It is currently necessary to manage chronic ischemic foot gangrene because the rate of hospitalization and operations is increasing as a result of diet change and the growth of an aging population. Chronic ischemic foot gangrene is caused by Buerger`s disease, atherosclerosis and particularly, diabetes. In this study, we used the Wagner ischemic index with Doppler flowmeter and Wagner classification on 62 patients over 8 years from 1991 to 1998 as an index for treatment and prognosis. We measured the systolic pressure to determine the ischemic index, and according to Wagner the blood flow was inadequate in cases of diabetic foot gangrene and nondiabetic foot gangrene when it was below 0.45 and 0.35, respectively. According to the observation of clinical symptoms, we divided the cases by Wagner classification. Based on the above data, we performed conservative treatment, skin graft, local flap, superficial sural arterial island flap and amputation. We then followed up the patients and observed the treatment results. We concluded that the Wagner ischemic index with Doppler flowmeter and Wagner classification was useful in determining, selecting, and predicting the rate of survival or death as a result of amputation and graft when a surgical operation is performed.
Aging ; Amputation ; Atherosclerosis ; Blood Pressure ; Classification* ; Diabetic Foot ; Diet ; Flowmeters* ; Foot Ulcer* ; Foot* ; Gangrene ; Hospitalization ; Humans ; Prognosis ; Skin ; Transplants

The purpose of this study is to seek the nursing intervention for the elderly people's positive lives by investigating the causes for their loss and its meanings. The method of this research derives from a phenomenological tool as a qualitative research design. The data collection had been performed from February, 2001 until August, 2001 through systematic interviews and participatory observations of six elderly people (4 elderly women and 2 elderly men) residing in downtown Seoul. It took one and a half hour for each interview arranged five times. The analysis of this research is based upon Giorgi method and the research results on the causes for elderly people's sense of loss and its meaning are as follows. 1) bitter disappointment of family members : unfaithful children, husband's infidelity, conflict with daughter-inlaw, economic hardships. 2) bereavement : loss of spouse or children, a sense of one's own mortality. 3) regret for the past : sorrowful things, unfair treatment, a sense of resentment, a sense of futility, a feeling of helplessness, despair, resignation. 4) unpleasant memories of others : hurt of self-esteem, hostile feelings aroused by betrayal or distrust. 5) grief of lost youth : loss of health, hard married life, unlucky fate. 6) sense of another superable life : regret, awareness, maturity through suffering. As a person ages, the number of deaths of close friends and family members usually increases. The occurrence of such multiple losses can cause the elderly to become overwhelmed by the events. Care givers need to be sensitive to these losses and need to be aware that the elderly can experience an overload of grief. Counselling can often be useful in helping them to come to terms with such multiple losses.
Adolescent ; Aged* ; Bereavement ; Caregivers ; Child ; Surveys and Questionnaires ; Female ; Friends ; Grief ; Humans ; Medical Futility ; Mortality ; Nursing ; Qualitative Research ; Seoul ; Spouses

PURPOSE: This study sought to find a nursing intervention tool for enhancing elderly women's lives by investigating the causes and the meaning of their grief. METHOD: This research was derived from a phenomenological tool such as qualitative research design. The data collection took place from December of 2000 until April of 2001 Through systematic interviews and participatory observations of five elderly women attending C welfare center located in downtown Seoul the data was collected. Each interview lasted an hour and a half and was arranged five times. The analysis of this research was conducted using the Giorgi method. RESULTS: (1) There was obvious physical and physiological decline caused by aging old; as well as there being spouse health problems, additional physical suffering, signs of senility, adn insomnia, (2) Further grief was imposed by unpleasant memories of the spouse; infidelity, incapability, and even disregard of her own well-being, (3) Then there was pity for children; unfaithful children, uncertain futures of the children, and early death of a child, (4) Also, regrettable fate, painful daily acttrities, unreliable factors, bad circumstances, and feelings emptiness were reported, (5) Finally, anxiety for the future; ac sense of despair, loneliness, economic hardship, and the fear of imminent death increased grief levels. CONCLUSION: A variety of programs and social meetings for the elderly to overcome their physiological or psychological crisis should be substantially developed and supported by the government. In order to implement the social welfare for the elderly women, special consideration whether on the governmental level or the personal level, should be devoted to the elderly who live without any financial support or social concern.
Aged* ; Aging ; Anxiety ; Child ; Surveys and Questionnaires ; Female ; Financial Support ; Grief* ; Humans ; Loneliness ; Nursing ; Qualitative Research ; Seoul ; Sleep Initiation and Maintenance Disorders ; Social Welfare ; Spouses

OBJECTIVE: The purpose of this investigation is to determine the frequency of chromosomal or genetic causes of recurrent spontaneous abortion. METHODS : A cytogenetic study was made in of 921 couples for 13 years from January 1984 to December 1997 in which the woman was ascertained to have had two or more spontaneous abortions at our Cytogenetic Laboratory, Institute of Reproductive Medicine and Population, Seoul National University. RESULTS : The overall incidence of chromosome anomaly was 80 out of 921 (8.7%). There were 34 cases (3.69%) of reciprocal balanced translocation and 13 cases (1.41%) of Robertsonian translocation. Also 17 cases (1.85%) of inversion and 5 cases (0.54%) of X chromosome mosiacism was observed. In the case of reciprocal balanced translocation, chromosome 8,6,7,13 were preferentially involved over others. And in the case of Robertsonian translocation, chromosome 13 was preferentially involved. CONCLUSION: Our study demonstrates that cytogenetic analysis is indicated in couples with 2 or more spontaneous abortion and about half of these disorders are reciprocal balanced or Robertsonian translocations.
Abortion, Spontaneous* ; Chromosomes, Human, Pair 13 ; Cytogenetic Analysis ; Cytogenetics* ; Family Characteristics ; Female ; Humans ; Incidence ; Pregnancy ; Reproductive Medicine ; Seoul ; X Chromosome

No abstract available.
Progeria*

The real time high resolution mechanical neurosonographic sector scanner is a convenient and useful instrumentfor detection of intracranial lesions in premature infants as well as low birth weight. From this experience,authors report with 104 neonates and infants who had been suspected intracranial hemorrhage and had been detectedand graded by sonography. The results were as followed: 1. The incidence of intracranial hemorrhage is 20 of 46(43.5%) neonates who had been studied before 3 days of age. But 7 of 16(43.7%) neonates showed ICH between the 4-7days of age. 2. There was no difference of prevalence in sex ratio in neonates with ICH. 3. There was closerelationship between ICH and gestational weeks. 15 of 27 (55.6%) neonates who were born under 32 gestational weeksshowed ICH was graded as 3 or 4 in 7 of 10. 4. 10 of 16(62.5%) neonate who were born under 1,500 gram body weighthad ICH within first 4 days. The severity of ICH was graded as 3 or 4 in 7 of 10. 5. The mode of deliveryinfluenced neonatal ICH incase of difficulty delivery such as forcep(4/4, 100%), vacuum (7/10, 70%), breech (3/3,100%), and C/S(13/33, 39.4%). 6. Incidence of ICH in neonates with pathologica lung conditions (29/40, 72.5%) washigher than ICH with normal chest findins(15/64, 23.4%). 7. For frequent follow up study of brain, neurosonographywas very helpul and economic in case of ICH, and could find congenital glioblastoma multiformed(1), and low gradeastrocytoma(1) incidentally.
Brain ; Follow-Up Studies ; Glioblastoma ; Humans ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Intracranial Hemorrhages ; Lung ; Prevalence ; Sex Ratio ; Thorax ; Vacuum

A 26-year-old Korean man had an erythematous scaly plaque on his right thigh for fifteen years. He was diagnosed with chronic eczema and treated with topical steroid, but no clinical improvement was obtained for 15 years. Laboratory studies including complete blood cell count, urinalysis, liver and renal function test, and peripheral blood smear were normal. A biopsy specimen showed hyperkeratosis, acanthosis, and mononuclear cellular infiltration in the epidermis. These cells had a perinuclear halo and showed a Pautrier's microabscess like configuration. In the dermis, there was a band like infiltration of inflammatory cells. Infiltrates of the epidermis were negative for leukocyte common antigen(CD45) and positive for Pan T cell(CD45RO). He was treated with topical PUVA twice a week for twelve weeks. Clinical and pathological improvements were obtained. We propose PUVA may be a useful therapeutic modality to treat Woringer Kolopp disease.
Adult ; Biopsy ; Blood Cell Count ; Dermis ; Eczema ; Epidermis ; Humans ; Leukocytes ; Liver ; Pagetoid Reticulosis* ; Thigh ; Urinalysis

We report the clinical evolution of two male patients with generalized granulama annulare(GGA) who were controlled with hydroxychloroquine. In the first case, a 3-year-old boy was treated with systemic steroid, and in the second case, a 68-year-old man was treated with prednisolone, niacin, and retinoic acid. But, remission and recurrence of the skin lesions were repeated. A good clinieal response was achieved in both cases after administration of hydroxychloroquine without side effects or any signs of recurrence. Hydroxychloroquine may be helpful to treat the GGA that have side effects to the systemic corticosteroid or resistence to other therapeutic modalities.
Aged ; Child, Preschool ; Granuloma Annulare* ; Granuloma* ; Humans ; Hydroxychloroquine* ; Male ; Niacin ; Prednisolone ; Recurrence ; Skin ; Tretinoin

No abstract available.
Adult* ; Humans ; Life Style*

PURPOSE: This study was performed to evaluate the success rate, failure causes, complications, safety and effectiveness of extracorporeal shock wave lithotripsy(SWL) with domestic SDS-5000 lithotriptor for the treatment of urinary calculi. MATERIALS AND METHODS: SWL monotherapy using the Domestic SDS-5000 lithotripter was performed in 195 urinary stones from 173 patients between 9 years and 74 years old from March 1998 to February 1999. Distribution of stones, location and size of stones, session, success rate, causes of failure and complications of SWL were reviewed. RESULTS: Of 195 cases, 88(45.1%) had renal, and 107(54.9%) ureteral stones. Of these cases 44.6% had stones smaller than 0.9cm, 33.3% from 1 to 1.9cm, 15.9% from 2 to 2.9cm, and 4% larger than 3cm. The overall success rate of complete SWL was 91.3% with 90.1% in 5-9mm, 96.9% in 10-19mm, 90.3% in 20-29mm and 62.5% over 30mm stone size. There were no significant complications. The cases of transient gross hematuria were developed in 11.3%, renal colic in 8.7%, steinstrasse in 2.0% and fever in 1.0%. These complications were controlled with conservative treatment or repeated session of shock wave lithotripsy, Double - J stent insertion. CONCLUSIONS: SWL with Domestic SDS-5000 lithotriptor is considered to be a safe and efficient outpatient procedure for the initial treatment of urinary stone.
Aged ; Fever ; Hematuria ; Humans ; Lithotripsy* ; Outpatients ; Renal Colic ; Shock* ; Stents ; Ureter ; Urinary Calculi*