This study examined and identified the relationship between the level of hope and self-care agency in hemodialysis patients. The purpose of the study was to reveal that hope is an essential factor to enhance self-care agency and to prepare the basic materials to help nurse the patients. The subjects for this study consisted of 108 persons who undergoing hemodialysis from 2 hospital. 2 hemodialysis center in Pusan, Korea. The degree of hope was measured by the questionnaire that has been developed by Miller. The self-care agency was measured by the questionnaire that has been developed by Kearney B.Y & Fleisher B.J. The collected data were analyzed by descriptive statistics and t-test. one-way ANOVA and Pearson's Correlation Coefficient with SPSS WIN program. Results were obtained as follows: 1) The mean scores of hope were 131.77+/-25.77 (range 67-195). The rate of hope classified said that the lowest hope was 2.8% and low hope was 27.8%. 2) The mean scores of self-care agency were 143.78+/-23.63(range 74-187). The degree of self-care agency classified said that the rate of self-care agency deficiency was 0.9% and low self-care agency was 12.0%. 3)The hope was significantly retated to self-care agency. That is, the higher the hope score was, the higher the level of self-care agency score (r = 0.668, p = 0.001) was. In this result, there were hemodialysis patients who have very low hope score and self-care agency score. In this cases self-care agency can be increased by encouraging the patients to be more hopeful. Conclusively nurses should access the degree of hope and self-care agency of hemodialysis patients individually and apply the hope therapy in order that the patient have higher hope than before.
Busan ; Hope* ; Humans ; Korea ; Surveys and Questionnaires ; Renal Dialysis* ; Self Care*

No abstract available.
Ambulances* ; Cardiopulmonary Resuscitation*

To evaluate the clinical and histopathological significance of electron dense deposits on capillary in IgA nephropathy, we reviewed and compared the clinical, laboratory, and pathological features of the patients with IgA nephropathy without loop extension of electron dense deposits(Group I, 91 cases) and IgA nephropathy with loop extension(Group II, 17cases) by ultrastructural examination using transmission electron microscope. IgA nephropathy associated with liver disease, Henoch-Schonlein purpura, systemic lupus erythematosus and the other IgA nephropathies associated with systemic diseases were excluded. The results were as follows; 1) There was no significant difference in age distribution. 2) Generalized edema was more common in group II. 3) Nephrotic ranged proteinuria(>3 g/24hr urine) was more prominent in Group II(52.9%) than Group I(8.8%). 4) Among the groups, segmental or mild deposits on the loops were noted in 13 cases, and severe and generalized deposits in 4 cases. Subendothelial deposits were noted in 6 cases, subepithelial deposits in 3 cases, subendothelial with intramembranous deposits in 1 case, subendothelial with subepithelial deposits in 1 case, intramembranous with subepithelial deposits in 2 cases, and subendothelial, subepithelial and intramembranous deposits in 4 cases. 5) The other associated ultrastructural changes of group II were diffuse effacement of foot processes with microvillous transformation, swelling or vacuolar degeneration of podocytes and glomerular endothelium. 6) According to the WHO morphologic criteria, the grade of Group II was significantly higher than Group I. From the above results, it can be concluded that the extension of electron dense deposits along the capillary loops in the cases of IgA nephropathy is highly correlated with proteinuria in the nephrotic ranged. It seems to be a poor prognostic indicator in view of the facts that it correlats with high histopathologic grading.

In 56 breast cancer tissues (infiltrating ductal carcinoma) with a clinical follow-up period of more than 5 years, positivity of estrogen receptor(ER) by enzyme immunoassay and expressions of bcl-2 and p53 oncoproteins by immunohistochemistry were evaluated. The purposes of this study were to determine prevalence of bcl-2 and p53 in breast cancer, the interrelationship between expression of the proteins and estrogen receptor, correlation between histologic grade and the expression of the tumor-related oncogenes, and to explore the biologic bahavior of breast cancer (lymph node metastasis, recurrence rate, and survival) via expression of bcl-2 and p53. Twelve of 56 (21.4%) carcinomas were bcl-2 positive, and seventeen (30.4%) were p53- positive. Eleven of 12 bcl-2 positive tumors (91.7%) were ER-positive, and bcl-2 expression was significantly associated with ER-positivity(P=0.043). Seven of 36 ER-positive tumors (12.5%) were p53 positive, and p53 expression was inversely associated with ER-positivity(P=0.006) significantly. The bcl-2 protein expression showed a significant relationship to low histologic grade of tumor (P=0.0002), and an almost significant relationship to lower recurrence rate (P=0.09). The p53 protein expression showed a significant relationship to high histologic grade of tumor (P=0.002) and an almost significant relationship to lymph node metastasis (P=0.09). Also an almost inverse relationship between bcl-2 and p53 was demonstrated (P=0.057). The bcl-2 expression had a tendency to be associated with longer patient survival(P= 0.09), but p53 immunoreaction was found not to be associated with shorter patient survival(P=0.16). These results provide further evidence that higher incidence of bcl-2 expression is correlated with higher incidence of ER and lower grade of tumor, while p53 expression is correlated with lower incidence of ER and higher grade of tumor. In conclusion, although the biologic function of bcl-2 protein is not yet well understood in breast cancer, our results suggest that bcl-2 and p53 oncoproteins might play significant roles in estrogen receptor and development of breast cancer. But their prognostic significance could not be determined; our results are 'not significant' but 'almost significant'. Thus, contribution of bcl-2 and p53 immunohistochemical phenotyping of breast cancer with ER to the clinical management need verification in larger series.
Humans ; Neoplasm Metastasis ; Breast Neoplasms

This study was designed to determine serum osmolality and to investigate the association among serum osmolality, health-related factors and biochemical indices. Two hundred thirty seven elderly(86 male, 151 female : mean age 73.8) residing in the chungbuk area participated. Sociodemographic data and self-perceived health status were obtained by interview, and biochemical parameters were measured. The mean serum osmolaity was 301.2+/-10.1 mOsm/ kg(range 240.8~328.9 mOsm/ kg) and serum osmolality of the females(302.4 mOsm/ kg) was significantly(p<0.05) higher than that of the males(299.0 mOsm/ kg). Only 11.0% of the elderly were within the accepted normal range(280~295 mOsm/ kg) and the majority of the subjects were in a hyperosmolar state(60.8% : 296~307 mOsm/ kg). It was observed that serum osmolality was reduced with increasing age but not statistically significant. There was no significant difference in serum osmolality according to marital status. Serum osmolality was significantly lower(p<0.05) in the elderly with higher self-perceived health scores than the elderly with lower self-perceived health scores, however no significant difference was observed between the presence or absence of disease. Serum osmolality tended to be higher(p=0.06) in the elderly with difficulty in mobility than the elderly who have no problem in mobility. Serum osmolality tended to be higher(p=0.06) among drug users compared to that of non-users. There was a significant association between serum osmolality and serum albumin in females but not in males. Significant associations were shown between serum osmolality and serum transferrin in both sexes. However, there was no significant correlation between serum osmolality and hemoglobin or hematocrit except with hematocrit in females only. The results of this study indicated that the elderly were dehydrated and hydration state seems to influence health status and, the elderly should be encouraged to drink an adequate amount of fluids. Also, the hydration state is required to be assessed and considered for the interpretation of biochemical parameters.
Aged* ; Chungcheongbuk-do ; Dehydration ; Drug Users ; Female ; Hematocrit ; Humans ; Male ; Marital Status ; Osmolar Concentration* ; Serum Albumin ; Transferrin