The purpose of this study was to identify the re lationship of hopelessness and spiritual-need of cancer patients. Subjects for this study were 272 cancer patients sampled from a madical center in Pusan. The data were collected from Feb. 1 to Mar. 10, 1998 using questionnaire method. Hopelessness measured hopelessness scale was the One(1986) modification of Beck(1974) and spiritual -need measured spiritual-need scale by Kim (1986) according to classification of Fish and Shelly. The questionnaire consisted of question regarding hopelessness scale(20 items 5 point) and spiritual-need scale (30 items 5 point scale). The reliability of this instrument was that the hopelessness scale was Cronbach's alpha=0.89 and the spiritual-need was Cronbach's alpha=0.93. The data were analyzed with the SFSS program using mean, standard deviation, frequency and percentage, t-test, ANOVA, Post hok test and Pearson's Correlation Coefficient. The results of this study were as follow : 1. The mean score of the total hopelessness was 2.79 in 1(lowest) -to-5(highest) scoring system. The analysis of the hopelessness according to general characteristics of the cancer patients showed duration of treatment(F=3.77), cognition prognosis(F=2.92) age(F=2.66), religional effect of life(2.48). 2. The mean score of the total spiritual-need was 3.47 in 1(lowest)-to-5 (highest) scoring system. age(F=5.517), sex(F= .919), religion(F=25.89), religional effect of life(F=18.54), diagnosis(F= 7.67), main care giver(F=4.09), cognition of disease(F=2,92), cognition of prognosis (F=331), inspiring source(F= 12.72), acceptioal attitude of present situation(F= 13.52). according to the categoiised paiL were showed to the need for meaning and purpose(9.40), to the need for love and relatedness(7.08), and to the need for being forgiven(6,93). 3. There was significant correlation between the degree of hopelessness and spiritual-need(gamma=.146, P<0.05).
Busan ; Classification ; Cognition ; Humans ; Love ; Prognosis ; Surveys and Questionnaires

PURPOSE: The treatment of choice for well-differentiated thyroid cancer is surgical excision. However, the operation method is still controversial. Also, the operation method has been changing gradually. Thus, we reviewed the records of patients with well-differentiated thyroid cancer who had received operations in our hospital to assess the trend in surgical procedure, and to determine the proper procedure, method, considering both recurrence and complications. METHODS: We retrospectively analyzed the cases of 452 patients with differentiated thyroid cancer who had received operations from January 1989 to December 1998. We divided the 10 years into two periods; period I was from 1989 to 1993 (254 patients) and period II was from 1994 to 1998 (198 patients). We analyzed recurrences and complications according to the operation method, including neck lymph-node dissection. The incidences and locations of lymph- node metastasis were taken into account, too. The statistical analysis was done by using the Fisher's exact test. RESULTS: In period I, 147 patients (58%) received a total thyroidectomy, and in period II, all patients received total thyroidectomy. In period I, 24 patients (9.4%) had a recurrence, and in period II, 13 patients (6.6%) had a recurrence. In period I, 55 patients (21.7%) had postoperative hypoparathyr oidism, and in period II, 38 patients (19.2%) had postoperative hypoparathyroidism. In period I, 15 patients (5.9%) had postoperative hoarseness, and in period II, 7 patients (3.5%) had postoperative hoarseness. Two hundred eighty-one patients (62.2%) had lymph-node metastasis, and the anterior neck region was the most common site of metastasis (60.2%). CONCLUSION: In the operation method for differentiated thyroid cancer, the trend is toward a total thyroidectomy away from a lobectomy. Also, a skillful and experienced surgeon can reduce the incidence of postoperative complications. Thus the best operation method for differentiated thyroid cancer is a total thyroidectomy, including a preventive anterior-neck lymph-node dissection, which is done by a skillful and experienced surgeon.
Hoarseness ; Humans ; Hypoparathyroidism ; Incidence ; Neck ; Neoplasm Metastasis ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

PURPOSE: This paper presented a descriptive study which aimed to identify the relationship among menstrual attitude, premenstrual distress and premenstrual coping in Korean college women and to propose fundamental data for the development of guidelines for effective management of premenstrual distress. METHODS: The data were collected from 111 college women and analyzed using descriptive statistics, t-tests, ANOVA and Pearson's correlation coefficients. RESULTS: The mean score of premenstrual coping was 3.25±0.60 out of 5 points. The ‘Awareness and Acceptance of Premenstrual Change’ score was highest and the ‘Avoiding Harm’ score was lowest. Menstrual attitude was significantly related to premenstrual distress (r=.37 p<.001) and the awareness and acceptance style of premenstrual coping (r=-.21. p=.021). And premenstrual distress was significantly related to the self-care coping style of premenstrual coping (r=.30, p=.001), the adjusting energy coping style of premenstrual coping (r=.45, p<.001) and the avoiding harm coping style of premenstrual coping (r=.48, p<.001). CONCLUSION: Results of this study support that positive attitude about menstruation is necessary for the effective management of premenstrual distress. Also, premenstrual coping programs that consider the level of premenstrual distress will be needed for college women.
Female ; Humans ; Menstruation ; Self Care

Primary or metastatic malignant melanoma can mimic benign blue nevus in rare cases, making the diagnosis challenging. Herein, we report an exceptionally rare case of blue nevus-like melanoma and its blue nevus-like metastasis which was detected by catheterized urine cytology. The patient presented with blue-colored papuloplaques on his temple which were diagnosed as blue nevus-like melanoma on punch biopsies. While he was admitted for administration of chemotherapy, hematuria was detected. Catheterized urine cytology revealed singly scattered oval to spindle-shaped pigmented cells with a moderate degree of variation in shape and size. Many of them had small nuclei with indiscernible to inconspicuous nucleoli while only a few cells showed nuclear enlargement and nuclear hyperchromasia, which could be diagnostic pitfalls. Most of the cells on the smear were positive for HMB45 immunostaining, which confirmed the diagnosis of metastatic blue nevus-like melanoma. To the best of our knowledge, the present case is the first report describing cytomorphologic findings of blue nevus-like metastasis of melanoma in the urine specimen.
Biopsy ; Catheters* ; Diagnosis ; Drug Therapy ; Hematuria ; Humans ; Melanoma* ; Neoplasm Metastasis ; Nevus, Blue

PURPOSE: We studied the value of clinical signs, laboratory findings and (99m)technetium dimercaptosuccinic acid(DMSA) scan in predicting the presence of vesicoureteral reflux(VUR) in children with first febrile urinary tract infection(UTI). METHODS: A retrospective analysis of 84 hospitalized children with first febrile UTI was performed. They underwent DMSA scan and voiding cystourethrography(VCUG) during the acute phase, and were divided into three groups according to the results of the VCUG: absence of VUR, mild(grade I-II) and severe VUR(grade III-V). We studied the relation of VUR to age, gender, fever duration, causative organism, white blood cell count, serum C-reactive protein and result of DMSA scan. RESULTS: Among 84 patients, 6 had mild and 17 had severe VUR. Thirty-eight had abnormal DMSA scan. results Patients with VUR were older than those without VUR(P<0.01). There was a lower probability of infection with Escherichia coli in patients with severe VUR than in those with mild and absent VUR(P<0.01). An abnormal DMSA scan correlated with the presence and severity of VUR(P<0.05). Severe VUR was present in 10.9% of patients with normal DMSA scan. The sensitivity, specificity, positive and negative predictive values of the DMSA scan in predicting the presence of VUR were 69.6%, 63.9%, 42.1%, and 84.8%, respectively. CONCLUSION: An abnormal DMSA scan correlated to the presence and severity of VUR, but the sensitivity, specificity and positive predictive value of the DMSA scan were low. Therefore, patient with an abnormal DMSA scan requires a VCUG. In order to prevent missing the 10.9% of patients with severe VUR but normal DMSA scans, a VCUG should be performed in patient with normal DMSA scan.
C-Reactive Protein ; Child* ; Child, Hospitalized ; Escherichia coli ; Fever ; Humans ; Leukocyte Count ; Retrospective Studies ; Sensitivity and Specificity ; Succimer ; Urinary Tract Infections* ; Urinary Tract* ; Vesico-Ureteral Reflux

Pseudohypoaldosteronism (PHA) type l is a rare neonatal disease characterized by salt wasting, dehydration, hyperkalemia and metabolic acidosis. It is unresponsive to mineralocorticoid treatment with elevated aldosterone concentration. The three different modes of inheritance has been described. The autosomal dominant form has a mild clinical course and gradually improves with age. In this form, resistance to aldosterone seems to be restricted to the kidney. The autosomal recessive form displays generalized aldosterone resistance including kidney, colon, lung, sweat and salivary gland system. This form is more severe and requires life-long supplement with high-dose salt. The sporadic form is mild and resembles the autosomal dominant form. In this paper, we describe a male patient diagnosed as PHA type l at the age of 19 months. He presented with recurrent vomiting, diaphoresis accompanying hyponatremia, hyperkalemia, metabolic acidosis, elevated plasma renin activity and aldosterone level. Ultimately he has improved with treatment by oral sodium bicarbonate.
Acidosis ; Aldosterone ; Colon ; Dehydration ; Humans ; Hyperkalemia ; Hyponatremia ; Kidney ; Lung ; Male ; Plasma ; Pseudohypoaldosteronism* ; Renin ; Salivary Glands ; Sodium Bicarbonate ; Sweat ; Vomiting ; Wills

OBJECTIVES: The purpose of this study was to investigate demographic, clinical, behavioral and metabolic-endocrine factors related to weight gain in patients with schizophrenia treated with serotonin-dopamine antagonists(SDA). METHODS: Forty-two in-patients with DSM-IV schizophrenia were recruited from Samsung Seoul Hospital and St. Andrew Neuropsychiatric Hospital. The subjects were first-episode patients or patients who did not take any antipsychotics for the previous two months. All the patients were administered with one of the SDAs for 8 weeks. Body weights and body mass index (BMI) were measured weekly during the treatment period. The mean levels of daytime activities were evaluated at baseline and 4 weeks and 8 weeks after the treatment. To assess the clinical response to the medication, the Krawiecka Rating Scale (KRS) and Clinical Global Impression (CGI) were applied before and after the treatment. Fasting blood levels of glucose, cholesterol, triglyceride (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL), and serum level of prolactin were measured before and after the treatment. RESULTS: The body weight and BMI were significantly increased through the treatment periods. There were significant increases in the blood levels of cholesterol, TG and prolactin after 8 weeks. KRS total score showed significant decrease and the mean level of daytime activities showed significant increase by the treatment. Significant negative correlations were observed between the weight gain indices and the baseline BMI. The level of clinical improvement was significantly correlated with the degree of weight gain. Gender, age, smoking, daily dosages of antipsychotics, level of daytime activity and changes in appetite did not show any association with the weight gain indices. Neither the baseline biochemical variables nor their changes after the treatment were significantly correlated with the indices of weight gain. CONCLUSION: This result implies that low baseline BMI could be a risk factor of weight gain in short-term treatment of schizophrenia with SDAs. And it is also suggested that the effects of SDAs on weight gain and the clinical improvement might be developed through the same pharmacodynamic pathway.
Antipsychotic Agents ; Appetite ; Body Mass Index ; Body Weight ; Cholesterol ; Diagnostic and Statistical Manual of Mental Disorders ; Fasting ; Glucose ; Humans ; Lipoproteins ; Prolactin ; Risk Factors ; Schizophrenia* ; Seoul ; Smoke ; Smoking ; Triglycerides ; Weight Gain*

Pulmonary hemorrhage is a rare but possibly fatal complication of systemic lupus erythematosus (SLE). We report a case of massive pulmonary hemorrhage in a 14-year-old boy recently diagnosed as SLE. He developed massive pulmonary hemorrhage during the courses of i.v. methylprednisolone pulse therapy, and did not respond to i.v. cyclophosphamide. However, he rapidly improved through the use of plasmapheresis. Although various factors can precipitate pulmonary hemorrhage in SLE, our case was probably caused by an immune mediated mechanism since the hemorrhage responded promptly to plasmapheresis. This case illustrates the importance of plasmapheresis in the treatment of pulmonary hemorrhage which is not improved by methylprednisolone and cyclophosphamide. We report this case with a brief review of the related literatures.
Adolescent ; Child* ; Cyclophosphamide ; Hemorrhage* ; Humans ; Lupus Erythematosus, Systemic* ; Male ; Methylprednisolone ; Plasmapheresis*

Pulmonary hemorrhage is a rare but possibly fatal complication of systemic lupus erythematosus (SLE). We report a case of massive pulmonary hemorrhage in a 14-year-old boy recently diagnosed as SLE. He developed massive pulmonary hemorrhage during the courses of i.v. methylprednisolone pulse therapy, and did not respond to i.v. cyclophosphamide. However, he rapidly improved through the use of plasmapheresis. Although various factors can precipitate pulmonary hemorrhage in SLE, our case was probably caused by an immune mediated mechanism since the hemorrhage responded promptly to plasmapheresis. This case illustrates the importance of plasmapheresis in the treatment of pulmonary hemorrhage which is not improved by methylprednisolone and cyclophosphamide. We report this case with a brief review of the related literatures.
Adolescent ; Child* ; Cyclophosphamide ; Hemorrhage* ; Humans ; Lupus Erythematosus, Systemic* ; Male ; Methylprednisolone ; Plasmapheresis*

PURPOSE: With previous methods based on only age and location, there are many difficulties in identifying the etiology of acute abdominal pain in children. We sought to develop a new systematic classification of acute abdominal pain and to give some helps to physicians encountering difficulties in diagnoses. METHODS: From March 2005 to May 2010, clinical data were collected retrospectively from 442 children hospitalized due to acute abdominal pain with no apparent underlying disease. According to the final diagnoses, diseases that caused acute abdominal pain were classified into nine groups. RESULTS: The nine groups were group I "catastrophic surgical abdomen" (7 patients, 1.6%), group II "acute appendicitis and mesenteric lymphadenitis" (56 patients, 12.7%), group III "intestinal obstruction" (57 patients, 12.9%), group IV "viral and bacterial acute gastroenteritis" (90 patients, 20.4%), group V "peptic ulcer and gastroduodenitis" (66 patients, 14.9%), group VI "hepatobiliary and pancreatic disease" (14 patients, 3.2%), group VII "febrile viral illness and extraintestinal infection" (69 patients, 15.6%), group VIII "functional gastrointestinal disorder (acute manifestation)" (20 patients, 4.5%), and group IX "unclassified acute abdominal pain" (63 patients, 14.3%). Four patients were enrolled in two disease groups each. CONCLUSION: Patients were distributed unevenly across the nine groups of acute abdominal pain. In particular, the "unclassified abdominal pain" only group was not uncommon. Considering a systemic classification for acute abdominal pain may be helpful in the diagnostic approach in children.
Abdominal Pain* ; Appendicitis ; Child* ; Classification* ; Diagnosis ; Humans ; Retrospective Studies ; Ulcer