Germ cell tumors(GCT) are not infrequently encounted tumor in pediartic age group. In order to study the clinical behaviors of the disease, we reviewed 29 cases of GCT diagnosed and treated at Kosin Medical Center in the period of 7 years form Jan. 1984 to Dec. 1991 and the results are summarized as follows: 1) The age distribution is the highest between 10 and 15 years(45%) and girls have 1.9 times higher frequency than that of boys. 2) The most frequent primary site of GCT was ovary(15). The next common primary site was testis(5), pineal body(4), sacrococcygeal region(2), retroperitoneum(1), soft palate(1), anterior mediastinum(1) in descending order of frequency. 3) In the pathological analysis of tumors, the most frequent type was mature teratoma(12). The next common type was endodermal sinus tumor(6), immature teratoma(5), dysgerminoma(3), mixed type(2), and choriocarcinoma(1)in descending order of frequency. 4) All the 5 cases of EST have elevated serum levels of alpha-fetoprotein. Two of the three dysgerminoma, one of the two mixed type tumors both of which have germinoma components, and one choriocarcinoma have elevated serum levels of beta-HCG above the age related physiological levels. 5) Among 17 cases of malignant GCT, 9 cases have metastatic areas such as regional lymph nodes, scrotum, pleura, retroperitoneum, omentum and lumbar spine. 6) All except on case of immature teratoma in the anterior mediastinum underwent surgery. Chemotherapy was given to 12 of 17 malignant GCT and radiotherapy was given to 4 of 17 malignant GCT. 7) Among the 4 expired cases within 12 months of follow up, three were originated from pineal body, which had been underwent simple V-P shunt or incomplete resection, and one case was metastatic immature teratoma of anterior mediastinum to the pleura which had not been undergone surgery. Finally, in review of literature and or cases, the survival of properly managed GCT except some of those difficult surgical access is relatively good. To continue the survival of children of GCT to be impoved, we should use all the treatment modalit properly with more positive outlook about the disease.
Age Distribution ; alpha-Fetoproteins ; Child* ; Choriocarcinoma ; Drug Therapy ; Dysgerminoma ; Endoderm ; Female ; Follow-Up Studies ; Germ Cells* ; Germinoma ; Humans ; Lymph Nodes ; Mediastinum ; Neoplasms, Germ Cell and Embryonal* ; Omentum ; Pineal Gland ; Pleura ; Pregnancy ; Radiotherapy ; Scrotum ; Spine ; Teratoma

No abstract available.
Antibody Formation* ; Lymphocytes* ; Mycobacterium tuberculosis* ; Mycobacterium*

PURPOSE: This study was done to understand the meanings and nature of experiences of the burnout of nurses working in oncology wards. METHODS: The hermeneutic phenomenology developed by van-Manen was used. The period for data collection was from November, 2006 to May, 2007. This study took place in 3 university hospitals in B & U cities. Nine nurses working in oncology wards participated. Data collection was done through individual in-depth interviews. RESULTS: The eight most common themes demonstrated by participants from this study were 'being fed up with endless demands', 'collapsing in front of deaths', 'gasping for breath due to overwhelming tasks', 'uncontrollable suffering of body', 'gradually loosing self-esteem', 'frustration from the work world', 'beleaguered relationships', and 'desire to escape'. CONCLUSION: The results of this study indicate that there is a need to develop a preventive burnout program for nurses working in oncology wards.
Data Collection ; Hospitals, University ; Hypogonadism ; Mitochondrial Diseases ; Oncology Service, Hospital ; Ophthalmoplegia ; Stress, Psychological

PURPOSE: In this study, the retrospective radiographic study is executed to evaluate amount of bone loss of various conditions in patients using customized abutment for 4 years of follow-up. MATERIALS AND METHODS: The subjects of this study were implant fixed dental prosthesis using CAD/CAM customized abutments. CAD/CAM customized abutment and fixed dental prosthesis were manufactured by the Prosthodontics Department of Chosun University Dental Hospital from August 1, 2011 to July 31, 2012. Radiological assessments were performed on the patients who were treated by the fixed prosthodontics. After each treatment, a retrospective study was performed for a total of 4 years at 3 months, 6 months, 1 year, 2 years, 3 years, and 4 years. RESULTS: As a result of the study, the customized abutment using CAD/CAM showed less bone loss than the results of existing research. There was no statistically significant differences at alveolar bone loss between splinting group and non-splinting group (respectively 0.27 mm, 0.5 mm). Also, there were statistically significant differences at alveolar bone loss in mx. anterior, mx. posterior, mn. anterior and mn. posterior part (respectively 1.37 mm, 0.39 mm, 0.00 mm, 0.30 mm). CONCLUSION: The customized abutment using CAD/CAM showed less bone loss than the results of existing research, there were statistically significant differences at alveolar bone loss in implant positions.
Alveolar Bone Loss ; Dental Prosthesis ; Follow-Up Studies ; Humans ; Prosthodontics ; Retrospective Studies ; Splints

PURPOSE: This study aimed to examine the levels of perceived self-management support, self-efficacy for self-management, and health-related quality of life (HRQoL) in cancer survivors, and to identify the mediating effect of self-efficacy in the relationship between perceived self-management support and HRQoL. METHODS: This study used a descriptive correlational design. Two hundred and four cancer survivors who had completed treatment participated in the study. Measurements included the Patient Assessment of Chronic Illness Care Scale, the Korean version of the Cancer Survivors' Self-Efficacy Scale, and the Medical Outcomes Study Short Form-36. Data were analyzed using descriptive statistics, Pearson's correlation coefficient analysis, and multiple regression analysis using Baron and Kenny's method for mediation. RESULTS: The mean score for perceived self-management support was 3.35 out of 5 points, self-efficacy was 7.26 out of 10 points, and HRQoL was 65.90 out of 100 points. Perceived self-management support was significantly positively correlated with self-efficacy (r=.29, p<.001) and HRQoL (r=.27, p<.001). Self-efficacy was also significantly correlated with HRQoL (r=.59, p<.001). Furthermore, self-efficacy (β=.55, p<.001) had a complete mediating effect on the relationship between perceived self-management support and HRQoL (Z=3.88, p<.001). CONCLUSION The impact of perceived self-management support on HRQoL in cancer survivors was mediated by self-efficacy for self-management. This suggests that strategies for enhancing self-efficacy in cancer survivors should be considered when developing self-management interventions for improving their HRQoL.

PURPOSE: This study aimed to examine the levels of perceived self-management support, self-efficacy for self-management, and health-related quality of life (HRQoL) in cancer survivors, and to identify the mediating effect of self-efficacy in the relationship between perceived self-management support and HRQoL. METHODS: This study used a descriptive correlational design. Two hundred and four cancer survivors who had completed treatment participated in the study. Measurements included the Patient Assessment of Chronic Illness Care Scale, the Korean version of the Cancer Survivors' Self-Efficacy Scale, and the Medical Outcomes Study Short Form-36. Data were analyzed using descriptive statistics, Pearson's correlation coefficient analysis, and multiple regression analysis using Baron and Kenny's method for mediation. RESULTS: The mean score for perceived self-management support was 3.35 out of 5 points, self-efficacy was 7.26 out of 10 points, and HRQoL was 65.90 out of 100 points. Perceived self-management support was significantly positively correlated with self-efficacy (r=.29, p<.001) and HRQoL (r=.27, p<.001). Self-efficacy was also significantly correlated with HRQoL (r=.59, p<.001). Furthermore, self-efficacy (β=.55, p<.001) had a complete mediating effect on the relationship between perceived self-management support and HRQoL (Z=3.88, p<.001). CONCLUSION: The impact of perceived self-management support on HRQoL in cancer survivors was mediated by self-efficacy for self-management. This suggests that strategies for enhancing self-efficacy in cancer survivors should be considered when developing self-management interventions for improving their HRQoL.
Chronic Disease ; Humans ; Methods ; Negotiating ; Quality of Life ; Self Care ; Self Efficacy ; Survivors

INTRODUCTION: It is now generally accepted that free radicals play an important role in the development of various forms of tissue damage and pathological events, such as heart disease, cancer, and aging. On the other hand, it is difficult to demonstrate the injurious actions of free radicals in vivo, and it has not been clearly proven experimentally whether the damage is really caused by free radicals, nor how the free radicals damage biological molecules, primarily because of the difficulty in generating free radicals in biological systems under controlled conditions. PURPOSES OF STUDY: In this study, we investigated whether the histologically different part of lesion is created in liver injuries by free radicals formed from each mechanism. we investigated the usefulness of the ICG excretion test as an early indicator of liver injury, and the significance of an increase of urinary biopterin in free radical injury. MATERIALS & METHODS: In this study, the acute hepatic injuries were induced in the Sprague-Dawley rat by intraperitoneal injection with CCl4(0.125 ml/100 gm body wt.) and AAPH(1 mg/100 gm body wt.). Control rats were treated with 0.5 ml of corn oil per 100 gm via intraperitoneal route. And then, liver function tests(ALT, AST, ALP, gamma-GTP, serum bilirubin and ICG excretion test), alpha-fetoprotein, urinary biopterin and histologic changes were serially examined. Total 130 rats were prepared, and each group of 5 rats of them were sampled at intervals of 2, 4, 8, 12, 24, 48 hours following administration of CCl4, AAPH solution. All values were expressed as mean +/- standard error. The results of all treatment groups and control group were analyzed by ANOVA with Duncan's multiple range test for variable. And then, the correlations between the increasing rates of urinary biopterins, ICG T1/2 and those of classic liver enzyme activities, serum bilirubin levels were analyzed for statistical significance by Pearson correlation analysis. In this analysis, a p-value below 0.05 was considered to be statistically significant. RESULTS: 1. Activities of liver enzymes(serum AST, ALT, ALP and gamma-GTP) and levels of serum bilirubin significantly increased in all the treatment groups compared to control. As time passed, these levels continued to increase(p<0.05). 2. In comparison with AAPH treatment group, serum AST and ALT of CCl4 treatment group increased more significantly(p<0.05). 3. In ICG excretion test, ICG T1/2 of all the treatment groups were greatly prolonged from about 4 - 12 hours. Compared to AAPH treatment group, ICG T1/2 of CCl4 treatment group was more significantly prolonged(p<0.05). 4. As time passed, urinary biopterin levels of all the treatment groups increased from about 24 hours. Urinary biopterin levels of AAPH treatment group increased more significantly than in CCl4 treatment group from about 48 hours(p<0.05). 5. In histopathologic view, CCl4 treated hepatic acini showed that hepatocytes in centrilobular zone were degenerated. But, AAPH treated livers showed that all hepatocytes were degenerated. 6. Passive hemagglutination tests of alpha-fetoprotein showed negative reaction in all the treatment groups and control group. 7. Correlations were statistically significant(p<0.05) between the increasing rates of urinary biopterin levels and those of classic liver enzyme activities(except, serum AST), and serum bilirubin levels in CCl4 induced hepatotoxicity. 8. In AAPH induced hepatotoxicity, the increasing rates of urinary biopterin levels correlated with those of classic liver enzyme activities(serum ALT, AST, ALP, -GTP) and serum bilirubin levels(p < 0.05). 9. The increasing rates of ICG T1/2 correlated significantly with those of liver enzyme activities and serum bilirubin in CCl4 and AAPH induced hepatotoxicity(p<0.05), but there were no statistically significant correlations between the increasing rates of ICG T1/2 and those of serum ALT in CCl4 induced hepatotoxicity. 10. And also, the increasing rates of ICG T1/2 correlated significantly with those of urinary biopterin in CCl4 and AAPH induced hepatotoxicity(p<0.05). CONCLUSION: We observed in this study that the difference in hepatic lesions induced by free radicals might be closely related to the site where free radicals had been generated. We indirectly found that the tissue damage is caused by free radicals. There were excellent correlations between urinary biopterin levels, ICG excretion test and classic liver enzyme activities, and serum bilirubin levels in acute hepatic injuries induced by free radicals from CCl4 and AAPH. Also, we determined that ICG excretion test is a saturable process for evaluation of acute hepatic injury. The urinary biopterin levels in CCl4 treated groups were significantly different from those of AAPH treated groups suggesting that an unknown mechanism is concerned with free radical induced biopterin elevation. However, the level of urinary biopterin in free radical injury may be a useful complementary index.
Aging ; alpha-Fetoproteins ; Animals ; Bilirubin ; Biopterin ; Corn Oil ; Free Radicals ; Hand ; Heart Diseases ; Hemagglutination Tests ; Hepatocytes ; Injections, Intraperitoneal ; Liver ; Rats ; Rats, Sprague-Dawley*

Inducible nitric oxide synthase (iNOS) expression of several organs on the lipopolysaccharides (LPS)-injected rats and on excisional wound was observed by immunohistochemical methods to investigate iNOS-positive cells during inflammation. iNOS expression was induced in response to LPS in the brain and these reactions were observed in the choroidal epithelium, ependymal cells and a few of nerve cells and fiber. A more intensive reaction of nerve cell and fiber was mainly observed in the corpus callosum and hypothalamus. Induction of iNOS of the lung was observed in alveolar macrophage, smooth muscle, pneumocytes and inflammatory cells infilterated in the alveolar septum. iNOS expression of the liver was detected in Kupffer cells, hepatocytes, bile duct and inflammatory cells of spotty necrosis. The cardiac muscle and endothelial cell of the heart showed positive iNOS expression. In the excisional wound, inflammatory cells including macrophages, neutrophil and fibrobast showed iNOS expression and mainly detected necrobiotic layer. Collectively, iNOS expression was induced in the several cell types during inflammatory process. So for better understanding the function of iNOS, more research should be done in relation to each cell type of organ.
Animals ; Bile Ducts ; Brain ; Choroid ; Corpus Callosum ; Endothelial Cells ; Epithelium ; Heart ; Hepatocytes ; Hypothalamus ; Inflammation ; Kupffer Cells ; Lipopolysaccharides ; Liver ; Lung ; Macrophages ; Macrophages, Alveolar ; Muscle, Smooth ; Myocardium ; Necrosis ; Neurons ; Neutrophils ; Nitric Oxide Synthase Type II* ; Pneumocytes ; Rats* ; Shock* ; Wound Healing* ; Wounds and Injuries*

Bilateral pneumothorax is very rare in primary spontaneous pneumothorax patients. This condition can cause chest pain, dyspnea, and even lead to tension pneumothorax. Spontaneous hemopneumothorax can be lethal due to massive bleeding and hypovolemic shock. This condition requires precise decision making and emergency management. We report on a case of simultaneous bilateral spontaneous pneumothorax combined with hemopneumothorax in a healthy 21-year-old male patient with chest discomfort. In the emergency department, closed thoracostomy was performed for decompression of hemopneumothorax, with drainage of 850 mL of blood. Then bilateral video-assisted thoracoscopic surgery was performed successfully.
Chest Pain ; Decision Making ; Decompression ; Drainage ; Dyspnea ; Emergencies ; Emergency Service, Hospital ; Hemopneumothorax* ; Hemorrhage ; Humans ; Male ; Pneumothorax* ; Shock ; Thoracic Surgery, Video-Assisted ; Thoracostomy ; Thorax ; Young Adult

Purpose: To compare the surgical outcomes of peritoneal irrigation versus suction alone during laparoscopic appendectomy and to identify the risk factors of surgical site infection in patients with uncomplicated acute appendicitis. Methods: Data from patients with uncomplicated acute appendicitis between January 2014 and March 2016 were reviewed. We compared the irrigation and suction alone groups with regard to the following parameters: postoperative complication incidence rate, length of hospital stay, operation time, time to flatus, time to diet commencement, and duration of postoperative antibiotic. Results: A total of 578 patients underwent laparoscopic appendectomy for uncomplicated acute appendicitis. Twenty-five patients were excluded from the analysis because of need for drain insertion, loss to follow-up, simultaneous surgery for another indication, presence of an appendix tumor, or pregnancy. A total of 207 patients (37.4%) had undergone irrigation, and 346 patients (62.6%) received suction alone during laparoscopic appendectomy. The preoperative fever rate was significantly higher in the irrigation group than in the suction alone group. Operative time was also significantly longer in the irrigation group than in the suction alone group (53.8 ± 18.5 minutes vs. 57.8 ± 21.4 minutes, P = 0.027). The postoperative complication rate was higher in the irrigation group than in the suction alone group (4.5% vs. 12.6%, P = 0.001). Multiple logistic regression analysis showed that irrigation and preoperative fever were risk factors for surgical site infection after laparoscopic appendectomy for uncomplicated acute appendicitis. Conclusion There is no advantage to irrigating the peritoneal cavity over suction alone during laparoscopic appendectomy for uncomplicated acute appendicitis. Irrigation may actually prolong the operative time and therefore be detrimental.