Cystadenoma of the liver is a rare neoplasm. Although many cystadenomas are asymptomatic, symptoms can include abdominal pain, postprandial epigastric discomfort, and nausea. Dramatic changes in hepatic imaging techniques have been helpful for diagnosing cystic lesions of the liver, such as simple cyst, hydatid cyst, cystadenoma, cystadenocarcinoma, and metastatic neuroendocrine tumors. However, it remains difficult to differentiate cystadenoma from cystadenocarcinoma for multiseptated cystic hepatic lesions with papillary projection on computed tomography (CT) and magnetic resonance imaging (MRI). Here we report the case of a 47-year-old woman with several months of postprandial discomfort and abdominal fullness. CT and MRI revealed multiseptated cystic lesions with papillary excrescences. A left hemihepatectomy was performed. Histology showed a benign mucinous cystic tumor with ovarian-like stroma.
Abdominal Pain ; Cystadenocarcinoma ; Cystadenoma ; Cystadenoma, Mucinous ; Cystadenoma, Papillary ; Echinococcosis ; Female ; Humans ; Liver ; Magnetic Resonance Imaging ; Middle Aged ; Mucins ; Nausea ; Neuroendocrine Tumors

BACKGROUND: Care for prehospital cardiac arrest is one of the major concerns of emergency medical services. But, in Korea, prehospital emergency medical service systems are not yet well established. We tried to offer one of the fundamental data for development of these systems. METHODS: After application of exclusion criteria, 183 patients who transferred to emergency center of our hospital after cardiac arrest in consecutive 24 months from Jan,1,1994 to Dec,31,1995 were included in this study. Retrospective review of the hospital charts of these patients was done. For statistical analysis, we divided patients to some categories. t-test or chi-square analysis was used. RESULTS: 24 patients of the 183 patients were secondary visitors(cardiac arrest was occurred during transfer from other hospitals), 159 patients were primary visitors. In the primary visitor group, only one third was ambulance visitors, and there is no statistical differences between arrest time of ambulance visitors and non-ambulance visitors(35+/-27 vs 37+/-24 min, p=NS). No organized bystander CPR was done. After arrival, 131 patients received CPR and 87 patients(66.4%) were not responded, 31 patients(23.1%) experienced transient ROSC, 13 patients(10.0%) survived until discharge, and only 2 patients(1.5%) were returned to their lives. CONCLUSION: We failed to find significant statistical survival differences between ambulance visitors and non-ambulance visitors, between presumed cardiac etiology group and non-cardiac etiology group. Survival rate was high in witnessed arrest group than unwitnessed arrest group(14.5% vs 2.1%, p=0.015).
Ambulances ; Cardiopulmonary Resuscitation ; Emergencies ; Emergency Medical Services ; Heart Arrest* ; Humans ; Korea ; Retrospective Studies ; Survival Rate

PURPOSE: This study aims to understand the influence of college entrance system-related factors and scores of college scholastic ability test on a first year nursing student's academic achievement. METHODS: Data collected include both a descriptive survey designed to assess college entrance system-related factors with respect to 182 nursing students attending a 4-year nursing college program and their test scores in the first year. The data were analyzed via descriptive statistics, Mann-Whitney U test, Kruskal-Wallis test with Bonferroni's correction, and Spearman's rank correlation coefficient through an SPSS 18.0 program. RESULTS: Student academic achievement with regard to college entrance system-related factors exhibited significant divergence from first year grade point averages (hereafter GPA) and natural science grades. CONCLUSION: This study confirmed the existence of significant differences, depending on the factors regarding the college entrance system. As a result, conducting assessment to evaluate the level of basic knowledge before college entrance is highly recommended. Also recommended is the development of a support program for students projected to have difficulties with respect to their academic achievement.
Education ; Humans ; Natural Science Disciplines ; Nursing ; School Admission Criteria ; Students, Nursing*

PURPOSE: The purpose of this study was to measure the level of job stress and health status and find out factors affecting the health status among circulation enterprise workers. METHOD: This study was a cross-sectional descriptive study. The subjects were 128 workers whose mean age was 33.2 years. Korean occupational stress questionnaire Short Form was used to measure job stress. Todai Heath Index that was made by Aoki in 1977 and translated by Kim(1997) was used to measure the health status. RESULTS: The total job stress scores of men and woman fell in the lower 50% of Korean workers. Job autonomy and interpersonal conflicts as a subcategories fell in upper level 50% in both men and women and job insecurity fell in the upper level 50% in women. The mean score of health status was 51.47, indicating slightly higher frequency of complains of health symptoms. There was no significant correlation between total job stress and total health status. Finally, factors influencing the health status were organizational system and age. CONCLUSION: Based on the results of this study, it is necessary to develop comprehensive stress management programs including interventions of personal and organizational levels for promoting workers' health.
Female ; Humans ; Male ; Surveys and Questionnaires

OBJECTIVE: The purpose of this study was to find out whether the duration of the silent period evoked by magnetic transcranial stimulation could be modulated by lorazepam. METHOD: Ten healthy volunteers were tested using the transcranial magnetic stimulation. Responses were recorded in the active abductor digiti minimi muscle, and baseline values were compared to the data obtained at 2 and 5 hours after administration of a single oral dose of 2.5 mg lorazepam. RESULTS: The motor threshold and size of the motor evoked potential remained unchanged after administration of lorazepam. The duration of cortical silent period was prolonged from 169.9+/-33.7 msec at baseline study to 248.1+/-50.4 msec at 2 hours and 248.5+/-47.3 msec at 5 hours after administration of the drug (p<0.01), but the peripheral silent period did not show any significant change. CONCLUSION: We have shown that the cortical silent period evoked by magnetic transcranial stimulation can be prolonged by administration of lorazepam. And the lack of effect on the motor threshold and on the size of the motor evoked potential after administration of lorazepam may indicate that these parameters are physiologically distinct from the cortical silent period. Therefore, prolonged cortical silent period may be resulted from the reinforcement of GABA action by lorazepam at the level of the motor cortex.
Evoked Potentials, Motor* ; gamma-Aminobutyric Acid ; Healthy Volunteers ; Lorazepam* ; Motor Cortex ; Transcranial Magnetic Stimulation

Maspin is a recently described gene with tumor suppressor activity. The gene product is a 42 kD protein with homology to the serpin family of protease inhibitors and may play a role as an inhibitor of tumor cell invasion. The prior observation that invasive breast cancers and their metastases showed decreased maspin protein expression by immunostaining supports this speculation. However, the role of maspin in breast cancer progression has not been studied in detail. We, therefore, studied maspin protein expression in a series of hyperplasia, atypical ductal hyperplasia, intraductal carcinoma and invasive carcinomas. Immunohistochemical staining (IHC) for maspin was performed on paraffin sections of 136 breast specimens using a commercially available monoclonal antibody. Among the 106 cases studied were 36 moderate/florid ductal hyperplasia, 11 atypical ductal hyperplasia (ADH), 29 intraductal carcinoma (IDC) (4 low grade, 13 intermediate grade, 12 high grade) and 30 invasive ductal carcinomas. Thirty cases of normal breast were also studied as control group. IHC stains were scored using a semiquantitative scoring system. The mean IHC scores for maspin for normal, moderate/florid hyperplasia, atypical ductal hyperplasia, intraductal carcinoma, and invasive carcinoma were 5.51 1.30, 7.36 0.72, 3.82 1.60, 4.48 2.69, 3.97 3.30, respectively. These scores for each category were statistically significant (p<0.05), except between ADH and IDC. Maspin protein expression was increased in most cases of moderate/florid hyperplasia, while maspin expression was more heterogeneous in ADH and IDC. In high grade IDC, maspin protein expression was stronger than low and intermediate grade IDC, and this suggests the possibility of a compensatory cellular response against the forces driving further tumor progression. Two thirds of invasive ductal carcinomas expressed maspin protein weakly and focally. All metastatic carcinomas of lymph nodes were negative for maspin. It is possible that high grade IDC with strong maspin expression may represent a subset less likely to progress to invasive cancer. This speculation merits investigation in clinical outcome studies.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Coloring Agents ; Humans ; Hyperplasia* ; Lymph Nodes ; Neoplasm Metastasis ; Outcome Assessment (Health Care) ; Paraffin ; Protease Inhibitors

BACKGROUND: The survival in patients with hepatocellular carcinoma (HCC) has recently been improved by the advancement in the early detection of HCC. Among the various treatment modalities, the surgical resection has been considered as the most effective for small HCC, and the clinical course of patients with small HCC who underwent curative resection is known to be dependent on the etiology of HCC. Since the differences in the etiology of HCC depend on the different geographical area, it is necessary to verify the clinical outcomes and their affecting factors in patients with small HCC after curative resection in Korea, one of the hepatitis- B-virus(HBU)-endemic areas. METHODS: A total of 89 patients with small HCC (or=50 years old), Child's classification and vascular invasion were factors affecting the rate of recurrence. CONCLUSION: These results verify that the clinical outcomes of patients with small HCC after curative resection in Korea are similar to those of patients with different etiology of HCC in other geographic areas. To improve the prognosis of patients with small HCC after curative resection, strict preoperative evaluation of the presence of vascular invasion and postoperative preservation of liver function are necessary as well as the close postoperative follow-up for the early detection of recurrence.
Carcinoma, Hepatocellular* ; Classification ; Follow-Up Studies ; Hepatitis B Surface Antigens ; Humans ; Korea ; Liver ; Liver Cirrhosis ; Mortality ; Prognosis ; Recurrence ; Retrospective Studies ; Seoul ; Survival Rate

It is deirable to identify the tumoric factors anticipating the therapeutic failure in breast cancer patients received postoperative adjuvant chemotherapy. So, we studued the tumoric topoisomerase II alpha enzyme, c-erbB-2 oncoprotein, and Pgp expression in breast cancer tissues to identify the roles of these factors as the predictors of chemotherapeutic result. The results were as follows. 1) There wee no significant differences in the average value of topoisomerase II alpha enzyme, c-erb B-2 oncoportein overexpression, and Pgp expression according to stages. 2) CAF chemotherapy was suggested to be more effective than CMF chemotherapy in more advance stages. 3) There was a possible suggestion that the breast cancer with high topoisomerase II alpha enzyme activity might indicate the failure with CMF chemotherapy. 4) C-erbB-2 oncoportein overexperession suggested the possibility of therapeutic failure with CMF chemotherapy and the selection of CAF chemotherapy might improve the survival of advanced breast cancer patients with c-erbB-2 overexpression. In conclusion, it was suggested that c-erb-2 oncopotein overexpression and high topoisomerase II alpha activity might have a meaningful role in the selection of proper chemotherapeutic regimen in setting of adjuvant chemotherapy and predict the therapeutic failure of some chemotherapeutic agents for breast cancer. An expanded study for these factors is required to reveal the clinical significance in chemotherapy for breast cancer patients.
Breast Neoplasms* ; Breast* ; Chemotherapy, Adjuvant ; DNA Topoisomerases, Type II* ; Drug Therapy* ; Humans ; P-Glycoprotein*

No abstract available.
Humans ; Hypophosphatemia*

PURPOSE: We report a rare case of bilateral macular infarction as an ocular presenting sign of primary antiphospholipid syndrome. CASE SUMMARY: A 29-year-old woman who had undergone a cesarean section for chorioamnionitis in the department of Obsterics was referred to the department of ophthalmology for bilateral visual loss. At examination, best-corrected visual acuity (BCVA) of the right eye was counting fingers, and for the left was 0.05. Fundus examination revealed extensive macular edema and cotton-wool spots in both eyes. We performed hematologic tests including thrombophilia examination. Antinuclear antibody and rheumatoid factor were negative but lupus anticoagulant presented high titers on two occasions 12 weeks apart. She was administered sub-Tenon's injections of triamcinolone acetonide 50 mg/week in both eyes under the diagnosis of bilateral macular arteriolar occlusion in primary antiphospholipid syndrome. Her BCVA remained 0.025 in her right eye and improved to 0.125 in her left eye. CONCLUSIONS: Macular infarction is an uncommon but severe complication of antiphospholipid syndrome. Early and regular fundus exam in patients with antiphospholipid syndrome is necessary to avoid progression of severe ocular complications.
Adult ; Antibodies, Antinuclear ; Antiphospholipid Syndrome* ; Cesarean Section ; Chorioamnionitis ; Diagnosis ; Female ; Fingers ; Hematologic Tests ; Humans ; Infarction* ; Lupus Coagulation Inhibitor ; Macular Edema ; Ophthalmology ; Pregnancy ; Rheumatoid Factor ; Thrombophilia ; Triamcinolone Acetonide ; Visual Acuity