PURPOSE: This study was done to explore experiences of persons living through the periods of cancer diagnosis, treatment, and self-care. METHODS: With permission, texts of 29 cancer survival narratives (8 men and 21 women, winners in contests sponsored by two institutes), were analyzed using Kang's Korean-Computerized-Text-Analysis-Program where the commonly used Korean-Morphological-Analyzer and the 21st-century-Sejong-Modern-Korean-Corpora representing laymen's Korean-language-use are connected. Experiences were explored based on words included in 100 highly-used-morphemes. For interpretation, we used 'categorizing words by meaning', 'comparing use-rate by periods and to the 21st-century-Sejong-Modern-Korean-Corpora', and highly-used-morphemes that appeared only in a specific period. RESULTS: The most highly-used-word-morpheme was first-person-pronouns followed by, diagnosis.treatment-related-words, mind-expression-words, cancer, persons-in-meaningful-interaction, living and eating, information-related-verbs, emotion-expression-words, with 240 to 0.8 times for layman use-rate. 'Diagnosis-process', 'cancer-thought', 'things-to-come-after-diagnosis', 'physician.husband', 'result-related-information', 'meaningful-things before diagnosis-period', and 'locus-of-cause' dominated the life of the diagnosis-period. 'Treatment', 'unreliable-body', 'husband . people . mother . physician', 'treatment-related-uncertainty', 'hard-time', and 'waiting-time represented experiences in the treatment-period. Themes of living in the self-care-period were complex and included 'living-as-a-human', 'self-managing-of-diseased-body', 'positive-emotion', and 'connecting past . present . future'. CONCLUSION: The results show that the experience of living for persons with cancer is influenced by each period's own situational-characteristics. Experiences of the diagnosis and treatment-period are negative disease-oriented while that of the self-care period is positive present-oriented.
Family Relations ; Female ; Humans ; Male ; Neoplasms/diagnosis/*psychology/therapy ; Patient Acceptance of Health Care ; Professional-Patient Relations ; Program Development ; Self Care ; User-Computer Interface

This study investigated the comparison of electromyographic change of neuromuscular blocking effect induced vecuronium between the ulnar, facial and tibial nerve in 24 healthy adult patients anesthetized with thiopental, N2O and enflurane. Neuromuscular monitoring commenced immediately after administration of thiopental. After supramaximal stimulation was achieved, a bolus of vecuronlum 0.08mg/kg was injected intravenously. And then single twitch nerve stimulation(T1) was applied to the nerves using surface electrodes and the electrical response of muscles recorded using the RELAXOGRAPH(Dates Co.). The patients were allocated randomly to 3 groups of 8 patients respectively: the ulnar nerve troup was the control, and the facial nerve group and the tibial nerve group were the studing group. We assessed electromyographic responses from abductor digiti minimi muscle in the ulnar nerve, orbicularis oris muscle in the facial nerve and flexor hallucis brevis muscle in the tibial nerve to single twitch nerve stimulation respectively. And the onset time, the time from injection of vecuronium to 25% and 75% recovery to T1, and recovery index of the ulnar, facial and tibial nerve groups were measured. The obtained results were as follos: 1) The onset time was faster in the facial nerve group compared with the ulnar nerve group. 2) The time from injection of vecuronium to 25% recovery of T1 was more prolonged in the facial nerve group compared with the ulnar nerve group. 3) The time from injection of vecuronium to 75% recovery of T1 and recovery index were more shorter in the tibial nerve group compared with ulnar nerve group.
Adult ; Electrodes ; Enflurane ; Facial Nerve ; Humans ; Muscles ; Neuromuscular Blockade ; Neuromuscular Monitoring ; Thiopental ; Tibial Nerve* ; Ulnar Nerve ; Vecuronium Bromide*

OBJECTIVES: The aim of this study is to enhance understanding the clinical features, pathogenesis, diagnosis and treatment of gouty arthritis in Korea by analyzing the clinical manifestations of the patients with urate crystal-proven gouty arthritis. METHODS: 78 cases who had been diagnosed as gouty arthritis by confirming the urate crystals in synovial fluids or tophi in Seoul National University Hospital between January 1, 1989 and July 31, 1995 were analysed for their histories, symptoms, signs, laboratory data, and X-ray findings. RESULTS: 1) Male to female ratio was 18.5:1. The mean age of onset is 49.3 +/- 14.5 years(range 11-83 years); the mean duration of disease 6.5 +/- 7.0 years(range 0-30 years); the mean duration of gouty attack 7.2 +/- 5.5 days(range 1-30 days). 2) The frequent precipitating factors of gouty arthritis were hospitalization(37%) and alcohol drinking(15%). The most frequent accompanying disease was hypertension(24%). Obesity, diabetes, chronic renal failure, hyperlipidemia, ischemic heart diseases, or cerebrovascular diseases were also accompanied by gouty arthritis. 3) The patterns of joint involvement were devided into 3 groups: monoarthritis; 42%, oligoarthritis; 35%, polyarthritis; 23%, The most frequent site of the first gouty attack was the 1st toe(65%). The most frequently involved joint at gouty attack was also the 1st toe(68%). While only lower extremities were involved in most cases with monoarthritis and oligoarthritis(91% and 78%, respectively), both lower and upper extremities were involved in most cases with polyarthritis(78%). 4) Hyperuricemia was found in 74% of the cases at gouty attack. But serum uric acid level was normal in 26%. With respect to pathogenesis of hyperuricemia, 14% of the cases had uric acid overproduction and 86% had uric acid underexcretion. 5) Bony changes in radiologic findings were found in 47% of the cases and tophi in 33%. Bony changes and tophi was significantly related to the younger age of gouty onset and higher serum uric acid level at gouty attack. 6) Acute gouty arthritis responded well to colchicine and NSAIDs. There was no difference in efficacy and the frequency of side effects between them. CONCLUSION: The clinical features of the gouty arthritis in Korea showed no difference from those in foreign studies except higher prevalence of oligo-/polyarthritis and tophi. To be remarkable, 26% of the patients with gouty arthritis did not have hyperuricemia at gouty attack. This finding indicates that urate crystals should be confirmed by synovial fluid examination for diagnosis of gouty arthritis.
Age of Onset ; Anti-Inflammatory Agents, Non-Steroidal ; Arthritis ; Arthritis, Gouty* ; Colchicine ; Diagnosis ; Female ; Gout ; Humans ; Hyperlipidemias ; Hyperuricemia ; Joints ; Kidney Failure, Chronic ; Korea ; Lower Extremity ; Male ; Myocardial Ischemia ; Obesity ; Precipitating Factors ; Prevalence ; Seoul ; Synovial Fluid ; Upper Extremity ; Uric Acid

Myasthenia gravis(MG) is an autoimmune disorder characterized by the presence of anti-acetylcholine receptor antibody and weakness of voluntary muscles. The pathogenesis of MG is decreased numbers of acetylcholine receptors at postsynaptic membranes of neuromuscular junctions. It has been reported that MG often coexists with other autoimmune disorders. This is a case report of systemic lupus erythematosus coexisting with MG in a 23 year old female patient presenting with dysarthria, dysphagia, and limb weakness. We report the case with relevant literature review.
Deglutition Disorders ; Dysarthria ; Extremities ; Female ; Humans ; Lupus Erythematosus, Systemic* ; Membranes ; Muscle, Skeletal ; Myasthenia Gravis* ; Neuromuscular Junction ; Receptors, Cholinergic ; Young Adult

Background: Needle insertion for spinal anesthesia using the Taylor approach is challenging as the L5-S1 space is difficult to locate from the surface anatomy. In this study, we suggest the use of three-dimensional (3D) pelvis computed tomography (CT) to assist anesthesiologists in locating the needle insertion point. By comparing the success rate of 3D pelvis CT-assisted Taylor approach to that of other approaches in the existing literatures, we suggest this technique as an alternative method for subarachnoid block in the L5-S1 space. Methods: In this retrospective observational study, we reviewed the records of hip arthroplasty using the 3D pelvis CT-assisted Taylor approach. An imaginary guidance line was created from the intersection point of the midline and intercristal line on the posterior view of the 3D pelvis CT to the ideal skin insertion point for Taylor approach. The primary outcome was the success rate. The secondary outcomes included the angle between the intercristal line and the guidance line, and the length of the guidance line and the distance between the ideal needle insertion point and the L5-S1 space. Results: We reviewed the records of the 276 patients who underwent hip arthroplasty using 3D CT-assisted Taylor approach. In this cohort, the 3D CT-assisted Taylor approach in L5-S1 subarachnoid block failed in only 25/276 patients. The success rate of 3D CT-assisted Taylor approach was 90.9%. Conclusions A 3D pelvis CT-assisted Taylor approach of spinal anesthesia can be an alternative method for subarachnoid block in the L5-S1 space with an acceptable success rate.

Hepatic angiomyolipoma is a rare benign lipomatous tumor of the liver. Radiologic studies usually reveal a fat component, but since this may be minimal, such a component is not always detected. We report a case of atypical hepatic angiomyolipoma which because of the non-visualization of fat at CT and MR imaging, was difficult to differentiate from other hypervascular tumors.
Angiomyolipoma* ; Liver ; Liver Neoplasms ; Magnetic Resonance Imaging

PURPOSE: To describe the use of an emergency department (ED)-based, in-depth injury surveillance system to determine the incidence and mechanism of preschool children injury. METHODS: We prospectively studied and registered injured children under 7 years old, (n=5,921) whose injuries resulted in ED treatment from August 2006 to July 2008. We upgraded the checklist surveillance items, included place, accident mechanism, and agent factors. The ED physicians recorded the injury data on checklists in real time as they gave the ED orders. The recorded data were stored in computer networks and automatically coded, which enabled access to the raw data sources. The statistical data were calculated in detail by using relative frequency distribution from the raw data. RESULTS: A total of 29,548 injured patients visited the ED from August 2006 to July 2008. Preschool children injuries, except those from traffic accidents, were 5,921(20.0%). The most common sources of injuries were from blunt trauma (37%), slips(17%), and falls(16%). Among those admitted to our hospital, fall injuries and inhalation of foreign body accidents accounted for 7.6% and 7.5%, respectively. The larger proportion of fall injuries occurred from a height of less than 1 meter(82.2%). The frequency of injury mechanism differed according to age: fall(35%), blunt(19%), and burn(14%) were noted under 1 year old, compared to blunt(34%), fall(14%), and slip(13%) from between 1 to under 3 years of age, and blunt(37%), slip(19%), and fall (11%) between 3 to under 7 years of age. CONCLUSION: The ED-based preschool children injury surveillance system could provide a useful and efficient method to determine injury incidence and injury-related factors.
Accidents, Traffic ; Checklist ; Child ; Child, Preschool ; Information Storage and Retrieval ; Emergencies ; Foreign Bodies ; Humans ; Hypogonadism ; Incidence ; Inhalation ; Mitochondrial Diseases ; Ophthalmoplegia ; Population Surveillance ; Prospective Studies

BACKGROUND: Investigation of the factors affecting blood donation practice is essential to develop the ways of making blood donation campaign, as well as efficient and facilitating blood donation practice. A few studies has been made concerning the factors affecting blood donation in Korea. METHODS: 637 participants were examined using self-administered questionnaires including demographic variables, experience, knowledge and attitude for blood donation and others. RESULTS: 51.5% of participants had experienced the blood donation. Students who donated blood in high school days showed tendency to donate blood more than those who didn t donate blood in high school days. Students who had more knowledge and desirable attitude about blood donation experienced more blood donations. CONCLUSION: It is necessary for adolescents to take the opportunity of blood donation. It is important to clarify factors affecting blood donation practice and to encourage the public education and campaign which enable public has accurate knowledge and positive attitude about blood donation.
Adolescent ; Blood Donors* ; Education ; Humans ; Korea ; Surveys and Questionnaires