The purpose of this study was to provide basic data useful to the training of hospice care members. For this study carried out to investigate the degree of death orientation of hospice care members. The subjects of study were 22 nurses, 85 clergies, 59 volunteers who registered on Hospice Education Programs. The data were analysed by descriptive analysis, t-test, ANOVA, Duncan test and Person's correlation coefficient. The results of the study can be summarized as follows; 1. The degree of death orientation were 85.95 in nurses group, 73.05 in clergies group, and 88.49 in volunteers group. So, clergies group has more positive death orientation than others. 2. The degree of death orientation showed significant differences between age group(F=4.62, p=.004), education program group(F=27.25, p=.000), and religiosity(t=3.77, p=.000). There were no significant differences between the degree of death orientation and the others general characteristics of hospice care members. In conclusion, the urgent need for educational preparation of death orientation and spiritual care of hospice care team, especially volunteers group and nurses group is emphasized. Furthermore, all of the hospice care members those who complete the hospice education program, should be performed efficient hospice care intervention for dying patients and their families.
Clergy ; Education ; Hospice Care* ; Hospices* ; Humans ; Volunteers

No abstract available.
Meningioma* ; Neoplasm Metastasis*

BACKGROUND: To evaluate the role of free fatty acids on the ischemic myocardium, influences of various free fatty acids upon transmembrane action potential and ATP-sensitive K+(KATP) channel activity were examined in the ventricular myocardium and single cardiac myocytes. METHODS: KATP channel activities were measured in the enzymatically (collagenase) isolated single rat ventricular cardiac myocytes by the method of the excised inside-out and the cell-attached patch clamp, and transmembrane action potentials were recorded using the conventional 3M-KCl microelectode techniques in the rat ventricular myocardium. RESULTS: Free fatty acids [FFAs; arachidonic acid (AA), linoleic acid (LA) and lysophosphatidylcholine (LPC)] reduced the KATP channel activity in a dose-dependent manner in the inside-out patch, and 50%-inhibition concentrations (IC50) were 88 +/- 11.2, 49 +/- 12.5, and 188 +/- 17.4 M respectively. Both frequency of channel opening and the mean open-burst duration were markedly decreased, but the amplitude of single channel currents were not changed by the FFAs. AA (50 micrometer) and LPC (50 micrometer) did not affect the dinitrophenol (DNP, 50 micrometer)-induced KATP channel activity, whereas LA (50 micrometer) had a tendency to reduce the activity. The channel inhibition effects by 10 micrometer AA in the inside-out patch were significantly augmented by diclofenac (10 micrometer), but was not changed by nordihydroguaiaretic acid. FFAs never stimulated KATP channel activity, even in the inside-out patch where KATP channel activity reduced in the presence of internal ATP (100 micrometer). Time for 90% repolarization (APD90) significantly increased during superfusion of the FFAs, to 22 (50 micrometer AA), 24 (50 micrometer LA), and 18 (50 micrometer LPC) % from those of the contol at the time of 10 min superfusion, but the other action potential characteristics were not changed by the FFAs. AA (10 micrometer) attenuated cromakalim (10 micrometer)-induced APD90 shortening effects. CONCLUSION: It was inferred that FFAs inhibit the KATP channel activity directly by themselves and/or indirectly by their metabolites in the rat ventricular cardiomyocytes, and therefore, duration of action potential lengthens to be a burden over the ischemic myocardium accounting for the injury of myocardium at the late stage of ischemia.
Action Potentials* ; Adenosine Triphosphate ; Animals ; Arachidonic Acid ; Cromakalim ; Diclofenac ; Fatty Acids, Nonesterified* ; Ischemia ; Linoleic Acid ; Lysophosphatidylcholines ; Masoprocol ; Myocardium* ; Myocytes, Cardiac ; Potassium Channels* ; Potassium* ; Rats*

Objective: To investigate the diagnostic performance of contrast-enhanced ultrasound (CEUS) and its role as a second-line imaging modality after gadoxetate-enhanced MRI (Gd-EOB-MRI) in the diagnosis of hepatocellular carcinoma (HCC) among at risk observations. Materials and Methods: We prospectively enrolled participants at risk of HCC with treatment-naïve solid hepatic observations (≥ 1 cm) of Liver Imaging Reporting and Data System (LR)-3/4/5/M during surveillance and performed Gd-EOB-MRI. A total of one hundred and three participants with 103 hepatic observations (mean size, 28.2 ± 24.5 mm; HCCs [n = 79], non-HCC malignancies [n = 15], benign [n = 9]; diagnosed by pathology [n = 57], or noninvasive method [n = 46]) were included in this study. The participants underwent CEUS with sulfur hexafluoride. Arterial phase hyperenhancement (APHE) and washout on Gd-EOB-MRI and CEUS were evaluated. The distinctive washout in CEUS was defined as mild washout 60 seconds after contrast injection. The diagnostic ability of Gd-EOB-MRI and of CEUS as a second-line modality for HCC were determined according to the European Association for the Study of the Liver (EASL) and the Korean Liver Cancer Association and National Cancer Center (KLCA-NCC) guidelines. The diagnostic abilities of both imaging modalities were compared using the McNemar’s test. Results: The sensitivity of CEUS (60.8%) was lower than that of Gd-EOB-MRI (72.2%, p = 0.06 by EASL; 86.1%, p < 0.01 by KLCA-NCC); however, the specificity was 100%. By performing CEUS on the inconclusive observations in Gd-EOB-MRI, HCCs without APHE (n = 10) or washout (n = 12) on Gd-EOB-MRI further presented APHE (80.0%, 8/10) or distinctive washout (66.7%, 8/12) on CEUS, and more HCCs were diagnosed than with Gd-EOB-MRI alone (sensitivity: 72.2% vs. 83.5% by EASL, p < 0.01; 86.1% vs. 91.1% by KCLA-NCC, p = 0.04). There were no false-positive cases for HCC on CEUS. Conclusion The addition of CEUS to Gd-EOB-MRI as a second-line diagnostic modality increases the frequency of HCC diagnosis without changing the specificities.

Diffuse idiopathic skeletal hyperostosis(DISH) is a relatively common disorder. It is a noninflammatory disease occuring predominantly in middle aged elderly men characterized by calcification and ossification of the anterolateral aspects of vertebral column. It's clinical manifestations are minor: usually cervical stiffness, trunk stiffness and moderate pain. However some severe neurologic complications can occur due to spinal cord compression. We report a case with DISH who got spinal cord injury after minor trauma. A 65-year-old man admitted to the neurosurgery department with a complaint of weakness in lower extremities and paresthesia in upper extremities which were developed after slip down. He had a 10 year history of slowly progressive neck stiffness and weakness in lower extremities. Plain X-ray does not reveal any evidence of fracture in cervical spine or sacroilitis but showed calcification of the anterior longitudinal ligament. The disc spaces were maintained well. MRI showed ossification of the posterior longitudinal ligament causing severe narrowing of the vertebral canal and compression of the spinal cord. Under the diagnosis of spinal cord injury with DISH, the patient was treated conservatively. Despite these treatment, neurologic impairment aggrevated. Surgical decompression of cervical and thoracolumbar spinal cord was done and the patient improved to the quadcane ambulation level.
Aged ; Decompression, Surgical ; Diagnosis ; Humans ; Hyperostosis, Diffuse Idiopathic Skeletal* ; Longitudinal Ligaments ; Lower Extremity ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neck ; Neurosurgery ; Paresthesia ; Spinal Cord Compression ; Spinal Cord Injuries* ; Spinal Cord* ; Spine ; Upper Extremity ; Walking

No abstract available.
Chondrocytes* ; Ear* ; Intercellular Signaling Peptides and Proteins*

PURPOSE: The aim of this study is to identify postoperative renal function and preoperative factors that can predict renal impairment after living donor nephrectomy. MATERIALS AND METHODS: We studied 172 patients undergoing living donor nephrectomy for kidney transplantation (115 males, 57 females). We analyzed the renal function measured by serum creatinine and the 99mTc- diethylenetriamine penta-acetic acid (DTPA) renal scan. Using a univariate and multivariate analysis, we also analyzed multiple independent variables for the remaining renal function following living donor nephrectomy, such as serum creatinine, glomerular filtration rate (GFR), age, sex, duration of follow-up, blood pressure, body mass index (BMI), serum calcium, serum phosphate, serum uric acid. RESULTS: The mean age of the donors was 34 years, and the mean duration of the follow-ups was 11 months. The mean serum creatinine at 11 months after kidney donation was increased compared to preoperative creatinine (1.26mg/dl vs. 0.93mg/dl), and significantly greater in the males than in the females (1.36mg/dl vs. 1.09mg/dl). Mean GFR measured by the 99mTc- DTPA renal scan at 11 months after kidney donation was 69.2 ml/min/ 1.73m2 and similar for men and women (72.3ml/min/1.73m2 vs. 68.3ml/ min/1.73m2). The univariate analysis showed that preoperative creatinine was significantly associated with postoperative creatinine only (p<0.001), and age and sex were associated with the change in creatinine (p=0.046, p<0.001). The univariate analysis also showed that preoperative GFR and age were significantly associated with postoperative GFR (p<0.001, p<0.001), and age was associated with compensatory change in GFR (p= 0.008). The multivariate analysis showed that preoperative GFR was the primary predictive factor of postoperative GFR (r=0.73, p<0.001), and age was an independent secondary predictive factor (r= 0.67, p<0.001). CONCLUSIONS: These results suggest that postoperative renal function has been preserved in kidney donors, and preoperative creatinine, preoperative GFR, and age at donation were the important predictive factors of renal function after living donor nephrectomy.
Blood Pressure ; Body Mass Index ; Calcium ; Creatinine ; Female ; Follow-Up Studies ; Glomerular Filtration Rate ; Humans ; Kidney ; Kidney Transplantation ; Living Donors* ; Male ; Multivariate Analysis ; Nephrectomy* ; Pentetic Acid ; Tissue Donors ; Uric Acid

The purpose of this descriptive correlational study was to understand and find the relationships among the degree of the stress, anxiety, and depression of pre-operational patients, and to describe strategies for pre-operational patient care through exact assessment. The Stress Inventory which was made by researcher, Spielberger's(1972) State-Trait Anxiety Inventory, and Beck's(1967) Depression Inventory were used as research instruments. Subjects were seventy-five patients who hospitalized in general hospital located in Seoul and Inchun. Data was collected from April 12th to April 24th 1998 using questionnaire. Data analysis consisted of Pearson correlation coefficiency, Multiple regression analysis, t-test, one-way ANOVA using SPSS PC+ program. The results were summarized as follows: 1. The average score for the stress was 73.87, for the state-anxiety was 57.05, for the trait-anxiety was 57.59, and for the depression was 37.41. The degree of stress, anxiety and depression were above moderate level. 2. The degree of pre-operational stress and anxiety(r=.692, p=.000), stress and depression (r=.644, p=.000), anxiety and depression (r=.647, p=.000) had significant relationships in statistically. 3. Pre-operational stress was significantly explained by anxiety and depression. 4. The relationships among general characteristics and stress, anxiety, and depression were significantly defferent in education and experience of operation. In conclusion, pre-operational stress, anxiety and depression had high relationships with each other. Because significant differences exist in degree of patients' pre-operational stress, anxiety, and depression on education and experience of operation, these characteristics are needed to be applicated in nursing intervention on pre-operational care. The importance of this study is that the stress inventory predict pre-operative anxiety and depression of patients, so it is valid instrument for mesuring pre-operational stress. I suggest that the necessity of studies involving physical, environmental, spiritual aspect, etc. include emotion aspect in mesuring the degree of stress. Because the effect of pre-medication was not controled in research design, I suggest that repeated studies are needed include the pre-medication, furthermore the studies which combine the self-report method and the physiological maker of mesuring the degree of stress are necessary for the future study.
Anxiety* ; Depression* ; Education ; Hospitals, General ; Humans ; Incheon ; Nursing ; Patient Care ; Research Design ; Seoul ; Statistics as Topic ; Surveys and Questionnaires

PURPOSE: The present study is a descriptive cross-sectional study of cause-and-effect relationship, which used the 7th year data of the Panel Study on Korean Children, to investigate the effects of parenting stress, depression, and family interactions of the parents of early school-age children on children's subjective happiness. METHODS: The present study included data of 1419 pairs of parents who participated in the mother and father survey of the Panel Study on Korean Children. The effects of parenting stress, depression, and parental family interactions on children's subjective happiness were analyzed as actor and partner effects using path analysis. RESULTS: Parenting stress had an actor effect on depression; maternal parenting stress (β=−.21, p < .001) and depression (β=−.30, p < .001) had an actor effect on maternal family interaction; and paternal parenting stress (β=−.18, p < .001) and depression (β=−.17, p < .001) had a partner effect on maternal family interaction. Paternal parenting stress was found to have an actor effect on paternal family interaction (β=−.30, p < .001), and parental depression was found to have actor effect (β=−.23, p < .001) and maternal depression had a partner effect on paternal family interactions (β=−.22, p < .001). Children's subjective happiness was found to have a statistically significant relationship with maternal family interaction (β=.40, p < .001). CONCLUSION: The significance of the study is in its provision of basic data for adjusting parents' family interactions that are closely related to the growth and development of children by confirming the effect of parents' parenting stress, depression, and family interaction on children's subjective happiness.
Child ; Cross-Sectional Studies ; Depression ; Fathers ; Growth and Development ; Happiness* ; Humans ; Mothers ; Parenting ; Parents*

We reviewed 7 cases of congenital mesoblastic nephroma (4 cases of classical mesoblastic nephroma (CMN) and 3 cases of atypical mesoblastic nephroma (AMN)) using immuno-histochemical and flow cytometric study. Results are as follows. 1) The mean tumor size was 5 (3 to 7cm)cm in CMN and 9 (7 to 10cm)cm in AMN. The AMN revealed hemorrhage and necrosis in two Of three cases. A case of AMN showed cystic change without hemorrhage and necrosis. Mitotic count ranged in 0~4/10HPF in CMN and 20-35/10HPF in AMN. 2) Immunohistochemistry for vimentin was all positive. Actin, desmin were weakly positive in CMN, but negative in AMN. The findings were consistent with myofibroblastic differentiation in CMN and AMN was considered to be the less differentiated form of CMN. 3) Flow cytometiic analysis showed diploidy in two of two CMNs and two of three AMNs. Only one AMN showed aneuploidy with DNA index of 1.41. %SG2M were 8.1 and 15.9 (mean 12.0) in CMN and 16.9, 32.9 and 19.3 (mean 22.9) in AMN, respectively. We concluded that AMN should be distinguished from CMN, clinicopathologically.