PURPOSE: The purpose of this Study was to identify the factors that affect the caregiving burdens felt by the female family caregivers and quality of caregiving. METHOD: The subjects were 247 female family caregivers who were living with the elderly and were residing in Seoul. Data was collected from June 30, 2000 to Agust 11 by using questionnaire. The collected data was analyzed using descriptive statistics and hierarchial multiple regression with SAS/PC. RESULT: Situational factors had the greatest influence on the caregiving burdens. While the interactive factors of discrepancy between past and present image of elder and the caregiving belief were proven to be significant, the former had greater influence. The factors affecting the quality of caregiving, this is greatly influenced by situational factors and interactive factors. The discrepancy between past and present image of elder had relatively little influence while caregiving belief had the greatest influence. Among the situational factors, family stress had the greatest influence, while the caregiving burdens had little influence on the quality of caregiving. CONCLUSION: In order to improve the quality of caregiving in elderly by the female caregiver in the family, and to reduce the caregiving burdens, it is important to consider variables related to interaction as well as those directly concerned with caregiver and the elderly for nursing intervention.
Aged* ; Caregivers* ; Female* ; Humans ; Nursing ; Seoul ; Surveys and Questionnaires

A 20-year-old woman was admitted because of intractable seizures, myoclonus, gait ataxia, and severe intellectual deterioration with age of onset at 16 years. She had no family history of neurological disease. A thorough laboratory investigation was unremarkable. Brain MRI showed generalized cerebral and cerebellar atrophy. Interictal EEG showed intermittent generalized polyspike and waves, maximum on the bilateral parieto-occipital areas, and MNSEP showed giant cortical SEP. Brain biopsy revealed intraneuronal accumulation of granular osmiophilic deposits (GROD), which is characteristic of electromicroscopic findings of neuronal ceroid lipofuscinosis (NCL). We report biopsy-proven adult NCL, which is one of the rare neurodegenerative diseases. (J Korean Neurol Assoc 19(1):45~48, 2001
Adult* ; Age of Onset ; Atrophy ; Biopsy* ; Brain* ; Electroencephalography ; Female ; Gait Ataxia ; Humans ; Magnetic Resonance Imaging ; Myoclonus ; Neurodegenerative Diseases ; Neuronal Ceroid-Lipofuscinoses* ; Neurons* ; Seizures ; Young Adult

BACKGROUND: The automated border detection(ABD) echocardiography has the ability of recognizing the endocardial-blood interface, and therefore, on-line estimation of the left ventricular(LV) volume every cardiac cycle. Compared with the off-line conventional 2-dimensional echocardiographic method that requires tracing the endocardial border manually, the ABDd system can be a convenient and objective method in the estimation of the LV volume and the ejection fraction(EF). The purpose of this study is to compare the LV volume and EF between the on-line ABD system and the convertional off-line echocardiographic method. METHODS: In two weeks, 83 adult patients older than 16 years of age were referred to our echocardiographic laboratory. Among these 83 patients, 64 patients who had a normal sinus rhythm were included to our study. Using the Hewlett-Packard SONOS 1500, a 2.5 MHz transducer was placed dat the cardiac apex. Patients with an apical 4 chamber view of the LV in which at least 75% of the endocardium was clearly seen were selected for study. On that view, the ABD system was turned on, and the reansmit power and the time-gain compensation controls were adjusted in order to approximate the automated border to the visually apparent endocardial surface. The LV end-diastolic volume(LVESV) and LV end-systolic volume(LVESV) were calculated by the method of disc. LVEDV, LVESV, and EF were displayed every cardiac cycle. Also the off-line estimation of the LV volume was performed by the method of disc, after manually tracing the endocardial border on the apical 4 chamber view. RESULTS: 44 patients(69%) of 64 patients had > or =75% of the LV endocardium visualized. LVEDV, LVESV, and Ef with the ABD system were highly correlated with those with the off-line, manually traced method(r=0.95, 0.8, respectively), but LVEDV and EF with toe ABD system were significantly less than those with the latter(p<0.01). The limits of agreement between tow methods(off-line, manually traced method-ABD system) were somewhat wide. Those of LVEDV, LVESV and EF were +22~-10ml(mean 6ml), +15~-14ml(mean 0.1ml), and +19~-12%(mean 3.8%), respectively. CONCLUSION: LVEDV,LVESV, and EF measurements by the ABD system and the off-line manually traced methods thve a strong correlation, The ABD system should habe clinical applications in setting, in which measurements of LV volume and Ef are important, But, the comparison with a more reliable method is necessary.
Adult ; Compensation and Redress ; Echocardiography* ; Endocardium ; Humans ; Toes ; Transducers

No abstract available.
Actinomycosis*

BACKGROUND: The recent studies shows that LV relaxation abnormalities are the important factors of heart failure in elders. To determine the association between LV diastolic functions and heart failure, we assessed LV diastolic functions in elderly patients with pulmonary congestion and in asymptomatic elders by using pulsed doppler echocardiography. METHODS: In order to assess LV diastolic function, we performed pulsed doppler echocardiography to elderly patients with pulmonary congestion and asymptomatic elders from Mar.2001 to Sep.2001. The following parameters were used as indices of LV diastolic function; Mitral E wave(E), Mitral A wave(A), Deceleration time(DT), Isovolumic relaxation time(IVRT), Systolic pulmonary venous flow(PVs), Diastolic pulmonary venous flow(PVd). RESULTS: In elderly patients groups, there was significant increase in deceleration time compared with asymptomatic elders(255.83+/-54.41 vs 210.80+/-48.53, p<0.05). There was significant increase in isovolumic relaxation time in elderly patient group compared with asymptomatic elders(123.06+/-25.07 vs 98.78+/-15.12, p<0.01). Although there was no significant difference, decreased E/A ratio and increased PVs/PVd were noted in both groups. CONCLUSIONS: The results shows that the impairments of LV diastolic function were noted in both groups. Especially DT and JVRT were significant increase in elderly patient group with pulmonary congestion. Therefore these parameters, such as DT, IVRT, can be helpful as predictive indices of diastolic heart failure in elders.
Aged* ; Deceleration ; Echocardiography, Doppler, Pulsed ; Estrogens, Conjugated (USP)* ; Heart Failure ; Heart Failure, Diastolic ; Humans ; Relaxation

Coronary artery fistula is an unusual anomaly that consists of a communication between one of the coronary arteries and a cardiac chamber or vein. It has hemodynamic significance, complicated by congestive heart failure, bacterial endocarditis, rupture or thrombosis of the fistula or an associated arterial aneurysm, myocardial ischemia, and arrhythmias. It occurs in congenital, traumatic, neoplastic, or artherosclerotic cardiac disorders. It is being diagnosed with increasing frequency with widespread use of selective coronary angiography. However, acquired coronary artery fistula after acute myocardial infarction is a rare clinical entity, and it has not been reported in Korea yet. We observed a 62-year-old male patient with intermittent chest pain at rest, in whom serial coronary angiography showed newly developed communications from the left anterior descending coronary artery to the left ventricular chamber several months after acute myocardial infarction of the anteroseptal wall. The area of communication corresponded to the site of infarction as established by contrast echocardiography.
Aneurysm ; Arrhythmias, Cardiac ; Chest Pain ; Coronary Angiography ; Coronary Vessels* ; Echocardiography ; Endocarditis, Bacterial ; Fistula* ; Heart Failure ; Heart Ventricles* ; Hemodynamics ; Humans ; Infarction ; Korea ; Male ; Middle Aged ; Myocardial Infarction* ; Myocardial Ischemia ; Rupture ; Thrombosis ; Veins

The association of carcinoma and tuberculosis in any organ is rare and in the endometrium is extremely rare. Only a small number of cases of endometrial tuberculosis with coexisting endometrial adenocarcinoma have been reported in the literature. We experienced a case of endometrial tuberculosis with coexisting endometrial adenocarcinoma and report with a brief review of literature.
Adenocarcinoma* ; Endometrium* ; Female ; Tuberculosis*

BACKGROUND: Despite advances in chemotherapy, the treatment of inoperable non-small cell carcinoma of the lung remains poor. According to the recent reports, the response rates of mitomycin, vinblastine, and cisplatin(MVP) chemotherapy are higher than those of other cisplatin based polychemotherapy and MVP chemotherapy can be used as neoadjuvant chemotherapeutic regimen. But the overall response rates of MVP chemotherapy range from 17 to 53 percent, so we studied the effect of MVP chemotherapy in advanced non-small cell lung cancer. METHOD: We treated forty patients with stage III or IV non-small cell lung cancer with two courses of MVP chemotherapy (8mg/m2 of mitomycin on day 1, 6mg/m2 of vinblastine on day 2 & day 14, and 100mg/m2 of cisplastin on day 1) at 4 weeks interval. Then all patients were evaluated the response of chemotherapy 4 weeks later, and received further chemotherapy, palliative radiotherapy or supportive therapy according to the patient's condition. We also determined the median survival time and prognostic factors. RESULTS: 1) Nine patients(23%) had a partial reponse, 23 patients(57%) had a stable disease, and disease progressed in 8 patients(20%). There were no patients with complete response. 2) The overall median survival time was 36 weeks(range, 9 to 119+ weeks). The median survival time of responder(partial response) and non-responder(stable and progressed) groups were 60 weeks(range, 36 to 82+ weeks) and 31 weeks(range, 9 to 119+ weeks) respectively(p=0.03). 3) The median survival time of the female group was 71 weeks and significantly prolonged in comparision with 35 weeks of the male group(p=0.01). But, the other prognostic factors didn't affect the survival time and response rate. 4) The median survival times of chemotherapy group and chemotherapy with palliative radiotherapy group were not significantly different. CONCLUSION: MVP combined chemotherapy is unsatisfactory in improving survival in advanced non-small cell lung cancer. Therefore, further studies are needed to find more active new agents and to estabilish the efficacy of the combined treatment with radiotherapy and/or surgery.
Carcinoma, Non-Small-Cell Lung* ; Cisplatin ; Drug Therapy* ; Drug Therapy, Combination ; Female ; Humans ; Lung ; Male ; Mitomycin* ; Radiotherapy ; Vinblastine*

Severe autoimmune hemolytic anemia was developed in the 45-year-old man whose anterior mediastinal growing mass, which was proved later as the invasive thymoma, had been found 4 years ago. The hemoglobin level was 6.2g/dl and both the direct and indirect Coombs' tests were positive. Prompt remission of the hemolytic anemia was achieved by thymectomy combined with corticosteroid therapy. Two months after the discontinuation of corticosteroid therapy his hemolytic anemia was recurred. The patient currently has been followed up for 8 months with no signs of local recurrence or hemolytic anemia and he is still receiving 15 mg of perdnisolone daily.
Anemia, Hemolytic ; Anemia, Hemolytic, Autoimmune* ; Coombs Test ; Humans ; Middle Aged ; Recurrence ; Thymectomy ; Thymoma*

BACKGROUND/AIMS: Colonoscopic surveillance is currently recommended after polypectomy owing to the risk of newly developed colonic neoplasia. However, few studies have investigated colonoscopy surveillance in Asia. This multicenter and prospective study was undertaken to assess the incidence of advanced adenoma based on baseline adenoma findings at 3 years after colonoscopic polypectomy. METHODS: A total of 1,323 patients undergoing colonoscopic polypectomy were prospectively assigned to 3-year colonoscopy surveillance at 11 tertiary endoscopic centers. Relative risks for advanced adenoma after 3 years were calculated according to baseline adenoma characteristics. RESULTS: Among 1,323 patients enrolled, 387 patients (29.3%) were followed up, and the mean follow-up interval was 31.0±9.8 months. The percentage of patients with advanced adenoma on baseline colonoscopy was higher in the surveillance group compared to the non-surveillance group (34.4% vs. 25.7%). Advanced adenoma recurrence was observed in 17 patients (4.4%) at follow-up. The risk of advanced adenoma recurrence was 2 times greater in patients with baseline advanced adenoma than in those with baseline non-advanced adenoma, though the difference was not statistically significant (6.8% [9/133] vs. 3.1% [8/254], P=0.09). Advanced adenoma recurrence was observed only in males and in subjects aged ≥50 years. In contrast, adenoma recurrence was observed in 187 patients (48.3%) at follow-up. Male sex, older age (≥50 years), and multiple adenomas (≥3) at baseline were independent risk factors for adenoma recurrence. CONCLUSIONS: A colonoscopy surveillance interval of 3 years in patients with baseline advanced adenoma can be considered appropriate.
Adenoma ; Asia ; Colon ; Colonic Polyps ; Colonoscopy ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Male ; Prospective Studies ; Recurrence ; Risk Factors