This study was designed to investigate the effects of exercise therapy on joint mobility, daily activity, pain and depression of patients with ankylosing spondylitis. 25 persons with the experimental group and 25 persons with the control group were conveniently sampled among out-patients diagnosed with ankylosing spondylitis at the rheumatism center of H University Medical Center. The control patients were matched to the experimental group and they were selected considering sex and age. The exercise therapy was developed by the author with the assistance of exercise specialists. The program includes muscle relaxation, flexibility, muscle strengths, breathing strengths and straight posture exercises. The 20-minute exercise therapy was carried out to the experimental group once a day for eight weeks from October, 1997 to February, 1998. Before and after the experiments, joint mobility, daily activity, pain and depression were measured respectively. Data were analyzed by x2-test, t-test, paired t-test and unpaired t-test. The results were as follows : Joint mobility(cervical flexion, extension, shoulder flexion, abduction, hip abduction, knee flexion and fingertip to floor distance) and daily activity in the experimental group after the exercise were significantly increased than that in the control group. The pain and depression score in the experimental group after the exercise were significantly decreased than that in the control group. These findings may indicate that the exercise therapy is effective in increasing the joint mobility and daily activity, and also effective in decreasing pain and depression in patients with ankylosing spondylitis. Accordingly, the exercise therapy can be adopted as an effective nursing intervention for ankylosing spondylitis.
Academic Medical Centers ; Depression* ; Exercise ; Exercise Therapy* ; Hip ; Humans ; Joints* ; Knee ; Muscle Relaxation ; Muscle Strength ; Nursing ; Outpatients ; Pliability ; Posture ; Respiration ; Rheumatic Diseases ; Shoulder ; Specialization ; Spondylitis, Ankylosing*

No abstract available.
Prune Belly Syndrome*

The grading of astrocytoma has traditionally relied on histological assessment, but there are some differences in their parameters, application, and reproducibility. Recently, numerous studies have attempted to correlate biological aggresiveness with tumor proliferation index using new immunohistochemical methods. The purpose of this study is to correlate the histopathological grades of astrocytoma with the expression of Ki-67, PCNA, p53 protein and AgNORs. The paraffin sections of 41 consecutive cases of astrocytomas were examined. Histologically the tumors were graded as three groups under the St. Anne-Mayo system and showed 14 cases in grade II, 15 cases in grade III and 12 cases in grade IV (glioblastoma multiforme). As a result, the Ki-67 labelling index and p53 protein expression tended to increase with increasing grade of malignancy. But the univariate analysis showed that there was no significant difference between the tumor grades (p>0.05). The PCNA labelling index and number of AgNORs revealed striking differences between the grade II and grade III astrocytomas (p<0.05). We concluded that the PCNA labelling index and AgNORs counting are useful markers for differentiation between grade II and III astrocytomas.
Astrocytoma* ; Paraffin ; Proliferating Cell Nuclear Antigen* ; Strikes, Employee

The purpose of this study was to investigate the correlations between social support, dependence of activities of daily living and depression among Parkinson's disease patients. Subjects were 122 patients with Parkinson's disease. Neurologic wards inpatients or neurology clinic out patients department in a tertiary-affiliated hospital in Seoul. Data were collected from April 1996 to March 1997. The results of this study were summarized as follows: 1. The lower the level of dependence of activities of daily living, the lower the level of depression. 2. The higher the level of perceived family support, the lower the level of depression. 3. The higher the level of perceived health personnel support, the lower the level of depression. 4. The rate of depression evaluated by Zung depression scale was 37.4%(mild to moderate:30.1%, moderate to severe:4.1%, severe:3.2%). 5. Socio-demographic characteristics sex, education, occupation, and the charge person of treatment cost, significantly influenced the level of depression. 6. There was no significant difference in level of depression, dependence of activities of daily living, stage of disease between user and nonuser of L-dopa. Suggestions were made for further studies: 1. To develop nursing intervention for decreasing the dependence of activities daily living is needed. 2. To identify the change pattern of depression by time.
Activities of Daily Living* ; Depression* ; Education ; Health Care Costs ; Health Personnel ; Humans ; Inpatients ; Levodopa ; Morinda ; Neurology ; Nursing ; Occupations ; Outpatients ; Parkinson Disease* ; Seoul

A case of lupus vulgaris who has the typical skin lesion on the patella region of the right knee was presented. The patient is 9 years old, the generally healthy male, and is no special finding of chest X-ray but tuberculin test was strong positive. The skin lesion started about 2 years ago as baby's palm sized erythematous patch with apple jelly nodule on the right knee joint region. Diagnosis was made by characteristic of clinical appearance and histulagial finding including other laboratory data. The treatment was done with INAH, PAS, streptomycin and pyridoxine for 3 months. Now,The skin lesion is almost healed and still continue treatment and observation go on.
Child ; Diagnosis ; Humans ; Knee Joint* ; Knee* ; Lupus Vulgaris* ; Male ; Patella* ; Pyridoxine ; Skin ; Streptomycin ; Thorax ; Tuberculin Test

A total of 213 fine needle aspirations from pulmonary lesions in 193 patients performed from January, 1986 to March, 1989 were analyzed. The cytologic diagnoses were unsatisfactory in 10, negative in 60, atypical in 6, suspicious in 11 and malignant in 126 cases. The cytologic types of the malignant cases were 47 squamous cell carcinomas, 40 adenocarcinomas, 10 small cell carcinomas, 6 large cell carcinomas and 10 metastatic tumors. They were verified by the histologic confirmation in 31 cases and by the clinical data in the remainder. There were 5 false-negative cases and none was false-positive, representing 96% sensitivity and 100% specificity. Primary lung cancers were accurately typed in 73% of histologically confirmed case. Cell blocks, prepared in 99 cases, were helpful in tumor typing of 11 cases.
Neoplasm Metastasis ; Lung Neoplasms

BACKGROUND: A retrospective study was performed to evaluate postoperative mortality within 30 days following surgery. METHODS: The records of 31,806 patients who received operation under general anesthesia were reviewed. RESULTS: 1) Postoperative deaths were 184 cases, the ratio of which was comprising 0.57% of all surgical operative cases. 2) The highest ratio of the mortality in age group was 51~60 years group which was 24.5%, and in physical status it was ASA class III which was 36.4%. The highest ratio to the mortality rate in postoperative days was 8~30 days which was 45.1%. 3) The most common causes of death was low cardiac output due to heart failure on operating theater, and hypovolemic shock within postoperative 2 days, and intracranial problem within postoperative 7 days, and pulmonary complication within postoperative 30 days. CONCLUSION: We conclude that fatality rate could be decreased by intensive and multidisciplinary care for postoperaive complications as respiratory and renal failure.
Anesthesia, General ; Cardiac Output, Low ; Cause of Death ; Heart Failure ; Humans ; Mortality ; Renal Insufficiency ; Retrospective Studies ; Shock

No abstract available.
Child ; Health Promotion ; Humans ; Immunization* ; Child Health

Fine needle aspiration biopsy cytology (FNA) for diagnosis of a variety of breast tum- ors has been proven to be a simple, safe, and cost saving diagnostic methodology with high accuracy. Cytologic specimens from 1,029 fine needle aspirations of the breast during last 3-year period were reviewed and subsequent biopsies from 107 breast lesions were reevaluated for cytohistological correlation. FNA had a sensitivity of 81.6% and a specificity of 98.3%. One out of 107 cases bio- psied revealed a false positive result (0.9%) and the case was due to misinterpretation of apocrine metaplastic cells in necrotic backgound as malignant cells. A false negative rate was 8.4% (9 of 107 cases biopsied). Six of 9 false negative cases were resulted from insufficient aspirates for diagnosis, and remaining three of 9 false negative cases revealed extensive necrosis with no or scanty viable cells on smears. The results indicate that for reducing false positive and false negative rates of FNA, an experienced cytopathologist and a proficient aspirator are of great importance.
Adenoma, Pleomorphic ; Aspirations (Psychology) ; Biopsy ; Biopsy, Fine-Needle ; Breast ; Carcinoma, Adenoid Cystic ; Carcinoma, Mucoepidermoid ; Child* ; Cost Savings ; Diagnosis ; Humans ; Necrosis ; Needles ; Sensitivity and Specificity ; Urinary Tract Infections* ; Urinary Tract* ; Vesico-Ureteral Reflux*

BACKGROUND/AIMS: Although the mechanism of hepatocellular carcinogenesis still remains to be clarified, it has been suggested that persistent hepatic necrosis and resultant irregular regeneration might cause genetic mutations, such as activation of protooncogenes, inactivation of tumor suppressor genes and modulation of apoptosis-related genes, finally leading to hepatocellular carcinoma (HCC). To elucidate the role of cell proliferative activity and apoptosis, a major mechanism of cell death, in hepatocellular carcinogenesis, we analyzed expression of proliferation cell nuclear antigen (PCNA), p53 protein and apoptotic cells in HCC and surrounding nonneoplastic hepatic parenchyma. METHODS: We performed immunohistochemical staining to detect P CAN, p53 protein, and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labelling (TUNEL) method for the detection of apoptosis in 52 hepatocellular carcinomas and their adjacent nonneoplastic liver. We scored the expression of PCNA and p53, and apoptotic index by a 5 point scale' 0, 0%,1, 1-25%', 2, 25-50%, 3, 50-75%', 4, >76%, and analyzed the results with other clinicopathologic characteristics. RESULTS: p53 protein was expressed in 42.3% of the HCC, but was not evident in nonneoplstic liver. P53 overexpression was correlated with the histologic grade of HCC (p<0.05). PCNA labelling indices (LI) of HCC were correlated with those of liver cell dysplasia and normal liver (p<0.05). Leading edges of HCCs showed higher proliferative activity than the central part of HCC. Four cases of HCCs with high TUNEL also showed high proliferative activity. There was no difference of the TUNEL between HCC and surrounding nonneoplastic liver. Expression of p53, PCNA LI and TUNEL had no relationship with clinicopathologic parameters including viral markers, aFP elevation, tumor size and underlying cirrhosis. CONCLUSION: p53 overexpression in HCC and absence of p53 mutation in nonneoplastic liver indicates the active participation of p53 in hepatocellular carcinogenesis. Invasiveness and metastatic potential appear to be related with the strong expression of PCNA, but apoptosis in HCC has no direct implication in hepatocellular carinogensis.
Apoptosis* ; Biomarkers ; Carcinogenesis ; Carcinoma, Hepatocellular* ; Cell Death ; Fibrosis ; Genes, Tumor Suppressor ; In Situ Nick-End Labeling ; Liver* ; Necrosis ; Proliferating Cell Nuclear Antigen ; Regeneration