Restoration of the M-P joint of a damaged or lost joint by trauma, tumor and others is necessary for adequate function of the hand. Several procedure have been described for restoration of the M-P joint. We experienced a case of vascularized joint transter for a lost joint by trauma. After 1 year and 2 months follow-up, there have been no degenerative change and no pain.
Follow-Up Studies ; Hand ; Joints

This study was performed to observe the therapeutic effects of interferon-gamma(IFN-gamma) and gamma-globulin(gamma-globulin) in experimental Pneumocystis carinii pneumonia of immune suppressed mice. After 9 weeks, trimethoprim-sulfamethoxazole(TMP-SMZ; 10-50 mg/mouse/day), mouse IFN-gamma(5 x 10(4) units/mouse/day) and mouse gamma-globulin(20 mg/mouse/day) were administered to the mice for 3 weeks by the experimental group. The therapeutic efficacy was evaluated by body weights, histopathologic and electron microscopic findings of the lungs, and number of P. carinii cysts by Gomori's methenamine silver stain. Body weights of the mice were significantly increased in the group of combination therapy of TMP-SMZ with IFN-gamma or gamma-globulin, and in the group of TMP-SMZ treatment (p < 0.05), however, little effect was found in the group of gamma-globulin alone. Histopathologic findings of P. carinii pneumonia were much improved in the group of combination therapy of TMP-SMZ with IFN-gamma. Treatment with either TMP-SMZ or IFN-gamma significantly reduced the number of cysts in the P. carinii pneumonia, but gamma-globulin alone was ineffective. In electron microscopic findings of P. carinii pneumonia, the number of trophozoites and cysts were reduced by treatment with either TMP-SMZ or IFN-gamma, and most of the cysts were empty or containing one or two intracystic bodies. The present results suggested, that combination therapy of TMP-SMZ with IFN-gamma had synergistic effects in treatment of P. carinii pneumonia in experimental mice.
Drug-Synergism ; Drug-Therapy,-Combination ; English-Abstract ; Gamma-Globulins-administration-and-dosage ; Interferon-Type-II-administration-and-dosage ; Mice- ; Trimethoprim-Sulfamethoxazole-Combination-administration-and-dosage ; *Gamma-Globulins-therapeutic-use ; *Interferon-Type-II-therapeutic-use ; *Pneumonia,-Pneumocystis-carinii-therapy ; Gamma-Globulins ; Trimethoprim-Sulfamethoxazole-Combination ; Interferon-Type-II

No abstract available.
Humans ; Infant, Newborn* ; Streptococcus pneumoniae* ; Streptococcus*

We experienced a case of unilateral vocal cord paralysis following tracheal extubation. The patient was a 60-year-old man undergoing subtotal gastrectomy. He had no laryngeal symptoms prior to operation and the trachea was intubated with a cuffed endotracheal tube. The surgical procedure lasted 6 hours and was uneventful. Three days later after operation, he began to complain of hoarseness and mild aspiration symptom. On endoscopic examination, left vocal cord paralysis was found. Fifteen weeks later the voice and left vocal cord function return to normal without specific management. In this case, we suggested that possible causes of unilateral vocal cord paralysis are compression of recurrent laryngeal nerve by overexpanded endotracheal cuff, laryngeal trauma during difficult intubation, stretching of the nerve as a result of traction on distant organ, decreased elasticity of trachea and surrounding tissues in the older age group and long operating time.
Airway Extubation* ; Elasticity ; Gastrectomy ; Hoarseness ; Humans ; Intubation ; Middle Aged ; Recurrent Laryngeal Nerve ; Trachea ; Traction ; Vocal Cord Paralysis* ; Vocal Cords ; Voice

PURPOSE: The purpose of this study was to identify relationships of resilience, Post-Traumatic Stress Disorder(PTSD), and quality of life of breast cancer patients. The findings from this study would provide baseline data needed for nursing intervention. METHODS: A sample of 129 breast cancer patients was recruited from three hospitals in J and C cities in Korea. The survey was conducted with participants by utilizing self-reported questionnaires. RESULTS: Quality of life showed statistically significant differences on religion (t=2.11, p=.033) and hobby (t=2.79, p=.006). Resilience and PTSD had a negative correlation (r=-.22, p=.010). Resilience and quality of life of the participants had a positive correlation (r=.58, p<.001), whereas PTSD and quality of life had a negative correlation (r=-.45, p<.001). Significant predictors of quality of life were resilience and PTSD. These variables explained 44.9% of the variance in quality of life. CONCLUSION: Findings indicate that as resilience of breast cancer patients rose higher and PTSD got lower, their quality of life increased. Based on these results, nursing interventions directed towards improving resilience and relieving PTSD is proposed.
Breast Neoplasms* ; Breast* ; Hobbies ; Humans ; Korea ; Nursing ; Quality of Life* ; Surveys and Questionnaires ; Stress Disorders, Post-Traumatic*

No abstract available.
Cutaneous Fistula ; Glomerulonephritis, Membranous* ; Humans ; Sarcoma, Kaposi*

PURPOSE: The purpose of this study was to explore and understand customized home visiting nurses' experiences in telephone visiting. METHODS: Qualitative data were collected from several discussions of 4 focus groups consisting of 20 customized home visiting nurses. All interviews were recorded and transcribed according to thematic content analysis processes. RESULTS: The five main themes on customized home visiting nurses' experiences of telephone visiting were 'greeting', 'counseling', 'using strategies', 'maintaining attitude for enhancing relations' and 'enduring difficulties'. The category of 'counseling' was composed of confirming, educating, supporting, adjusting, and indicating. And, the category of 'using strategies' included complimenting, scolding, persuading, compensating, and ignoring. CONCLUSION: Developing a standardized manual on telephone visiting is needed to guide an effective counseling. In order for a customized home visiting nurse to be a good telephone counselor, training of motivational interviewing is recommended.
Counseling ; Focus Groups ; House Calls* ; Motivational Interviewing ; Nurses, Community Health ; Telephone*

Here we report an autopsy case of diabetic ketoacidosis (DKA) with severe hypertriglyceridemia (12,900 mg/dl). A 29-year-old woman with a history of type 1 diabetes was found dead at a motel. There was no injury on external inspection, but a lump of cheese-like material was noted in the heart at autopsy and peripheral blood plasma had a creamy appearance. After postmortem biochemical analysis, we made a diagnosis of DKA with severe hypertriglyceridemia and concluded that these unusual autopsy findings were caused by DKA and postmortem change. Uncontrolled diabetes often causes DKA and hypertriglyceridemia. To the best of our knowledge, this is the first report in Korea of DKA with severe hypertriglyceridemia diagnosed by autopsy.
Adult ; Autopsy* ; Diabetic Ketoacidosis* ; Diagnosis ; Female ; Heart* ; Humans ; Hypertriglyceridemia* ; Korea ; Plasma ; Postmortem Changes

Background and Objectives: This study aimed to examine factors of poor outcome by analyzing the outcomes of bilateral subthalamic deep brain stimulation in Parkinson’s disease after 3 years. Methods: We assumed that patients who could not manage independent life in their best stimulationon/medication-on condition after a defi ned period might not have been a good surgical candidate. A poor outcome is defi ned as a failure to maintain functional independence at three years during a stimulation-on/medication-on state. Results: A total of 84 patients underwent bilateral subthalamic deep brain stimulation and all were followed up for 3 years. We excluded one patient who had intracranial hemorrhage. Twenty-one patients of the 83 patients could not keep up independent life even during their best condition for the following reasons: freezing in 15 patients, dementia in 5, depression in 3, musculoskeletal problems in 7, and cancer in one patient. Conclusions: Many patients could not keep up independent life during their best condition as early as three years after deep brain stimulation. Musculoskeletal problems were one major cause of disabilities, as were freezing and dementia. We emphasize that musculoskeletal problems need more attention in the preoperative screening of deep brain stimulation candidates and during the follow up.

PURPOSE: Simulation-based learning has become a powerful method to improve the quality of care and help students meet the challenges of increasingly complex clinical practice settings. The purpose of this study was to identify the learning effects using high-fidelity SimMan and multi-mode simulation. METHODS: Participants in this study were 38 students who were enrolled in an intensive course for a major in nursing at R college. Collected data were analyzed using Chi-square, t-test, and independent t-test with the SPSS 18.0 for Windows Program. RESULTS: There were no statistically significant differences in learning effects between high-fidelity SimMan and multi-mode simulation group. However, skills in clinical performance in the high-fidelity SimMan group were higher than in the multi-mode group (p=.014), communication in clinical performance in multi-mode simulation group was higher than in the high-fidelity SimMan group (p<.001). CONCLUSION: Multi-mode simulation with a standardized patient is an effective learning method in many ways compared to a high-fidelity simulator. These results suggest that multi-mode simulation be offered to students in nursing colleges which cannot afford to purchase a high-fidelity simulator, or offered as an alternative.
Adult ; Education, Nursing, Baccalaureate ; Emergency Medical Services ; Female ; Heart Arrest/*nursing ; Humans ; Learning ; Male ; Manikins ; *Patient Simulation ; Students, Nursing/psychology