This study examined burdens of primary family carcgivcrs of paticnto with cerebrovascular accidents (CVA) along with related factors. In addition, their needs for support group intervention were assessed to develop a support group to reduce the burdens of caregiving. Eighty-one primary family caregivers of patients with CVAs at a general hospital in Seoul participated in this study . The patients with CVAs aged from 26 to 83 years with mean age of 63 years. About 90% of the patients had some paralysis and 56.6% suffered speech problems. Fifty-eight percent of the primary family caregivers were spouses of the patients and 80.2% were women. Primary family caregivers' burdens were assessed by the Burden Scale originally devel oped by Zarit (1980) and Novak & Geust(1989) and modified by Jang (1995) for use in Korea. The instrument consists of six subscales time-dependent burden, developmental burden, physical burden, emotional burden, social burden, and financiaI burden. The results were as follows : 1. The average of burden score was 91.7, indicating moderate to severe level of burden. The time-dependent burden was scored highest followed by physical, developmental, social, financial, and emotional burdens. 2. of the characteristics of patients, age, gender, and severity of the disease were found to be associated with the level of burden. Of the characteristics of primary family caregivers, age and educational level were significantly related to the level of burden. Time of care since the CVA and the quality of relationship between a patient and a caregiver prior to the stroke were significant situational factors affecting the level of burden. 3. The need for support group intervention for the caregivero was very high (95.1%). The earcgivcrs of patients who had a CVA for the first time showed higher levels of need compared to those of patients who had a CVA more than once. The caregivers indicated a support group held once a month near home or hospital would be welcomed. In addition, they replied that a group composed of 9 to 10 caregivers and guided by health care professionals (e.g., physicians and nurses) would be most desirable. More than 85% of the earegivers identified the areas that they wanted intervention in as follows : knowledge, skills, and resources to care for a patient with a CVA. the counsel of health care professionals, share of their experiences with those who have similar situations, stress management skills, and methods to overcome emotional isolation due to the great responsibility for a patient. Given the results, support group is expected to be an effective way to reduce the burdens of primary family caregivers of patients with CVAs. As a follow up It is necessary to examine the effect of support group intervention on the patient's recovery and rehabilitation.
Caregivers* ; Delivery of Health Care ; Female ; Hospitals, General ; Humans ; Korea ; Paralysis ; Rehabilitation ; Self-Help Groups* ; Seoul ; Spouses ; Stroke*

This study was performed to evaluate the effect of placebo(emotional stimulus) on physical fitness and psychological wellbeing. The subjects for the study were divided into tow groups. One experimental group received placebo and the other control group did not receive. Each group was composed of 15 women. The subjects continued aerobic exercise for an hour each time, three times a week, for eight weeks. The enhancement of physical fitness has been evaluated by body weight, BP, pulse rate, skinfolds thickness, circumference of waist and hip, body fat, % body fat, lean body mass, % lean body mass they were measured three times every 4 weeks. Also to evaluate the enhancement of psychological wellbeing, the self-esteem and self-perception were measured. The results can be summarized as follows : 1. The % body fat of experimental group decreased significantly than that of control group(p<0.1). 2. The % lean body mass of experimental group decreased significantly than that of control group(P<0.1). 3. There was no significant difference of other physical fitness factors between experimental group and control group. 4. There was no significant difference of self-esteem between experimental group and control group. 5. There was no significant difference of self-perception between experimental group and control group. From these results, it may be concluded that placebo(emotional stimulus) which received during aerobic exercise period is partially effective in the enhancement of the physical fitness.
Adipose Tissue ; Body Weight ; Exercise* ; Female ; Heart Rate ; Hip ; Humans ; Physical Fitness* ; Placebo Effect ; Self Concept

BACKGROUND : The recent studies shows that Helicobacter pylori (H. pylori) related chronic gastritis leads to dysplasia, intestinal metaplasia and gastric cancer. The aim of this study was to determine the association between precancerous lesion of stomach (dysplasia, intestinal metaplasia) and H.pylori infection in the elderly. METHODS : 469 patients were enrolled this study, Patients with intestinal metaplasia or dysplasia (case, n=148) were compared with controls (without intestinal metaplasia and dysplasia, n=321) about H. pylori positive rates H. pylori positivity was confirmed by histologic determination of endoscopic biopsy specimens. Results : 1) Among study populations H. pylori positive rates were 51.8% (55.8% in male, 40.7% in female). It was significantly higher in male (p=0.001). 2) There were no significant differences in sex distribution between cases and controls, but in old age, the cases were more frequent than in young age (p<0.001). 3) Age distribution of H. pylori positive rates were not significant between cases and controls. 47.5% in intestinal metaplasia, 43.4% in dysplasia, 21.3% in dysplasia+intestinal metaplasia were H. pylori positive. H. pylori positive rates were more higher in controls than cases, followed by in decreasing order by the intestinal metaplasia group, the dysplasia group, and those having both (p=0.003). 4) Age and sex adjusted H. pylori positive rates were more higher in controls (42.7%) than in cases (25.0%)(p<0.009). CONCLUSION : The prevalence of intestinal metaplasia and dysplasia was age dependent. But we couldn't explain the carcinogenic effect of H. pylori, because H. pylori positive rates were lower in cases than in controls
Age Distribution ; Aged ; Aging* ; Biopsy ; Gastritis ; Helicobacter pylori* ; Helicobacter* ; Humans ; Male ; Metaplasia* ; Prevalence* ; Sex Distribution ; Stomach ; Stomach Neoplasms

No abstract available.
Sarcoma, Endometrial Stromal*

BACKGROUND: Malignant skin tumor cells derived from epidemal keratinocyte penetrate the basement membrane to proliferate in dermal interstitial strozirarnd invade surrounding tissue and finally metastasize to distant organs. In this stage of invaiac a and metastsis, the existence of proteolytic enzymes, which are capable of degrading the tissue barrier composed primarily of collagen, elastin, glycoproteins and proteoglycans, is imagnant. One of theses enzymes, cathepsin B, a lysosomal thiol protease, has been reported to ie ound in association with plasma membrane in animal and human tumors and to be releasec b tumor cells. OBJECT: We assayed the cathepsin B activities of squamo is cell carcinoma and basal cell carcinoma in order to investigate the correlation between the degree of cathepsin B activities and invasiveness or metastatic potential of skin tumors. METHODS: Cathepsin B-like protease activity was measurec by the method of Hirao using a synthetic substrate, Z-Phe-Arg-MCA. The skin tissues (penie Koreskin for control, basal cell carcinoma and squamous cell carcinoma tumor masses) were homogenized and their subcellular organelles were fractionated by centrifugation. Each of the fractionated preparations were used as enzyme solution. RESULTS: Cathepsin B-lilke activities were found mainly in the membrane fractions in all the samples. The activities of squamous cell carcinoma (12.484+1.904) and basal cell carcinoma (10.598+1.926) were higber than those of the control skin (9.115+0.815). CONCLUSION: These results suggest that membrane-bound conrt epsin B-like protease participates in local dissolution of the extracellular matrices and were ar endothelial cells to be able to make metastasis to other remote organ during the invasivest ges of malignant skin tumors.
Animals ; Basement Membrane ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cathepsin B* ; Cathepsins* ; Cell Membrane ; Centrifugation ; Collagen ; Elastin ; Endothelial Cells ; Extracellular Matrix ; Glycoproteins ; Humans ; Immunohistochemistry ; Keratinocytes ; Membranes* ; Neoplasm Metastasis ; Oncogenes ; Organelles ; Peptide Hydrolases ; Proteoglycans ; Skin*

No abstract available.
Lutein* ; Luteinizing Hormone* ; Puberty, Precocious*

PURPOSE: This study was performed to investigate the type and frequency of end colostomy-related complications and to identify the risk factors for those complications. METHODS: Retrospective analysis of medical records was made in 708 patients who underwent end colostomy in Samsung Medical Center between October 1994 and February 2005. The type was divided into stomal and peristomal complications: stomal complications included bleeding, necrosis, mucocutaneous separation, prolapsed stoma, retraced stoma, stenosis, and hyperplasia; peristomal complications did peristomal varix, peristomal hernia, irritant contact dermatitis, allergic contact dermatitis, maceration, folliculitis, hyperplasia, bacterial infection, candidal infection, malignancy in the peristomal area, mechanical damage and pyoderma gangrenosum. RESULTS: For stomal complications, hyperplasia was most common(9.0%). For peristomal complications, irritant contact dermatitis was developed in 17.4%. Sex and BMI were risk factors for irritant contact dermatitis, hyperplasia, peristomal hernia, flat stoma, and retracted stoma. CONCLUSION: Teaching for preventing irritant contact dermatitis such as proper pouching and peristomal skin protection, and for comprehensive weight control should be emphasized on self care program for ostomates, while ostomy care nurse should take a careful consideration of preoperative ostomy site marking in female obese patients.
Bacterial Infections ; Colostomy ; Constriction, Pathologic ; Dermatitis, Allergic Contact ; Dermatitis, Contact ; Female ; Folliculitis ; Hemorrhage ; Hernia ; Humans ; Hyperplasia ; Medical Records ; Necrosis ; Ostomy ; Pyoderma Gangrenosum ; Retrospective Studies ; Risk Factors ; Self Care ; Skin ; Varicose Veins

PURPOSE:Decreased bone mineral density(BMD) has been reported in girls with Turner syndrome. Estrogen therapy is recommanded to improve sexual infantilism and decreased BMD. Short stature is also characteristic finding in patients with Turner syndrome. Treatment modality for short stature has included estrogen, anabolic steroids and growth hormone(GH). Recently GH therapy in GH deficient children could increase BMD in addition to improve short stature. We observed the treatment effects on bone mineral density in patients with Turner syndrome. METHODS: Bone Mineral Density in second to fourth lumbar spine area were measured by dual energy X-ray absorptiometry in 56 girls with Turner syndrome, before and after growth hormone and/or estrogen. All Turner girl was confirmed by clinical and chromosomal examination. RESULTS: 1) There was no significant difference in BMD according to karyotype. 2) The mean BMD of untreated Turner syndrome was 0.752+/-0.122g/cm2. 3) The mean BMD before and after GH treatment were 0.620+/-0.028g/cm2, 0.793+/-0.093g/cm2 respectively. The mean BMD before and after estrogen treatment were 0.761+/-0.125g/cm2, 0.918+/-0.141g/cm2 respectively. In combined group, the BMD were 0.752+/-0.087g/cm2 and 0.939+/-0.134g/cm2. Growth hormone was also effective to improve BMD as well as estrogen. But the changes of BMD were more significant in estrogen and combined group(p<0.05). 4) A significant positive correlation was found between age and BMD(p<0.05). CONCLUSIONS:Estrogen therapy can accelerate epiphysial maturation and compromise final height. Growth hormone therapy in Turner girls was effective for improvement bone mineral density as well as growth improvement. But growth hormone and estrogen combined therapy or Estrogen therapy is more effective to improve bone mineral density in Turner syndrome. Estrogen replacement can be delayed for a while on growth hormone treatment and the appropriated time of estrogen therapy should be elucidated.
Absorptiometry, Photon ; Bone Density* ; Child ; Estrogen Replacement Therapy ; Estrogens ; Female ; Growth Hormone ; Humans ; Karyotype ; Sexual Infantilism ; Spine ; Steroids ; Turner Syndrome*

To determine effects of the direction of the rotational work shifting on the circadian rhythm and adaptation of physiological and psychological components were investigated with nursing students. Two groups of seven volunteers participated as experimental subjects, and eight nursing students participated as a control group. The directions of rotation work shift were as follows : CW(clockwise)-shift system rotation in the direction of day shift(3 lays), evening shift(3days), off duty(1day) and night shift(5days). and CCW(counterclockwise)-shift system rotation in the reverse direction. Urinary free cortisol and 17-hydroxycorticoster oids in the urine were measured by the solid-phase radioimmunoassay and the colorimetry methods, re spectively. Plasma melatonin was measured by radioimmunoassay. The urinary free cotisol rhythm changed to ir-regular on the evening and night shift in the CCW shift system, whereas the rhythm seems to adapt on night shift in the CW shift system. The daily rhythms of urinary 17-OHCS indicate that they are well synchronized to shift work. These results show that the rotation of shift in the CW direction is more acceptable in terms of the adaptation of hormonal rhythms. These results indicate that the CCW rotation of shift work makes it more difficult for the workers to adapt on a physiological level, and has many more negative effects on nurses when compared with the CW rotation. Thus, a clockwise rotating shift systern seems to be more desirable for the optimal health and performance of nurses.
Circadian Rhythm* ; Colorimetry ; Humans ; Hydrocortisone* ; Melatonin ; Plasma ; Radioimmunoassay ; Students, Nursing ; Volunteers

PURPOSE: This study was designed to investigate the relationships of the types of nurse staffing, the competency of nursing performance and job satisfaction by analyzing the types of nurse staffing in operating room. METHOD: The subjects were 472 nurses who work in operating room. The instruments used in this study were three tools: competency of nursing performance, job satisfaction and type of nurse staffing. RESULT: Type 4 was most in the type of nurse staffing of the subjects. According to the type of nurse staffing, the competency of nursing performance was significantly different. There was significant difference in the competency of nursing performance according to age, marital status, bachelor, employ, position, and career, and job satisfaction according to age, position, and career. In opinion about the ideal type of nurse staffing, type 2 was most regardless of career. CONCLUSION: Type 4 which has lower competency of nursing performance was adopted in many hospitals now but, type 2 which has highest competency of nursing performance was selected by many nurses as the best one. So, it should be considered the type of nurse staffing of in operating room and change it.
Job Satisfaction* ; Marital Status ; Nursing* ; Operating Rooms*