Sphenoid sinus aspergillosis is notorious for its serious complications, such as permanent cranial nerve deficits and possible death. The most common associated symptoms are headache, followed by visual changes, and cranial nerve palsies. Because of an insidious onset, frequently resulting in missed and delayed diagnosis, sphenoid sinus aspergillosis is a potentially lethal medical condition. We report a case of visual loss secondary to isolated sphenoid sinus aspergillosis. A 69-year-old man presented to our hospital with the complaint of headache. The headache started one year previously and was described as severe dull pain localized bilaterally to the temporo-orbital region. The patient took daily NSAIDs for the pain. The neurological examination was normal. The MRI of the brain showed a left sphenoid sinusitis. A transnasal endoscopic superior meatal sphenoidotomy was performed. Aspergillosis was confirmed after a surgical biopsy was obtained. The patient was discharged from hospital without antifungal therapy. One month later, the patient complained of headache and loss of vision bilaterally. The orbital MRI showed a left cavernous sinus and bilateral optic nerve invasion. The loss of visions was permanent. In our case, the diagnosis was delayed; antifungal agents were not administered after surgery and the patient lost his vision as a result. Therefore, early diagnosis and proper treatment are important. Although the treatment of an invasive type of aspergillus has not been established, surgical removal of a nidus and aggressive antifungal therapy are recommended.
Aged ; Anti-Inflammatory Agents, Non-Steroidal ; Antifungal Agents ; Aspergillosis* ; Aspergillus ; Biopsy ; Blindness* ; Brain ; Cavernous Sinus ; Cranial Nerve Diseases ; Cranial Nerves ; Delayed Diagnosis ; Diagnosis ; Early Diagnosis ; Headache* ; Humans ; Magnetic Resonance Imaging ; Neurologic Examination ; Optic Nerve ; Orbit ; Sphenoid Sinus* ; Sphenoid Sinusitis

A clinical study was made on 14 cases of coronary sinus rhythm and 17 cases of left atrial rhythm seen at the Kyungpook University Hospital during the past 13 years. The incidence of coronary sinus rhythm among 23, 137 electrocardiograms was 0.07% and that of left atrial rhythm was 0.08%. Among the various types of left atrial rhythm as diagnosed by Mirowski's criteria, type III, posterior type and inferior type were far more common than others. The most common underlying diseases were heart diseases in both coronary sinus rhythm and left atrial rhythm: five cases out of 14 in the former and 11 cases out of 17 in the latter were cardiac cases, respectively.
Coronary Sinus* ; Electrocardiography ; Gyeongsangbuk-do ; Heart Diseases ; Incidence

PURPOSE: This study was conducted to identify ethical climate factors in hospitals and analyze their influence on job satisfaction and organizational commitment. METHODS: A convenience sample of 196 nurses from one national university hospital in J city participated in this descriptive study survey. Instruments included the Ethical Climate Questionnaire, Job Satisfaction Scale, and Organizational Commitment Scale. Cronbach's alpha and factor analysis were done to test reliability and construct validity of the scales. Data were collected from March 15 to March 25, 2013 and analyzed using descriptive statistics, one-way ANOVA, t-test, Pearson correlation, and multiple regression with SPSS/WIN 18.0. RESULTS: Seven ethical climate factors were identified; laws and professional codes, social responsibility, company rules and procedures, self-interest, personal morality, efficiency, and friendship. Factors influencing job satisfaction were friendship (beta=.25), social responsibility (beta=.20), laws and professional codes (beta=.20), and educational level (beta=.27), explaining 37.6% of variance in job satisfaction. Factors influencing organizational commitment included social responsibility (beta=.29), friendship (beta=.27), laws and professional codes (beta=.23), and age (beta=.19), with explanatory power of 44.6%. CONCLUSION: Results can be used as preliminary data for developing new strategies to establish positive ethical climates in hospital environments and thus enhance nurses' job satisfaction and organizational commitment.
Climate ; Friends ; Humans ; Job Satisfaction ; Jurisprudence ; Morals ; Surveys and Questionnaires ; Social Responsibility ; Weights and Measures

No abstract available.
Breast Diseases* ; Breast*

Cutaneous or subcutaneous metastases occur in 2% to 9% of visceral malignancies. Skin metastases are seen most commonly from carcinomas of the breast, lung, large intestine. Skin metastases of prostatic origin are quite uncommon and preferentially localized to the lower abdomen and genital area. Two cases of cutaneous metastases of prostatic origin have been reported in the Korean dermatological literature in our review. We report a case of cutaneous metastases from prostatic cancer
Abdomen ; Breast ; Intestine, Large ; Lung ; Neoplasm Metastasis* ; Prostatic Neoplasms* ; Skin

Nevus lipomatosus superficialis is a fairly uncommon disease characterized by ectopic fat tissue in the dermis. Lesions most commonly occur on the lower trunk, especially on the back, buttocks or abdomen. Rarely, lesions also occur on the knee, axilla, arm, ear and scalp. To our knowledge this is the first case of nevus lipomatosus superficialis developing on the dorsal foot.
Abdomen ; Arm ; Axilla ; Buttocks ; Dermis ; Ear ; Foot* ; Knee ; Nevus* ; Scalp

No abstract available.
Humans ; Microcomputers*

Although intramedullary nailing is mostly used in the management of fractures in the long bone shaft, plate fixation is still alternative option in periprosthetic or metaphyseal fractures. For the rigid fixation during plating, sometimes we need wiring. Many surgeons experience slippage of wire resulting in loss of rigid fixation because plate and wire is so slippery and the diameter of bone is changing by level especially in the metaphyseal area. Wiring plate(CHO plate) was designed to prevent slippage. This plate has transverse holes for wires between screw holes on traditionally used dynamic compression plate. Sixteen fractures of long bone shaft were fixed with wiring plate and 11 cases which were followed up for more than one year were evaluated. There were periprosthetic fractures(4 cases), spiral or butterfly fractures(4 cases) and fractures of poor bone quality(two cases of malignancy and one case of osteoporosis). Nine cases were successfully reduced and the healed without loss of fixation. In two cases, delayed union and nonunion were observed due to wire breakage with plate loosening. Preliminarily, wiring plate fixation can be used for the periprosthetic fracture and one of alternative option in butterfly or spiral fracture and fracture in osteoporotic bone or pathologic fracture.
Butterflies ; Fracture Fixation, Intramedullary ; Fractures, Spontaneous ; Periprosthetic Fractures

PURPOSE: This study intends to examine the effects of a stepwise communication education program among nursing college students, focusing on scenarios and nursing case-based role playing. METHODS: The study design was a one-group repeated measure ANOVA. Participants were 27 nursing students in practice. Students participated in 5-week stepwise communication education program using SBAR; including 1 week of lecture education, 4 weeks of scenarios and nursing case-based role playing. The data were collected at each level of the education process: pre-education, after 1 week of lectures, and after completion of scenarios and nursing case-based role playing. Repeated measures ANOVA was used to determine changes in SBAR technique knowledge and communication self-efficacy. RESULTS: The stepwise communication education program using SBAR was effective in increasing SBAR technique knowledge, and communication self-efficacy. The lecture-based education was effective only in the area of SBAR technique knowledge and its subscale, attitudes towards SBAR. However, scenarios and nursing case-based role playing was broadly effective across communication self-efficacy, SBAR technique knowledge, and its subscale, knowledge of the SBAR. CONCLUSION: Based on this study, we propose that it is necessary to confirm the effect of long-term SBAR communication education using scenarios and nursing case-based role playing in nursing students' practice.
Education* ; Humans ; Lectures ; Nursing* ; Role Playing* ; Self Efficacy ; Students, Nursing*

A healthy 18-year-old woman presented with an asymptomatic tiny papular eruption on the hands, forearms, legs and trunk. A skin biopsy from the left forearm revealed a typical lichen nitidus lesion associated with an adjacent transepidermal perforating lesion. We report a case of perforating lichen nitidus, and briefly review the relevant literature of perforating lichen nitidus.
Adolescent ; Biopsy ; Female ; Forearm ; Hand ; Humans ; Leg ; Lichen Nitidus* ; Lichens* ; Skin