We herein report a 28-year-old woman with typical marginal keratoderma of the palms of 4 years duration. She denied any chronic pressure or trauma. Histological findings disclosed marked hyperkeratosis, parakeratosis, acanthosis, elongation of rete ridges, edema and capillary dilatations of papillary dermis, and infiltration of chronic inflammatory cells. There was no changes in collagenous and elastic fibers. Treatment with oral 13-cis retinoid and topical application of 0.02% flumethasone ointment containing 3%, salicylate resulted in only transit effect.
Adult ; Capillaries ; Collagen ; Dermis ; Dilatation ; Edema ; Elastic Tissue ; Female ; Flumethasone ; Humans ; Parakeratosis

Purpose: The purpose of this study was to analyze the experiences of acute care hospital nurses’ on spiritual care with focus group interviews. Methods: Data were collected from 24 nurses recruited from one acute-care hospital in a southern province of Korea. Six focus groups were assembled considering age and religion. All interviews were recorded and transcribed. Data were analyzed using qualitative content analysis. Results: Five categories with 14 sub-categories emerged: 1) ambiguous concept: confusing terms, an additional job; 2) assessment of spiritual care needs: looking for spiritual care needs, not recognizing spiritual care needs; 3) spiritual care practices: active spiritual care, passive spiritual care ; 4) outcomes of spiritual care: comfort of the recipient, comfort of the provider; and 5) barriers to spiritual care: fear of criticism from others, lack of education, lack of time, space constraints, and absence of a recording system. Conclusion Participants perceived spiritual care as an uncertain concept. Some participants recognized it as a form of nursing care, and others did not. They practiced spiritual care in acute-care settings according to their personal perceptions of spiritual care. Therefore, in order to perform spiritual nursing in acute-care hospitals, it is a priority for nurses to recognize the concept of spiritual nursing accurately. It is also necessary to prepare a hospital environment suitable for the provision of spiritual care.

Thirty-eight patients with a musculoskeletal chest wall syndrome were evaluated for the musculoskeletal findings of chest wall. All patients had the chest wall tenderness and the typical chest pain could be reproduced by the palpation. There was no significant difference in the diagnostic features of the pain for the onset, location, characteristics, duration, radiation, and area of references for chest pain among the different groups of the patients. However, a reproduction of pain by palpation and the pressure threshold difference between the lesion and control points by using pressure algometry was a reliable and specific diagnostic tool. Pressure threshold difference was correlated with numerical rating scale by the correlation coefficient 0.96. The common causes of the chest wall syndrome were the myofascial pain syndrome, chostochondritis, sternalis syndrome, rib-tip syndrome, xiphodynia in order. Six patients had chest wall disorders in conjunction with other associated intrathoracic condition. Thirty-two patients had an isolated chest wall syndrome. Chest wall syndrome should be considered in all patients with the chest pain, as its recognition could help the patient management.
Chest Pain ; Humans ; Myofascial Pain Syndromes ; Palpation ; Reproduction ; Thoracic Wall* ; Thorax*

The gray vibrissae of Korean males(n =189) between 15 and 75 years old and females(n =111) between-15 and 74 years old who visited the department of otorhinolaryngology, Konkuk university Chungju hospital during 1996 to 1998, were counted for the purpose of estimating approximate age range in individuals of unknown age . The lowest age appearing gray hairs in both sexes was 15-year-old. The Pearson's correlation coefficient in both sexes was 0.490 (p<0.01). The age appearing gray vibrissae in females was slightly earlier than that of males, however, the differences between right and left sides of nasal cavity were insignificant. This method of counting gray vibrissae would be useful to estimate age range in personal identification together with other methods available until now.
Adolescent ; Aged ; Chungcheongbuk-do ; Female ; Hair* ; Humans ; Male ; Nasal Cavity ; Otolaryngology ; Vibrissae*

BACKGROUND: Radiation has been used in t,he medical field of dragnosis and treatment. There is widely used ionizing radiat:ion such as naturally occuring r-rays or machine-made X-ray. This radiation is able to induce the structural and functional alterations of the mammalian cells. But we have few detailed reports on the effects of radiation on epidermal cells and their immune functions. OBJECTIVE: This study was performed to investigate the effect of radiation on cultured human keratinocytes and melanocytes. MATERIALS AND METHODS: Cultured human keratinocytes and melanocytes were irradiated with 2,6, l0Gy from a Co saurce and stimulated by 100 U/ml of ekratinocyte immediately after irradiation. We investigated cell numbers and morphological changes, DNA synthesis and HLA-DR antigen expression. RESULTS: After exposure to r-ray, the proliferation of keratinocytes and melanocytes decreased in a time and dose dependent fashion to each control group. Tliey showed decreased density, a larger size and a round appearance after radiation exposure and an especially shortened and decreased number of dendrites in the melanocytes. In DNA synthesis counted using [H]-thymidine incorporation, the keratinocvtes decreased values in a dose depen(lent manner at 24 and 72 hours after irradiation but no differense was observed at 168 hours. In melanocytes, there was a greater decrease than that of keratinocytes. The melanin content/cell in all radiation exposed groups increased in a time and dose dependent fashion t,o each contr ol group. HLA-DR antigen expression on keratinocytes after radiat,ion exposure decreased to the control group, but there were no significant differences acccirding to the dose of radiation, And there were no significant diifferences of HLA-DR antigen expression on the melanocytes betweer. controls and the radiation exposed groups. CONCLUSION: Antiproliferative activity was dependent on the exposure time and dose of r-ray exposure. According to the time after radiation exposure, melanogenic activity was stimulated. The expression of HLA-DR, antigen decreased in keratinocyte after radiation exposure but there was no decrease in melanocytes.
Cell Count ; Dendrites ; DNA ; HLA-DR Antigens ; Humans* ; Keratinocytes* ; Melanins ; Melanocytes*

BACKGROUND: Radiation has been used in t,he medical field of dragnosis and treatment. There is widely used ionizing radiat:ion such as naturally occuring r-rays or machine-made X-ray. This radiation is able to induce the structural and functional alterations of the mammalian cells. But we have few detailed reports on the effects of radiation on epidermal cells and their immune functions. OBJECTIVE: This study was performed to investigate the effect of radiation on cultured human keratinocytes and melanocytes. MATERIALS AND METHODS: Cultured human keratinocytes and melanocytes were irradiated with 2,6, l0Gy from a Co saurce and stimulated by 100 U/ml of ekratinocyte immediately after irradiation. We investigated cell numbers and morphological changes, DNA synthesis and HLA-DR antigen expression. RESULTS: After exposure to r-ray, the proliferation of keratinocytes and melanocytes decreased in a time and dose dependent fashion to each control group. Tliey showed decreased density, a larger size and a round appearance after radiation exposure and an especially shortened and decreased number of dendrites in the melanocytes. In DNA synthesis counted using [H]-thymidine incorporation, the keratinocvtes decreased values in a dose depen(lent manner at 24 and 72 hours after irradiation but no differense was observed at 168 hours. In melanocytes, there was a greater decrease than that of keratinocytes. The melanin content/cell in all radiation exposed groups increased in a time and dose dependent fashion t,o each contr ol group. HLA-DR antigen expression on keratinocytes after radiat,ion exposure decreased to the control group, but there were no significant differences acccirding to the dose of radiation, And there were no significant diifferences of HLA-DR antigen expression on the melanocytes betweer. controls and the radiation exposed groups. CONCLUSION: Antiproliferative activity was dependent on the exposure time and dose of r-ray exposure. According to the time after radiation exposure, melanogenic activity was stimulated. The expression of HLA-DR, antigen decreased in keratinocyte after radiation exposure but there was no decrease in melanocytes.
Cell Count ; Dendrites ; DNA ; HLA-DR Antigens ; Humans* ; Keratinocytes* ; Melanins ; Melanocytes*

We tried extracapsular cataract extraction and PCL implantation with Ocutome-FragmatomeII System and Disposable Two-Way Needle. 160 eyes were operated with this method, 101 eyes were followed up over 2 months period. Clinical results were not significantly different from previous reports of ECCE and PCL implantaion. Corrected visual acuity 0.5 or better after 2 months of surgery were 95%. No serious intra-operative and post-operative complications were noted. We suggest Ocutome-FragmatomeII System and Disposble Two-Way Needle could be used for ECCE and PCL implantation in case of absence of I and A system.
Cataract Extraction* ; Cataract* ; Needles* ; Visual Acuity

PURPOSE: The purpose of this study was to explore the experiences of family caregivers who care for the elderly under Long-term Care Insurance. METHODS: Data were collected using focus group interviews and analyzed using a phenomenological approach. The four focus groups consisted of eight caregivers, two social workers and three nurses in B city, Korea. RESULTS: Five themes were identified: 'Obtaining a care-helper certification for employment', 'Taking care of the elderly in their homes', 'Difficulties due to life changes', 'Difficulties due to reduced wages' and 'Dissatisfaction with the Long-term Care Insurance operating system'. CONCLUSION: The results of this study demonstrate that the long-term care system for family caregivers faces many systematic challenges in providing care for the elderly harmoniously in their home. To help them succeed in their tasks, Long-term Care Insurance system must offer respite and support programs to family caregivers.
Aged ; Caregivers ; Certification ; Focus Groups ; Humans ; Insurance ; Insurance, Long-Term Care ; Long-Term Care ; Qualitative Research ; Social Workers

In transmembrane and intracellular sites of neurom, calcium ion(Ca(++)) has been known to have an important role of signalling process. It is naw well accepted that calcium binding proteins, calbindin D-28K (calbindin) and parvalbumin, modulate and mediate above aclcium ionss action as a second messenger. Although it has been reported that calbindinergic and parvalbuminergic neurons comprise different subpopulations in the cat and rat spinal cords, the studies of their morphology, topographical distribution and ultrastructural features have not been done extensively in the mammalian spinal cords until now. This study was conducted to localize calbidinergic and parvalbuminergic neurons and to define their morphology, topographical distribution and ultrastructural features in the rabbit cervical cord by the preembedding immunocytochemical method using anti-calbindin and anti-parvalbumin antisera. In the rabbit cervical cord, calbindin immunoreactive neurons were mainly distributed in the dorsal horn, especially in lamina II, and a smaI1 number of labelled neurons were observed in the intermediate gray matter (IGS), but calbindin immunoreactivities were not observed in the intermediate gray substance(IGS), but calbindin immunoreactiveties were not observed in thr ventral horn. The somata of calbindin immunoreactive neurons received synaptic inputs from non-immunoreactive axon terminals in the dorsal horn and in the IGS. Parvalbumin immunoreactive neurons were mainly observed in the IGS and in the ventral horn, but only a few of parvalbumin immunoreactive neurons were distributed in the dorsal horn. In the ventral horn, two types of parvalbumin immunoreactive neurons were identified according to the sizes of the somata and labelled motor cells received synaptic inputs from labelled and unlabelled axon terminals. These results demonstrate that calbindinergic neurons are a number of neurons located in lamina II of dorsal horn and a few of neurons located in the intermediate gray and parvalbuminergic ne.urons are laocated in the intermediate gray substance and in the ventral horn, and these neurons comprise different subpopulations of neurons. It was suggest that calbindinergic neurons might play an important role in the process of pain modulation and parvalbumiergic neurons in the control of motor activity with their specific synaptic circuitry in the spinal cord.
Animals ; Calbindins ; Calcium ; Calcium-Binding Proteins ; Cats ; Horns ; Immune Sera ; Motor Activity ; Neurons* ; Presynaptic Terminals ; Rats ; Second Messenger Systems ; Spinal Cord

BACKGROUND: Vascular lesions can be diagnosed by biopsy, simple x-ray, ultrasound, CT, MRI, venography and MR angiography. These diagnostic tools can identify the detailed structure and abnormalities in the peri-lesional area of vascular lesions. Color Doppler ultrasound (CDU) can demonstrate the hemodynamic features, distribution of veins and arteries, shunts and structures of vascular lesions. Authors have tried to categorize vascular lesions with CDU and also applied this to the selection of treatment methods. MATERIALS AND METHODS: Forty-seven vascular lesions were evaluated by means of CDU. All patients underwent a complete clinical evaluation as well as peak systolic velocity (PSV), peak diastolic velocity (PDV), resistive index (RI) of feeding arteries. In particular, we evaluated the hemodynamic features and structures of vascular lesions. We categorized the vascular lesions and then treated them with systemic steroid, compression, SPTL1 Dye laser, steroid intralesional injection and sclerotherapy. We evaluated the clinical improvement and objective effects of treatments by CDU. RESULTS: There were 37 hemangiomas and 10 vascular malformations. Vascular lesions were classified by the hemodynamic features and structures: category Ia (infantile hemangioma, regressed infantile hemangioma), Ib (RICH), Ic (deep hemangioma, mixed hemangioma), II (arteriovenous malformation), III (venous malformation, verrucous hemangioma). The clinical improvement after treatment was associated with the decrease of PSV and RI values. The clinical improvement above 50% resolution of the lesion showed 70.9% in category Ia, 50% in Ib, 66.6% in Ic, 83.3% in II and 50% in III. CONCLUSIONS: The analysis of hemodynamic feature and structures by CDU can be helpful in the study of vascular lesions. These processes suggest CDU be a useful modality in differential diagnosis of vascular lesions and a more advantageous tool in the decision of treatment policy than the conventional modalities. And it is also useful for the evaluation of treatment effects.
Angiography ; Arteries ; Biopsy ; Diagnosis, Differential ; Hemangioma ; Hemodynamics ; Humans ; Injections, Intralesional ; Lasers, Dye ; Magnetic Resonance Imaging ; Phlebography ; Sclerotherapy ; Ultrasonography* ; Vascular Malformations ; Veins