Graft-versus-host disease (GVHD) is a life threatening complication that may occur following allogenic bone marrow transplantation (BMT) in the patients with aplastic anemia, leukemia or genetic immunodeficiency. It has been known that GVHD occurs approximately 70% of recipients of BMT in western countries but no definite incidence has been reported in Korea. In our St. Mary's Hospital, GVHD occurs in about 30% of BMT recipients. Histopathologically the acute phase skin shows diffuse lymphocytic infiltrates in the upper dermis with extensive exocytosis. Scattered throughout the epidermis are many degenerated keratinocytes, which are often associated with one or more satellite lymphocytes (satellite cell necrosis). In the chronic phase, acanthosis, eosinophilic keratinocytes resembling colloid bodies and mononuclear cell infiltrates in the upper dermis are noted. We reviewed 5 cases of acute GVHD and 6 cases of chronic GVHD. All patients received allogenic BMT from Jan. 1, 1992 to July 1, 1993. Ten patients were male and one was female. The mean age was 34 (20-70). The pathologic diagnosis was 3 cases of CML, 2 of ALL, 2 of AML (FAB M2), 2 of aplastic anemia, 1 of CLL and 1 of AML (FAB M5). The interval from BMT to GVHD varied from 14 days to 4 years (median 220 days). The skin and GI tract were involved in all eleven cases. Ten cases were histologically proven by skin biopsies, and two cases by salivary gland and colonic biopsies, respectively. The histological findings of the skin, salivary gland and colonic biopsieds were described. Immunohistochemical stain of the skin was done using CD4, CD8, HLA DR and Leu 7 antibodies.
Adult ; Aged ; Antigens, CD4/analysis ; Antigens, CD8/analysis ; Biopsy ; Female ; Graft vs Host Disease/immunology/*pathology ; HLA-DR Antigens/analysis ; Human ; Immunohistochemistry ; Male ; Middle Age

Burkitt's lymphoma with a frankly leukemic picture is an extremely rare condition, and usually has a very acute course with a poor prognosis. The authors experienced two cases of Burkitt's lymphoma developed acute leukemia. The first case was 8 years-old boy who had rapidly growing large abdominal mass, which revealed typical Burkitt's lymphoma with characteristic "starrysky" pattern. The second case was 20 year old male who had not definite tumor mass. Their peripheral blood and bone marrow aspiration revealed acute leukemia with multiple vacuolated lymphoblast of Burkitt's type. We report these cases with brief review of literatures.
Male ; Humans

PURPOSE: The purpose of study is to develop a home nursing care project model suitable for Korea's heath care system and policy directions for expansion and establishment of home nursing care. METHOD: The first, status of home nursing care program in medical institution and public health center was evaluated respectively in view of structure, process and performance. And then, issues of the program were analyzed in view of accessibility, safety, and sufficient supply. The second, demand projection of home nursing care according to income level and technical level of service that is needed to the subject was tried. In addition, the level of supply for home nursing care at present was estimated. The third, home nursing care program in advanced countries (Japan and U.S.A.) was examined. RESULT AND CONCLUSION: Community-based home nursing care program is developed into public-operation model and private-operation model from above the sub-subject result. Functional network for referral system among related institutions is built up to meet various needs, regardless of accessibility to distance and economy. And prior settlements and policy directions for expansion and establishment of home nursing care are suggested.
Home Nursing* ; Public Health ; Referral and Consultation

Spinal reflex activity that remains after insult to the spinal cord brings with it significant functional impairment. Our patient had suffered from general spasticity and hyperreflexic neurogenic bladder caused by sixth cervical cord injury. Unfortunately, the use of oral medication (baclofen) was limited by an inadequate effect. So we performed two times of subarachnoid block with 0.5% heavy bupivacaine, the patient experienced improvement in bladder and sphincter function. We concluded that subarachnoid block with 0.5% heavy bupivacaine is an effective and safe modality for spasticity control in patients who are refractory to oral medication before neurolytic block.
Bupivacaine ; Humans ; Muscle Spasticity ; Reflex ; Spinal Cord ; Urinary Bladder ; Urinary Bladder, Neurogenic*

PURPOSE: The purpose of this study is to analyze the CT features of the cystic masses in the neck and to review differential diagnosis. MATERIALS AND METHODS: We retrospectively reviewed and analyzed the CT findings of 22 histopathologically proved, cystic neck masses in regard to the location in fascial plane and relationship with adjacent organ. RESULTS: Of 22 cases, ten congenital cysts two ranulas, seven inflammatory lesions, and three solid tumors were includded. Ten congenital cystic masses were located in typical locations as branchial cleft cyst(5) in mandibular angle, thyroglossal duct cyst(3) in visceral space embeded within the strap muscles, cystic hygroma(1) and cavernous hemangioma(1) in posterior cervical space with insinuating appearance. Two cases of ranula included one simple ranula localized in sublingual space and a plunging ranula extending to adjacent submandibular space. Seven cases of inflammatory lesions were characterized by multispatial locations and good contrast-enhancement of walls and adjacent tissue. Solid masses of low density mimicking cyst were two pleomorphic adenomas of submandibular gland and one neurilemmoma. CONCLUSION: It is considered that thorough analysis of the CT findings with attention to typical location, CT appearance, and the relationship with the adjacent structures usually leads to the correct diagnosis.
Adenoma, Pleomorphic ; Branchial Region ; Diagnosis ; Diagnosis, Differential* ; Muscles ; Neck* ; Neurilemmoma ; Ranula ; Retrospective Studies ; Submandibular Gland

The hypoglycemic effects of four edible plants (Angelicae tenuissimae (A. ten.), Pleurospermum kamtschaticum (P. kam.), Adenophora remotiflora (A. rem.) and Zanthoxylum schinifolium (Z. sch.)) in streptozotocin (STZ)-induced diabetic rats were investigated. Sprague-Dawley male rats weighing 190-230 g were induced diabetes mellitus by the STZ injection (45 mg/kg) into the tail vein and were divided into six groups ; normal, STZ-control and four edible plant groups (A. ten., P kam., A. rem. and Z. sch. groups). Normal and STZ-control groups were fed a AIN-93 diet and four groups of STZ-induced diabetic rats were fed one of each experimental diets containing 10% of the edible plant powder for 4 weeks. Diabetic rats showed the lower weight gain compared to the normal rats. In experimental groups except P. kam., AST activities were close to normal. A. ten. group were lowered ALT activities slightly. The plasma glucose levels of the diabetic experimental groups were significantly decreased at 4th week. The plasma insulin levels in diabetic experimental groups were not significantly different compared to the STZ-control group. The liver glycogen levels in STZ injected rats were significantly lower in compared to the normal rats. However no significant differences were found in response experimental plants intake in diabetic rats. The muscle glycogen were not significantly different among all the groups.
Animals ; Blood Glucose* ; Campanulaceae ; Diabetes Mellitus ; Diet ; Glycogen* ; Humans ; Hypoglycemic Agents ; Insulin ; Liver Glycogen ; Male ; Plants, Edible ; Plants, Medicinal* ; Plasma ; Rats* ; Rats, Sprague-Dawley ; Streptozocin* ; Veins ; Weight Gain ; Zanthoxylum

PURPOSE: Communication in hospitals is one of the major factors in patient safety. So, the purpose of this study was to identify the relationship between intra-organizational communication satisfaction and the safety attitude of nurses in hospitals. METHOD: A descriptive survey design with convenience sampling was used. Data collection was done using a self-report questionnaire answered by 278 nurses from one university hospital located in Kyeoung-gi Province, Korea. RESULT: Intra-organizational communication satisfaction positively correlated with safety attitude (r=.747, p<.01). Among the 6 sub dimensions of safety attitude, perceptions of management (r=.675, p<.01), job satisfaction (r=.640, p<.01) and teamwork climate (r=.600. p<.01) were strongly related to intra-organizational communication satisfaction. Multiple regression analysis was done to identify explanation power of intra-organizational communication satisfaction against safety attitude. The model was significant (F=48.540, p<.01). Intra-organizational communication satisfaction accounted for 60.9% of variance in safety attitude (Adj R2=.609). CONCLUSIONS: The results of this study indicate that higher levels of intra-organizational communication satisfaction promote positive safety attitude in hospital nurses and that communication media quality is an important factor in patient safety attitude. Therefore, developing interventions to revitalize intra-organizational communication level based on communication media quality will help in the construction of positive safety attitude in nurses.
Climate ; Surveys and Questionnaires ; Job Satisfaction ; Patient Safety

PURPOSE: This study was designed to create a job description for Korean geriatric care managers and examine performance frequency, importance, and difficulty of task elements. METHOD: The sample consisted of 38 geriatric care managers and professors who performed duties related to geriatric care management at community based-facilities in Korea. A survey method was used, and the questionnaire included frequency, importance, and difficulty of task elements in job descriptions using the DACUM method. Using SPSS WIN 10.0, descriptive statistics such as frequency distribution, means, and standard deviation were conducted to examine the subject's general characteristics, frequency, importance, and difficulties of task performance. RESULT: The job descri ption of geriatric care managers revealed 10 duties, 34 tasks, and 105 task elements. On all ten duties, the average performance frequency, importance, and difficulty was 2.55, 2.21 and 2.43 respectively. CONCLUSION: The job description of geriatric care managers includes duty, task, and task elements and the definition of a completed job. Thus we recommend a data based trial to confirm and validate the information gathered.
Adult ; Female ; Geriatric Nursing/*organization & administration ; Humans ; *Job Description ; Korea ; Male ; Nursing Staff ; *Task Performance and Analysis ; Workload

We investigated the pathobiological course of uranyl nitrate (UN) induced polyuric acute tubular necrosis (ATN) in male Sprague Dawley rats. UN (5mg/kg 15mg/kg and 3Omg/kg) in 5% NaHCO3 induced weight loss, polydipsia, and polyuria 24 hrs after injection when compared to the controls which were treated with 5% NaHCO3 only. Twenty four hours following the injection of UN, serum creatinine and blood urea nitrogen levels had increased. These changes continued for at least 72 hours, although the concentration of uranium had decreased. Light microscopic studies conducted 24 hours after injection, revealed partial degeneration and necrosis of the proximal tubules and many casts m the distal convoluted tubules. These changes progressed for 72 hours. Despite this tubular damage, the glomeruli were relatively intact. 5 days after injection, the epithelial cells lining the proximal tubules displayed regenerative activities; these findings were more prominent after 10 days. Through electron microscopic examination, we observed the destruction of mitochondria in the proximal tubular cells, a possible cause of polyuria. Ten days post injection regenerative activities in the proximal tubular cells showed that the maturation of intracellular organelles followed the proliferation of the premature cells.
Animal ; Kidney Failure, Acute/chemically induced* ; Kidney Function Tests ; Kidney Tubular Necrosis, Acute/chemically induced* ; Male ; Rats ; Rats, Inbred Strains ; Uranium/pharmacology* ; Uranyl Nitrate/pharmacology*

Calcium and vitamin D are essential components for bone health, thus calcium and vitamin D supplementation is an important strategy in the management of osteoporosis. However, the benefit of calcium and vitamin D supplementation on bone health is still controversial. Moreover, potentially harmful effects of excessive calcium supplementation on cardiovascular health are recently suggested. Too high a level of vitamin D has been also reported to have several, possibly related, harmful events. Korea is well known for low dietary calcium intake and vitamin D deficiency in its population. This position statement developed the following recommendation for adequate levels of calcium and vitamin D intake in Korean, postmenopausal women and men older than 50 years: Adequate calcium intake and optimal vitamin D level are essential for preventing and treating osteoporosis in postmenopausal women and men older than 50 years. We recommend a daily calcium intake of 800 to 1,000 mg/day. Food remains the best source of calcium; however calcium supplements should be considered when dietary intake of calcium is inadequate. We recommend dietary vitamin D intake of more than 800 IU per day, a level which appears to reduce the risk of fractures. When vitamin D deficiency is suspected, serum 25-hydroxy-vitamin D (25-[OH]D) level should be tested. We suggest that a serum 25-(OH)D level greater than 20 ng/mL is generally appropriate for prevention of osteoporosis. However, a serum 25-(OH)D level greater than 30 ng/mL is probably helpful for management of osteoporosis and prevention of fractures.
Calcium* ; Calcium, Dietary ; Cardiovascular Diseases ; Female ; Humans ; Korea ; Male ; Osteoporosis ; Vitamin D Deficiency ; Vitamin D* ; Vitamins*