Uterine perforation related with dilatation and curettage (D&C) is an uncommon event. Combined complications such as hemorrhage, adjacent organ injury, and omental incarceration may require an emergent surgical treatment. These are usually evident immediately or several days after the D&C, and a delayed presentation of uterine perforation are extremely rare. Herein, we report a rare case of omental incarceration presenting as a hyperechoic endometrial mass in a postmenopausal woman, diagnosed twenty-three years after the D&C. According to this case, when we encounter a hyperechoic endometrial lesion penetrating the uterine wall in women with a history of an intrauterine procedure such as D&C, we need to consider the possibility of an incarcerated omentum.

Uterine perforation related with dilatation and curettage (D&C) is an uncommon event. Combined complications such as hemorrhage, adjacent organ injury, and omental incarceration may require an emergent surgical treatment. These are usually evident immediately or several days after the D&C, and a delayed presentation of uterine perforation are extremely rare. Herein, we report a rare case of omental incarceration presenting as a hyperechoic endometrial mass in a postmenopausal woman, diagnosed twenty-three years after the D&C. According to this case, when we encounter a hyperechoic endometrial lesion penetrating the uterine wall in women with a history of an intrauterine procedure such as D&C, we need to consider the possibility of an incarcerated omentum.

BACKGROUND: High glucose upregulates MCP-1 expression in rat glomerular mesangial cells and in human peritoneal mesothelial cells. However, the role of high glucose-induced MCP-1 on the development and progression of diabetic renal injury and peritoneal injury during peritoneal dialysis(PD) using high glucose PD solutions are not clear. Since MCP-1 was shown to upregulate transforming growth factor-beta1(TGF-beta1) and collagen expression in lung fibroblasts, the present study investigated the effects of MCP-1 on fibronectin secretion by mouse mesangial cells(MMC), human peritoneal mesothelial cells (HPMC), and human peritoneal fibroblasts(HPFB). METHODS: Synchronized cells were stimulated by different concentrations of MCP-1(0.1-100 ng/mL) or TGF-beta1(0.1-10 ng/mL) for 48 hours. Fibronectin protein secreted into the media was analyzed by Western blot analysis. RESULTS: MCP-1 up to 100 ng/mL did not affect fibronectin secretion by MMC. TGF-beta1 10 ng/mL, however, increased fibronectin secretion by MMC 2.8 fold that of control. MCP-1 up to 100 ng/mL did not affect fibronectin secretion by HPMC. But, TGF-beta1 0.1 ng/mL increased fibronectin secretion by HPMC 1.8 fold compared to control. On the other hand, MCP-1 increased fibronectin secretion by HPFB in a dose-dependent manner. MCP-1 at 1-10 ng/mL significantly increased fibronectin when compared to M199 control. 100 ng/mL MCP-1 further increased fibronectin secretion by HPFB compared to 0.1-10 ng/mL MCP-1. CONCLUSION: These results suggest a possible role for MCP-1 in the development and progression of peritoneal fibrosis and support the view that in addition to recruiting inflammatory cells MCP-1 may play a role in tissue fibrosis in other organs.
Animals ; Blotting, Western ; Chemokine CCL2* ; Collagen ; Fibroblasts* ; Fibronectins* ; Fibrosis ; Glucose ; Hand ; Humans* ; Lung ; Mesangial Cells ; Mice ; Monocytes* ; Peritoneal Fibrosis ; Rats ; Transforming Growth Factor beta1

Ascending aortic aneurysm of the thorax is a condition characterized by an increase in the diameter of the ascending aorta between the aortic valve and the brachiocephalic artery. Most patients with ascending aortic aneurysm are asymptomatic and do not require treatment; the rates of dissection, rupture, and mortality are also low. In this report, we describe the autopsy findings in a case of sudden death due to acute myocardial infarction secondary to the previously asymptomatic, unruptured, and undissected aortic aneurysm of the thoracic ascending aorta extending to the sinus of Valsalva. The findings in this case emphasize the importance of preventive management of asymptomatic ascending aortic aneurysms, and possible mechanisms of sudden cardiac death in patients with uncomplicated ascending aortic aneurysm is also discussed.

We investigated the work-life balance of clinical professors in charge of patient care, research, and education at medical schools and the demand for work-life balance support according to position (professor, associate professor, or assistant professor). In total, 163 clinical professors completed the consent form and participated in the study. They filled out an online survey consisting of questions about essential characteristics, a work-life balance test, stress, burnout, work-life satisfaction, and work-life balance support needs. We analyzed the results by analysis of variance and cross-tabulation using IBM SPSS ver. 23.0. Differences were found in work-life balance, stress, burnout, and satisfaction with life and work by position. The requirements for support for work-life balance also varied by professional status. Professors had a higher balance between life and work than associate professors or assistant professors. The specific requirements for work-life balance support were also slightly different for each position. Overall, there was a high demand for work process simplification and efficiency for work support, flexible working hours and sabbatical years for family and leisure, and career management consulting and training support for growth. Assistant professors and associate professors had a lower level of work-life balance than professors, as well as higher levels of stress and burnout. Professors' job satisfaction was also higher than that of the other groups. Based on the results of this study, we hope that a healthy work environment can be established through work-life balance support suitable for clinical professors’ positions.

Methods: Three hundred and sixty-nine students in art high school completed a battery of measures, including the Korean version of the KMPAI, State-Trait Anxiety Inventory (STAI), Liebowitz Social Anxiety Scale (LSAS), Center for Epidemiologic Studies-Depression Scale (CES-D), and Frost Multidimensional Perfectionism Scale-Korean version (FMPS-K). The construct validity of the Korean version of KMPAI was examined by performing explorative factor analysis. The reliability was assessed by the internal consistency using Cronbach’s alpha. Results: Explorative factor analysis for the construct validity showed that the Korean version of KMPAI was composed of seven factors (factor 1: Worry/dread and Negative cognitions; factor 2: Proximal somatic anxiety and Worry about performance; factor 3: Depression/hopelessness; factor 4: Parental empathy–Memory–Controllability; factor 5: Generational transmission of anxiety;factor 6: Trust; factor 7: Rumination), explaining 61% of the total variance. The T Concurrent validity with the other scales (STAI, LASA, CES-D, and FMPS-K) was statistically significant. The Cronbach’s alpha value for the internal consistency of the Korean version of KMPAI was excellent (r=0.961). Conclusion The Korean version of the KMPAI is a reliable and valid instrument for measuring music performance anxiety in Korea.

Purpose: To explore the scope and method of applying standardized nursing terminologies to nursing diagnosis and problems used in nursing practice. Methods: A descriptive study was done with a retrospective analysis of the nursing records of 141,420 patients that were hospitalized in 4 tertiary hospitals. The nursing diagnosis and problems collected from the records were standardized, and the standardized nursing diagnosis and problems cross mapped with NANDA-I, confirmed in a nursing focus group. Results: 65 (67.7%) of the 96 standardized nursing diagnosis and problems were equal with NANDA-I and included in the 10 domains of NANDA-I. Among 86 nursing diagnosis and problems excluded from the cross mapping with NANDA-I, the 63 terms (73.3%) related to surgery/procedure were the most common. Conclusion It is meaningful that multi-tertiary hospital nursing diagnosis and problems were standardized and cross mapping with standard nursing terminologies was performed. As for the method of applying standardized nursing terminologies in nursing practice, it is appropriate to use several standardized nursing terminologies complementarily.

PURPOSE: In order to assess the usefulness of serum ferritin as a marker of disease activity and prognostic factor in pediatric malignancy, serum ferritin levels were measured. METHODS: Peripheral blood samplings for ferritin level were made at presentation, in remission following therapy, and in relapse in 95 children with malignancy admitted to the Department of Pediatrics, Kosin University Gospel Hospital between January, 1986 and August, 1995. The patients were comprised of 35 acute lymphoblastic leukemia(ALL), 17 acute myelogenous leukemia(AML), 20 non- Hodgkin's lymphoma(NHL) and 23 neuroblastoma(NB). RESULTS: The mean values of serum ferritin at presentation were 465.3+/-53.9 ng/mL in ALL, 468.9+/-69.4 ng/mL in AML, 274.1+/-69.2 ng/mL in NHL and 337.3+/-64.4 ng/mL in NB. Those values were increased significantly compared to the mean of 20 control children(69.5+/-12.9 ng/mL). The mean values of serum ferritin concentration in remission stage(first, second, and third remission) tend to be lower compared to those in the active stage(at presentation, first relapse and second relapse). But these differences reached a statistical significance only in patients with ALL when the mean values of the active stage were compared to those checked in the remission stage over 12 months(P= 0.0002). Comparison of overall survival according to initial serum ferritin levels(below and above 200 ng/mL) did not show any significant difference in ALL, AML and NHL. However, there was a borderline relationship in NB(relative risk 3.12, P=0.06). CONCLUSION: The study showed that normalization of serum ferritin levels were found in ALL who had continuous, complete remission for more than 12 months. And patients with lower serum ferritin levels were not associated with better survival except in patients with NB in which the lower ferritin group showed borderline significance.
Child ; Ferritins* ; Humans ; Leukemia ; Lymphoma ; Neuroblastoma ; Pediatrics ; Prognosis ; Recurrence

Traumatic thyroid hematoma is a rare problem in cases of blunt trauma, but it can be a life-threatening condition. We report here on a case of thyroid hematoma that was complicated with unexpected airway obstruction due to blunt trauma on the anterior neck. A 23-year-old man who developed neck painful swelling and dyspnea was admitted to the emergency room with a blunt neck injury after motor-bicycle accident, and he hit his anterior neck against the handle-bar. He had no previous thyroid pathology and other medical problems. On the initial examination, his vital signs were stable and the oxygen saturation was 97.8%. A computed tomography (CT) scan of the neck showed fragmentation and extensive hematoma within the right thyroid gland and dislocation of the trachea. No definite bleeding focus was identified on the angiography that was done through the carotid artery. Two hours later, the patient experienced sudden respiratory distress and the oxygen saturation dropped rapidly. The patient needed emerg encyendotracheal intubation and surgical intervention. He successfully underwent right lobectomy of the thyroid gland, and was discharged on the 6th hospital day without any complications. The thyroid function was normal after 3 months.
Airway Obstruction* ; Angiography ; Carotid Arteries ; Dislocations ; Dyspnea ; Emergency Service, Hospital ; Hematoma* ; Hemorrhage ; Humans ; Intubation ; Neck ; Neck Injuries ; Neck Pain ; Oxygen ; Pathology ; Thyroid Gland* ; Trachea ; Vital Signs ; Young Adult

BACKGROUND: The transforming growth factor-beta1 (TGF-beta1) plays a key role in lung fibrosis. However, the mole?cular mechanisms involved in TGF-beta1-induced lung fibrosis are unclear. TGF-beta1 is the key inducer of myofibroblast transdifferentiation via de novo synthesis of alphasmooth muscle actin (alpha-SMA). Since TGF-beta1 signals through reactive oxygen species (ROS) and ROS have been shown to induce accumulation of extracellular matrix (ECM) in various tissues, this study examined if ROS play a role in TGF-beta1-induced fibronectin secretion and alpha-SMA expression in human lung fibroblasts, MRC-5 cells. METHODS: Growth arrested and synchronized MRC-5 cells were stimulated with TGF-beta1 (0.2-10 ng/ml) in the presence or absence of N-acetylcysteine (NAC) or diphenyleneiodonium (DPI) for up to 96 hours. Dichlorofluorescein (DCF)- sensitive cellular ROS were measured by FACScan and secreted fibronectin and cellular alpha-SMA by Western blot analysis. RESULTS: TGF-beta1 increased the level of fibronectin secretion and alpha-SMA expression in MRC-5 cells in a dose- dependent manner. Both NAC (20 and 30 mM) and DPI (1 and 5 microM significantly inhibited TGF-beta1-induced fibronectin and alpha-SMA upregulation. The TGF-beta1-induced cellular ROS level was also significantly reduced by NAC and DPI. CONCLUSIONS: The results suggest that NADPH oxidase-dependent ROS play an important role in TGF-beta1-induced fibronectin secretion and alpha-SMA expression in MRC-5 cells, which leads to myofibroblast transdifferentiation and progressive lung fibrosis.
Acetylcysteine ; Actins* ; Blotting, Western ; Extracellular Matrix ; Fibroblasts* ; Fibronectins* ; Fibrosis ; Humans* ; Lung* ; Muscle, Smooth* ; Myofibroblasts ; NADP ; Pulmonary Fibrosis ; Reactive Oxygen Species* ; Transforming Growth Factor beta1 ; Transforming Growth Factors* ; Up-Regulation