No abstract available.
Epinephrine*

No abstract available.
Epinephrine*

PURPOSE: This study aimed to define the relationship among self-care, symptom experiences, and health-related quality of life(HRQoL) according to the severity of disease in chronic obstructive pulmonary disease(COPD) patients. METHODS: The participants, 195 COPD patients, were recruited at a pulmonology clinic of a universityaffiliated medical center in B metropolitan city. Inclusion criteria were patients who were diagnosed as COPD and had less than 0.7 of FEV1/FVC(Forced Expiratory Volume for 1 second/Forced Vital Capacity) ratio. The severity was classified with GOLD(Global initiative for Obstructive Lung Disease) stages, FEV1% predicted value from mild to very severe. The data were gathered by the medical records and self-reported questionnaires. RESULTS: The self-care, symptom experience, and HRQoL were all significantly different by COPD severity based on pulmonary function(p<.05). There were significant moderate negative relationships between symptom experiences and self-care(r=-.54, p<.001) and between symptom experiences and HRQoL(r=-.64, p<.001). There was a moderate positive correlation between self-care and HRQoL(r=.63, p<.001). CONCLUSION: It suggests that the assessment of disease severity based on pulmonary function and subjective symptom experience in patients with COPD may be a key component to develop a tailored self-management program and to improve their quality of life.
Humans ; Lung ; Medical Records ; Pulmonary Disease, Chronic Obstructive ; Pulmonary Medicine ; Quality of Life ; Self Care

Heterotopic pregnancy with coexistiong intrauterine and extrauterine pregnancy, is a rare event in natural pregnancy. However, in recent years, the increase in the incidence of pelvic inflammatory disease and use of assisted reproductive technology had led to an increase in the frequency of heterotopic pregnancy. When the diagnosis of heterotopic pregnancy is delayed, maternal mortality and morbidity may be increased, and unwanted loss of intrauterine pregnancy may occur. Therefore, the early diagnosis of heterotopic pregnancy is clinically important, and clinicians have to consider the possibility of heterotopic pregnancy and conduct careful and thorough evaluation if suspected. We experienced a case of heterotopic pregnancy in a woman in the absence of the known risk factors. She underwent underwent spontaneous abortion of intrauterine pregnancy at postoperative 4th day, after laparoscopic salpingectomy for left tubal pregnancy. We report this case with brief review of literature.
Abortion, Spontaneous ; Diagnosis ; Early Diagnosis ; Female ; Humans ; Incidence ; Maternal Mortality ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Heterotopic* ; Pregnancy, Tubal* ; Reproductive Techniques, Assisted ; Risk Factors ; Salpingectomy

Heterotopic pregnancy with coexistiong intrauterine and extrauterine pregnancy, is a rare event in natural pregnancy. However, in recent years, the increase in the incidence of pelvic inflammatory disease and use of assisted reproductive technology had led to an increase in the frequency of heterotopic pregnancy. When the diagnosis of heterotopic pregnancy is delayed, maternal mortality and morbidity may be increased, and unwanted loss of intrauterine pregnancy may occur. Therefore, the early diagnosis of heterotopic pregnancy is clinically important, and clinicians have to consider the possibility of heterotopic pregnancy and conduct careful and thorough evaluation if suspected. We experienced a case of heterotopic pregnancy in a woman in the absence of the known risk factors. She underwent underwent spontaneous abortion of intrauterine pregnancy at postoperative 4th day, after laparoscopic salpingectomy for left tubal pregnancy. We report this case with brief review of literature.
Abortion, Spontaneous ; Diagnosis ; Early Diagnosis ; Female ; Humans ; Incidence ; Maternal Mortality ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Heterotopic* ; Pregnancy, Tubal* ; Reproductive Techniques, Assisted ; Risk Factors ; Salpingectomy

PURPOSE: Supernumerary nipple or polythelia is one of the developmental anomalies occurring at the embryonic stage and this anomaly usually arises from the milk line. While this atypical feature is determined during early developmental stage, it may not come out obviously or become troublesome until puberty or lactation. Moreover, sometimes it is confused with a pigmented nevus. METHODS: Case 1, a 18-year-old woman with intramammary supernumerary breast consisted of another nipple with middle sized areola on the right lower breast was admitted for a 2.8 x 3.1 cm-sized mass on the right breast which was starting appeared 1 year earlier. The preliminary cytological examination of the material obtained by needle aspiration biopsy from the mass was revealed by fibroadenoma with no malignant change. The patient had the surgical excision of the mass and accessory breast. Case 2, a 16 year-old woman admitted for intra-areolar polythelia of the left breast, even she doesn't have any family history of polythelia. Since she wanted surgical correction of her atypical nipple for aesthetic and psychological reasons, we reconstructed the areola using transposition flaps in an S-plasty design. RESULTS: Case 1, the excised supernumerary nipple showed following histological features. In the superficial layer, an acanthotic and hyperpigmented epithelium with elongated rete ridges was found. In the dermis, there were follicles with hairs surrounded by hypertrophic sebaceous glands. In the deepest portion, abundant secretory glomerules and excretory ducts of apocrine gland type were observed. Case 2, follow-up visits 3 months after the procedure showed a satisfactory result with good shape and projection of the nipple. CONCLUSION: We report two cases of aberrant mammary tissue who underwent surgical correction, including complete breast (with nipple, areola, and glandular tissue) and intra-areolar polythelia according to the Kajava's classification, and the results were satisfactory.
Adolescent ; Apocrine Glands ; Biopsy, Needle ; Breast ; Dermis ; Epithelium ; Female ; Fibroadenoma ; Follow-Up Studies ; Hair ; Humans ; Lactation ; Milk ; Needles ; Nevus, Pigmented ; Nipples ; Puberty ; Sebaceous Glands

PURPOSE: Supernumerary nipple or polythelia is one of the developmental anomalies occurring at the embryonic stage and this anomaly usually arises from the milk line. While this atypical feature is determined during early developmental stage, it may not come out obviously or become troublesome until puberty or lactation. Moreover, sometimes it is confused with a pigmented nevus. METHODS: Case 1, a 18-year-old woman with intramammary supernumerary breast consisted of another nipple with middle sized areola on the right lower breast was admitted for a 2.8 x 3.1 cm-sized mass on the right breast which was starting appeared 1 year earlier. The preliminary cytological examination of the material obtained by needle aspiration biopsy from the mass was revealed by fibroadenoma with no malignant change. The patient had the surgical excision of the mass and accessory breast. Case 2, a 16 year-old woman admitted for intra-areolar polythelia of the left breast, even she doesn't have any family history of polythelia. Since she wanted surgical correction of her atypical nipple for aesthetic and psychological reasons, we reconstructed the areola using transposition flaps in an S-plasty design. RESULTS: Case 1, the excised supernumerary nipple showed following histological features. In the superficial layer, an acanthotic and hyperpigmented epithelium with elongated rete ridges was found. In the dermis, there were follicles with hairs surrounded by hypertrophic sebaceous glands. In the deepest portion, abundant secretory glomerules and excretory ducts of apocrine gland type were observed. Case 2, follow-up visits 3 months after the procedure showed a satisfactory result with good shape and projection of the nipple. CONCLUSION: We report two cases of aberrant mammary tissue who underwent surgical correction, including complete breast (with nipple, areola, and glandular tissue) and intra-areolar polythelia according to the Kajava's classification, and the results were satisfactory.
Adolescent ; Apocrine Glands ; Biopsy, Needle ; Breast ; Dermis ; Epithelium ; Female ; Fibroadenoma ; Follow-Up Studies ; Hair ; Humans ; Lactation ; Milk ; Needles ; Nevus, Pigmented ; Nipples ; Puberty ; Sebaceous Glands

PURPOSE: Radical surgical extirpation in advanced breast cancer patients produces extensive loss of skin with large defects requiring plastic surgical procedures for the closure. Many reconstructive methods exist, the choice of which depends upon the characteristic of the wound, extent of resection and patient comorbidities. For adequate coverage of the large skin defects following resection of advanced breast cancer, current authors have performed a thoracoabdominal flap. METHODS: From August 2008 to June 2009, 4 cases of thoraco-abdominal flap were performed for chest wall reconstruction after mastectomy of advanced breast cancer. Flap dissection was entirely performed in a subfascial plane and the flap involving the external oblique abdominal muscle. The flap was rotated clockwise in left chest wall defects and counterclockwise in right chest defects and the donor site was closed directly. RESULTS: Their mean age, 55.7 years and the average follow-up interval was 9 months. Patients' oncologic status ranged from stage IIIc to stage IV, it was classified according to the TNM staging system. Flap dimensions ranged between 15 x 15 and 25 x 25 cm. One flap sustained a partial loss at the distal margin and revision with pectoralis major musculocutaneous island flap. CONCLUSION: Large chest wall reconstructions are usually required after radical excision of advanced cancer stages patients with poor general conditions. Thoracoabdominal flap is a simple, quick single-stage procedure, and offer to patient fast recovery, low complication rate, enabling further concomitant adjuvant therapy.
Abdominal Muscles ; Breast ; Breast Neoplasms ; Comorbidity ; Follow-Up Studies ; Humans ; Mastectomy ; Neoplasm Staging ; Skin ; Thoracic Wall ; Thorax ; Tissue Donors

OBJECTIVE: To evaluate for the clinical analysis on abruptio placenta, we examined its incidence, diagnostic methods, symptom and sign, perinatal mortality, and recurrence rate. METHODS: We reviewed the medical records of the 396 cases of abruptio placenta among 72.580 deliveries, from Jan. 1, 1990 to Dec. 31, 1997, at St. Mary, Kang Nam St. Mary, and Holy Family Hospital of Catholic University. RESULTS: The total incidence of abruptio placenta was 0.51%, the incidence plotted by age from 1993 to 1997 has shown that the age incidence was higher in 20-24years old(0.7%), and over 35years old (0.8%). 42.5% of the case occurred between 32 to 37weeks of gestational age, 39.6% was over 37weeks. 38% of the patient was diagnosed before delivery with ultrasonography and the most common complaint was vaginal bleeding. The complication of abruptio placenta is as follows, Couvelaire uterus occurred in 26cases(7.0 %), DIC in 10cases(2.7 %), ARF in 4cases (1.1 %), and uterine rupture in 1case(0.3 %). Perinatal mortality including 41cases of stillbirth was 19.9 %(73cases) but no maternal death was noted. A history of abruptio placenta increased risk of a similar incident in a subsequent pregnancy by 19 cases(4.6 %: 9.0 fold)complicated with 13 cases of pregnancy induced hypertension(76.5 %). CONCLUSION: The incidence of abruptio placenta plotted by age have shown higher in 20-25years old and over 35 years old, hypertensive women experienced abruptio placenta are more likely to have higher graded recurrent rate in subsequent pregnancy, and abruptio placenta is major obstetric bleeding disease causing serious maternal and fetal complication.
Adult ; Dacarbazine ; Female ; Gestational Age ; Hemorrhage ; Humans ; Hypertension ; Incidence ; Maternal Death ; Medical Records ; Perinatal Mortality ; Placenta* ; Pregnancy ; Recurrence ; Stillbirth ; Ultrasonography ; Uterine Hemorrhage ; Uterine Rupture ; Uterus

Recent studies in western countries have reported that the mechanism pf pain are concorded with gate control opiage receptor binding sites and the release of intrinsic morphine like substances, sodium glutamate and also with bradykinin, seroconin, histamine and prostaglandin E. Otherwise the mechanism of the stimulstion producing analgesia has been reported to involve a neurophysiologic and neurohumoral inhibitory effect at the level of spinal cord, brain stem, thalamus and cortex. This has been clarified but further study should improve the chance of understanding the mechanism of pain. From the standpoint of pain management, medications used to manage pain have some unfortunate side effects. nerve blocks cause anesthesia toxicity, major neurosurgical procedures have many complications. Subarachnoidal and epidural analgesics have unknown irritation pneumonia and drug toxicity, and plexus or pituitary gland block with phenol or alcohol has uneventful complication. From January 1980 to December 1982, electrical acupuncture stimulation has been used on 210 cases at HANYANG university hospital in the pain clinic. I found it useful in relieving pain which has not responded to various conventional methods which included medications, nerve blocks, neurosurgical intervantion and neuropolytics. The results are as follows: 1) There are two kinds of treated patients: One is consultation case-12 from internal medicine, 16 from orthopedic surgery, 10 from neurosurgical and 2 from psychiatry. Another 170 cases were patients who directly to the clinic. And the age distribution shows the highset number of patients in the 3rd decade(21%) and in the 4th decade(24.8%). 2) The region of pain was 21% lumbar, 13.8% shoulder, 10% lower leg and head or face with 9.5%. 3) The duration of the pain showed 10 days 25.7%, 1~2 month 18.6%, one year 11.4% and the longest up to 20 years. 4) Patients who were able to walk into the clinic were 19.5%, moderate cases who to be accompanied were 58.6% and bedridden cases were 21.9%. 5) Treatment was conducted mainly on low frequency stimulation with various waves that included the general dynamic activity point plus reactive electro permeable point (REPP) 81.9% and REER plus head in situ needle 18.1%. 6) In 16.7% only one treatment was administered, in 46.1% 2~5 treatments were given, in 28.6% 6~10 treatments were given and in 3 cases more than 100 treatments were administered. 7) Of the 210 cases, 43.3% showed marked improvement, 41.4% were improved, 13.8% showed translent improvement and there were 3 cases of no improvement. The total confidence was 84.7%. 8) There are no serious complications except hypertensive shock case, submucosal hemorrhagic petechia 7 cases and generalized fatigue 18 cases. In conclusion, electrical acupuncture stimulation of the peripheral nervous system can be used to relieve pain replacing such conventional means as medications, nerve blocks, major neurosurgical procedures, neuroytics and physiopsychic therapy which are generally less effective.
Acupuncture ; Age Distribution ; Analgesia ; Analgesics ; Anesthesia ; Binding Sites ; Bradykinin ; Brain Stem ; Drug-Related Side Effects and Adverse Reactions ; Electric Stimulation* ; Fatigue ; Head ; Histamine ; Humans ; Internal Medicine ; Leg ; Morphine ; Needles ; Nerve Block ; Neurosurgical Procedures ; Orthopedics ; Pain Clinics ; Pain Management ; Peripheral Nerves* ; Peripheral Nervous System ; Phenol ; Pituitary Gland ; Pneumonia ; Shock ; Shoulder ; Sodium Glutamate ; Spinal Cord ; Thalamus