PURPOSE: Experience of chest pain may be different in women from that of men and this discrepancy may cause misdiagnosis of angina contribute to mortality by this disease in women. The purpose of this study was to analyze the characteristics of chest pain and responses to the symptoms in women. METHOD: A content analysis was conducted with interviewed data obtained from women who underwent the treadmill test RESULT: Seven major categories were identified from this content analysis: attributes of chest pain; accompanied symptoms; precipitating factors; relief strategies; family support; communication with physicians; and effects of chest pain on their lives. Characteristics of pain were described as heaviness, tightness, heating sensation, tearing, and others. Duration and intensity of pain varied in a wide range. Radiating pain presented in 9 patients, and the locations of radiation were throat, neck, shoulder arm and fingers. Women tended not to respond actively to their chest pain, and didn't get appropriate support either from their family or from their physicians when they reported chest pain. CONCLUSION: Women express non-typical as well as typical patterns of pain when they experience chest pain. Clinicians have to consider the variability of symptoms when they assess women with suspicions of angina.
Angina Pectoris* ; Arm ; Chest Pain* ; Diagnostic Errors ; Exercise Test* ; Female ; Fingers ; Heating ; Hot Temperature ; Humans ; Male ; Mortality ; Neck ; Pharynx ; Precipitating Factors ; Sensation ; Shoulder ; Thorax*

A phenomenological study was conducted to investigate the experiences of mothers pregnant via in vitro fertilization (IVF). Sample of nine mothers participated. Ten theme clusters emerged when the formulated meanings were organized into categories. During the infertility period, the participants were subject to self- depreciation, envy, anxiety, and depression. It changed their priorities in life from a job-oriented life to one where having a baby was the most important thing. After trying numerous alternative therapies, IVF became their last hope in having a baby. Since the success rate for IVF is low (only 20-30%), the participants for the treatment were overwhelmed with uncertainty, and it led to further anxiety, depression and despair. Success of pregnancy gave them extreme satisfaction, but they became very cautious in their day-to-day life because of their fear of abortion and early delivery. Some were even worried about the side effect of IVF during the pregnancy. Finally, the delivery of the baby gave them relief from the obligation of having a baby. Women did not have any difficulties in rearing a "test tube baby" except in the case of twins. Most women had no ethical difficulty in having a baby by IVF. However they did not wish this information to be revealed to other people. They again turned to IVF to have a son(s) when the resultory child(s) was a daughter(s). This is because of the strong preference for sons in Korean society.
Anxiety ; Complementary Therapies ; Depreciation ; Depression ; Female ; Fertilization in Vitro* ; Hope ; Humans ; Infertility ; Mothers* ; Pregnancy ; Twins ; Uncertainty

PURPOSE: The purpose of this study was to investigate the effects of biofeedback exercise training on muscle activity and activities of daily livings (ADL) in hemiplegic patients. An experimental group consisting of 17 people, was given biofeedback exercise training for 30- 60 minutes per week for 5 weeks, while a control group consisting of 18 people, was given normal exercise with quasi-experimental design. RESULT: The results of the study show that biofeedback exercise is effective for improving muscle activity in hemiplegic patients, especially in the hemiplegic limbs. However, this study found no significant differences in ADL and IADL between the experimental and the control groups. It implies that ADL and IADL may not be improved for a short period of time, such as 5 weeks, for people with more than five years of hemiplegia. The study suggests that the effect of biofeedback exercise on ADL and IADL should be determined in hemiplegic patients in acute stage.
Activities of Daily Living ; Biofeedback, Psychology* ; Extremities ; Hemiplegia ; Humans ; Muscle Strength ; Range of Motion, Articular ; Stroke*

PURPOSE: This study was to determine the effects of abdominal breathing training using biofeedback on stress, immune response, and quality of life. METHOD: The study design was a nonequivalent control group pretest- posttest, quasi-experimental design. Twenty-five breast cancer patients who had completed adjuvant chemotherapy were enrolled. The experimental group(n=12) was provided with abdominal breathing training using biofeedback once a week for 4 weeks. State anxiety, cancer physical symptoms, serum cortisol, T cell subsets(T3, T4, T8), NK cell and quality of life were measured both before and after the intervention. RESULT: Though state anxiety, cancer physical symptoms, and serum cortisol were reduced after 4 weeks of abdominal breathing training using biofeedback, there was no statistical significance. It showed, however, improvement in quality of life (p=.02), and T3(p=.04). CONCLUSION: Abdominal breathing training using biofeedback improves quality of life in breast cancer patients after a mastectomy. However, the mechanism of this beneficial effect and stress response requires further investigation with special consideration in subject selection and frequency of measurement. Nurses should consider this strategy as a standard nursing intervention for people living with cancer.
*T-Lymphocyte Subsets ; Stress, Psychological/psychology/therapy ; *Quality of Life ; Middle Aged ; Mastectomy/*psychology/rehabilitation ; Hydrocortisone/blood ; Humans ; Female ; *Breathing Exercises ; Breast Neoplasms/immunology/*psychology/surgery ; *Biofeedback (Psychology) ; Adult

PURPOSE: A medullary carcinoma of the breast (MC) is a rare disease that hae a better prognosis than an infiltrating ductal carcinoma of no special type. An MC creates diagnostic difficulties, and there are numerous controversies associated with the histopathological definition of this special type of breast cancer. Among many criteria, Ridolfi's criteria seems to be the strictest and to give a more reliable prognosis. METHODS: We analyzed 2,953 primary breast carcinomas treated between Jan. 1981 and Jan. 2000. Thirty-seven patients previously defined as having an MC were reclassified by one pathologist using Ridolfi's criteria. The mean follow-up period was 62.7 months (range: 4 to 162 months), and hospital records were reviewed retrospectively for clinical information. RESULTS: Of the 37 treated patients, 24 (64.9%) were reclassified as having a typical medullary carcinoma (TMC), 6 (16.2%) as having an typical medullary carcinoma, and 7 (18.9%) as having a non-medullary carcinoma (NMC). The diagnostic conversion rate was, 37.8% and 10 of 30 patients (33.3%) previously diagnosed with TMC were reclassified into other forms. TMC had the least chance and NMC had the highest chance for lymph-node metastasis, and this difference was marginally significant (p=0.069). TMC showed a better 10-year overall survival rate (p=0.01) and 10-year disease-free survival rate (p=0.09) than NMC. CONCLUSION: TMC has the least chance of lymph-node metastasis, and the best prognosis in MC. Because of the relatively high diagnostic conversion rate, physician should be careful about omitting adjuvant therapy for TMC.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal ; Carcinoma, Medullary* ; Disease-Free Survival ; Follow-Up Studies ; Hospital Records ; Humans ; Neoplasm Metastasis ; Prognosis ; Rare Diseases ; Retrospective Studies ; Survival Rate

The persistence of muscle fiber number regardless of size reduction in muscle atrophy has not yet been fully explained. For the mechanism inherent in skeletal muscle tissues for preventing cellular death, the protective function of muscle tissue through transglutaminases has been tested, since the enzyme is responsible for structural stabilization and participates in signal transduction. In the present experiment, hindlimb suspension for two weeks caused a marked muscle atrophy in Wistar female rats. Comparison of muscle weight and histological analysis showed that suspension-induced atrophy in the hindlimb was more prominent in the soleus muscle, comprised mainly of type I fiber than that in the plantaris muscle of type II fibers. The immunohistochemical analysis with antitransglutaminase C antibody (anti TGase C Ab) showed that some atrophic bundles of soleus muscle were positively reacted with the antibody. The anti-TGase C Ab-reactive substances were observed to disappear significantly after endurance exercise, indicating their characteristic atrophy-dependency. The enzymatic analysis of transglutaminase showed the increase in activity in the atrophic soleus muscle tissue, compared with that in the normal or exercise-trained muscle tissues. From these results, the expression of TGase in the atrophic muscle is suggested to be the possible marker for muscle atrophy and its expression is probably related with the protective mechanism of the muscle tissue to prevent further cellular damage in the atrophic process.
Animal ; Atrophy ; Comparative Study ; Enzyme Induction ; Female ; Hindlimb ; Immobilization ; Muscle Fibers/pathology ; Muscle Proteins/*biosynthesis ; Muscles/*enzymology/pathology ; Physical Conditioning, Animal ; *Physical Endurance ; Rats ; Rats, Wistar ; Support, Non-U.S. Gov't ; Swimming ; Transglutaminases/*biosynthesis

PURPOSE: Medullary carcinoma of breast was known to have a better prognosis than other breast cancer, but the histopathological definition of medullary carcinoma has varied with time. This study was performed to clarify the clinicopathologic features of medullary breast cancer. MATERIALS AND METHODS: Twenty cases of breast cancer originally were diagnosed as medullary carcinoma at the Department of Surgery, Seoul National University Hospital from Jan. 1985 to Jun. 1995. The whole cases were reviewed and reclassified using the strictly defined histologic criteria applied by Ridolfi et al. RESULTS: When reclassified, 16 tumors fulfilled the criteria of typical medullary cancer. But the rest 4 tumors were found to be nonmedullary cancer. The patients ranged from 29 to 69 years in age with an average of 49. The main symptom was the painless mass. The diameter of the tumor ranged from 1 to 8 cm with a mean size of 2.7 cm. The axillary lymph node was positive in three cases. The estrogen receptor was positive in 10%, and the progesterone receptor was positive in 20% of the cases. There were no local recurrences or distant metastasis during a mean follow-up period of 5.5 years.. All patients survived until the last follow-up. CONCLUSION: Medullary breast cancer has good prognosis but strict, uniform histopathological diagnostic criteria are needed.
Breast Neoplasms* ; Breast* ; Carcinoma, Medullary ; Estrogens ; Follow-Up Studies ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Receptors, Progesterone ; Recurrence ; Seoul

PURPOSE: Irritable bowel syndrome (IBS) is frequently yet little understood disease. Review was performed to promote understanding on the characteristics, pathophysiology, and risk factors of IBS. CONTENT: IBS is characterized by abdom in women and people with higher educational and social background, but there are some controversies. IBS is diagnosed by the Rome II or Manning criteria after excluding organic gastrointestinal diseases. The pathophysioloy is explained by abnormal control mechanism of central and enteric nervous system. Mucosal immunity, secretions, and neurotransmitter are also associated with the hypersensitivity and motility change of bowel function. Stress is known as a major triggering factor and contributed to symptoms. Other risk factors are genetic elements, childhood experiences, inflammation, anxiety, depression, diet, and sleep disorders.
Anxiety ; Depression ; Diet ; Enteric Nervous System ; Female ; Gastrointestinal Diseases ; Humans ; Hypersensitivity ; Immunity, Mucosal ; Inflammation ; Irritable Bowel Syndrome* ; Neurotransmitter Agents ; Risk Factors* ; Sleep Wake Disorders

ression and quality of life of family caregivers of patients with Parkinson's disease(PD). METHODS: A cross-sectional descriptive study was conducted in one neurology outpatient clinic in Seoul, Korea from March to June, 2006. Sixty eight family caregivers of PD patients were participated to the study, using CES-D and SF-36. RESULTS: Mean scores of depression were 16.18+/-8.39 (range: 0-48) and it was a little lower than caregiver's who took care of Dementia patients and were higher than primary caregivers of the patients with Stroke. Time for caregiving, perceived severity, duration of PD were significantly related with depression respectively. Higher ADL scores which mean greater motor disabilities were related to higher caregiver depression. Lower income and greater medical expenditure were closely related with the depression of family caregivers respectively. The mean scores of total QOL were 435.5+/-96.5 and the mean scores of PF, SF, RE and MH were lower than general population. Time for caregiving, depression, patients' ADL scores were significantly associated with QOL respectively. People who were older and had lower educational background showed lower QOL scores respectively. CONCLUSION: Healthcare professionals should pay more attention to emotional aspects of caregivers who take care of PD patients, and develop comprehensive management strategies both for patients and their caregivers.
Activities of Daily Living ; Ambulatory Care Facilities ; Caregivers* ; Delivery of Health Care ; Dementia ; Depression* ; Health Expenditures ; Humans ; Korea* ; Neurology ; Parkinson Disease* ; Quality of Life* ; Seoul ; Stroke

The purpose of this research was to uncover the expertise of ICU nursing in Korea, and to describe nurses' practice based on the degree of skill acquisition. A total of 18 ICU nurses participated in the study. The data was collected through individual in-depth interviews and it was managed using the NUDIST 4.0 software program. The data was analyzed using interpretive phenomenology suggested by Benner. Four properties of expertise of ICU nursing were identified. These are 1) concern and love toward patients; 2) knowledge; 3) skill, and 4) abilities in interpersonal relationships. And the characterisitcs of four levels of skill acquisition, that is advanced beginner, competent, proficient, and expert, were described with exemplars. The results of this study might help nurse researchers clarify and elaborate on the concept of expertise in ICU nursing, and enable them to understand how the process of skill acquisition occurs in the ICU setting. They might also help nurse managers establish educational goals for ICU nursing for student or novice nurses.
Humans ; Korea ; Love ; Nurse Administrators ; Nursing*