The purpose of this study was to explore the effect of diabetic camp program on depression, self-efficacy and self-esteem of the juvenile diabetic patient who had participated with diabetic camp program at Seoul and Kyung In area from August 5 to August 9, 1995. Nursing staffs explained them how to respond to the questionnaire of depression. self-efficacy and self-esteem prior to beginning the program and following the program. The questionnaire of depression, self-efficacy and self-esteem was developed by both diabetes mellitus nurse specialist and pediatric nursing professors in reference with the previous research. Response items of the questions were structured as yes or no for the elementary school students and that of the questions were structured as 5 likert scale for the both middle and high school students. Paired t-test was used for the significance of the difference between values before and after the diabetic camp program. Depression decreased following the program, while self-esteem increased significantly following the program in elementary school students. There was no change in self-esteem, while self-efficacy increased significantly following the program in middle and high school students. Self-efficacy following the program was high as the frequency of exercise increased in the elementary school students. Self-efficacy prior to the program was high as the experience of diabetic education increased in the middle and high school students. Self-efficacy and self-esteem prior to the camp was highly correlated with that following the camp in middle and high school students. The result suggests that diabetic camp program could be on of ways to decrease depression and to increase self-efficacy of the diabetic children.
Adolescent* ; Child* ; Depression* ; Diabetes Mellitus ; Education ; Humans ; Nursing Staff ; Pediatric Nursing ; Seoul ; Specialization ; Child Health ; Surveys and Questionnaires

PURPOSE: We performed this study to describe the findings of MR Myelography(MRM) of herniated disc disease, spinal stenosis and spinal tumor and to evaluate the usefulness of the MRM in comparison to MRI. MATERIALS AND METHODS: MRI and MRM were performed in 31 patients with herniated disc disease(12 patients), spinal stenosis(11 patients) and spinal tumor(8 patients). MRI and MRM were done with 1.5-T Signa MR, using fat suppressed heavily T2-weighted fast spin echo technique. We retrospectively analyzed MRM images about the thecal sac indentation, compression or displacement of the nerve root, extent and degree of narrowing of spinal canal, relationship between spinal tumor and spinal cord. MRM findings were compared with MRI in all cases. RESULTS: In 18 herniated disc cases of 12 patients, focal filling defect with cutoff or displacement of the nerve root in eight cases of paracentral herniated disc was seen. Cutoff and displacement of the nerve root were more clearly delineated on MRM than rvlRI. In the patients of spinal stenosis(11 cases), hourglass deformity of the thecal sac or complete spinal block of the subarachnoid space was clearly demonstrated. The extent and severity of spinal stenosis were more accurately evaluated on MRM than MRI. MRM finding of intramedullary tumor(3 cases) was enlargement of spinal cord. Five cases of intradural extramedullary tumor showed intradural filling defect, which caused contralateral displacement of the spinal cord with meniscus sign on inferior margin of the mass. CONCLUSION: MRM shows characteristic findings of herniated disc disease, spinal stenosis and spinal tumor. MRM yields excellent definition of the thecal sac, nerve roots and nerve root sleeves in relation to herniated disc and may be more accurate in evaluation of the degree and extent of spinal stenosis than MRI.
Congenital Abnormalities ; Constriction, Pathologic ; Humans ; Intervertebral Disc Displacement ; Magnetic Resonance Imaging ; Myelography* ; Retrospective Studies ; Spinal Canal ; Spinal Cord ; Spinal Diseases ; Spinal Stenosis ; Subarachnoid Space

Complications of diabetes can develop without any sign or symptom, and their progress could be slow. Because most complications cannot be completely cured, their prevention is very important. Appropriate monitoring of diabetes-related complications should include management of blood pressure and blood glucose, regular check-ups of the feet and eyes, and assessment of renal and cardiovascular function. It is very important to maintain quality of life for diabetes patients through the early detection and treatment of complications. For that, diabetic patients should check blood sugar levels and other signs and symptoms of complications by visiting the doctor's office regularly.
Blood Glucose ; Blood Pressure ; Diabetes Complications ; Diabetes Mellitus ; Eye ; Foot ; Humans ; Quality of Life

We report a case of fine needle aspiration cytology of endodermal sinus tumor of the ovary. A 13-year-old girl complained of abdominal mass and pain. The abdominal sonography revealed a well-demarcated huge mass, which was solid and multiseptated. Percutaneous fine needle aspiration was performed from the mass. The smears revealed moderate cellularity, which was arranged in sheets or clumps of pleomorphic malignant cells on mucoid background. The valuable characteristic features of tumor cells were papillary configuration, vacuolated cytoplasm and intracellular and extracellular hyaline globules. The diagnosis was confirmed later by histologic study of surgical resection of the specimen.
Adolescent ; Biopsy, Fine-Needle ; Cytoplasm ; Diagnosis ; Endodermal Sinus Tumor ; Female ; Humans ; Hyalin ; Infant, Newborn ; Infant, Premature* ; Neurilemmoma ; Ovary ; S100 Proteins ; Urinoma*

OBJECTIVE: Activities of nucleases (acid DNase and neutral RNase) and RNase inhibitor known to be involved in carcinogenesis and suppression of cancer were determined in cancer tissue, serum and ascitic fluid of patients with hepatocellular carcinoma and were compared with those of the controls. Also studied were nucleases and RNase inhibitor isolated from hepatocellular carcinoma tissue and ascitic fluid of the cancer patients to evaluate the properties and interactions between them. METHOD: Activities of nucleases and RNase inhibitor were measured in cancer tissue, serum and ascitic fluid of patients with hepatocellular carcinoma by ultraviolet spectrophotometry. Nucleases and RNase inhibitor were isolated from hepatocellular carcinoma tissue and ascitic fluid of the cancer patients by DEAE-cellulose column chromatography. As controls, normal tissue of the cancer patients, serum of healthy persons and ascitic fluid of cirrhotic patients were used. RESULT: Activities of DNase, RNase and RNase inhibitor were significantly increased in hepatocellular carcinoma tissue. DNase activity was not detected, RNase activity was increased and RNase inhibitor activity was unchanged in both serum and ascitic fluid of the hepatocellular carcinoma patients. DNase was isolated as a single enzyme and RNase as seven isozymes from the hepatocellular carcinoma tissue. The DNase isolated preferentially cleaved ds DNA over ss DNA and was endonuclease in nature (majority of hydrolytic products of DNA by the DNase were oligodeoxyribonucleotides). Of seven RNase isozymes isolated from the hepatocellular carcinoma tissue, isozyme I exhibited nonsecretory nature of RNase and other six isozymes secretory nature of the enzyme. Activity of RNase isozyme V was greatly increased and the activity of inhibitor complexed with the isozyme V was also increased. RNase in ascitic fluid of the cancer patient was separated into four isozymes, of which isozyme I exhibited mixed form of secretory and nonseretory nature and greatly increased in its activity. RNase isozyme V isolated in the hepatocellular carcinoma tissue was not detected in the ascitic fluid. CONCLUSION: The use of the nucleases and the inhibitor in the cancer tissue as biochemical markers for the hepatocellular carcinoma was suggested. RNase was released into the body fluid from the cancer tissue and could be used as a diagnostic marker for the hepatocellular carcinoma. An important role of the DNase in carcinogenesis of the liver was suggested. RNase isozyme V was limited in the cancer tissue and RNase isozyme I and V and inhibitors associated with these isozymes might be involved in carcinogenesis processes, suppression of cancer and maintenance of hepatocellular carcinoma through their interactions.
Ascitic Fluid ; Biomarkers ; Body Fluids ; Carcinogenesis ; Carcinoma, Hepatocellular* ; Chromatography ; DEAE-Cellulose ; Deoxyribonucleases* ; DNA ; Humans ; Isoenzymes ; Liver ; Ribonuclease, Pancreatic ; Ribonucleases* ; Spectrophotometry, Ultraviolet

BACKGROUND: Blood transfusion is important for life saving treatment in many patients with tolerable adverse effects. Some data suggest that transfusions might cause an increased risk for post-operative infections and a higher relapse or mortality rate in cancer patients. We investigated whether immune dysfunction might result after transfusions from the cellular components. METHODS: We studied 5-week-old mice BALB/c (H-2d, donor), C3H/He (H-2k, recipient), and C57/BL (H-2b, third party). We obtained irradiated spleen cells (SP) from the BALB/c or C57/BL, and injected them into the C3H/He with intraperitoneal IL-2 administration. After 24 hours, we obtained bone marrow (BM), thymus and SP. We identified mixed lymphocyte proliferation (MLR) by the BrdU method and we used irradiated BALB/c SP, as a stimulator for that trial. For the analysis of immune cells, we analyzed the cell surface markers from each organ. For cytokines, we identified TNF-alpha, IFN-gamma, TGF-beta, and IL-10 by ELISA from the supernatant of the MLR. RESULTS: The cell proliferation decreased according to specific H-2 complexes. There were increased CD4+CD25+ cells in the thymus. For the paracrine effects, the B-C3H SP showed ratio-dependent inhibitory effects, although the C-C3H SP inhibited some cell proliferation. There was no difference in the IFN-gamma, TNF-alpha and TGF-beta between the control and experimental groups. However, IL-10 was higher in the 1:10 ratio mixture in the control and transfused SP compared to the other groups. CONCLUSION: The results of this study suggested that the cellular components in transfusions might contribute to the immune regulatory effects by CD4+CD25+ cells after 24 hours.
Animals ; Blood Transfusion ; Bone Marrow ; Bromodeoxyuridine ; Cell Proliferation ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunomodulation* ; Interleukin-10 ; Interleukin-2 ; Lymphocytes ; Mice ; Mortality ; Recurrence ; Spleen ; Thymus Gland ; Transforming Growth Factor beta ; Tumor Necrosis Factor-alpha

Objectives: The purpose of this study was to identify any difference in user experience between tablet- and augmented reality (AR) glasses-based tele-exercise programs in elderly women. Methods: Participants in the AR group (n = 14) connected Nreal glasses with smartphones to display a pre-recorded exercise program, while each member of the tablet group (n = 13) participated in the same exercise program using an all-in-one personal computer. The program included sitting or standing on a chair, bare-handed calisthenics, and muscle strengthening using an elastic band. The exercise movements were presented first for the upper and then the lower extremities, and the total exercise time was 40 minutes (5 minutes of warm-up exercises, 30 minutes of main exercises, and 5 minutes of cool-down exercises). To evaluate the user experience, a questionnaire consisting of a 7-point Likert scale was used as a measurement tool. In addition, the Wilcoxon rank-sum test was used to assess differences between the two groups. Results: Of the six user experience scales, attractiveness (p = 0.114), stimulation (p = 0.534), and novelty (p = 0.916) did not differ significantly between the groups. However, efficiency (p = 0.006), perspicuity (p = 0.008), and dependability (p = 0.049) did vary significantly between groups. Conclusions When developing an AR glasses-based exercise program for the elderly, the efficiency, clarity, and stability of the program must be considered to meet the participants’ needs.

BACKGROUND: Accurate measurement of blood glucose concentrations is essential for defining diabetes, and the minimization of ex vivo glycolysis has been recommended. Recent guidelines advocate two kinds of methods for sample collection and processing: either the sodium fluoride (NaF) method or immediate refrigeration using a serum separation tube (SST). We investigated the difference between the two methods in measuring subsequent glucose concentrations using blood specimens from participants recruited for the fourth Korean National Health and Nutrition Examination Survey. METHODS: Paired venous blood samples were collected in an SST and a NaF tube from 1,103 men and women. SST serum was separated within 30 min, including standing for 15 min, and then refrigerated. The NaF samples were refrigerated, but not separated until immediately before analysis. We compared the blood glucose concentrations between the SST (SST glucose) and NaF (NaF glucose) methods. RESULTS: The mean SST glucose was significantly higher than NaF glucose (99.0 mg/dL vs 96.5 mg/dL, P<0.05). NaF glucose showed a negative mean bias of 2.6 mg/dL vs SST glucose but showed high correlation (R=0.9899). There was no significant correlation between the bias of blood glucose concentrations by two methods and the storage time of NaF glucose. CONCLUSIONS: The negative bias associated with the use of NaF tubes may significantly affect the prevalence of diabetes. Serum separation and refrigeration within 30 min after venous sampling is recommended over NaF method, not only to minimize the preanalytical impact on detecting diabetes but also to reduce sample volume and number of tubes.
Blood Glucose/*analysis ; Blood Specimen Collection/*methods ; Diabetes Mellitus/diagnosis ; Female ; Glycolysis/*drug effects ; Humans ; Male ; Nutrition Surveys ; Republic of Korea ; Sodium Fluoride/*pharmacology ; Specimen Handling

OBJECTIVE: The vulvar cancer is an uncommon disease among female population. Because of its rare incidence, sufficient clinical studies have not been accomplished. However, the prevelance of vulvar cancer will continue to increase because of rapid growth of senile population. The goal of this study is to review the clinical outcome and prognosis of patients with vulvar cancer through the analysis of their clinical data. METHODS: We have performed a retrospective clinical study on 23 patients diagnosed with primary invasive vulvar cancer at Asan medical center from May, 1989 to December, 2003. We reviewed demographic data, pathologic findings, treatments, stages, complications, prognosis and survival time. RESULTS: The mean age was 58.9 years. The most common symptoms were palpable mass (69.5%) and itching sense (21.7%). Among the 23 patients, 21 patients have underwent operation, and two patients who refused to receive operation underwent radiotherapy only. 3 of 21 patients who were surgically treated underwent neoadjuvant chemotherapy, and 5 patients, adjuvant radiotherapy. Histopathologically, squamous cell carcinoma (69.5%) was dominant, and 15 patients turned out to have stage II disease or greater (60.8%). Among the 21 patients who have underwent operation, postoperative complications occurred in 8 patients (38.0%) and 4 of them had underwent radical vulvectomy and bilateral groin lymph node dissection. The most common postoperative complication was wound breakdown (23.8%). CONCLUSION: Although surgery is the principal treatment in vulvar cancer, radical vulvectomy and bilateral groin lymph node dissection more often result in complications than other operations such as wide local excision and hemivulvectomy. Considering the mortality and morbidity, the prognosis of vulvar cancer is poor, but early diagnosis and adequate treatment according to each individual will improve the outcome and prognosis of vulvar cancer.
Carcinoma, Squamous Cell ; Chungcheongnam-do ; Drug Therapy ; Early Diagnosis ; Female ; Groin ; Humans ; Incidence ; Lymph Node Excision ; Mortality ; Postoperative Complications ; Prognosis ; Pruritus ; Radiotherapy ; Radiotherapy, Adjuvant ; Retrospective Studies* ; Vulva ; Vulvar Neoplasms* ; Wounds and Injuries

Hyperthyroidism may be associated or present with a variety of neuromuscular disorders, including thyrotoxic myopathy, exophthalmic ophthalmoplegia, periodic paralysis and myasthenia gravis. In contrast to muscle, peripheral nerve involvement in hyperthyroidism is exceedingly rare, and has received little attention. Paraplegia-like weakness during severe hyperthyroidism was first described by Charcot in 1889, and called Basedow's paraplegia' by Joffory in 1894. However, there has been no reported case in Korea. A 38-year-old woman was admitted for evaluation of progressive weakness and a gait disturbance. Her endocrinological results were compatible with hyperthyroidism. The polyneuropathy was also confirmed with sequential electrophysiological studies of the nerves and muscles. Drug therapy for hyperthyroidism resulted in resolution of the clinical neurological symptoms and progressive improvement of electrophysiological findings. Hyperthyroidisms are common medical disorders, which are often accompanied by diverse types of neurological and neuromuscular dysfunctions. All of these neurological manifestations are important, as they can serve as important clues to the diagnosis of a thyroid disorder. Furthermore, they are often related to the patient's presenting complaint. Therefore, the physician must be alert to the diverse manifestations of thyroid dysfunction, as they can lead to the diagnosis of potentially serious but treatable disorders. Herein is reported a case of myopathy and neuropathy associated with hyperthyroidism (Basedow's paraplegia), with a review of the literature
Adult ; Diagnosis ; Drug Therapy ; Female ; Gait ; Humans ; Hyperthyroidism ; Korea ; Muscles ; Muscular Diseases ; Myasthenia Gravis ; Neurologic Manifestations ; Ophthalmoplegia ; Paralysis ; Paraplegia* ; Peripheral Nerves ; Polyneuropathies ; Thyroid Gland