Esophageal involvement by malignant lymphoma is extremely rare. A case of follicular lymphoma of the esophagus, misdiagnosed as focal lymphoid hyperplasia (pseudolymphoma) in a 72-year-old man is presented. The esophagogram revealed diffuse narrowing of the lumen in the middle and distal portion without ulceration. The resected esophagus showed mural thickening without any remarkable mucosal change. Microscopically, the esophagus showed scattered follicular lymphoid aggregates in the submucosa, extending into periadventitial fat tissue. Most follicles were devoid of germinal center and consisted of loosely aggregated small cleaved cells without atypia. The surrounding stroma of the submucosa showed dense fibrosis entrapping the infiltrating small lymphocytes in a "indian-file" appearance. There were some reactive follicles with germinal center. In the lamina propria, many plasma cells and a few eosinophils were infiltrated. The gene rearrangement study showed rearranged band for Jk probe which confirmed monoclonal B-cell nature of infiltrated small lymphoid cells. The small cleaved lymphocytes arranged in follicles were positive for L26 and bcl-2 protein. This case demonstrated the necessity of immunophenotypic and gene rearrangement study in the diagnosis of pseudolymphoma in the digestive tract.
Male ; Humans

PURPOSE: To analyze and compare the immunohistochemical distributions of HO-1 and HO-2 with the developmental process of retina, focusing on the time of birth and opening eyes because it is the time of the exposure to hyperoxia and light exposure. METHODS: The retina of 16-day-old embryo, 18-day-old embryo, 20-day-old embryo and postnatal rats at 0 day, 5 days, 10 days, 15 days, 20 days, 1 month, 2 months, 3 months were examined by hematoxylineeosin staining and immunohistochemistry of HO-1 and HO-2. RESULTS: Similar distribution of HO-1 and HO-2 from embryo to mature retina were observed. It was observed that HO-1 and HO-2 was contained in ganglion cell layer, inner plexiform layer, inner nuclear layer, outer plexiform layer and pigment layer of the mature retina. In the developmental process, reactivity was observed in the cell body of ganglion cells after 0 day of its birth. The reactivity was increased after 5 days of its birth, staining was observed in nerve cell and nerve fiber of ganglion cell layer, inner plexiform layer, inner segment of neuroblastic layer, pigment layer at this time. Reactivity of ganglion cell layer and pigment layer was increased intensively after 15 days of its birth and weak reactivity in some of horizontal cells and amacrine cells in inner plexiform layer was observed. The same distribution as that of mature retina was observed after 20 days of its birth. CONCLUSIONS: HO-1 and HO-2 expression was temporally and spatially correlated with the normal development of retina in rats. HO was concerned with the structure and function of retinal development by the activation of its products and with anti-oxidant mechanism on the time of birth and opening eyes.
Amacrine Cells ; Animals ; Embryonic Structures ; Ganglion Cysts ; Heme Oxygenase (Decyclizing)* ; Heme* ; Hyperoxia ; Immunohistochemistry ; Isoenzymes* ; Nerve Fibers ; Neurons ; Parturition ; Rats* ; Retina* ; Retinaldehyde

Airway obstruction following endotracheal intubation may be fraught with danger. Foreign bodies often become lodged in the airway as a result of trauma or rupture of lung lession. Somtiems they are revealed at the time of respiratory obstruction. Injury to individual mass lession is not seen so often. We experienced two cases of airway obstruction due to dislodging of foreign bodies. By exchanging obstructed endotracheal tube or removal of extracted teeth with aid of bronchoscope, the patency of the airway could secured. The aim of this case report is to emphasize that the insertion of an endotrahceal tube does not completely guarantee the patency of the airway.
Airway Obstruction ; Anesthesia* ; Bronchoscopes ; Foreign Bodies ; Intubation, Intratracheal ; Lung ; Rupture ; Tooth

Massive blood transfusion may be defined as the acute administration of blood more than one and a half times the patient's estimated blood volume. When stored whole blood is infused, complications such as coagulation defect, volume overload, acid base disturbance and pulmonary complications will develop. Massive transfusion has been associated with the development of adult respiratory distress syndrome(ARDS) in man, and both humoral factor and microemboli have been proposed as the injurious agent in the transfused blood. WE experiecned the patient who had suffered from acute respiratory failure after the transfusion of massive amount of whole blood and managed him effectively with ventilatory support with positive end expiratory pressure under the monitoring of cardiopulmonary function via the Swan-Ganz Catheter at ICU.
Adult ; Blood Transfusion* ; Blood Volume ; Catheters ; Humans ; Positive-Pressure Respiration ; Respiratory Insufficiency

PURPOSE: This study was aimed at exploring the current status of graduate programs for an advanced practice nurse(APN) to recommend future directions of APN education. METHODS: A total of 142 students enrolled in seven APN specialty programs, 67 professors who were involved in APN education, and nine nurse administrators participated in the study. Data was collected by questionnaires and focus group interviews. RESULTS: The current definition of APN was found not to be specific enough to represent expected roles of APN in regards to knowledge, attitudes, roles, and skills. Standard curricula employed regardless of the area of APN specialty, lack of qualified clinical practice settings, as well as prepared instructors were found to be problematic. CONCLUSION: The following needs to be addressed: 1. redefining of APN roles, 2. tailoring specialty areas of APN, 3. consolidating educational programs, and 4. ensuring APN role models and faculty. Suggesting a CNS role in Korean APN, areas of APN should be rearranged toclarify their roles and educational programs need to be further developed to meet the expectations and quality of APNs. It is necessary to ensure APN's employment in the health care system by laws and policies to perform advanced nursing roles.
Adult ; Curriculum ; Education, Nursing, Continuing ; Education, Nursing, Graduate ; Educational Measurement ; Focus Groups ; Humans ; Interviews as Topic ; Middle Aged ; Nurse Clinicians/*education ; Nurse Practitioners/*education ; Nursing Evaluation Research ; Questionnaires ; Societies, Nursing ; Specialties, Nursing/*education

PURPOSE: The purpose of this study was to develop a critical thinking disposition scale for nursing students. METHOD: The developmental process was construction of a conceptual framework, development of preliminary items, verification of content validity, development of secondary items, verification of construct validity and extraction of final items. The conceptual framework and first preliminary 60 items were obtained through a review of relevant literature and the development of critical disposition scales by 10 researchers who had been studying critical thinking for one year. These items were reviewed by five specialists for content validity and finally 55 items were chosen. The data was collected from October 1 to 15, 2004 and was analyzed using factor analysis and Cronbach's alpha with the SPSS program. The subjects were composed of 560 Bachelor of Science nursing students from 8 nursing schools. RESULT: There were 35 final items which were sorted into 8 factors. The factors were identified as 'intellectual integrity(6 items)', 'creativity(4 items)', 'challenge(6 items)', 'open-mindedness(3 items)', 'prudence(4 items)', 'objectivity(4 items)', 'truth seeking(3 items)' and 'inquisitiveness(5 items)'. The cumulative percent of variance was 55.107%. The reliability of the scale, Cronbach's alpha was .892 and the factors' ranged from .562-.836. CONCLUSION: The result of this study could be used for measuring critical thinking dispositions of nursing students. However, for further validity and reliability, repeated research is necessary.
Adult ; Data Collection ; Education, Nursing, Baccalaureate ; Factor Analysis, Statistical ; Female ; Humans ; *Judgment ; Male ; Research Design ; Students, Nursing/*psychology ; *Thinking

The incidence of postspinal headache is one of the well known complications of spinal anesthesia. Several factors such as needle size, bevel direction, multiple dural puncture and previous history of postspinal headache were thought to influence the incidence of postspinal headache. This studies were done to see the effect of needle size (22 and 25 gauge needle) and needle bevel direction (parallel, vertical, oblique insertion to the longitudinal dural fiber) on the incidence, duration, severity and location of spinal headache in the 548 patients underwent spinal anesthesia. The following results wre observed: 1) Neither needle size nor needle bevel direction had effect on the incidence of severity, duration and location of postspinal headache. 2) The ineidence of headache was 8.8% (48 cases), 3) The onset of headache was 1~2 day (67%) and duration of headache was 4~5 day (85%) in postanesthetic day. 4) The severity of headache was mild and moderate in 77% cases. 5) In the half cases, headache was relieved by means of bed rest alone.
Anesthesia, Spinal ; Bed Rest ; Headache* ; Humans ; Incidence ; Needles* ; Punctures

BACKGROUND: High dose of aprotinin has been known to reduce the requirement for homologous transfusion and the loss of blood during cardiac operation. The aim of this study was to investigate an effective minimal dose of aprotinin. METHODS: With IRB approval 61 patients undergoing cardiac operation were divided into four groups. Group I was control (n=15). Group II(high dose aprotinin, n=16) received an infusion of 24,000 KIU/kg of aprotinin followed by continous infusion of 6,000 KIU/kg per hour until the end of operation. A bolus of 24,000 KIU/kg was added to pump prime solution. Group III(low dose aprotinin, n=16) received a bolus of 24,000 KIU/kg to prime solution. Group IV(minimal dose aprotinin, n=14) received a bolus of 12,000 KIU/kg to prime solution. Coagulation profiles were analysed and blood loss through chest tubes & amount of homologous transfusion was measured. Statistical analysis was performed using one-way variance analysis. RESULTS: Group II demonstrated less amount of blood loss than group I with statistical significance. Blood loss in group III was reduced about 20% but the reduction was not statistically significant. Group IV could not reduce the blood loss. CONCLUSION: This study shows the efficacy of high and low dose(not statistically significant) aprotinin infusion during cardiac surgery in postoperative blood loss. Use of aprotinin less than low dose regimen may not be effective in reducing the blood loss and amount of homologous transfusion in cardiac operation.
Aprotinin* ; Chest Tubes ; Ethics Committees, Research ; Heart* ; Humans ; Postoperative Hemorrhage ; Thoracic Surgery*

PURPOSE: Parkinson's disease (PD) is a common neurodegenerative disorder characterized by motor disabilities and increasing dependence on others for daily life activities with consequent impact on patients' and caregivers' quality of life. The aim of this study was to elucidate the burden on primary caregivers of patients with PD, and identify related factors. METHODS: A cross-sectional descriptive study. Seventy-six primary caregivers of PD patients in a neurology outpatient clinic, Seoul, Korea completed structured questionnaires, of which 68 were analyzed. The structured self-report questionnaire included (1) demographic information on the caregivers, (2) information regarding the disease characteristics of the patients, and (3) the subjective and objective caregiver burdens as assessed on Montgomery, Gonyea, & Hooyman's scale. RESULTS: The mean age of the caregivers was 54.56 years, and spouses represented the largest proportion(47.0%). Caregivers of PD patients experienced high levels of burden (mean scores on the subjective and objective burdens were 45.22 and 34.90, respectively), which were comparable to the caregiver burdens in stroke, and higher than the caregiver burdens in general chronic disease. Older caregivers and spousal caregivers experienced significantly higher burdens (p=.004 and p=.019, respectively). A greater motor disability and higher modified Hoehn and Yahr grade were related to higher caregiver burden (p=.001 and p=.018, respectively). CONCLUSION: Caring for PD patients is associated with a high level of caregiver burden. Therefore, healthcare professionals should identify the burden of caregivers who look after PD patients and develop comprehensive management strategies both for patients and their caregivers.
Adult ; Aged ; *Caregivers/psychology ; *Cost of Illness ; Cross-Sectional Studies ; Female ; Humans ; Korea ; Male ; Middle Aged ; *Parkinson Disease ; *Quality of Life

PURPOSE: The purpose of this study was to identify the trends in research studies published in Journal of Korean Academy of Fundamentals of Nursing from 2009 to 2011. METHODS: A total of 156 studies published between 2009 and 2011 were reviewed using analysis criteria developed by the researchers. RESULTS: Quantitative studies accounted for 90.4% and qualitative studies, 8.3%. The research designs for the quantitative studies were experimental, 28.0% and survey, 63.8%. IRB approval was received for only 25.6% of the studies and 61.0% of studies presented participant criteria. Questionnaires were used for data collection in 90.8% of studies. Individual or group education was the most frequent intervention in the experimental studies. CONCLUSION: The results indicate that more randomized controlled trials with a low risk of bias are needed to support greater evidence-based nursing practice. Considering the low rate of ethical consideration, it is important that stricter application of research methods needs to be encouraged to improve the quality of Journal of Korean Academy of Fundamentals of Nursing.
Bias (Epidemiology) ; Surveys and Questionnaires ; Ethics Committees, Research ; Evidence-Based Nursing ; Nursing Research ; Research Design