PURPOSE: Aspirin(acetylsalicylic acid) has been used to treat unstable angina and acute myocardial infarction in adults and Kawasaki disease in children. The antithrombotic effect of aspirin was attributed to its ability to inhibit platelet aggregation by inhibiting platelet cyclooxygenase, which leads to decreased thromboxane synthesis. The purpose of this study was to evaluate the effect on the platelet aggregation by low dose aspirin in Kawasaki patients and to learn the side effects of low-dose aspirin. METHODS: Fifty patients with Kawasaki disease who were treated with low-dose aspirin, and 22 normal children were studied from Jan. 1996 to Dec. 1997. The platelet count, bleeding time, clotting time, platelet aggregation test(induced by ADP, epinephrine, collagen and ristocetin) and blood aspirin level by colorimetric method were checked. RESULTS: The platelet count, bleeding time, and clotting time in the patient group were not significantly different from the control group. The mean maximum platelet aggregation was 54.4+/-12.8% induced by ADP, 15.9+/-11.7% by epinephrine, 55.5+/-23.8% by collagen, 52.6+/-32.2% by ristocetin in the patient group. It was significantly lower than the control group(P<0.05). The mean blood aspirin level in the patient group was 5.4+/-3.7mg/dl. Side effects of low-dose aspirin were bruise, epistaxis and hematuria. CONCLUSION: Low-dose aspirin therapy in patients with Kawasaki disease inhibited platelet aggregation, but attention would be needed because of the tendency to bleed in these patients. Further investigations should be focused on the subject such as the onset of the maximal antiplatelet effect and time needed for the recovery of platelet function.
Adenosine Diphosphate ; Adult ; Angina, Unstable ; Aspirin* ; Bleeding Time ; Blood Platelets* ; Child ; Collagen ; Contusions ; Epinephrine ; Epistaxis ; Hematuria ; Humans ; Mucocutaneous Lymph Node Syndrome* ; Myocardial Infarction ; Platelet Aggregation* ; Platelet Count ; Prostaglandin-Endoperoxide Synthases ; Ristocetin

Fibrosarcoma is a malignant mesenchymal neoplasm of fibroblasts that rarely affects the thyroid gland and can cause local recurrences or metastasis. We describe a case of primary fibrosarcoma of the thyroid in a 31-year-old man. Microscopically, the tumor showed highly cellular proliferation of spindle cells with cytologic atypia and mitotic figures. Immunohistochemically, the cells only showed immunoreactivity for vimentin and negativity for S-100 protein, CK, CD31, CD34, TTF-1, desmin. Based on clinical, radiological, histological and immunohistochemical findings, the final diagnosis was intra-thyroid fibrosarcoma. The treatment of choice is radical surgery. Radiation therapy is used as adjuvant treatment. So, we review the clinical, radiologic, histologic findings and treatment modalities of the fibrosarcoma of the thyroid gland.
Adult ; Cell Proliferation ; Desmin ; Diagnosis ; Fibroblasts ; Fibrosarcoma* ; Humans ; Neoplasm Metastasis ; Recurrence ; S100 Proteins ; Thyroid Gland* ; Vimentin

PURPOSE: The aims of the current study were to evaluate the effects of superficial cold and heat after spine surgery on pain, satisfaction with pain control and comfort level, and to identify subjective responses and adverse effects. METHODS: A prospective, single-blind, randomized controlled trial was utilized. The intervention group (n=36) received superficial cooling until the wound drain was removed and thereafter followed by superficial heating until discharge, while the control group (n=34) received only superficial cooling until wound drain was removed. Data were collected from August 4 to November 11 2014. RESULTS: There was significant difference in pain according to time within groups (F=71.87, p<.001). However, we found no difference in pain between groups. The intervention group reported higher patient satisfaction with pain control (4 vs 3, z=-2.83, p=.005) and higher comfort level (5 vs 4, z=-4.12, p<.001) than the control group. CONCLUSION: Results indicate that sequential application of superficial cold and heat is a useful method in clinical practice for management of pain after spine surgery.
Cryotherapy ; Heating ; Hot Temperature* ; Humans ; Methods ; Pain, Postoperative ; Patient Satisfaction* ; Personal Satisfaction ; Prospective Studies ; Spine* ; Wounds and Injuries

OBJECTIVE: The aim of this study were to examine the serum level of estradiol, estriol, progesterone, oxidized LDL in preeclamtic patients and to evaluate the protective effects of estrogen and progesterone against lysophosphatidylcholine (LPC) induced cell death in Human umbilical vein endothelial cells (HUVECs). METHODS: We analysed the serum level of estradiol, estriol, progesterone, oxidized LDL in patients with preeclampsia and control. We used LPC to induce cell death in HUVECs. For cytotoxic assay, we did LDL assay for cell death and Resazurin assay for cell viability. HUVECs were exposed to various concentrations of LPC, LPC+estrogen, LPC+progesterone and we did cytotoxic assay. RESULTS: The serum estradiol, estriol were lower in the preeclamptic patients (P<0.05). Oxidized LDL were higher in the preeclamptic patients(P<0.05). LPC induced cell death in a concentration-dependant manner. Estrogen or progesterone inhibited LPC-induced cell death in a concentration-dependant manner (P<0.05). CONCLUSION: Estrogen and progesterone attenuated LPC-induced cytotoxicity. The results suggest that Oxidized LDL induced endothelial damage in preeclampsia may be induced by low serum estradiol, estriol and progesterone levels and prevented by estrogen and progesterone addition.
Cell Death ; Cell Survival ; Estradiol ; Estriol ; Estrogens* ; Human Umbilical Vein Endothelial Cells ; Humans ; Lysophosphatidylcholines ; Pre-Eclampsia ; Progesterone*

PURPOSE: Nurses' knowledge regarding advance directives may affect their administration of and confidence towards end of life care. This study aimed to describe the relationships of knowledge, confidence, and learning needs with advance directives among hospital nurses.METHOD: This cross-sectional study was performed at a tertiary university hospital in Seoul between September 25 and October 14, 2017. Convenience sampling was used to recruit nurses who provided bedside care and had at least 1 year of clinical experience. We used a validated self-report questionnaire.RESULTS: The mean score of knowledge, confidence and learning needs were 5.00±1.73, 29.81±7.52, and 64.54±8.48 respectively. Hospital nurses' knowledge, confidence and learning needs were significantly different according to age, job position, educational level and perceived advance directives. Knowledge regarding advance directives was significantly associated with confidence (r = .27, p < .001) and learning needs (r = .16, p = .005).CONCLUSION: Knowledge regarding advance directives was relatively low compared to the findings of previous studies. Therefore, nurses should be knowledgeable and encouraged to initiate advance directives. It is necessary to develop a standardized educational program regarding advance directives based on Korean cultures.
Advance Directives ; Cross-Sectional Studies ; Learning ; Methods ; Seoul ; Terminal Care

Fine-needle aspiration (FNA) is considered the most accurate, cost-effective and relatively safe method in the evaluation of thyroid nodules and fatal complications after thyroid FNA are uncommon. In particular, the large hematomas after FNA causing airway compromise are extremely rare complications and were reported in only a few literatures. We reported a 51-year-old woman who showed airway compromise caused by bilateral intrathyroidal and perithyroidal hematoma after FNA of thyroid. A large thyroid hematoma after FNA is a rare but possible complication and sometimes can be fatal for the patient. Proper preventive efforts should be considered while performing thyroid FNA and prompt intervention is mandatory for patients with acute hematoma after FNA.
Biopsy, Fine-Needle* ; Female ; Hematoma* ; Humans ; Middle Aged ; Thyroid Gland* ; Thyroid Nodule

PURPOSE: This study was conducted in order to analyze themes, concepts, research methods and results of previous domestic research on the nursing of hematologic patients conducted through the last 10 yr, to find trends in the research, and to provide basic materials for setting the direction of future research on the nursing of hematologic patients. METHODS: This study analyzed a total of 72 nursing theses related to hematology sampled from domestic theses for a master's or doctoral degree and papers published in six nursing journals registered in Korea Research Foundation from January 2000 to July 2009. RESULTS: Of the 72 theses, 51 were for a master's degree, 7 for a doctoral degree, and 14 not for an academic degree. The concept covered most frequently in correlation research was 'quality of life' and concepts found in comparative research were stress and quality of life. In experimental research, the most common nursing intervention was oral care. The scale used most frequently was Spielberger's Anxiety Scale. CONCLUSION: It is necessary to expand experimental research applying nursing interventions, and to use objective physiological indexes for more effective assessment in experimental research. Furthermore, interdisciplinary research is required for enhancing the quality of clinical nursing research.
Anxiety ; Clinical Nursing Research ; Hematology ; Hematopoietic Stem Cell Transplantation ; Humans ; Korea ; Nursing Research ; Quality of Life

PURPOSE: To evaluate the incidence of secondary contiguous or non-contiguous subchondral bone impactions (SBI) in subaxial cervical spinal injury and associated primary injury patterns. MATERIALS AND METHODS: A retrospective review of computed tomography, magnetic resonance imaging, and medical records was carried out for 47 patients who had sustained a subaxial cervical spinal injury. Presence, number, level, and sites of secondary contiguous or non-contiguous SBI were recorded. To evaluate primary injury patterns, the level and number of primary injury sites of subaxial cervical spine injury, injury morphology, anterior/posterior discoligamentous complex (ADC/PDC) injury, posterior ligamentous complex (PLC) injury, spinal cord injury, and mechanism of injury (MOI) were analyzed. Differences in primary injury pattern of subaxial cervical spine injury and MOI between patients with and without SBI, and between contiguous or non-contiguous SBI were analyzed using the Mann-Whitney U test, Pearson's chi square test and Fisher's exact test. RESULTS: Eighteen patients (18/47, 38.29%) had developed contiguous (n=9) or non-contiguous (n=9) SBI, most commonly involving T3 (15/47, 31.91%) and 3 levels (6/18, 33.33%). All SBIs had developed near the anterosuperior region of the body and the superior endplate and were the result of a high-impact MOI. SBIs were statistically significant in association with injury morphology and PLC injury (P=0.001, P=0.009, respectively) at the primary injury site. Non-contiguous SBI was more frequently accompanied by upper cervical spinal injuries in association with PDC injuries, as opposed to contiguous SBI, with statistical significance (P=0.009), while no other statistically significant differences were found. CONCLUSION: Secondary SBIs are common and probably associated with subaxial cervical spinal injuries with high energy compressive flexion forces.
Humans ; Incidence* ; Ligaments ; Magnetic Resonance Imaging ; Medical Records ; Retrospective Studies ; Spinal Cord Injuries ; Spinal Injuries* ; Spine

Osteosarcomas usually occur as secondary tumors after radiation therapy or chemotherapy. Without a history of irradiation to the head and neck area, primary osteosarcoma of the turbinate is extremely rare. We report here a rare case of primary turbinate osteosarcoma presenting as a relatively small, well-circumscribed, turbinate mass. Its appearance mimicked a benign nasal mass like mucocele and polyp. We also reviewed the previously reported cases of tumor arising from turbinate.
Head ; Humans ; Mucocele ; Neck ; Osteosarcoma ; Polyps ; Turbinates

PURPOSE: To quantitatively and qualitatively compare fat-suppressed MRI quality using iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) with that using frequency selective fat-suppression (FSFS) T2- and postcontrast T1-weighted fast spin-echo images of the head and neck at 3T. MATERIALS AND METHODS: The study was approved by our Institutional Review Board. Prospective MR image analysis was performed in 36 individuals at a single-center. Axial fat suppressed T2- and postcontrast T1-weighted images with IDEAL and FSFS were compared. Visual assessment was performed by two independent readers with respect to; 1) metallic artifacts around oral cavity, 2) susceptibility artifacts around upper airway, paranasal sinus, and head-neck junction, 3) homogeneity of fat suppression, 4) image sharpness, 5) tissue contrast of pathologies and lymph nodes. The signal-to-noise ratios (SNR) for each image sequence were assessed. RESULTS: Both IDEAL fat suppressed T2- and T1-weighted images significantly reduced artifacts around airway, paranasal sinus, and head-neck junction, and significantly improved homogeneous fat suppression in compared to those using FSFS (P < 0.05 for all). IDEAL significantly decreased artifacts around oral cavity on T2-weighted images (P < 0.05, respectively) and improved sharpness, lesion-to-tissue, and lymph node-to-tissue contrast on T1-weighted images (P < 0.05 for all). The mean SNRs were significantly improved on both T1- and T2-weighted IDEAL images (P < 0.05 for all). CONCLUSIONS: IDEAL technique improves image quality in the head and neck by reducing artifacts with homogeneous fat suppression, while maintaining a high SNR.
Artifacts* ; Ethics Committees, Research ; Head* ; Lymph Nodes ; Magnetic Resonance Imaging* ; Mouth ; Neck* ; Pathology ; Prospective Studies ; Signal-To-Noise Ratio ; Water