A 49-year old man was admitted to the Korea university hospital, department of surgery, for evaluation of anterior neck mass which was slowly growing for five years. His past history was unremarkable except for known hypertension for several years. Physical examination revealed high blood pressure, measuring 180 mmHg in systolic phase and 120 mmHg in diastolic phase. A soft nontender mass was palpated at anterior neck just above the sternal notch with smooth surface and its size was about 4 x 5 cm in cross. On laboratory examination, diabetic evidence such as high blood sugar (FBS 170 mg/dl, PP2hr. 234 mg/dl) and glucosuria. The CBC finding suggested polycythemia with high hemoglobin (18.0 g/dl) and hematocrit (54%) levels. The differential count and platelet count were within normal limits.
Male ; Humans

The purpose of the study was to develop and test the model for the quality of life in mothers of children with nephrotic syndrome. A hypothetical model was constructed on the basis of previous studies and a review of literature. The conceptual framework was built around ten constructs. Exogenous variables included in this model were mother's health, father's health, marital intimacy, mother's attitude on children, economic state, side effect of steroid, severity of illness and social support. Endogenous variables were mother's burden and quality of life. Empirical data for testing the hypothetical model were collected by using a self-report questionnaire from 152 mothers of children with nephrotic syndrom at the outpatient clinics and in the hospital. The data was collected from May, 1999 to August, 1999. Reliability of the seven instruments was tested with Cronbach's alpha which ranged from 0.71 - 0.92. For the data analysis, SPSS 8.0 WIN program and LISREL 8.20 WIN program were used for descriptive statistics and covariance structural analysis. The results of covariance structural analysis were as follow : 1.The hypothetical model showed a good fit with the empirical data.[x2 = .56, df = 3, p = .90(p > .05 ), GFI = .99, AGFI = .99, RMSR = .005.] 2. For the parsimony of model, a modified model was constructed by deleting 1 variable and excluding 2 paths according to the criteria of statistical significance and meaning. 3.The modified model also showed a good fit with the data[x2 = 2.83, df = 7, p = .90( p > .05 ), GFI = 1.00, AGFI = .97, RMSR = .011]. The result of the testing of the hypothesis were as follows : 1.Mother's health( gamma 21 = .26, t = 4.16), father's health( gamma 22 = .19, t = 2.92), marital intimacy( gamma 23 = .26, t = 4.13) and social support( gamma 28 = .12, t = 2.03) had a significant direct effect on the quality of life. 2. Mother's burden( beta 21 = -.20, t = -3.10) had a significant negative direct effect on the quality of life. 3. Mother's attitude on children( gamma 14 = -.34, t = .-4.57), mother's health( gamma 11 = -.22, t = -2.96) and side effect of steroid ( gamma 16 = -.23, t = .-2.69) had a significant direct negative effect on the burden. The result of this study showed that mother's health, marital intimacy, mother's burden, father's health, and social support had a significant direct effect on the quality of life. Mother's attitude on children, mother's health, and side effect of steroid had a significant direct effect on mother's burden. These six variables, mother's health, marital intimacy, father's health, social support, mother's attitude on children and side effect of steroid were identified as relatively important variables. The results of this study suggest, it needed to determine the nursing intervention will alleviate mother's burden and promote a greater quality of life in mothers of children with nephrotic syndrom.
Ambulatory Care Facilities ; Child* ; Humans ; Mothers* ; Nephrotic Syndrome ; Nursing ; Quality of Life* ; Statistics as Topic ; Child Health

Purpose: : The purpose of this study was to not only examine the importance and performance status of patient safety nursing activities in the intensive care unit but also to understand nurses’ educational needs in this respect. Methods: : In this descriptive study, 196 nurses working in the intensive care units of university hospitals located at B City and G Province were enrolled. They completed the Importance–Performance Analysis (IPA) questionnaire, and the data were statistically analyzed. Results: : Mean±standard deviation item scores of importance and performance of patient safety nursing activities were 4.75±0.33 and 4.48±0.38, respectively. In the IPA results, a total of 10 items were included in the second quadrant, including 1 item related to ‘transfer,’ 1 to ‘infection,’ and 1 to ‘firefighting surveillance.’ As the second quadrant contains the high-importance, low-performance items, these 10 items resemble the nurses’ educational needs that should be prioritized. Conclusion : The results of this study can be used as a basis for the development of nursing educational programs for patient safety in the intensive care unit.

OBJECTIVES: Anticardiolipin antibody (ACA) and lupus anticoagulant (LA) are acquired antiphospholipid antibodies (APAs), which are regarded as important risk factors far vascular thrombosis and recurrent fetal loss. Although the clinical relevance of APAs in dialysis patients is uncertain, recent studies have suggested that APAs are involved in bioincompatibility and thrombogenic complications in hemadialysis (HD) patients. METHOD: We performed a cross sectional study of ACA and LA in 50 stable HD patients and their 68 vascular accesses (52 native arteriovenous fistulae and 16 synthetic arterovenous grafts), with the analysis of factors associated with the presence of APAs and the retrospective evaluation of vascular access occlusion (VAO). LA was assessed by platelet neutralization method whereas IgG-ACA was measured by a solid phase ELISA. Values higher than 23GPLU/ml (IgG phospholipid units) were considered to be positive for IgG-ACA and positive values for LA was more than 8 seconds in prolongation of the clotting time with human platelet lysate. Vascular access survival was assessed by Kaplan- Meier method, RESULTS: The mean age of the subject (M:F 21:29) was 46 years and the mean duration of hemodialysis was 49 months. The frequency of VAO in entire subjects was 0.45+/-0.98 episodes/patient year. The median value of IgG-ACA was 16.0 GPLU/ml with a distribution from 2.7 to 46.1GPLU/ ml. The median titer of I.A was 4.5 (3.1-45.6) seconds. Fourteen patients (28%) were found to have at least one episode of VAO. In spite of comparable clinical and biochemical data according to the presence of VAO, the titers of IgG-ACA (13.6+/-7.7 vs, 20.3+/-8.7GPLIJ/ml, P<0.05) and LA (4.5+/-2.9 vs. 11.7 +/-12.6sec, P<0.05) were significantly higher in VAO group. Six out of 50 patients(12%) had an increased titer of IgG-ACA and LA was found in 11 patients(22%). No patients were positive for ACA and LA simultaneously. There was no significant difference in sex, etiology of ESRD, diabetic status, the dosage of heparin during HD or the amount of erythropoietin administered according to the presence of APAs. We could not find any significant correlation between the titer of APAs and age, duration of dialysis, blood pressure, platelet count and biochemical parameters. In the patients with positive ACA, the frequency of VAO was 1.05+/-0.12 episodes/patient year, which was significantly higher than patients without ACA (0.33+/-0.17 episodes/ patient year, P<0.05). In the patients with the presence of LA(1.06+/-0.43 vs. 0.12+/-0.06 episodes/ patients year, P<0.01). The median vascular access survival time in IgG-ACA positive patients (32.7 months) was significantly decreased compared to 66.8 months in IgG-ACA negative group. CONCLUSION: Our data suggest that the presence of APAs (ACA and/or LA) affects the event-free vascular access survival in HD patients. Therefore the evaluation of APAs status have to be included in the diagnostic strategies for the patients with recurrent VAO. Further studies are necessary to explore the pharmacologic intervention method to decrease APAs and prevent VAO in HD patients.
Antibodies, Anticardiolipin* ; Antibodies, Antiphospholipid ; Arteriovenous Fistula ; Blood Platelets ; Blood Pressure ; Dialysis ; Enzyme-Linked Immunosorbent Assay ; Erythropoietin ; Heparin ; Humans ; Kidney Failure, Chronic ; Lupus Coagulation Inhibitor* ; Platelet Count ; Renal Dialysis* ; Retrospective Studies ; Risk Factors ; Thrombosis

Fabry's disease is a rare hereditary metabolic disease caused by alpha-galactosidase deficiency, resulting in abnormal accumulation of galactosyl galactosyl galactosyl ceramide (ceramide trihexoside) in various organs. Articles in English reported approximately one hundred cases but only two cases in Korea. Recently the authors experienced a case of Fabry's disease of a male patient and studied the electronmicroscopy on skin biopsied tissue and enzyme assay of alpha -galactosidase activity in his peripheral blood leukocytes. The male patient was a 21-year-old soldier who suffered from anhidrosis with heat intolerance and generalized telangietatic papules (Angiokeratoma corporis diffusum) since childhood. Other clinical findings were ocular change, paroxysmal pain of lower extremities and proteinuria with oval fat bodies on urinalysis. The ultrastructural study of skin demonstrated abnormal lysosomal deposits of finger-prints or "zebra" body configuration in the endothelial cells, pericytes, perineural cells and intercalated ductal epithelium of sweat glands. Enzyme activity of alpha-galactosidase was markedly decreased in the peripheral blood leukocytes comparing to the normal control, which was conclusive to make a diagnosis of Fabry's disease.
Child ; Male ; Female ; Humans

Fabry's disease is a rare hereditary metabolic disease caused by alpha-galactosidase deficiency, resulting in abnormal accumulation of galactosyl galactosyl galactosyl ceramide (ceramide trihexoside) in various organs. Articles in English reported approximately one hundred cases but only two cases in Korea. Recently the authors experienced a case of Fabry's disease of a male patient and studied the electronmicroscopy on skin biopsied tissue and enzyme assay of alpha -galactosidase activity in his peripheral blood leukocytes. The male patient was a 21-year-old soldier who suffered from anhidrosis with heat intolerance and generalized telangietatic papules (Angiokeratoma corporis diffusum) since childhood. Other clinical findings were ocular change, paroxysmal pain of lower extremities and proteinuria with oval fat bodies on urinalysis. The ultrastructural study of skin demonstrated abnormal lysosomal deposits of finger-prints or "zebra" body configuration in the endothelial cells, pericytes, perineural cells and intercalated ductal epithelium of sweat glands. Enzyme activity of alpha-galactosidase was markedly decreased in the peripheral blood leukocytes comparing to the normal control, which was conclusive to make a diagnosis of Fabry's disease.
Child ; Male ; Female ; Humans

PURPOSE: This study was done to develop a new nursing intervention, Meridian Massage, and to investigate its effect on weight in infants and mother-infant interaction. METHOD: This study was conducted using a quasi experimental non equivalent control group pretest-posttest design. Thirty-one newborn infants from a postpartum Management Center were selected and assigned to two groups, experimental and control. Data were collected from February 1 to September 30, 2004. Infants in the experimental group (16) were given Meridian massage for 15 minutes daily for 6 days and weighed every day at 10 am. Using the Nursing Child Assessment Feeding Scale(1978), mother-infant interaction was determined before the treatment, after 1 week and 1 month after the massage. RESULTS: Infants in the experimental group had a higher average weight than those in the control group and the difference was significant (Z=-2.29, p=.022). For mother-infant interaction, the experimental group had higher scores than the control group, and the difference was significant between both the two groups, and the 3 measurement times. CONCLUSION: The Meridian Massage in this study showed positive weight gain and positive mother-infant interaction. This study shows that meridian massage is an effective nursing intervention in improving infant development.
Child ; Child Development ; Humans ; Infant* ; Infant, Newborn ; Massage* ; Mother-Child Relations* ; Nursing ; Postpartum Period ; Weight Gain ; Child Health

PURPOSE: The purpose of this study was to investigate the relationships among variables of body image, self-esteem and depression in college female students according to the normal and overweight. METHOD: The subjects of this study consisted of 245 college female students. The data was collected through personal interviews using questionnaires from May to June of 2001. The data was analyzed by the SPSS computer program, and it included descriptive statistics, x2-test, t-test and the pearson correlation coefficient. RESULT: Demographics provided a significant difference in grade, household income, weight control experience. There was a perceived health status difference, according to the normal and overweight subjects. There was a significant difference in body image, self-esteem and depression between the two groups. There was a significant positive correlation between body image and self-esteem, and negative correlation between body image and depression, and self-esteem and depression in college female students. CONCLUSION: The Findings of this study give useful information to construct further studies in intervention program relating overweight control for college female students.

Neurofibromatosis, first clearly described by von Recklinghausen in 1882, is a dominantly inherited mesodermal and ectodermal dysplasia with a broad spectrum of clinical findings. Most common is the classical neurofibromatosis, which has three major features: (1) multiple neural tumors dispersed anywhere on or in the body; (2) numerous pigmented skin lesions, some of which are "cafe au lait" spots; and (3) pigmented iris hamartomas also called Lisch nodules. Other lesions sometimes seen in patients with von Recklinghausen's disease include congenital malformations of various types, vascular lesions, neurilemoma meningioma and other intracranial neoplasms, pheochromocytoma, medullary carcinoma of thyroid gland, neuroblastoma, ganglioneuroma and Wilms' tumor. Approximately 10% of the patients with neurofibromatosis have the gastrointestinal tract tumors as neurofibroma, ganglioneuroma and leiomyoma. Some of them show evidence of malignancy. Increased activity of the protein "nerve growth factor" in the sera of the patients with disseminated neurofibromatosis has been reported. We would like to report here two cases of von Recklinghausen's neurofibromatosis with involvement of the gastrointestinal tract.
Hamartoma ; Meningioma

Osteoblastoma is a rare tumor which forms osteoid and bone with highly vascular stroma, account for less than 1 percent of all bone tumors. The lesion had been thought to be controlled with curettage and locat excision. In recent years, cases of locally aggressive but not metastasizing osteoblastomas have been described as aggressive osteoblastoma or malignant osteoblastoma, separated from the innocuous behavior of usual osteoblastoma. It represents the histologic characteristics of the presence of epithelioid osteoblasts, trabecular rather than lace-like osteoid, low mitotic rate with no atypical form with prominent giant cells of osteoclastic type The differential diagnosis between aggressive osteoblastoma and osteogenic sarcoma is extremely difficult, but its peculiar histologic pattern and ist different clinical and radiologic features and better prognosis are helpful. We report here a case of aggressive osteoblastoma of 17 years old female patient with 2 years and 5 months follow-up period and review the literature.
Female ; Humans ; Diagnosis, Differential