This descriptive study was conducted between October 1, and December 31, 1998 in order to provide basic data for understanding the emotional states of patients with systemic lupus erythematosus and their compliance with a medical regimen. Data was collected by using questionnaires administered to 100 lupus inpatients and outpatients at the Kangnam St. Mary's Hospital. Frequencies, percentage, average, standard deviation, t-test, ANOVA, Duncan's multiple range test, Pearson correlation coefficients, and stepwise multiple regression were applied to the data using the SAS program. The results of study are summarized below. The mean compliance score was 91.21. The highest compliance score was found in "risk factor management", followed by "taking medicine", "follow-up care", "daily life management", "stress management", "diet", "activity and rest" in that sequence. The mean depression score was 43.58. 24% for subjects who showed more than mild depression. The compliance score of depressed subjects was significantly lower than that of the subjects without depression. The mean score of anxiety was 44.01. 36% for subjects who had scores lower than 40 points, 37% for those between 41-50 points, and 27% for those with more than 51 points. As for compliance scores according to anxiety levels, the compliance scores for those with anxiety scores of below 40 significantly higher than that of those of the above 51 group. There was a negative correlation between compliance and depression and between compliance and anxiety. In addition, a strong positive relationship was found between depression and anxiety. The major variable affecting compliance was anxiety, accounting for 13.6%. We concluded that when we care for the patients with lupus, we have to consider the outcomes of this study because emotional status affects the lupus patients' compliance. In addition, it is necessary to develop nursing interventions in order to alleviate the lupus patient's depression and anxiety.
Anxiety ; Compliance* ; Depression ; Humans ; Inpatients ; Lupus Erythematosus, Systemic* ; Nursing ; Outpatients ; Surveys and Questionnaires

This study was conducted between October 1, 1998, and December 31, 1998, in order to provide basic data to develop better self-management educational programs for systemic lupus erythematosus (lupus) patients. In the study, the extent of each patients knowledge on the disease and their learning needs about it were examined for 100 lupus inpatients and outpatients at the Kangnam St. Marys Hospital. Data were collected by using questionnaires to those patients. Frequencies, percentage, average, standard deviation, t-test, ANOVA, and Duncans multiple range test were examined through the SAS program. The result of study follows: 1) The average score of patients knowledge on the disease was 15.7 (range, 7-20; standard deviation, 2.74). Subjects scored higher as far as the extent of their knowledge in the following categories : management of daily life, diet, characteristics of the disease, risk factors, and medication. Two categories shared the highest percentage of correct answers: 99% of subjects correctly identified that fatigue and stress aggravate symptoms of lupus and symptoms of lupus vary among individuals in range and type. However, when subjects were asked if patients should get a regular examination by an ophthalmologist every 4-6 months while they are on medication to treat rashes, lupus can be completely cured, and contraceptives that include a female hormone (estrogen) are good as contraceptive methods, the percentages of correct answers were low (32%, 31%, and 20%, respectively). In terms of subjects knowledge about the disease by their general characteristics, single subjects had more knowledge about the disease than married subjects did (t=2.14, p=0.0353). The extent of knowledge also varied by monthly income (F=4.96, p=0.0097). Those with more formal education had more knowledge about lupus than those who had less formation education did (t=2.95, 0.0039). Additionally, those who were satisfied with their education about the disease had better knowledge about it than those who were dissatisfied with their education did (t=2.71, p=0.0090). 2) The extent to which lupus patients wanted to be educated about the disease was, on average, 64.5 (range, 46-75; standard deviation, 7.91). Areas for which patients requested education are listed here in order : risk factors, sexual lives and patients associations. Patients who had been hospitalized demonstrated wanting more education than those who had not been did (t=3.73, p=0.0003). The extent to which they wanted the information was different by the number of educational sessions they had (F=3.98, p=0.0249). In conclusion, the results above would be considered when the education programme is planned for SLE patients.
Contraception ; Contraceptive Agents ; Diet ; Education ; Exanthema ; Fatigue ; Female ; Humans ; Inpatients ; Learning* ; Lupus Erythematosus, Systemic* ; Outpatients ; Surveys and Questionnaires ; Risk Factors ; Self Care

OBJECTIVES: The most common chromosomal abnormality contributing to recurrent abortion is the balanced chromosomal translocation. However the exact incidence of fetal losses are still unknown. The objectives of this study were to evaluate the incidence of fetal chromosomal abnormalities and outcome of pregnancy in recurrent miscarriage couples with balanced translocation. DESIGN: A retrospective analysis of recurrent spontaneous abortion patients with balanced chromosomal translocation. MATERIALS AND METHODS: Cytogenetic analysis was performed in 56 couples with history of recurrent abortions from 1995 to 1999. The use of high resolution banding technique and fluorescent in situ hybridization (FISH) in the chromosomal analysis has made the precise evaluation of chromosome aberrations. RESULTS: Among 56 couples, 42 patients had reciprocal translocation and 14 had Robertsonian translocation. Chromosomal aberrations were more frequent in women (36 cases) than in men (20 cases). Prenatal cytogenetic analyses were carried out in 14 subsequent pregnancies for carrier couples with balanced translocation. The fetal karyotypes showed that 5 cases (35.7%) was normal, 8 (57.1%) were balanced translocation, and 1 (7.1%) was unbalanced translocations. And cytogenetic analyses were done on 15 subsequent chorionic villi samples of abortuses for carrier couples with balanced translocations. Fourteen of fifteen abortuses (93.3%) were abnormal karyotype. CONCLUSIONS: Although the incidence of chromosomal imbalance in the fetuses was relatively low in prenatal cytogenetic analysis, individuals with balanced translocations are predisposed to giving birth to malformed offsprings with chromosomal imbalance (partial trisomy or monosomy). Therefore we recommend preimplantation genetic diagnosis (PGD) for recurrent abortions with balanced translocation and preventing the birth of offspring with chromosomal abnormalities.
Abnormal Karyotype ; Abortion, Habitual* ; Abortion, Spontaneous ; Chorionic Villi ; Chromosome Aberrations* ; Cytogenetic Analysis ; Family Characteristics* ; Female ; Fetus ; Humans ; In Situ Hybridization, Fluorescence ; Incidence* ; Karyotype ; Male ; Parturition ; Pregnancy ; Preimplantation Diagnosis ; Retrospective Studies ; Translocation, Genetic ; Trisomy

Objective of this study was to compare the color stability, mechanical and chemical properties of three different types of temporary crown resins. Commercially available powder-liquid (Group PL), light-cured (Group LC) and auto-mix syringe (Group AM) types' temporary crown resins were used as experimental groups for each of the evaluation. All the test groups were evaluated after 1 day and 7 days of immersion in various staining solutions. The colors of all groups before and after storage in the staining solutions were measured by a spectrophotometer based on CIE Lab system, and the color differences (ΔE(*)) thereby calculated. Micro hardness test was performed before water storage and aging after 7 days at 37 ℃. In addition, flexural strength, water sorption and solubility tests were performed according to international standard, ISO 10477. All experimental groups showed significant color change in staining solutions when compared to those stored in the control solution (distilled water) (p<0.05). Group PL showed the least color change among the three groups followed by Group AM (p<0.05). This tendency was observed after 7 days of immersion. In terms of the micro hardness test, Group PL showed the highest value among the three groups followed by Group AM (p<0.05). Additionally, the flexural strength decreased in the following order: AM > PL > LC (p<0.05). Water sorption and solubility increased in the following order: AM < PL < LC (p<0.05). The results of this study would provide useful information when choosing temporary crown resin types in various clinical situations.
Aging ; Crowns ; Hardness Tests ; Immersion ; Solubility ; Syringes ; Water

PURPOSE: To analyze the improvement of symptoms and signs of dry eye after surgical punctual occlusion and to evaluate the effects of secondary systemic disease in dry eye patients. METHODS: From March 2011 to July 2014, 15 eyes of 8 dry eye patients with a history of punctal plug insertion underwent surgical punctal occlusion. Schirmer test was measured based on mean 2.9 mm. The patients consisted of 4 dry eye patients with Sjogren's disease, 1 with rheumatoid arthritis, 1 with graft-versus-host disease (GVHD), and 2 with no secondary systemic disease. Preoperative and postoperative ophthalmic examinations of log MAR visual acuity, subjective symptoms, corneal staining (National Eye Institute [NEI] score), and tear break-up time (BUT) were performed and the effects of secondary systemic disease in dry eye patients were evaluated. The results of surgical punctual occlusion were analyzed. RESULTS: All patients showed a statistically significant improvement of log MAR visual acuity, subjective symptoms, corneal staining (NEI score), and tear BUT. The patients with rheumatoid-related diseases showed improved symptoms after surgery, but the patient with GVHD showed no significant improvement after surgery. Among the study patients, 80.0% showed completely closed punctum and 20.0% showed partial recanalization. CONCLUSIONS: Surgical punctal occlusion is an effective alternative in patients with severe aqueous deficient dry eye who show recurrent punctal plug loss or complications associated with punctal plugs.
Arthritis, Rheumatoid ; Graft vs Host Disease ; Humans ; Sjogren's Syndrome ; Tears ; Visual Acuity

PURPOSE: Food allergies are adverse immune reactions to food. Despite their importance, there have only been a few studies conducted on situations that may cause food allergies in Korean children. This study aims to obtain basic data that are necessary to provide information on food allergies to both patients and caregivers. METHODS: In this study, a survey was conducted on 97 caregivers of patients below 18 years old. The patients' situation upon occurrence of food allergy was examined by a questionnaire. RESULTS: Approximately 89.7% of the patients were at 6 years of age or younger. The most common allergens were eggs (37%) and milk (28%) in a total of 163 cases, including multiple responses. Skin symptoms were most common (77.8%). At the time of occurrence, 85% of the patients were with their parents. As for the exposure place, house was 65%, followed by restaurant (16%), nursery (7%), and relative's or neighbor's house (4%). Exclusive of unknown cases, the most common reason of exposure was the caregiver giving the food to the patient for reconfirmation (13.6%). CONCLUSION: It is concluded that the understanding of food allergies based on this research will assist in the management of patients with food allergies.
Allergens ; Caregivers* ; Child ; Education ; Eggs ; Food Hypersensitivity ; Humans ; Hypersensitivity* ; Milk ; Nurseries ; Ovum ; Parents ; Restaurants ; Skin

OBJECTIVE: Preimplantation genetic diagnosis (PGD) is reserved for couples with a risk of transmitting a serious and incurable disease, and hence avoids the undesirable therapeutic abortion. In this study, we evaluated the efficacy of PGD for Duchenne muscular dystrophy (DMD) cases by the fluorescent PCR with polymorphic linked markers and the conventional duplex-nested PCR methods. METHODS: Biopsy of one or two blastomeres was done from the embryos fertilized by ICSI on the third day after fertilization. We performed two cases of PGD-DMD by the duplex-nested PCR for the causative mutation loci and the SRY gene on Y chromosome. The triplex fluorescent PCR for the mutation loci, the SRY gene and the polymorphic microsatellite marker on X chromosome was applied for two cases of PGD-DMD. RESULTS: By the duplex-nested PCR, successful diagnosis rate was 95.5% (21/22), but we could not discriminate the female embryos whether normal or carrier in this X-linked recessive disease. However, the triplex fluorescent PCR method showed 100% (27/27) of successful diagnosis rate, and all female embryos (n=17) were distinguished normal (n=10) from carrier (n=7) embryos. Unaffected and normal embryos were transferred into mother's uterus after diagnosis. A healthy normal male was achieved after PGD with the duplex-nested PCR method and a twin, a male and a female, were delivered with triplex fluorescent PCR method. The normality of dystrophin gene was confirmed by amniocentesis and postnatal genetic analysis in all offsprings. CONCLUSION: The fluorescent PCR with polymorphic marker might be useful in improving the specificity and reliability of PGD for single gene disorders.
Abortion, Therapeutic ; Amniocentesis ; Biopsy ; Blastomeres ; Diagnosis ; Dystrophin ; Embryonic Structures ; Family Characteristics ; Female ; Fertilization ; Genes, sry ; Humans ; Male ; Microsatellite Repeats ; Muscular Dystrophy, Duchenne* ; Polymerase Chain Reaction* ; Pregnancy ; Preimplantation Diagnosis* ; Prostaglandins D ; Sensitivity and Specificity ; Sperm Injections, Intracytoplasmic ; Twins ; Uterus ; X Chromosome ; Y Chromosome

A 31-year-old woman admitted because of fever, chilling and sore throat for 4 days. The symptom was developed after receiving methimazole 20mg per day and carteolol 10mg per day due to Graves disease during last 4 weeks. Physical examination revealed hyperemic enlarged tonsils with whitish plaque. The peripheral blood total neutrophil count was 1,400/mm3 (absolute neutrophil count, ANC 36) and a peripheral blood smear revealed rare neutrophil with lymphocytosis. On the first day of hospitalization, the patient was severely ill with ANC 0, it was decided to administer G-CSF 2ug/kg daily. On the fifth day of hospitalization, ANC in peripheral blood count was persistently zero and bone marrow aspiration and biopsy were performed, which revealed hypocellularity and myeloid hypoplasia. G-CSF given daily for 7days, it was discontinued when the ANC reached 1,539/mm3. The availability of G-CSF may help to shorten the course of agranulocytosis and to reduce its mortality rate.
Adult ; Agranulocytosis* ; Biopsy ; Bone Marrow ; Carteolol ; Colony-Stimulating Factors* ; Female ; Fever ; Granulocyte Colony-Stimulating Factor* ; Granulocytes* ; Graves Disease ; Hospitalization ; Humans ; Lymphocytosis ; Methimazole* ; Mortality ; Neutrophils ; Palatine Tonsil ; Pharyngitis ; Physical Examination

PURPOSE: The microRNA-221/222 (miR-221/222) gene cluster has been reported to be associated with the promotion of epithelial-mesenchymal transition (EMT), downregulation of estrogen receptor-α, and tamoxifen resistance in breast cancer. We studied the expression of miR-222 in human breast cancer samples to analyze its relationship with clinicopathologic features of the tumor, including estrogen receptor status, expression of EMT markers, and clinical outcomes. METHODS: Quantitative real-time polymerase chain reaction was performed to detect the expression of miR-222 in 197 invasive breast cancers. Expression of EMT markers (vimentin, smooth muscle actin, osteonectin, N-cadherin, and E-cadherin) was evaluated using immunohistochemistry. RESULTS: High miR-222 levels were associated with high T stage, high histologic grade, high Ki-67 proliferation index, and HER2 gene amplification. Its expression was significantly higher in the luminal B and human epidermal growth factor receptor 2-positive (HER2+) subtypes than in the luminal A and triple-negative subtypes. In the hormone receptor-positive subgroup, there was a significant negative correlation between miR-222 and estrogen receptor expression, and miR-222 expression was associated with EMT marker expression. In the group as a whole, high miR-222 expression was not associated with clinical outcome. However, subgroup analyses by hormone receptor status revealed that high miR-222 expression was a poor prognostic factor in the hormone receptor-positive subgroup, but not in the hormone receptor-negative subgroup. CONCLUSION: This study showed that miR-222 is associated with down-regulation of the estrogen receptor, EMT, and tumor progression in hormone receptor-positive breast cancer, indicating that miR-222 might be associated with endocrine therapy resistance and poor clinical outcome in hormone receptor-positive breast cancer.
Actins ; Breast Neoplasms* ; Breast* ; Cadherins ; Down-Regulation ; Epithelial-Mesenchymal Transition ; Estrogens ; Genes, erbB-2 ; Humans ; Immunohistochemistry ; Multigene Family ; Muscle, Smooth ; Osteonectin ; Phenobarbital ; Prognosis ; Real-Time Polymerase Chain Reaction ; Receptor, Epidermal Growth Factor ; Tamoxifen

PURPOSE: Headaches are associated with psychiatric illness, and can affect all aspects of a functioning child. We examined the behavioral and emotional problems of children and adolescents suffering from headaches. METHODS: Children and adolescents(N=269) aged 4 to 17 suffering from headaches and their age-matched controls(N=31) were assessed using the Korean Child Behavior Checklist(K-CBCL), Korean Personality Inventory for Children (KPI-C), and Children's Depression Inventory(CDI). RESULTS: Psychological profiles were analyzed in three stages. First, the primary headaches had a statistically significant tendency to show problems in anxiety, depression, somatization, and psychosis scales of KPI-C, and somatic complaints, thought, and internalizing problems of K-CBCL than in the control group(P<0.05). Second, migraines(N=162) and tension-type headaches(N=57) showed no statistically significant difference(P>0.05). Finally, the chronic daily headaches(CDH)(N=43) had statistically significantly higher scores in CDI and somatization of KPI-C than in the episodic headaches(P<0.05). In respect to ego-resilience scale of KPI-C, CDH had statistically significantly lower score than in the episodic headaches(P<0.05). CONCLUSION: Children and adolescents with headaches show greater internalizing problems(anxiety, depression, somatization, and thought problems) than their healthy peers. Patients with CDH will have a negative effect on their adaptations because they have a lower ego-resilience and more symptoms of depression and somatization than children suffering from episodic headaches and controls.
Adolescent ; Aged ; Anxiety ; Child ; Child Behavior ; Depression ; Headache ; Humans ; Personality Inventory ; Psychotic Disorders ; Stress, Psychological ; Weights and Measures