No abstract available.
Animals ; Cricetinae* ; Fertilization in Vitro* ; Humans*

PURPOSE: To correlate the atypical sonographic patterns of fibroadenoma of the breast with the pathologicfindings. MATERIALS AND METHODS: Among 203 surgically proven 43 which were sonographi-cally atypicalfibroadenomas, were retrospectively reviewed. The diagnostic criteria for atypical va riety, as seen onsonography, were an ill-defined margin, microlobulated or irregular shape, heterogeneous internal echo-pattern,posterior shadowing, micro-calcification, and clefts. The atypical sonographic patterns of these 43 fibroadenomaswere analysed and compared with the pathologic findings. RESULTS: Among 43 lesions, ill-defined margins orirregular shapes were seen in 15 c a s e s, heterogeneous internal echo-patterns in 27, posterior attenuation innine, and clefts in seven. Thirty-seven (86%) of the 43 were predominantly ductal or hada mixed ductal and stromalcomponent. Eleven (73.3%) of fifteen ill-defined margin or irregular shaped lesions were caused by interdigitationof surrounding normal breast parenchyma and mass. Twenty two (81.5%) of 27 heterogeneous internal echo-pat-ternswere related to dilated ducts, phyllodes features, collagen bundles, adenosis, mi-crocalcification, or fatvacuoles. Eight (88.9%) of nine posterior attenuations were caused by collagen bundles, microcalcification, ductalproliferation or dilatation. All seven cases showing clefts revealed phyllodes features and dilated ducts. CONCLUSIONS: Most atypical fibroadenomas had a redominantly ductal or mixed component. Ill-defined margin orirregular shape was mainly due to interdigitation of normal surrounding parenchyma. Variable histologic featureswere related to the het-erogeneous internal echo-pattern, posterior shadowing, and the clefts revealed by atypicalsonographic findings.
Breast Neoplasms ; Breast* ; Collagen ; Dilatation ; Fibroadenoma* ; Retrospective Studies ; Shadowing (Histology) ; Ultrasonography*

PURPOSE: To define and correlate characteristic sonographic and pathologic findings in men with gynecomastia. MATERIALS AND METHODS: We reviewed medical records and sonographic findings of 26 patients with pathologically proven gynecomastia. All of the chief symptoms, physical findings and causes were categorized. Characteristic sonographic patterns of gynecomastia were analyzed and compared with pathologic findings. RESULTS: Gynecomastia was most common in the 20- to 40-year-old age group (50%) 6;palpable mass was found in 62% of all those cases. Gynecomastia was unilateral or asymmetrical in 22 men (85%), and was caused idiopathically in 21 (81%). The characteristic sonographic patterns correlated with pathologic findings were as follows : (1) focal subareolar smooth oval (or triangular) indistinct margined homogeneous hypoechoic(or isoechoic) patterns were found in 14cases (54%). Eight of these (57%) were of the florid type of gynecomastia (67%) ; (2) diffuse homogeneous hyperechoic (or isoechoic) patterns were found in five cases (19%) ; four of these (80%) were of the intermediate or fibrotic type : (3) involuting female breast parenchymal patterns were found in seven cases (27%), of which six(86%) were of the intermediate or fibrotic type. CONCLUSION: The characteristic sonographic patterns of gynecomastia correlate closely with pathologic types related to the duration of the condition. Ultrasonography isa useful primary diagnostic modality for the evaluation of gynecomastia.
Adult ; Breast ; Female ; Gynecomastia* ; Humans ; Male ; Medical Records ; Ultrasonography

Comflicting results have been reported on whether ketamine potentiates the neuromuscular effect of succinylcholine or other non-depolarizing agents. Notably, there has been no reported clinical evatuation of the influence of ketamine upon the neuromuscular action of vecuronium a new muscle relaxant. The present study was undertaken to estimate the influence of ketamine upon the neuromuscular action of vecuronium with a single bolus injection of ED95. Forty-five ASA class l or ll surgical patients were divided into three groups: l, ll and lll and were given thiopental sodium(5mg/kg), ketamine 3mg/kg and ketamine 5mg/kg as induction agents, respectively. The duration and recovery index of group ll and lll (35.20+/-2.30 and 16.20+/-1.37 min., 52.60+/-3.98 and 25.47+/-3.78min., respectively) were longer than those in group l (24.87+/-1.59 and 10.66 +/- 1.23 min.). But group l had a lower TOF ratio(27.40+/-3.09%) at 75% single twitch recovery than group ll and lll (41.87+/-3.25 and 45.27+/-3.67%, respectively). The increase in duration and the recovery index of group lll were greater than that of group ll. It was concluded that ketamine woudly potentiate the neuromuscular action of vecuronium in a dose-dependent manner. We suggest that combination of ketamine and vecuronium requires careful postoperative neuromuscular monitoring for the recovery from a vecuronium induced neuromuscular block.
Humans ; Ketamine* ; Neuromuscular Agents ; Neuromuscular Blockade* ; Neuromuscular Monitoring ; Succinylcholine ; Thiopental ; Vecuronium Bromide

PURPOSE: This study was done to evaluate the effects of a recreation therapy program on burn rehabilitation patients to determine if the program is an effective nursing intervention which can affect mental health problems and heart rate variability. METHODS: Subjects were 54 hospitalized burn rehabilitation patients (25 in the control group, 29 in the experimental group). The experimental group participated 6 times in a recreation therapy program led by a qualified instructor. Brief symptoms inventory-18 (somatization, anxiety, depression) questionnaire, and heart rate variability were checked before and after the recreation therapy program. RESULTS: The mental health scale showed significant differences in somatization (p<.001), anxiety (p<.001) and depression (p<.001). There was no significant difference in heart rate variability (autonomic activity, autonomic balance, stress resistance, stress parameter and fatigue, mean heart rate, electro-cardiac stability). CONCLUSION: The findings from this study suggest that a recreation therapy program is an effective nursing intervention to decrease the level of mental health problems of burn rehabilitation patients. However, a subsequent study is needed to develop an intervention program that will induce the effect of physiological parameters like heart rate variability (HRV).
Anxiety ; Burns* ; Depression ; Fatigue ; Heart Rate* ; Heart* ; Humans ; Mental Health* ; Nursing ; Recreation Therapy* ; Recreation* ; Rehabilitation*

PURPOSE: The purpose of this study is to analyze how the experiences of nurses influence their role model function when they are mothers of children who in turn have become nurses or nursing students. METHOD: The subjects of this study were 12 nurses, 8 of their children who became nurses and another 4 children then in training to become one. Data were collected through in-depth personal interviews and subsequently analyzed through a phenomenological approach. RESULTS: Four main themes were identified as follows; 'Persuasion and dissuasion,' 'Proud but still pathetic,' 'As mom and senior nurse' and 'Great to pass it down.' CONCLUSION: The results of this study show that the nurse as mother could be a positive professional role model for her children. However, they tended to stress the arduous clinical routines and poor work conditions nurses currently experience. Should such routines and conditions improve, mothers who are nurses would be more willing to recommend the nursing profession to their children. Improving the professional environment is thus important because inter-generation nursing mobility provides a reliable resource to recruit qualified and dedicated nursing personnel.
Career Mobility ; Child ; Humans ; Intergenerational Relations ; Mothers ; Nursing ; Professional Role ; Qualitative Research ; Students, Nursing

No abstract available.
Adult* ; Humans ; Technetium Tc 99m Dimercaptosuccinic Acid* ; Tomography, Emission-Computed, Single-Photon* ; Urinary Tract Infections* ; Urinary Tract*

No abstract available.
Thyroid Diseases* ; Thyroid Gland*

No abstract available.
Thyroid Diseases* ; Thyroid Gland*

Background: To test the hypothesis that Galphas gene mutation may suppress the expression of TRH-R gene, we investigated whether hTRH-R gene expression is lower in human GH-secreting pituitary adenomas with Galphas mutation than in tumors without the mutation. Method: TRH-induced paradoxical response of GH was observed in 8 acromegalic patients. The mutation of gene was identified by direct sequencing of the genomic DNA prepared from GH-secreting pituitary adenomas. The expression of hTRHT mRNA was quantitated by RT-PCR. Results: The transcript of hTRH-R gene was detected in 6 of 8(75%) tumors. Three of these(50%) showed the paradoxical GH response to TRH and the other three patients did not show the response. The relative expression of hTRH-R mRNA in the tumors from patients with the paradoxical response of GH to TRH did not differ from that in the tumors from patients without the paradoxical response. Direct PCR sequencing of Galphas disclosed a mutant allele and a normal allele only at codon 201 in 4 of 8 tumors. The paradoxical response to TRH was observed in 2 of 4 patients without the mutation, and 2 of 4 patients with the mutation. The hTRH-R gene expression of pituitary adenomas did not differ between the tumors without the mutation and those with mutation. Conclusion: This study suggests that the expression of TRH-R gene is not likely to be a main determinant for the paradoxical response of GH to TRH, and that Galphas mutation does not seem to suppress the gene expression of TRH-R in GH secreting adenoma.
Acromegaly ; Adenoma* ; Alleles ; Codon ; DNA ; Gene Expression ; Growth Hormone-Secreting Pituitary Adenoma ; GTP-Binding Proteins ; Humans ; Pituitary Neoplasms ; Polymerase Chain Reaction ; Receptors, Thyrotropin-Releasing Hormone* ; RNA, Messenger