Ostomates have suffered from many difficulties due to their physical, psychosocial handicaps and changes of life style to include ostoma management that influences their daily and quality of life. An appropriate nursing education for ostoma management is very important. Practical education materials needs revision because those were developed by pharmaceutical companies and hospital institutions. The purpose of this study is to provide more practical and resonable education materials for ostomates by doing analysis and survey of educational materials now being used. We surveyed 8 types of educational materials used in 23 university hospitals and medical centers used in 23 university hospitals and medical centers in Seoul ; four of them were developed by department of nursing and the remainder by an Ostomy Company. Data, collected from July 14, 1997 through July 31, 1997 were analyzed. The results are as follows ; 1. The analyzed of education guide, on ostomate included 14 subcategories ; introduction, structure and fuction of gastrointestinal tracts, definition of stoma, types of ostomy, definition of peristalsis, methods of defection management, selection of instrument, resolution of problems and general situations following surgery, daily life, where to ask for help, explanations for terms, information about where to buy instrument, explanations for enterostomal therapist, a matter of consultation with doctor, etc. 2. Introduction contained specific contents on practical ostomate management that ostomates would experience through their lives. Ostomate education guides were developed 3 hospitals except one which missed this point. 3. Most ostomate education guides, except one hospital, helped ostmates to understand their physical structure change with specific explanation on gastrointestinal tracts with figures. 4. Six institution did not talk about the definition of peristalsis. 5. All institutions, except two, helped ostomates to understand types of ostomy with figures. 6. More detailed explanations in natural defecation are needed. The benefits and pitfalls in natural defection should be more specified. 7. No psychosocial difficulties of ostomy management were addressed. 8. The efficiency off enema can be better understand through all explanations with figures. Some institutions did not mention items about definition, benefits, pitfalls of enema, sequency of enema, how to wash, cautions performing and enema, skin management, cleaning instrument after enema proper time to spend. 9. There were no detailed contents and what to do in case of not being able to do enema. 10. Only one educational material mentioned emotional aspects after the surgery. 11. Most institution explained sucategory of daily life but did not provide specific contents on the difficulties of physical, psychological, and sociocultural controls. 12. The subcategory of ureterostomy education guides included explanations in normal structure and function of urinary tracts, types of ureterostomy, how to management skin, usage and types instrument, commercial urostomy, how to manage instrument, daily life, introduction the general contents. However, more specific explanations were needed.
Defecation ; Education ; Education, Nursing ; Enema ; Gastrointestinal Tract ; Hospitals, University ; Life Style ; Nursing ; Ostomy ; Peristalsis ; Quality of Life ; Seoul ; Skin ; Ureterostomy ; Urinary Tract

No abstract available.
Adipose Tissue* ; Bone Density* ; Female ; Humans ; Middle Aged*

The syndrome of postural headache associated with low CSF pressure usually occurs after a dural puncture, myelography, or spinal anesthesia. However, it can also develop spontaneously or after minor trauma. Although the clinical and MRI findings of this syndrome are well described, radionuclide cisterno-graphic findings have not yet been clearly characterized. We report four patients presenting with postural headache associated with very low or unmeasurable CSF pressure. Three patients developed after minor trauma, while one developed spontaneously. Brain MRI revealed symmetric pachymeningeal enhancement in all four patients. Radionuclide cisternography demonstrated delayed migration of tracer to the cerebral convexity at 6 and 24 hours in three patients, and early soft tissue uptake suggestive of CSF leakage in one. We suggest that these radionuclide cisternographic findings are supportive evidences for the presence of intracranial hypotension and may provide useful information for appropriate treatment.
Anesthesia, Spinal ; Brain ; Headache ; Humans ; Intracranial Hypotension* ; Magnetic Resonance Imaging ; Myelography ; Punctures

Omphalocele is a rare congenital malformation which is a herniation of the abdominal viscera into the base of the umbilical cord. We experienced a ruptured large omphalocele of short duration which contained of intestines, stomach, liver and speen without major of additional anomalies. He was repaired with the simple skin converage as a part of second staged operation. He had an eventful postoperative course but wad discharged on the 52th postoperative days with the good condition and with the plan of repair of ventral hernia about 1 year. Here, the literature on omphalocele was reviewed with the experienced case briefly.
Hernia, Umbilical* ; Hernia, Ventral ; Intestines ; Liver ; Skin ; Stomach ; Umbilical Cord ; Viscera

Authors had experienced 5 cases of Reye's syndrome in a 15mo. old female patient, 16mo. old male patient, two cases of 4 years old male patients, and 9mo. old male infant who were compatible with this syndrome since Mar. 1976. 2 cases of this patients have been recovered and observed at O.P.D. of ped. Department. Laboratory findings disclosed increased SGOT, SGPT, LDH, blood ammonia levels atthe all cases and decreased FBS and CSF sugar levels. Liver biopsy showed diffuse fatty metamorphosis of hepatic cells. A brief review of the related literaturre was also presented.
Alanine Transaminase ; Ammonia ; Aspartate Aminotransferases ; Biopsy ; Child, Preschool ; Female ; Hepatocytes ; Humans ; Infant ; Liver ; Male ; Reye Syndrome*

PURPOSE: To evaluate the morphologic differential diagnosis of benign and malignant ductal breast tumors, as seen on US. MATERIALS AND METHODS: US findings in 29 pathologically proven cases of ductal breast tumor were retrospectively reviewed. All patients were female and their mean age was 42 years. Nineteen tumors were benign and ten were malignant, and all ductal or cystic lesions showed solid masses. According to the location of the mural nodule, we classified the sonographic appearance of these tumors into three types : intraductal, intracystic and amorphic. The intraductal type was divided into three subtypes: incompletely obstructive, completely obstructive and multiple mural nodules. For the intracystic type, too, three subtypes were designated : the intracystic mural nodule (mural cyst), intracystic mural nodule with the duct (mural cyst+duct) and intracystic multiple mural nodules. The amorphic type is defined as an atypical ductal tumor with the mural nodule extending into adjacent parenchyma. RESULTS: The margin of the duct or cyst was smooth in 68.4% of benign, and irregular in 90% of malignant ductal tumors. Internal echogeneity of the duct or cyst usually showed homogeneity in both benign and malignant tumors. 73.7% of tumors connecting the duct were benign and 50% were malignant. In benign tumors, 52.6% of mural nodule had an irregular margin, while in malignant tumors, the corresponding proportion was 100% ; both types usually showed heterogeneous hypoechogeneity. Among benign tumors, the most common morphologic type was the intraductal incompletely obstructive subtype (36.8%) ; among those that were malignant, the amorphic type was most common, accounting for 40% of tumors. No amorphic type was benign and no incompletely obstructive subtype was malignant. CONCLUSION: When ductal breast tumors are morphologically classified on the basis of sonographic findings, the intraductal incompletely obstructive subtype suggests benignancy, and the amorphic type, malignancy. The morphologic classification of ductal breast tumors based on sonography is therefore useful for the differential diagnosis of benignancy and malignancy.
Breast Neoplasms* ; Breast* ; Classification* ; Diagnosis, Differential* ; Female ; Humans ; Retrospective Studies ; Ultrasonography*

PURPOSE: The purpose of this study is to assess the efficacy of enteroclysis through the previously inserted Miller-Abbott (M-A) tube for decompression in the postoperative intestinal obstruction. MATERIALS & METHODS: This study includes twenty patients who had intestinal obstruction symptoms after operation for benign(12) ormalignant(8) abdominal lesions. Small amount of barium was introduced to M-A tube for enteroclysis. We evaluated the presence, level, degree, and causes of obstruction on enteroclysis, compared with surgical(11) and clinical(9)findings. RESULTS: Obstruction was seen in 18 cases including the two cases in which the level of obstruction wasnot clear. There was no obstruction in two cases. Obstruction on enteroclysis was demonstrated in all 11 operated cases(100% accuracy, 11/11). The level of obstruction on enteroclysis were jejunum in three cases, ileum in seven,and colon in one case. The levels of obstruction on enteroclysis were matched with those in operation field in 10 cases. There were two cases of nonobstruction, nine cases of low-grade partial obstruction, and nine cases of high-grade partial obstruction. We analyzed the findings on enteroclysis regarding causes of obstruction in 16 patients with the findings of adhesive bands of extrinsic cause(9), cancer recurrence of intrinsic cause(6), and bezoar of intraluminal cause(1). Misinterpreted cases were two cases(87.7% accuracy, 14/16). The cause, for nonvisualization of obstruction site on enteroclysis in four patients included technical failure such asin adequate location of tube(1) and bowel overlapping(1), minimal obstruction(1), and nonexistent obstruction(1), in spite of diffuse edematous mucosa. CONCLUSION: Enteroclysis through the M-A tube for decompression in patients with postoperative intestinal obstruction is an useful method for evaluation of intestinal obstruction.
Adhesives ; Barium ; Colon ; Decompression* ; Humans ; Ileum ; Intestinal Obstruction ; Jejunum ; Mucous Membrane ; Recurrence

The 46, XX male syndrome is rare disease that is characterized by a phenotypic male who has a 46, XX female karyotype. Since the first report by de la Chapelle and associates in 1964, several cases have been reported, but it is still a rare entity. Recently we examined a 20-year-old XX male who had the symptoms of gynecomastia, an infantile appearance of the external genitalia, scanty pubic hair, no Adams apple, and no axillary hair. We presently describe a patient with the 46, XX male syndrome who showed a 46, XX karyotype on chromosomal study and review the literatures.
46, XX Testicular Disorders of Sex Development* ; Female ; Genitalia ; Gynecomastia ; Hair ; Humans ; Karyotype ; Male ; Rare Diseases ; Young Adult

OBJECTIVES: This study aimed to examine the effect of biofeedback treatment on the clinical symptoms and stress responses in chronic headache patients. METHODS : We recruited 18 chronic headache patients who were treated with 8 sessions of biofeedback treatment and 18 age and sex-matched control headache patients. All subjects consisted of patients with chronic tension headache and migraine headache. Stress responses were measured using Symptoms of stress (SOS) inventory and all subjects performed Beck depression inventory (BDI), Spielberger state anxiety inventory (STAIS), and visual analogue scale (VAS). Biofeedback physiological variables including frontal and forearm EMG, electrodermal response (EDR) and skin temperature at pre-and post-treatment were also measured in all subjects. RESULTS : Compared with control patients, patients on biofeedback treatment showed significant reduction in scores of STAIS (t=3.705, p<.001), and VAS (t=3.392, p=.001) as well as SOS subscales;peripheral manifestations (t=1.788, p=.042), habitual patterns (t=2.008, p=.027), depression (t=2.081, p=.023), anxiety (t=1.990, p=.028), and total score (t=2.045, p=.025). There was a significant increase of skin temperature (t=-1.835, p=.038) only in the biofeedback treatment group. CONCLUSION : These results suggest that biofeedback treatment may be effective in relieving chronic headache by reducing psychological and physiological stress responses.
Anxiety ; Biofeedback, Psychology ; Depression ; Forearm ; Galvanic Skin Response ; Headache ; Headache Disorders* ; Humans ; Migraine Disorders ; Relaxation* ; Skin Temperature ; Stress, Physiological ; Tension-Type Headache

No abstract available.
Gwangju* ; Humans ; Pediatric Obesity*