BACKGROUND: Recently the number of elderly gallstone patients has increased, in Korea. The aim of this study is to analyze and to measure the risk factors associated with operation on elderly gallstone patients. METHODS: We reviewed the medical records of 206 gallstone patients who had been admitted and operated on in the department of general surgery. Konkuk University Hospital, between January, 1993 and December, 1999. The patients were divided into 2 groups, over and under age 65. In each group, analysis was done on sex distribution, the ratio according to location of gallstone, duration of hospital stay, duration of general anesthesia and operative mortality, and then the above factors of each group were compared. RESULTS: 1) The ratio of common bile duct stones in patients over age 65 was two times of that in patients under age 65(48%,24%) 2) The overall operative mortality was 1.9% and has no correlation with old age. 3) Severe coexisting disease may seem the risk factor for operative mortality. CONCLUSION: In the diagnosis and management of gallstones in the elderly, the possibility of common bile duct stone should be suspected. And in order to reduce the operative mortality, careful preoperative evaluation and treatment of coexisting disease should be done.
Aged ; Anesthesia, General ; Common Bile Duct ; Diagnosis ; Gallstones* ; Humans ; Korea ; Length of Stay ; Medical Records ; Mortality ; Risk Factors ; Sex Distribution

Authors experienced a rare adenocarcinoma arising in presacral sacrococcygeal teratoma in a adult and herein reported. The patient was a 52 year old female admitted because of lower abdominal pain for 5 to 6 months. Past and familial history were unremarkable. On rectal examination a mass was palpated 3 cm above the anal verge. The large bowel was displaced by an extrinsic mass but there was no evidence of intrinsic tumor lesion on barium enema, CT was done and showed a large presacral tumor attached to the sacrum. Clinical impression was sacrococcygeal teratoma. Resected tumor mass was a relatively well circumscribed cystic mass, measuring 11 x 11 cm and the cystic content was previously evacuated. Inner surface showed ragged appearance, and focal nodular solid area was noted. On microscopic examination, the tumor revealed the derivatives of three germ layers and main components were tissues of respiratory tract. Sections from the solid area showed a well differentiated adenocarcinoma and with stromal, capsular and perineural invasion. Borderline malignant epithelial lesions are also noted suggesting the pathogenesis and progression of this tumor. There was no recurrence for one year after surgery in the follow up.
Adult ; Male ; Female ; Humans ; Adenocarcinoma

The purpose of this study was to develop a job stress scale for hospital-based home care nurses in Korea. The process was construction of the conceptual framework, development of the preliminary items, verification of the content validity, item analysis and test of the reliability. The preliminary items were based on literature review and in-depth interviews with home care nurses. As a result, eight categories and sixty items were selected. These were reviewed by seven specialists for content validity and finally fifty one items were chosen. Data was collected from 180 home care nurses who were engaged in 87 hospitals from August to September 2003. The result of item analysis one was excepted. The final item count was 50. Categories were as follows: overload work(8 items), lack of specialized knowledge and technique(5 items), ethical dilemma(4 items), role conflict(5 items), interpersonal relationships(6 items), visiting home environment(9 items), driving conditions(4 items) and lack of administrative support(9 items), The reliability of the scale by Cronbach's alpha was .948 and the domain's reliability ranged from .649 to .841. The result of this study could be used to measure the job stress of home care nurses. However, for further validity and reliability, repeated studies will be necessary.
Adult ; Female ; *Home Care Services, Hospital-Based ; Humans ; Job Satisfaction ; Korea ; Middle Aged ; Nurses/*psychology ; *Nursing Services ; Questionnaires ; Stress, Psychological/diagnosis/*etiology

PURPOSE: The number of residents in elderly institution has been increasing due to the change of the family support system. This study was focused on understanding the process of adjustment of the institutionalized elderly using the Grounded Theory approach. METHOD: There were seven participants, 4 men and 3 women living in 3 different elderly facilities. The data was collected through in-depth interviews and participant observation from June 20, 1999 to January 10, 2000 and analyzed by the Strauss and Corbin's analysis method. RESULT: 125 concepts were found and grouped into 30 sub-categories and then grouped into 13 categories. These categories are , , , , , , , , , , , and , which were synthesized into the process of adjustment. being the core category. The adjustment process of the facility elderly consisted of: 1. expressive phase of 'reluctance' 2. control phase of 'reluctance' 3. latent phase of 'reluctance' CONCLUSION: This study offers better understandings on the adjustment process of the institutionalized elderly and provides more appropriate nursing care to the New Comers of these facilities.
Aged* ; Female ; Humans ; Male ; Nursing Care

No abstract available.
Aged* ; Humans ; Personal Satisfaction

We report herein a case of tuberculosis cutis orificialis in a 50-year-old man. He suffered from well demarcated, 2x5cm sized, slightly tender, pus discharging, perianal ulcer with bluish edges for 3 months. The biopsy specimen from the ulcer revealed tuberculoid structure with Langhans giant cells in the deep dermis and a few acid-fast bacilli. AFB cultures from the sputum, pus, and tissue were successful. Intradermal test with PPD showed positive result. Chest roentgenographic findings disclosed advanced pulmonary tuberculosis. Almost complete healing of the perianal ulcers occurred following 2 months of therapy using antituberculosis drugs.
Biopsy ; Dermis ; Giant Cells, Langhans ; Humans ; Intradermal Tests ; Middle Aged ; Sputum ; Suppuration ; Thorax ; Tuberculosis* ; Tuberculosis, Pulmonary ; Ulcer

All authors would like to withdraw the article because they have found a mistake in selecting subjects for this study.

We report herein a 53-year-old male patient with a large condyloma acuminaturn of 16 months duration on his penis. Clinically, an approximat;ely 3.5 X 2.0 Cm sized, asyrnptomatic, verrucous-surfaced, papilloma was present on his prepuce and glans. Elistological examination disclosed hyperkeratosis, marked acanthosis, papillomatosis, vacuolated upper malphigian cells, dilated capillaries, and mononuclear infiltrntes in the upper dermis. Trial of DNCB immunotherapy showed a dramatic effect on tumor regression.
Capillaries ; Dermis ; Dinitrochlorobenzene* ; Humans ; Immunotherapy ; Male ; Middle Aged ; Papilloma ; Penis

PURPOSE: Prostatic tumor induced gene-1 (PTI-1) is a mutated human EF-la and putative prostatic carcinoma tumor-inducing oncogene, that is differently expressed in prostatic cancer and benign prostatic hyperplasia. And, it is more sensitive marker than prostate- specific antigen (PSA) for detecting human prostate cancer in the bloodstream. This study invastigated the expression of PTI-1 in paraffin embedded tissue of prostatic carcinoma, prostatic intraepithelial neoplasia, and benign prostatic hyperplasia using in situ PCR. MATERIALS AND METHODS: we evaluated expression of PTI-1 in prostatic carcinoma with prostatic intraepithelial neoplasia (PIN) of 32 cases, benign hyperplasia of 20 cases, high grade transitional cell carcinoma of 10 cases and colon cancer of 10 cases for control group. Also, the immunohistochemical staining for PSA was performed to comparison with clinical value of PSA. RESULTS: The serum level of PSA was closely related to stage and Gleason score (p < 0.05). However, the results of immunohistochemical stains were variable to stage and Gleason score. PTI-1 using in situ PCR expressed in 50% of prostatic carcinoma, 41% of prostatic intraepithelial neoplasia, 10% of benign hyperplasia and colon cancer (p < 0.05). No expression is observed in transitional cell carcinoma. In prostatic carcinoma, PTI-1 expressed in 43.8% (7/16) of stage II, 50.0% (5/10) of stage III, and 66.7% (4/6) of stage IV (p<0.05). In PIN, expression of PTI-1 was similar to prostatic carcinoma (p<0.05). CONCLUSION: PTI-1 represented a relatively sensitive marker for prostatic carcinoma and PIN, indicator of prostatic carcinoma progression.
Carcinoma, Transitional Cell ; Colonic Neoplasms ; Coloring Agents ; Humans ; Hyperplasia ; Neoplasm Grading ; Oncogenes* ; Paraffin ; Polymerase Chain Reaction* ; Prostatic Hyperplasia* ; Prostatic Intraepithelial Neoplasia* ; Prostatic Neoplasms

PURPOSE: The purpose of this study was to develop a scale of free nursing home adjustment for the elderly in Korea. METHOD: The developmental processes were construction of a conceptual framework, development of preliminary items, verification of content validity, twice data gathering, verification of construct validity, and reliability of final items. The first 53 preliminary items were obtained through review of literatures about nursing home adjustment and in depth interviews with 5 staffs of nursing home. These items were reviewed by five specialists for content validity and 39 items were chosen. The first data was collected from 107 elderly residing in 3 nursing homes and the second survey was from 147 residents who were living in five nursing homes. Finally this data was analyzed for construct validity and reliability. RESULT: There were 23 final items which were sorted into 5 factors. The factors were identified as 'Relocation distress symptom'(8items), 'Making friends'(4items), 'Acceptance of new residence' (6items), 'Difficulty in group life'(3items), and 'Having self-worth'(2items). The cumulative percent of variance was 53.466%. The reliability of the scale, Cronbach's alpha was .837. CONCLUSION: The result of this study could be used for measuring nursing home adjustment of the elderly. However, for further validity and reliability, repeated researches are needed.
Adaptation, Psychological ; Aged/*psychology ; Aged, 80 and over/*psychology ; Female ; *Homes for the Aged ; Humans ; Interviews as Topic ; Male ; Middle Aged/*psychology ; *Nursing Homes ; Questionnaires ; Reproducibility of Results ; Stress, Psychological