No Abstract available.
Korea*

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

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*

Botulium toxin A has been used therapeutically in humans for over 20 years for a variety of medical indications. Some wrinkle and unsightly facial expressions are due to hyperkinetic muscle. For the past year, the author has injected it for variant purpose, so we describe the our experience with the variant extended use of the toxin including correction for just dynamic wrinkle, used with subperiosteal face lifting or peeling, post-traumatic twitching, and facial paralysis and relevant anatomy are discussed. Also we have another concept about muscle anatomy which have superficial and deep portion. The superficial portion is for harmonious action with SMAS during facial expression, which is also related to fine wrinkle, and the deep portion play role gross movement. Botulium toxin is safe and effective in varient field without complication. Its use is associated with a high degree of patient and physician satisfaction.
Exotoxins* ; Facial Expression ; Facial Paralysis ; Humans ; Rhytidoplasty

PURPOSE: This study was done to investigate the mediation effects of cognitive emotion regulation on influences of self-differentiation and family function in high school students' problem behavior. METHODS: Study design was a cross-sectional descriptive analysis of causal research. A survey was conducted with 194 students in a C city high school. Data were analyzed using SPSS 21.0 and AMOS 21.0. RESULTS: There were direct effects of self-differentiation (β= -.39, p<.001), adaptive cognitive emotion regulation strategies (β=-.16, p=.004) and maladaptive cognitive emotion regulation strategies (β=.34, p<.001) on problem behavior in these students. A mediator effect was found for self-differentiation, as it had a direct impact on the maladaptive cognitive emotion regulation strategy (β=-.15, p=.014), which then had a direct impact on problem behavior. However, family function had no direct impact on both the maladaptive cognitive emotion regulation strategy and the adaptive cognitive emotion regulation strategy and on problem behavior, no mediator effect was observed. Explanatory power of these variables for problem behavior was 48.0%. CONCLUSION: Study findings suggest that to intervene for problem behavior in high school students, there is a need to develop and utilize programs that not only intervene for self-differentiation but also decrease high school students' use of non-adaptive cognitive emotion regulation.
Humans ; Negotiating* ; Problem Behavior*

No abstract available.

PURPOSE: MRI is known to display the anatomy of the larynx in excellent detail with its remarkable soft tissue delineation and multiplanar imaging capability. We evaluate the accuracy of MRI in diagnosis and staging of laryngeal cancer MATERIALS AND METHODS: Sixteen cases with pathologically proved squamous cell carcinoma of the larynx were reviewed, retrospectively. The examination was performed with a 0.5 T superconductive MR system and C1 surface coil. Axial, sagittal and coronal plane with T1WI(TR/TE 450/20) and T2WI(TR/TE 18OO/80) were done. RESULTS: Eleven cases with glottic cancer(5 Tla, 3 Tlb, 1 T3 and 2 T4) and 5 cases with supraglottic cancer (1 T1, 1 T3 and 1 T4) were included. Cancer tissue showed intermediate signal intensity on TIWI and high signal intensity on T2Wl. Among 16 cases, 13 cases were correctly staged and 3 cases were overstaged due to edema caused by previous biopsy, partial volume averaging effect of abutted lesion, or surrounding inflammation. CONCLUSION: MRI is an useful modality for diagnosis of laryngeal cancer, especially in evaluation of paraglottic extention on coronal image and cartilage invasion.
Biopsy ; Carcinoma, Squamous Cell ; Cartilage ; Diagnosis ; Edema ; Inflammation ; Laryngeal Neoplasms ; Larynx ; Magnetic Resonance Imaging ; Retrospective Studies

BACKGROUND: During the adolescent growths spurt, iron deficiency becomes more common, particularly with the additional factors of menstrual blood loss in females and the androgen-related rise in hemoglobin concentration in males. This study was conducted to investigate the iron status in the adolescent students. METHODS: Venous peripheral blood was sampled from 178 males(79 of 12-13years, 99 of 15-16years) who were 1st grade students of two boy's middle schools and two high schools and from 186 females(87 of 12-13years, 99 of 15-16years) who were 1st grade students of two girl's middle schools and two high schools. Laboratory procedures included a hemoglobin, hematocrit, serum iron, TIBC and serum ferritin. Transferrln saturation was calculated. RESULTS: 1) Mean values were hemoglobin 13.7+/-0.78 g/dl, hematocrit 40.6+/-2.47%, serum iron 127.6+/-43.02 ug/dl, TIBC 387.9+/-47.73 ug/dl, transferrin saturation 33.3+/-11.38%, and serum ferritin 26.1+/-16.90 ng/ml in 12-13years old males. 2) Mean values were hemoglobin 13.7+/-0.85 g/dl, hematocrit 40.9+/-3.79%, serum iron 99.4+/-34.93 ug/dl, TIBC 387.8+/-45.53 ug/dl, transferrin saturation 26.2+/-9.99%, and serum ferritin in 22.7+/-14.18 ng/ml in 12-13years old females. 3) Mean values were hemoglobin 15.2+/-0.84 g/dl, hematocrit 45.9+/-2.77%, serum iron 144.9+/-51.97 ug/dl, TIBC 419.8+/-52.46 ug/dl, transferrin saturation 34.2+/-10.44%, and serum ferritin 31.2+/-20.91 ng/dl in 15-16years old males. 4) Mean values were hemoglobin 13.2+/-0.89 g/dl, hematocrit 39.9+/-2.78%, serum iron 111.1+/-39.78 ug/dl, TIBC 392.8+/-50.06 ug/dl, transferrin saturation 28.9+/-10.85%, and serum ferritin 21.4+/-17.11 ng/ml in 15-16years old females. 5) The prevalence of iron deficiency was 8.9% and 10.1% in 12-13years and 15-16years old males respectively. In 12-13years and 15-16years old females, the prevalence was 16.1% and 29.3% respectively. The prevalence of iron deficincy anemia was 1.1% and 2.0% in 12-13years and 15-16years old female and absent in male. CONCLUSIONS: Although hemoglobin is normal, we recommend to check other parameters to optimize the identification of individuals with iron deficiency.
Adolescent* ; Anemia ; Female ; Ferritins ; Hematocrit ; Humans ; Iron* ; Male ; Prevalence ; Seoul* ; Transferrin

Cyanide intoxication results in severe metabolic acidosis and catastrophic prognosis with conventional treatment. Indications of extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT) are expanding to poisoning cases. A 50-year-old male patient arrived in the emergency room due to mental change after ingestion of cyanide as a suicide attempt 30 minutes prior. He was comatose, and brain stem reflexes were absent. Initial laboratory analysis demonstrated severe metabolic acidosis with increased lactic acid of 25 mM/L. Shock and acidosis were not corrected despite a large amount of fluid resuscitation with highdose norepinephrine and continuous renal replacement therapy. We decided to apply ECMO and CRRT to allow time for stabilization of hemodynamic status. After administration of antidote infusion, although the patient had the potential to progress to brain death status, vital signs were improved with correction of acidosis. We considered the evaluation for organ donation. We report a male patient who showed typical cyanide intoxication as lethal metabolic acidosis and cardiac impairment, and the patient recovered after antidote administration during vital organ support through ECMO and CRRT.
Acidosis ; Brain Death ; Brain Stem ; Coma ; Cyanides ; Eating ; Emergency Service, Hospital ; Extracorporeal Membrane Oxygenation* ; Hemodynamics ; Humans ; Lactic Acid ; Male ; Middle Aged ; Norepinephrine ; Organ Transplantation ; Poisoning ; Prognosis ; Reflex ; Renal Replacement Therapy* ; Resuscitation ; Shock ; Suicide ; Tissue and Organ Procurement ; Vital Signs

Varieties of telepathology system had been developed and in use, but their functional capability and diagnostic accuracy are considered to be inferior to those of conventional optical microscope. This study is intended to find out: 1) the diagnostic accuracy and reproducibility rate according to the input devices and the video signals; 2) any potential technical problems of the telepathology system; 3) any possible physical and psychological impacts. We devised a virtual telepathology system using our existing microscope equipped with CCD camera unit that has no restriction of network speed. Total fifty-five surgical pathology cases from 11 different organs were selected. Three pathologists were involved in making diagnoses. The resulting diagnostic accuracies were: 1 CCD camera with composite video signal was 86.2%; 3 CCD camera with composite video signal was 93.1%; 3 CCD camera with component video signal was 95.0%. The 3 CCD camera with component video signal resulted in 95.0% diagnostic accuracy and was superior to 1 CCD camera with composite video signal. Some technical problems noted during this study were: the visual field of the virtual telepathology system was smaller by 43% than that of microscope; the difference of cell sizes between microscope and monitor; low resolution of image. Some physical and psychological symptoms were noted.
Cell Size ; Diagnosis ; Pathology, Surgical ; Telepathology* ; Visual Fields