This survey was conducted from January 1991 to May 1991. Two hundred and eight residents in 4 government supported homes for the aged and hundred and eleven living in the community in Taegu, Korea, were examined to evaluate the depression and the anxiety of the aged with combined anxiety and depression scale (CADS) and somatization symptom check list (SCL). There are no significant differences between residents in the home for the aged and those living in the community on the total scores of CADS and SCL. However, in the case of the total score of CADS of the female subjects in the home for the aged were significantly higher than those of the community residents. The elderly in the home for the aged tended to have pure depression, while community residents were likely to have anxiety and depression. Fifty-two subjects of home for the aged and sixty-nine of the community scored over 50 points of CADS, which indicates considerable depression or anxiety. In psychosocial factors, the subjects who in the following situations had statistically significant higher scores than others. The results were as follow. Poor health, unhappiness, unsatisfaction to the past occupation, pessimistic thought in future view for both group and unsatisfaction of the relationship with familiar people for the elderly in the community. The SCL scores of two groups subgrouped by under 49 and 50 on CADS showed significant differences between each subgroup on all of the SCL items. It could be suggested that somatic symptoms for the aged is a sign of depression.
Aged* ; Anxiety* ; Daegu ; Depression* ; Female ; Homes for the Aged ; Humans ; Korea ; Occupations ; Psychology

A 12-year-old girl presented with a 1-week duration of hair loss associated with splitting of the hair ends and whitish dots on the occipital hairs. On microscopic examination, a longitudinal splitting of the hair shaft with reconstitution of the normal hair distal to the fracture, nodular swellings, with the appearance of broomsticks pushed into one another, at the site of whitish swellings, and the flattening and twisting of the hair shaft around the long axis were demonstrated. Minor trauma to injury-prone hair is a common cause of hair shaft defects, however the reports with the combined conditions are insufficient in the literature. We describe a patient with central trichoptilosis associated with localized trichorrhexis nodosa and pili torti.
Axis, Cervical Vertebra ; Child ; Female ; Hair ; Humans

PURPOSE: The purpose of this study was to define and clarify the concept of 'resilience' in patients with cardiovascular diseases. METHODS: A hybrid model was used to develop the concept of resilience. The model included a field study carried out in Cheonan, Korea. The participants in this study were 9 patients with cardiovascular diseases who underwent a percutaneous coronary intervention. RESULTS: The concept of resilience was found to be a complex phenomenon having meanings in two dimensions: the personal-dispositional and interpersonal dimensions. Four attributes and seven indicators were defined. CONCLUSION: A resilient person was defined as one who has a positive attitude toward restoration, the power to reconstruct and control his/her disease (personal dimension), and support from a supportive system with supportive persons (interpersonal dimension). In the clinical setting, resilience plays an important role in managing the care plans of cardiovascular patients. Therefore, nurses who work closely with patients suffering from cardiovascular diseases should be aware of the attributes and indicators of resilience to enhance the resilience of their patients.
Adaptation, Psychological ; Adult ; Attitude to Health ; Cardiovascular Diseases/*psychology ; Female ; Humans ; Interviews as Topic ; Male ; Middle Aged ; *Resilience, Psychological

Nine-month-old female infant was seen with a 7-month history of a nodule on the right temporal scalp, which had gradually increased in size. Stroking of the lesion resulted in urtication and blistering and there were no other cutaneous lesions. The histology showed subepidermal bulla formation and a dense infiltration of mast cells in the papillary and reticular dermis. We present an infant with solitary mastocytoma on the scalp, a rare site.
Blister ; Dermis ; Female ; Humans ; Infant ; Mast Cells ; Mastocytoma* ; Scalp* ; Stroke

The aim of this study was to investigate the relationships between the gadd genes expression and an apoptosis induction in two different growing cell types after treatments with cisplatin and methylmethan sulfonate (MMS). We have examined the kinetics and specificity of gadd45 and gadd153 expression following cisplatin and MMS treatments to HL-60 cells and primary cultured human kidney (HKN) cells. We have also determined an induction time of apoptosis by DNA fragmentation analysis and the presence of the cell cycle arrest by a flow cytometric measurement. The results were as follows. In non-adherent HL-60 cells, a typical ladder pattern was observed within 4 hours after treatments of 20 micrometer of cisplatin and 100 microgram/ml of MMS. At the same time while adherent HKN cells failed to exhibit a ladder pattern at even higher doses of genotoxic agents. Since HL-60 cells do not have p53 gene, these findings suggest the presence of a p53-independent apoptotic pathway. The increasing patterns of the mRNA levels of gadd45 and gadd153 varied with the type of genotoxic agents. In the case of MMS treatment, the induction was rapid and transient, regardless of the cell types. The mRNA level peaked at 4 hours after MMS treatment and markedly decreased after 12 hours. On the other hand, cisplatin-induced transcriptions of gadd45 and gadd153 continued to increase for at least 24 hours and reached a peak level at 48 hours after cisplatin treatment, regardless of the cell types. HL-60 cells revealed G2 arrest following 24 hours after cisplatin and MMS treatments. These findings suggest that the regulation mechanism of apoptosis between adherent and non-adherent cells, might be different and that gadd45 and gadd153 might have an important role in DNA repair rather than apoptosis. Also, the findings suggest that an expression pattern of gadd45 and gadd153 might be different according to the type of genotoxic agents.
Apoptosis* ; Cell Cycle Checkpoints ; Cell Cycle* ; Cisplatin ; DNA Damage ; DNA Fragmentation ; DNA Repair ; Genes, p53* ; Hand ; HL-60 Cells ; Humans ; Kidney ; Kinetics ; RNA, Messenger ; Sensitivity and Specificity

A 36-year-old female presented with a 5-month history of an indurated asymptomatic nodule on the left palm. A skin biopsy was done and the histopathological findings were consistent with those of a giant cell tumor of tendon sheath (GCTTS). A GCTTS occurs in the tendon sheath of digits or in the joints of the extremities, and most commonly involves the distal fingers. However, palmar involvement of this tumor is unusual. We present a case of GCTTS on the palm.
Adult ; Biopsy ; Extremities ; Female ; Fingers ; Giant Cell Tumors* ; Giant Cells* ; Humans ; Joints ; Skin ; Tendons*

To evaluate the usefulness of continuous wave Doppler echocardiography in the quantitative assessment of aortic regurgitation, the aortic regurgitant flow velocity curves taken by continuous wave Doppler echocardiography were analyzed to develop indexes such as the peak velocity(PV), the deceleration slope(SLOPE) and the pressure half time(PHT) in 66 patients with aortic regurgitation. The Doppler indexes were compared with the aortic regurgitation fraction(RF) obtained from gated radionuclide ventriculography in 33 patients without other valvular regurgitation, and were also compared with angiographic grading of aortic regurgitation in 47 patients who under went aortic angiography. The results were as follows : 1) The deceleration slope and the pressure half time were correlated well with the regurgitation fraction measured by gated radionuclide ventriculography (r=0.68, -0.78). 2) The deceleration slope increased significantly with increasing angiographic grading (rade 1+vs.2+ ; 1.89+/-0.61m/sec vs.2.64+/-0.39, P<0.05, Grade 2+ vs.3+ ;2.64+/-0.39 vs. 4.37+/-1.35, P<0.01, but statistical singnificance was not found between Grade 3+ and 4+(4.73+/-1.35vs. 5.00+/-0.39, P<0.05). 3) The pressure half time decreased significantly with increasing angiographic grading (Grade 1+vs.2+ ; 0.61+/-0.16 sec vs. 0.49+/-0.08, p<0.05, Grade 2+ vs.3+ ; 0.49+/-0.08vs. 0.29+/-0.07, p<0.01), but statistical significance was not found between Grade 3+ and 4+ (0.29+/-0.07vs. 0.26+/-0.08, p>0.05), either. 4) The pressure half time was independent of aortic or mitral stenosis associated with aortic regurgitation. 5) The peak velocity had no significant relationshop with the regurgitation fraction by gated radionuclide ventriculography or angiographic grading by aortic angiography. 6) A PHT threshold of 400 msec separated mild (Grade 1+ and 2+)and severe (grade 3+ and 4+) aortic regurgitation with sensitivity of 88%, specificity of 96% and predictive value of 95%. Therefore continuous wave Doppler echocardiographic method of anlyzing aoritc regurgitant flow velocity curve seemed to be useful for the noninvasive assessment of the severity of aortic regurgitation.
Angiography ; Aortic Valve Insufficiency* ; Deceleration ; Echocardiography ; Echocardiography, Doppler* ; Gated Blood-Pool Imaging ; Humans ; Mitral Valve Stenosis ; Sensitivity and Specificity

This study was performed to investigate the effects of enflurane anesthesia and surgery on thyroid function by determining the plasma concentration of thyroxid(T4) and trilodothyronine(T3) in 10 patients who had neither hepatic disorder nor endocrine disease. Each patient was premedicated with diazepam 10mg and atropine sulfate 0.5mg intramuscularly one hour before induction of anesthesia. Anesthesia was induced with pentohal sodium and maintained with enflurane and oxygen supplemented with pancuronium bromide in divided dose as needed. plasma concentrations of thyroxine and triiodothyronine were measured by means of radiommunoassay. The results obtained were as follows: 1) No significant change in the plasma concentration of thyroxine was detected during enflurane anesthesia and surgery. 2) Plasma concentration of triidothyronine decreased significantly, compared with the control level, during enflurane anesthesia alone and anesthesia plus surgery. Although the precise mechanisms for the decrease in triiodothyronine following anesthesia and surgery remain unknown, decreased peripheral conversion from T4 to T3 may be responsible for this decline. Our data imply that enflurane anesthesia did not stimulate thyroid funcion judged by plasma concentration of T4 or T3. Therefore, enflurane anesthesia may be an useful anesthetics for patients with hyperthyroidism.
Anesthesia* ; Anesthetics ; Atropine ; Diazepam ; Endocrine System Diseases ; Enflurane* ; Humans ; Hyperthyroidism ; Oxygen ; Pancuronium ; Plasma ; Sodium ; Thyroid Gland* ; Thyroxine ; Triiodothyronine

A metastatic umbilical carcinoma from internal malignancy is known as Sister Mary Joseph's nodule. A 56-year-old man presented with a progressively enlarging umbilical nodule. Skin biopsy was done and the patient was diagnosed as metastatic adenocarcinoma of umbilicus. Search for the primary tumor revealed gastric adenocarcinoma with metastasis to perigastric lymph node, portal vein and intrahepatic duct. Sister Mary Joseph's nodule, a rare form of cutaneous metastasis, generally carries very poor prognosis. We describe a case of Sister Mary Joseph's nodule preceding a diagnosis of gastric cancer with review of the literature, and emphasize the importance of careful evaluation of any umbilical nodule.
Adenocarcinoma ; Biopsy ; Diagnosis ; Humans ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis ; Portal Vein ; Prognosis ; Siblings* ; Sister Mary Joseph's Nodule* ; Skin ; Stomach Neoplasms ; Umbilicus