The purpose of this study was to identify the effect of follow-up care for stroke survivors on primary caregivers' quality of life. Quasi-experimental research was conducted in which an experimental group and a control group-each of 15 stroke survivors and their primary caregivers-were consecutively sampled. Data collected from July to September, 1999 by interview using a structured questionnaire with both the experimental and the control groups. After a month, the two groups were given the same questionnaire. The experimental group was also given a telephone follow-up every week for a month, as well as a home visit. The survey instruments used in this study were Saha and Cooper's Modified Barthel index (11 items) for checking the stroke survivors' level of activities of daily living, and a modified form of Jeong's Quality of life (18 items) for primary caregivers' QOL level. The obtained data were analyzed by percentage, t-test. chi-test. Kruscal-Wallis test, Spearman correlation coefficient by SAS/PC program. The results were as follows: 1. There was no significant difference in the stroke survivors' ADL level. though the level of the experimental group was higher than that of the control group. 2. There was a statistical difference in the before and after treatment of the primary caregivers' QOL level. In conclusion. the follow-up a care program had useful effect on the quality of life of primary caregivers.
Activities of Daily Living ; Caregivers ; Follow-Up Studies* ; House Calls ; Humans ; Quality of Life* ; Surveys and Questionnaires ; Stroke* ; Survivors* ; Telephone

Authors report a case of separation anxiety disorder, which developed as a side effect during haloperidol treatment of Tourette syndromes(TS). In this case, 14 years old boys developed attention deficit symptoms during his infancy. At 4th grade of primary school, he developed vocal tic, motor tic, and coprolalia. With 5mg/day of haloperidol treatment his symptoms of TS were subsided. During the treatment, he developed features of separation anxiety disorder, including dependence, pleading, clinging, and sadness. Symptoms of attention deficit and separation anxiety disorder were improved by 25mg/day of imipramine treatment. During haloperidol treatment of TS, careful observation may be needed whether separation anxiety disorder-like symptom develops.
Adolescent ; Anxiety, Separation ; Haloperidol* ; Humans ; Imipramine ; Tics ; Tourette Syndrome*

INTRODUCTION: There has been an increasing interest in the relationship between sleep and suicidality. In addition, suicidal patients habitually report their sleep problems. Although sleep-related complaints and electroencephalographic changes are generally encountered in psychiatric disorders, sleep complaints such as insomnia, hypersomnia and nightmares are more common in suicidal patients. In current study, we aimed at investigating the relationship between self-reported sleep duration and suicidality in general population. METHODS: One thousand general population (male : female=500 : 500, mean age=39.6+/-11.6 years, ranged age=20-77 years) completed Center for Epidemiologic Study-Depression (CES-D), Beck Suicide Intent scale (BSI), Spielberger State-Trait Anger Expression Inventory (STAXI), Barratt Impulsiveness Scale (BIS), Morningness-Eveningness Scale (MES) and brief questionnaire of sleep habits. RESULTS: After controlling for age and sex, score of BSI was correlated positively with the score of CES-D, STAXI and BIS on partial correlation analysis (r(p)=0.251 ; p<0.001, r(p)=0.352 ; p<0.001, and r(p)=0.175 ; p<0.001, respectively). In addition, score of BSI was inversely correlated with the score of MES (r(p)=-0.066; p=0.037). However, score of BSI showed no significant correlation with sleep duration. However, regression analysis revealed that short (<6 hrs) or long (>10 hrs) sleep duration, the family history of psychiatric illness, the score of CES-D, and the score of STAXI predicted higher score of BSI significantly in total subjects (F=17.837, adjusted R2 =0.166 ; p=0.003, p=0.003, p<0.001, and p=0.003, respectively). This model was explained better in depressed subjects with 16 or higher score of CES-D (F=9.920, adjusted R2=0.298). CONCLUSION: Current result suggested that not only short sleep duration (<6 hrs) but also long sleep duration (>10 hrs) might be related to suicidality.
Anger ; Depression ; Disorders of Excessive Somnolence ; Dreams ; Humans ; Surveys and Questionnaires ; Republic of Korea ; Sleep Initiation and Maintenance Disorders ; Suicide

OBJECTIVES: Working at other times than the regular day shift has been reported to be a stressor associated with health consequences and mental disorders as well as disturbance of sleep. In current study, we aimed at investigating the relationship between work schedule, sleep quality and depression among police officers. METHODS: Eleven hundreds and forty five police officers (male:1040, female:105) completed questionnaires of basic socio-demographic data, Pittsburgh Sleep Quality Index (PSQI), Korean Scale of Occupational Stress (KOSS), Impact of Event Scale - Revised (IES-R) and Center for Epidemiologic Study-Depression (CES-D). RESULTS: After controlling for age, sex and educational level, score of CES-D was correlated positively with the score of KOSS, PSQI and IES-R on partial correlation analysis (r=-0.077;p=0.009, r=0.262;p<0.000 and r=0.421, p<0.000, respectively). Logistic regression analysis revealed that female sex, age, the score of KOSS and IES-R and schedule of rotating shift work predicted higher score than 16 score of CES-D significantly in total subjects (p=0.023, p=0.015, p=0.000, p=0.000 and p=0.022, respectively). CONCLUSION: Current result suggested that not only female sex, age, higher occupational stress and impact of event scale but also rotating shift work schedule might be related to depression among police officers.
Appointments and Schedules ; Depression ; Female ; Humans ; Logistic Models ; Mental Disorders ; Police ; Surveys and Questionnaires ; Risk Factors

OBJECTIVE: To analyze 543 cases of amniocentesis with indications, cytogenetic results. METHOD: This study includes 543 cases cytogenetic study results which amniocentesis to detect fetal chromosomal abnormality in the Cytogenetic Laboratory at Eun Hospital in Kwang-Ju from August 1996 to December 2000, as gestational ages, indications of amniocentesis, maternal age distributions, chromosome aberrations with cytogenetic results. The cytogenetic results of chromosome aberration was identified by parents inheritance and de novo karyotypes as parents periperal blood cytogenetic study. RESULTS: Amniocentesis performed mostly from 15 weeks to 20 weeks of gestaional ages. Requested indication of amniocentesis presents abnormal maternal serum screening (37%), infertility (23%) and maternal old age (> or =35) (17%). Chromosome aberration according to amniocentesis indication was suspected fetal anomaly by ultrasonogram (8.6%), previous family history (5.7%). Chormosome aberration following maternal ages, more 40 years old women were found highly 7.9%. The frequency of chromosome aberration was 5.5% but de novo chromosome aberration was 2.2%. Numerical aberration was overall new karyotypes (1.3%). Structural aberration was inheritance karyotypes (3.3%) and de novo karyotypes (0.9%). CONCLUSION: Amniocentesis is a effective diagnostic tools in fetal chromosome aberration. Indication of fetal chromosomal anormality by ultrasonography and advanced maternal ages is an important diagnostic method with chromosome aberrations. Prenatal fetal chromosome aberrations included inheritance and de novo karyotypes. Especially, identification of de novo chromosome aberrations may predict fetal anomaly and counsel the fetus for pregnant parents.
Adult ; Amniocentesis* ; Chromosome Aberrations ; Cytogenetic Analysis* ; Cytogenetics* ; Female ; Fetus ; Gestational Age ; Gwangju ; Humans ; Infertility ; Karyotype ; Mass Screening ; Maternal Age ; Parents ; Ultrasonography ; Wills

Extracorporeal shock wave lithotripsy monotherapy was performed in 72 renoureteral units from 66 patients with the Northgate SD-3 lithotriptor using ultrasound stone localization between June 21, and August 25, 1989. Of 72 cases renal stones were 46 cases( 63.9% ) and ureteral stones 26 cases ( 36.1% ). No regional or general anesthesia were necessary but sedatives or analgesics were required in most patients. Among 67 cases who completed extracorporeal shock wave lithotripsy, the success rate of treatment(rate free of calculi plus that of clinically insignificant residual stone fragments) was achieved 100% below 20mm, 87.5% in 21-30mm and 100% over 31mm and the total mean success rate was 97%. 23 cases( 31.9% ) were required auxiliary procedures such as Double-J stent in 14 cases, push up procedures 6 cases and stone basket 3 cases. Poet-lithotripsy complications were transient macroscopic hematuria in 90%, renal colic 20.8%, steinstrasse 13.9%, fever 6.9% and subcapsular hematoma 2.8% and these complications were controlled with conservative management. We suggest that extracorporeal shock wave lithotripsy monotherapy with the Northgate SD-3 lithotriptor was considered to be effective and safe procedure for the initial treatment of urinary stone.
Analgesics ; Anesthesia, General ; Calculi ; Fever ; Hematoma ; Hematuria ; Humans ; Hypnotics and Sedatives ; Lithotripsy* ; Renal Colic ; Shock* ; Stents ; Ultrasonography ; Ureter ; Urinary Calculi

PURPOSE: The purpose of this study was to describe and explore the experience process of life of patients with Crohn's disease. METHODS: Using a grounded theory methodology, 24 interviews were performed with 7 men and 5 women, 17-47 years of age, suffering from Crohn's disease. RESULTS: 'Tuning of two conflicting lives' was identified as the core category, and 5 subcategories were identified and they were integrated into the core category. The identified outcomes were 'Living a withdrawn life', 'coping flexibly', 'drifting with tangled emotions' and 'maintaining long-term remission'. CONCLUSION: When caring for these patients, it is important to identify needs, allow patients to express what they want at that moment and support them in maintaining a daily life that can be perceived as normal.
Adaptation, Psychological ; Adolescent ; Adult ; Crohn Disease/*psychology ; Female ; Humans ; Interviews as Topic ; *Life Change Events ; Male ; Middle Aged ; Stress, Psychological ; Young Adult

Transforming growth factor (TGF)-beta1 plays an important role in hepatocarcinogenesis and has been described as a useful tumor marker and one of the poor prognostic indicators in patients with hepatocellular carcinoma (HCC). To investigate the role and cellular localization of TGF-beta1 during multistep hepatocarcinogenesis we performed a quantitative analysis of TGF-beta1 mRNA and immunohistochemical expression of TGF-beta1 and TGF-beta receptor II (TGF-betarII) in female Sprague-Dawley rats. The experimental groups included neoplastic lesions produced by Solt-Farber's protocol, regenerating liver after partial hepatectomy, and normal control. Quantitative change of TGF-beta1 mRNA was analysed by competitive reverse-transcription polymerase chain reaction (RT-PCR). TGF-beta1 protein and TGF-betarII expression were evaluated by immunohistochemical stain. The discrete tumor nodules were detected on 14th day and then increased in number and size. Three HCCs were induced on 8th or 9th month. RT-PCR demonstrated TGF-beta1 mRNA band in all examples of the normal and regenerating liver, nodules and HCCs. Competitive RT-PCR displayed higher TGF-beta1 mRNA in nodules, HCCs and regenerating liver than in normal controls. Hepatocytes from control and regenerating livers showed weak immunoreactivity for TGF-beta1. In contrast, the cytoplasm of hepatocytes of nodules in 7th, 8th and 9th month and HCCs were intensely stained for TGF-beta1. Some sinusoidal cells showed immunoreactivity for TGF-beta1 in all experimental groups. In early phase of carcinogenesis, the cytoplasm of hepatocytes in liver of 12h, 1d and 3d showed transiently increased immunoreactivity for TGF-beta1 and The immunoreactivity decreased thereafter. TGF-beta1 mRNA was also detected in the neoplastic hepatocytes by in-situ hybridization. Although TGF-betarII expression was correlated with TGF-beta1 immunoreactivity during early phase of carcinogenesis, hepatocytes in most nodules in 7th, 8th, 9th month and carcinomas showed decreased or little immunoreactivity for TGF-betarII. Based on the above results, it is concluded that TGF-beta1 expression increases not only in precancerous nodules but also in HCCs and its increase seems to be correlated with decrease or loss of TGF-betarII expression although its mechanism remains unclear. Hepatocytes may be a major cellular source of TGF-beta1 during hepatocarcinogenesis.
Carcinogenesis ; Carcinoma, Hepatocellular ; Cytoplasm ; Diethylnitrosamine* ; Female ; Hepatectomy ; Hepatocytes ; Humans ; Liver ; Polymerase Chain Reaction ; Rats, Sprague-Dawley* ; Receptors, Transforming Growth Factor beta* ; RNA, Messenger* ; Transforming Growth Factor beta* ; Transforming Growth Factor beta1* ; Transforming Growth Factors*

No abstract available.

According to the Mainz classification, renal cell carcinoma (RCC) consists of three subtypes: each has characteristic genetic alterations within the chromosomal or mitochondrial DNA. The three subtypes are: clear cell type, chromophil type, and chromophobe type. E-cadherin is a Ca++-dependent adhesion molecule which plays a major role in the maintenance of intercellular adhesion in epithelial tissues. In a normal kidney, E-cadherin is expressed in the distal tubule and the collecting duct, but not in the proximal tubule. We reclassified 110 cases of RCC according to mainz classification. Immunohistochemical staining for E-cadherin was done on twenty eight cases of RCC, including 18 cases of clear cell type, four cases of chromophil type, and six cases of chromophobe type. The results were as follows: 1) of the 110 cases of RCC, 96 cases (87.3%) were of clear cell type, four cases (3.6%) of chromophil type, and ten cases (9.1%) of chromophobe type, 2) there was no significant correlation between the nuclear grade and clinical stage according to each subtype, 3) E-cadherin expression showed a strong positive reaction along the cell membranes in all six cases of chromophobe type. The differential expression of E-cadherin in RCC may suggest that the chromophobe type may have different biologic characteristics from other types of RCC.
Cadherins* ; Carcinoma, Renal Cell* ; Cell Membrane ; Classification* ; DNA, Mitochondrial ; Immunohistochemistry ; Kidney ; Population Characteristics