MOC) efferent system. This study investigated the cochlear regional differentials in the function and morphology of the MOC system, and addressed the functional implications of regional MOC efferent terminals (ETs) in the mouse cochlea. METHODS: In CBA/J mice, MOC reflex (MOCR) was assessed based on the distortion product otoacoustic emission in the absence and presence of contralateral acoustic stimulation. High, middle, and low frequencies were grouped according to a mouse place-frequency map. Cochlear whole mounts were immunostained for ETs with anti-α-synuclein and examined using confocal laser scanning microscopy. The diameters of ETs and the number of ETs per outer hair cell were measured from the z-stack images of the basal, middle and apical regions, respectively. RESULTS: The middle cochlear region expressed large, clustered MOC ETs with strong MOCR, the base expressed small, less clustered ETs with strong MOCR, and the apex expressed large, but less clustered ETs with weak MOCR. CONCLUSION: The mouse cochlea demonstrated regional differentials in the function and morphology of the MOC system. Strong MOCR along with superior MOC morphology in the middle region may contribute to ‘signal detection in noise,’ the primary efferent function, in the best hearing frequencies. Strong MOCR in spite of inferior MOC morphology in the base may reflect the importance of ‘protection from noise trauma’ in the high frequencies.
Acoustic Stimulation ; Animals ; Cochlea* ; Hair ; Hearing ; Mice* ; Microscopy, Confocal ; Noise ; Reflex