PURPOSE: The current study was aimed to investigate the transformational experience of a female student nurse living with type 1 diabetes. METHODS: A case study of a 24-year-old diabetes patient was conducted, with interviews concerning the evolving process she had lived through during the period from her later high school years to her graduation from nursing college. RESULTS: Followings were identified as 5-transformation process: With her diabetes-related limitation, the participant experienced 'conflict involving choosing a college and major'. The participant tried to be in charge of managing her diabetes and stepped forward to 'adaptation to college life as a new environment', and she learned more about the process of 'evolving awareness of caring' and developed herself further through the process of 'integration of the nurse identity into self-identity', and finally through the process of 'progression and preparation for getting a job' she achieved her goals, being positive about the future. CONCLUSIONS: The results of the study can provide individuals with diabetes a way of self-management and help the patients and their families in diabetes education. Further research will be needed to refine the results of this study and to learn more about the experiences of patients with type I diabetes in college years.
*Adaptation, Psychological ; Adult ; Career Choice ; Conflict (Psychology) ; Diabetes Mellitus, Type 1/*psychology ; Empathy ; Female ; Humans ; Job Application ; Korea ; Social Identification ; Students, Nursing/*psychology

No abstract available.
Hepatitis B* ; Hepatitis* ; Humans ; Infant, Newborn* ; Vaccination*

Pulmonary vein velocities have recently been estimated in conjunction with mitral flow velocities to increase our understanding o ventricular filling. The advent of transesophageal echocardiography with pulsed Doppler imaging capability has provided a method by which both the mitral valve and pulmonary vein velocities can be easily recorded because of the posterior approach providing unimpeded interrogation of cardiac structures. The purpose of this present study was to evaluate the normal pulmonary venous, mitral and aortic flow pattern by transthoracic echocardiography in neonate according to the postnatal age. The results were as follows. 1) With regard to the aortic flow, the early systolic was of pulmonary flow peaked after the onset of aortic flow and the late systolic wave occured consistently before aortic valve closure. 2) The peak velocities of early systolic, late systolic, late systolic, diastolic and atrial systolic in the pulmonary venous flow were 36.4 (13.2cm/sec, 45.3 (15.3cm/sec, 48.5 (14.1cm/sec and 16.6( 5.7cm/sec at 1 day old. the difference according to the postnatal age was not significant. 3) The ratio of peak systolic to peak distolic velocity of pulmonary venous flow was 1.0( 0.3 at 1 day o1, 1.1( 0.4 at 1 week old and 1.2 (0.3 at 1 month old. The difference between old and 1 month old was statistically significant(p<0.05). 4) The peak early diastolic velocity of mitral flow was 51.3 (15.2cm/sec at 1 day old, 54.7( 13.7cm/sec at 1 week old and 80.7 (16.6cm/sec at 1 month old. The difference between 1 week old and 1month old was statistically significant(p<0.01). 5) The peak late diastolic velocity of mitral flow was 48.3 (14.6cm/sec at 1 day old, 50.1( 9.9cm/sec at 1 week old and 71.8 (16.6cm/sec at 1 month old. The difference between 1 week old and 1 month old was statistically significant(p<0.01). 6) The ratio of peak mitral early diastolic to peak late diastolic velocity was 1.1( 0.2 at 1 day old, 1.1( 0.3 at 1 week old and 1.2( 0.7at 1 month old. The difference between 1 week old and 1 month old was statistically significant(p<0.01). 7) The peak aortic valve flow velocity was 62.1 (14.2cm/sec at 1 day old, 67.8 13.4cm/sec at 1 week old and 76.6 14.1cm/sec at 1 month old. The difference between old and 1 month old was statistically significant(p<0.05). In conclusion, improvement of left ventricular diastolic function was noted at 1 month old by echocardiography. These normal data will be useful in comprisons with the data, which obtained in newborn with various congenital heart disease that affects flow dynamics.
Aortic Valve ; Echocardiography ; Echocardiography, Doppler* ; Echocardiography, Transesophageal ; Heart Defects, Congenital ; Humans ; Infant, Newborn* ; Mitral Valve ; Pulmonary Veins

BACKGROUND: Cardiovascular disease is the major cause of morbidity and mortality. It is well known that androgen and sex hormone-binding globulin(SHBG) in women were associated with risk factors for cardiovascular disease such as obesity, central fat accumulation and atherogenic lipid profile. High resolution B-mode ultrasonography can visualize directly both luminal and vessel wall characteristics, and ultrasonic measurement of carotid intima-medial thickness(IMT) can be used to investigate the atherosclerosis of coronary, cerebral and peripheral arteries. The aim of this study was to evaluate the relationship between the serum dehydroepiandrosterone sulfate(DHEA-S) and SHBG, and body fat distribution pattern, cardiovascular risk factor and carotid atherosclerosis in women. METHODS: Blood pressure, fasting serum glucose, insulin, lipid profile, SHBG and DHEA-S were measured. Body fat distribution pattern was assessed by waist to hip ratio, waist to thigh ratio and subscapular to triceps skin fold thickness ratio, faf mass measured by bioelectric impedance analyzer, subcutaneous fat area, visceral fat area, and visceral to subcutaneous fat area ratio(VSR) at the level of umbilicus using the computed tomography. The IMT of the carotid artery was measured by high resolution B mode ultrasound as a marker of atherosclerosis. RESULTS: 1) There was no significant difference of age-adjusted values of carotid IMT among subjects with NGT(0.426+/-0.09mm), IGT(0.46+/-10.09mm) and NIDDM(0.453+/-0.11mm). 2) In postrnenopausal women, carotid IMT was greater(0.484+/-0.11mm, p=0.05) than premenopausal women(0.426+/-0.08mm), but it was not significant after age adjustment. Serum SHBG and DHEA-S levels in postmenopausal women were significantly lower(p<0.05) than premenopausal women, but they were not significant after age adjustment. 3) Carotid IMT was significantly correlated with age(r=0.37, p<0.01), fasting serum glucose (r=0.32, p<0.01), total cholesterol(r= 0.25, p<0.05), LDL-cholesterol(r=0.26, p<0.05), visceral fat area(r=0.35, p<0.01) and VSR(r=0.31, p<0.05). 4) By the stepwise multiple regression analysis, carotid IMT was positively and significantly associated with age(p<0.01) and serum DHEA-S concentration(p<0.05) in dent of age, body mass index, waist to hip ratio, fasting serum glucose. CONCLUSION: Carotid IMT was associated with age and serum DHEA-S concentration in women without cardiovascular disease. Therefore, serum DHEA-S may be one of risk factors for cardiovascular disease in women. However, we could not conclude its cause-result relationship because of cross sectional nature of our study, and prospective study will be needed.
Arteries ; Atherosclerosis ; Blood Glucose ; Blood Pressure ; Body Fat Distribution ; Body Mass Index ; Cardiovascular Diseases ; Carotid Arteries ; Carotid Artery Diseases* ; Dehydroepiandrosterone Sulfate* ; Dehydroepiandrosterone* ; Electric Impedance ; Fasting ; Female ; Humans ; Insulin ; Intra-Abdominal Fat ; Mortality ; Obesity, Abdominal ; Phenobarbital ; Risk Factors ; Sex Hormone-Binding Globulin* ; Skin ; Subcutaneous Fat ; Thigh ; Ultrasonics ; Ultrasonography ; Umbilicus ; Waist-Hip Ratio

MELAS (mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes) is one of the mitochondrial encephalomyopathy, A rare disease caused by a disturbance of the mitochondrial chain of respiration. MELAS is confirmed by typical light and electron microscopic findings : "ragged red fibers" by modified Gomori trichrome stain on light microscope and numerous abormal mitochondria on electron microscope. We experienced a boy with the characteristic clinical and pathologic findings of MELAS. Our patient demonstrated bilateral basal ganglia calcifications and infarction at right parieto-occipital and thalamic areas on CT and MR We found that MRI was more sensitive and represented the infarcted lesions better than CT. Detection of cerebral insults of MELAS by MRI is important in making decision on patient treatment and also in predicion of the patient prognosis.
Acidosis, Lactic ; Basal Ganglia ; Brain Diseases ; Child* ; Humans ; Infarction ; Magnetic Resonance Imaging ; Male ; MELAS Syndrome* ; Mitochondria ; Mitochondrial Encephalomyopathies ; Muscular Diseases ; Rare Diseases ; Respiration

No abstract available.
Female ; Female* ; Humans ; Menarche* ; Menstruation*

Intravascular injection of hydrogen peroxide produces oxygen microbubbles suitable for echocardiographic contrast enhancement. To evaluate the effect of a method of myocardial contrast 2-D-echocardiographic delineation of myocardium during acute coronary occlusion, injection of a fresh mixture of 2ml of 0.2% H2O2 and 1ml of heparinized dog blood into aortic root were made in 12 poenchest dogs 10 minutes after occlusion of left anterior descending coronary artery distal to the first diagonal branch and left ventricular short axis 2-D echocardiographic images at the midpapillary muscle level were obtained. On injection of H2O2 blood mixture normally perfused myocardium was enhanced in echodensity but the area of malperfusion did not change in echodensity. The borderlines between the area of normal perfusion and malperfusion was well delineated. The malperfused area measured at mid papillary muscle level by planimetry area method was 29.7+/-6.0% and 32.6+/-6.7% by endocardial circumferential length method. There was a linear correlation between planimetric estimate of area of malperfusion by H2O2 contrast echocardiography and visual determination of regional wall motion abnormality by 2-D echocardiography(r=0.93, P<0.001). There was no change in heart rate before, during and after H2O2 injection. Infection of H2O2 blood mixture caused bradycardia(8.3%), second degree A-V block(16.6%) and ventricular fibrillation(8.3%). H2O2 clearance was achieved in 3-10 minutes. These findigs suggest that H2O2 enhanced myocardial contrast ehocargiography using 2ml of 0.2% H2O2 and 1ml of blood muxture is an accurate, reproducible, real-time in vivo method of quantifying the extent of myocardial perfusion defect during acute coronary occlusion in dog.
Animals ; Axis, Cervical Vertebra ; Coronary Occlusion ; Coronary Vessels ; Dogs* ; Echocardiography* ; Heart Rate ; Heparin ; Hydrogen Peroxide* ; Hydrogen* ; Microbubbles ; Myocardium ; Oxygen ; Papillary Muscles ; Perfusion*

PURPOSE:Obesity is a common complication in children who were surgically treated for craniopharyngioma. We analysed body composition, metabolic parameters and evaluated for correlation between adiponectin and metabolic parameters in children who were surgically treated for craniopharyngioma. METHODS:Sixteen patients with craniopharyngioma (9 males, 7 females) were included in this study (patient group). The data of patient group were compared to those of children who visited the clinic for normal short stature with appropriate gestational age (14 males, 4 females) (control group). Height SDS, weight SDS, BMI were calculated. Total body fat, abdominal fat distribution were measured by bioelectrical impedance analysis. Plasma levels of total cholesterol, HDL-cholesterol, triglycerides, adiponectin, and insulin were measured after overnight fasting. The degree of insulin resistance was calculated by HOMA-IR. RESULTS:Four of 16 patients were obese. and three were overweight. Patient group had higher total body fat percentage (27.5+/-6.8 vs 17.6+/-6.8, P=0.01), triglycerides (207.9+/-241.6 vs 76.7+/-30.8, P=0.001), lower HDL-cholesterol (37.5+/-14.6 vs 61.4+/-15.4, P=0.000) and adiponectin levels (7.1+/-4.2 vs 10.7+/-4.3, P=0.012). Adiponectin levels were correlated negatively with total body fat percentage (r=-0.631, P= 0.009), abdominal fat distribution (r=-0.547, P=0.03), triglycerides (r=-0.518, P=0.04), insulin (r=-0.525, P=0.037) and correlated positively with HDL-cholesterol (r=0.572, P=0.021). CONCLUSION: These results suggest that children who were surgically treated for craniopharyngioma, had tendency to develop obesity, dyslipidemia and Insulin resistance. Therefore, patients who were surgically treated, should be closely monitored to minimize the effect of metabolic syndrome on their health and well being.
Abdominal Fat ; Adiponectin ; Adipose Tissue ; Body Composition ; Child* ; Cholesterol ; Craniopharyngioma* ; Dyslipidemias ; Electric Impedance ; Fasting ; Gestational Age ; Humans ; Insulin ; Insulin Resistance ; Male ; Obesity ; Overweight ; Plasma ; Triglycerides

No abstract available.
Urinary Tract Infections* ; Urinary Tract*

BACKGROUND: Adolescent girls are interested in weight reduction, but effective and adequate education for weight reduction is not done in Korea. And so much information is accepted via mass media. We investigated body image perception, weight control activities and their side effects among adolescent girls. METHODS: We used questionnaire about body image and weight control activities of middle and high school girls in Seoul in Sep. 1995. RESULTS: 88.6% of girls were not satisfied with their own height and 85.1% of girls with their own weight. 66.3% underweight students(BMI<20kg/m2) thought they were too fat and 98% acceptable weight students(20kg/m2<_KBMI<25kg/m2) thought they were too fat. So most girls had body image disturbance. 42.4% of girls were trying to lose weight and 85.1% were trying to lose weight reason for attractiveness and 16.6% were trying to lose for health. Self reported weight reduction methods were exercise(31.6%), fasting(21.9%), diet(21.5%), monodiet(10.8 %), laxatives(2.3%), very low calorie diet(1.8%) etc. Students who tr ied to lose weight for attractiveness selected more undesirable methods than who tried to lose weight for health(P<0.01). Most common route is via magazine, TV and newspaper. 43.4% of girls who tried to lose weight experienced side effects after weight reduction, those were dizziness(71.3%), general weakness(51%), apathy(26.S%) etc. CONCLUSIONS: Most girls had body image distortions. Useless weight reduction activities were done or planned and most of information was accepted via mass media. It is important to educate the girls to get adequate body image and effective weight reduction program is needed for health in adolescent girls.
Adolescent* ; Body Image* ; Education ; Female* ; Humans ; Korea ; Mass Media ; Periodicals ; Periodicals as Topic ; Self Report ; Seoul ; Thinness ; Weight Loss ; Weight Perception ; Weight Reduction Programs ; Surveys and Questionnaires