OBJECTIVE: The purpose of this study were to: (1) describe the individual characteristics, perceived health status, body image, and health promoting behaviors of staff nurses working in a metropolitan hospital and (2) determine the relationship of perceived health status, body image, and health promoting behaviors. METHODS: Data were collected from 311 staff nurses working at one of university affiliated hospitals using a self-administered questionnaire for perceived health status(SF 36 V2), body image(BAQ), and health promoting behaviors (HPLP-II) and using the report of year 2002 employee physical check-up results for health related characteristics. RESULTS: Most of nurses were within the normal range of BMI, total cholesterol, and liver enzymes but 42.2% had systolic BP above 120mmHg and 37.3% hemoglobin below 12g/dL. Although 96.4% of BMI score indicated 'underweight' or 'normal', 'feeling fat' showed the highest. Among health promoting behaviors the most frequently reported one was spiritual growth and the least one was engagement in physical activity. In the correlational analysis, health promoting behaviors had the positive relationships with perceived health status, vitality, mental health, attractiveness, strength and fitness (p=.000 - .004). CONCLUSION: These findings provide information that is relevant in designing interventions to enhance health promoting behaviors among nurses working in a hospital.
Body Image* ; Cholesterol ; Hospitals, Urban ; Liver ; Mental Health ; Motor Activity ; Reference Values ; Surveys and Questionnaires

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

Mural nodules in ovarian mucinous tumors, whether benign, borderline, or malignant, have been described by several authors since Prat and Scully first described sarcoma or sarcoma-like mural nodules occurring in association with mucinous epithelial neoplasia in 1979. Three distinct types of the mural nodule have been identified; i. e., 1) sarcoma-like lesion, 2) true mesenchymal sarcome, and 3) anaplastic carcinoma simulating a sarcoma. Mural nodules of sarcomatous and carcinomatous foci associated with mucinous ovarian tumors should be separated from sarcoma-like nodules because of the poor prognosis of the former compared to the favorable prognosis of the latter. We experienced a case of ovarian mucinous cystadenocarcinoma with sarcoma-appearing mural nodule of anaplastic carcinoma occurred in a 59-year-old woman and reported with brief review of the literatures.
Carcinoma* ; Cystadenocarcinoma, Mucinous* ; Female ; Humans ; Middle Aged ; Mucins* ; Ovary ; Prognosis ; Sarcoma

Angiomyofibroblastoma is a distinctive, hitherto uncharacterized, benign soft tissue tumor of the vulva with histology similar to an aggressive pelvic angiomyxoma. It can be distinguished from an aggressive angiomyxoma by its circumscribed borders, higher cellularity, more numerous blood vessels, the frequent presence of plump stromal cells, minimal stromal mucin, and rarity of erythrocyte extravasation. We experienced a case of angiomyofibroblastoma of the vulva occurring in a 45-year-old woman. The lesion was a well-defined but not encapsulated mass, 4.5x4.2 cm. Histologically the mass was characterized by alternating hypercellular and hypocellular edematous zones in which abundant blood vessels were irregularly distributed. Immunohistochemically, the spindled, plump spindled, and oval stromal cells were reactive for vimentin and desmin, but not for cytokeratin, or S-100 protein.
Female ; Humans

Primary extrapulmonary small cell carcinoma (EPSCC) of the appendix is an extremely rare entity, and there has been only one previous report on this in the English medical literature. We report here on the first Korean case of EPSCC of the appendix in a 55-year-old woman. The patient had no history of an identified pulmonary tumor, and she presented with constipation and lower abdominal pain. The patient underwent right hemicolectomy with regional lymph node dissection and bilateral salphigo-oophorectomy. The histology of the entire appendiceal tumor revealed pure EPSCC with diffuse immunoreactivity for pancytokeratin, cytokeratin 7, cytokeratin 20, CD56, thyroid transcription factor 1, c-kit and carcinoembryonic antigen, and there was focal weak immunoreactivity for chromogranin A and synaptophysin. After the second cycle of chemotherapy, the condition of the patient gradually deteriorated due to cancer peritonei and the patient died 7 months later. EPSCC of the appendix is a distinctive clinicopathological entity that displays highly aggressive behavior and an unfavorable outcome.
Abdominal Pain ; Appendix ; Carcinoembryonic Antigen ; Carcinoma, Small Cell ; Chromogranin A ; Constipation ; Female ; Humans ; Keratin-20 ; Keratin-7 ; Lymph Node Excision ; Middle Aged ; Nuclear Proteins ; Synaptophysin ; Thyroid Gland ; Transcription Factors

The purpose of this study was to develop a critical pathway for the patients following lumbar laminectomy. Development of this critical pathway was the fundamental phase to implement case management, which is a new health care delivery system. For this study, a preliminary critical pathway was developed first through a literature review and analysis of the medical records and seven critical pathways being used currently in Korea and the USA. In order to identify the health care services provided for the patients, who had lumbar laminectomiess and to draw up the conceptual framework, 30 medical records were analyzed from January, 1997 to December, 1997 at the Spinal Center in the Yonsei University Medical Center. The results of this study are as follows: 1. The vertical axis of the critical pathway included the following 7 items: test, assessment, treatment, activity, medication, diet, teaching and discharge planning; and the horizontal axis included the time frame from the pre-operative day to the third post-operative day. 2. Analysis of the 30 medical records indicated that the average length of stay was 13.7 days, including 4.8 days from admission to operation, and 8.9 days from operation to discharge. 3. According to the validity study using seven experts, 54 items, among the total of 86 items, reached over 86% agreement, while 32 items showed less than 86%. These 32 items were reviewed for deletion or modification before inclusion. A final critical pathway then was developed. On the basis of this research, it is anticipated that this critical pathway can be uesd in clinical situations to provide care for the patients following lumbar laminectomy in the most effective and efficient manner.
Academic Medical Centers ; Axis, Cervical Vertebra ; Case Management ; Critical Pathways* ; Delivery of Health Care ; Diet ; Humans ; Korea ; Laminectomy* ; Length of Stay ; Medical Records ; Patient Discharge

Ramsay-Hunt syndrome (RHS) is a well known disease caused by varicella-zoster virus infection in the geniculate ganglion of the facial nerve. Although the otic vesicle and facial palsy are easily recognized clinical signs of RHS, cases of associated multiple cranial nerve palsies present a difficult diagnostic challenge and furthermore, the mechanisms is unclear. We report a case of an 86-year-old man with otic crusted vesicles and peripheral typed facial palsy preceded by severe headache and fever. Several days later, he developed diplopia, dysphagia, hiccup and abdominal myoclonus. On fluid attenuated inversion recovery image of brain, diffuse subdural inflammatory exudates, which disappeared after treatment of acyclovir and corticosteroid, and ipsilateral facial nerve enhancement were observed in follow-up imaging.
Acyclovir ; Aged, 80 and over ; Brain ; Cranial Nerve Diseases ; Cranial Nerves ; Deglutition Disorders ; Diplopia ; Exudates and Transudates ; Facial Nerve ; Facial Paralysis ; Fever ; Follow-Up Studies ; Geniculate Ganglion ; Headache ; Herpesvirus 3, Human ; Hiccup ; Humans ; Myoclonus

Angiosarcomas of the pleura are very rare tumors and it is difficult to differentiate them from other common pleural tumors such as mesothelioma and metastasic carcinoma clinically and pathologically. We report a case of a young Korean woman with angiosarcoma arising in the pleura. A 34-yr-old woman presented with dyspnea and chest tightness and pain for several months. A computed tomographic scan of the chest showed diffuse thickening of the left pleura and effusion with passive atelectasis. At thoracotomy the left pleura was thick and indurated. Histologically, the decorticated pleura revealed infiltration of sheets or cords of polygonal and epithelioid tumor cells showing rudimentary vascular differentiation. Immunohistochemically, the tumor cells were strongly positive for CD31, CD34, and vimentin, whereas weakly positive for factor VIII, and negative for cytokeratin, which are characteristic and specific findings of angiosarcoma.
Adult ; Case Report ; Female ; Hemangiosarcoma/*pathology ; Human ; Pleural Neoplasms/*pathology ; Sarcoma/*pathology ; Tomography, X-Ray Computed

PURPOSE: Single-port laparoscopic surgery is a rapidly advancing technique in laparoscopic surgery. However, there is currently limited evidence on the learning curve for this procedure. The aim of this study was to estimate the number of single port laparoscopic cholecystectomies required until improvement in the performance of the technique ceases. METHODS: This is a descriptive, single-center study using routinely collected clinical data from 70 patients who underwent single port laparoscopic cholecystectomy between May 2009 and June 2010 at Dong-A University Medical Center in Busan, Korea. The review includes the mean operating time, conversion cases, intra-operative GB perforation, post-operative wound infection and mean hospital stay. RESULTS: The mean operating time of the first 30 cases (the learning period) was 91.83 minutes. After 30 operations (the experience period), it plateaued to an average of 75.25 minutes, which remained steady in the next 40 operations - a reduction of more than 16%. Reduction in the operating time was significant (P<0.001) between the learning period and the experience period. Other factors including additional ports, intraoperative gall bladder perforation, mean hospital stay, post-operative wound infection were not significantly different between the two periods. CONCLUSION: We suggest that the learning curve for single port laparoscopic cholecystectomy should be around thirty cases for a surgeon with prior conventional laparoscopic cholecystectomy experience and for self-taught single port technique.
Academic Medical Centers ; Cholecystectomy, Laparoscopic ; Cholecystitis ; Humans ; Korea ; Laparoscopy ; Learning ; Learning Curve ; Length of Stay ; Urinary Bladder ; Wound Infection

Pleuropulmonary blastoma (PPB) is an unusual intrathoracic blastoma presenting in childhood and characterized by a biphasic neoplastic population of undifferentiated, small round blastemal cells and larger spindle-shaped sarcomatous cells with entrapped benign epithelial-lined structures. We experienced the cytologic features of PPB in imprint smear from the pleural-based huge mass of the middle lobe of the right lung in a 4-year-old boy. The smears showed high cellularity composed of small ovoid blastemal elements and scattered spindle mesenchymal tumor cells. Lobectomy and pathologic investigation confirmed the diagnosis. PPB seems to be a tumor in which accurate diagnosis may be achieved by cytology if appropriate clinical information were given. Timely and accurate diagnosis of PPB by cytology paves the way for attempting preoperative treatment in future cases.
Child, Preschool ; Diagnosis ; Humans ; Lung ; Male