The purpose of this study was to identify the degree of self-care activities of stroke patients, the family burden, and the educational needs of primary caregivers. A descriptive survey research was conducted in 97 stroke patients and their respective primary caregivers. Data were collected the using 26th to by interviews a structure questionnare from July August 5th, 1999. NIH stroke status was 12.15+/-8.40, the degree of self-care activities of stroke patients was 26.85+/-9.39. The score of objective burden of primary caregivers was 31.24+/-4.81 and subjective burden was 24.30+/-6.99. The score of the educational needs was 89.78+/-9.99. We present several imformations about clients from these scores as follows: The patients were convalescent and their depentant level of self-care was middle range: The objective burden was higher than the subjective burden: And the educational needs of family caregivers were very high. The Elain Mattis Educational Wants of Family Caregivers of Disabled Adults Questionnaire was used to assess the educational needs of primary caregivers of stroke patients. The results of this research are offered to help nurses understand the feelings of uncertainty about the new and unexpected role that family caregivers face and to help nurses meet the needs of families preparing to care stroke survivors at home.
Adult ; Caregivers* ; Humans ; Surveys and Questionnaires ; Self Care* ; Stroke* ; Survivors ; Uncertainty

Marjolins ulcer is a special type of skin malignancy arising from previous scar site. We report two cases of Marjolins ulcer arising from chronic deg enerating burn scar. A 65-year-old male had a 9 x 15cm sized ulcer on his right popliteal fossa. He had a history of burn when he was seventeen years old and an ulcerati 1g tumor developed at the site of burn scar about 1 year ago. The ulcer became progressively penlarged in size and also painful. Skin biopsy revealed squamous cell carcinoma and,subsequently Above-Knee amputation was done. Another 54-year-old male had a painful coin sized ulcer on his right popliteal fossa where he had burn at the age of thirty-four. The ulcer was developed at the site of burn scar about 2months ago. The pathologic diagnosis was squamous cell carcinoma. He was recommended to get his leg amputated, but it was refused.
Aged ; Amputation ; Biopsy ; Burns ; Carcinoma, Squamous Cell ; Cicatrix ; Diagnosis ; Humans ; Leg ; Male ; Middle Aged ; Numismatics ; Skin ; Ulcer*

Isolated infernal iliac artery aneurysms and rupture are relatively infrequent, often difficult to detect and therefore rarely considered in the differential diagnosis for abdominal pain. The consequences can be grave, The incidence of isolated iliac artery aneurysm is 1~2% of that of abdominal aortic aneurysm(AAA). The natural history is of gradual enlargement, with rupture the most common clinical presentation. The signs and symptoms of such an aneurysm are influenced by its concealed location within the bony pelvis. Awareness of these special characteristics improves the chances of early diagnosis and proper surgical treatment before possible rupture. Here is a case of ruptured aneurysm of left internal iliad artery. A 73-year-old man was presented to our emergency center with severe abdominal pain and voiding difficulty Abdominal Computed Tomography(Cf) and angiography showed ruptured aneurysm of left infernal iliad artery. Emergency operation was successfully performed for the ruptured internal iliad artery aneurysm.
Abdominal Pain ; Aged ; Aneurysm* ; Aneurysm, Ruptured ; Angiography ; Arteries ; Diagnosis, Differential ; Early Diagnosis ; Emergencies ; Humans ; Iliac Artery* ; Incidence ; Natural History ; Pelvis ; Rupture ; Rupture, Spontaneous*

We report a case of atrophoderma vermiculata with an unusual location. Besides symmetrical small pitted macules and linear atrophic depressions on both cheeks, there were unilateral atrophic depressed macules on the forehead, the right popliteal fossa and left up-per arm in our case. The histopathologic findings of these lesions showed a slight degree of epidermal atrophy with follicular pluggings and flattened rete ridges. In the dermis, there were mild perivascular in-filtrations of mononuclear cells. In addition, we could find out no pilosebaceous unit and other adnexal structures were diminished in number.
Arm ; Atrophy ; Cheek ; Depression ; Dermis ; Forehead

BACKGROUND: The reproducibility in grading a cervical intraepithelial neoplasia (CIN) are not perfect. The aim of this study was to assess the value of the immunohistochemical expression of p63 and the other biomarkers for grading a CIN (dysplasia and in situ carcinoma), and diagnosing invasive carcinomas. METHODS: Sixty six cervical specimens were immunostained with the monoclonal antibodies against p63, Ki-67, p27Kip1, and p53 to determine the localization. RESULTS: The p63 positive cells are well linked with squamous cell maturation and the degree of dysplasia. In mild dysplasia, the p63 positive cells were localized to the basal and parabasal cells, which gradually extended into the middle and upper layers in moderate and severe dysplasia. p63 expression was strong in immature squamous epithelium and invasive squamous cells, but was constantly absent in an adenocarcinoma. The Ki-67 positive cells were scattered from the parabasal cells to the superficial cells in accordance with the degree of dysplasia. p27Kip1 expression was noted in the intermediate cells in the normal cervix. In CIN, the p27Kip1 positive nuclei tended to extend to the basal cells, but it showed no diagnostic consistency in an invasive carcinoma. p53 expression was also variable. CONCLUSION: p63 is a useful diagnostic adjunct for grading CIN as well as for detecting microinvasion and squamous differentiation in invasive carcinoma. However, immunohistochemical expressions for the p27Kip1 and p53 have no correlation with the grade of CIN and squamous cell carcinoma.
Adenocarcinoma ; Antibodies, Monoclonal ; Biomarkers ; Carcinoma, Squamous Cell ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Epithelium ; Female ; Uterine Cervical Neoplasms

Typhlitis or neutropenic enterocolitis is a life-threatening, necrotizing process of the cecum whose incidence is increasing. Typhlitis presents as fever, abdominal pain, and diarrhea in neutropenic patients. As the incidence of typhlitis increases, emergency physicians must be aware of this rapidly progressive and potentially fatal disease. The definitive management of typhlitis is controversial. The most prudent course for the emergency physician is to initiate aggressive medical management early in the ED. We describe a 25-year-old man with severe neutropenia presented to the emergency department with fever, abdominal pain, diarrhea that began 2days earlier. Abdominal computerized tomography(CT) demonstrated diffuse concentric thickening of the cecal wall, intramural edema, inflammatory bowel changes but no free air and abscess formation. He was recovered by early diagnosis and aggressive medical therapy. We report a case of typhlitis with literature reviews.
Abdominal Pain ; Abscess ; Adult ; Cecum ; Diarrhea ; Early Diagnosis ; Edema ; Emergencies* ; Emergency Service, Hospital ; Enterocolitis, Neutropenic ; Fever ; Humans ; Incidence ; Neutropenia ; Typhlitis*

Tuberculomas in the spine are estimated to be 15 to 50 times less common than those occurring in the cranium. We experienced a case of intramedullary spinal tuberculoma and brain tuberculoma associated with pulmonary tuberculosis. A 39-year-old male was referred to the National Medical Center via emergency room because of urinary difficulty and lower limb weakness for 3 days. He had been treated with anti-tuberculosis regimens against pulmonary tuberculosis for 20 days. Spinal MRI revealed intradural intramedullary tuberculoma at T5. On the 21st day at the hospital, a generalized seizure attacked him. Brain MRI revealed multiple tuberculoma in both hemispheres, brainstem and cerebellum. He was treated anti-tuberculosis regimens and corticosteroids for 9 months. His condition improved clinically and radiologically. We report this case with a review of the literature.
Adrenal Cortex Hormones ; Adult ; Brain Stem ; Brain* ; Cerebellum ; Emergency Service, Hospital ; Humans ; Lower Extremity ; Magnetic Resonance Imaging ; Male ; Seizures ; Skull ; Spine ; Tuberculoma* ; Tuberculosis, Pulmonary*

No abstract available.

No abstract available.
Fetal Development* ; Gestational Age*

No abstract available.
Fetal Development* ; Gestational Age*