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

Luteal phase defect (LPD) is an ovulatory disorder of considerable clinical importance that leads to delayed endometrial maturation and inadequate endometrium for blastocyst implantation. This disorder is implicated in infertility and recurrent spontaneous abortion. We analyzed the endometrial histological maturation, and the estrogen receptor(ER) and progesterone receptor(PR) status in patients with unexplained delayed ovulation, and in patients with ovulation induction by clomiphen citrate. The purpose of this study was to determine whether the length of the follicular phase influences the endometrial histological maturation and the hormonal receptor status, and to know the effect of clomiphen citrate on the endometrium. In the delayed ovulation group, the endometrium was characterized by an irregular outpouching and dilated lumina of the glands, a decreased secretory activity and predecidualization, and a decreased number of granulocytes in the stroma. In the clomiphen citrate-ovulation induction group, glandular proliferation was markedly diminished with poorly convoluted and narrow glands, secretory activity was decreased, stroma was undecidualized, and there was an absence of granulocytes. ER expression was increased in the glandular epithelium in the delayed ovulation group, and both ER and PR expressions were markedly decreased in the glandular epithelium and stromal cells in the ovulation induction group. Endometrial maturation and differentiation may be diminished by increased estrogenic and relatively deficient progesterone effects in patients with delayed ovulation. The hormonal receptor status might also be influenced by hormonal changes. Clomiphen citrate successfully induced ovulation in patients with delayed ovulation, however, endometrial proliferation and maturation were markedly suppressed. This might be related to the lower pregnancy rate and higher abortion rate in patients with clomiphen citrate induced ovulation.
Pregnancy ; Female ; Humans

Menkes disease is an X-linked recessively inherited neurodegenerative disorder of copper metabolism leading to death in early childhood. This disease is characterized by low serum, liver and brain Cu levels, whereas the Cu content in nearly all other organs is increased. The main clinical features are irregular kinky hair, characteristic face, progresssive degeneration of the central nervous system, bone changes, arterial rupture and thrombosis, and instability of temperature. We have experienced a case of Menkes disease in a eight months old male patient, who manifested by seizure, developmental delay, hypotonia, characteristic hair and face along with low levels of serum copper and ceruloplasmin. We report the characteristic findings of cranial MRI and MR angiography in this Menke's patient. In cranial MRI, he showed progressive brain atrophy with subdural hemorrhage and effusion. MR angiography revealed tortuosity of vessels clearly obviating necessity of more invasive conventional arteriography in diagnosis of this disease. This study suggested that cranial MRI and especially MR angiography might be helpful in making early diagnosis of this disease.
Angiography ; Atrophy ; Brain ; Central Nervous System ; Ceruloplasmin ; Copper ; Diagnosis ; Early Diagnosis ; Hair ; Hematoma, Subdural ; Humans ; Liver ; Magnetic Resonance Imaging ; Male ; Menkes Kinky Hair Syndrome ; Metabolism ; Muscle Hypotonia ; Neurodegenerative Diseases ; Rupture ; Seizures ; Thrombosis

Neuroblastoma, ganglioneuroblastoma and ganglioneuroma are derived from primordial neural crest cells and can be conceptualized as three different maturational manifestations of a common neoplasm. To assess the validity of immunohistochemistry and DNA Ploidy in the diagnosis of neuroblastic tumor in terms of prognostication, histologic and immunohistochemical evaluation with NB-84, neuron specific enolase(NSE) and S-100 protein and flow Cytometric DNA analysis were done on 21 neuroblastomas and 19 ganglioneuromas. Thirteen of 21 neuroblastomas were undifferentiated and 8 differentiating in type. Eleven of the 19 ganglioneuromas were mature in type and 8 had immature foci. Eighty one percent of neuroblastomas were positive for NB-84, 100% for NSE and 67% for S-100 protein, respectively. All ganglioneuromas were positive for NSE and S-100 protein, in contrast, only immature foci in ganglioneuroma were positive for NB-84. B-84 reacted positively with undifferentiated and differentiating neuroblasts including neuropil but not with mature ganglion cells. In contrast, NSE reacted positively with all components of neuroblastic tumor and S-100 protein mainly with cells of Schwannian differentiation. Three of eight(37.5%) differentiating neuroblastomas were strongly positive for NB-84 in contrast with seven of thirteen(53.8%) undifferentiated tumors, reflecting that undifferentiated cells tended to be positive for NB-84 in neuroblastoma. Twenty two percent of neuroblastoma showed diploidy and 78% aneuploidy including 11% of near-diploidy. Seven of eight(87.5%) differentiating neuroblastomas in contrast with seven of ten(70%) undifferentiated tumors showed aneuploidy. By contrast, 53% of ganglioneuroma showed diploidy and 47% aneuploidy with DNA index ranged from 1.12 to 1.19. Three of nine(33.3%) mature ganglioneuromas in contrast with five of eight(62.5%) ganglioneuromas with immature foci showed aneupolidy. Differentiating neuroblastoma tended to be aneuploid and ganglioneuroma with immature foci tended to be near-diploid. In conclusion, immunohistochemistry for NB-84, NSE and S-100 protein is useful for confirming neuronal, both neuronal and Schwannian, and Schwannian differentiation, respectively. Immunohistochemistry together with flow cytometric DNA analysis would be helpful to confirm the immature foci in ganglioneuroma.
Neuroblastoma

The authors analysed 261 cases of mycoplasmal pneumonia in children who were admitted to the pediatric department of Seoul Adventist Hospital between July 1986 and June 1991. The result obtained were as follows; 1) Yearly distribution of the cases showed high in 1987 and 1991, but no significant difference was noted in seasonally or monthly distribution. 2) The peak incidence of age was between 2 and 6 years of age, and the sex ratio of boy to girl was 1.1:1. 3) pulmonary manifestations were asthma in 21 cases (8.0%), atelectasis in 5 cases (1.9%), emphysema in 3 cases (1.2%), pleural effusion in 16 cases (6.1%), otitis media in 4 cases (1.2%) and sinusitis in 9 cases (3.4%). 4) Extrapulmonary complication were hepatitis in 53 cases (20.3%), skin rash in 9 cases (2.4%), proteinuria in 6 cases (2.3%), and hematuria in 4 cases (1.5%). 5) On the chest X-ray examination, the most common type of pneumonia was interstitial pneumonia (94 cases, 39.8%), and unilateral involvement was common (85.6%), and the most common involvement was right lower lobe (83 cases, 41.4%). 6) The relationship between the type of pneumonia and cold agglutinini titer, and between the type of pneumonia and Mycoplasma antibody titer were not found (P>0.05). 7) In the 16 cases of pleural effusion, The type of pneumonia was lobar, lobular (9 cases), bronchopneumonia (7 cases), and interstitial type was not present. The site of pneumonia was left (6 cases), right (9 cases), and 1 case showed bilatrality. The extent of pleural effusion was mild (10 cases), moderate (3 cases), and severe (3 cases). The result of pleural fluid exam in severe cases was all exudate. 8) The mean duration of admission was most common from 6 to 10 days. the mean duration of admission by the type of pneumonia was lobar, lobar (10.71+/-3.40), interstitial (8.78+/-2.14), and bronchopneumonia (8.83+/-2.47). 9) Both mycoplasma antibody test and cold agglutinin test were carried out in 185 cases and sensitivity of mycoplasma antibody test was 55.1%.
Asthma ; Bronchopneumonia ; Child* ; Emphysema ; Exanthema ; Exudates and Transudates ; Female ; Hematuria ; Hepatitis ; Humans ; Incidence ; Lung Diseases, Interstitial ; Male ; Mycoplasma* ; Otitis Media ; Pleural Effusion ; Pneumonia* ; Pneumonia, Mycoplasma* ; Proteinuria ; Pulmonary Atelectasis ; Seasons ; Seoul ; Sex Ratio ; Sinusitis ; Thorax

PURPOSE: Although varicose veins are very common in adults, the mechanism of the disease has not been established. Degradation of the extracellular matrix is regulated by various matrix metallopreteinases (MMPs) and their inhibitors tissue inhibitor of metallaproteinase (TIMPs). This study was performed to analyse the relationship between venous wall degeneration and expression of these matrix proteinases. METHODS: Twelve great saphenous vein (GSV) segments from 7 patients without varicose veins (control) and 86 GSV segments from 18 patients (22 limbs) with varicose veins (C2,4,5EPASPR) were used for this study. Light microscopic examination was used in the evaluation of vein wall degeneration, immunohistochemistry and Western blotting for the expression of MMPs (MMP-1, MMP-2, MMP-9 and MMP-13) and TIMPs (TIMP-1 and TIMP-2), and zymography for gelatinolytic activity of MMP-2 and MMP-9 were performed. RESULTS: MMP-9 was more strongly expressed in the vein wall of both control and patient groups, especially in the endothelial cells and medial muscle layers and TIMP-2 followed. The expression of MMP-9 was closely related to the degree of venous wall degeneration. Activated MMP-2 and MMP-9 were observed in both groups and expressed more in the proximal GSV of the patients. In the Western blotting, the expression of MMP-9 and TIMP-1 were significantly higher than other MMPs and TIMP-2 in the patients with varicose veins. CONCLUSION: MMP-9 is much more expressed in the wall of degenerative veins. This matrix-degrading enzyme may play an important role in the degeneration of venous wall followed by its remodeling.
Adult ; Blotting, Western ; Endothelial Cells ; Extracellular Matrix ; Humans ; Immunohistochemistry ; Light ; Matrix Metalloproteinases ; Metalloproteases ; Muscles ; Saphenous Vein ; Tissue Inhibitor of Metalloproteinase-1 ; Tissue Inhibitor of Metalloproteinase-2 ; Varicose Veins ; Veins

The Diego blood group system consists of two pairs of antigens, Dia and Dib The incidence of Dia is low among pure Caucasian, Blacks, Polynesian and Eskimo, however, the rnongolians and American indians have both Dia and Dib. We report a case of two days old male who was admitted on first day of life for jaundice and subsquently exchange transfusion was performed on second day of life for bilirubin of 20 mg/dl. The blood groups of patient and his mother were both Rh D positive 0 type. Direct and indirect Coombstest were strong positive in the patient and indirect Coombstest was positive in his mother. We found anti-Dib antibody in his rnother's serum. The phenotype of Diego blood group system of the patient and his mother were Di (a+b+) and Di (a+b- ), respectively and hemolytic anemia in this case was due to anti-Dib antibody.
African Continental Ancestry Group ; Anemia, Hemolytic ; Bilirubin ; Blood Group Antigens ; Humans ; Incidence ; Indians, North American ; Inuits ; Jaundice ; Male ; Mothers ; Phenotype

Midtrimester genetic amniocentesis has been a gold standard for prenatal diagnosis in antenatal care since last 25 years. After the triple serum marker test was introduced as a prenatal screening method for Down syndrome, the frequency of genetic amniocentesis was increased. OBJECTIVE: To determine the complication, risk of amniocentesis and detection rate of chromosomal abnormality. MATERIAL AND METHODS: A retrospective clinical analysis of 1,064 midtrimester genetic amnicentesis in IL Sin Christian Hospital antenatal clinic from Jan 1995 to Dec 1997. Chi square test was used for the statistical analysis and p value < 0.05 was considered significant. RESULTS: Amnicentesis were significantly increased in the age of 35-39 yrs and 40yrs over. And also the incidence of chromosomal abnormality was higher than younger age group. The indications of amnicentesis were screen positive of triple marker test(43%), advanced maternal age(20.8%), abnormal beta-hCG level, past history of chromosome abnormality or malformed baby and abnormal alpha-FP level in order. Total number of chromosomal abnormalities was 30 and the incidence of chromosomal abnormalities was 2.8%(30/1,064). The complications were developed in 13 cases and fetal loss rate was 0.78%(9/1,064). CONCLUSION: The detection rate of chromosomal abnormality in midtrimester amnicentesis for prenatal diagnosis was high and relatively safe procedure but, we should be attention to more careful manipulation.
Amniocentesis ; Biomarkers ; Chromosome Aberrations ; Down Syndrome ; Female ; Humans ; Incidence ; Pregnancy ; Pregnancy Trimester, Second* ; Prenatal Diagnosis ; Retrospective Studies

No abstract available.

PURPOSE: To evaluate the role of CT in the diagnosis of bowel and mesenteric injury we studied the CT findings and its usefulness in patients of abdominal trauma. MATERIALS AND METHODS: CT scans of 27 patients who were confirmed to have bowel and/or mesenteric injury due to abdominal trauma were analyzed retrospectively. Of these 27 patients 15 had bowel injury only and 12 had both bowel and mesenteric injury. CT findings analysed were bowel wall thickening, presence or absence of highly attenuated bowel wall, sentinel clot, mesenteric infiltration, peritoneal fluid collection and free intraabdominal air in cases with bowel injury only and with both bowel and mesenteric injury respectively. Ten patients had other accompanying abdominal injuries, such as liver, spleen, pancreas, kidney, bladder injuries, intraperitoneal abscess or retroperitoneal hemorrhage. RESULTS: Findings observed were bowel wall thickening in 23 cases(85%), peritoneal fluid collection in 21 (78%), highly attenuated bowel wall in 19(70%), mesenteric infiltration in 17(63%), free intraperitoneal air in 10 (37%) and sentinel clot in 7(26%). Pneumoperioneum were observed in 10 of 24 patients(41.7%) having bowel perforation. Two cases did not show any CT findings suggesting bowel and/or mesenteric injury. There was no significant difference in the prevalence of the CT findings between the patient group with bowel injury only and the patient group with both bowel and meseneric injury. CONCLUSION: CT scan is a useful tool in evaluating the degree and extent of bowel and/or mesenteric injury as well as in planning the patient's management.
Abdominal Injuries ; Abscess ; Ascitic Fluid ; Diagnosis ; Hemorrhage ; Humans ; Kidney ; Liver ; Pancreas ; Prevalence ; Retrospective Studies ; Spleen ; Tomography, X-Ray Computed ; Urinary Bladder