Aneurysm of the internal carotid artery is a rare disease and is known to be associated with congenital arterial anomalies such as neurofibromatosis type I (NF-I). NF-I is an autosomal dominant neurocutaneous disorder characterized by a variety of manifestations that involve the central and peripheral nervous systems, skin, vascular system, and skeleton. In particular, the involvement of vascular abnormalities in NF-I is well known. Any vessel may be affected by this condition, although the renal artery is most frequently involved. The vascular abnormality can be occlusive or an aneurysmal degenerative change. Therefore, symptomatic presentations might assume an indolent pathophysiologic course such as hypertension, or manifest as a catastrophic event such as arterial rupture that could result in sudden death. We report a rare autopsy case of an aneurysmal rupture of the internal carotid artery in a woman with suspected NF-I, who collapsed in her home.
Aneurysm ; Autopsy ; Carotid Artery, Internal ; Death, Sudden ; Female ; Glycosaminoglycans ; Humans ; Hypertension ; Neurocutaneous Syndromes ; Neurofibromatoses ; Neurofibromatosis 1 ; Peripheral Nervous System ; Rare Diseases ; Renal Artery ; Rupture ; Skeleton ; Skin

PURPOSE: This study was conducted to investigate the factors influencing the quality of life among the patients with Crohn's disease. METHOD: Data were collected from 97 Crohn's disease patients between September 17 and October 20 in 2009. The collected data were analyzed by SPSS program. RESULTS: There were significant differences in the participants' quality of life depending on their age, economic status, pain, diarrhea, weight loss, Crohn's disease activity index (CDAI), and use of medications such as antidiarrhotica, steroid, and analgesics. The results also showed the correlations between the participants' qualities of life and thier pain, CDAI, anxiety, depression, perceived health condition, and of body image. Finally, the factors affecting the quality of life in patients with Crohn's disease included anxiety, perceived health state, pain, and CDAI. The explanatory power of these factors was 79.5%. CONCLUSION: The results imply that controlling the patients' pain and providing emotional support for anxiety reduction are crucial. In a similar vein, tailored nursing interventions considering individual patients' conditions are believed to help the patients positively perceive their disease. A future research, can conduct further investigations of these factors from more diverse perspectives, which is expected to promote more effective nursing strategies for Crohn's disease patients.
Analgesics ; Anxiety ; Body Image ; Crohn Disease ; Depression ; Diarrhea ; Humans ; Quality of Life ; Veins ; Weight Loss

Purpose: This study aimed to identify the mediating effects of career motivation and job-esteem and the effect of the nursing work environment on intention to stay among hospital nurses. Methods: Data were collected from 289 nurses working at an advanced general hospital. The research model design was based on the PROCESS macro proposed by Hayes and analyzed using SPSS 24.0 program. Results: The results showed a positive correlation between intention to stay and nursing work environment (r = .19, p = .001), career motivation (r = .34, p < .001), and job-esteem (r = .37, p < .001). Nursing work environment (B = 0.34 [.09~.59]) and job-esteem (B = 0.27 [.04~.49]) had a direct effect on intention to stay. There was a two-mediator sereal mediation effect of career motivation and job-esteem. The nursing work environment showed a significant effect on the intention to stay among hospital nurses through career motivation and job-esteem. Conclusion In order to increase the retention rate of hospital nurses, it is suggested that government and medical institutions provide multifaceted support that can increase nurses’ motivation for career development and recognition of the nursing profession through improvement of the nursing work environment.

A 56-year-old man presented with sudden onset of congestive heart failure (New York Heart Association class III to IV) after mild stress and developed various cardiovascular manifestations. At first visit, cardiac enzyme elevation, regional left ventricular (LV) wall motion abnormality and pulmonary edema were evident. However, coronary angiography was normal. LV function was totally recovered at discharge, suspicious of fulminant myocarditis. During the hospital stay, acute non-obstructive stroke without neurologic sequelae occurred. After 3 years, he re-admitted because ventricular tachycardia and severe LV systolic dysfunction (ejection fraction, 15%) were developed. After 3 days of applying percutaneous cardiopulmonary bypass system, the patient was completely recovered. Suspicious of pheochromocytoma, we checked 24-hour urine catecholamines and metanephrines and abdomen computed tomography, which revealed pheochromocytoma. The patient underwent laparoscopic adrenalectomy.
Abdomen ; Adrenalectomy ; Cardiomyopathies ; Cardiopulmonary Bypass ; Catecholamines ; Coronary Angiography ; Heart ; Heart Failure ; Humans ; Length of Stay ; Middle Aged ; Myocarditis ; Pheochromocytoma* ; Pulmonary Edema ; Stroke ; Tachycardia, Ventricular

We studied the ultrastructural alteration of glomerular anionic sites in 6 patients with minimal change nephrotic syndrome, 5 patients with membranous glomerulonephritis, 4 patients with focal segmental glomerulosclerosis, and 4 patients with IgA nephropathy by staining with polyethyleneimine (PEI) as a cationic probe. The control study was examined by using a nephrectomy specimen of non-glomerular disease which had no proteinuria. This method seems to selectively stain heparan sulphate in the basement membranes and has been widely used to evaluate changes in basement membrane charge in various human diseases as well as in experimental studies. The anionic sites in the lamina rara interna and lamina densa of normal glomerular basement membrane were always less numerous and less regularly distributed than those in the lamina rara externa. Characteristic common findings in these glomeruli showed a marked decrease of glomerular anionic sites in the regions with immune-complex deposits and normal distribution in the regions with focally those being absorbed and newly forming glomerular basement membrane. They were not detected in the gap of the basement membrane and on the area of the detached overlying epithelium using the PEI method. But the foot process fusion of epithelial cells seems not to influence the loss of anionic sites on the glomerular basement membrane.
Basement Membrane ; Epithelial Cells ; Epithelium ; Foot ; Glomerular Basement Membrane* ; Glomerulonephritis, IGA ; Glomerulonephritis, Membranous ; Glomerulosclerosis, Focal Segmental ; Humans ; Nephrectomy ; Nephrosis, Lipoid ; Polyethyleneimine ; Proteinuria

OBJECTIVES: There was an outbreak of foodborne and waterborne disease among high school students at Okcheon in June, 2018. First attack occurred June 5(th) but seven days later it was notified. The purpose of this investigation was to evaluate the pathogen of outbreak and cause of delayed notification. METHODS: First, we did a questionnaire survey for 61 cases and 122 controls to find what symptoms they had and whether they ate foods or drank water from June 2(nd) to June 12(th). Second, we investigated the environment of cafeteria and drinking water. Third, we examined specimen of cases and environment to identify bacteria or virus. RESULTS: Attack rate of this outbreak was 7.8%. Drinking water was strongly suspected as a source of infection in questionnaire survey but we could not find the exact time of exposure. Norovirus was identified in specimen of cases (2 students), drinking water (at main building and dormitory) and cafeteria (knife, dishtowel, hand of chef) CONCLUSIONS: We decided norovirus as the pathogen of this outbreak based on the clinical features of cases with diarrhea vomiting, abdominal pain and recovery within 2 or 3 days after onset, outbreak due to drinking water and microbiologic examination, And the cause of delayed notification might be the non-existence of the nurse teacher at that time and the lack of understanding of teachers on immediate notification under the outbreak. To prevent the delayed notification, notification system about outbreak of foodborne and waterborne disease in school is needed to be improved.
Abdominal Pain ; Bacteria ; Diarrhea ; Drinking Water ; Hand ; Humans ; Norovirus* ; Vomiting ; Water ; Waterborne Diseases*

No abstract available.
Abscess* ; Injections, Intramuscular* ; Pseudomonas aeruginosa* ; Pseudomonas*

No abstract available.

No abstract available.
Adult* ; Humans ; Therapeutic Equivalency*

PURPOSE: To make a histological study of a urethral plate using light and transmission electron microscopies to find evidence responsible for ventral curvature in hypospadias. MATERIALS AND METHODS: Full thickness biopsies of the urethral plate were obtained from 5 patients with proximal hypospadias; including 4 children and 1 adult. All specimens were examined with light and transmission electron microscopies. RESULTS: With the light microscope, all specimens demonstrated well vascularized connective tissue, comprised of smooth muscle and collagen. With the transmission electron microscope, all specimens demonstrated intact endothelial cells and fibroblasts, with dispersed chromatin distribution, intercellular loose collagen and a regular arrangement of collagen fibrils in intercellular spaces. No histological evidence of fibrous cord could be found in any of the specimens. CONCLUSIONS: No histological evidence of fibrous cord could be historically found that could be considered responsible for ventral penile curvature in hypospadias.
Adult ; Biopsy ; Child ; Chromatin ; Collagen ; Connective Tissue ; Endothelial Cells ; Extracellular Space ; Female ; Fibroblasts ; Humans ; Hypospadias ; Male ; Microscopy ; Microscopy, Electron ; Microscopy, Electron, Transmission* ; Muscle, Smooth ; Urethra