Improvements in therapy have resulted in increasing numbers of children being successfully treated for cancer. However the aggressiveness of therapy & uncertainty about prognosis are associated with many adverse effects, psychological as well as physical for both the child & family. The purpose of this study were to measure the degree of perceived uncertainty, self-efficacy & coping, and then to examine the relationship between the perceived uncertainty, self-efficacy & coping in parents of children cancer patients. The subjects of this study consist of 140 parents with pediatric cancer, registered at pediatric cancer ward & Out Patient Department. Data was collected from July 1st to August 15th 1998. The tools used in this study were Mishel's the Parents' Perception of Uncertainty Scale(28item, 4 likert scale), Shere's Self-Efficacy Scale)17item, 5 likert scale) & Folkman & Lazarus Ways of Coping Checklist)34 items, 4 likert scale). Data was analyzed by t-test, Anova, Pearson Correlation co-efficient. Results of this study are summarized as follows : 1. Parents perceived their uncertainty to be slightly high(Mn 2.41). The degree of perceived uncertainty by the four components were followed as : lack of clarity(2.60), unpredictability(2.59), ambiguity(2.51) & lack of information(1.90). The degree of perceived uncertainty of parents with pediatric cancer revealed to be influenced significantly by the family outcome, reliability about health care provider & perceived severity of illness. 2. The range of parents' self-efficacy was measured from 35 to 85 point, so revealed slightly high. The degree of self-efficacy related to be influenced significantly by the sequency of child birth, family religion & degree of perceived support. 3. The degree of parents' coping was measured slightly high(Mn 2.78). The degree of coping related to be influenced significantly by the sequency of child birth, number of sible & degree of perceived support. 4. parents' uncertainty was related inversely to the parents' self-efficacy(r=-.38, p<.001) & coping(r=-.26, p<.001). And also parents' self-efficacy was positively related to coping(r=.56, p<.001). From the above results, it can be concluded that predicting & controlling parents' uncertainty with children cancer are necessary to improve positive coping strategies. This information may be used as a foundation for developing nursing interventions to decrease perceived uncertainty & to foster self-efficacy & coping for parents with children cancer.
Child* ; Health Personnel ; Humans ; Nursing ; Parents ; Parturition ; Prognosis ; Uncertainty* ; Child Health

For the purpose of the precise diagnosis and proper treatment planning of obstructive jaundice, various techniques to obtain tissues from biliary strictrue sites have been proposed. We performed perutaneous transcatheter biopsies of biliary strictrues with a biotome in six patients with obstructive jaundice. The sites of biliary stricture were distal common bile ducts (n=3), common hepatic duct (n=1), and confluence of both intrahepatic ducts (n=2). Their histologic diagnoses were adenocarcinoma (n=2), chronic choledochitis (n=3), and atypical cell suspicious of malignancy (n=1). False positive or false results were not documented by other means (including laparotomy),when regarding atypical cell suspicious of malignancy as true positive for malignancy. Percutaneous transcatheter biliary biopsy with biotome is easy to perform in conjunction with percutaneous transhepatic biliary drainage procedure, and can be able to obtain specific tissues for correct diagnosis.
Adenocarcinoma ; Biopsy* ; Common Bile Duct ; Constriction, Pathologic ; Diagnosis ; Drainage ; Hepatic Duct, Common ; Humans ; Jaundice, Obstructive

For the purpose of the precise diagnosis and proper treatment planning of obstructive jaundice, various techniques to obtain tissues from biliary strictrue sites have been proposed. We performed perutaneous transcatheter biopsies of biliary strictrues with a biotome in six patients with obstructive jaundice. The sites of biliary stricture were distal common bile ducts (n=3), common hepatic duct (n=1), and confluence of both intrahepatic ducts (n=2). Their histologic diagnoses were adenocarcinoma (n=2), chronic choledochitis (n=3), and atypical cell suspicious of malignancy (n=1). False positive or false results were not documented by other means (including laparotomy),when regarding atypical cell suspicious of malignancy as true positive for malignancy. Percutaneous transcatheter biliary biopsy with biotome is easy to perform in conjunction with percutaneous transhepatic biliary drainage procedure, and can be able to obtain specific tissues for correct diagnosis.
Adenocarcinoma ; Biopsy* ; Common Bile Duct ; Constriction, Pathologic ; Diagnosis ; Drainage ; Hepatic Duct, Common ; Humans ; Jaundice, Obstructive

No abstract available.
Vena Cava, Inferior*

No abstract available.
Tumor Lysis Syndrome*

BACKGROUND: It is understood that amylase is poor and lipase is a little better than amylase in specificity for the diagnosis of acute pancreatitis. But we recognized that the general knowledge was resulted from the study of inappropriate design of some researchers. So, we tried to find out the true diagnostic value of amylase and lipase by the study of appropriate design, and with the above result, evaluated the usefulness of lipase as a diagnostic test for acute pancreatitis. METHODS: We reviewed the serum levels of the amylase and lipase in 33 patients complaining acute abdominal pain diagnosed as acute pancreatitis by image study (computed tomography, ultrasonography) , and in the 134 patients of control group who, with abdominal pain, were diagnosed finally as non-pancreatic disease at discharge after admission and treatment. Serum amylase and lipase activity were measured by aca IVTM (Chiron Inc.). RESULTS: The sensitivity of amylase and lipase for the diagnosis of acute pan creatitis was 81.8% and 87.8%, respectively. The specificity of amylase and lipase for the diagnosis of acute pancreatitis was 92.5% and 86.5%, respectively. The sensitivity and specificity was 84.6% and 96.3% respectively, when two enzymes were combined by 'and' strategy. The lipase activity remained elevated longer than the amylase in acute pancreatitis. CONCLUSIONS: On the contrary of the general knowledge, sensitivities and specificities of the amylase and lipase were fairy high and didn't show big dirt ferences between two enzymes. Though only one of the two enzymes could be selected for the diagnosis of acute Pancreatitis, using both of the enzymes increased the specificity, and lipase was useful to detect the patient who came to hospital a few days later after the onset of symptom.
Abdominal Pain ; Amylases ; Diagnosis* ; Diagnostic Tests, Routine ; Humans ; Lipase* ; Pancreatitis* ; Sensitivity and Specificity

PURPOSE: To evaluate the frequently of low ahetenuation area in enhanced CT scans of non-Hodgkin lymphoma(NHL) and to find out if there is any pertinent relationship between this and the histopathologic classification. MATERIALS & METHODS: The authors reviewed CT scans in the newly diagnosed 53 patients with NHL. We defined the-low attenuation area as the one with CT attenuation value lower than that of the muscle, surrounding lesion, or other lymph nodes after contrast enhancement. NHL with the low attenuation areas were correlated with the histopathologic findings according to the classification based on the Working Formulation and the frequency of the lesion was evaluated. RESULT: Of the 53 patients, the low attenuation area was found in 13 patients (25%) at CT. The histopathologic classification could be made in 12 patients, among whom one patient was classified as low grade, six as intermediate grade, and five as high-grade. Concerning the specific cell typing, the diffuse large cell type was most common in intermediate-grade NHL seen in five patients and the large cell, immunoblastic type was most common in high-grade NHL seen ih three patients. CONCLUSION: The authors concluded that the low attenution area within lymphoma is not an infrequent finding at CT, and there was no stastistically significant correlation between this finding and the prognostic grading of the Working Formulation.
Classification ; Humans ; Lymph Nodes ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Tomography, X-Ray Computed

BACKGROUND: Rotavirus activity in Korea has been reported beginning in October, peak in November, continuing in winter and ending in spring. But the peak month and the incidence of rotavirus seems to be changed recently. So we investigated the trends of rotavirus activity for the last 10 years in Hanyang University Hospital (HUH). Also latex agglutination test was compared with automated enzyme-linked fluorescent immunoassay for the detection of rotavirus in stool specimens. METHODS: Stool specimens (3,636 from HUH, 1989-1998; 1,171 from Hanyang University Kuri hospital, HUKH, 1996-1998) from pediatric patients with acute diarrhea were tested for rotavirus,. Sixty specimens were tested by latex agglutination test (Sliders Rota-kit 2, bioMerieux Vitek, France) and enzyme-linked fluorescent immunoassay (VIDAS Rotavirus, bioMerieux Vitek, France) according to the instructions from the manufacturer. RESULTS: The annual incidence of rotavirus diarrhea from 1989 to 1998 was 47%, 32%, 33%, 25%, 26%, 24%, 24%, 17%, 17%, 14%, respectively. Positive rate of rotavirus was 25% for the 10year period in HUH, 20% for the recent 3 years in HUKH. Peak month was November (46%) in the first 5 year, but November incidence decreased to 17% in the last 5 year, and the peak moved to January, February, and March (34%, 35%, 33%, respectively). Epidemic period was from October to February during the first 5 year, but from December to April during the last 5 year period. The agreement rate of the two methods was 90% and VIDAS Rotavirus showed significantly higher sensitivity compared to Sliders Rota-kit 2. CONCLUSIONS: The incidence of rotavirus diarrhea decreased gradually for the last 10 years and the peak month of rotavirus activity was changed from November to January, February, and March. The VIDAS Rotavirus was more sensitive than the Sliders Rota-kit 2 for the detection of rotavirus in stool.
Diarrhea ; Epidemiology ; Gastroenteritis* ; Humans ; Immunoassay ; Incidence ; Korea* ; Latex Fixation Tests ; Rotavirus*

A newborn infant, who was low-birth weight(1,780gm), showed severe degree of jaundice on second day of life and skin color became dark greenish-yellow and moderate hepatosplenomegaly was noted on physical examination. Results of liver function test & radioimmuniassay for hepatitis B antigen of both infant and mother suggested that neonatal hepatitis B seemed to occure transplacentally during pregnancy from infected mother. Pancytopenia was followed, but we could not confirm aplastic anemia due to lack of bone marrow specimen. As mentioned above, we experienced a case of vertically transmitted neonatal hepatitis B with pancytopenia. We present a brief review of related literatures.
Anemia, Aplastic ; Bone Marrow ; Hepatitis B* ; Hepatitis* ; Humans ; Infant ; Infant, Newborn ; Jaundice ; Liver Function Tests ; Mothers ; Pancytopenia* ; Physical Examination ; Pregnancy ; Skin

BACKGROUND: Helicobacter pylori(H. pylori) has been implicated in the pathogenesis of chronic active gastritis and peptic ulcer disease. All patients with ulcers who are infected with H. pylori receive antimicrobial therapy. Therefore diagnosis of H. pylori infection is imperative for the treatment gastritis or ulcer patients. We evaluated the four diagnostic methods and three culture media for the isolation of H. pylori. MATERIALS AND METHODS: Rapid urease test(CLO test), modified Gram stain, culture, and nested polymerase chain reaction (PCR) were performed with 108 gastroscopic biopsy specimens from patients with peptic ulcer or chronic gastritis. Among them 40 specimens were inoculated onto each of 5% sheep blood agar, e99 Yolk emulsion (EYE) agar, and 7% horse blood agar containing antibiotics. RESULTS: The positive rates were the highest by the PCR(72%), 67% by modified Gram stain, 64% by CLO test, and 57% by culture. Among the three media the horse blood agar (selective medial) gave the highest isolation rate (48%), followed by sheep blood agar (45%), and EYE agar (38%). CONCLUSION: Though PCR was the most sensitive method for the detection H. pylori modified Gram stain was sensitive enough, simple, rapid, and economical as the routine diagnostic method of H. pylori. For the culture of H. pylori combination of sheep blood agar as nonselective media and horse blood agar as selective media would show the highest isolation rate.
Agar ; Anti-Bacterial Agents ; Biopsy* ; Culture Media* ; Diagnosis ; Gastritis ; Helicobacter pylori* ; Helicobacter* ; Horses ; Humans ; Peptic Ulcer ; Polymerase Chain Reaction ; Sheep ; Ulcer ; Urease