A thymoma often occurs in patients with myasthenia gravis, but the development of multiple thymoma is very rare. The authors report the radiologic and pathologic findings of multiple invasive thymoma in a 59-year-old male with myasthenia gravis.
Humans ; Male ; Middle Aged ; Myasthenia Gravis* ; Thymoma*

PURPOSE: The prognosis of non-Hodgkins lymphoma (NHL) in elderly patients seems to be poorer than that in patients aged less than 60 years. This may be due to the lower tolerance for combination chemotherapy in the elderly. Aggressive combination chemo-therapy, which is the treatment of choice in intermediate and high grade NHL of adulthood, may be associated with unpredictab1y severe and lethal toxicity and worsened quality of life in the elderly. We investigated the treatment responses, toxicities and prognostic factors of NHL in elderly patients treated with combination chemotherapy. MATERIALS AND METHODS: We treated 116 elderly (>60 yrs) patients with NHL between January 1986 and June 1996 with adriamycin-containing regimens, such as CHOP (cyclo- phosphamide, adriamycin, vincristine, prednisolone), BACOP (bleomycin, adriamycin, cyclophosphamide, vincristine, prednisolone), and mBACOP (methotrexate, bleomycin, adriamycin, cyclophosphamide, vincristine, prednisolone). Patients in this study ranged from 60 to 81 (median 67) years of age. Fifty-five percent of patients were in stage I or II and the rest (45%) were in stage III or IV. The histologic grade was predominantly (91%) of intermediate and high grade type. RESULTS: The treatment responses were complete (CR) in 55% and partial (PR) in 25%. The median durstion of CR was 32 (3-132) months. The CR rate was significantly higher in patients treated with RDI (relative dose intensity) > 75% than that in the patients treated with RDI < 75% (p 0.003), but there was no significant difference in CR rate between treatment regimens (p-0.38). At a median follow up of 48-months (range, 12 to 132 months), the estimated 5-year ovetall survival was 46%. Ann Arbor Stage (I, II vs III, IV), ECOG performance (0-1 vs 2-3), RDI (>75% vs <75%) and the treatment response were important prognostic factors in the univariate analysis, and the treament response (CR vs non-CR) was the only independent prognostic parameter in the multivariate analysis. The most frequent and severe toxicity associated with chemotherapy was infection with or without neutropenia. The rate of severe infection was significantly decreased in the patients supported with G/GM-CSF but not in the dose-reduction group (RDI<75% vs >75%). CONCLUSION: Our data suggests that achievement of the CR after combination chemotherpy is the most important prognostic factor in the elderly patients with NHL. Suboptimal chemotherapy (RDI<75%) reduced the complete remission rate without reducing the likelihood of developing severe toxicities. Optimal chemotherapy with supportive cares involving the use of hematopoietic growth factors may be needed to improve the treatment response and the survival in the elderly patients with aggressive NHL.
Aged ; Bleomycin ; Cyclophosphamide ; Dimethoate ; Doxorubicin ; Drug Therapy ; Drug Therapy, Combination ; Follow-Up Studies ; Hodgkin Disease* ; Humans ; Intercellular Signaling Peptides and Proteins ; Lymphoma, Non-Hodgkin ; Multivariate Analysis ; Neutropenia ; Prognosis* ; Quality of Life ; Vincristine

BACKGROUND: Hepatitis B vaccination schedule commonly used in Korea is divided largely into 0, 1, 2 month scheduled vaccination group(0, 1, 2 group) and 0, 1, 6 month scheduled vaccination gorup(0, 1, 6 group). The only difference bet.ween two groups is the interval from 2nd dose to 3rd dose. This st,udy had been carried out, to find whether t.he difference of vaccination interval influence the vaccination complet,ion rate or not. METHODS: Study objects are 135 persons over 20 years old who had heptitis B vaccination more than once in injection room of Dongkuk University Kyong-ju Hospital from Jan. 1st in 1996 to Dec. 31th in 1996. Data about vaccination completion were gathered from record book of injection room and telephone interview. RESULTS: Hepatitis B vaccination completion rate is 73.8% in 0, 1, 2 group and 72.5% in 0, 1, 6 group. The reasons for incomplete vaccination are forgetting vaccinat.ion date(36.4% in 0, 1, 2 group and 50% in 0, 1, 6 group), having no time to spare for vaccination(54.5% in 0, 1, 2 group and 43% in 0, 1, 6 group) and knowing positive HBsAb before completion of scheduled vaccination(9.1% in 0, 1, 2 group and 7% in 0, 1, 6 group). CONCLUSIONS: There is no difference in Hepatitis B vaccination complet,ion rate bet.ween 0, 1, 2 group and 0, 1, 6 group.
Appointments and Schedules ; Gyeongsangbuk-do ; Hepatitis B* ; Hepatitis* ; Humans ; Interviews as Topic ; Korea ; Vaccination* ; Young Adult

Purpose: This study examined the impact of a drinking reduction program on drinking motivation, drinking refusal self-efficacy, and problematic drinking behaviors in college students with problematic drinking habits. Methods: This study incorporated a non-equivalent control group prepost-test design. Study participants included 58 college students who scored 12 or more in the AUDIT-K test (Alcohol Use Disorders Identification Test-Korean version) (experimental group: 30; control group: 28). The intervention consisted of eight sessions and was conducted once a week.It was designed to promote autonomy, competence, and relatedness-the three elements of basic psychological needs in self-determination theory. The participants were assessed before the intervention, immediately after, and four weeks post intervention. Data were collected from October 12 to December 31, 2017. The analysis employed the chi-square test, Fisher’s exact test, independent t-test, and repeated measures ANOVA using SPSS/WIN 22.0. Results The mean age of participants was 21.8 years. There were 30 men (51.7%) and 28 women (48.3%). The differences in drinking motivation, drinking refusal self-efficacy, and problematic drinking behaviors were statistically significant for the group by time interaction (F = 42.56, p < .001; F = 54.96, p < .001; F = 39.90, p < .001, respectively). Conclusion: The findings indicate that the intervention effectively decreases drinking motivation, increases drinking refusal self-efficacy, and decreases problematic drinking behaviors. It can be an efficient strategy for college students with problematic drinking habits to enhance their self-determination ability.

Purpose: This study examined the impact of a drinking reduction program on drinking motivation, drinking refusal self-efficacy, and problematic drinking behaviors in college students with problematic drinking habits. Methods: This study incorporated a non-equivalent control group prepost-test design. Study participants included 58 college students who scored 12 or more in the AUDIT-K test (Alcohol Use Disorders Identification Test-Korean version) (experimental group: 30; control group: 28). The intervention consisted of eight sessions and was conducted once a week.It was designed to promote autonomy, competence, and relatedness-the three elements of basic psychological needs in self-determination theory. The participants were assessed before the intervention, immediately after, and four weeks post intervention. Data were collected from October 12 to December 31, 2017. The analysis employed the chi-square test, Fisher’s exact test, independent t-test, and repeated measures ANOVA using SPSS/WIN 22.0. Results The mean age of participants was 21.8 years. There were 30 men (51.7%) and 28 women (48.3%). The differences in drinking motivation, drinking refusal self-efficacy, and problematic drinking behaviors were statistically significant for the group by time interaction (F = 42.56, p < .001; F = 54.96, p < .001; F = 39.90, p < .001, respectively). Conclusion: The findings indicate that the intervention effectively decreases drinking motivation, increases drinking refusal self-efficacy, and decreases problematic drinking behaviors. It can be an efficient strategy for college students with problematic drinking habits to enhance their self-determination ability.

Purpose: The purpose of this study was to develop nurses’ core competencies and sub-competencies and to verify the validity and importance-performance of core competencies. Methods: The core competencies of nurses were derived through an analysis of strengths, weaknesses, opportunities, and threats, as well as a literature analysis of domestic and foreign accreditation institutions. Validity and importance-performance analyses were conducted on the core competencies derived from nursing colleges nationwide. Results: Six core competencies of nurses were revealed: integration of knowledge and nursing skills, critical thinking, communication, leadership, safety management, and global competency. Further, eighteen sub-competencies were derived. The content validity ratio values for the core competencies were higher than 0.74. Communication skills among multidisciplinary teams and communication skills among nursing teams were shown to be the most important competencies to be improved. Conclusion The results of this study are meaningful in terms of how the core competencies of nurses were derived and evaluated for the fourth cycle of nursing education accreditation according to the changes of time and culture.

BACKGROUND: Pediatric cardiopulmonary bypass (CPB) often results in increased capillary permeability and accumulation of excess total body water, which can lead to multiple organ dysfunctions. Recently, modified ultrafiltration (MUF) has been used during pediatric cardiac surgery to limit various deleterious effects of CPB. We investigated the effects of MUF on lung compliance and gas exchange in pediatric open heart operations. METHODS: Fifteen pediatric open heart surgery patients were evaluated. Lung compliance (dynamic compliance), arterial oxygen tension (PaO2), arterial to end-tidal carbon dioxide tension difference (Pa-ETCO2), systolic blood pressure (SBP), heart rate, and hematocrit (Hct) were measured. Measurements were made after induction of anesthesia, after CPB, after MUF and after sternal closure. RESULTS: Lung compliance, PaO2, SBP and Hct increased significantly after MUF compared to after CPB. After sternal closure, lung compliance decreased significantly from the value following MUF. PaO2, SBP, Hct decreased significantly after CPB compared to the values obtained after induction of anesthesia. Pa-ETCO2 and heart rate did not change significantly. CONCLUSIONS: Modified ultrafiltration increases lung compliance, PaO2, SBP and Hct. MUF is an excellent option for improving cardiopulmonary function immediately following pediatric cardiopulmonary bypass.
Anesthesia ; Blood Pressure ; Body Water ; Capillary Permeability ; Carbon Dioxide ; Cardiopulmonary Bypass ; Heart ; Heart Rate ; Hematocrit ; Humans ; Lung Compliance* ; Lung* ; Oxygen ; Thoracic Surgery* ; Ultrafiltration*

PURPOSE: This study aimed to examine the development of socializing and emotional expressions through vocalizations and joint attention (JA) behaviors in Korean-speaking children with autism spectrum disorder (ASD), compared to those with developmental delay (DD). MATERIALS AND METHODS: Video samples were collected from 28 toddlers with ASD and 18 age-matched toddlers with DD, and vocalizations were each coded in detail for the purpose of this retrospective research. In addition to some statistical analysis, Computerized Language Analysis was conducted to obtain the final results. RESULTS: Although they produced a higher number of vocalizations than the DD group, the ASD group did not engage in emotional or social interactions with their caretakers, whereas the DD group did. The children with ASD used more atypical vocalizations and socially unengaged vocalizations than the children with DD did. JA using vocalizations in the ASD group, in particular, was largely dyadic, with triadic types occurring at a significantly lower frequency than those in the DD group. CONCLUSION: Results from this study indicate the importance of assessing early vocalizations in toddlers with ASD, suggesting that some common symptoms of ASD, such as lack of typical, emotional, and social functions in early vocalizations, could be used to develop screening and intervention programs related to ASD.
Autism Spectrum Disorder* ; Autistic Disorder* ; Child ; Child Behavior ; Communication Disorders ; Developmental Disabilities ; Humans ; Interpersonal Relations ; Joints ; Mass Screening ; Mother-Child Relations ; Retrospective Studies

Intralobular fibrogenesis of the liver following hepatocellular damage has long been a controversial subject in regard to its initiation and prevention. To investigate the site of hepatic fibrogenesis and the effect of glucocorticoids during the early stage of hepatic fibrogenesis, dexamethasone was administered in a daily dose of 8 mg/rat following a sing1e dose of CCl4 to induce hepatic necrosis with or without combination of vitamin A to Stimulate lipocytes. Light and electron microscopic examinations of the liver at 2, 4, 6, 8 and 10 days after CCl4, vitamin A and dexamethasone treatment demonstrated that hepatocellular damage stimulated perisinusoidal lipocytes which in turn actively produced collagens. Concomitant administration of vitamin A enhanced stimulation of lipocytic activity and consequently increased collagen formation, while administration of dexamethasone suppressed lipocytic activity leading to an inhibition of collagen formation.
Animal ; Carbon Tetrachloride/toxicity ; Dexamethasone/pharmacology* ; Histocytochemistry ; Liver/drug effects ; Liver/pathology* ; Liver/ultrastructure ; Male ; Microscopy, Electron ; Necrosis ; Rats ; Vitamin A/pharmacology