The purpose of this is to understand the aspect of human spirituality and its general meaning to nursing practice. This conceptual analysis has been defined thus : 1) spirituality is a basic human attribute 2) spirituality gives meaning to life 3) spirituality is a relationship between the omnipotent and the supernatural. Spirituality assumes these : 1) all human beings possess a spiritual nature 2) it is the source of human power 3) it assumes mutual relationship between the individual and others 4) conviction etc. And the result of spirituality leads to : 1) petition 2) peacefulness 3) hope 4) love between the self and the surrounding others and etc. The experience of the spirituality refers to the relationship between the self, others, and with the environment as well as the relationship with God. And that positive and assertive mentality and attitude will result in a desirable spiritual relationship between the caregiver(the nurse and the receiver.
Hope ; Humans ; Love ; Nursing ; Spirituality*

No abstract available.
Breast Neoplasms* ; Breast* ; Cyclin D1* ; Cyclins* ; Survival Rate*

Acute hybrid leukemia is an uncommon disease that demonstrates malignant transformation expressing lymphoid and myeloid cell lineage. We experienced a case of 25-year-old man with acute leukemia with unusual characteristics: unclassifiable morphology and undifferentiated cytochemistry by French-American-British (FAB) criteria. Microscopically, it disclosed monotonous tumor cell population in lymph node with vascular plugging and perivascular infiltration, and indian file appearance in capsule and surroun ng adipose tissue. Results of flow cytometry and immunohistochemical studies of frozen sections, cytospins, and formalin fixed lymphoid tissues disclosed hybrid form characterized by myeloid and lymphoid cell lineage. The immunophenotype analysis showed both anti-T cell, anti-B cell and anti-myeloid cell monoclonal antibody reactivity; blast cells were consistently CD7+(94.6%), CD13+(97.1%), and CD19+(85.22%). The normal hematopoietic cells were almost replaced by tumor cells in PB and bone marrow. In preparation of cytospin of peripheral blood(PB) cells separated by a Ficoll-hypaque gradients, blast cells were negative for Sudan black B, myeloperoxidase, periodic acid Schiff, and nonspecific esterase.
Male ; Humans

The retinoblastoma (Rb)/cyclin D1/p16 pathway is an important constituent of cell cycle regulation. Perturbations in this pathway due to a variety of genetic aberrations have been reported in many human cancers including breast cancer. We examined the significance of immunoexpression of p16 protein, cyclin D1 protein, Rb protein (pRb), and p53 protein in 128 cases of invasive breast carcinoma. The results were correlated with survival rate and clinicopathological variables, including age, histologic grade, lymph node status, tumor size, estrogen receptor (ER), and progesterone receptor (PR) content. Abnormal expressions of p16 and pRb which were defined as negative staining were seen in 21% and 43% of tumors, respectively. There was a significant inverse relationship between p16 and pRb expression. There was no correlation between p16 staining and any other parameters, including survival rate, cyclin D1, p53, and clinicopathologic variables. Surprisingly, there was a trend for tumors which were positive for pRb to be grade III ductal carcinomas. Cyclin D1 positivity was noted in 46% of cases. The expression of cyclin D1 protein was significantly higher in lower histologic grade, higher ER and PR expression. The expression of p53 protein showed a significant correlation with high tumor grade. In a Cox multivariate analysis, neither p16, pRb, cyclin D1 nor p53 was an independent predictor, but tumor size and lymph node status were independent predictors of patient outcome.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Cell Cycle ; Cyclin D1* ; Cyclins* ; Estrogens ; Humans ; Lymph Nodes ; Multivariate Analysis ; Negative Staining ; Receptors, Progesterone ; Retinoblastoma ; Retinoblastoma Protein ; Survival Rate

Lung cancer is the most common malignant tumor worldwide and its incidence continues to rise each year. Recent development of molecular biologic method has led to advances in determining the etiologic factors of lung cancer and the establishment of cell lines has provided a lot of information on the through chemosensitivity, radiation biology studies, cytogenetics, and molecular biologic studies, which permits improved treatment for lung cancer. We established a small cell lung cancer cell line, designated JePa-1, obtained from malignant pericardial effusion of small cell lung cancer patient and characterized its morphologic and molecular biologic features. the JePa-1 cell line grew relatively slowly (doubling time 45hrs) as very loosely adherent floating aggregates growing in small clumps with distinct cell outlines and intertwined cords. Also JePa-1 cell line secreted antidiuretic hormones. Electronmicroscopic examination revealed that JePa-1 cell line and xenografts contained electron dense core granules, characteristic of being of neuroendocrine origin. To investigate the tumorigenic capacity, the JePa-1 cell line was injected into SCID and nude mice. Tumors taken from xenografts were observed in 3 out of 4 of the SCID mice and 2 out of 4 of the nude mice. The histologic characteristics of the xenografts were similar to those of the cell line and the original cytologic finding of the pericardial fluid, suggesting small cell carcinoma. The results of immunohistochemical markers showed reactivity for Rb protein, c-myc, TGF-alpha, TGF-beta , EGFR, keratin, NSE, chromogranin, and EMA. The DNA ploidy and the index of the JePa-1 cells was tetraploid and 2.13, respectively. The positive rate for the Rb, c-myc and K-ras proteins of the JePa-1 cell line were 98.9%, 99.3%, and 99.7% respectively as determined by flow cytometry. Cytogenetic analysis using the G-banding technique showed 65 chromosomes with various numerical and structural abnormalities. On examination of the expression of TGF-alpha, TGF-beta , and EGFR by PCR, only the EGFR was positive Through the establishment of JePa-1 cell line, we report in this paper the characterization of a small cell lung cancer such as morphologic and immunocytochemical features, growth characteristics in culture, hormone production, expression of oncoprotein and several growth factors, tumorigenicity, chromosomal abnormalities, and DNA ploidy and index. The JePa-1 cell line will be valuable in vitro studies for the etiology, treatment and the prognostic factors in small cell lung cancer.
Animals ; Carcinoma, Small Cell ; Cell Line ; Chromosome Aberrations ; Cytogenetic Analysis ; Cytogenetics ; DNA ; Flow Cytometry ; Heterografts ; Humans ; Immunohistochemistry ; Incidence ; Intercellular Signaling Peptides and Proteins ; Lung Neoplasms ; Mice ; Mice, Nude ; Mice, SCID ; Pericardial Effusion ; Ploidies ; Polymerase Chain Reaction ; Radiobiology ; Retinoblastoma Protein ; Small Cell Lung Carcinoma* ; Tetraploidy ; Transforming Growth Factor alpha ; Transforming Growth Factor beta ; Vasopressins

BACKGROUND: Tuberculosis continues to be a major threat to health throughout the world, with an estimated 8 to 10 million new cases and 3 million deaths annually. And control of the disease is further threatened by the emergence of drug resistance. Recent major advances have been made in unravelling the molecular basis of M. tuberculosis resistance to isoniazid, streptomycin, quinolones and rifampin. And rifampin resistance is the useful indicator for the occurance of the multi-drug resistance. Hence, the rapid detection of rifampin resistant strain of M. tuberculosis is the key to have successful anti-tuberculosis therapy. Here we present our experience using PCR and line probe assay (INNO-LiPA) for easy and rapid detection of rifampin resistance of M. tuberculosis. METHODS: Thirty rifampin resistant and twenty susceptible strains of M. tuberculosis were collected from the routine culture and analyzed with INNO-LiPA. And results were compared with conventional antibiotic susceptibility testing. After amplification of the region of the RNA polymerase(rpoB), the amplified product is hybridized with a set of 10 oligonucleotides immobilized onto a membrane strip. From the pattern obtained the presence or not of rifampin resistance M. tuberculosis can be assessed. RESULTS: Ninety three percent of patients who had rifampin resistant strain revealed the multidrug resistance while only two showed resistance to rifampin only. The INNO-LiPA test results were generally agreeable with that of the conventional susceptibility testing(90%). The mutations in codon 531 (absence of 55 probe) were most commonly observed. In 55.2% of the 31 rifampin resistance M. tuberculosis confirmed on mutation by R-probes on the INNO-LiPA strips. CONCLUSIONS: The line probe assay after polymerase chain reaction is a fast and convenient method to detect both presence of M. tuberculosis complex strains and its resistance to rifampin in clinical specimens. We have suggested that detection of rifampin resistance may play a key role in monitoring multi-drug resistance. Consequently, the INNO-LiPA test may constitute an important tool for the control of tuberculosis.
Codon ; Drug Resistance ; Drug Resistance, Multiple ; Humans ; Isoniazid ; Membranes ; Mycobacterium tuberculosis* ; Mycobacterium* ; Oligonucleotides ; Polymerase Chain Reaction ; Quinolones ; Rifampin* ; RNA ; Streptomycin ; Tuberculosis

The purpose of this study was to investigate the relation between hypertension and risk factors. A positive association between obesity, age, serum lipid and such life style factors as smoking, exercise, alcoholic beverage use with blood pressure problems and the prevalence of hypertension has been described in many studies. Therefore to identify and evaluate the effects of variables, which were known to be related to hypertension, multiple regression analysis was performed. We studied 110 subjects. The participants were 45 men and 65 women who visited one university hospital located in Seoul from January to December 1998. All 110 persons were identified as having primary hypertension by their physicians. The significant risk factors identified for hypertension were Obesity, BMI, length of time with hypertension. The results were as follows; 1. The systolic blood pressure average in 110 subjects was 156.65mmHg +/- 14.08mmHg, the diastolic blood pressure average was 100.73mmHg +/- 5.64mmHg. 18.2% of the subjects were smokers, 26.4% of the subjects were drinkers, and 33.6% of the subjects exercised regularly. 13.6% had a family history of hypertension. The average mean pressure was 119.37 +/- 7.40mmHg. The average history of hypertension was 28.36 +/- 34.56months. The average body weight of subjective was 65.25kg, and their average BMI was 24.54kg/m2. The average serum cholesterol of the subjects was 204.54mg/dl, HDL was 50.93mg/dl. 2. The result of this study were that variables which showed significance rationale for high systolic blood pressure in hypertension were mean arterial pressure(R2=0.808), and age(R2=0.032). And the variables which showed significance rationale for diastolic blood pressure in hypertension were mean arterial pressure(R2=0.697), age(R2=0.051), sex(R2=0.014), and somking(R2=0.010). And the best variable for prediction of mean blood pressure was the length of history of the disease. 3. According to multiple regression analysis by demographic variables, age and the length of history of hypertension were predictable variables for hypertension. And mean the blood pressure was identified best explaining variable of hypertension by biophysical variables. Therefore, life style modification for hypertension patients as a primary regimen is less important than for normal blood pressure patients. Life style modification is important intervention for normal blood pressure subjects, on the other hand drug therapy and its compliance is the most important intervention for hypertensive subjects. So to regulate blood pressure and prevent the complication of hypertension, the first regime of all should pharmacologic therapy. There is a need to develop nursing intervention to improve pharmacologic compliance for primary hypertension patients.
Alcoholic Beverages ; Blood Pressure* ; Body Weight ; Cholesterol ; Compliance ; Drug Therapy ; Female ; Hand ; Humans ; Hypertension* ; Life Style ; Male ; Nursing ; Obesity ; Prevalence ; Risk Factors* ; Seoul ; Smoke ; Smoking

VATER association represents vertebral defects, anal atresia, tracheo-esophageal fistula with without esophageal atresia, renal defects and radial limb dysplasia. The probability of the simultaneous occurrence of any three of these defects is so unlikely that it suggests a sporadic non-random association. This non-random association appears to be related to some chromosomal anomalies, the caudal regression syndrome, mesodermal defects in early developmental period or the matemal use of sex hormones during embryogenesis. We report three autopsy cases of the VATER association that showed most of the known major and minor defects as well as an unusual concurrence of other defects, i.e., scoliosis, talipes varus, absent penis, urethral agenesis and stenosis, rectourethral fistula, rib anomaly, single umbilical artery, Meckel's diverticulum, diaphragmatic hemia, absent rectum, short neck, simian crease, low set ear, and hypoplastic lung.

In this study of 64 cases of breast cancer with a clinical follow-up period of more than 5 years, several prognostic factors were evaluated. The purpose of this study was to determine whether any one parameter or group of parameters serves as adequate predictors of tumor behavior and patient's prognosis. Several prognostic factors included clinicopathological variables (patient's age, histologic grade, status of lymph node (LN) metastasis, and tumor size), expression of estrogen receptor (ER), progesterone receptor (PR), p53, bcl-2 and CD44 by immunohistochemistry, and DNA ploidy pattern. The results showed that the expression of ER and PR had a significant inverse correlation with the histologic grade (ER, p=0.05; PR, p<0.05). The expression of p53 protein showed a significant relationship with high histologic grade of tumor (p<0.05). The expression of bcl-2 protein was preferably seen in low histologic grade of tumor (p<0.05) and significantly associated with ER positive or PR positive tumors (ER, p<0.05; PR, p<0.05). This results suggest that bcl-2 protein might play significant roles in ER and PR. The CD44 expression showed a significant relationship with tumor size (p<0.05). The large size and aneuploidy pattern of tumor had a tendency to be associated with shorter patient survival. Cox's multivariate analysis showed that overall survival was affected by LN metastasis because of the shorter survival in patients with LN metastasis. In conclusion, tumor size, DNA ploidy pattern, and LN metastasis were themselves significant predictors of breast cancer survival rate.
Aneuploidy ; Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; DNA* ; Estrogens ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Ploidies* ; Prognosis ; Receptors, Progesterone ; Survival Rate

We report a case of a large asymptomatic Rathke cleft cyst in a 14-year-old boy. This cyst was of considerable size, measuring 2x1.8x1.8 cm, but did not produce any symptoms and was confined to the suprasellar area. The cyst wall was lined by pseudostratified ciliated columnar epithelium with goblet cells. The lining epithelium of the Rathke cleft cyst was immnoreactive for cytokeratin, EMA and CEA.
Cysts