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

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*

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

No abstract available.
Breast Neoplasms* ; Breast* ; Mammography*

To study the clinical characteristics and treatment results of childhood soft tissue sarcoma, the retrospective study was performed on 67 patients with soft tissue sarcoma, experienced at the Department of Pediatrics, Seoul National University Hospital from January, 1982 to July, 1990. The median age of 67 soft tissue sarcoma patients was 4 years 5 months and age distribution showed that 0-4 year age group was most common (55.2%). The sex ratio of male to female was 1.2:1. There were 3 cancers among relatives of soft tissue sarcoma patients, including one cancer among first-degree relatives. As for pathological classification, rhabdomyosarcoma (67.1%) was the most common childhood soft tissue sarcoma, followed by malignant Schwannoma (8.9%), extraskeletal Ewing's sarcoma (6.0%), infantile fibrosarcoma (4.5%), malignant fibrous histiocytoma (3.0%), malignant hemangiopericytoma (3.0%), and there were 1 case each of angiosarcoma, leiomyosarcoma, synovial sarcoma, malignant mesenchymoma and mesenchymal chondrosarcoma. The median age of 45 rhabdomyosarcoma patients was 3 years 8 months and age distribution showed that 0-4 year age group was most common (64.5%). Twenty three patients were male and 22 were female. The histologic subtype of rhabdomyosarcoma was embryonal type in 38 patients (84.5%), alveolar type in 5 patients (11.1%) and unclassified type in 2 patients (4.4%). As for primary site of soft tissue sarcomas, the most frequent site was the head and neck region (32.8%) including parameningeal region (13.4%) and orbit (6.0%), followed by extremities (20.9%), trunk (19.4%), retroperitoneum and pelvis (11.9%), urogenital region (7.5%), perineum and perianal region (4.5%) and other region (3.0%). As for primary site of 45 rhabdomyosarcoma cases, the most frequent site was also the head and neck region (37.8%). The most common initial symptom of soft tissue sarcoma patients was mass (68.7%). As for Intergroup Rhabdomyosarcoma Study clinical grouping system of 67 soft tissue sarcoma patients, clinical group III (58.2%) was most common, followed by clinical group II(20.9%), IV (14.9%) and I (6.0%). Of 10 cases of clinical group IV with distant metastasis, lung (8 cases) was the most common metastaic region and other metastatic regions were bone, kidney, liver and bone marrow. As for IRS clinical grouping system of 45 rhabdomyosarcoma patients, clinical group III was most common (68.9%). Of 6 cases of clinical group IV, lung (5 cases) was also the most common metastatic region, followed by kidney and liver. From 1982 to 1985, chemotherapy was done with pulse VAC or pulse VAdrC-VAC regimen based on IRS-I and IRS-II. From 1986, patients in clinical group I and II received vincristine and actinomycin-D for 1 year and patients in clinical group III, IV and II with alveolar histologic subtype(unfavorable histologic group) received vincristine, actinomycin-D, adriamycin, cyclophosphamide and cisplatinum based on IRS-III. Radiation therapy was administered to patients in clinical group II, III and IV. Of 67 cases of soft tissue sarcoma, 54 case were eligible for treatment analysis. The 3 year disease free survival (DFS) of all 54 cases was 54.1%, 3 year DFS of clinical group I and II was 83.9%,3 year DFS of clinical group III and IV before 1986 was 35.7% and after 1986 was 48.2%. Of 45 cases of rhabdomyosarcoma, 41 cases were eligible for treatment analysis. The 3 year DFS of all 41 cases was 49.1%,3 year DFS of clinical group I and II was 87.5%,3 year DFS of clinical group III and IV before 1986 was 27.2% and after 1986 was 45.0%. Patients in clinical group I and II who had no gross residual tumor after primary surgical excision had best prognosis with 3 year DFS approximating 90% with only 2 drugs regimen, significantly better than patients in clinical group III and IV with 3 year DFS below 50% even after intensifying chemotherapy since year 1986. This analysis suggests that total surgical removal is very important for improving prognosis and should be undertaken where possible in all patients without distant metastasis. Treatment results also showed that after year 1986 with intensification of chemotherapy, 3 year DFS of clinical group III and IV as well as early toxic deaths increased, and after lowering doses of chemotherapeutic agents of regimen 35 of IRS-III, treatment results improved much. Therfore to improve prognosis of patients with gross residual tumor after surgical excision of biopsy and patients with distant metastasis at diagnosis, intensified multiagent chemcherapeutic regimen with adequate dose modification should be done to lower early toxic deaths.
Age Distribution ; Biopsy ; Bone Marrow ; Chondrosarcoma, Mesenchymal ; Classification ; Cyclophosphamide ; Diagnosis ; Disease-Free Survival ; Doxorubicin ; Drug Therapy ; Extremities ; Female ; Fibrosarcoma ; Head ; Hemangiopericytoma ; Hemangiosarcoma ; Histiocytoma, Malignant Fibrous ; Humans ; Kidney ; Leiomyosarcoma ; Liver ; Lung ; Male ; Mesenchymoma ; Neck ; Neoplasm Metastasis ; Neoplasm, Residual ; Neurilemmoma ; Orbit ; Pediatrics ; Pelvis ; Perineum ; Prognosis ; Retrospective Studies ; Rhabdomyosarcoma ; Sarcoma* ; Sarcoma, Ewing ; Sarcoma, Synovial ; Seoul ; Sex Ratio ; Survival Rate ; Vincristine

Sex typing may become the start point in investigations that are usually performed through amelogenin typing. In cases involving genotype-phenotype discrepancy, amelogenin typing could yield misleading results. The rare XX male syndrome is characterized by a phenotypic male with a 46, XX female karyotype. In this point, this case report would help understand the importance of genotype-phenotype discrepancy.
Amelogenin ; Female ; Genes, sry ; Humans ; Karyotype ; Klinefelter Syndrome ; Male ; Y Chromosome