Chromophobe cell renal carcinoma is an uncommon variety of renal cell carcinoma first described in humans in 1985 by Thoenes and his colleagues. It is a distinct type of renal cancer presumably derived from the intercalated cells of the collecting duct system and exhibiting a better prognosis than other types of renal cell carcinoma. This type of renal cell carcinoma has not been reported in Korean literature. We experienced three cases of chromophobe cell renal carcinoma from surgical pathology files of Dong-A medical center. The patients were a 65-year-old female, a 54-year-old female, and a 50-year-old male who had 8.2x6 cm, 4x2.5 cm and 4.3x3.2 cm sized, yellowish gray, beige to tan colored masses in the kidneys, respectively. Microscopically, the tumor cells were arranged in sheets or nests with delicate intervening vasculature. The cells were voluminous, uniform in appearance and contained finely reticulated cytoplasms delineated by prominent cell borders. With Hale's iron colloid staining the cytoplasm showed positive reaction; with PAS staining the result was negative. Immunohistochemically, the tumor cells showed positive reaction for cytokeratin but negative for vimentin. Electron microscopy showed numerous small, round to oval cytoplasmic vesicles, 150-300nm in size. All the patients received only radical nephrectomy and survived without evidence of recurrence or metastasis during follow-up intervals ranging from 4 months to 5 years.
Female ; Male ; Humans ; Neoplasm Metastasis

The purpose of this study was to identify the effects of breathing biofeedback training on the stress of nursing students in clinical practice. The research design was a nonequivalent control group pretest-posttest design. The subjects of this study were 39 nursing students from the College of Nursing of K University. The study was conducted from July 20 to September 3, 1998. The subjects were assigned to one of two groups : the experimental group (19 students), and the control group (20 students). The breathing biofeedback training was performed 12 times with the experimental group. The level of psychological stress was measured using the State Anxiety Inventory, Profile of Mood State, and Visual Analogue Stress Scale. The level of physiological stress was measured using pulse rate and blood pressure. The data were analyzed using descriptive statistics, x2-test, t-test, and repeated measures of ANOVA. The results of study are as follows : 1) State anxiety scores were not significantly different between the experimental group and the control group after the biofeedback training. 2) Profile of mood state scores were not significantly different between the experimental group and the control group after the biofeedback training. 3) Visual Analogue Stress Scale scores were significantly different between the experimental group and the control group after the biofeedback training(F=11.68, p=0.002). 4) Pulse rates were not significantly different between the experimental group and the control group after the biofeedback training. 5) Systolic blood pressures were significantly different between the experimental group and the control group after the biofeedback training(F=5.44, p=0.025). 6) Diastolic blood pressures were not significantly different between the experimental group and the control group after the biofeedback training. On the basis of the above findings, the following recommendations for further study are made ; 1) Identification of the effects of breathing biofeedback training at times of high stress during clinical practice. 2) Identification of the effects of stress reduction according to the frequency of the breathing biofeedback training.
Anxiety ; Biofeedback, Psychology* ; Blood Pressure ; Heart Rate ; Humans ; Nursing* ; Research Design ; Respiration* ; Stress, Physiological ; Stress, Psychological ; Students, Nursing*

No abstract available.
Anencephaly* ; Humans

Patients with chronic renal failure, generally, sufferred from normocytic normochromic anemia caused by decreased level of erythropoietin. But, secondary erythrocytosis has been reported in patients with several renal diseases; renal artery stenosis or throm- bosis, polycystic kidney disease, bilateral hydronephrosis, etc. We report one case of chronic renal failure combined with polycythemia vera. The case was 32 year-old man whose chief complaints were dyspnea, back pain, itching sensation, headache. 6 month ago, the laboratory examination showed only proteinuria and hematuria without deterioration of renal function. The renal function was aggravated with an accelerated course, and bone marrow examination revealed hypercellularity (erythroid predominance), and renal biopsy showed the finding of the end stage of renal disease which may be originated from IgA nephropathy.
Adult ; Anemia ; Back Pain ; Biopsy ; Bone Marrow Examination ; Dyspnea ; Erythropoietin ; Glomerulonephritis, IGA* ; Headache ; Hematuria ; Humans ; Hydronephrosis ; Immunoglobulin A* ; Kidney Failure, Chronic* ; Polycystic Kidney Diseases ; Polycythemia Vera* ; Polycythemia* ; Proteinuria ; Pruritus ; Renal Artery Obstruction ; Sensation

No abstract available.
Methemoglobinemia*

Familial benign chronic pemphigua is a rare disease characterized by a localized recurrent eruption of grouped vesicles and exudative lesions involving the neck, groin, axillae and intertriginous areas. There are no systemic manifestations but chronicity and pruritic lesions creates a significant social and psychological handicap to those afflicted. We presented a case of familial benign chronic pemphigus in a 39 years old man He has had recurrent vesicles, fissures and crust formation in inguinal area for 10 years. Light microscopic findings showed suprabasal vesiculation with acantholysis and villi formation. And electron-microscopic findings showed as follows: Bizzare microvilli changes with widened intercellular spaces, followed by loss of desmosome and complete acantholysis. Tonofilament-desmosome complex is disrupted. Many of acantholytic cells are associated with abnormal keratinization which is repreaented by perinuclear thickened bundles of tonofilament arranged in whorls or lumps. Authors diagnosed with clinical symptoms, light and electron-microscopic findings as Hailey-Hailey disease. The lesions were improved by systemic antibiotics and steroid with cold soaking.
Acantholysis ; Adult ; Anti-Bacterial Agents ; Axilla ; Desmosomes ; Extracellular Space ; Groin ; Humans ; Intermediate Filaments ; Microvilli ; Neck ; Pemphigus, Benign Familial* ; Rare Diseases

PURPOSE: The replacement of functional genes into cells that lack genes or mutant genes is the basis of gene therapy. In cancer, where cells often have multiple genetic defects, the replacement of critical genes may suffice to suppress cell growth or induce cell death. In malignant brain tumors, p53 mutation are among the most frequently observed genetic findings and inactivation p53 suggests that p53 plays a critical role in carcinogenesis and tumor progression. Therefore, we study the successful transfer of the wild-type p53 gene using a replicative deficient adenovirus vector into human glioma and medulloblastoma c~ell lines. Meterials and Methods: The human glioma cell line T-98G, U-87MG, U-373MG were used. To determine the efficiency of the adenovirus vector, cell lines were transfected with the Ad-p gal and analysed with X-Gal staining. Cell viability was determined by trypan blue exclusion every day after infection and Westem blot analysis was used to conform the expression of the exogenous p53 protein. RESULTS: Cell growth of the Ad-CMV-p53 infected U-373MG, and U-87MG was significantly suppressed. It appeared that exogenous p53 protein expression had an earlier ad more profound suppressive effect on U-373MG having a mutated p53 gene than on U-87MG having a wild-type p53. The expression of the exogenous p53 was more than 10 times higher than the expression of the endogenous p53. To examine the decreased viability, U-373MG was stained with Hochest 33258 and detected nuclear condensation and apoptic body. Staining results suggest that cells undergo apoptosis. CONCLUSION: The replicative deficient adenoviral vector can transfer and express p53 in human glioma cell lines in vitro, restoring wild-type p53 tumor suppressor functions. The restoration of normal p53-encoded protein in the mutant ceil lines induced cell death. The high expression of the newly transduced protein had different effects on the growth rate of the infected cell lines depending on the p53 status of the cells.
Adenoviridae* ; Apoptosis ; Brain Neoplasms ; Carcinogenesis ; Cell Death ; Cell Line* ; Cell Survival ; Genes, p53 ; Genetic Therapy ; Glioma* ; Humans ; Medulloblastoma ; Trypan Blue

PURPOSE: The purpose of the study was to explore and describe hospice palliative nurses' experience of caring for terminal cancer patients. METHODS: Eleven hospice palliative nurses participated in the study. Data were collected through individual in-depth unstructured interviews with participants from November, 2012 to October, 2013. Theoretical sampling was used to the point of theoretical saturation. Data were analyzed using Corbin and Strauss' 'Grounded Theory Method.' RESULTS: From open coding, 25 sub-categories and 12 categories were identified. Analysis revealed that the core category was 'becoming stepping-stones between life and death enduring burdens', consisting of three phases: the phase of withdrawal, the phase of exertion, and the phase of maturity. Through this process, participants utilized various action/interactional strategies such as 'maintaining a distance', 'sharing intimate daily life', 'being a mediator for a peaceful death', 'grieving and remembering'. The consequences of these strategies were a transcendental perspective towards life and ambivalent feelings toward hospice nursing. CONCLUSION: In-depth understanding of the hospice palliative nurses' experience of caring for terminal cancer patients will guide nurse managers and policy makers to promote effective nursing strategies to better support hospice palliative nurses.
Administrative Personnel ; Clinical Coding ; Hospice and Palliative Care Nursing ; Hospices* ; Humans ; Nurse Administrators ; Nursing ; Patient Care ; Qualitative Research ; Terminal Care

Background: Brain MRI may unexpectedly display abnormalities in splenium of the corpus callosum (SCC). However, the clinical implications of this lesion are unclear and are not always consistent with ischemic infarctions. We performed this study to clarify the clinical and radiological implications in patients with SCC lesions. Methods: We retrospectively reviewed consecutive patients with MRIreported SCC changes between 2009 and 2012. We analyzed clinical and radiological findings, etiologies, cognitive impairment, and clinical outcomes. Results: We found 30 patients (16 females; mean 50.5 years) who had SCC lesions on MRI. Confusion was the most common clinical finding in 50% of cases. Cerebral infarction was the most common etiology (50%). The most consistent SCC changes on MRI were low signal in T1WI, high signal on T2WI and FLAIR, and high signal on DWI. We classified SCC lesions into in situ SCC lesions (SCC only) and multiple (SCC plus) lesions for patients with multiple lesions. The clinical symptoms of SCC only lesions were relatively mild. Cognitive functions were evaluated by Mini Mental State Examination (MMSE) and clinical dementia rating (CDR) scale at the time of discharge and patients with SCC only lesions showed less impaired cognition compared with those with SCC plus lesions. Clinical outcomes were evaluated by the modified Rankin scale at 1 month and patients with SCC only lesions revealed good clinical outcomes compared with those with SCC plus lesions. Conclusions: MRI-reported SCC lesions may have heterogeneous etiologies and present with various symptoms. The clinical course and outcome are relatively good, particularly in small isolated and oval shaped SCC lesions.

Background & Objective: Hiccups is a disabling condition of lateral medullary infarction (LMI). Unlike other symptoms of LMI, the anatomical lesions of hiccups are not well known. Few studies have evaluated the relationship between the lesional location of LMI and hiccups. We performed this study to correlate hiccups and magnetic resonance imaging (MRI)-based lesional location in pure LMI. Methods: Between January 1997 and February 2013, we identified 24 patients with pure LMI who presented with hiccups in addition to typical lateral medullary syndrome. Sixty six pure LMI patients without hiccups were included as a control group. Clinical and radiologic findings were compared between the two groups. MRI-identified lesions were classified rostrocaudally as rostral, middle and caudal, and horizontally as typical, ventral, large, lateral and dorsal. Results: The pure LMI patients with hiccups had significantly more frequent aspiration pneumonia (P = 0.001) and longer hospital stay (P = 0.03). The patients with hiccups significantly more often had dorsal rather than ventral lesion at horizontal levels (P = 0.012). But, there were no rostro-caudal differences at vertical levels (P = 0.162). Conclusions: We suggest that pure LMI associated with hiccups often locates in the dorsal medulla at horizontal correlation. This MRI-based comparative study has advanced the understanding of the neural substrate for hiccups in LMI, and indicates that hiccups become predictable when specific lesional locations in the lateral medulla are considered.