The purpose of this phenomenological study was to understand and describe the essence and the structure of lived experience of liver transplant recipient. Five individual interviews were conducted to gather data regarding their subjective experiences. About 130 significant statements were extracted and these were clusterd into 9 themes. End stage liver disease patients chose their last treatment - liver transplantation. After liver transplantation. recipients experience vague anxiety and uneaseness related to much information and life style change that they had to accept. And they feared to lose their health again. But they felt free from medication and restriction of food. And they satisfied with regaining their physical status. Most of the recipients also had financial difficulties and social restrictions. And they experience uncertainty about their future. But they restored their previous social life. And they experience psychological wellbeing and hope. The results of this study might help nurses who work with liver transplant recipient in establishing and implementing an effective nursing intervention by understanding their lived experience.
Anxiety ; End Stage Liver Disease ; Hope ; Humans ; Life Style ; Liver Transplantation ; Liver* ; Nursing ; Transplantation* ; Uncertainty

The purpose of this study was to identify the degree of learned helplessness and self-care agency in dialysis patients and the relationship between learned helplessness and self-care agency. The subjects were 168 dialysis patients who were undergoing hemodialysis and peritoneal dialysis from 1 university hospital, 1 hospital, 1 hemodialysis center in Seoul, 1 hospital in Incheon, Korea. The data were collected with two interview questionnaires which were Learned Helplessness Scale (LHS) and Self-as-Carer Inventory (SCI). The collected data were analyzed by descriptive statistics and t-test, One-way ANOVA and Pearson Correlation with SPSSWIN program. Results were obtained as follows : 1) The mean scores of learned helplessness were 45.93(range 20-80). The mean learned helplessness scores of peritoneal dialysis patient and hemodialysis (HD) patient were not different significantly. However by the aging process, the mean scores of learned helplessness has a tendency to get higher and who had a job were likely to low score of learned helplessness. 2) The mean scores of self-care agency were 142.48 (range 33-198). The mean self-care agency scores of peritoneal dialysis (PD) patient much higher than the score of it with hemodialysis. The score of self-care agency were significantly different between peritoneal dialysis patient and hemodialysis patient. The patients who have job were likely to be higher score of self-care agency than other groups. 3) There was significant relationship between the score of learned helplessness and self-care agency. In conclusion, there was an inverse relationship between learned helplessness and self-care agency in dialysis patients. Considering this, the high level of learned helplessness of dialysis patients should be intervened by nurse with a well developed edicational program or cognitive behavioral therapy.
Aging ; Cognitive Therapy ; Dialysis* ; Helplessness, Learned* ; Humans ; Incheon ; Korea ; Peritoneal Dialysis ; Surveys and Questionnaires ; Renal Dialysis ; Self Care* ; Seoul

Forearm bone fractures are difficult to manage, because of their special functions (pronation and supination) and peculiar anatomy. Authors have experienced 68 cases of various types of forearm bone fractures from January, 1968 to December, 1971. They were analized as following. 1. Out of 68 patients, males were 54 cases (79.4%) and females were 14 cases (30.6%). Among them, 91.2% of the cases were occured in people over 15 years old. About 47% of the cases were caused by automobile accidents. 2. Both forearm bone fractures were 51 cases (75%), and most common site of the fractures were mid 1/3(66.2%). Stable (transverse or incomplete) fractures were 24%, and unstable(comminuted, segmental, oblique or spiral) fractures were 76%. Open fractures were 26.5% 3. Conservative treatment was given to 41 cases (60.3%), and open reduction & internal fixation was given to 27 cases (39%). 4. A comparison has been made between the groups treated by conservative method and open reduction & internal fixation. 1) Average healing time of open reduction group was 19.5 weeks and conservative group was 16.4 weeks. 2) Non-union was occured in 7.4% of conservative treatment group, and 22.7% of open reduction group. 3) Satisfactory functional results were shown in 23.5% of conservative group and 54.5% of open reduction & internal fixation group. 4) Rotational deformities were noticed in 53.3% of the conservative treatment group and 54.5% of the open reduction group (No difference was noticed). 5) Angulatory deformities were shown in 70.4% of the conservative treatment group and 44.4% of the open reduction group. 5. Three cases were complicated by cross unoin, and no postoperative wound infection was noted. But two cases of open fracture developed to chronic osteomyelitis.
Automobiles ; Congenital Abnormalities ; Female ; Forearm ; Fractures, Bone ; Fractures, Open ; Humans ; Male ; Methods ; Osteomyelitis ; Surgical Wound Infection

No abstract available.
Lymphangioleiomyomatosis*

Ischemic stroke is a serious neurological complication of infective endocarditis. Intravenous tissue plasminogen activator (t-PA), which has only been approved for treatment of hyperacute stroke, has been excluded as an ischemic stroke treatment due to infective endocarditis according to current expert consensus guidelines. Here, we describe a case of a hyperacute stroke patient treated with intravenous t-PA, who was later diagnosed with infective endocarditis.

Fracture of the metal base of tihial components of total knee arthroplasty has heen occasionally reportecl. The most common cause of the failure of the metal hase plate was known to be a fatigue fracture around the screw hole where the strength of the metal hase plate was the weakest. We experienced a case of the fracture of the metal hase plate secondary to the t'racture of the posteromedial corner of the metal tihial condyle which was weakened due to the shoil peg hole for the base plate of MG II implant. Since the proximal portion of the posterior tihial condyle was normally thin, cutting the hone for the base plate made it thinner and wcaker than normal. Therefore stress fracture of the bone occurred and the overlying metal plate was subsequently hroken. From this experience. we concluded that the posterior peg hole may cause unwanted failure of the posteromedial corner of the tibial base plate.
Arthroplasty* ; Fractures, Stress ; Knee*

The purpose of this study was to investigate the effects of combined exercise on visceral fat, cardiac function, adipocytokine, and NT-pro BNP concentration according to angiotensin-converting enzyme(ACE) genotype in obese middle aged men. Fifty three obese men (II type: 18, ID type: 20, DD type: 15), ratio of visceral and subcutaneous were over 0.4, were enrolled in the study. The combined exercise program included stretching, resistance training, aerobic exercise, and yoga. The exercise was conducted for 60 minutes, 4 times a week for 12 week period. ACE genotype was determined using a polymerase chain reaction (PCR), and the genetic subtype was classified in three patterns e.g. II, ID, DD. As a results, body weight, BMI, and WHR significantly decreased after 12 weeks of combined exercise in ID type and DD type. Body fat(%), visceral fat and V/S significantly decreased after 12 weeks in DD type. HDL-C and LDL-C significantly improved in II, ID and DD type. Cardiac structure decreased in all genotype and cardiac function increased in DD type. IL-6 and NT-pro BNP, the risk factors of cardiovascular disease, were significantly decreased in DD type, after 12 weeks. Therefore, exercises have shown to be most effective in type DD which is also considered as the risk of cardiovascular diseases. Among all the ACE genotype, DD type requires the most exercise.

No abstract available.
Child* ; Femoral Fractures* ; Humans

Since last August, 29 cases of synovial punch biopsy have been carried out with Franklin-Silverman needle which was used in liver biopsy, instead of the specialized needle for the synovium. Authors report the applicable utility of Franklin-Silverman needle for the synovial biopsy, diagnostic value of this procedure and histopathologic findings of the results. The rate of the technical success to abtain synovial tissue was about 76%. Complications after procedure have been very rarely encountered, consisting of mild transient hemarthrosis. In 17 cases, the histopathologic changes was compatible with their clinical findings. In the remainders, we experienced the failures to get synovial tiasue at all in 7 cases and to give the significant synovial changes in 5 successful specimens. Fortunately, the important diagnostic aid was achieved in 3 cases which were conformed early diagnosis of tuberculous arthritis. This needle biopsy was also thought to contribute to rule out the gouty arthritis from other hyperuricemic conditions. But the histologic changes were non specific inflammatory findings in the synovial mambrane of rheumatoid arthritis, osteoarthritis, traumatic and infectious arthritis.
Arthritis ; Arthritis, Gouty ; Arthritis, Infectious ; Arthritis, Rheumatoid ; Biopsy ; Biopsy, Needle ; Early Diagnosis ; Hemarthrosis ; Liver ; Needles ; Osteoarthritis ; Synovial Membrane

Biopsy has proved to be of value in the diagnosis of many inflammatory and malignant diseases, and needle biopsy of the synovial membrane in arthritis is well established and often employed as the final diagnostic aid in patient with joint disease. Authors have carried out synovial needle biopsy in 76 joints with Franklin-Silverman needle used commonly in liver biopsy. The results obtained were as followa; 1) Of seventy five biopsies attempted, adequate amount of tiasue was obtained in 51 of 53 knee cases (96.2%), 11 of 14 wrists (78.6%). 3 of 5 elbows (60%), 1 of 3 ankles (33.3%). Adequate amount of tissue was obtained in 66 cases and the overall succese rate was 88%. 2) Histopathological diagnosis was made in 53 of 75 cases (70.7%). In 12 cases, correct specimens were obtained but proved to be incompatible with the diagnosis done by either clinical data or open biopsy. 3) Histopathological diagnoses were made in 25 of 35 cases of rheumatoid arthritis (71.4%) 14 of 18 cases of tuberculous arthritis (77.8%), 7 of 13 cases of degenerative arthritis (53,8%), 4 of 6 cases of suppurative arthritis (66.7%), 2 cases of traumatic arthritis (100%), and one case of villonodular synovitis (100%). 4) The complications resulting from this proedure were pare; mild transient hemarthrosis was found in only 5 cases We also discovered that for an accurate diagnosis multiple specimens should be obtained because otherwise the specimens were too small to interprete histopathologically. In addition we concluded that the success rate depended not upon the sorts of needle used but rather more upon the biopsy technique. Franklin-Silverman needle biopsy proved to be a simple, safe and reliable procedure for diagnosis of the synovial diseases in which conventional arthrotomy is inadvisable and other diagnostic procedures are inadequate.
Ankle ; Arthritis ; Arthritis, Infectious ; Arthritis, Rheumatoid ; Biopsy ; Biopsy, Needle ; Diagnosis ; Elbow ; Hemarthrosis ; Humans ; Joint Diseases ; Joints ; Knee ; Liver ; Needles ; Osteoarthritis ; Synovial Membrane ; Synovitis ; Wrist