BACKGROUND: We prospectively evaluated the incidence and possible factors causing intramuscular injection during lumbar sympathetic ganglion block and compared the multiple needle technique to the single technique to obtain a profound and complete block effect. METHODS: Among 83 patients, 58 patients (group A, n = 27, multiple needle technique and group B, n = 31, single needle technique) were reevaluated for the changes of skin temperature (Ts) and mean segment of longitudinal contrast spread. After injecting the contrast agent, the incidence of psoas muscle injection and the change of Ts was compared between two groups. RESULTS: The incidence of psoas muscle injection was 21.3% (46/216) and it was associated with the level of injection (L2) significantly (chi-square = 14.773, P = 0.001). DT(post) (postblock temperature difference between ipsilateral and contralateral great toe, 4.6 +/- 2.8degrees C, 1.8 +/- 1.6degrees C, P < 0.001 for group A and B) and DT(net) (DT(post) - DT(pre), 3.9 +/- 2.7degrees C, 1.5 +/- 1.5degrees C, P < 0.001 for group A and B) was significantly higher in group A. The mean segment of longitudinal contrast spread was 8.1 +/- 0.9 for group A and 3.2 +/- 1.6 for group B (P < 0.001). CONCLUSIONS: The LSGB at the L2 level showed the lowest incidence of psoas muscle injection of contrast. Multiple needle approach showed more significant increase of DT(net) and DT(post).
Ganglia, Sympathetic ; Humans ; Incidence ; Injections, Intramuscular ; Needles ; Prospective Studies ; Psoas Muscles ; Skin Temperature ; Toes

The elderly can experience a lot of stressful events and the stress acts as a various fluent that affects a well-being level, the self-contentment of lives. and the achievements by themselves. Also. the elderly are different from the young in many unexpressed stress and have diverse copings for perceived stress. Moreover. they mainly seem to use a problem-focused coping and an emotion-focused coping. To use whatever copings is to improve the quality of life in the old period and very important fact to achieve their ends. The purpose of this study was to investigate the relationship between Perceived Stress and the Ways of Coping in the Elderly and to gain the baseline data for development of nursing intervention program for improve to the quality of life in the elderly. The design of this study was a correlational study. The subjects of this study consisted of 230 of the elderly living in Pusan. The data was collected from 1st July, to 1st September. 2002. The instruments used for this study were 'Perceived Stress Scale(20items, 5point. scale)' developed by Kang In(990) and translated by Lee young-ja(1999). and its reliability is Cronbach's a= .89. Coping Scale(30items, 4point. scale. 14 items about a problem-focused coping, 16 items about an emotion-focused coping, 4 points scale) developed by Lazarus & Folkman (1984) and translated by Yang Young-hee(1998). The reliability of this study is Cronbach's a = .90. The data was analyzed by the SPSS WIN 10.0 program using frequency, percentage, mean, standard deviation, t-test, ANOVA & Scheffe test and Pearson's correlation coefficient. The results of this study were as follows: 1. The mean score of perceived stress was 31.75+/-0.23(Min 20, Max 100), which the item mean score was 1.59+/-.51(Min 1. Max 5). 2. The number of subjects in a problem-focused coping was 72(31.3%), the number of subjects in an emotion-focused coping was 158(68.7%) 3. There were statistically significant positive correlation between perceived stress and problem-focoused coping method and the more emotion-focoused coping method. (r = .180, r= .209, p< .05). It means the more stress, the more problem-focoused coping method and the more emotion-focoused coping method. 4. There was significant difference the score of perceived stress according to sex (F=-5.057, P=.000)marital status, (F=-2.909. P=.004) , economic level, (F=10.243, P=.000), paticipated meeting, (F=9.346, P=.000), perceived health status(F=5.1l7, P=.007). 5. There was significant difference the score of problem-focoused coping method according to age(F=14.200, P=.000), marital status (F=2.432, P=.0160), economic level (F=14.410, P=.000), monthly income, (F=8.300. P= .000), income resource (F=10.235, P=.000), educational level (F= 15.222, P= .000), occupation (F= 1.544, P=.04l), paticipated meeting (F=4.936, P= .008), perceived health status(F=5.655, P= .004). And there was significant difference the score of emotion-focoused coping method according to monthly income(F=4.781, P= .009), income resource (F=2.930, P= .035), educational level (F=6.101. P=.003), religion(F=2698, P= .032), paticipated meetings(F=7.285, P= .00l). As a result of the study, the elderly had a bit less stress and the two-thirds of the elderly used the emotion-focused coping. Thus, the more perceived stress, the more problem-focoused coping method and the more emotion-focoused coping method. Accordingly, to improve the quality of life of the elderly, there needs and applies a nursing intervention program that relieves the stress and use effective coping method.
Aged* ; Busan ; Humans ; Life Change Events ; Marital Status ; Nursing ; Occupations ; Quality of Life

Aged ; Female ; Humans ; Male ; Middle Aged ; Pharyngeal Diseases ; pathology ; Polyps ; pathology

The cystic lesions within the knee joint are rare, contrary to those located around the knee. They usually are eniscal or ganglion cyst, reported in association with the joint capsule of the knee or the menisci and close to the peroneal tendons. The intraarticular ganglion cyst arising from the cruciate ligaments are rare and cause pain, effusion and limitation of the knee joint. We report (he case of a patient with right knee joint pain caused hy an intraarticular ganglion cyst arising from the posterior cruciate ligament with review of reference.
Ganglion Cysts* ; Humans ; Joint Capsule ; Knee ; Knee Joint ; Ligaments ; Posterior Cruciate Ligament* ; Tendons

This study was undertaken to investigate the effect of anesthesia(balanced anesthesia) and surgery on plasma thyroxine and triiodothyronine levels in ten surgical patients by means of the radioimmunoassay method which provides a quantitative measure of thyroid function. The sex ratio between male and female patients was 1:1, mean age was 30.1+/-12.26 and the average body weight was 57.38+/-15.81kg. The plasma triiodothyronine level before anesthesia and surgery was 138.1+/-32.64(ug/dl) but at 90 minutes and 120 minutes after anesthesia and surgery they were 100+/-19.64(ug/dl) and 92.4+/-7.49(ug/dl) respectively. The plasma thyroxine level remained unchanged during anesthesia and surgery. Consequently there was a statistically significant decreased level in plasma triiodothyronine but there was no change in plasma thyroxine level during anesthesia and surgery.
Anesthesia* ; Balanced Anesthesia* ; Body Weight ; Female ; Humans ; Male ; Plasma* ; Radioimmunoassay ; Sex Ratio ; Thyroid Gland ; Thyroxine* ; Triiodothyronine*

Chilblain lupus erythematosus(CLE) is a chronic unremitting from of LE seen predomin antly in women, The chilblain lesion occurs commonly on the digits, calves and heels. Chronic facial discoid LE usually appears before the chilblain form. A 23-year-old female had relatively well defined, erythematous discoid plaques on her both cheeks and scattered erythema multiforme-like ring lesions on her right hand and right wrist. There were also chilblain lesions showing multiple, purple colored macules on her knees, lower legs and periungual areas of fingers and toes. The skin lesions developed at November, 1982 and then the skin lesions remitted during the next summer. The skin lesions recurred at December, 1983.
Cheek ; Chilblains* ; Erythema ; Female ; Fingers ; Hand ; Heel ; Humans ; Knee ; Leg ; Skin ; Toes ; Wrist ; Young Adult

By Enzinger and Weiss classification, 664 cases of soft tissue tumors, which were confirmed histologically at the department of pathology of Hangang Sacred Heart Hospital from Janusry 1979 to December 1988, were analyzed statistically. The results were as follows : 1. Of the 664 cases, 261 cases (39.3%) were consulted at the Department of General Surgery, 124 cases (18.7%) were consulted at the Department of Orthopedic Surgery, 115 cases (17.3%)were consulted at the Department of Dermatology. 2, Of the 664 cases, 631 cases (95%) were benign and 33 cases (5%) were malignant. 3. The most common benign tumor was lipoma, which was followed by hemangioma and lymphangioma. Among malignant tumors liposarcoma was the most common one, followed by malignant fibrous histiocytoma. 4. The distribution of age of benign tumor was relatively even from childhood to old age but that of malignant tumor showed highest prevalence in 7th decade. 5. The distribution of sex of benign tumor showed male to female ratio of 1: 1.1 but that of malignant tumor showed male to female ratio of 1.5: l. 6. The predilection sites of benign tumors were head, neck and trunk, but those of malignant tumors were lower extremities and trunk. 7. Kinds of soft tissue tumors consulted at the Department of Dermatology were hemangioma, neurofibroma, lipoma, dermatofibroma, ymphangioma, leiomyoma, juvenile xanthogranuloma, xanthoma, keloid and neurilemmoma.
Classification ; Dermatology ; Female ; Head ; Heart ; Hemangioma ; Histiocytoma, Benign Fibrous ; Histiocytoma, Malignant Fibrous ; Humans ; Keloid ; Leiomyoma ; Lipoma ; Liposarcoma ; Lower Extremity ; Lymphangioma ; Male ; Neck ; Neurilemmoma ; Neurofibroma ; Orthopedics ; Pathology ; Prevalence ; Xanthogranuloma, Juvenile ; Xanthomatosis

Actins ; metabolism ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Back ; Desmin ; metabolism ; Diagnosis, Differential ; Fibrosarcoma ; pathology ; Humans ; Infant ; Male ; Neoplasm Recurrence, Local ; Reoperation ; Rhabdomyosarcoma ; drug therapy ; pathology ; surgery ; Vimentin ; metabolism

Psychopharmacotherapy is one of the effective treatments for the children and adolescents with attention-deficit hyperactivity disorder (ADHD). If there were a marginal improvement or significant adverse effects after having the first line medication such as psychostimulants and atomoxetine, the youth with ADHD can take alternative medications. If they have comorbidities such as disruptive behavior disorder, bipolar disorder, mental retardation and tic disorder, they need to have more medications. Recently, prescriptions of atypical antipsychotics were increasing among them. The efficacy, safety, and tolerability of atypical antipsychotics in the youth should be considered.
Adolescent ; Antipsychotic Agents ; Attention Deficit and Disruptive Behavior Disorders ; Bipolar Disorder ; Child ; Comorbidity ; Humans ; Intellectual Disability ; Prescriptions ; Propylamines ; Tic Disorders ; Atomoxetine Hydrochloride

OBJECTIVETo investigate the expression of zinc finger E-box binding homebox 1 (ZEB1) in the prepuce of hypospadias children and its relationship to the incidence of hypospadias.

METHODSPrepuce tissues were collected from 37 children aged 6-15 months undergoing hypospadias repair and 11 age-matched controls receiving circumcision. Based on the position of the urethral meatus, the hypospadias cases were classified as severe (n = 13) and mild-moderate (n = 24). The mRNA and protein expressions of ZEB1 were determined by immunohistochemistry and RT-PCR.

RESULTSThe expression of the ZEB1 protein was remarkably higher in the severe (100% [13/13]) and mild-moderate hypospadias patients (75.0% [18/24]) than in the controls (9.1% [1/11]), with statistically significant differences between any two groups (P < 0.05). RT-PCR showed the integrated density value (IDV) of the ZEB1 mRNA expression to be (0.67 ± 0.21), (0.81 ± 0.24), and (1.55 ± 0.29) in the control, mild-moderate, and severe hypospadias patients, respectively, significantly higher in the severe hypospadias than in the control and mild-moderate hypospadias groups (P < 0.05), but with no significant difference between the latter two (P = 0.64).

CONCLUSIONThe expression of ZEB1 is significantly increased in hypospadias patients, and its upregulation is positively correlated with the severity of hypospadias, which suggests that the overexpression of ZEB1 may contribute to the development of hypospadias.

Biomarkers ; metabolism ; Case-Control Studies ; Circumcision, Male ; Foreskin ; metabolism ; Homeodomain Proteins ; genetics ; metabolism ; Humans ; Hypospadias ; classification ; etiology ; metabolism ; Immunohistochemistry ; Infant ; Male ; Penis ; RNA, Messenger ; metabolism ; Transcription Factors ; genetics ; metabolism ; Up-Regulation ; Urethra ; Zinc Finger E-box-Binding Homeobox 1