The Carneys complex is a multisystemic tumorous disorder that features myxoma(heart, skin, and breast), spotty skin pigmentation(cutaneous and mucocutaneous), endocrine tumors(adrenal, testicular, and pituitary) and peripheral nerve tumors. The criteria far diagnosis of the complex is the presence of two or more of the above conditions. The condition is transmitted as an autosomal dominant trait. The most serious components of the syndrome are cardiac myxoma and psammomatous melanotic schwannoma. The cutaneous manifestations are a major clue in the disorder. We report a case of Carneys complex in a 19-year-old woman. She had spotty pigmentation on her face, left atrial myxoma, and myxoma on her right nipple. Her mother and sister had left atrial myxoma.
Diagnosis ; Female ; Humans ; Mothers ; Myxoma* ; Neurilemmoma ; Nipples ; Peripheral Nervous System Neoplasms ; Pigmentation ; Siblings ; Skin ; Young Adult

The purpose of the study was to investigate the characteristics of the clients registered in the department of home health care nursing in a hospital and to analyze nursing intervention activities recorded in charts by application of Nursing Intervention Classification (NIC) system. For the descriptive survey study, data were collected by reviewing charts of 572 home health care clients between May, 1997 and July, 2000 at K hospital in Seoul. The average age of the clients was 66 years and the number of clients in their 70s ranked first with 28.2 percent(158 people). The mean length of home care service was 47 days with the highest frequency of less than four weeks (56 %). With regard to medical diagnosis, cancer showed the highest frequency (48%, 271 people), followed by cerebrovascular disease (19%), and pulmonary disease (6.9%). According to analysis of nursing interventions by the NIC system, the most frequently used nursing interventions in level 1 were interventions in the Physiological: Complex domain which were used 3,663 times (33%) among 11,107 total interventions. The Safety domain was the second most frequently used intervention, followed by the Physiological: Basic, and the Behavioral domains. In level 2, the Risk Management class was the most frequently used interventions with 3,108 interventions (27.9%), followed by Drug Management, and Tissue Perfusion Management classes. In level 3 interventions, Vital Sign Monitoring was the most frequently used intervention, 569 times (5.1%), followed by Health Screening, and Neurological Monitoring interventions. In sum, half of the clients in the study had cancer and were in their 70s. The most frequent reason for ending home care was death (40%), followed by readmission (28%). These findings represent clients with severe conditions referred to the home care nursing department as it was a University teaching hospital. Further research on analyzing nursing interventions performed in each institution needs to be conducted to develop a standardized list of nursing interventions to use in home health care settings.
Classification ; Delivery of Health Care* ; Diagnosis ; Home Care Services ; Home Health Nursing ; Hospitals, Teaching ; Lung Diseases ; Mass Screening ; Nursing* ; Perfusion ; Risk Management ; Seoul ; Vital Signs

PURPOSE: The best predictors of prognosis in prostate cancer are the stage of disease and histologic differentiation. But, preoperative prediction of pathologic stage in prostate cancer is currently limited and histologic differentiation may be somewhat subjective. Therefore, more accurate predictors of biological progression are needed. The author designed this study to determine the prediction efficacies of neovascularity and proliferating cell nuclear antigen (PCNA) labeling index using immunohistochemical staining. MATERIALS AND METHODS: Immunohistochemical stains in 48 cases of prostate cancers and 5 cases of benign prostatic hyperplasia (BPH) were performed and analysed. Microvessels were identified by immunostaining of endothelial cells for factor VIII-related antigen. PCNA labeling indices were obtained in 200X field by counting more than 1,000 cells. RESULTS: 1. The mean microvessel count (MVC) was 34.2+/-5.9 per 200X field in BPH group and 63.5+/-38.6 (p<0.05) in prostate cancer group. The mean MVCs were 32.2, 38.3, 58.8, 78.1 and 86.8, from grade I to V respectively. According to stage, the mean MVCs were 40.8, 48.5, 55.0 and 89.0 from A to D. Between well (grade I-III) and poorly (grade IV-V) differentiated cancer group, there was significant difference in MVC (p<0.05). And also, the difference between localized and metastatic groups was statistically significant. High MVC (MVC->60) group survived longer than low MVC group, but the difference was not significant. 2. The mean PCNA labeling indices were 14.6+/-8.0% in BPH group and 32.3 +/- 15.4% in cancer group. According to Gleason grade, the mean PCNA labeling indices showed 33,4%, 30.8%, 26.3%, 38.0% and 36.6% from I to V respectively. The mean values were 23.1%, 27.4%, 30.4% and 36.2% in stage A, B, C and D. Between localized and metastatic groups, the difference of PCNA labeling index was not statistically significant. The mean survival of high labeling index (>=30%) group was 66.0 +/- 12.2 months contrasted with 72.4 +/- 14.6 months of low labeling index group (p>0.05). CONCLUSIONS: Microvessel density in prostate adenocarcinoma may be an another prognostic factor supporting clinical stage and histologic differentiation. But negative results were obtained for PCNA labeling index from this study. To further define MVC as a predictor of prostate cancer, more enthusiastic and well designed studies are needed.
Adenocarcinoma ; Coloring Agents ; Endothelial Cells ; Microvessels ; Neoplasm Metastasis* ; Prognosis* ; Proliferating Cell Nuclear Antigen* ; Prostate* ; Prostatic Hyperplasia ; Prostatic Neoplasms ; von Willebrand Factor

Multiple fixation techniques for arthrodesis of the ankle and hindfoot have been introduced. The cannulated screw fixation provides excellent internal compression for arthrodesis. We used 5.0 and 6.5mm cannulated screws for seven ankle, seven subtalar, four tibiotalocalcaneal, three pantalar and two triple arthrodesis between January 1994 and September 1995. No iliac bone graft was utilized. The follow-up period was from 12 to 25 months. Ages of the patients ranged from 25 to 58 years. All fused except one who was preoperatively diagnosed as pyogenic arthritis of the ankle and hindfoot. One patient with diagnosis of Streeter's disease was complicated with partial necrosis of the forefoot. We think this procedure has several advantages; 1. The leg or foot length is largely preserved because minimal subchondral bone is removed. So, the leg and foot is aesthetically pleasing and the musculature around the ankle and foot can be maintained in the normal balanced position. 2. The rate of fusion is high, because the soft tissues are minimally stripped and cannulated screw compresses the subchondral bone surface. 3. The cannulated screws rarely requires removal. So, we believe that the cannulated screw fixation for the ankle and hindfoot arthrodesis is an excellent treatment method.
Ankle* ; Arthritis ; Arthrodesis* ; Diagnosis ; Follow-Up Studies ; Foot ; Humans ; Leg ; Necrosis ; Transplants

PURPOSE: To compare the two transscleral fixation (TSF) techniques of intrascleral pocket and conventional scleral flap with conjunctival division techniques in terms of short-term clinical effects. METHODS: This retrospective cohort study included all consecutive patients with aphakia in Gyeongsang National University Hospital in Jinju, Korea, who underwent TSF between January 2012 and December 2014. The medical records of all patients were retrospectively reviewed, and the endothelial cell count (ECC), refraction, best-corrected visual acuity (BCVA), intraocular pressure, slit lamp, and fundus examination results before and 1 day and 6 months after surgery were recorded. The postoperative complications and visual outcomes were also recorded. RESULTS: The intrascleral pocket and conventional-flap groups did not differ significantly in terms of demographics, presurgical BCVA, or ECC. However, the intrascleral pocket group had a significantly lower BCVA at 1 day and 6 months after surgery compared to the conventional-flap group. The two groups did not differ in terms of ECC 6 months after surgery. The intrascleral pocket group had no postoperative complications, but five patients in the conventional-flap group complained of irritation. In both groups, the intraocular lens was well positioned without tilting or subluxation, and astigmatism was significantly reduced at 1 day and 6 months after surgery. CONCLUSIONS: The intrascleral pocket technique of TSF does not involve conjunctival dissection and is a successful method of sulcus fixation. It stably corrects the intraocular lens and is easy to perform, which helps to reduce operation time. It also reliably yields rapid visual acuity recovery without complications.
Aphakia ; Astigmatism ; Cohort Studies* ; Demography ; Endothelial Cells ; Gyeongsangnam-do ; Humans ; Intraocular Pressure ; Korea ; Lenses, Intraocular ; Medical Records ; Postoperative Complications ; Retrospective Studies* ; Visual Acuity

BACKGROUND: Cardiac arrhythmias and other cardiac dysfunctions occur in relation with acute cerebral ischemia. This study was undertaken to evaluate the sequential changes of electrocardiogram and cardiac enzymes after acute ischemic stroke, and to evaluate the incidence of cardiac arrhythmias. METHODS: Forty-three patients with acute ischemic stroke were recruited for this study. Electrocardiogram and cardiac enzymes were checked at 1, 3, 5, 7, 15, and 30 days after onset. RESULTS: Heart rates were decreased acutely after ischemic stroke and showed maximal decrease at day 3 (p<0.05). Heart rates were more significantly decreased in the right-sided lesions than the left (p<0.05) and in the supratentorial lesions than the infratentorial (p<0.05). PR intervals and durations of QRS complex were prolonged at day 3 and 5 but were not significant. The prolongation of the QTc interval was found in 21 patients (48.8%) and sustained QTc prolongation at day 30 were seen in 16 patients. Compared with controls, patients showed significantly higher incidence of arrhythmias (p<0.01). Creatine phosphokinase-MB (CK-MB) was significantly increased at day 5 (p<0.01) and lactic dehydrogenase (LDH) was increased at day 7 (p<0.01). CONCLUSIONS: In our study, the incidence of neurogenic cardiac abnormalities in acute ischemic stroke was higher than that of previous studies. Abnormalities peaked at days 3 and 5 were nearly similar to control levels at day 30. These periods of peak abnormalities coincided with those of increasing brain edema. Therefore, we postulate that cardiac autonomic controls are also influenced by acute brain edema. (J Korean Neurol Assoc 19(3):207~212, 2001)
Arrhythmias, Cardiac ; Brain Edema ; Brain Ischemia ; Cerebral Infarction ; Creatine ; Electrocardiography* ; Heart Rate ; Humans ; Incidence ; Oxidoreductases ; Stroke*

PURPOSE: To compare the choroidal thickness of unaffected and affected eyes in children with unilateral high myopia when measured using enhanced depth imaging and to analyze the relationship among choroidal thickness and axial length, spherical equivalent and best corrected visual acuity (BCVA). METHODS: Twenty children with high unilateral high myopia who received optical coherence tomography from December 2012 to May 2014 were retrospectively analyzed. Choroidal thickness was measured with a caliper at 500 microm apart from fovea superiorly and inferiorly, 2,500 microm apart nasally and at 2,500 microm apart temporally at 500 microm intervals. For statistical analyses, paired t-test was used for choroidal thickness and linear regression analysis for the relationship among choroidal thickness and axial length, spherical equivalent and BCVA. RESULTS: The patients were 10.4 +/- 3.5 years of age and the average BCVA of myopic eye was 0.38 +/- 0.2. Mean spherical equivalent was -9.8 +/- 1.9D. The choroidal thickness was significantly thinner in the myopic eye (102.5 +/- 16.9 microm) than the fellow eye (282.9 +/- 14.0 microm). The thickest choroid in the myopic eye was the temporal and the thinnest was the nasal area (p = 0.008). Choroidal thickness was significantly associated with axial length and spherical equivalent but not BCVA. CONCLUSIONS: Highly myopic eyes tend to have thinner choroidal thickness than the fellow eyes and choroidal thickness tends to be thicker temporally. Therefore, several anatomical changes in unilateral highly myopic children may exist.
Child* ; Choroid* ; Humans ; Linear Models ; Myopia* ; Retrospective Studies* ; Tomography, Optical Coherence ; Visual Acuity

PURPOSE: To evaluate the glaucoma discrimination ability of visual field index (VFI), a new perimetric index of Humphrey field analyzer II, in glaucoma patients with central and peripheral visual field defects (VFD). METHODS: Humphrey visual field test and OCT were performed in 204 glaucomatous eyes and 70 healthy eyes. The associations of VFI with mean deviation (MD), pattern standard deviation (PSD), and average retinal nerve fiber layer thickness (RNFLT) were analyzed using Pearson's correlation. The diagnostic abilities of the parameters were analyzed using the areas under the receiver operating characteristic curves (AUROC). The AUROC were compared between MD-matched patients with central VFD (at least one point with p < 1% within the central most 16 points of 30-2 SITA standard automated visual field) and peripheral VFD (VFD beyond the central most 16 points of 30-2 SITA standard automated visual field). RESULTS: The associations between analyzed parameters and VFI were statistically significant. The MD, RNFLT, age, intraocular pressure, and central cornea thickness were not different between the two groups (p > 0.05). The AUROC value of VFI was greater than those of the MD and average RNFLT but was not different from that of PSD (p = 0.332) in the central VFD group. However, there were no significant differences between AUROC value of VFI and those of other parameters in the peripheral VFD group (all, p > 0.05). CONCLUSIONS: The results from the present study suggest that VFI may be more useful than MD in diagnosing glaucoma, especially in patients with central VFD.
Cornea ; Discrimination (Psychology) ; Eye ; Glaucoma ; Humans ; Intraocular Pressure ; Nerve Fibers ; Retinaldehyde ; ROC Curve ; Visual Field Tests ; Visual Fields

The main purpose of this study was to examine factors related to exercise behavior of civil airmen. The subjects for the study were 200 civil airman including pilots, flight officers and flight engineers working for "A" airline in South Korea. The data was collected from April, 1 to 30, 1996 using a questionnaire that was developed for this study, and analyzed using SPSS(Statistical Package for Social Science). The subjects consisted of 200 males. The average age was 42 years old and the majority(82.5%) were married. The large proportion of subjects had received four years of college education or more(86%), and reported having a religion(71%). The average height and weight were 171.7cm and 69.4kg respectively. The average working period and total flight time were 8 years and 6002 hours respectively. Ninety-five percent of sample exercised regularly. As for the frequency of the exercise, 4% of the sample never exercised and 26% of the sample exercised less than once per week, while 44.5% and 24.5% of the sample exercised once or two times, and more than three times per week respectively. The type of exercise was strengthening (30.0%) and aerobic exercise such as jogging(54%), mountain climbing(37.5%) and golf(33.0%). Nearly three fourths of the sample were involved in more than the "light heavy" level of intensity(72.5%) and the average duration was 74.9 minutes. The following factors are related to the exercise behavior. 1) Age and marriage were positively related to exercise behavior(p<.05). 2) The cognitive/perceptual factor is related to exercise behavior. Those who perceived that their health was poor, that health was out of their control exercised less frequently. Also those who showed low self efficacy, and those who valued their health less exercised less frequently. 3) Among environmental factors, social support such as peers, spouse and media influenced exercise behavior. Also the use of a health center was related to a higher level of exercise behavior compared to self-regulated home exercise. Irregular duty was the higher barrier to exercise. 4) The type and intensity of exercise were related to exercise behavior, but not duration. Those who have been jogging or mountain climbing regularly, and those who exercised rather intensely showed a higher frequency of exercise. However, there was no difference in duration 5) The results of stepwise multiple regression analysis showed that the variables which were related to exercise behavior were exercise intensity, exercise place and whether the subject was married. These three factors accounted for 37% of the variance.
Adult ; Education ; Exercise ; Fibrinogen ; Humans ; Jogging ; Korea ; Male ; Marriage ; Self Efficacy ; Spouses ; Surveys and Questionnaires

PURPOSE: We studied the therapeutic effect and safety of transurethral prostatectomy (TURP) performed with improved instruments by a moderately experienced resectionist. PATIENTS AND METHODS: Clinical data of the 95 consecutive patients who underwent TURP by one surgeon from March 1995 to June 1997 were analyzed. During this period, a continuous-irrigation 26F TUR sheath with a 30-degree lens attached to a monitor screen was used in most patients. RESULTS: The average weight of the resected adenoma was 10.8 7.4 gm, and the resection time was 47.2 21.2 minutes. The average weight of tissue resected per minute was 0.23 0.13 gm. Six patients required transfusion, and four suffered operative complications (one bladder perforation, one bladder neck injury, and two urethral injuries that enforced prolonged catheterization). Postoperative complications developed in seven cases. The duration of postoperative urethral catheterization averaged 2.8 days. The maximal flow rate was improved from 11.3 mL/sec to 20.6 mL/sec. Subjective satisfaction was mentioned by 95.6% of patients (91/95). In comparison with data from the first authors former report, all differences in terms of resection speed, safety, and morbidity were statistically significant. The therapeutic efficacy of the operation with the new equipment seems to be superior to that of other less invasive procedures, and even in terms of complications and duration of catheterization, these results are comparable to those of other procedures. CONCLUSIONS: We think that TURP deserves to be the primary treatment modality for the patients with benign prostatic hyperplasia who need surgical therapy if the procedure is performed by a properly trained surgeon equipped with modern TUR instruments.
Adenoma ; Catheterization ; Catheters ; Humans ; Neck Injuries ; Postoperative Complications ; Prostatic Hyperplasia ; Transurethral Resection of Prostate* ; Urinary Bladder ; Urinary Catheterization ; Urinary Catheters