BACKGROUND: We prospectively evaluated the incidence and possible factors causing intramuscular injection during lumbar sympathetic ganglion block and compared the multiple needle technique to the single technique to obtain a profound and complete block effect. METHODS: Among 83 patients, 58 patients (group A, n = 27, multiple needle technique and group B, n = 31, single needle technique) were reevaluated for the changes of skin temperature (Ts) and mean segment of longitudinal contrast spread. After injecting the contrast agent, the incidence of psoas muscle injection and the change of Ts was compared between two groups. RESULTS: The incidence of psoas muscle injection was 21.3% (46/216) and it was associated with the level of injection (L2) significantly (chi-square = 14.773, P = 0.001). DT(post) (postblock temperature difference between ipsilateral and contralateral great toe, 4.6 +/- 2.8degrees C, 1.8 +/- 1.6degrees C, P < 0.001 for group A and B) and DT(net) (DT(post) - DT(pre), 3.9 +/- 2.7degrees C, 1.5 +/- 1.5degrees C, P < 0.001 for group A and B) was significantly higher in group A. The mean segment of longitudinal contrast spread was 8.1 +/- 0.9 for group A and 3.2 +/- 1.6 for group B (P < 0.001). CONCLUSIONS: The LSGB at the L2 level showed the lowest incidence of psoas muscle injection of contrast. Multiple needle approach showed more significant increase of DT(net) and DT(post).
Ganglia, Sympathetic ; Humans ; Incidence ; Injections, Intramuscular ; Needles ; Prospective Studies ; Psoas Muscles ; Skin Temperature ; Toes

The elderly can experience a lot of stressful events and the stress acts as a various fluent that affects a well-being level, the self-contentment of lives. and the achievements by themselves. Also. the elderly are different from the young in many unexpressed stress and have diverse copings for perceived stress. Moreover. they mainly seem to use a problem-focused coping and an emotion-focused coping. To use whatever copings is to improve the quality of life in the old period and very important fact to achieve their ends. The purpose of this study was to investigate the relationship between Perceived Stress and the Ways of Coping in the Elderly and to gain the baseline data for development of nursing intervention program for improve to the quality of life in the elderly. The design of this study was a correlational study. The subjects of this study consisted of 230 of the elderly living in Pusan. The data was collected from 1st July, to 1st September. 2002. The instruments used for this study were 'Perceived Stress Scale(20items, 5point. scale)' developed by Kang In(990) and translated by Lee young-ja(1999). and its reliability is Cronbach's a= .89. Coping Scale(30items, 4point. scale. 14 items about a problem-focused coping, 16 items about an emotion-focused coping, 4 points scale) developed by Lazarus & Folkman (1984) and translated by Yang Young-hee(1998). The reliability of this study is Cronbach's a = .90. The data was analyzed by the SPSS WIN 10.0 program using frequency, percentage, mean, standard deviation, t-test, ANOVA & Scheffe test and Pearson's correlation coefficient. The results of this study were as follows: 1. The mean score of perceived stress was 31.75+/-0.23(Min 20, Max 100), which the item mean score was 1.59+/-.51(Min 1. Max 5). 2. The number of subjects in a problem-focused coping was 72(31.3%), the number of subjects in an emotion-focused coping was 158(68.7%) 3. There were statistically significant positive correlation between perceived stress and problem-focoused coping method and the more emotion-focoused coping method. (r = .180, r= .209, p< .05). It means the more stress, the more problem-focoused coping method and the more emotion-focoused coping method. 4. There was significant difference the score of perceived stress according to sex (F=-5.057, P=.000)marital status, (F=-2.909. P=.004) , economic level, (F=10.243, P=.000), paticipated meeting, (F=9.346, P=.000), perceived health status(F=5.1l7, P=.007). 5. There was significant difference the score of problem-focoused coping method according to age(F=14.200, P=.000), marital status (F=2.432, P=.0160), economic level (F=14.410, P=.000), monthly income, (F=8.300. P= .000), income resource (F=10.235, P=.000), educational level (F= 15.222, P= .000), occupation (F= 1.544, P=.04l), paticipated meeting (F=4.936, P= .008), perceived health status(F=5.655, P= .004). And there was significant difference the score of emotion-focoused coping method according to monthly income(F=4.781, P= .009), income resource (F=2.930, P= .035), educational level (F=6.101. P=.003), religion(F=2698, P= .032), paticipated meetings(F=7.285, P= .00l). As a result of the study, the elderly had a bit less stress and the two-thirds of the elderly used the emotion-focused coping. Thus, the more perceived stress, the more problem-focoused coping method and the more emotion-focoused coping method. Accordingly, to improve the quality of life of the elderly, there needs and applies a nursing intervention program that relieves the stress and use effective coping method.
Aged* ; Busan ; Humans ; Life Change Events ; Marital Status ; Nursing ; Occupations ; Quality of Life

Aged ; Female ; Humans ; Male ; Middle Aged ; Pharyngeal Diseases ; pathology ; Polyps ; pathology

The cystic lesions within the knee joint are rare, contrary to those located around the knee. They usually are eniscal or ganglion cyst, reported in association with the joint capsule of the knee or the menisci and close to the peroneal tendons. The intraarticular ganglion cyst arising from the cruciate ligaments are rare and cause pain, effusion and limitation of the knee joint. We report (he case of a patient with right knee joint pain caused hy an intraarticular ganglion cyst arising from the posterior cruciate ligament with review of reference.
Ganglion Cysts* ; Humans ; Joint Capsule ; Knee ; Knee Joint ; Ligaments ; Posterior Cruciate Ligament* ; Tendons

This study was undertaken to investigate the effect of anesthesia(balanced anesthesia) and surgery on plasma thyroxine and triiodothyronine levels in ten surgical patients by means of the radioimmunoassay method which provides a quantitative measure of thyroid function. The sex ratio between male and female patients was 1:1, mean age was 30.1+/-12.26 and the average body weight was 57.38+/-15.81kg. The plasma triiodothyronine level before anesthesia and surgery was 138.1+/-32.64(ug/dl) but at 90 minutes and 120 minutes after anesthesia and surgery they were 100+/-19.64(ug/dl) and 92.4+/-7.49(ug/dl) respectively. The plasma thyroxine level remained unchanged during anesthesia and surgery. Consequently there was a statistically significant decreased level in plasma triiodothyronine but there was no change in plasma thyroxine level during anesthesia and surgery.
Anesthesia* ; Balanced Anesthesia* ; Body Weight ; Female ; Humans ; Male ; Plasma* ; Radioimmunoassay ; Sex Ratio ; Thyroid Gland ; Thyroxine* ; Triiodothyronine*

Mucoceles usually occur as solitary, asymptomatic, translucent, and dome-shaped cysts containing clear viscous fluid on lower lip or oral mucosa. The authors reviewed the clinical and histopathological findings in 33 patients with mucocele and attempted to clarify the difference between the histopathologic types (retention and extravasation). The results were summarized as follows. 1. Age distribution was from 2 to 53 years and mean age was 21.4 years. Male to female ratio was 1.2:1(18 males.15 females). 2. Histopathologic type was classified. 4 cases(12.1%, mean age.17.3 years) were retention type, 19 cases(57.6%, mean age.'21.5 years) mixed type, and 10 cases(30.3 %, mean age.20.9 years) extravasation type. Among 19 mixed types, 13 cases were retention dominant and 6 cases extravasation dominant. 3. Durations from the onset to the diagnosis could be clarified in 16 cases. Those were below 1 year in 14 cases(87.5% ) and below 3 years in 16 cases all. Mean duration was 9.4 months. 4. The sites of involvement were lower lip(72.7%), tongue(24.3%), and oral mucosa(3.0%), in decreasing order of frequency. 5. The visited departments were otolaryngology(72.7%), dentistry(12.1%), plastic surgery(9,1%) and dermatology(6.1%), in decreasing order of frequency. 6. In the histopathologic observation, surface epithelium was observed in 25 cases (75.8%), cyst in 23 cases(69.7%), granlation tissue in 29 cases(87.9%), mucin in 28 cases(84.8%), surrounding salivary glands in 20 cases(60.6%) and foamy macrophages in 32 cases(97.0% ), 7. Special stains(PAS, D-PAS, and alcian blue at pH2.5 and 0.4) for the mucin were performed in 10 cases. The results were compatible with sialomucin.
Age Distribution ; Alcian Blue ; Diagnosis ; Epithelium ; Female ; Humans ; Lip ; Macrophages ; Male ; Mouth Mucosa ; Mucins ; Mucocele* ; Salivary Glands ; Sialomucins

Psychopharmacotherapy is one of the effective treatments for the children and adolescents with attention-deficit hyperactivity disorder (ADHD). If there were a marginal improvement or significant adverse effects after having the first line medication such as psychostimulants and atomoxetine, the youth with ADHD can take alternative medications. If they have comorbidities such as disruptive behavior disorder, bipolar disorder, mental retardation and tic disorder, they need to have more medications. Recently, prescriptions of atypical antipsychotics were increasing among them. The efficacy, safety, and tolerability of atypical antipsychotics in the youth should be considered.
Adolescent ; Antipsychotic Agents ; Attention Deficit and Disruptive Behavior Disorders ; Bipolar Disorder ; Child ; Comorbidity ; Humans ; Intellectual Disability ; Prescriptions ; Propylamines ; Tic Disorders ; Atomoxetine Hydrochloride

OBJECTIVETo investigate the expression of zinc finger E-box binding homebox 1 (ZEB1) in the prepuce of hypospadias children and its relationship to the incidence of hypospadias.

METHODSPrepuce tissues were collected from 37 children aged 6-15 months undergoing hypospadias repair and 11 age-matched controls receiving circumcision. Based on the position of the urethral meatus, the hypospadias cases were classified as severe (n = 13) and mild-moderate (n = 24). The mRNA and protein expressions of ZEB1 were determined by immunohistochemistry and RT-PCR.

RESULTSThe expression of the ZEB1 protein was remarkably higher in the severe (100% [13/13]) and mild-moderate hypospadias patients (75.0% [18/24]) than in the controls (9.1% [1/11]), with statistically significant differences between any two groups (P < 0.05). RT-PCR showed the integrated density value (IDV) of the ZEB1 mRNA expression to be (0.67 ± 0.21), (0.81 ± 0.24), and (1.55 ± 0.29) in the control, mild-moderate, and severe hypospadias patients, respectively, significantly higher in the severe hypospadias than in the control and mild-moderate hypospadias groups (P < 0.05), but with no significant difference between the latter two (P = 0.64).

CONCLUSIONThe expression of ZEB1 is significantly increased in hypospadias patients, and its upregulation is positively correlated with the severity of hypospadias, which suggests that the overexpression of ZEB1 may contribute to the development of hypospadias.

Biomarkers ; metabolism ; Case-Control Studies ; Circumcision, Male ; Foreskin ; metabolism ; Homeodomain Proteins ; genetics ; metabolism ; Humans ; Hypospadias ; classification ; etiology ; metabolism ; Immunohistochemistry ; Infant ; Male ; Penis ; RNA, Messenger ; metabolism ; Transcription Factors ; genetics ; metabolism ; Up-Regulation ; Urethra ; Zinc Finger E-box-Binding Homeobox 1

OBJECTIVETo study the relationship of the expression of FOXA1 in the prostate cancer (PCa) tissue with the Gleason score and clinical staging of PCa and with castration-resistant PCa (CRPC).

METHODSUsing the immunohistochemical method, we detected the expressions of FOXA1 and Ki-67 in the pathological sections of 35 cases of PCa and 21 cases of benign prostatic hyperplasia (BPH). Then we analyzed their correlation with the Gleason score and TNM staging of PCa and that with CRPC.

RESULTSThe positive expression of FOXA1 was significantly higher in the PCa than in the BPH tissue (P < 0.001) and was positively correlated with that of Ki-67 (P < 0.001) as well as with the Gleason score (P = 0.027) and clinical staging of PCa (P = 0.002), but showed no correlation with CRPC (P = 0.391).

CONCLUSIONThe positive expression of FOXA1 is increased in PCa, most significantly in the advanced stage of the tumor.

Disease Progression ; Hepatocyte Nuclear Factor 3-alpha ; metabolism ; Humans ; Ki-67 Antigen ; metabolism ; Male ; Neoplasm Grading ; Neoplasm Proteins ; metabolism ; Prostatic Hyperplasia ; metabolism ; pathology ; Prostatic Neoplasms ; metabolism ; pathology

A case of adenocarcinoma of cystic duct associated with GB empyema is presented. A 72 year old male was admitted to Kwangju Christian hospital because of abdominal pain in right upper quadrant for 4 days. He underwent explolaparotomy under the impression of GB empyema or GB cancer. For seeking causative factor of GB empyema, serial sections of cystic duct and mapping were performed. We can find adenocarcinoma of cystic duct in the specimen removed at cholecystectomy. The criteria for disgnosis of cystie duct carcinoma which was outlined by Farrar. These criteria are; 1) The growth must be restricted to the cystic duct, 2) There is no neoplastic process in the gall bladder, hepatic and common bile duct. 3) Histopathological examination must be comfirm carcinoma. Here we report a case of adenocarcinoma of cystic duct associated with GB empyema with brief review of Literature.
Abdominal Pain ; Adenocarcinoma* ; Aged ; Cholecystectomy ; Common Bile Duct ; Cystic Duct* ; Empyema* ; Gwangju ; Humans ; Male ; Urinary Bladder