No abstract available.
Asthma*

Dermatofibroma with granular cells is composed mainly of spindle shaped cells mixed with in-conspicuous foamy cells that contain granular cytoplasm. We present a case of dermatofibroma with granular cells in a 36-year-old male who visited our clinic to evaluate a slow-growing nodule on the medial side of the left lawer leg. He have had the nodule for five years and sometimes felt an itching sensation. Biopsy of the nodule identified a dermal nodular tumor showing cellular spindle cell proliferation admixed with peripheral foamy histiocytes. With the immunohistochemical staining, the granular cell was positive for alpha-1-antitrypsin and CD68, and negative for S-100. A few electron-dense granules were seen in the cytoplasm on the electronmicroscopic study. These results suggested that the granular cells originated from histiocytes.
Adult ; Biopsy ; Cell Proliferation ; Cytoplasm ; Histiocytes ; Histiocytoma, Benign Fibrous* ; Humans ; Leg ; Male ; Pruritus ; Sensation

PURPOSE: This study was designed to construct a structural model explaining depression in university students. METHODS: Data were collected from 1,640 university students by questionnaire, and analyzed using AMOS 5.0 to test the hypothetical model. RESULTS: Fitness statistics for the modified model were GFI=.93, AGFI=.89, NFI=.91, and RMSEA=.081. All the 12 paths in the modified model proved to be statistically significant. Depression of university students accounted for 52% of the covariance by the factors. The factor that had the most influence on depression was individual vulnerability, and followed by sequence order, stress, social support, coping, and self-efficacy. Depression was influenced directly by individual vulnerability, stress, social support, and coping, and indirectly by individual vulnerability, stress, social support, and selfefficacy. CONCLUSION: A screening and management system for the high risk group is needed to effectively prevent depression and reduce rate of depression in university students. Detailed support programs which specifically deal with prevailing stressors should be developed to effectively reduce the harmful effects of individual vulnerability and stress. It is anticipated that the model constructed in this study could be utilized as a reference in developing various strategies to prevent and intervene depression in university students.
Adaptation, Psychological ; Adolescent ; Adult ; Data Interpretation, Statistical ; *Depression ; Female ; Humans ; Male ; *Models, Psychological ; Questionnaires ; Self Efficacy ; Social Support ; Stress, Psychological ; Students/*psychology ; Universities ; Young Adult

PURPOSE: The purpose of this study was to verify influencing factors on service quality provided by care helpers working for the elderly in long term care. METHODS: The data were collected using self-reported questionnaire from 221 care helpers working in long-term care facility or home care service center. The data were analyzed using multiple regression with the SPSS/WIN 17.0 program. RESULTS: There were significant differences in service quality depending on the health status, intimacy level, pleasure level, job education, and turnover intention. Factors influencing service quality were gender, intimacy level with elderly, type of working place and job satisfaction with R2 value of 17.3%. The most influencing factor was intimacy level (beta=.249), followed by job satisfaction (beta=.208), gender (beta=.170), and type of working place (beta=.146). CONCLUSION: The results of this study indicate that the effort to improve the service quality of care helper should be focused on helping intimacy building between the elderly and the care helper. Also, a more effective way to improve service quality would be intervening for care helpers providing institutional care.
Aged ; Home Care Services ; Humans ; Hypogonadism ; Intention ; Job Satisfaction ; Long-Term Care ; Mitochondrial Diseases ; Ophthalmoplegia ; Pleasure ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to verify influencing factors on service quality provided by care helpers working for the elderly in long term care. METHODS: The data were collected using self-reported questionnaire from 221 care helpers working in long-term care facility or home care service center. The data were analyzed using multiple regression with the SPSS/WIN 17.0 program. RESULTS: There were significant differences in service quality depending on the health status, intimacy level, pleasure level, job education, and turnover intention. Factors influencing service quality were gender, intimacy level with elderly, type of working place and job satisfaction with R2 value of 17.3%. The most influencing factor was intimacy level (beta=.249), followed by job satisfaction (beta=.208), gender (beta=.170), and type of working place (beta=.146). CONCLUSION: The results of this study indicate that the effort to improve the service quality of care helper should be focused on helping intimacy building between the elderly and the care helper. Also, a more effective way to improve service quality would be intervening for care helpers providing institutional care.
Aged ; Home Care Services ; Humans ; Hypogonadism ; Intention ; Job Satisfaction ; Long-Term Care ; Mitochondrial Diseases ; Ophthalmoplegia ; Pleasure ; Surveys and Questionnaires

Deliberate hypotension in the surgery of intracranial aneurysm's used to diminish bleeding and render an aneurysmal sac slack to make clipping easy. It has been reported by Murtagh (1960) and Schettini et al. (1967) that deliberate hypotension induced with halothane anesthesia is a useful method. We are reporting clinical experience of halothane induced hypotension in 13 cases of intracranial aneurysm surgery. The results of clinical observation were as follows: 1. On the average, the systolic blood pressure lay between 60 and 80 mmHg. Hypctension by halothane was readily controllable by increasing and decreasing the inspired concentration of halothane. The use of vasopressors was not necessary to raise the blood pressure. Recovery from anesthesia was rapid. The mean of Mean Arterial Blood Pressure of 13 cases was 56.077 mmHg during the .hypotensive phase. The rate of fall of the mean arterial blood pressure was 1.862 mmHg per minute. 2. The common EKG finding was bradycardia associated with hypotension, but the pulse rate increased by raising the blood pressure. 3. The serum electrolytes, Na, K, Cl, and CO₂ combining power, checked in the pre and posto-perative period, showed no significant change. 4. Arterial blood gas study showed increased values for PaCO₂ and oxygen saturation during the hypotensive phase. The PaCO₂ was slightly lowered during hypotension. The pH was within normal limits. 5. The Hb and Hct, checked pre and postop ratively, showed lowered values in the postopertive period. During surgical clipping of the aneurysm, there were two cases of aneurysmal rupture, requiring blood transfusion; the amount of whole blood transfused was 500 ml to 1, 000 ml. 6. Urinary excretion, observed during hypoension, showed a decreased urine output at a systolic blood pressure of about 70 mmHg. 7. Postoperatively there was one death at the end of second week and the cause was thought to be cerebral infarction, not directly relnted to anesthesia.
Anesthesia ; Aneurysm ; Arterial Pressure ; Blood Pressure ; Blood Transfusion ; Bradycardia ; Cerebral Infarction ; Electrocardiography ; Electrolytes ; Halothane ; Heart Rate ; Hemorrhage ; Hydrogen-Ion Concentration ; Hypotension ; Hypotension, Controlled* ; Intracranial Aneurysm* ; Methods ; Oxygen ; Rupture ; Surgical Instruments

Pheochromocytoma-arises in the adrenal proper or in paraganglions, Occasionally produce Hypertension, Hyperglycemia and Hypermetabolism, A case of typical functioning pheochromocytoma associated with Hypertensive Retinopathy is reported because of its rarity. A 17 year old student was admitted to the Ewha Womans University Hospital with Hypertension (200/140). Headache, palpitation and blurring' vision. On admission. the fundoscopica-l findings were arteriolar narrowing, Exudates, Hemorrhages and macular star in both fund i and visual acuity were 20/200 (N. C.) in each eye. The patient's general and Ocular changes returned to nearly normal level after surgical removal of the tumor from the kidney.
Adolescent ; Exudates and Transudates ; Female ; Financial Management ; Headache ; Hemorrhage ; Humans ; Hyperglycemia ; Hypertension ; Hypertensive Retinopathy ; Kidney ; Pheochromocytoma* ; Visual Acuity

The purpose of this study is to compare the effects of the femoral attachment points of the graft and knee flexion angles at the time of graft fixation on stability of posterior cruciate ligament reconstruction. We analyzed the posterior stability of the knee on 23 patients(24 knees) with posterior cruciate ligament injury whose posterior cruciate ligament had been reconstructed arthroscopically and followed for minimum 1 year period at Asan Medical Center from May 1992 to June 1994. The patients were divided into the two groups according to femoral attachment points of the graft and knee flexion angles at the time of graft fixation. The distance from the junction of the intercondylar notch with trochlear groove of the femoral attachment points and knee flexion angles were 11mm and 0°-30° in group A and 7mm and 70°-90° in group B, respectively. 11 knees were included in group A and 13 knees in group B. Posterior stability was determined by difference in posterior tibial translation between the injured and the opposite knee with Telos device. In group A, 5 cases were at the range of 0-2mm, 3 cases 3-5 mm, 3 cases 6-10mm. In group B, 10 cases were at the range of 0-2mm and 3 cases 3-5mm, respectively. Differences in posterior tibial translation on average were 3.6mm and 1.7mm in group A and B, respectively. Conclusively, arthroscopic postrior cruciate ligament reconstruction with femoral attachment point at 7mm from the junction of interconlylar notch with trochlear groove and 70°
Chungcheongnam-do ; Humans ; Knee ; Ligaments ; Posterior Cruciate Ligament ; Transplants

BACKGROUND: The objectives of the study were to determine how gas exchanges indices including alveolar-arterial oxygen tension difference(A-aDO2), PaO2/PAO2, PaO2/FIO2 and pulmonary shunt ratio (QS/QT) were changed after open heart surgery according to the change of inspired fraction of oxygen(FIO2) and to identify the reliable parameters for postoperative respiratory care in the intensive care unit. METHODS: Blood gases were measured from radial and pulmonary arterial blood for arterial and mixed venous blood in 15 patients, with a mean age of 45.1 yr, after open heart surgery, in mechanically ventilated states with 1.0, 0.6 and 0.4 of FIO2 with normocarbia maintained (PaCO2 30~40 mmHg). Above mentioned gas exchange indices were calculated and compared. RESULTS: After decreasing the FIO2 from 1.0 to 0.6 and 0.4 in order, the major changes were significant decrease in pulmonary shunt ratio : 24+/-3%, 17+/-3% and 11+/-3% at FIO2 1.0, 0.6 and 0.4, respectively and A-aDO2 : 347+/-34 mmHg, 184+/-16 mmHg and 94+/-11 mmHg at FIO2 1.0, 0.6 and 0.4 respectively, while PaO2/PAO2 showed the only significant increase at FIO2 0.4 compared with those at FIO2 1.0 and PaO2/FIO2 was unchanged. CONCLUSIONS: In cases of open heart surgical patient with cardiovascular stability, pulmonary shunt ratio and A-aDO2 appear to be more sensitive on gas exchange, but the oxygen tension indices such as PaO2/PAO2 as well as PaO2/FIO2 might be suggested as possible alternatives for the shunt measurement.
Gases ; Heart* ; Humans ; Intensive Care Units ; Oxygen ; Thoracic Surgery*

PURPOSE: The evolution of cirrhosis from chronic inflammatory liver disease represents a dysmorphogenic "response to injury". It is important to understand how inflammatory cytokines, known to be associated with such responses, influence the growth of different cell populations within the liver. The purpose of this work is to establish a role of serum interleukin-6 (IL-6) in liver regeneration following partial hepatectomy in N-nitrosodieth ylamine (DEN)-induced cirrhotic rats. METHODS: Male Sprague-Dawley rats were used for this study. Liver cirrhosis was induced using DEN (100 mg/kg) given once a week for 6 weeks. In Group I (n=18), 70% partial hepatectomy was accomplished and then the resected liver weight, regenerated liver weight, serum IL-6, and serum GOT/GPT was determined on postoperative days 1, 2, and 4 and at intervals. In Group II (n=19), partial hepatectomy was carried out and Laennec, a hepatocyte growth promoter, was injected on preoperative 1 day and postoperative days 1 and 2. RESULTS: The value of serum GOT in Group I was 415 IU/ml on the first postoperative day and peaked at 1870 IU/ml on the third day. In Group II, the level of serum GOT was 404 IU/ml on the first postoperative day and peaked at 593 IU/ml on the third day, then decreased gradually thereafter. The value of serum IL-6 was 106.54 pg/ml on the first postoperative day, 130.59 pg/ml on the 14th postoperative day in Group I, however in Group II, it was 40 pg/ml on thefirst postoperative day and then decreased to 29.18 pg/ml on the 14th postoperative day. The percentages of regenerated weights of liver at intervals following the 70% partial hepatectomy was 55.1% on the first postoperative day, and 102.3% on the 4th week in Group I and 60.4% on the first postoperative day, 95.8% on the first week postoperatively, and 116.1% on the 2nd week in Group II. CONCLUSION: As the value of serum IL-6 was sustained below 40 pg/ml, which was the value on the first postopeative day following partial hepatectomy with Laennec treatment, the resected liver was rapidly regenerated and restored to normal liver function. In cirrhotic liver, regenerative activity was related to serum IL-6 level, so downregulation of serum IL-6 might be helpful to the regeneration of resected liver.
Animals ; Cytokines ; Down-Regulation ; Fibrosis ; Hepatectomy* ; Hepatocytes ; Humans ; Interleukin-6* ; Liver Cirrhosis ; Liver Diseases ; Liver Regeneration* ; Liver* ; Male ; Rats* ; Rats, Sprague-Dawley ; Regeneration ; Weights and Measures