The immunohistochemical expression of transforming growth factor-beta(TGF-beta), epidermal growth factor(EGF) and alpha-1-antitrypsin(AAT) was studied in 47cases of endoscopic biopsy matearials of gastric carcinoma to determine me correlation to the expression of alpha fetoprotein(AFP). And immunoreactivity of the antigens was correlated to me degree of tumor infiltrating lymphocytes and histologic differentiation of the tumors. And the results were analyzed to elucidate pathological AFP-producing gastric cancer. The results were summarized as follows. AFP immunoreactivity was demonstrated in 30 cases(63.8%) of the tumors, TGF-beta in 26 cases(55.3%), EGF in l4 cases(29.8%) and AAT in l0 cases(21.3%). The incidence of expression of the antigens was significantly higher in the cases of elevated serum AFP(>2ng/ml) than that of the cases with normal serum AFP(p<0.05). There was no relation between the expression of antigens and histological differentiation of gastric cancer. The expression of AFP and TGF-beta revealed good correlation(k=0.72). The relation between expression of TGF-beta and AAT and the degree of tumor infiltrating lymphocytes disclosed negative correlation(p<0.05). These results suggest that TGF-beta and AAT prodution contribute to the worse prognosis of AFP-producting gastric cancer. Possible immunosuppressive action of TGF-beta and AAT in the cancer tissue is discussed.
Incidence ; Biopsy ; Stomach Neoplasms

We report two cases of recurrent extramarnmary Pagets disease after wide local excision. Both cases involved the scrotum and the penoserotal junction, respectively. On histopathological examination, we could observed many Paget cells confined to the epidermis and the hair follicle, but not invading the underlying dermis in both cases. There was no evidence of internal malignancy. Both cases were treated with wide local reexcision.
Dermis ; Epidermis ; Hair Follicle ; Paget Disease, Extramammary* ; Scrotum

Epidural anesthesia for cesarean section requires sensory blockade up to T4 level. 18 to 20 ml of 0.5% bupivacaine, 1.5 to 2.0% lidocaine, or 3.0% chloropmcaine usually produces an adequate sensory blockade to T4 level. However, when we used that amount of local anesthetics, most of the patients often complained of mild to moderate pain or discomfort during delivery of baby, manipulation of peritoneum or the uterus. So we feeled the need of increase in dosage of local anesthetics and we used 26 ml of local anesthetics or local anesthetic-fentanyl mixture. This study was undertaken to measure plasma concentration of lidocaine and observe the possible systemic toxicity of local anesthetics with the total dosage of beyond maximum recom-mended dose. Epidural anesthesia were performed with a 17 gauge Tuohy needle and local anesthetics were injected as follows. Group 1 (n;17): 0.5% bupivacaine 100 mg+2% lidocaine 80 mg+fentanyl 100 ug (50 ug/ml) Group 2 (n; 15): 2% lidocaine 520 mg without epinephrine Group 3 (n; ll): 2% lidocaine 480 mg + fentanyl 100 ug All groups were received 26 ml of local anesthetics or local anesthetic-fentanyl mixture. We checked the level of anesthesia, length of spinal column, cardiovascular changes, plasma concen- tration of lidocaine, toxic systemic reactions and patient's complaints. The plasma concentration of lidocaine were measured by immunofluorescence assay at 2, 5, 7, 10, 12 and 15 minutes after injection of local anesthetics. The results were as follows; 1) The peak plasma concentration of lidocaine were measured 12 minutes after administration of local anesthetics in the group 2 and 3. 2) Sensory blockade up to T4 level could be accomplished within 10 minutes after epidural anesthesia in the group l. 3) In the group 2 and 3, onset of action was more rapid. These groups had a tendency to fall in blood pressure than the group 1, but recovered soon with small dose of ephedrine. 4) In one patient, maximum peak plasma concentration of hdocaine was 6.8 ug/ml, but no adversereaction was observed. Above results suggested that 26 ml of local anesthetics in all groups could be used for appropriate anesthesia for cesarean section with minimal camplications and patient's satisfaction.
Anesthesia ; Anesthesia, Epidural* ; Anesthetics, Local* ; Blood Pressure ; Bupivacaine ; Cesarean Section* ; Ephedrine ; Epinephrine ; Female ; Fentanyl ; Fluorescent Antibody Technique ; Humans ; Lidocaine ; Needles ; Peritoneum ; Plasma* ; Pregnancy ; Spine ; Uterus

Epidural anesthesia for cesarean section requires sensory blockade up to T4 level. 18 to 20 ml of 0.5% bupivacaine, 1.5 to 2.0% lidocaine, or 3.0% chloropmcaine usually produces an adequate sensory blockade to T4 level. However, when we used that amount of local anesthetics, most of the patients often complained of mild to moderate pain or discomfort during delivery of baby, manipulation of peritoneum or the uterus. So we feeled the need of increase in dosage of local anesthetics and we used 26 ml of local anesthetics or local anesthetic-fentanyl mixture. This study was undertaken to measure plasma concentration of lidocaine and observe the possible systemic toxicity of local anesthetics with the total dosage of beyond maximum recom-mended dose. Epidural anesthesia were performed with a 17 gauge Tuohy needle and local anesthetics were injected as follows. Group 1 (n;17): 0.5% bupivacaine 100 mg+2% lidocaine 80 mg+fentanyl 100 ug (50 ug/ml) Group 2 (n; 15): 2% lidocaine 520 mg without epinephrine Group 3 (n; ll): 2% lidocaine 480 mg + fentanyl 100 ug All groups were received 26 ml of local anesthetics or local anesthetic-fentanyl mixture. We checked the level of anesthesia, length of spinal column, cardiovascular changes, plasma concen- tration of lidocaine, toxic systemic reactions and patient's complaints. The plasma concentration of lidocaine were measured by immunofluorescence assay at 2, 5, 7, 10, 12 and 15 minutes after injection of local anesthetics. The results were as follows; 1) The peak plasma concentration of lidocaine were measured 12 minutes after administration of local anesthetics in the group 2 and 3. 2) Sensory blockade up to T4 level could be accomplished within 10 minutes after epidural anesthesia in the group l. 3) In the group 2 and 3, onset of action was more rapid. These groups had a tendency to fall in blood pressure than the group 1, but recovered soon with small dose of ephedrine. 4) In one patient, maximum peak plasma concentration of hdocaine was 6.8 ug/ml, but no adversereaction was observed. Above results suggested that 26 ml of local anesthetics in all groups could be used for appropriate anesthesia for cesarean section with minimal camplications and patient's satisfaction.
Anesthesia ; Anesthesia, Epidural* ; Anesthetics, Local* ; Blood Pressure ; Bupivacaine ; Cesarean Section* ; Ephedrine ; Epinephrine ; Female ; Fentanyl ; Fluorescent Antibody Technique ; Humans ; Lidocaine ; Needles ; Peritoneum ; Plasma* ; Pregnancy ; Spine ; Uterus

PURPOSE: The purpose of this study is to analyze the CT features of the cystic masses in the neck and to review differential diagnosis. MATERIALS AND METHODS: We retrospectively reviewed and analyzed the CT findings of 22 histopathologically proved, cystic neck masses in regard to the location in fascial plane and relationship with adjacent organ. RESULTS: Of 22 cases, ten congenital cysts two ranulas, seven inflammatory lesions, and three solid tumors were includded. Ten congenital cystic masses were located in typical locations as branchial cleft cyst(5) in mandibular angle, thyroglossal duct cyst(3) in visceral space embeded within the strap muscles, cystic hygroma(1) and cavernous hemangioma(1) in posterior cervical space with insinuating appearance. Two cases of ranula included one simple ranula localized in sublingual space and a plunging ranula extending to adjacent submandibular space. Seven cases of inflammatory lesions were characterized by multispatial locations and good contrast-enhancement of walls and adjacent tissue. Solid masses of low density mimicking cyst were two pleomorphic adenomas of submandibular gland and one neurilemmoma. CONCLUSION: It is considered that thorough analysis of the CT findings with attention to typical location, CT appearance, and the relationship with the adjacent structures usually leads to the correct diagnosis.
Adenoma, Pleomorphic ; Branchial Region ; Diagnosis ; Diagnosis, Differential* ; Muscles ; Neck* ; Neurilemmoma ; Ranula ; Retrospective Studies ; Submandibular Gland

PURPOSE: Research related to social support in Korea has been hampered by paucity of measurement tools reflecting Korean culture. The aim of the study was to develop Korean social support questionnaire (KSSQ) based on the Korean social support pyramid and to test psychometric properties of the KSSQ. METHODS: The questionnaire was administered to 701 subjects and 658 college students. Psychometric analyses included factor analyses, expert validity, criterion-related validity, internal consistency, and test-retest reliability. RESULTS: A principal components analysis support for construct validity, eliciting a three factor solution accounting for 65.46% of variance in scores. Concurrent and discriminant validity supported criterion-related validity. Internal consistency of reliability was support with Cronbach's alpha of .97-.98 for the entire scale. Test-retest reliability was .76. CONCLUSION: This initial testing of KSSQ to measure Korean social support demonstrates evidence of reliability and validity. Assessment of known-group validity and norm establishment of KSSQ are suggested to provide further sound psychometric properties and practical measurement tools.
Adolescent ; Adult ; Female ; Humans ; Korea ; Male ; Middle Aged ; *Psychometrics ; *Questionnaires ; *Social Support ; Students/psychology ; Universities ; Young Adult

PURPOSE: A structural equation model was analysed to explore the determinants of health behaviors of university students in Korea. METNOD: Nine hundred sixty nine university students were selected by random cluster sampling from five universities located in the central area of Korea. DATA COLLECTION: The data was collected by questionnaires about demographic characteristics, stressful life events, perceived social support, perceived health status and health behaviors. RESULTS: 1. Gender showed indirect effect on health behaviors. 2. Living together with(out) family had a direct effecton health behaviors: students living with family showed more positive health behaviors. 3. Stressful life events had an indirect effect on health behaviors via perceived health status;a higher score of stressful life events was the predictor for negative health behaviors. 4. A higher score of perceived health status predicted positive health behaviors. RECOMMENDATION: Each university should be encouraged to develop a health behavior control program and health promotion program for their own university students. It would be more effective to develop health programs separately according to the demographic or social characteristics of the students. It is also necessary for the Ministry of Education to reform the School Health Act and school health policy to strengthen a health promotion program for university students. In conclusion, following studies should identify and promote the validity and reliability of perceived health status and health behaviors measurements.
Adult ; Attitude to Health ; Female ; *Health Behavior ; Health Status ; Humans ; Korea ; Life Change Events ; Male ; Social Support ; *Students/psychology ; Universities

PURPOSE: This cross-sectional study was designed to explore the relationship among social support, experienced stressful life events and health behaviors of Korean undergraduate students, and validate the mediator effect of social support. METHOD: One thousand four hundred fifty-three undergraduate students were randomly selected from five universities located in the middle area of Korea. RESULT: The health behaviors of Korean undergraduates tend to have unhealthy patterns. In the case of the students living without family, experiencing more stressful life events and perceiving lower social support, health behaviors are poor. The relationship between perceived social supports, the frequency of the experienced stressful life events and the score of health behavior patterns is statistically significant. After controlling the effect of social support, the correlation coefficient between the frequency of experienced stressful life events and the score of health behavior patterns was slightly lower. The score of health behaviors between the group with an extremely high score of social support and the group with an extremely low score were statistically significantly different. CONCLUSION: Future studies need to be pursued to develop various strategies such as a health education programs and counseling programs for health maintenance and health promotion of undergraduates.
Counseling ; Cross-Sectional Studies ; Health Behavior* ; Health Education ; Health Promotion ; Humans ; Korea

BACKGROUND: The role of cutaneous bacterial flora in eczematous dermatitis has been discussed for decades. Areas of active dermatitis in patients with atopic dermatitis(AD) are known to be heavily colonized with Staphylococcus aureus. The density of S. aureus is correlated with the severity of AD. S. aureus is considered to be an exacerbating factor in this disease. The bacterium interferes in the inflammatory process of atopic dermatitis in various ways, among which the ability to release superantigens in a high percentage of clinical isolates is of great importance. OBJECTIVE: The purpose of this study was to evaluate the microbiology of the skin of the patients with AD and non-atopic dermatitis(NAD). We compared bacterial colonization of AD with those of NAD and healthy controls(HC). METHODS: Cutaneous organisms were obtained using Tape method from the worst lesion and uninvolved forearm skin of 30 patients with AD, 25 patients with NAD and 30 individuals as HC. Bacterial growth was examined in aerobic culture and the counts of colony forming unit(CFU) were estimated. The sensitivity to ten antibiotics of the bacteria isolated was also tested. RESULTS: 1.S. aureus colonizations of the eczematous skin were found in 19 of 30 AD patients(63%) and in 9 of 25 NAD patients(36%). The difference between the two groups was statistically significan t(p=0.076, alpha<0.1). 2.In AD patients, the frequencies of S. aureus colonizations revealed 63%(19 of 30) in the lesion and 60%(18 of 30) in uninvolved skin, which were significantly higher than 33%(10 of 30) of HC(p<0.05). 3.The frequency of S. aureus colonizations in the lesions of NAD patients revealed 36%, which was not significantly higher than 33% of HC(p=0.836). 4.Coagulase negative strains of staphylococcus were found in 20 of 30 HC(66%) and 17 of 25(68%) uninvolved skin of NAD patients(68%) compared with 12 of 30 uninvolved skin of with AD(40%). 5.In AD patients with positive nasal colonization with S. aureus, the frequencies of S. aureus colonization in the lesion and uninvolved skin were increased in significance compared with patients with negative nasal colonization(p<0.05). And total counts of CFU in the lesion and uninvolved skin of AD patients were significantly higher compared with HC(p<0.05). 6.Total counts of CFU correlated with severity of dermatitis. CONCLUSION: Colonization of S. aureus was significnatly increased in the skin of AD patients compared with healthy controls. As the severity of the AD lesions increased, the numbers of S. aureus isolated increased. These results support the role of S. aureus in the AD described in the previous reports. Tape method had the advantage of being inexpensive, quick and straightforward to prepare, easy for the clinician to use and was well tolerated by children. It is hoped that the result of this study and the availability of Tape method in the culture of bacteria of the skin will facilitate and promote investigations of pathophysiology and treatment of eczematous dermatitis as well as AD.
Anti-Bacterial Agents ; Bacteria ; Child ; Colon ; Dermatitis* ; Dermatitis, Atopic* ; Eczema ; Forearm ; Hope ; Humans ; NAD ; Skin ; Staphylococcus ; Staphylococcus aureus ; Superantigens

PURPOSE: The purpose of this study was to identify the teaching effectiveness and adequacy of practical training in nursing students. METHODS: This descriptive research was conducted using a convenience sampling. The sample consisted of 619 nursing students with experience in practical training among five colleges, located in four cities. The data collection was performed using self-reported questionnaires. Research tools, developed by Kim (1996), were used to measure the effectiveness of clinical instructors and the adequacy of practical training developed by researchers. The data was analyzed using SPSS 20.0. RESULTS: The average of teaching effectiveness was 3.43 (out of 5) and adequacy of practical training was 3.33 (out of 5). Teaching effectiveness and adequacy of practical training showed a significant positive correlation (r=.74, p<.001). Teaching effectiveness and each sub-area: adequacy of practical training, practical contents (r=.59, p<.001), practical attitude (r=.45, p<.001), practical instructor (r=.62, p<.001), practical environment (r=.46, p<.001), and practical evaluation (r=.64, p<.001), revealed a significant positive correlation. CONCLUSION: Nursing students prefer the actual training from professors who are more professional and clinical experienced. Professors presenting the theory lectures should also be aware of clinical practice so that education can be more professional and effective in terms of clinical practice.
Data Collection ; Education ; Humans ; Lectures ; Nursing* ; Students, Nursing*