Cutarieous manifest,ations and systemic complications were observed in 521 patient., with diabetes mellitus. The results were as follows: Total 70, 8% of patients had complications', In 16. 5%, cutaneous manifestation were observed. Systemic complications were observed in 27 6%, Both eutaneous manifestations and systemic complications were observed in 26 7% 2 The cutaneous mariifestations observed in 43 2%, were cutaneous infection, pruritus, shin spot, diabetic foit, peripheral edema, diahetic bulla, foot gangrene and rutieosis in the order of frequency, 3, The cutaneous manifestations were much more observed in patients with systemic complications than without them(p<0 05), and with longer duration more than 10 years history, 4. It seems to be no relationship between the cutancous manifestations and fasting blood sugar level.
Blood Glucose ; Diabetes Mellitus* ; Edema ; Fasting ; Foot ; Gangrene ; Humans ; Pruritus ; Statistics as Topic*

The purpose of this research was to develop the clinical nursing process model through linked nursing diagnoses, related factors, defining characteristics, nursing interventions, nursing activities and nursing outcomes and was to make graphic user interface using the clinical nursing process model. The linked clinical record sets in the developed database system were arranged in reverse order statistically in order to construct the clinical nursing process model from the patients' database tables concerning nursing diagnoses, related factors, defining characteristics, nursing interventions, nursing activities and nursing outcomes. The arranged clinical nursing record sets were suggested as the nursing process model in a general surgery clinical unit. The nursing process model of a general surgery clinical unit could be used for its accessibility as an indicator for other medical departments. The most available clinical nursing process data were presented on only one graphic user interface window to be able to select the nursing process easily for nurses in a general surgery clinical unit. Graphic user interface programming was designed to show all related factors, defining character stics, nursing interventions, nursing activities and nursing outcomes based on a nursing diagnosis which have unique properties. Using the clinical nursing process model in this database system, it was also possible to construct the electronic nursing record system.
Nursing Diagnosis ; Nursing Process* ; Nursing Records ; Nursing*

Professional nurse Autonomy is an essential attribute of a discipline striving for full professional status. PURPOSE: This study was to clarify the concept of professional nurse autonomy to provide basic data needed for development of professional autonomy enhancing strategies. METHOD: This study use the process of Walker & Avante's concept analysis based on Wade's research (1999), and field data of 21 nurses. RESULTS: Professional nurse autonomy is defined as competency and creative performance of the professional nurse in practice, to decide independently or interdependently nursing activities and to be had accountable for results of decisions, that reflect advocacy and caring. It was identified that critical attributes include responsible discretionary decision making, collegial interdependence, initiative, creativity, and caring, advocacy, cooperative relationship with clients, receptive capacity to others, activeness, self confidence, and devotion and responsibility to their profession. Antecedents include personal characteristics, educational background, experience and structural characteristics that enhance professional nurse autonomy. Consequences of professional nurse autonomy are feelings of self-efficacy, empowerment, job satisfaction, reduction of intention to leave their job. CONCLUSION: According to these results, it is recommended that the curriculum provides an environment for learning professional nurse autonomy, and that is used as basic data to develope strategies to enhance professional autonomy of nurse in practice and it's effects.
Creativity ; Curriculum ; Decision Making ; Humans ; Intention ; Job Satisfaction ; Learning ; Nursing ; Power (Psychology) ; Professional Autonomy

Normal and abnormal follicular growth and steroidogenesis depend on gonadotropins as well as intraovarian peptides, which may mediate or potentiate gonadotropin action. Inhibin also affect follicular development and steroidogenesis and may play a role in dominant follicle selection and follicular atresia. Therefore, we studied the differences of serum inhibin, gonadotropin and androgen levels in the women with only the ultrasound findings and no disorder, and polycystic ovary (PCO) with ovulatory disturbance. We prospectively analysed forty-three women with PCO. The diagnosis of PCO was based on typical appearance of the ovaries on TVS. Twelve women with regular menstrual cycle and normal ovarian morphology were selected as control. Basal levels of inhibin, luteinizing hormone(LH), follicle stimulating hormone(FSH), estradiol(E2), testosterone(T), androstenedione(ADD), dehydroepiandrosterone-sulfate(DS), prolactin and TSH in serum were determined. There were significant differences in basal LH levels and LH/FSH ratio between the control and the women with PCO. The basal levels of inhibin and E2 in the oligo-amenorrheic PCO (N=34) were significantly higher than those in the control. There was higher negative correlation between the inhibin and T levels in the oligo-amenorrheic PCO, but, not in the regular cycling PCO. Also, there was higher positive correlation between the LH and T levels in the oligo-amenorrheic PCO, but not in the regular cycling PCO. These data presume that the initial event of PCO is elevated pituitary LH secretion. Elevated levels of LH may down-regulate LH receptors on granulosa cells and also cause hypertrophy of the thecal layer. High level of androgen secreted by the hypertrophied thermal layer may stimulate inhibin secretion from granulosa cells and can be converted to estrogen by extraovarian tissues and could serve to augment pituitary sensitivity to GnRH with a resultant secretion of more LH follicular development and dominant follicle selection resulted in ovulatory disturbance.
Diagnosis ; Estrogens ; Female ; Follicular Atresia ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Granulosa Cells ; Humans ; Hypertrophy ; Inhibins* ; Lutein ; Menstrual Cycle ; Ovary* ; Peptides ; Prolactin ; Prospective Studies ; Receptors, LH ; Ultrasonography

Doppler sonography has been introduced to evaluate uterine and ovarian diseases. It has been reported to be used to distinguish benign from malignant adnexal masses. The purpose of this study was to assess the blood flow characteristics of adnexal masses and to determine the optimal cut-off points for the Doppler indices obtained, resistance index and pulsatility index, to best differentiate benign from malignant lesions. We performed pulsed Doppler ultrasound in seventy-eight adnexal masses between February 1989 and June 1994. The pulsatility and resistance index were calculated from the waveforms generated from blood flow within the ovary. There were 51 benign and 27 malignant histologically proved ovarian lesions. All women have been operated on. The results were as follows ; Benign tumors and cysts had a significantly higher pulsatility index(mean, 1.23+/-0.74; range, 4.46-3.36) and resistance index(mean, 0.64+/-0.19; range 0.34-1.43) than did malignant tumors(pulsatility index : mean, 0.87+/-0.49; range, 0.31-2.27; resistance index : mean, 0.50+/-17; range, 0.23-0.8). However, some overlap in individual values for benign and malignant lesions was found. In conclusion, our data suggest that high pulsatility and resistance indices may indicate benign adnexal masses ; however, considerable overlap in pulsatility and resistance indices between benign and malignant lesions were noted, and further work will be needed before the validity of these factors is proved.
Female ; Humans ; Ovarian Diseases ; Ovary ; Ultrasonography

Retinal dysplasia is an important disease in the study of retinal development. The differential diagnosis of retinal dysplasia from retinoblastoma is very difficult to make clinically, but histologically the diagnosis is made by the structure of rosettes. The authors experimentally gave trauma to retina of rats and produced retinal dysplasia; we observed under electron microscope the incomplete rosette of retinal dysplasia and the complete rosette appearing in retinoblastoma. We concluded that both rosettes are formed in developing retina with environmental or hereditary defects and did a comparative study of their characteristic fine structures.
Animals ; Diagnosis ; Diagnosis, Differential ; Rats* ; Retina ; Retinal Dysplasia* ; Retinaldehyde* ; Retinoblastoma*

PURPOSE : JAK kinases play important roles not only in normal cellular processes, but they are also important in tumor development. A recent study identified two somatic mutations of JAK1 in leukemia cells that were detected in exon 10 (p.T478S) and exon 13 (p.V623A). The aim of this study was to see whether the JAK1 mutations in these exons occur in non-small cell lung cancers (NSCLC). MATERIALS AND METHODS : We analyzed the exons 10 and 13 of JAK1 for detecting somatic mutations in NSCLC by performing polymerase chain reaction (PCR) and single-strand conformation polymorphism (SSCP) assay. RESULTS : The SSCP analysis revealed no evidence of somatic mutation in the DNA sequences of JAK1 exon 10 and exon 13 in the 47 NSCLCs. CONCLUSION : The data presented here indicate that the JAK1 exons 10 and 13 may not be somatically mutated in human NSCLCs, and this suggests that the JAK1 mutation in exons 10 and 13 may not play an important role in the tumorigenesis of NSCLCs
Base Sequence ; Carcinoma, Non-Small-Cell Lung ; Cell Transformation, Neoplastic ; Exons ; Humans ; Janus Kinases ; Leukemia ; Lung ; Lung Neoplasms ; Polymerase Chain Reaction ; Polymorphism, Single-Stranded Conformational

Intestinal lymphangiectasia, one of the protein-losing gastroenteropathies, is an uncommon disease characterized by dilated intestinal lymphatics, enteric protein loss, edema, hypoalbuminemia, and lympocytopenia. Small bowel biopsy and CT have been used to confirm the diagnosis of intestinal lymphangiectasia. Small bowel biopsy shows collections of abnormal dilated lacteals in submucosa with distortion of villi and CT findings have been described as diffuse nodular thickening of the small bowel and as linear hypodense streaking densities in the small bowel caused by dilated lymphatic channels. Demonstration of increased enteric protein loss using 51Cr-, 131I- or 99mTc-labeled albumin, timed measurement of fecal excretion of radioactivity or by measuring fecal clearance of alpha 1-antitrypsin can also help the diagnosis. We experienced a rare case of intestinal lymphangiectasia in an eight year old boy who presented with facial edema, abdominal distension and intermittent diarrhea. We report a patient with intestinal lymphangiectasia, in whom abdominal CT, 99mTc-labeled albumin scintitigraphy, and stool alpha 1-antitrypsin measurement played key roles in determining the diagnosis. A brief review of literature was made.
alpha 1-Antitrypsin ; Biopsy ; Diagnosis ; Diarrhea ; Edema ; Humans ; Hypoalbuminemia ; Male ; Radioactivity ; Tomography, X-Ray Computed

PURPOSE: Nephrogenesis is normally accompanied by a tightly regulated and efficient vascularization. We investigated the effect of angiotensin II inhibition on angiogenesis in the developing rat kidney. METHODS: Newborn rat pups were treated with enalapril (30 mg/kg/day) or vehicle (control) for 7 days after birth. Renal histological changes were checked using Hematoxylin & Eosin staining. We also investigated the intrarenal expression of vascular endothelial growth factor (VEGF)-A, VEGF receptor 1 (VEGFR1), VEGFR2, platelet-derived growth factor (PDGF)-B, and PDGF receptor-beta with Western blotting and immunohistochemical staining at postnatal day 8. Expression of the endothelial cell marker CD31 was examined to determine glomerular and peritubular capillary density. RESULTS: Enalapril-treated rat kidneys showed disrupted tubules and vessels when compared with the control rat kidneys. In the enalapril-treated group, intrarenal VEGF-A protein expression was significantly higher, whereas VEGFR1 protein expression was lower than that in the control group (P<0.05). The expression of VEGFR2, PDGF-B, and PDGF receptor-beta was not different between the 2 groups. The increased capillary CD31 expression on the western blots of enalapril-treated rat kidneys indicated that the total endothelial cell protein level was increased, while the cortical capillary density, assessed using CD31 immunohistochemical staining, was decreased. CONCLUSION: Impaired VEGF-VEGFR signaling and altered capillary repair may play a role in the deterioration of the kidney vasculature after blocking of angiotensin II during renal development.
Angiotensin II ; Animals ; Blotting, Western ; Capillaries ; Enalapril ; Endothelial Cells ; Eosine Yellowish-(YS) ; Growth and Development ; Hematoxylin ; Humans ; Infant, Newborn ; Kidney* ; Parturition ; Platelet-Derived Growth Factor ; Rats* ; Receptors, Vascular Endothelial Growth Factor ; Vascular Endothelial Growth Factor A

PURPOSE: To investigate the effects of angiotensin II inhibition on the epithelial to mesenchymal transition (EMT) in the developing kidney, we tested the expression of EMT markers and nestin in angiotensin converting enzyme (ACE) inhibitor-treated kidneys. METHODS: Newborn rat pups were treated with enalapril (30 mg/kg/d) or a vehicle for 7 days. Immunohistochemistry for the expression of alpha-smooth muscle actin (SMA), E-cadherin, vimentin, and nestin were performed. The number of positively-stained cells was determined under 100 magnification in 10 random fields. RESULTS: In the enalapril-treated group, alphaSMA-positive cells were strongly expressed in the dilated tubular epithelial cells. The number of alphaSMA-positive cells in the enalapril-treated group increased in both the renal cortex and medulla, compared to the control group (P<0.05). The expression of E-cadherin-positive cells was dramatically reduced in the cortical and medullary tubular epithelial cells in the enalapril-treated group (P<0.05). The number of vimentin- and nestin-positive cells in the cortex was not different in comparisons between the two groups; however, their expression increased in the medullary tubulointerstitial cells in the enalapril-treated group (P<0.05). CONCLUSION: Our results show that ACE inhibition in the developing kidney increases the renal EMT by up-regulatingalphaSMA and down-regulating E-cadherin. Enalapril treatment was associated with increased expression of vimentin and nestin in the renal medulla, suggesting that renal medullary changes during the EMT might be more prominent, and ACE inhibition might differentially modulate the expression of EMT markers in the developing rat kidney.
Actins ; Angiotensin II ; Angiotensins ; Animals ; Cadherins ; Cell Transdifferentiation ; Enalapril ; Epithelial Cells ; Growth and Development ; Humans ; Immunohistochemistry ; Infant, Newborn ; Intermediate Filament Proteins ; Kidney ; Kidney Diseases ; Muscles ; Nerve Tissue Proteins ; Peptidyl-Dipeptidase A ; Rats ; Vimentin