The concept of caring as the core value of nursing has been widely explored in many researchers. However, a clear conceptualization of what caring in nursing does not yet exist. The purpose of this study is to examine the attributes of caring by content analysis of journaling and to provide basic information for developing the theory of caring and teaching the humanism centered education. The study design was descriptive survey design. Data was colleged 82 cases of journaling which came from 26 junior and 30 senior nursing students from Oct. 1995 to June 1996. The collected data were analyzed using the content analysis by Ko, and et als.(1989) and Polit & Hngler(1987). To improve the validity two researchers examined the significant statements extracted from original contents. The results are as follows: The emphasized contents clusters of caring were 12 categories- , , , , , , , , , , , . , elements of the caring emerged new attributes of caring and the <> element of the caring was mentioned with high frequency as strongest element. The emphasized contents clusters of non caring were 9 categories - , , , , , , , , .
Education ; Humanism ; Humans ; Nursing* ; Students, Nursing*

An accurate preoperative evaluation of lymph nodes(LNs) in gastric cancer is a prerequisite for successful surgery and favorable prognosis. We retrospectively analyzed the Ct accuracy in perigastric LN localization and LN staging of gastric cancer as well as the size criteria for the metastasized LN in 64 patients who hed undergone a surgery for gastric cancer. The results of perigastric LNs evaluation by CT are as follows; sensitivity 67%(64/95), specificity 90%(839/929), accuracy 88%(903/1024). Of 95 pathologically metastasized LN groups, 66 could be retrospectively identified on Ct scans(69%). In LN staging, CT was correct in 60%(38/64), overstaged in 32%(21/64), and understaged in 8%(5/64). The perigastric LN groups which were easily localized on CT were #3, 7, 8, and 13. The mean size of metastasized LNs on CT according to the I.N group was #3 (13mm), #4(9mm), #6 (10mm), #7(10.5mm), #8 (10mm), #9 (11mm), #13 (9mm).
Humans ; Lymph Nodes* ; Prognosis ; Retrospective Studies ; Sensitivity and Specificity ; Stomach Neoplasms*

The sparsity of publication concerning CT findings of tuberculous arthritis prompted authors to retrospectively evaluate 12 patients with tuberculous arthritis for characteristic CT findings. In each patient, the diagnosis of tuberculous arthritis was confirmed by surgery or biopsy. The CT examinations were evaluated by two radiologists retrospectively. Involved joints were the hip joint in seven patients, the sacroiliac joint in three parients, and the shoulder and ankle joint in one patients each. CT features included subchondral bony erosion(12 patients), soft tissue mass in the joint space(nine), widenining of the joint space(eight), ipsilateral muscle atrophy(eight), thickening of the joint capsule(seven), intra-articular effusion(six), soft tissue abscess(five),and bony sclerosis(four). In seven patients with the duration of symptoms less than 1 year, thickening of joint capsule and intra-articular effusion were the predominent findings, while bony sclerosis, gross bone destruction, and soft tissue mass in joint space were seen in five patients with the duration of symptoms longer than 1 year. Our results indicate that CT is useful in the diagnosis of tuberculous arthritis by demonstrating characteristic pathologic changes of the joint space, soft tissue abnormality and bony involvement.
Ankle Joint ; Arthritis* ; Biopsy ; Diagnosis ; Hip Joint ; Humans ; Joint Capsule ; Joints ; Publications ; Retrospective Studies ; Sacroiliac Joint ; Sclerosis ; Shoulder

BACKGROUND/AIMS: Thrombopoietin (TPO) is an important cytokine for megakaryocyte maturation and platelet production. Because the main site of its production is liver, the failing liver may have a role in thrombocytopenia in chronic liver disease. The aims of this study were to determine the serum TPO levels in cirrhotic patients with thrombocytopenia and clarify the relation between the serum TPO levels and liver function impairment. METHOD: Cirrhotic paitents with thrombocytopenia (LC, n=57, Child class A/B/C; 20/13/24), chronic hepatitis patients (CH, n=24), oncologic patients with thrombocytopenia induced by chemotherapy (HO, n=7), acute viral hepatitis patients (AVH, n=5) and healthy controls (HC, n=5) were enrolled. Serum TPO was measured by an ELISA method. RESULTS: Although the mean platelets counts of LC (69+/-32, x103/ul: mean+/-SD) were lower than those of HC (229+/-29, x103/ul), serum TPO levels in LC (108+/-63 pg/ml: mean+/-SD) were not significantly different from HC (122+/-24 pg/ml). In HO, serum TPO was significantly higher than LC (623+/-746 vs 108+/-63 pg/ml, p<0.05) inspite of comparable platelets counts. In LC, serum TPO level was not significantly different among Child class groups. It was not correlated with serum ALT, serum albumin levels, prothrombin time, serum bile acid, Child class, Child score and partial thromboplastin time, but weakly correlated with serum total bilirubin (p=0.038, r=0.288) and platelet counts (p=0.041, r=0.287). CONCLUSIONS: Although impaired hepatic production of TPO seems to be the main cause of low serum TPO levels in thrombocytopenic cirrhotic patients, there was no correlation between serum TPO level and the severity of liver dysfunction. The role of other factors such as megakaryocyte mass in bone marrow, portal hypertension and hypersplenism may be necessary to explain the putative mechanism between TPO and platelet numbers in liver cirrhosis with thrombocytopenia.
Bile ; Bilirubin ; Blood Platelets ; Bone Marrow ; Child ; Drug Therapy ; Enzyme-Linked Immunosorbent Assay ; Hepatitis ; Hepatitis, Chronic ; Humans ; Hypersplenism ; Hypertension, Portal ; Liver ; Liver Cirrhosis ; Liver Diseases ; Megakaryocytes ; Partial Thromboplastin Time ; Platelet Count ; Prothrombin Time ; Serum Albumin ; Thrombocytopenia* ; Thrombopoietin*

Eosinophilic cystitis is an uncommon disease which is characterized by eosinophilic infiltration into all layers of bladder. It was first described in 1959 by Brown and 50 cases have been reported in the literature. The presenting symptoms are frequency, urgency, dysuria and hematuria. It is chronic disease with remission and exacerbation and mimics other forms of chronic cystitis, such as interstitial cystitis, tuberculosis and bladder neoplasm. Diagnosis is made by biopsy. Treatment consists of removal of inciting allergens, corticosteroids, antihistamines, and antibiotics for secondary bacterial infection. Most women and children with eosinophilic cystitis had the history of allergic disease or asthma and most male patients had bladder or prostatic disorders, such as benign prostatic hypertrophy, bladder carcinoma, and congenital anomalies. But eosinophilic cystitis has not been found in diabetic patients yet. We report a case of eosinophilic cystitis in a 59- year-old diabetic patient with brief review of the literature.
Adrenal Cortex Hormones ; Allergens ; Anti-Bacterial Agents ; Asthma ; Bacterial Infections ; Biopsy ; Child ; Chronic Disease ; Cystitis* ; Cystitis, Interstitial ; Diabetes Mellitus* ; Diagnosis ; Dysuria ; Eosinophils* ; Female ; Hematuria ; Histamine Antagonists ; Humans ; Male ; Prostatic Hyperplasia ; Tuberculosis ; Urinary Bladder ; Urinary Bladder Neoplasms

Primary biliary cirrhosis(PBC) is a chronic cholestatic liver disease of unknown origin. The small and medium sized intrahepatic bile ducts are destroyed by an inflammatory process, which, it has been suggested, is of the autoimmune type. It is strongly associated with the presence of antimitochondrial antibodies, predominantly IgM and IgG. The liver changes are classified into four stages, of which stage IV represents the development of cirrhosis, which required orthotropic liver transplantation in the longrun. The prevalence rates was reported 128 per millon in Sweden , but the disease is relatively rare in Oriental area. In medical treatment, long-term administration of ursodeoxycholic acid improves both clinical and biochemical signs, slows the progression of the disease and reduces the complication requiring liver transplantation. We report two cases of PBC, one with histologically proven cirrhosis, and the other with bile duct destruction consistent with stage III and hypothyroidism.
Antibodies ; Bile Ducts ; Bile Ducts, Intrahepatic ; Fibrosis ; Hypothyroidism ; Immunoglobulin G ; Immunoglobulin M ; Liver ; Liver Cirrhosis, Biliary* ; Liver Diseases ; Liver Transplantation ; Prevalence ; Sweden ; Ursodeoxycholic Acid

Classic distal renal tubular acidosis(type 1 RTA) is a hypokalemic, hyperchloremic metabolic acidosis due to selective defect in distal acidification. Type 1 RTA may be associated with genetic(usually autosomal dominant) or autoimmune disease, drugs and toxin and various tubulointerstitial diseases. This case report describes a 27 year-old female patient with distal RTA, Sjogren' s syndrome and Graves' disease the first case. She had been suffered from muscle weakness and peripheral numbness and was found to have low serum potassium(1.6mEq/L). She was revealed to have 1) distal RTA by NaHCO3 loading test 2) Sjogren' s syndrome by Schirmer' s test and palate biopsy and 3) Graves' disease by exophthalmometry and autoantibody test, thyroid function test. This is the first case as far as I search that report the association of distal RTA, Sjogren' s syndrome, and Graves' disease caused by autoimmune mechanism.
Acidosis ; Acidosis, Renal Tubular* ; Adult ; Autoimmune Diseases ; Biopsy ; Female ; Graves Disease* ; Humans ; Hypesthesia ; Muscle Weakness ; Palate ; Thyroid Function Tests

No abstract available.
Anti-Bacterial Agents/therapeutic use ; Biopsy ; Echocardiography, Doppler, Color ; Echocardiography, Transesophageal ; Endocarditis, Bacterial/complications/diagnosis/drug therapy/*microbiology ; Fluorescent Antibody Technique ; Heart Septal Defects, Ventricular/*complications/diagnosis/surgery ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Pulmonary Valve Stenosis/*complications/diagnosis ; Purpura, Schoenlein-Henoch/diagnosis/drug therapy/*etiology ; Risk Factors

PURPOSE: To evaluate the efficacy of CT imaging in differentiating pheochromocytoma from primary adrenalcarcinoma and metastasis. MATERIALS AND METHODS: The authors retrospectively reviewed CT imagings of 24 patients(9 males, 15 females, mean age 49) with 27 surgically or clinically proven adrenal neoplasms larger than 3cm indiameter. These neoplasms included pheochromocytomas(n=11), adrenal carcinomas(n=6), and adrenal metastases(n=10,bilateral : 3). Two radiologists visually inspected CT features with respect to tumor size, shape, intratumoral hypodensity, and calcification, and agreed upon their evalvation. These results were compared with the final histopathologic and clinical diagnosis. RESULTS: Ten of eleven pheochromocytomas(91%) were observed to be round or ovoid; this shape was rarely seen in primary carcinomas(0/6) or metastases(2/10). in contrast, mostcarcinomas(6/6, 100%) were lobulated or irregular in shape, as were most metastases(8/10, 80%). smooth, round orovoid intratumoral hypodensity was noted in all pheochromocytomas. Stellate or linear, irregular intratumoral hypodensity was present in all carcinomas and metastases. However, there were no significant differences in CTdensity of calcification. CONCLUSION: Tumor shape and intratumoral hypodensity are very useful CT findings for differentiating adrenal pheochromocytomas from primary carcinomas and metastases.
Adrenal Gland Neoplasms ; Diagnosis ; Female ; Humans ; Male ; Neoplasm Metastasis* ; Pheochromocytoma* ; Retrospective Studies