OBJECTIVE: We report here on two cases of pseudoaneurysms that were diagnosed using computed tomographic angiography (CTA), with one arising in the superficial temporal artery and the other arising in the occipital artery. METHODS: Case 1: A 29-year-old man presented with a slow growing, pulsatile mass on the left side of his forehead following a blow from a fist 10 days earlier. CTA revealed an 11 x 8 x 11-mm oval pseudoaneurysm arising from the frontal branch of the left superficial temporal artery. Case 2 : A 36-year-old man presented with a pulsatile mass in the right suboccipital region that had been present for the past year. He had no history of direct trauma. CTA revealed a 15 x 8 x 13-mm oval dye-filled sac arising from the right occipital artery. RESULTS: Based on the CTA images, the parent arteries were exposed and ligated proximally and distally to the pseudoaneurysms and then they were completely excised. CONCLUSION: CTA is a minimally invasive technique for making the diagnosis of scalp pseudoaneurysms and CTA is also useful for the preoperative planning.
Adult ; Aneurysm, False ; Angiography ; Arteries ; Diagnostic Tests, Routine ; Forehead ; Humans ; Parents ; Scalp ; Temporal Arteries

Medroxyprogesterone acetate(MPA) is one of the most commonly used hormonal agents for the treatment of advanced or recurrent endometrial adenocarcinoma. However, the progesterone receptor content of endometrial carcinoma varies directly to the degree of differentiation and inversely with stage of the tumor. Thus one would predict that MPA therapy would be less effective in advanced and poorly differentiated tumors. In addition, MPA has been shown to reduce progesterone receptor content of both normal and malignant endometrial cells, which could result in loss of hormone responsiveness. Tamoxifen, which is often used in breast cancer therapy, has also been used in the treatment of patients with advanced and recurrent endometrial carcinoma. Tamoxifen is known to have some estrogenic effects at low concentration and one of these effects is induction of progesterone receptor both in normal and malignant endometrium. This property has focused interest on sequential or simultaneous use of tamoxifen and MPA in the therapy of endometrial carcinoma. The growth inhibitory effects of MPA and tamoxifen were tested on six longestablished endometrial carinoma cell line(HEC-1-A, HEC-1-B, RL 95-2, AN3CA, KLE) and on SCHE-1, a new endometrial carcinoma cell line established in our laboratory. MPA and tamoxifen were used in growth experiments either alone, simultaneously or sequentially. The MCF-7 breast cancer cell line was used as a control. Only 20% reduction in cell number was achieved after 10 days of exposure to the drug, even with the highest MPA concentration tested(10micronm) in endometrial carcinoma cell lines. But in MCF-7 cells, 60% reduction in cell number was achieved with the same concentration of MPA(10um). Ten days of feeding with 5micronm tamoxifen produced a 96% reduction in cell number in MCF-7, a 91% reduction in HEC-1-A, a 88% reduction in HEC-1-B, a 98% reduction in AN3CA and a 71% reduction in KLE cultures. In SCHE-1 cultures a 83% reduction in cell growth was seen and no viable cells remainde in RL 95-2 cultures after 10 days of feeding with a 5uM tamoxifen. In AN3CA cultures, simultaneous exposure to 5um tamoxifen and 5um MPA resulted in partial reversal of the tamoxifen-induced growth inhibition. In RL 95-2, HEC-1-A and HEC-1-B cultures, simultaneous use of these drugs had the same effect as tamoxifen alone, whereas in KLE and SCHE-1 cultures a slight additive growth effect was observed. All six endometrial carcinoma cell lines resumed logarithmic growth when medium containing tamoxifen of logarithmic growth under these conditions was slower than that in the other endometrial carcinoma cultures. Our results show that MPA does not have growth inhibitory effects in these endometrial carcinoma cell cultures, whereas tamoxifen has been shown to have potent endometrial carcinoma cells. These findings are of special importance since patients who are most likely to need adjuvant therapy for advanced or recurrent endometrial carcinoma are those with estrogen receptor and progesterone receptor negative tumors.
Adenocarcinoma ; Breast Neoplasms ; Cell Count ; Cell Culture Techniques ; Cell Line* ; Endometrial Neoplasms* ; Endometrium ; Estrogen Receptor Modulators* ; Estrogens ; Female ; Humans ; MCF-7 Cells ; Medroxyprogesterone ; Receptors, Progesterone ; Tamoxifen*

PURPOSE: To find out the characteristic MR findings of reversible posterior leukoen-cephalopathy syndrome (RPLS) due to various causes in children. MATERIALS AND METHODS: Eight children with RPLS underwent MR imaging, and the findings were retrospectively analyzed. All eight were acutely hypertensive at the time of a neurotoxic episode. Three had intra-abdominal tumors (one adrenal pheochromo-cytoma, one para-aortic paraganglioma and one para-aortic ganglioneuroma encasing the left renal artery); three were being treated with cyclosporine; one was being treat-ed with steroid; and one had hemolytic uremic syndrome. Initial cranial MR images were analyzed with particular emphasis on the distribution of the lesions. To assess possible sequelae, follow-up MR images were obtained in seven patients at least one week after the treatment of hypertension. Four underwent proton MR spectroscopy. RESULTS: Characteristic distribution of lesions in the occipital and posterior parietal lobes was identified in all cases regardless of the causes of RPLS. The cerebellum, basal ganglia, anterior parietal, and frontal lobe were involved in four, two, one, and one case, respectively. Cortical gray matter involvement was predominant in six and subcortical white matter involvement predominated in two patients. The distribution of lesions was bilateral and asymmetric. Gyriform enhancement was identified in six cases, and small hemorrhage was noted in one. In seven patients, the clinical and MR findings improved without sequelae on follow-up study. In one, proton MR spectroscopy demonstrated a high lactate peak at the time of the neurologic event. Nearnormal spectra were noted in three children who underwent proton MR spectroscopy after recovery. CONCLUSION: The MR findings of RPLS are characteristic in that lesions are distributed in the posterior region of the brain and they are reversible on follow-up study. In children with RPLS due to unknown causes, the possibility of intra-abdominal tumors should also be considered.
Basal Ganglia ; Brain ; Cerebellum ; Child* ; Cyclosporine ; Follow-Up Studies ; Frontal Lobe ; Ganglioneuroma ; Hemolytic-Uremic Syndrome ; Hemorrhage ; Humans ; Hypertension ; Lactic Acid ; Magnetic Resonance Imaging* ; Magnetic Resonance Spectroscopy ; Paraganglioma ; Parietal Lobe ; Posterior Leukoencephalopathy Syndrome* ; Protons ; Rabeprazole ; Retrospective Studies

PURPOSE: This study was to investigate the relationship between the level of emotional labor and occupational job stress of hospital nursing staff. METHODS: The survey was conducted from Mar. to Oct. 2009 to collect data from clinical nurses (N=496). RESULTS: The study showed that nurses without religion and those working in big-sized hospitals had higher scores in emotional labor, and those of 26~30 years old felt the highest stress in the occupational role. The same applied to the married, more work experienced, atheist and those working in big-sized hospitals. Unmarried, under educated nurses with less work experience working in the big-sized hospitals showed higher scores in personal strain. The scores of the personal resources depended on religion, work experience, marital status and position of their jobs. Emotional labor was positively correlated with an occupational role and personal strain, respectively, but the emotional labor, occupational role and personal strain were negatively correlated with personal resources respectively. CONCLUSION: Intervention program is required to reduce overload of nurse's role and to relieve physical and psychological strains of the under-30-age-group. Also, social support and rational/cognitive coping must be reinforced.
Humans ; Marital Status ; Nurse's Role ; Nursing Staff, Hospital ; Single Person ; Sprains and Strains

No abstract available.

PURPOSE: This study was conducted to develop health education program components for early childhood and to investigate teachers' awareness of the importance of health education and their performance rate of health education. METHODS: Early childhood health education program components were developed using two rounds of the Delphi method. The Delphi group consisted of 21 experts in childhood education. After health education program components were developed, they were used in surveying child care teachers' awareness of importance and performance rate and 151 teachers sampled from 30 child care centers participated in the survey. RESULTS: The early childhood health education program components consisted of 5 areas, 16 subjects and 33 specific contents. Early childhood teachers' awareness of importance was over 4.5 points in all the areas and in 11 out of the 16 subjects. The most frequently educated subjects were 'the importance of hand washing' and the least frequently educated subject was 'obesity prevention'. The teachers' awareness of importance and their performance rate of specific contents were high in 'maintaining order' and 'using children's rides safely,' and low in 'obesity prevention' and 'infectious disease prevention.' CONCLUSION: The components of this health program were developed in consideration of field feasibility and the relationship of health program education in elementary, middle and high school.
Child ; Child Care ; Education ; Hand ; Health Education* ; Humans

No abstract available.
Alopecia

The utilization of medical care services has been partly regionalized with the implementation of referral requirement by the government since July 1, 1989 when the health insurance coverage was extended to all the people. For the purpose of regionalization, the whole country has been primarily divided into tertiary care regions, and each of them again into secondary care regions. This study investigates the self-sufficiency for in-patient care services of secondary care regions focusing on why it varies among the regions. In doing so, analysis is performed to examine a model which embodies three sets of hypotheses as follows: 1) The regional self-sufficiency for medical care services would be subject to direct influences of regional characteristics, amount of available services and structural properties of regional medical care system ; 2) The regional characteristics would have indirect effects on the self-sufficiency which are mediated by medical care services ; and 3) The amount of available services would indirectly affect the self-sufficiency by influencing the structure of regional medical care system. The results of analysis were generally consistent with the model. The findings have some practical implications. The regional self-sufficiency for medical care services partly depends upon basic properties of each region which cannot be changed in a short period of time. Thus the self-sufficiency for medical care services can be improved by health policy measure. In some of the regions the self-sufficiency for in-patient care services was much higher or lower than can be predicted from the bed-population ratio. Indication is that the allocation of health resources should be made considering a variety of factors bearing upon the supply of and demand for health care ; not on the basis of just a single criterion like the availability. The self-sufficiency of a certain region is related to not only its own characteristics but also the characteristics of neighboring regions. Therefore, attention should be also directed to the inter-regional relationships in health care when the needs for investment of health resources in a region are assessed. However, it should be noted that this study used the data collected before the referral requirement was imposed. A replication of this analysis using recent data would provide an evaluation of the impact on the self-sufficiency of the referral requirement as well as a confirmation of the findings of this study.
Delivery of Health Care ; Health Policy ; Health Resources ; Insurance, Health ; Investments ; Referral and Consultation ; Secondary Care ; Tertiary Healthcare

BACKGROUND: Angiotensin II plays a potential role in renal injury not only by its vasoconstrictive effects but also its biochemical effects. alpha-Actinin, an actin-linked glycoprotein, is expressed in podocytes and known to be rearranged and changed in various glomerular diseases. We investigated the effect of angiotensin II on the alpha-actinin in the glomerular epithelial cells to find out the fact that it could be prevented by losartan, a type 1 angiotensin receptor antagonist. METHODS: Glomerular epithelial cells were treated with various concentrations of angiotensin II in culture media, and then we compared the localization and amount of alpha-actinin by confocal microscopy and Western blot analysis, respectively. We also compared the differences in the localization and protein amount of alpha-actinin by various concentrations of losartan in the presence of angiotensin II. In addition, we tried to observe the mRNA expression of alpha-actinin via RT-PCR. RESULTS: The fluorescent and band intensities of alpha-actinin were decreased by angiotensin II in a dose-dependent manner by confocal microscopy and Western blot analysis, respectively. These changes of alpha-actinin by angiotensin II were reversed by losartan in dose dependent manner. Angiotensin II also changed the distribution of alpha-actinin from peripheral to inner cytoplasm in dose-dependent manner, which was also reversed by losartan. The different expression of alpha-actinin m-RNA by RT-PCR were unremarkable. CONCLUSIONS: Angiotensin II decreases the amount of alpha-actinin protein and and makes cytoskeletal changes in glomerular epithelial cells, which could be reversed by losartan. It suggests that it could be prevented by angiotensin II AT1 receptor blockers.

BACKGROUND: Angiotensin II plays a potential role in renal injury not only by its vasoconstrictive effects but also its biochemical effects. alpha-Actinin, an actin-linked glycoprotein, is expressed in podocytes and known to be rearranged and changed in various glomerular diseases. We investigated the effect of angiotensin II on the alpha-actinin in the glomerular epithelial cells to find out the fact that it could be prevented by losartan, a type 1 angiotensin receptor antagonist. METHODS: Glomerular epithelial cells were treated with various concentrations of angiotensin II in culture media, and then we compared the localization and amount of alpha-actinin by confocal microscopy and Western blot analysis, respectively. We also compared the differences in the localization and protein amount of alpha-actinin by various concentrations of losartan in the presence of angiotensin II. In addition, we tried to observe the mRNA expression of alpha-actinin via RT-PCR. RESULTS: The fluorescent and band intensities of alpha-actinin were decreased by angiotensin II in a dose-dependent manner by confocal microscopy and Western blot analysis, respectively. These changes of alpha-actinin by angiotensin II were reversed by losartan in dose dependent manner. Angiotensin II also changed the distribution of alpha-actinin from peripheral to inner cytoplasm in dose-dependent manner, which was also reversed by losartan. The different expression of alpha-actinin m-RNA by RT-PCR were unremarkable. CONCLUSIONS: Angiotensin II decreases the amount of alpha-actinin protein and and makes cytoskeletal changes in glomerular epithelial cells, which could be reversed by losartan. It suggests that it could be prevented by angiotensin II AT1 receptor blockers.