No abstract available.
Islets of Langerhans* ; Lymph Nodes* ; Neoplasm Metastasis*

PURPOSE: Emotional and behavioral disturbances have been reported in severe short stature children. The purpose of this study was to examine psychosocial problems in children with Growth hormone deficiency(GHD), comparing with their normal height siblings. METHODS: Twenty three children with GHD(17 boys and 6 girls, mean age:13.1+/-2.8 yrs) were included. Their normal height siblings(8 boys and 2 girls, mean age:12.3+/-2.9 yrs) were included as control group. Parents of all participating children completed the Child Behavior Checklist. Patients 10 years and older completed the Youth Self Report. RESULTS: 1)Internalizing problem scores(somatic complaints, anxiety, depression, social incompetence) were higher in GHD compared to control group(49.0+/-15.0 vs 43.2+/-6.2, P<0.05). Externalizing problem scores and social competences were not different between GHD and control group. 2) Total problem scores in GHD were not different by sex. 3)Total problem scores were not different between idiopathic GHD and organic GHD. 4)Attention problems(r=0.45, P<0.05), delinquent behavior(r=0.49, P=0.01) and aggressive behavior(r=0.51, P<0.01) increased by age. 5)Height SDS negatively correlated with social problem(r=-0.47, P<0.05) and delinquent behavior(r=-0.61, P<0.01). Height SDS also negatively correlated with somatic complaints(r=-0.75, P<0.01), anxiety and depression(r=-0.66, P=0.01). CONCLUSION: Internalized problems such as somatic complaints, anxiety and depression were higher in GHD than control group. Behavioral problem scores were increased by age and behavioral problem scores were correlated with height deficit. When we treat GHD children, appropriate medical and psychological counseling should be included.
Adolescent ; Anxiety ; Checklist ; Child Behavior ; Child* ; Counseling ; Depression ; Female ; Growth Hormone* ; Humans ; Parents ; Self Report ; Siblings

Thirty cases of rhabdomyosarcoma in patients under the age of 15 years were reviewed retrospectively to find out characteristics of histologic subtypes related to prognosis. Histologic diagnosis were embryonal in 21(70%), alveolar in 7(23%) and mixed type in 2(7%). Cellular anaplasia was noted in 6 cases. Round to polygonal cells with abundant eosinophilic cytoplasmic rim or globules were most characteristic cytologic feature or rhabdomyosarcomas, being followed by myofibrils. Myxoid and edematous stroma in embryonal type and alveolar pattern in alveolar type wee nost characteristic growth pattern. Immunohistochemically, tumors were positive for desmin, actin and myoglobin in 97%, 27%, and 40%, respectively. Consequently, characteristic cytologic features are important to differentiate rhabdomyosarcomas form other kinds of small round cell tumor and growth pattern is more critical in categorizing histologic subtypes. Desmin is far more useful than actin or myoglobin in the diagnosis of rhabdomyosarcoma.
Child ; Male ; Female ; Humans

Pseudoangiomatous stromal hyperplasia (PASH) of the breast occurs in premenopausal women and is characterized by anastomosing channels lined by spindle cells. It has been suggested to be of hormonal origin. This unusual condition may also be mistaken for a vascular tumor. We analyzed eight cases of PASH of the breast in Samsung Cheil Hospital from 1992 through 1998. All patients were premenopausal and had painless breast lump. Clinical diagnoses were fibroadenomas. Grossly, the masses were well circumscribed, nonhemorrhagic and measure 2.2 to 5 cm. Histologically, they consisted of complex interanastomosing channels lined by slender spindle cells, which resembled low grade angiosarcoma. Cells that line the interanastomosing channels showed no immunoreactivity for Factor VIII and electron microscopic findings consistent with fibroblast. All patients were treated with surgical excision and none of them had recurrence for 1 to 69 months (mean: 19 months) postoperatively. Pathologic diagnosis of PASH may be difficult unless the pathologists are aware of the presence of a mass lesion and appreciate the characteristic stromal changes. PASH should be included in the differential diagnosis of a circumscribed mass, especially in the premenopausal women.
Breast* ; Diagnosis ; Diagnosis, Differential ; Factor VIII ; Female ; Fibroadenoma ; Fibroblasts ; Hemangiosarcoma ; Humans ; Hyperplasia* ; Recurrence

Purpose: This is a methodological study investigating the validity and reliability of the rehabilitation nursing competency measurement tools by clinical career stage for rehabilitation nurses. Methods: Data were collected from 475 rehabilitation nurses at 13 rehabilitation hospitals across South Korea. Questionnaires were organized based on the ARN (Association of Rehabilitation Nurses) competency model for professional rehabilitation nursing. We verified content validity, construct validity (using factor analysis), convergent validity (using correlation with clinical performance ability), and reliability. Results: The CVI (Content Validity Index) of the measurement tools were all above CVI=.75 except for one item for beginner. After analyzing the measurement tools, there were 7 factors for beginner, 6 factors for intermediate, and 4 factors for advanced. Clinical performance ability and rehabilitation nursing competencies indicated a positive correlation for every clinical career stage. The Cronbach's ⍺ of the tool by clinical career stage were found to be .97, .98, and .99 for beginner, intermediate, and advanced stages respectively. Conclusion This study verified validity and reliability of the measurement tools for rehabilitation nursing competency and provided an opportunity to present the competency for rehabilitation nursing according to clinical career stage.

Purpose: This exploratory study aims to identify the influence of clinical practice belonging, satisfaction with major, and work values on the level of career identity among nursing students. Methods: The subjects of this study are 251 senior students from three nursing departments located in a metropolitan city. Using SPSS 22.0, the study uses technical statistics, t-test, One-way ANOVA, correlation, and multiple regression analysis. Results: The average scores for clinical practice belonging, satisfaction with major, and work values were 3.61, 3.87, and 3.70 out of 5.00, respectively, and 2.85 out of 4.00 for career identity. The factors affecting students' career identity were clinical practice belonging, aptitude, satisfaction with clinical practice, satisfaction with major, indoor work, service and employment at hospitals with 40 percent being explained by these variables. Conclusion Through this study we found that clinical practice belonging has the greatest impact on career identity. In order to enhance clinical practice belonging, universities and clinical institutions need to develop new programs and curricula.

BACKGROUND: Idiopathic left ventricular tachycardia with a QRS pattern of right bundle branch block and left axis deviation that is sensitive to verapamil is electrophysiologically distinct arrhythmia entity but descriptions in pediatric ages are infrequent. This study attempted to describe the clinical presentation and dignostic clues from the surface ECG in children with idiopathic left venteicular tachycardia. METHODS: We retrospectively reviewed the medical records, electrocardiograms, Holter recordings, echocardiographic reports of 10 children with idiopathic left ventricular tachycardia who have been managed at Sejong General Hospital and Asan Medical Center, Seoul, Korea from January 1991 to July 1996. Follow-up periods are 2 months to 5 years(mean=26 months). RESULTS: 1) Age of tachycardia onset was 8 months to 14 years(median=4.3 years). In 3 children tachycardia began from infancy. The main complaint in older children was palpitation and chest discomfort but young childen complained abdominal pain during tachycardia attack. Tachycardia was paroxysmal and sustained. Tachycardia responded to intravenous use of verapamil in 9 patients and was controlled by chronic verapamil medication in 6 patients. 2 patients were well without medication. Radiofrequency catheter ablation was done in an adolescent patient successfully. 2) In sinus rhythm, surface ECG showed normal QRS axis and normal QRS morphologies in all patients. During ventricular tachycardia, the heart rate was 183 to 270 beats/min. The taxhycardia of RBBB morphology was observed in all patients. The mean QRS duration was 109+-12ms and the QRS axis was -50* to -90*. Themean RS interval was 60+-12ms. AVdissociation was found on surface RCG in all patients and confirmed in 4 patients by transesophageal ECG. We tried rapid transesophageal atrial pacing in 3 patients and could induce and terminate the ventricular tachycardia. CONCLUSIONS: Idiopathic left ventricular tachycaedia is rare in childhood and is seen from infancy. Idiopathic left ventricular tachycardia is generally benign but occasionally causesmyocardial dysfunction. Idiopathic ventricular tachycardia with a QRS pattern of right bundle branch block amd left axis deviation that is sensitive to verapamil in children should not be confused with supraventricular tachycardia with aberrancy and most helpful diagnostic clue is AV dissociation in surface ECG.
Abdominal Pain ; Adolescent ; Arrhythmias, Cardiac ; Axis, Cervical Vertebra ; Bundle-Branch Block ; Catheter Ablation ; Child ; Chungcheongnam-do ; Echocardiography ; Electrocardiography ; Follow-Up Studies ; Heart Rate ; Hospitals, General ; Humans ; Korea ; Medical Records ; Retrospective Studies ; Seoul ; Tachycardia ; Tachycardia, Supraventricular ; Tachycardia, Ventricular* ; Thorax ; Verapamil

A 21-year-old man presented with a 7 days history of fever. Careful clinical examination led to the discovery of left supraclavicular lymphadenopathy without hepatosplenomegaly. Serologic tests for Ebstein-Barr virus, HIV, hepatitis type B & C, syphilis and typhoid fever were negative. Blood, urine, and stool cultures yielded no growth. Histologically, the process mainly involved the connective tissue framework of the lymph node, sharing the features of inflammatory pseudotmor(IPT) of other organs: a storiform growth pattern, increased vascularity with associated vascular lesions, and a polymorphous inflammatory infiltrate in a collagen-rich stroma. Immunohistochemical study for spindle cells showed positive reaction for actin and vimentin but not for desmin, and lymphoid cells revealed polyclonality. Characteristics of mass formation, and the inflammatory nautre of the process enabled us adopt the term IPT which should be differentiated from hematolymphoid proliferative disorder or mesenchymal neoplasia.
Male ; Humans

No abstract available.
Aorta* ; Pulmonary Artery*

Higenamine is known to possess stimulatory activity on beta-receptor of the heart. Chronotropic actions of higenamic were studied in spontaneously beating right atrial muscle isolated from rabbits. The frequency of spontaneous beating and the relative threshold voltage of the right atrium were examined. The relative threshold voltage was defined as the minimal voltage of the given impulse above which the right atrium could be paced at the frequency of 20% of higenamine was also observed. Higenamine caused the postive chronotropic effect. This response became prominent as the ca2+ concentration in the bathing solution lowered. When tetrodotoxin was added to the bathing solution, the effect of higenemine altered and became similar to that of epinephrine. Higenamine reduced the relative threshold voltage of the right atrium in the bathing solution with [ca2+] of 0.5mM. Such effect was abolished by tetrodotoxin. The effects of verapamill on the spontaneous rate and the relativel threshold voltage were inhibited by higenemine. The above results suggest that, aithough the main action og higenamine is on the Ca channel, higenamine also have a minor effect of augmenting the Na channel.
Baths ; Epinephrine ; Heart ; Heart Atria* ; Heart Rate ; Rabbits ; Tetrodotoxin ; Verapamil