Suffering is a human burden that may not be truly avoidable. In order to put that view in perspective we must examine suffering in a form as isolated from self-inflicted behavior as possible. The suffering of a child is one such example. The purpose of this study is to understand the meaning of suffering in the teenager and is to analyze difference of suffering in children and adult. The subjects of this study were 6 children (12year-17year) including in-patients and out-patients of a general hospital who were diagnosed as having cancer. The data was collected from October 10,1996 to April 15, 1997. Qualitative research methods of in-depth interview and participant observation were used for data collection. Data analysis progressed according to the fieldwork phases suggested by the Hybrid Model. According to the results of the study, the meaning of suffering in the teenager can be described as follows: Suffering is an inevitable experience of all human beings. When each child experiences pain and destroying child-adult relationship, suffering in which threaten one's personal integrity is perceived differently among each child depending on their personal inner factors, one's significant others, exterior circumstances and stimuli. Suffering brings severs and unendurable distress which accompany anguish, depression, anxiety and fear. This findings provide data for new insights of suffering. When caring for teenager who experience suffering, nurse need to consider the influence of suffering. Moreover, appropriate nursing interventions aimed at relieving suffering need to be developed.
Adolescent ; Adult ; Anxiety ; Child ; Data Collection ; Depression ; Hospitals, General ; Humans ; Nursing ; Outpatients ; Qualitative Research ; Statistics as Topic ; Stress, Psychological ; Child Health

Undifferentiated carcinoma with osteoclast-like giant cells (OGCs) is the least common type of gallbladder carcinoma. Here, the author presents a case of undifferentiated gallbladder carcinoma with OGCs in an 81-year-old male patient. Grossly, the tumor was a 10x7 cm sized, polypoid, lumen-filling mass with extensive hemorrhage and necrosis. Microscopically, the tumor was composed of pleomorphic ovoid to spindle cells admixed with numerous OGCs. There was a minute focus of mucosal dysplasia and carcinoma in situ. Immunohistochemically, the mononuclear cells were positive for cytokeratin, p53 and Ki-67, while the OGCs were negative for these markers but positive for CD68. These findings support an epithelial origin for the ovoid to spindle cells and the nonneoplastic reactive histiocytic lineage of the OGCs.
Aged, 80 and over ; Carcinoma ; Carcinoma in Situ ; Gallbladder* ; Giant Cells* ; Hemorrhage ; Humans ; Keratins ; Male ; Necrosis ; Osteoclasts

No abstract available.
Nephrolithiasis* ; Uric Acid*

No abstract available.

PURPOSE: The present study purposed to investigate Korean adults health status, smoking perception. and self-efficacy of smoking cessation according to whether smoking or not. METHODS: This study conducted a questionnaire survey of 694 adults at D County in Korea during the period from the 10th of June to the 10th of July 2004. The instruments used for this study were scales on health status, smoking perception and self-efficacy: of smoking cessation. Data was analyzed by frequency and percentage, mean and SD, chi2-test, t-test, ANOVA using SPSS 11.0 program. RESULTS: The subjects of this study were 503 men and 191 women, and 60.8% of the male subjects and 6.8% of the female subjects were smokers. With respect to health status (t=-2.58, p=0.010), smoking perception (t=10.59. p<0.000) and the self-efficacy of smoking cessation (t=-23.04, p<0.000), there were significant differences according to whether smoking or not. CONCLUSIONS: It is necessary to make repeated study to find other variables that affect adults smoking and to develop smoking cessation programs that enhance the self-efficacy of smoking cessation.
Adult ; Female ; Humans ; Korea ; Male ; Smoke* ; Smoking Cessation* ; Smoking* ; Weights and Measures ; Surveys and Questionnaires

Ganglia in soft tissue are common and usually occur in close relations with joints, tendon sheaths, or tendons. However, intra-osseous ganglia are very rare. We report a case of intra-osseous ganglion arising from the right sided proximal humerus in a 33 year-old woman. It was multiple cysts surrounded by thin rims of sclerotic bone in the subchondral epiphysis without other features of degenerative joint disease or destruction of adjacent soft tissue.
Female ; Humans ; Cysts

BACKGROUND: The relationship and differentiation among various dendritic cells of the dermis are unclear. Recently it has hecome possible to identify different subpopulat,ions of dermal dendritic cells using anti-CD34 and anti-factor XIIIa antibodies. OBJECTIVE: To elucidate which cell types the fibrous dermal turnors consist of we compared the staining patterns of these antibodies as well as of anti-Mac 387 antibody which are labeled as inflammatory cells of the monocyte-macrophage lineage. METHODS: Tumors studied included dermatofibrosarcoma protuberans(DFSP, n=2), dermato-fibroma(n=22), neurofibroma, n=27), acrochordon(n=15), keloid, hypertrophic scar(n=10), juvenile xanthogranuloma(n=1, and malignant fibrous histiocytoma (MFH, n=1). We performed immunoperoxidase staining(AUSC technique) with polyclonal anti FXIIIa antibody, monoclonal anti-CD34 antibody, and monoclonal anti-Mac 387 antibody on the formalin-fixed-paraffin-embedded tissue specimens of these fibrous tumors. The intensity of staining was graded as negative, weakly staining, or strongly stainiring. RESULTS: FXIIIa reactivity was strongly present in dendritic and spindle-shaped cells of all dermatofibromas and some nurofibromas(11 of 27 specimens), but absent from the other fibrous tumors. Among these tumors, one of the two DFSPs was uniquely expressed CD34. Dendritic and spindle-shaped cells within tiese tumors were MAC 387 negative. In inflammatory conditions, variable numbers of MAC 38 positive cells were observed, corresponding to histiocytes and mac-rophages, but the labeling of ipithelioid cells and multinucleated foreign body giant cells were variable. CONCLUSION: The findings of significant numbers of FXIIIa positive cells in dermal fibrous tumors studied suggest that thet may be diagnostic utility associated with the use of this antit)ody. In addition, CD 34 expression by the tumor cells can be an extremely useful marker in establishing a definitive diagnosis of IFSP.
Antibodies ; Dendritic Cells ; Dermatofibrosarcoma ; Dermis ; Diagnosis ; Factor XIIIa* ; Giant Cells, Foreign-Body ; Histiocytes ; Histiocytoma, Benign Fibrous ; Histiocytoma, Malignant Fibrous ; Keloid ; Langerhans Cells ; Neurofibroma

PURPOSE: This study was conducted to detect the correlations and the main factors influencing depression, life satisfaction, burden, defenition of suffering, meaning of life, and suffering. METHOD: The samples were composed of 160 cancer patients who were or outpatients of four hospitals in Seoul. The reliability of the 6 instruments was tested with Cronbach's alpha which ranged from .62 to .90. The data was analyzed using a SAS program for descriptive statistics, Pearson correlation coefficients, and stepwise multiple regression. Results: The results were as follows: 1. The scores on the suffering scale ranged from 132 to 40 with a mean of 87.3 (SD 17.5). 2. There were significant correlations between all the predictive variables and even the amounts of suffering (r=.27-.84, p <.05). 3. Stepwise multiple regression analysis showed that depression was the main predictor of suffering, and accounted for 71.6% of the variance. In addition burden accounted for 4.6% of the variance in suffering. The two variables combined to account for 76.2% of the variance in suffering. CONCLUSION: In conclusion and depression, burden were identified as important variables in explaining the suffering of patients with cancer.
Depression ; Humans ; Outpatients ; Seoul

The cytologic heterogeneity of the tumor cells in gastric signet ring cell carcinoma was studied with 13 surgically early gastric carcinoma specimens by means of histochemical stainings on mucin(periodic acid Schiff-alcian blue at pH 2.5, paradoxical concanavalin A, high iron diamine) and electron microscopy. Of the 13 cases of early gastric cell carcinomas, 6 were mucosal type and 7 were submucosal type. Eleven cases consisted of mixture of gastric and intestinal type signet ring cells and the remaining 2 of the mucosal type were entirely made of gastric type. The colonic goblet cell type was found in 4 of the submucosal type. Within the mucosa the tumor cells showed a layering phenomenon; type A signet ring cells were distributed at the central zone and type B and C at the superficial or deeper zone. Each type of signet ring cell showed variable mucin histochemical stainability of gastric and/or intestinal nature. Above finding strongly suggest that the variable phenotypes of signet ring cells result from a heterogeneity of cytoplasmic mucin as well as different stages of differentiation of signet ring carcinoma cells.

OBJECTIVE: Although cor pulmonale due to chronic lung disease was not uncommon, there was uncertainty in its diagnosis due to the difficulty in measuring functional and anatomical changes of right heart and pulmonary vascular system. Among various non-invasive diagnostic methods presented so far, no ideal standard diagnostic criterion has been established. The authors attempted to know positive diagnostic ratio of cor pulmonale and to study the presence of the relationship between these diagnostic criteria when electrocardiographic and echocardiographic diagnostic criteria for cor pulmonale were applied to the patients with chronic lung disease. And we investigated the usefulness of echocardiogaphic diagnostic criteria for the diagnosis. METHODS: One electrocardiographic and two echocardiographic diagnostic criteria were applied to 38 patients with chronic lung disease(21 pulmonary emphysema and 17 chronic advanced pulmonary tuberculosis) for the diagnosis of cor pulmonale. Comparison was also made in their relationship. Then pulmonary artery diameter, measurement of pulmonary function test and echocardiographic examination and radio-nuclear right ventricular ejection faction were compared between the groups to ensure each criterion was satisfied. RESULTS: 1) When the three diagnostic criteria for confirming the cor pulmonale, electrocardiographic rriterion(right ventricular hypertrophy), right ventricular dimension criterion(right ventricular end-diastolic dimension>25mm, RVDd>25mm), and right ventricular wall thickness criterion (right ventricular wall thickness>6mm, RVWT>6mm) were applied to the patients, the positive rate were 32%(12/37), 30%(10/33) and 17%(6/36) respectively. A statistically significant correlation between electrocardiographic criterion and right ventricular wall thickness criterion was found to exist. 2) Various parameters of pulmonary function test and echocardiographic examination were compared in the patient groups with and without cor pulmonale when each non-invasive diagnostic criterion was applied to all patients. Followings are the results. (1) In the positive group on electrocardiographic criteria, vital capacity, forced vital capacity, and arterial oxygen tension were significantly smaller than in the negative group on electrocardiographic criterion(p<0.05), and the echocardiographic parameters of right ventricle, ie. end-diastolic area, end-systolic area, end-diastolic dimension, end-systolic dimension, mid-ventricular short axis and maximal short axis in positive group were significantly larger than in the negative group. (2) In the positive group on right ventricular diastolic dimension criterion(RVDd>25mm), percentage forced expiratory volume in 1 second and forced expiratory flow 25-75% were significantly smaller than in the negative group on right ventricular diastolic dimension criterion. (3) In the positive group on right ventricular wall thickness criterion(RVWT>6mm), vital capacity, forced vital capacity, forced expiratory volume in 1 second, forced expiratory flow 25-75% and arterial oxygen tension were significantly smaller than in the negative group on right ventricular wall thickness criterion. CONCLUSION: When several non-invasive diagnostic criteria for cor pulmonale were applied to the patients with chronic lung disease, there were some differences in its positive diagnostic ratio depending on the applied diagnostic criteria. There was also a statistically significant correlation between electrocardiographic criterion and right ventricular wall thickness criterion. When each diagnostic criterion was applied to the patients, significant differences were found in several parameters resulted from pulmonary function test and echocardiographic examination based on presence or nonpresence of cor pulmonale. But no difference in the ejection fraction measured by radio-nuclear method was shown between cor pulmonale group and non cor pulmonale group. Consequently it was suggested that applying echocardiographic criteria in addition to electrocardiographic criterion for the diagnosis of cor pulmonale in the patients with chronic lung disease is clinically useful.
Axis, Cervical Vertebra ; Diagnosis ; Echocardiography* ; Electrocardiography ; Forced Expiratory Volume ; Heart ; Heart Ventricles ; Humans ; Lung ; Lung Diseases ; Oxygen ; Pulmonary Artery ; Pulmonary Emphysema ; Pulmonary Heart Disease* ; Respiratory Function Tests ; Uncertainty ; Vital Capacity