Nurses working with families who has a hospitalized child are aware of the complexity of the tasks and stresses they deal with new setting of environment. The challenge is to assess the family coping activity that require the most immediate intervention for the effective nursing care for child and family. This study describe the family coping inventory for the clinical guidance to identify a family coping with stressors. The purpose of this study was to look at the factors related to the family's coping activity when the child was hospitalized. The data were collected with a questionnaire between July and August, 1999, in a sample of 106 families who have hospitalized child. Family coping was assessed using Family Crisis Oriented Personal Evaluation Scale(F-COPES). Data was analyzed using correlation coefficent and analysis of variance. Positive correlation was found between social support, reframe with mobilizing the family to acquire and accept help in sub-domain of family coping. Strongest correlation existed between the family's spiritual support and total family coping. The type of diagnosis, the level of family income, religion, and child's age were significantly different in family coping. The result show that the family coping is affected by the characteristics of child and family, as well as the factors of coping activity. Therefore, early assessment of family coping skill and activity is important to the prevention of problem with function toward wholeness as a unit and child's well being. It can be used with a broad range of child's hospitalization process. It also serve as a nursing record and planning tool for documenting issues that may become priorities for future interventions.
Adaptation, Psychological ; Child ; Child, Hospitalized* ; Diagnosis ; Hospitalization ; Humans ; Nursing Care ; Nursing Records ; Child Health ; Surveys and Questionnaires

In this study, we report that an acute phase reactant, serum amyloid A (SAA), strongly inhibits dendritic cell differentiation induced by GM-CSF plus IL-4. SAA markedly decreased the expression of MHCII and CD11c. Moreover, SAA decreased cell surface GM-CSF receptor expression. SAA also decreased the expression of PU.1 and C/EBPα, which play roles in the expression of GM-CSF receptor. This inhibitory response by SAA is partly mediated by the well-known SAA receptors, Toll-like receptor 2 and formyl peptide receptor 2. Taken together, we suggest a novel insight into the inhibitory role of SAA in dendritic cell differentiation.
Dendritic Cells* ; Granulocyte-Macrophage Colony-Stimulating Factor* ; Interleukin-4 ; Receptors, Formyl Peptide ; Receptors, Granulocyte-Macrophage Colony-Stimulating Factor* ; Serum Amyloid A Protein* ; Toll-Like Receptors

BACKGROUND: Colorectal cancer is the third most common cancer in the world and the fourth most common cancer in Korea. The incidence of colorectal cancer is increasing steadily in Korea. In some countries, mortality rates have started to decline, and survival rates have increased. The survival rates of colorectal cancer is increasing due to early detection and to advances in adjuvant therapy. METHODS: This analysis studied colorectal cancer patients who had been operated on at Eul-Ji Medical college Hospital from Jan. 1991 to Dec. 1996. We analyzed the 5-year survival rate according to age, sex, duration of symptoms, stage, resectability, and histopathologic differentiation by the Kaplan- Meier method. RESULT:Age (p=0.482), sex (p=0.394), duration of Symptoms (p=0.346), and tumor location (p=0.685) did not appear to be statistically significant as prognostic factors. The 5-year survival rates according to the Dukes' stage were as follows:stage A (100%), stage B (77.7%), stage C (47.4%), and stage D (0.0%). The 5-year survival rates showed 8.2% in palliative resected cases and 67.2% in radical resected cases. In 139 radically resected adenocarcinoma cases, the 5-year survival rates were 73.4% of the highly differentiated cases, 67.6% of the moderately differentiated cases, and 35.7% of the poorly differentiated cases (p=0.043). CONCLUSION:Early diagnosis, well differentiation, and radical resection were significant as prognostic factors in our result. We could confirm that early diagnosis and radical resection are necessary to increase the survival rate in patients with colorectal cancer.
Adenocarcinoma ; Colorectal Neoplasms* ; Diagnosis ; Early Diagnosis ; Humans ; Incidence ; Korea ; Mortality ; Survival Rate*

Among the bronchogenic carcinomas, especially squamous cell carcinoma and large cell carcinoma frequently present with cavitation, which may result from tumor necrosis. Cavitary lesions of the tumor are occasionally associated with infection and misdiagnosed as benign lung abscess owing to the partial responsiveness to antibiotics. It is very difficult to distinguish the carcinomatous abscess from the benign lung abscess, because of their similar clinical and radiologic features. Delay in diagnosis of underlying lung cancer may result in poor outcome. Therefore, clinicians should remember that the patients with highly suspicious carcinoma of the lung should undergo further precise examinations to find out malignant cells.
Abscess ; Anti-Bacterial Agents ; Carcinoma, Bronchogenic ; Carcinoma, Large Cell ; Carcinoma, Squamous Cell ; Humans ; Liver Abscess ; Lung ; Lung Abscess ; Lung Neoplasms ; Necrosis

The middle mediastinum contains several important organs and pluripotent cells. It is difficult to make a definitive diagnosis in patients with middle mediastinal tumors due to a wide range of diseases. The likelihood of malignancy is influenced primarily by the following factors: patient age, size, tumor location, and the presence or absence of symptoms. We describe a case of a middle mediastinal tumor, which was suspected on chest x-ray; chest computed tomography revealed the eccentric mass of distal esophagus. This case emphasizes the diagnostic importance of the chest x-ray to the physicians. The possible differential diagnoses are reviewed.
Diagnosis, Differential ; Esophagus ; Humans ; Leiomyoma ; Mediastinal Neoplasms ; Mediastinum ; Thorax

The ulcerative colitis is a chronic inflammatory bowel disease with an unknown etiology. The major symptoms of ulcerative colitis are diarrhea, abdominal pain and hematochezia. However, arthritis, skin disorders, hepatobiliary inflammation and uveitis are occasionally recognized as systemic complications. Although there are few reports of coexistent pulmonary and inflammatory bowel disease, the lung is not generally considered to be a target organ in ulcerative colitis. We report a patient with ulcerative colitis-related bronchilolitis obliterans organizing pneumonia confirmed by video-assisted thoracoscopic surgery, who responded to corticosteroid therapy.
Abdominal Pain ; Arthritis ; Colitis, Ulcerative ; Cryptogenic Organizing Pneumonia ; Diarrhea ; Gastrointestinal Hemorrhage ; Humans ; Inflammation ; Inflammatory Bowel Diseases ; Lung ; Pneumonia ; Skin ; Thoracic Surgery, Video-Assisted ; Ulcer ; Uveitis

Bronchobiliary fistula is a rare disorder consisting of an abnormal communication between the bronchial tree and the biliary duct. In Western countries, trauma, postoperative biliary stenosis, and biliary lithiasis are the predominant causative factors of bronchobiliary fistula. Bilioptysis (bile stained sputum) is a pathognomic finding for bronchobiliary fistula. To date, there are just a few reported cases of bronchobiliary fistula after sclerosis of a liver cyst. We describe the case of a 74-year-old woman who developed bronchobiliary fistula after sclerosing therapy of a liver cyst. The diagnosis was confirmed by the presence of bilioptysis and the chest and dynamic liver CT findings. The patient was successfully treated with antibiotics and percutaneous transhepatic catheter drainage.
Aged ; Anti-Bacterial Agents ; Catheters ; Constriction, Pathologic ; Drainage ; Female ; Fistula ; Humans ; Lithiasis ; Liver ; Sclerosing Solutions ; Sclerosis ; Thorax

We report a case of Mycobacterium intracellulare pulmonary infection presenting as a solitary pulmonary nodule (SPN). A 35-year-old male was admitted due to a SPN in the right upper lobe which was detected on the chest radiography being examed due to recurrent cough for 1 year. The computed tomography (CT) revealed a spiculated nodule containing air-bronchogram, which was suspicious of malignancy. We performed transbronchial biopsy and the pathology showed granulomatous inflammation with caseous necrosis. Under the presumptive diagnosis of pulmonary tuberculosis, we started anti-tuberculous medication including isoniazid, rifampin, ethambutol, and pyrazinamide. In one month, however, the sputum culture was positive for Mycobacterium intracellulare. The follow-up chest CT showed slight aggravation of the previous lesions. Under the final diagnosis of Mycobacterium intracellulare pulmonary infection presenting as a solitary pulmonary nodule, we changed the regimen to rifampin, ethambutol, and clarithromycin. The follow-up chest CT after the completion of treatment, revealed resolution of the previous lesions.
Adult ; Biopsy ; Clarithromycin ; Cough ; Ethambutol ; Follow-Up Studies ; Humans ; Inflammation ; Isoniazid ; Lung ; Lung Diseases ; Male ; Mycobacterium avium Complex ; Mycobacterium Infections, Nontuberculous ; Necrosis ; Pyrazinamide ; Rifampin ; Solitary Pulmonary Nodule ; Sputum ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary

We report a case of Mycobacterium intracellulare pulmonary infection presenting as a solitary pulmonary nodule (SPN). A 35-year-old male was admitted due to a SPN in the right upper lobe which was detected on the chest radiography being examed due to recurrent cough for 1 year. The computed tomography (CT) revealed a spiculated nodule containing air-bronchogram, which was suspicious of malignancy. We performed transbronchial biopsy and the pathology showed granulomatous inflammation with caseous necrosis. Under the presumptive diagnosis of pulmonary tuberculosis, we started anti-tuberculous medication including isoniazid, rifampin, ethambutol, and pyrazinamide. In one month, however, the sputum culture was positive for Mycobacterium intracellulare. The follow-up chest CT showed slight aggravation of the previous lesions. Under the final diagnosis of Mycobacterium intracellulare pulmonary infection presenting as a solitary pulmonary nodule, we changed the regimen to rifampin, ethambutol, and clarithromycin. The follow-up chest CT after the completion of treatment, revealed resolution of the previous lesions.
Adult ; Biopsy ; Clarithromycin ; Cough ; Ethambutol ; Follow-Up Studies ; Humans ; Inflammation ; Isoniazid ; Lung ; Lung Diseases ; Male ; Mycobacterium avium Complex ; Mycobacterium Infections, Nontuberculous ; Necrosis ; Pyrazinamide ; Rifampin ; Solitary Pulmonary Nodule ; Sputum ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary

When all the conventional treatments have failed for patients with acute respiratory distress syndrome (ARDS), extracorporeal membrane oxygenation (ECMO) can offer these patients a chance to survive. We report here on a case of successful treatment with prolonged ECMO support for a patient with severe ARDS. A 41-year-old female patient with acute A-viral hepatitis developed pneumonia and progressive ARDS. After tracheostomy, her clinical condition deteriorated despite proper antibiotic administration and other conventional treatments, including the recruitment maneuver and steroid use. Venoarterial ECMO was given for the management of refractory hypoxemia that developed 14 days after the initiation of mechanical ventilation. The duration of ECMO support was 4 weeks, and she was successfully weaned off ECMO and mechanical ventilation.
Adult ; Anoxia ; Extracorporeal Membrane Oxygenation ; Female ; Hepatitis ; Humans ; Critical Care ; Pneumonia ; Respiration, Artificial ; Respiratory Distress Syndrome, Adult ; Tracheostomy