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*

No abstract available.
Nephrotic Syndrome*

PURPOSE: This paper evaluate and classified the risk factors that could possibly cause ischemic stroke in children, and investigate whether TOAST classification could be applied to the ischemic stroke in children. METHODS: From March 1995 to February 2002, we retrospectively reviewed the medical record of 87 patients under the age 16 who had been registered to the Ajou Stroke Registry. We evaluated the risk factors of ischemic stroke according to the Ajou Stroke Registry Protocol, and classified the risk factors into 6 main subgroups. In addition, the risk factors were investigated according to the age distribution. TOAST classification had been applied to children with ischemic stroke. RESULTS: There was 64 ischemic stroke(73.6%) and 23 hemorrhagic stroke(26.4%) among the 87 patients. In children with ischemic stroke, there was three major peak age; 13 patients younger than 1 year old(15.3%), 26 patients in age 5 to 8 years old(40.6 %), 22 patients in 9 to 12 years old(34.3%). Vasculopathy(48.6%) was the most common risk factor of the ischemic stroke in this study. Other important risk factors in order of frequency were hypertensive encephalopathy(12.5%), infectious disease(7.8%), metabolic disease(7.8%), and hematologic disease(6.2%). Moyamoya disease was the most common cause of ischemic stroke due to vasculopathy. If we analyze the risk factors according to the age at the presentation of ischemic stroke, 90% of the ischemic stroke due to vasculopathy had been developed after 5 years of age. However, ischemic stroke due to infectious disease had been developed less than 4 years of age. Major stroke was the most common subtype of the ischemic stroke in children, but TIA had been found in 80% of the patients with ischemic stroke due to moyamoya disease. TOAST classification determined the subtype of the ischemic stroke only in 2 children. Risk factors of ischemic stroke in the remained 62 patients were extremely variable, and could not be applicable to the TOAST classification. CONCLUSION: Risk factor of ischemic stroke were found in the 90% of patients. Although risk factors of ischemic stroke were extremely variable in children, cerebral vasculopathy including moyamoya disease was the most common. However, inherited metabolic disorder, coagulopathy, and hypertensive encephalopathy were also relatively common risk factors of ischemic stroke especially in children older than 5 years old. Therefore, we must extensively evaluate all the possible risk factors of ischemic stroke in children. TOAST classification could not be applicable in children because the risk factors of ischemic stroke were extremely variable.
Age Distribution ; Child* ; Child, Preschool ; Classification ; Communicable Diseases ; Humans ; Hypertensive Encephalopathy ; Medical Records ; Moyamoya Disease ; Retrospective Studies ; Risk Factors* ; Stroke*

Staphylococcus epidermidis is a normal inhabitant of skin, throat, mouth, vagina, and urethra. It is not usually pathogenic, particularly in immunocompetent hosts. This report describes a case of a pyogenic liver abscess caused by Staphylococcus epidermidis in a healthy 12-year-old boy. He was admitted to Seoul St. Mary's Hospital with intermittent fever for 6 days. Findings on abdominal computed tomography (CT) showed a mass measuring 7.0x6.5 cm in the right hepatic lobe. Culture of the abscess resulted in growth of Staphylococcus epidermidis as a causative organism. The patient was successfully treated with intravenous administration of antibiotics and percutaneous drainage of the abscess.
Abscess ; Administration, Intravenous ; Anti-Bacterial Agents ; Child ; Drainage ; Fever ; Humans ; Liver Abscess ; Liver Abscess, Pyogenic ; Mouth ; Pharynx ; Skin ; Staphylococcus ; Staphylococcus epidermidis ; Urethra ; Vagina

The purpose of this study was to evaluate the influence of high dose carbon tetrachloride (CCI4) on the hepatotoxic effect of dimethylnitrosamine (DMN) which induces acute hemorrhagic necrosis in liver. Rats were injected intraperitoneally DMN dissolved in physiologic saline by a dose of 40 mg/kg. For changes related to CCI⁴ pretreatment, rats were injected intraperitoneally CCI⁴ dissolved in olive oil by a dose of 0.4 mg/kg, and then injected DMN. The livers were extracted from the rats 3, 6, 12, 24, 48, 72, and 120 hours after CCI⁴ and/ or DMN injection. Liver tissues were examined with light and electron microscopes. The results were summarized as follows; Light microscopic findings: Severe centrilobular hemorrhagic necrosis developed from 12 hours after injection of DMN and continued to 120 hours. On injection of DMN after CCI4 pretreatment, Massive necrosis occurred early. But active regenerative changes were produced in 24 hours. In 120 hours, the liver recovered in almost normal appearance. The degree of necrosis in pretreated group was similar to that in DMN injection only, and the time of recovery was faster in pretreated group. Electron microscopic findings: The early change was mainly disorganization of RER in DMN injection, and clumping and vesicular dilatation of ER in injection of CCI4. In pretreatment group, the early change was similar in appearance with CCI4 group, but severer in degree. According to the results, it was revealed that acute toxic effect of DMN was recovered more rapidly in pretreatment group. Thus it was suggested that CCI4 had protective effect in DMN hepatotoxicity.
Animals ; Carbon Tetrachloride* ; Carbon* ; Dilatation ; Dimethylnitrosamine ; Hepatocytes* ; Liver ; Necrosis ; Olive Oil ; Rats

No abstract available.
Echocardiography* ; Endocarditis*

Lovastatin, a competitive inhibitor of the rate limiting enzyme in cholesterol biosynthesis was administered to 34 patients with primary hypertlipidemia, 20 mg once daily with the evening meal. Patients experienced mean total and LDL cholesterol reductions of 30.9% and 34.0% respectively. HDL cholesterol level was significantly increased by 15.4% and plasma triglyceride level was decreased by 11.2%. maximal hypocholesterolemic effects were evident at 8 weeks, after which the effects were stable. Adverse effects were noted in 2 patients who had mild gastrointestinal symptoms, that subsided after discontinuing the drug. We concluded that lovastatin is a well tolerated and effective agent for the treatment of primary hyperlipidemia.
Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Humans ; Hyperlipidemias* ; Lovastatin ; Meals ; Plasma* ; Triglycerides

No abstract available.
Heart Valve Prosthesis* ; Heart Valves*

No abstract available.

BACKGROUND: The claudins are a family of transmembrane proteins associated with tight junctions and they are critical for maintaining cell-to-cell adhesion in sheets of epithelial cells. However, their role in the progression of cancer remains largely unexplored. The aims of this study were to evaluate the expression patterns of claudin-1 and -4 in benign lesions and invasive ductal carcinomas (IDC) of the breast, and relationships between the expression of these markers and the clinicopathological characteristics in IDC patients. METHODS: We examined the claudin-1 and -4 protein expressions by performing immunohistochemical stainings in 54 benign lesions and 120 IDCs via the tissue microarray method. We evaluated the correlation between the expression of these markers and the clinicopathological characteristics of IDC. RESULTS: The expressions of claudin-1 (p=0.099) and -4 (p=0.000) were up-regulated in IDCs as compared with benign lesions. The claudin-1 expression correlated with the loss of estrogen receptor (p=0.036) and progesterone receptor (p=0.011). The claudin-4 expression correlated with lymph node metastasis (p=0.043), the nuclear grade (p=0.030), the histologic grade (p=0.007), and the loss of estrogen receptor (p=0.001) and progesterone receptor (p= 0.029). CONCLUSIONS: These results suggest that claudin-1 and -4 may play a significant role in the carcinogenesis of IDC of the breast and these may represent novel markers for this disease.
Breast* ; Carcinogenesis ; Carcinoma, Ductal* ; Claudin-1* ; Claudin-4 ; Claudins ; Epithelial Cells ; Estrogens ; Humans ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Receptors, Progesterone ; Tight Junctions