Postoperative colonoscopy is an effective tool for management of colonic adenomas. Authors analyzed the pattern of colonic adenomas detected during follow-up colonoscopy after colorectal cancer surgery and evaluated the characteristics of adenornas, risk groups, and effective fo1low-up schedule. Study group were 222 patients and colonoscopy was performed 389 times. Patterns of adenornas were analyzed by variables as age, sex, preoperative serum CEA level, location of primary colorectal cancer, Borrmann type, Duke's stage, histologic differentiation, DNA ploidy, recurrence and histology. Metachronous adenomas were detected in 79 patients(35.6%) and both metachronous and syachronous adenomas were observed in 29 cases(13.1%). High risk variables for adenomas were male, old age and presence of synchronous adenoma. There were 2 patients with maligant change of adenomas. Yearly follow-up by complete colonoscopy over 3 years or more is recommended and follow-up interval should be shortened in the high risk groups.
Adenoma* ; Appointments and Schedules ; Colon ; Colonic Neoplasms ; Colonoscopy ; Colorectal Neoplasms* ; DNA ; Follow-Up Studies ; Humans ; Male ; Ploidies ; Recurrence

No abstract available.
Colon* ; Lymphangioma, Cystic*

OBJECTIVES: With the increase in cancer prevalence, the health behavior of cancer survivors has become an important issue. This study was conducted to examine the psychosocial correlates of behavior changes after cancer diagnosis. METHODS: 95 patients completed questionnaires assessing depression, anxiety, insomnia, posttraumatic stress symptoms, social constraints, personal beliefs about cancer cause and health-related behavior changes after cancer diagnosis. RESULTS: In the multiple logistic regression analysis, insomnia was the only significant predictor of positive change in physical behavior : normal sleep group(Odds ratio=9.462, 95% CI 1.738-51.509) and subthreshold insomnia group(Odds ratio=10.529, 95% CI 1.701-65.161) showed a larger increase compared to the insomnia group. In psychosocial behavior, low age, religion and causal belief in hormonal factors were independent factors that predicted increase in positive change. CONCLUSIONS: This study showed a difference between predictors of physical and psychosocial health behavior change after breast cancer diagnosis. Multi-faceted approaches are required to promote positive change in health behavior in cancer patients.
Anxiety ; Breast ; Breast Neoplasms ; Depression ; Health Behavior ; Humans ; Logistic Models ; Prevalence ; Questionnaires ; Sleep Initiation and Maintenance Disorders ; Survivors

No abstract available.
Carcinoma, Small Cell* ; Female ; Ovary*

Purpose : Shortness is the most frequent and quite disturbing characteristics of patients with Turner syndrome. The aim of this study was to evaluate the factors affecting final adult height(FAH) in these patients. METHODS : The study group was comprised of 19 patients who were diagnosed as Turner syndrome and attained FAH. We analyzed the influences of various factors on FAH in GH treated group with those in GH untreated group. Results : Nineteen patients were enrolled; thirteen received GH treatment and six did not. The mean duration of GH treatment was 24.3 months(range : 9 to 50 months), and the mean dosage of GH was 0.98+/-0.35IU/kg/wk in GH treated group. The mean growth velocity during GH treatment was 5.6+/-1.8 cm/yr, which was significantly higher than that during pretreatment period(P<0.05). In GH treated group, the mean chronological age, bone age, mean height, and height SD score at GH therapy were 13.7+/-1.7yr, 11.3+/-1.9yr, 129.7+/-7.9cm, and -4.1+/-1.1, respectively, which were not statistically different from those at diagnosis of GH untreated group. In GH treated group, the mean FAH and FAH SD score were 144.8+/-5.0cm, and -3.2+/-0.9, respectively, which showed no significant difference compared with those of GH untreated group. Analyzing the factor affecting FAH in all Turner girls of both groups together, parental height, chronological age, bone age, and bone age delay at diagnosis(or at the initiation of GH therapy) were not related to FAH. Height and height SD score at diagnosis(or at the initiation of therapy) were positively related to FAH(P<0.05, r=0.72). CONCLUSION : The results suggest that GH treatment dose not improve FAH in patients with Turner syndrome, despite increased growth velocity during GH treatment, which might come from intermittern GH therapy. This should be remained to be clarified with more Turner patients who attained FAH.
Adult* ; Diagnosis ; Female ; Growth Hormone ; Humans ; Parents ; Turner Syndrome*

It has been well known that ischemia reperfusion injury to skeletal muscle following an acute arterial occlusion causes significant morbidity and mortality. There are many causes of reperfusion injury, but the oxygen free radicals have a significant role. During ischemia the ATP is catalyzed to hypoxanthine anaerobically and hypoxanthine dehydrogenase is converted to xanthine oxidase under the presence of O2 resulting in the production of cytotoxic oxygen free radical, which are harmful to muscle. The reactivity of superoxide dismutase(SOD), one of the major antioxidant enzymes, is increased against the formation of the superoxide radical during reperfusion. SOD metabolyzes the superoxide radical to H2 O2 and O2.The severity of ischemic damage deports on the duration of muscle ischemia. The reversible changes in the muscle occur afar 2 hours of ischemia and recover within 24 hours after reperfusion. After 6 hours ischemia, irreversible damage occurs and causes necrosis of muscle. The authors performed the resent study to investigate the changes of Mn-SOD and the effects of allopurinol, the inhibitor of xanthine oxidase, by measuring the immunoreactivitiy of the ischemic reperfused rectus femoris muscle of rats after 2 hours and 6 hours ischemia and timely reperfusion. A total of 176 healthy spraque-Dawley rats weighing from 200 gm to 250 gm were used. Under urthane(3.0 gm/kg.,IP) anesthesia, a lower-abdominal incision was made and the left common iliac artery was ligated by using a vascular clamp for 2 hours and 6 hours. Rectus femoris muscle was obtained at 0 hour, 1 hour, 2 hours, 24 hours, and 48 hours after removal of the vascular clamp. The specimens were sectioned in 14micro miter thickness with a cryostat. The immunoreactivities of Mn-SOD were observed by using Mn-SOD antibodies. The result were as follows. 1. The immunoreactivies of Mn-SOD around sarcolemma were stronger than those on the sarcoplasm. 2. The immunoreactivities of Mn-S0D after 2 hours of ischemia increased to moderate or weak reactivities at 1 hour and 2 hours of reperfusion and returned to week or trace reactivities at 24 hours and 48 hours of reperfusion 3. The pretreatment of allopurinol decreased the immunoreactivies of Mn-SOD during reperfusion. The pattern of changes of SOD immunoreactivies were similar, but the range of changes significantly decreased. 4. The immunoreactivies of Mn-SOD after 6 hours of ischemia increased after 6 hours of ischemia increased after reperfusion and showed peak at 2 hours and 24 hours specimen. After 48 hours in the reperfused group, the reactivities slightly decreased. 5. After 6 hours in the ischemia-reperfused group, the pretreatment of allopurinol decreased the immunoreactivies of Mn-SOD during reperfusion, but the effects were weak. These results suggest that the immunoreactivities of the 6 hours ischemia reperfused group were higher than those of 2-hours ischemia reperfused group in the rectus femoris muscle of rats and that allopurinol pretreatment can be credited with decreasing ischemia reperfusion injury within a reversible period.
Adenosine Triphosphate ; Allopurinol ; Anesthesia ; Animals ; Antibodies ; Free Radicals ; Hypoxanthine ; Iliac Artery ; Ischemia ; Mortality ; Muscle, Skeletal ; Necrosis ; Oxygen ; Quadriceps Muscle* ; Rats* ; Reperfusion Injury* ; Reperfusion* ; Sarcolemma ; Superoxide Dismutase* ; Superoxides ; Xanthine Oxidase

PURPOSE: Congenital hypothyroidism(CH) is not uncommon disorder, leading to retardation of mental development and growth, if not treated early. The aim of this study is to determine the factors influencing IQ of children with CH, diagnosed after 1 month of life. METHODS : Thirteen children with CH were included. They had intelligence test by KEDI-WISC(Korean Educational Development Institute-Wechsler Intelligence Scale for Children) and their medical records were reviewed. Their T4, TSH, height, age at diagnosis were investigated retrospectively. To evaluate the influence of T4, TSH, height, age at diagnosis on IQ, children were divided into three groups ; athyroid(n=8), sublingual(n=3), inborn errors of thyroid hormone synthesis(n=2) according to the result of thyroid scan. Results : In athyroid group, IQ closely correlated to VIQ and PIQ and had close relationship to T4 at diagnosis(.p=0.0086, r=0.8427), but no relation to TSH. There was no difference in height, T4 TSH, and IQ between athyroid and sublingual group. CONCLUSION : The results suggest that intellectual function in children with CH, diagnosed after 1 month of life depends on serum level of T4 at diagnosis. Further study is mandatory to elucidate the relationship between final IQ and factors, including thyroid function, age at diagnosis, adequacy of treatment, etc.
Child* ; Congenital Hypothyroidism* ; Diagnosis ; Growth and Development ; Humans ; Intelligence ; Intelligence Tests ; Medical Records ; Retrospective Studies ; Thyroid Gland

No abstract available.
Pregnancy* ; Uterine Hemorrhage*

PURPOSE: Type I diabetes mellitus(DM) is an autoimmune disease which decreases insulin secretion of pancreatic beta-cell. The honeymoon period in type I DM is known to be related to the partial recovery of C-peptide and preservation of pancreatic beta-cell function. The aim of this study was to determine factors influencing the onset of honeyrnoon period in children with type I DM. METHODS: The study group was composed of 50 patients with type I DM. The honeymoon period was defined as a period requiring less than 0.5U/kg/day to maintain near-normal blood glucose control without urine glucose for consecutive days. The factors for three study were age at diagnosis, sex, initial 24-hr urine C-peptide, initial HbA C, diabetic ketoacidosis and maximum insulin dose for near-normal blood glucose control before honeymoon. RESULTS: The group with honeymoon period received significantly smaller doses of insulin near-normal blood glucose control, compared to the group without honeymoon period, before honeymoon(P<0.01). Other factors had no significant connection with the development of honeymoon period. CONCLUSION: The developrnent of honeymoon period in type I DM had a significant relationship with maximum insulin dose before the onset of honeymoon period for near-normal blood glucose control. This needs remains to be further study.
Autoimmune Diseases ; Blood Glucose ; C-Peptide ; Child* ; Diabetes Mellitus* ; Diabetes Mellitus, Type 1 ; Diabetic Ketoacidosis ; Diagnosis ; Glucose ; Humans ; Insulin

PURPOSE: The present study was designed to understand the conceptual definition and attributes of the clinical critical thinking ability(CCTA) in nursing and to grasp the characteristics of clinical critical thinking abilities. METHODS: The data were analyzed using the Hybrid model of Schwartz-Barcott and Kim(2000). RESULTS: Having the skills and dispositions to think critically, CCTA refers to something that implies the cognizant ability to interpret contextual meanings, analyze the relationships between materials or circumstances, draw out the best conclusions, predict things using relevant information and evaluate the reliability of information and the strength of inference on the one hand and the emphatic disposition to be curious, open-minded, intellectually integral, systematic and creative and to reflect on things in contextual terms on the other. CONCLUSION: CCTA is characterized by clinical circumstances, such as guessing the reasons for facts, predicting things, connecting theory to practice and approaching individual situation in total terms as well as by the Korean circumstances, such as taking another person's perspective. Hence, this study proposes developing the tools to measure the clinical critical thinking ability and the strategies to improve the clinical critical thinking ability and seeking to verify their validity, on the basis of the findings.
Chimera ; Clinical Competence ; Concept Formation ; Hand ; Hand Strength ; Problem Solving ; Thinking