Neurocutaneous melanosis is a very rare congenital syndrome characterized by the presence of large or multiple congenital melanocytic nevi and benign or malignant melanotic tumors of the central nervous system. We report herein a case of neurocutaneous melanosis with leptomeningeal melanosis and a malignant melanoma of the right temporal lobe in a 46-year old man. The case is exceptional as regards the late onset of symptoms and death. Even without a malignant melanoma, the symptomatic neurocutaneous melanosis has a fatal course. The syndrome is rare but lethal, so the dermatologist should be aware of this syndrome when evaluating the patients with large or numerous congenital melanocytic nevi so as to watch for the usual signs of increased intracranial pressure and to take prompt palliative measures.
Central Nervous System ; Humans ; Intracranial Pressure ; Melanoma ; Melanosis* ; Nevus, Pigmented ; Temporal Lobe

This study is designed to compare differences of the infant mothers' nursing educational needs between primipara and multipara. And also this study will provide the basic data for the development of Infant care educational programs based on personal characteristics. The subjects of this study were 71 infant-mothers who just experienced delivery. They were selected from a collage hospital and a obstetric hospital in D city, Korea. The tool used in this study was educational need scale developed by Choe, SeonJeong(2000), and modified by researchers. The subjects were requested to check complete the questionnaires by self-report method at the time of hospital discharge. The data were collected from February 7 to April 10, 2001. and were analysed by descriptive statistics, mean, std deviation, t-test, ANOVA with SPSS 10.0. The results of this study were as follows ; 1. The differences of the infant mothers' nursing educational needs were not significantly between primipara and multipara. 2. In the each category of the infant mothers' nursing educational needs, we could see the differences between primipara and multipara as following ; Infant care(t=2.803, p=.007), Attachment between parents and infant (t=2.442, p=.017). 3. In accordance with general characteristics, the infant mothers' nursing educational needs differed significantly according to religion in primipara and according to satisfaction of marriage in multipara. 4. In accordance with obsterical characteristics, the infant mothers' nursing educational needs differed significantly according to places of postpartum care in primipara. In conclusion, this study confirmed that the nursing educational needs of the mothers did not show significant difference between primipara and multipara. However, two subareas' parts of the infant mothers' nursing educational needs, infant care and attachment between parents and infant showed significant difference between primipara and multipara. And the infant mothers' nursing educational needs differed significantly between primipara and multipara according to several personal characteristics. Therefore the results of this study might give some real data for the development of the Infant Care Programs based on personal characteristics.
Humans ; Infant ; Infant Care* ; Infant* ; Korea ; Marriage ; Mothers ; Nursing ; Parents ; Postnatal Care ; Child Health ; Surveys and Questionnaires

The purpose of this study was to construct model of sexual adjustment in people with spinal cord injury and to determine factors that relate to sexual adjustment using methodological triangulation. A total of 134 persons who were registered members of spinal cord injury organization and admitted rehabilitation unit in the hospital were included in the study. Participants answered questionnaire concerning importance of life events, sexual concern, sexual adjustment. Qualitative data were collected through semi-structured indepth interviews from 10 individuals with spinal cord injury who were previously included in the quantitative study. Constant compatative method was used to analyze the data. The results were as follows: 1) With respect to eleven other areas of life, sex life ranked the sixth and economic status ranked the highest in terms of importance. However social life ranked the lowest among the 11areas. 2) Among seven topics related to sexuality were methods and techniques to achieve sexual satisfaction, and helping a partner cope emotionally with limitation on sexual dysfunction was the second greastest. 3) The mean score for sexual adjustment was 19.47 which can be considered. 4) A process on how individuals with spinal cord injury adjust to their changed sexual life immerged from the qualitative data. It includs 4 stages: 'stage of loss' 'stage of endeavoring' 'stage of effort' and 'stage of adjustment'. Categories showing context for the action/interaction strategies were 'steadiness' and 'rediscovery as a sexual being'. There were three factors which may stimulate the adjustment process while the others may interrupt it. Those factors included personal matters, family matters and social matters. The individuals may follow each stage step by step but may go back to the previous step depending on the outcomes of their adjustment. 5) There were three factors which may stimulate the adjustment process while the others may interrupt it. Those factors included personal matters, family matters and social matters.
Humans ; Surveys and Questionnaires ; Rehabilitation ; Sexuality ; Spinal Cord Injuries* ; Spinal Cord*

PURPOSE: To evaluate the radiologic manifestations of the rectal leiomyosarcoma. MATERIALS AND METHODS: We reviewed CT and barium study of 2 cases of rectal leiomyosarcoma, which were operated and pathologically proved. RESULTS: In both cases colon studies showed a huge smooth marginated filling defect in the rectum. Precontrast CT scans showed a well-circumscribed, slightly Iobulated, inhomogeneous mass without calcification. Postcontrast scans showed minimal enhancement with internal low-density areas. In pathologic specimens there were large areas of necrosis and hemorrhage in the masses. Pericolic fat infiltration, lymph node metastasis, or distant metastasis were not detected. CONCLUSION: Leiomyosarcoma is rarely developed in the rectum, but general radiologic findings are similar to that of other part of the gastrointestinal tracts except for the tendency of intraluminal growth due to narrow pelvic space.
Barium ; Colon ; Gastrointestinal Tract ; Hemorrhage ; Leiomyosarcoma* ; Lymph Nodes ; Necrosis ; Neoplasm Metastasis ; Rectum ; Tomography, X-Ray Computed

The purpose of this study is to identify and describe a process of sexual adjustment of individuals with spinal cord injury: and to describe and explore positive and negative influences on the adjustment process. This qualitative study was conducted with 10 Korean individuals with spinal cord injury who had been physically disabled for more than one year. Data were collected and analysed at a same time using grounded theory method. Major categories of this study showed a process how the individuals with spinal cord injury adjust to their individual life as sexual beings. The process included Changes of life caused by physical disability> Emotional distress> Stability of life> Recognition of self as a sexual being> Re-establishing own sense of values for sexual life> Behavioral efforts for restoration of sexual life> and individual responses to the behavioral efforts including Frustration> Resignation> Satisfaction> Dissatisfaction> and Limited satisfaction>. Initially physical aspects of sexuality seemed to be affected by spinal cord injuries. The changed physical aspects then influenced other aspects of their sexual life. Life satisfaction of each individual as a sexual being revealed as very subjective. It could be defined according to how the individual approved their sexual life no matter what and how much behavioral effort the person had done. In this study 3 types of sexual adjustment aspects were explored: 'Active adjustment' 'Passive adjustment' 'Maladjustment'. There were negative and positive factors influencing the adjustment process of individuals with spinal cord injury. Those factors might come from themselves. from families. or from social situations. Findings of this study suggested that sexual life of individuals with spinal cord injury should not be understood as a physical or behavioral matter. It was a combination of physical. psychological and social aspects of life. Therefore. appropriate rehabilitation programs for the sexual adjustment of individuals with spinal cord injury need to concern heterogeneous life values of them and obtain individualized services for each individual at a different stage of the sexual adjustment process.
Disabled Persons ; Humans ; Rehabilitation ; Sexuality ; Spinal Cord Injuries* ; Spinal Cord*

The purposes of this study were to identify sexual interest and adjustment in patients with spinal cord injury and to determine the factors that relate to sexual adjustment. A total of 134 persons included in this study was the members of spinal cord injury organization and the impatients in rehabilitation unit between February and June 1999. Five questionnaires were answered concerning importance of life events, sexual concern, sexual adjustment, relationship with a sex partner, and depression. The collected data were analyzed by Frequency, t-test, ANOVA and pearson correlation. The results were as follows: 1) Considering the importance among 11 areas of life, economic status occupied the top, sex life held the sixth rank, and the mean rating for social life being 3.78 was the lowest of all. 2) As regard to 7 topics related to sexuality, the most attention was drawn to methods and techniques achieving sexual satisfaction, and the next interest was for helping partners cope emotionally with sexual dysfunction. 3) The mean for sexual adjustment and depression was average, and the mean for sex partner relationship was high. 4) Sexual adjustment in spinal cord injury patients correlated with economic status and sex partner relationship. While it was inversely correlated with age and depression. It was found that lower age and less depression play a positive role on sexual adjustment by SCI people. Also, higher economic status and favorable sex partner relationship increase sexual adjustment. In conclusion, a sex partner relationship, depression, economic status, and age seemed to influence on their sexual adjustment after SCI. Also, psychosocial factors would be more important for satisfying sexual life and relationship rather than physical factors.
Depression ; Economic Recession ; Humans ; Psychology ; Surveys and Questionnaires ; Rehabilitation ; Sexuality ; Spinal Cord Injuries* ; Spinal Cord*

BACKGROUND: Unstable angina is a critical phase of ischemic heart disease, but there are no reliable noninvasive methods of assigning patients to different prognostic actegories. Recently cardiac Troponin-T has been developed as a new myocardial specific marker, especially myocardial injury. We investigated the value of the Troponin-T in unstable angina to determine whether the increase of cardiac Troponin-T might be a useful predictor of prognosis. METHODS: Unstable angina is defined as Braunwald classification(Class I, II, III). CLass I is new onset of severe angina or accelerated angina and no rest pain, class II is angina at rest but not within preceding 48 hour, and class III is angina at rest within 48 hour. We studied 16 cases of unstable angina(male:10, mean age:57+/-2year). We measured Troponin-T and CK-MB at admission, after 6 hours, and every 8 hour for 2 days. For the determination of serum Troponin-T, an enzyme immunosorbent assay (Boehringer Mannheim, ES 300 analyzer) was used. Above 0.1ng/ml was regarded as positive. During the admission, we investigated the myocardial infartion, sudden death, and the need of emergency PTCA and CABG. RESULTS: 1) Among 16 unstable angina patients, there are 12 patients in Class I(range 0.001-0.13, mean SD 0.04 0.01, median 0.02ng/ml) and 4 patients in Class III(range 0.03-1.56, mean SD 0.39 0.2, median 0.27ng/ml) and 4 patients showed positive value of Troponin-T. One was in Class I and the others were in Class III. 2) During the admission, one patient expired due to cardiogenic shock preceding inferior myocardial infarction, and 2 patients progressed non-Q wave myocardial infarction(NQMI). These 3 patients were in unstable angina Class III and had positive Troponin-T value. In Class I, one patient performed emergency CABG due to consistent chest pain at the sixth hospital day. These patient had negative Troponin-T value. 3) CK-MB increased in one patient with NQMI, and the other patients were not increased. CONCLUSION: Cardiac Troponin-T in serum appears to be a more sensitive indicator of myocardial cell injury than serum creatine Kinase MD activity, and its detection in the circulation may be a useful porgnostic indicator in patients with unstable angina.
Angina, Unstable* ; Chest Pain ; Creatine Kinase ; Death, Sudden ; Emergencies ; Humans ; Inferior Wall Myocardial Infarction ; Myocardial Ischemia ; Prognosis ; Shock, Cardiogenic ; Troponin T*

BACKGROUND: Bacteria of the Mycobacterium abscessus group are the second most common pathogens responsible for lung disease caused by nontuberculous mycobacteria in Korea. There is still a lack of studies investigating the genetic mechanisms involved in M. abscessus resistance to antibiotics other than clarithromycin. This study investigated the characteristics of drug resistance exhibited by M. abscessus clinical isolates from Korea. METHODS: We performed drug susceptibility testing for a total of 404 M. abscessus clinical strains. Subspecies were differentiated by molecular biological methods and examined for mutations in drug resistance-related genes. RESULTS: Of the 404 strains examined, 202 (50.00%), 199 (49.26%), and 3 (0.74%) strains were identified as M. abscessus, M. massiliense, and M. bolletii, respectively. Of the 152 clarithromycin-resistant strains, 6 possessed rrl mutations, while 4 of the 30 amikacin-resistant strains contained rrs mutations, and 5 of the 114 quinolone-resistant strains had gyr mutations. All mutant strains had high minimal inhibitory concentration values for the antibiotics. CONCLUSIONS: Our results showed the distribution of the strains with mutations in drug resistance-related genes was low in the M. abscessus group. Furthermore, we performed drug susceptibility testing and sequence analyses to determine the characteristics of these genes in the M. abscessus group.
Anti-Bacterial Agents/pharmacology ; Bacterial Proteins/genetics ; Clarithromycin/pharmacology ; DNA Gyrase/genetics ; *Drug Resistance, Bacterial ; Humans ; Methyltransferases/genetics ; Microbial Sensitivity Tests ; Mutation ; Mycobacterium/drug effects/*isolation & purification ; Mycobacterium Infections, Nontuberculous/diagnosis/*microbiology ; Republic of Korea ; Sequence Analysis, DNA

To report on Achromobacter xylosoxidans keratitis in two healthy patients who had worn contact lenses foran extended period of time. A 36-year-old female and a 21-year-old female visited our hospital with ocular pain and blurred vision. Both patients had a history of wearing soft contact lenses for over fve years with occasional overnight wear. At the initial presentation, a slit lamp examination revealed corneal stromal infiltrations and epithelial defects with peripheral neovascularization in both patients. Microbiological examinations were performed from samples of corneal scrapings, contact lenses, contact lens cases, and solution. The culture resulting from the samples taken from the contact lenses, contact lens cases, and solution were all positive for Achromobacter xylosoxidans. Confrming that the direct cause of the keratitis was the contact lenses, the frst patient was prescribed ceftazidime and amikacin drops sensitive to Achromobacter xylosoxidans. The second patient was treated with 0.3% gatifoxacin and fortifed tobramycin drops. After treatment, the corneal epithelial defects were completely healed, and subepithelial corneal opacity was observed. Two cases of Achromobacter xylosoxidans keratitis were reported in healthy young females who wore soft contact lenses. Achromobacter xylosoxidans should be considered a rare but potentially harmful pathogen for lens-induced keratitis in healthy hosts.
Achromobacter denitrificans/*isolation & purification ; Adult ; Amikacin/administration & dosage ; Anti-Bacterial Agents/*administration & dosage ; Ceftazidime/administration & dosage ; Contact Lenses, Extended-Wear/*adverse effects ; Female ; Fluoroquinolones/administration & dosage ; Gram-Negative Bacterial Infections/diagnosis/*drug therapy/*microbiology ; Humans ; Keratitis/diagnosis/*drug therapy/*microbiology ; Tobramycin/administration & dosage