Nowadays administration of bone marrow transplantation is increasing state by developing society and high leukemia incidence. Decrease of relapse and infection rate result from chemo therapy drug development of treatment and strength. So we look for continuos development of treatment. But through before and after BMT, it takes several months by planing and HLA typing matching possibility of BMT. Also, it takes one or two month by duration of BMT and discharge. During BMT, patients experience emotional change-suggering, anxiety, depression and so on-due to changed body image and strictly isolation in special facility. After BMT, the patients also experience stress such as conditions self-care, support from family, concern of relapse risk and so far enlarge mental, economic and physical change surrounding them due to high cost. Accordingly nurses are required high quality of nursing attentive assesment, understanding of patient's environment and consideration, and teaching in administrative work. The study is attempted to establish nursing theory patients' experience in BMT treatment. Research method followed grounded theory methodology by strauss & Corbin. Subjects were 1 adolescent including highschool patient and 6 adults. This study continued from February 1996 through August 1996. All of these subjects were interviewed by this author. Interview were done by long interview technique and observation. Each interview took 1 hour to 2 hours Content of interview was recorded and transcribed later. The data thus collected were analyzed immediately after interviews and fed into the next round of interviews until the data collection reaches the saturation point. In the process of data analysis, "Terribleness" or "Miserableness" was found to be the core phenomenon. Results were composed to 103 concepts. These concepts were grouped into twenty four categories, and then to eleven categories. Categories include "physical burden", "economic burden", "mental distressing", "heartbreaking", "being gloomy", "horror", "being crushed", "feel oppressed", "being exhausted", "family dependent", "support", "previous data for procedure", "inclination", "exploding", "sharing", "mitigation", "bracing oneself", "becoming attached", "dependence", "thanks", "anxiety", and "abandonment". Patients with bone marrow transplantation were revealed to face "terribleness". Terribleness is found to be progressed through the cycle production-coping-solution. Fourteen hypotheses were derived from the integration of categories as follows ; (1) The stronger the term of suffering as perceived by the subjects, the stronger the "terribleness" will be. (2) The more excessive the degree of suffering as perceived by the subjects, the more excessive the "terribleness" will be. (3) If subjects have family dependent "terribleness" is expressed with abusement. (4) If subjects have no family dependent, "terribleness" will be expressed with exposure and suppressing. (5) The more abundant the sufficient support, "terribleness" will be expressed with exposure and suppressing. (6) The less abundant the sufficient support, "terribleness" will be expressed with abusement. (7) The more abundant the previous data, "terribleness" will be expressed with exposure and suppressing. (8) The less abundant the pervious data, "terribleness" will be expressed with abusement. (9) The more introvert the subject's inclination, "terribleness" will be expressed with exposure and suppressing. (10) The more extrovert the subject's inclination, "terribleness" will be expressed with abusement. (11) The more excessive the degree of "terribleness" will be expressed with abusement. (12) The less excessive the degree of "terribleness" it will be expressed with exposure and suppressing. (13) The more expressive the abusment, "terribleness" will be solved despair. (14) The more expressive the exposure and suppressing, "terribleness" will be solved with expectation. On the basis of the patterns that have the four these below were confirmed. 1. If patients felt large amount of terribleness because of severe suffering, they had family dependent. insufficient support, no previous data and their inclination was extrovert, "terribleness" is solved despair with abusement. 2. If patients felt large amount of terrible because of severe suffering family dependent, sufficient support, pervious data, and their inclination was introvert, "terribleness" is solved expectation with suppressing and exposure. 3. If patients felt small amount of terribleness because of little suffering, no family dependent, insufficient support, no previous data, and their inclination was extrovert, "terribleness" is solved despair with abusement. 4. If patients felt small amount of terribleness because of little suffering, no family dependent, sufficient support, previous data, and their inclination was introvert, "terribleness" is solved expectation with exposure and suppressing. On the basis of the above result, in orer to help nurses take good care of their patient, and understands patient's inclination and background, nursing assessment and intervention on life readjustment, and getting support should be required. It is expected that theoretical framework provided by this study, which shows how "terribleness" products, changes, increases and decrease. Therefore public relations, education, counseling emotional support, understanding inclination and exchange of information will have to be accomplished.
Adolescent ; Adult ; Anxiety ; Body Image ; Bone Marrow Transplantation* ; Bone Marrow* ; Counseling ; Depression ; Education ; Equidae ; Histocompatibility Testing ; Humans ; Incidence ; Leukemia ; Nursing ; Nursing Assessment ; Nursing Theory ; Public Relations ; Recurrence ; Self Care ; Statistics as Topic ; Surveys and Questionnaires

To evaluate the incidence and clinico-pathologic correlation of benign epithelial changes of endometrium, we tried to classify the changes into squamous cell change, ciliary change, eosinophilic cell change, papillary surface epithelial change, and mucinous cell change by the criteria of Hendrickson. Based on the 450 hysterectomy specimens obtained from Jan. 1994 to Dec. 1994 in PMC, the incidence of the cell changes was as follows: squamous cell change: 1.1%, eosinophilic cell change: 6.8%, mucinous cell change: 6.6%, ciliary change: 10.4%, papillary surface epithelial change: 16.4%. Squamous cell change was noted in severe endometritis or endometrial hyperplasia and papillary surface epithelial proliferation was mainly associated with plasma cell infiltration in adenomyosis or leiomyoma. Eosinophilic change and ciliary change were sometimes concomitantly found in dilated glands of the basal layer or in the invaded glands of adenomyosis. The results of this study suggested a correlation of benign epithelial changes with endometritis, adenomyosis, leiomyoma and dysfunctional uterine bleeding.
Incidence

Serum is free of cellular components. Because DNA is located in the nuclei or mitochondria of cells, serum could be assumed DNA free. Few previously published case reports to date have used serum for DNA typing. Here, we report on human genotyping via short tandem repeat (STR) analysis using serum as a sample, and discuss problems involved in the process.
DNA Fingerprinting* ; DNA* ; Humans ; Microsatellite Repeats* ; Mitochondria

The 38 kDa protein of Mycobacterium tuberculosis, which was known previously as antigen 5, has been extensively used in the serodiagnosis of tuberculosis. In an attempt to develop and evaluate a serodiagnostic test using the antigen, we expressed the 38 kDa protein in BCG and its seroreactivity was compared to that expressed in Escherichia coli. The coding region of the 38 kDa protein was amplified by PCR, and the gene was cloned into a Mycobacterium-E. coli shuttle expression vector pYMC-his and pQE30 expression vector and expressed in BCG and E. coli, respectively. Both recombinant 38 kDa proteins showed strong seroreactivity against pooled serum from tuberculosis patients. There was no significant difference in seroreactivity between the two recombinant antigens in sera from the far advanced tuberculosis patients. However, of 25 tuberculosis patients graded as ""minimal"" by chest X-ray, 5 (20.0%) were seropositive by r38 kDa expressed in E. coli, while 8 (32.0%) by that expressed in BCG. Likewise, higher seroreactivity by r38 kDa expressed in BCG was found in sera from the moderately advanced tuberculosis. This study thus indicates that the recombinant 38 kDa expressed in BCG is more effective than that expressed in E. coli in detecting antibodies to the native 38 kDa protein of M. tuberculosis in sera from minimally affected tuberculosis patients.
Antibodies ; Clinical Coding ; Clone Cells ; Escherichia coli ; Humans ; Mycobacterium bovis* ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymerase Chain Reaction ; Serologic Tests* ; Thorax ; Tuberculosis*

Angiomyofibroblastoma of the vulva is a rare mesenchymal tumor. It has been diagnostically confused with aggressive angiomyxoma which has a somewhat different clinical course and therapy. Herein we report a case of angiomyofibroblastoma of the vulva in a 46-year-old female. Microscopically, there were alternating hypercellular and hypocelluar edematous zones in which abundant capillary blood vessels were irregularly distributed. Spindle, plump spindle, and oval stromal cells were concentrated around the blood vessels, or loosely dispersed in the hypocellular area. Immunohistochemically, the stromal cells were positive for desmin, vimentin, muscle-specific actin and weakly positive for S-100 protein. Ultrastructural studies showed well developed rough endoplasmic reticulum, abundant intermediate filaments, and pinocytic vesicles in the stromal cells.
Female ; Humans

Staphylococcus epidermidis is a normal inhabitant of skin, throat, mouth, vagina, and urethra. It is not usually pathogenic, particularly in immunocompetent hosts. This report describes a case of a pyogenic liver abscess caused by Staphylococcus epidermidis in a healthy 12-year-old boy. He was admitted to Seoul St. Mary's Hospital with intermittent fever for 6 days. Findings on abdominal computed tomography (CT) showed a mass measuring 7.0x6.5 cm in the right hepatic lobe. Culture of the abscess resulted in growth of Staphylococcus epidermidis as a causative organism. The patient was successfully treated with intravenous administration of antibiotics and percutaneous drainage of the abscess.
Abscess ; Administration, Intravenous ; Anti-Bacterial Agents ; Child ; Drainage ; Fever ; Humans ; Liver Abscess ; Liver Abscess, Pyogenic ; Mouth ; Pharynx ; Skin ; Staphylococcus ; Staphylococcus epidermidis ; Urethra ; Vagina

The ability to introduce recombinant DNA molecules back into mycobacteria would greatly increase the potential of molecular genetic approaches for the study of mycobacteria as well as for the use in clinical purposes. We have initiated the construction of vectors that facilitates the introduction of recombinant DNA into mycobacteria. The vector was designed to contain replicons for multiplication in mycobacteria and Escherichia coli, a promoter for gene expression, a drug resistant gene for selecting transformants, and a few restriction enzyme sites for convenient cloning. Constructed Mycobacterium-E. coli shuttle vector named p YMC (hsp60) was shown to transform M. smegmatis at high efficiency and maintain plasmid at stable level. The ability of the vector to express cloned foreign gene was also monitored by measuring the expressed level of luciferase gene which was used as a reporter. High level of luciferase activity in M. smegmatis with pYMC (hsp60:luc) was detected confirming successful construction of Mycobacterium-E. coli shuttle vector.
Clone Cells ; Cloning, Organism ; DNA, Recombinant ; Escherichia coli* ; Escherichia* ; Gene Expression ; Genetic Vectors* ; Luciferases ; Molecular Biology ; Mycobacterium* ; Plasmids ; Replicon

Regional anesthesia for Cesarean section is a popular anesthetic method and a subarachnoid injection of local anesthetics provides rapid onset and a reliable block. Furthermore, it maintains airway reflexes and consciousness of the parturient and is associated with less neonatal depression. Complications related with spinal anesthesia are most often postdural puncture headache, back pain, hematoma, abscess, paresthesia or motor weakness and very rarely, myoclonus. Generalized seizures as a complication following epidural anesthesia with bupivacaine has been reported, but rarely following spinal anesthesia. We present a case of a parturient who was well antenatally, but presented with generalized tonic-clonic seizures following delivery. Although the possible etiologic factors of these transient seizures after spinal anesthesia are difficult to clarify, we emphasize that careful airway monitoring after regional anesthesia is important.
Abscess ; Anesthesia, Conduction ; Anesthesia, Epidural ; Anesthesia, Spinal ; Anesthetics, Local ; Back Pain ; Bupivacaine ; Cesarean Section ; Consciousness ; Depression ; Female ; Hematoma ; Myoclonus ; Paresthesia ; Post-Dural Puncture Headache ; Pregnancy ; Reflex ; Seizures

As an effort to develop a rapid and sensitive diagnostic test, we produced previously a monoclonal antibody (MAb) specific to the lipoarabinomannan (LAM) antigen and used in a sandwich ELISA for detection of mycobacterial antigens in sputum. In this study, we attempted to improve the antigen detection assay by combination of af5nity-purified antibodies against Mycobacterium tuberculosis soluble antigen and anti-LAM MAb. With the new assay, the LAM antigen was detectable as low as 2 ng/ml, and none of 10 gram-negative and gram-positive organisms gave significant absorbance, thus indicating the specific detection of mycobacterial antigens. Sputum samples from 62 patients who were suspected having tuberculosis and from 37 healthy controls were examined. The sensitivity of the antigen detection assay ranged from 0% in the 1+ culture group to 78.8% in the 3+ culture group. When the results were combined, 15 of 24 culture-positive samples were antigen-positive, thus giving an overall sensitivity of 62.5%. The overall specificity was 96.0%, when all the culture-negative samples were combined. The results thus demonstrate that the antigen detection assay can provide a rapid supplemental information for the diagnosis of pulmonary diagnosis.
Antibodies ; Diagnosis* ; Diagnostic Tests, Routine ; Enzyme-Linked Immunosorbent Assay ; Humans ; Mycobacterium tuberculosis* ; Mycobacterium* ; Sensitivity and Specificity ; Sputum* ; Tuberculosis ; Tuberculosis, Pulmonary*

In the present study, we made an attempt to compare polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) with PCR-direct sequence analysis for their accuracy and sensitivity in detecting resistance to rifampicin (RMP). A total of 32 clinical isolates of Mycobacterium tuberculosis including 22 resistant and 10 sensitive isolates, whose drug susceptibility have been tested by conventional proportion method, were analyzed by using PCR-SSCP and PCR-sequence analysis. Among 22 RMP resistant isolates, 16 isolates showed SSCP profiles different from that of a RMP sensitive control strain, M. tuberculosis H37Rv indicating the possible existence of a sequence alteration in this region of the rpoB gene, while 6 resistant isolates displayed SSCP profiles indistinguishable from the sensitive control strain. On the other hand, all of 10 RMP sensitive isolates showed SSCP profiles similar to that of the sensitive control strain. Therefore, overall agreement rste between conventional proportion method and PCR-SSCP reached 81%. Subsequently, all of 32 clinical isolates were subjected to sequence analysis. The results from the sequence analysis revealed that all of 22 resistant isolates indeed contain mutations in the stretch of 81 bp region of rpoB gene, while none of 10 sensitive isolates contain any sequence alterations. Therefore, this study suggests that PCR-sequence analysis works more efficiently and accurately than PCR-SSCP analysis for rapid screening of RMP-resistant M. tuberculosis clinical isolates.
Hand ; Mass Screening ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymerase Chain Reaction* ; Polymorphism, Single-Stranded Conformational ; Rifampin* ; Sequence Analysis* ; Tuberculosis