Nowadays administration of bone marrow transplantation is increasing state by developing society and high leukemia incidence. Decrease of relapse and infection rate result from chemo therapy drug development of treatment and strength. So we look for continuos development of treatment. But through before and after BMT, it takes several months by planing and HLA typing matching possibility of BMT. Also, it takes one or two month by duration of BMT and discharge. During BMT, patients experience emotional change-suggering, anxiety, depression and so on-due to changed body image and strictly isolation in special facility. After BMT, the patients also experience stress such as conditions self-care, support from family, concern of relapse risk and so far enlarge mental, economic and physical change surrounding them due to high cost. Accordingly nurses are required high quality of nursing attentive assesment, understanding of patient's environment and consideration, and teaching in administrative work. The study is attempted to establish nursing theory patients' experience in BMT treatment. Research method followed grounded theory methodology by strauss & Corbin. Subjects were 1 adolescent including highschool patient and 6 adults. This study continued from February 1996 through August 1996. All of these subjects were interviewed by this author. Interview were done by long interview technique and observation. Each interview took 1 hour to 2 hours Content of interview was recorded and transcribed later. The data thus collected were analyzed immediately after interviews and fed into the next round of interviews until the data collection reaches the saturation point. In the process of data analysis, "Terribleness" or "Miserableness" was found to be the core phenomenon. Results were composed to 103 concepts. These concepts were grouped into twenty four categories, and then to eleven categories. Categories include "physical burden", "economic burden", "mental distressing", "heartbreaking", "being gloomy", "horror", "being crushed", "feel oppressed", "being exhausted", "family dependent", "support", "previous data for procedure", "inclination", "exploding", "sharing", "mitigation", "bracing oneself", "becoming attached", "dependence", "thanks", "anxiety", and "abandonment". Patients with bone marrow transplantation were revealed to face "terribleness". Terribleness is found to be progressed through the cycle production-coping-solution. Fourteen hypotheses were derived from the integration of categories as follows ; (1) The stronger the term of suffering as perceived by the subjects, the stronger the "terribleness" will be. (2) The more excessive the degree of suffering as perceived by the subjects, the more excessive the "terribleness" will be. (3) If subjects have family dependent "terribleness" is expressed with abusement. (4) If subjects have no family dependent, "terribleness" will be expressed with exposure and suppressing. (5) The more abundant the sufficient support, "terribleness" will be expressed with exposure and suppressing. (6) The less abundant the sufficient support, "terribleness" will be expressed with abusement. (7) The more abundant the previous data, "terribleness" will be expressed with exposure and suppressing. (8) The less abundant the pervious data, "terribleness" will be expressed with abusement. (9) The more introvert the subject's inclination, "terribleness" will be expressed with exposure and suppressing. (10) The more extrovert the subject's inclination, "terribleness" will be expressed with abusement. (11) The more excessive the degree of "terribleness" will be expressed with abusement. (12) The less excessive the degree of "terribleness" it will be expressed with exposure and suppressing. (13) The more expressive the abusment, "terribleness" will be solved despair. (14) The more expressive the exposure and suppressing, "terribleness" will be solved with expectation. On the basis of the patterns that have the four these below were confirmed. 1. If patients felt large amount of terribleness because of severe suffering, they had family dependent. insufficient support, no previous data and their inclination was extrovert, "terribleness" is solved despair with abusement. 2. If patients felt large amount of terrible because of severe suffering family dependent, sufficient support, pervious data, and their inclination was introvert, "terribleness" is solved expectation with suppressing and exposure. 3. If patients felt small amount of terribleness because of little suffering, no family dependent, insufficient support, no previous data, and their inclination was extrovert, "terribleness" is solved despair with abusement. 4. If patients felt small amount of terribleness because of little suffering, no family dependent, sufficient support, previous data, and their inclination was introvert, "terribleness" is solved expectation with exposure and suppressing. On the basis of the above result, in orer to help nurses take good care of their patient, and understands patient's inclination and background, nursing assessment and intervention on life readjustment, and getting support should be required. It is expected that theoretical framework provided by this study, which shows how "terribleness" products, changes, increases and decrease. Therefore public relations, education, counseling emotional support, understanding inclination and exchange of information will have to be accomplished.
Adolescent ; Adult ; Anxiety ; Body Image ; Bone Marrow Transplantation* ; Bone Marrow* ; Counseling ; Depression ; Education ; Equidae ; Histocompatibility Testing ; Humans ; Incidence ; Leukemia ; Nursing ; Nursing Assessment ; Nursing Theory ; Public Relations ; Recurrence ; Self Care ; Statistics as Topic ; Surveys and Questionnaires

A case of toxic epidermal necrolysis (TEN) was presented in 46 year-old male patient. The characteristic skin lesions of TEN were developed after some medictions and tetanus anti-toxin (TAT) injection due to trauma. Probably, the cause of the disease was drugs, TAT injection or trauma inself. On the pathologic findings, lower epidermis and dermo-epidermal cleavage were noticed. He was treated with massive antibiotics and steroid. About 7 days after therapy, much improvement achived. However foul odorous yellowish discharge was noticed since 20 days of hospitalization. Wide debridement of necrotic tissue was carried without improvement. Patient expired on 48th hospital day due to sepsis and impending hepatic coma.
Anti-Bacterial Agents ; Debridement ; Epidermis ; Hepatic Encephalopathy ; Hospitalization ; Humans ; Male ; Middle Aged ; Odors ; Sepsis ; Skin ; Stevens-Johnson Syndrome* ; Tetanus

Incontinentia pigmenti is an uncommon genodermatosis. It affects female infants predominantly, described first by Bardach in l925, with the diagnosis of systematized nevus and Bloch in 1926, and Sulzberger in 1928 rnore compIetely. Skin lesions are characterized by 3 stages such as vesicobullous, verucous and finally pigmentary lesions and leave brownish pigmentation on the extremities and trunk. Hesides skin lesions some ectodermaI and mesodermal organs are affected and show developmental abnormalities. We experienced a case of incontinentia pigmenti in a 45-day-old female infant and present it with the review of literature. She showed extensive vesicobullopustular eruption with linear and reticular pigmentation on the extremities and trunk. Clinical and histopathologic findings of these lesions are compatible with Bloch-Sulzberger type of incontinentia pigmenti.
Diagnosis ; Extremities ; Female ; Humans ; Incontinentia Pigmenti* ; Infant ; Mesoderm ; Nevus ; Pigmentation ; Skin

Pityriasis lichenoides chronica is considered to be a benign disease. Erythematous yelIowieh scaly maeulea appear insidiously, chiefly on the sides of trunk, thighs and upper arms. Acanthosis nigricans is a rare cutaneous disorder with peak incidence in puberty characterized by hyperkeratosis and, dark pigmentation. We report a case of pityriasis lichenoides chronica assaciated with pseudoacanthosis nigricans in a 14 year-old obeae male patient who has bean sized erythematoua scaly papules on the trunk and extremities, velvety black brownish colored patchea on the neck and both axillary regions.
Acanthosis Nigricans ; Adolescent ; Arm ; Extremities ; Humans ; Incidence ; Male ; Neck ; Pigmentation ; Pityriasis Lichenoides ; Pityriasis* ; Puberty ; Thigh

Serum zinc is an essential element in men and animals. Recently on the dermatologic fields, the serum and the skin levels and the roles of zinc have been studied especially in acne vulgaris, but the results were controversial. So to confirm the previous reports and for evaluation of the relationship between the various aspects of acne vulgaris and the serum levels of zinc, the serum levels of zinc were measured by atomic absorption spectrophotometer in 13 healthy controls and 46 patients with acne vulgaris. In the healthy controls, their mean values of zinc were 0.843+0.251 ppm in total, 0.920+0.219 ppm, in females and 0.777+0.260 ppm in males. There was no statistical difference attributable to sex. In the 46 patients with acne vulgaris, their mean value of zinc was 0.741+0.195 ppm. There was no significant difference in the mean serum zinc level compared with the controls. In the males with acne, the mean va1ue of zinc was 0.727+0.166 ppm, and 0.748+0.208 ppm in females with acne. There was no significant statistical difference between males and females with acne. And females, but not males, with acne had significantly lower serum zinc levelss than controls of the corresponding sex. (p<0.1) By clinical severity, classifying the 46 patients with acne vulgaris into three groups: mild type (only comedones), moderate type (comedones with pa.pules) and severe type (includes pustules, comedones, and papules, etc.), the serum zinc levels of each group were 0.774+0.185 ppm, 0.7880. 200 ppm and 0.666+0.176 ppm. The significant statistical difference was found only in the severe type of acne compared with the healthy controls (p<0.05). Also classifying the patients into three groups (acute, moderate and chronic types of acne) by duration of acne, the serum values of zinc were 0.738+0.158 ppm, 0.692+0.283 ppm and 0.769+0.241 ppm, respectively. Only in the moderate type of acne, the mean serum level of zinc was significantly reduced compared with the control group (p<0.1)
Absorption ; Acne Vulgaris* ; Animals ; Female ; Humans ; Male ; Skin ; Zinc*

The purpose of this study is to build up the foundation to prepare the effective nursing intervention devices for the seriously ill patient's families nursing through the nurse understanding of the experiences of the seriously ill patient's families in the field by setting up grounded theory. In this study, the subjects is the 6 families members of ICU patients, who were being cared in university hospital and the data were collected from 4.15 to 5, 1996 by the recordings and transcring the interview. The intervention lasted from 2 hours to 2 and a half hours. The data were analyzed in the framework of grounded theory as mapped out by Strauss & Corbin. The core category in the analysis of the experiences of the families of the seriously ill patients was the process of setting the "distress". In the process of datas analysis, the categories were 19 conceptions-'serious', 'bad', 'fear', 'press', 'hearburn', 'impatient', 'insufficient', 'change of patients' status', 'economic ability', 'family relationship', 'whilled power', 'request', 'direct caring', 'passive effort', 'control', 'receive', 'tired', 'blame'. These categories were again grouped into 12 categories, including 'exigency', 'overwhelming', 'worry', 'change of status', 'economic ability', 'relationship', 'caring will' 'active caring', 'passive response', 'accept', 'exhaustion', 'blame'. In the above mentioned categories, 'overwhelming' and 'worry' were categorized into the "distress!". On the basis of the patterns that have emerged on process of data analysis, the five below were confirmed. (1) When the patient's status is worse and economic ability is bad and the family relation to the patient is close and the distress is expressed with active caring willness is strong, the distress is expressed with active caring and brings about accept and blame. (2) When the family relation to the patient is distant and the distress decrease and the subject's caring willness is weak, the distress is expressed with passive response and brings about accept and exhaustion in spite of the patient's status is worse and bad economic ability. (3) When the patient's status is worse and economic ability is bad and the family relation to the patient is close and the distress increase, the subject's caring willness is strong, the distress is subject's caring willness is strong, the distress is expressed with passive response and brings about accept and exhaustion. (4) When the patient's status is improve and economic ability is good and the distress decrease and the subject's caring willing is strong, the distress is expressed with active caring and brings about accept and blame in spite of the family relation to the patient is close. (5) When the patient's status is improve and economic ability is bad and the family relation to the patient is close and the distress increase, the subject's caring willness is strong, the distress is expressed with active caring and brings about accept and blame.
Family Relations ; Humans ; Nursing ; Statistics as Topic

During acute stages of hospitalized stroke patients, family caregivers face many challenges. They often experience emotional distress. social isolation. and financial constraints. However. the burden of caregiving of stroke patients in acute stages has never been studied properly. The purpose of this study was to investigate the factors related to the caregivers' burden with acute stroke. The subjects were 123 acute stroke patients and their caregivers who were admitted to neurology and neurosurgery units at Dan Kook University Hospital in Chung-Nam area. An interview was performed with the use of standardized questionnaire which included data pertaining to the patients/caregivers characteristics, caregiver burden (Modified Zarit's Burden Scale), and social support (Fersonal Resource Questionnaire). Our results showed that the mean burden score was 3,11. indicating high level of burden, Among the sub-domain scores, financial burder was the highest, In univariate analysis, the factors related to caregiver burdens were: inability to communicate between patients and caregiver (p<.001): low cognitive function of the patients(p<.001): low level of ADL(p<.001), the gender of caregiver(p<.001) the current employment status of caregivers(p<.01) the presence of social support for caregiver(p<.001), and the availability of alternative caregivers (p<.001). In multiple regression analysis, social support for family caregivers (87%), low level of patient's cognition (2%), availability of 2nd caregiver (1%). and gender of caregiver (female, 0,4%) were significant explanatory factors of overall burden, The caregivers' burden in acute stages during hospitalization following stroke was high, Recognition of high levels of caregivers' burden and those relating factors affecting caregiver burden may allow us to develop different nursing strategies to unload the level of burden for caregivers in acute stages of stroke.
Caregivers ; Cognition ; Employment ; Hospitalization ; Humans ; Neurology ; Neurosurgery ; Nursing ; Surveys and Questionnaires ; Social Isolation ; Stroke*

OBJECTIVE: To investigate the bone mineral density(BMD) in Korean postmenopausal women. METHODS: We performed the retrospective study for 1,508 postmenopausal women who had menopause after 40 years of age and didn't take any hormonal agent before measuring bone mineral density. Spinal and femur neck BMD were measured using dual energy X-ray absorptiometry(DXA, Lunar Co.). RESULTS: The mean age of the study subjects was 53.7+/-5.7 years and the average BMD of the lumbar spine(L2-L4; L24) and femur neck(FN) were 0.996+/-0.173 g/cm(2) and 0.821+/-0.133 g/cm(2), respectively. Of all subjects, 44.1%(665/1,508) had osteopenia and 14.7%(222/1,508) were already osteoporotic. The prevalence of osteoporosis increased with age; 5.2% in 41-50 years of age, 15.6% in fifties, 32.5% in sixties, and 45.5% in over 70 years of age. There was no significant difference in the age-adjusted BMD between naturally menopausal women(n=828) and surgically menopausal women(n=78). The mean age at menopause of surgically menopausal women was significantly younger than that of naturally menopausal women(47.6+/-3.6 vs 49.2+/-3.5). Duration of menopause, body weight, and height were revealed to be the significant risk factors for osteoporosis. The annual bone loss rates in lumbar spine and femur neck were 1.2% and 1.1% respectively in naturally menopausal women, and 1.5% and 1.2% in surgically menopausal women. CONCLUSIONS: This study established the BMD curve and regression equation in Korean postmenopausal women according to the causes of menopause. There was no significant difference in the mean BMD and the prevalence of osteoporosis between naturally and surgically menopausal women. Duration of menopause, body weight, and height were found to be the risk factors which influence the development of the osteoporosis. So the postmenopausal women who are at increased risks of developing osteoporosis need more active interventions for preventing the osteoporotic fracture.
Body Weight ; Bone Density* ; Bone Diseases, Metabolic ; Female ; Femur ; Femur Neck ; Humans ; Menopause* ; Osteoporosis ; Osteoporotic Fractures ; Prevalence ; Retrospective Studies ; Risk Factors ; Spine

Authors report a case of separation anxiety disorder, which developed as a side effect during haloperidol treatment of Tourette syndromes(TS). In this case, 14 years old boys developed attention deficit symptoms during his infancy. At 4th grade of primary school, he developed vocal tic, motor tic, and coprolalia. With 5mg/day of haloperidol treatment his symptoms of TS were subsided. During the treatment, he developed features of separation anxiety disorder, including dependence, pleading, clinging, and sadness. Symptoms of attention deficit and separation anxiety disorder were improved by 25mg/day of imipramine treatment. During haloperidol treatment of TS, careful observation may be needed whether separation anxiety disorder-like symptom develops.
Adolescent ; Anxiety, Separation ; Haloperidol* ; Humans ; Imipramine ; Tics ; Tourette Syndrome*

PURPOSE: To report a case of keratoconjunctival chemical injury caused by exposure to EMLA(R) 5% cream. CASE SUMMARY: A 51-year-old woman presented with ocular pain and decreased visual acuity in her left eye after an autologous fat injection for forehead lifting. At her initial visit, her best corrected visual acuity was 20/40 in the left eye. Slit-lamp examination showed a diffuse corneal epithelial defect and conjunctival injection. Based on history of inadvertent seepage of EMLA(R) 5% cream into the left eye and clinical findings consistent with chemical injury, the patient was treated with antibiotics, steroids, and artificial tears. Two weeks after treatment, several corneal erosions remained, and best corrected visual acuity improved to 20/20. After two months, the corneal and conjunctival epithelia were healed. CONCLUSIONS: EMLA(R) 5% cream is commonly used as topical anesthetic ointment for dermatologic surgery, including laser procedures. The cream is highly alkaline and can cause chemical injury to the eye, thus extreme caution should be used when applying the cream to the eyelid or face.
Anti-Bacterial Agents ; Dermatologic Surgical Procedures ; Eye ; Eyelids ; Female ; Forehead ; Humans ; Lifting ; Middle Aged ; Ophthalmic Solutions ; Steroids ; Visual Acuity