No abstract available.

A 2-month-old Korean boy presented with a solitary papule on the cheek which was noted at birth. Histopathologic findings were consistent with angiofibroma of fibrous papule of the face (FPF). FPF is known to affect adults, and congenital occurrence has not been reported to the best of our knowledge. We report a case of congenital FPF which showed a facial papule clinically and an angiofibroma histologically.
Adult ; Angiofibroma ; Cheek ; Humans ; Infant ; Male ; Parturition

Kasabach-Merritt syndrome is the association of thrombocytopenia, disorder of coagulation, spontaneous bleeding and enlargement of a hemangima or extensive hemangiomatosis, which can be often life threatening. We experienced a three years-old girl with suddenly enlarging hemangioma of right cheek, complicated by severe thrombocytopenia, consumptive coagulopathy and hemorrhagic cystitis. Generalized petechia and ecchymosis were noted on the overlying skin of hemangioma, trunk and extremities. But the study of MRI and angiography, hypevascular was located within the right masseter muscle extending to temporalis muscle and anterior to parotid gland. So selective embolization with PVA (polyvinyl alcohol) was performed through the distal branch of internal maxillary artery and facial artery. She was medicated with oral corticosterioid for 3 weeks. After embolizationn, blood flow to hemangioma and facial swelling were markedly decreased. Patient was followed up for 7 years and she showed normal contour of face and no bleeding diathesis.
Angiography ; Arteries ; Cheek ; Cystitis ; Disease Susceptibility ; Ecchymosis ; Extremities ; Female ; Hemangioma ; Hemorrhage ; Hemorrhagic Disorders* ; Humans ; Kasabach-Merritt Syndrome* ; Magnetic Resonance Imaging ; Masseter Muscle ; Maxillary Artery ; Parotid Gland ; Skin ; Thrombocytopenia

Posterior lumbar apophyseal fracture characterized by osteochondral fragments from posterior rim of a lumbar vertebral body, has often been misdiagnosed as herniated disc or spinal stenosis due to its similarity of symptoms. But recent use of CT scan facilitated the diagnosis of the lesion as a separate entity. This study was performed to verify the clinical characteristics, to find out the mechanism of injury and to determine the most effective method of diagnosis and treatment. Authors reviewed 17 patients(14 male, 3 female) who were subjected to surgical treatment at Department of Orthopaedic Surgery, Seoul National University Hospital for posterior lumbar spophyseal fracture during the period of 1990-1992, and followed up for average of 1 year and 6 months(range 1 to 3 years). Thirteen patients (76%) were related to a history of trauma or strenuous physical activity prior to the onset of symptoms. The mechanism of injury was the rapid flexion with axial compression in 7, hyperextension in 4, and pure axial compression in 2 patients. The mean age at the time of injury was 20 years(range 10 to 31 years). All patients presented low-back pain radiating to lower extremities and 11 patients showed neurogenic intermittent claudication. The mean age at the time of surgical intervention was 23 years and 10 months(range 15 to 31 years), and the mean duration of symptoms was 3 years(range 2 months to 13 years). Simple X-ray revealed the lesion in only 3 cases but CT scan demonstrated the characteristic osteochondral fragment displaced posteriorly into the spinal canal and the corresponding defect with degenerative changes in all patients. The fracture occured through the superior apophyseal rim of L5 in 9 superior rim of L4 in 3, inferior rim of L4 in 2, inferior rim of L5 in, superior rim of L2 in 1, and superior rim of L1 in 2 patients. Two patients had concomitant fractures at two levels. All patients except one were treated with posterior decompression including the removal of the displaced fragment and posterolateral fusion with pedicular screws was carried out to prevent further degenerative change and instablilty. One patient with the lesion at the superior rim of L1 was treated by anterior decompression and fusion. All patients showed relief of pain and claudication with satisfactory results. One patient had partial tear of L4 root with slight weakness of greater toe dorsiflexion, but it recovered in 4 months. In conclusion, posterior lumbar spophyseal fracture predominantly affected young males and the most common causative mechanism was rapid flexion with axial compression. The CT scan facilitated identification of the lesion. The most frequently affected site was the superior rim of L5. Satisfactory results could be achieved bvy adequate posteriior decompression with the removal of the fragment and posterolateral fusion with pedicular screws.
Decompression ; Diagnosis ; Humans ; Intermittent Claudication ; Intervertebral Disc Displacement ; Lower Extremity ; Male ; Methods ; Motor Activity ; Seoul ; Spinal Canal ; Spinal Stenosis ; Tears ; Toes ; Tomography, X-Ray Computed

No abstract available.
Carcinoma, Basal Cell ; Paget Disease, Extramammary

PURPOSE: The study was undertaken to investigate influence of nurses' work environment, organizational commitment, and nursing professionalism on turnover intention of nurses working in long term care hospitals. METHODS: The study was cross-sectional study. Participants were 199 nurses working in one of 7 long term care hospitals. Data were collected from May 1 to June 30, 2016 and analysed using two stage hierarchial regression analysis with SPSS 22.0. RESULTS: There was a statistically significant difference in turnover intention according to age (F=6.23, p < .001), present work career (t=−2.11, p=.036), frequency of night duty (t=−3.53, p=.001), and present position (t=−4.07, p < .001). The significant predictors of turnover intention were attachment (β=−0.29, p=.005), nursing professionalism (β=−.21, p=.030), identification (β=−.21, p=.014), continuance (β=−.19, p=.008), collegial nurse-physician relations (β=−.16, p=.039), and originality of nursing (β=.16, p=.014). These factors explained 50.4% of the variance. CONCLUSION: The results suggest that several points need to be considered in order to reduce turnover intention in long term care hospital nurses. These points include building work environments to improve collegial nurse-physician relations, promoting recognition of nurses' organizational commitment, nursing professionalism and the political efforts of organizations supporting nursing originality.
Cross-Sectional Studies ; Intention ; Long-Term Care ; Nursing ; Physician-Nurse Relations ; Professionalism

No abstract available.
Arm

PURPOSE: A heterotopic pancreas is defined as one for which pancreatic tissue is present outside its usual or habitual location and without an anatomic relation either of continuity or of vascularization with the pancreas proper. Most heterotopic pancreases are incidentally encountered during surgery, and on rare occasions, epigastric pain, weight loss, hemorrhage, gastric outlet obstruction, and intussusception have been directly attributable to the presence of a heterotopic pancreas. The purpose of this article is to report the clinical characteristics of the heterotopic pancreas. METHOD: We retrospectively observed 24 patients, who had been pathologically proven to have a heterotopic pancreas, at the Department of Surgery, Korea University Hospital, from Jan. 1990 to Dec. 1998. RESULTS: 16 of the 24 cases were found incidentally during operations due to by other primary diseases; 8 cases were symptomatic. The ratio of males to females was 1.18:1 and most common sites were the stomach and the duodenum (71%). The mean size of the lesion was 1.26 cm, and the sizes in symptomatic cases were larger (mean 1.89 cm) than those in cases where the lesions were found incidentally (mean 0.94 cm). We experienced a case of a ductal adenocarcinoma originating from the heterotopic pancreas in the jejunum of a 73 year old man. CONCLUSION: A heterotopic pancreas should be considered in the differential diagnosis of submucosal tumors, polyps, ulceration, and intestinal tumors, When suspected, an intraoperative frozen section is recommended, and the range and the method of the operation should be decided based on the results of the frozen section.
Adenocarcinoma ; Aged ; Diagnosis, Differential ; Duodenum ; Female ; Frozen Sections ; Gastric Outlet Obstruction ; Hemorrhage ; Humans ; Intussusception ; Jejunum ; Korea ; Male ; Pancreas* ; Polyps ; Retrospective Studies ; Stomach ; Ulcer ; Weight Loss

No abstract available.
Adult* ; Humans ; Purpura, Thrombocytopenic, Idiopathic* ; Splenectomy*

PURPOSE: To assess the efficacy and toxicity of a new protocol that consists of CHOP- Bleo alternated with a new regimen of Cyclophosphamide, methotrexate, etoposide, and dexamethasone(CMED) for aggressive Non-Hodgkin's Lymphoma(NHL). PATIENTS AND METHODS: Between January 1991 and December 1996, forty-six patients with Ann Arbor stages II-IV aggressive NHL were treated with alternating cycles of CHOP-Bleo and CMED for a total of 12 cycles. All eligible patients were evaluated for response, disease-free survival, and overall survival. RESULTS: Twenty-two patients(47.8%) achieved a complete response and overall response rate was 83.9%. The range of survival duration was 1-68+months and the median survival time was 42 months. Overall 3-year survival rate was 54%. The range of disease-free survival time was 6-63+months and 3-year disease-free survival rate was 61%. The most common hematologic toxicity was leukopenia and the incidence of severe leukopenia(<1,000/mm3) was 11%. And alopecia(84.8%) was the most common non-hematologic toxicity. CONCLUSION: The results of CHOP-Bleo/CMED alternating chemotherapy for patients with aggressive Non-Hodgkin's Lymphoma is not superior to other results of previous studies. Therefore further study will be warranted to determine clinical effectiveness of alternating chemotherapy.
Cyclophosphamide ; Disease-Free Survival ; Drug Therapy* ; Etoposide ; Hodgkin Disease* ; Humans ; Incidence ; Leukopenia ; Lymphoma, Non-Hodgkin ; Methotrexate ; Survival Rate