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

PURPOSE:Cardiovascular morbidity has recently been demonstrated to potentially reduce life expectancy in growth hormone deficiency(GHD). The aim of this study was to evaluate cardiovascular abnormalities and atherosclerotic changes in adults with childhood-onset GHD in whom GH treatment had been stopped at the achievement of final height. METHODS:Nine patients with childhood-onset GHD(7 idiopathic and 2 organic), with an age of 24.0+/-.0 year, were studied. Clinical characteristics of subjects were determined and blood pressure, body mass index(BMI), and serum concentrations of lipids were measured. Structural and functional evaluation of cardiovascular system was performed by M-mode echocardiography and linear phase array imaging transducer. RESULTS:BMI of patients was 27.3+/-.7 mg/m2, and four patients(44%) were overweight(BMI 25-30 mg/m2), but none was obese(BMI >30 mg/m2). The percentage of patients who had total cholesterol > or = 200 mg/dL, triglyceride > or = 150 mg/dL, LDL cholesterol > or = 140 mg/dL, and HDL cholesterol < or = 40 mg/dL were 56%, 44%, 33 %, and 44%, respectively. Interventricular septum thickness(IVST), left ventricular posterior wall thickness(LVPWT), left ventricular end-diastolic internal diameter (LVID), left ventricular mass index(LVMI) of patients were 6.4+/-2.1 mm(SDS -1.5+/-1.1), 6.3+/-1.2 mm(SDS -2.1+/-0.8), 44.9+/-4.3 mm(SDS -1.0+/-0.9), and 85.4+/-94.8 g/m2 (SDS -0.5+/-6.8), respectively. The number of patients whose IVST, LVPWT, LVID, and LVMI were decreased(<-2SD) were 4(44%), 5(56%), 1(11%), and 6(67%), respectively. Carotid artery intima-media thickness(IMT) was 0.86+/-0.22 mm, and it was increased(>2SD) in 3 patients(33%). Three out of four patients with IVST lower than -2SD had increased carotid artery IMT, whereas none of five patients with IVST higher than -2SD had increased carotid artery IMT. There were no differences in echocardiographic findings between groups according to sex, age, duration of disease, duration after GH discontinuation, BMI, and severity of dyslipidemia. CONCLUSION: Decreases in IVST, LVPWT, and LVMI, and an increase in carotid artery IMT were observed in a significant number of patients with childhood-onset GHD. These findings support the need of GH replacement after completion of growth and careful evaluation of cardiovascular changes in patients with childhood-onset GHD.
Adult* ; Blood Pressure ; Cardiovascular Abnormalities* ; Cardiovascular System ; Carotid Arteries ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Dyslipidemias ; Echocardiography ; Growth Hormone* ; Humans ; Life Expectancy ; Transducers ; Triglycerides

PURPOSE:Improved adult final height(FH) is a major goal in the treatment of children with short stature due to growth hormone deficiency(GHD). The purpose of this study was to evaluate final height in idiopathic and organic GHD children after long-term growth hormone(GH) treatment. METHODS:Twenty five(16 males and 9 females) patients with GHD(14 idiopathic and 11 organic GHD) were included. GHD was diagnosed by two or more GH provocation tests(peak GH level <10 ng/mL). All subjects had multiple pituitary hormone deficiencies, and aged 10.7+/-.5(5.5-14) years at the start of GH treatment. The patients were treated with GH 0.45-0.7 IU/kg/week in 3-7 divided doses for 6.9+/-.8(5.2-10) years. Treatment was ended when growth velocity reached lower than 2 cm/year and/or bone age reached 16 years. Standard auxologic measurements were performed at the start of GH treatment and at every 6 month after initial GH treatment. RESULTS:FH was 166.9+/-.8 cm, which was not significantly lower than target height(167.1+/-.9 cm) and predicted adult height(169.1+/-5 cm). FH SDS was significantly improved to -0.8+/-.5 compared with -3.4+/-.0 of height SDS at the start of GH treatment. The largest height increment was observed in the first year of GH treatment, with a gradual decrease in the following years. There was no difference in FH and FH SDS between idiopathic and organic GHD. Unwanted serious adverse events were not observed in all patients during GH therapy. CONCLUSION: Early diagnosis and continuous treatment with optimal doses of GH to near adult height improve the outcome in children with short stature due to idiopathic and organic GHD.
Adult ; Child* ; Early Diagnosis ; Growth Hormone* ; Humans ; Male

BACKGROUND: Hypertrophic scars and keloids have been regarded as representative of the proliferative change of the connective tissue of the dermis. Clinically, postburn and surgical scars show a smooth, shiny, erythematous appearance at an early stage. It is readily conceivable that, in such scars, changes may take place not only in the dermis but also in the epidermis and, possibly in the stratum corneum (SC). However, in contrast to the tremendous number of studies of scars on the dermis, those studies focusing on the epidermis and the SC have been scarce. OBJECTIVE: We have focused on the function of the SC covering the post-burn scar tissue and keloids. METHODS: Using noninvasive bioengineering measurements of functional properties of the SC, such as transepidermal water loss(TEWL), we evaluated the SC barrier function in various types of healing wounds, such as early erythematous lesion, hypertrophic scar, keloid, healed atrophic scar, scar occurring at the recipient site of the skin grafts and the adjacent normal appearing skin for control. RESULTS: 1. The TEWL values were 14.9+/-7.3 in early erythematous lesions, 13.2+/-7.5 in hypertrophic scars, 10.2+/-5.8 in keloids, 5.6+/-1.3 in healed atrophic scars, 6.9+/-4.3 in scars occurring at the recipient site of the skin grafts. Significantly increased TEWL values were found in all individual lesions(p>0.01) except for the scars occurring at the recipient site of the skin grafts(p<0.05) compared with the corresponding normal control skin. 2. When we randomly compared early erythematous lesions, hypertrophic scars, kelids, atrophic
Bioengineering ; Cicatrix ; Cicatrix, Hypertrophic* ; Connective Tissue ; Dermis ; Epidermis ; Keloid* ; Skin* ; Transplants ; Wounds and Injuries

This study was performed to investigate clinical and histopathologic features of steroid acne, which was induced by systemic administration and topical application of corticosteroids. Thirty five cases of steroid acne visited to Department of Dermatology, Hangang Sacred Heart Hospital from September, 1g79 to June, 1984 were analyzed, and the results obtained can be summarized as follows: 1. The peak age of the subjects was third decade(42.9%) with an average age of 30. 1 years, and male to female ratio was l.9: 1,2. The skin lesions had unique clinical features that showed many, uniform sized, erythematous papules and pust;ules. 3 The predilection sites of steroid acne induced by systemic steroid therapy were anterior chest(93.1%), back(44,8%), neck(31.0%), shoulder(31.0%) and face (20.7%) 4 Among thirty five cases of steroid acne, twenty cases were induced by parenteral adrninistration of dexamethasone disodium phosphate(group A), nine cases by oral administration of prednisolone(group B), and six cases by topical application of three kinds of steroid creams(group C). 5. The mean induction time after starting steroid in group A(ll. 3 days) was shorter than those in group B and C(18.9 days and l4.8 days respective)y). The mean total dosage of used steroid in group A was 191. 3mg of dexamethasone disodium phosphate and that in group B was 515. 7mg of prednisolone. On histopathologic findings of twenty two skin biopsy specimens of the three groups, perivascular inflammatory reaction was the most common finding followed by intra-and peri-follicular inflammatory reaction, dermal vascular dilatation, necrosis of follicular epithelium, comedo, intraand periollicular abscess and rupture of follicle.
Abscess ; Acne Vulgaris* ; Administration, Oral ; Adrenal Cortex Hormones ; Biopsy ; Dermatology ; Dexamethasone ; Dilatation ; Epithelium ; Female ; Heart ; Humans ; Male ; Necrosis ; Prednisolone ; Rupture ; Skin

BACKGROUND: Specified clinical observations regarding skin changes in viral hepatitis have not yet been accomplished in Korea, especially in view of serotypes. OBJECTIVE: This study was conducted to identify various cutaneous manifestations of viral hepatitis according to viral serotypes and the stages of the disease. METHODS: We performed a clinical observation of cutaneous manifestations in 450 patients who were diagnosed with viral hepatitis. RESULTS: 1. Cutaneous manifestations were found in 383(85.1%) patients. Patients with a longer duration seemed to have skin lesions more frequently. 2. The frequency of cutaneous manifestations was highest in HAV(94.4%) and HBV(84.9%) serotypes. The most common cutaneous manifestation was pruritus(32.4%) in all studied subjects. In HBV hepatitic patients, the most common cutaneous manifestation was pruritus(35.4%), in HCV hepatitic patients, vasculitic purpura(74.5%), in HAV hepatitic patients, urticaria(88.8%), in the hepatitic patients with the mixed form, spider angioma(30.2%) and vasculitic purpura(30.2%). 3. Urticarial lesions in non-HCV hepatitis were of the lymphocytic vasculitis type but HCV hepatitis was associated with neutrophilic vasculitis. The purpuric lesions with HCV hepatitis were of the neutrophilic vasculitis type while lymphocytic vasculitis was present in non-HCV hepatitis. 4. The most severe pruritus was present in HBV hepatitic patients. CONCLUSION: The cutaneous manifestations in viral hepatitis have different clinical features depending on the viral types.
Hepatitis* ; Humans ; Korea ; Neutrophils ; Pruritus ; Skin ; Spiders ; Vasculitis

No abstract available.
Carcinoma* ; Nevus*

A 45-Year-old para 1-0-1-1 had submucosal myoma diagnosed by ultrasonogram and hysteroscopic examination. During 60 minutes hysteroscopic myomectomy, 8,000 ml of sorbitol-mannitol distention medium was used and 6,500 ml collected, resulting in a deficit of 1,500 ml. The patient received Ringer`s lactate 1,000 ml intravenously. Her urine output was 400 ml. Blood loss was 40 ml. After operation, hyponatremia(115 mEq/L) was developed and pulmonary edema was also diagnosed clinically at that time and later confirmed by chest radiograph. The judicious administration of diuretics and normal saline fluid replacement to prevent overcorrection to hypernatremia resulted in return of serum electrolytes to normal level and resolution of the pulmonary edema by postoperative day 1. We have experienced a case of pulmonary edema during hysteroscopic myomectomy with sorbitol-mannitol distention medium, which is presented with a brief review of literatures.
Diuretics ; Electrolytes ; Humans ; Hypernatremia ; Hyponatremia ; Lactic Acid ; Middle Aged ; Myoma ; Pulmonary Edema* ; Radiography, Thoracic ; Ultrasonography

This article has been retracted at the authors' request.

CD44, also known as the Hermes antigen, H-CAM, pgp-1 antigen, and extracellular matrix receptor ECM-III, is a widely distributed integral membrane protein that exists in a variety of forms with different molecular sizes ranging from 85kd to 160kd. A number of evidence implicates CD44 as a cell adhesion molecule with a possible role in tumor progression. To evaluate the possible roles of CD44 in the metastatic process of gastric carcinoma to the regional lymph nodes, we applicated immunohistochemical stains with the CD44H and CD44v6 primary antibodies onto the 2 groups of gastric adenocarcinomas. Each group was comprised of 22 primary tumors extending to the subserosa, and one group showed nodal metastasis, while the other group did not. Seventeen primary tumors (77%) out of the 22 cases with the nodal metastasis demonstrated positivity to the CD44v6, while only 9 primary tumors (41%) out of the 22 cases without nodal metastasis did. However CD44H immunoreactivity was demonstrated in tumor cells of all cases (100%) of both groups as well as in the normal cell components. These results suggest that CD44H form is not related to the metastasis to the regional lymph nodes of gastric carcinoma. However, the expression of CD44v6 seems to play a certain role in the metastatic process of the gastric carcinoma.
Adenocarcinoma* ; Antibodies ; Cell Adhesion ; Cellular Structures ; Coloring Agents ; Extracellular Matrix ; Lymph Nodes ; Membrane Proteins ; Neoplasm Metastasis