No abstract available.
Adult* ; Female* ; Humans

The cause of essential hypertension is yet unknown, but in general is caused by interaction of hereditary factors, diet, obesity, lack of exercise and stress. The aging process influences various physiological mechanism related to regulation of blood pressure. So elderly hypertensives have a tendancy to consider the disease as a result of the physiological aging process. This attitude causes many complications, worsening of the disease and even early death because of inappropriate care. In order to improve self-management of elderly hypertensives in this study the researcher examined the effect of blood pressure regulation by an education program that improves self-care behavior, through increasing self-efficacy. The education program consisted of group education on hypertension and self-care strategies, and encouraging and reinforcing self-efficacy resources such as verbal persuation, performance accomplishment and vicarious experiences. A quasi-experimental pre-and post-test design was used. Thirty-two elderly hypertensives participated in the study. Eighteen in the education group and fourteen in the control group. The education program consisted of eight sessions twice a week for four weeks. There was no intervention for the control group. Data were analysed using SPSS for Windows(Version 8.0). The results were as follows. 1. There was a significant decrease in systolic and diastolic blood pressure between the experimental group and control group over three different times, and interaction by groups and over time. 2. There was no significant difference in the level of self-care behavior between the experimental group and control group over three different times, and interaction by groups and over time. 3. There was significant difference in self-efficacy of experimental and control group, depending on the measuring period, but there was no difference between these groups on interaction by groups and over time. 4. There was positive correlation between self efficacy and self care behavior depending on the measuring period. There was negative correlation between diastolic blood pressure and self-care behavior on the posttest of the program, and between systolic blood pressure and self-care behavior on the follow-up test of the program. Findings indicate that this study will contribute to develop nursing strategies for the regulation of blood pressure for the elderly, which is easy for the elderly to learn as a nonpharmacologic approach.
Aged* ; Aging ; Blood Pressure* ; Diet ; Education* ; Follow-Up Studies ; Humans ; Hypertension ; Nursing ; Obesity ; Self Care* ; Self Efficacy

Morphometry of nuclei of the benign and malignant prostatic lesions was performed to study the relationship between nuclear size and shape and the prognosis of prostatic adenocarcinoma. Fifty one cases of prostatic adenocarcinoma and 13 cases of benign prostatic hyperplasia were included to evaluate area, perimeter, Dmax, Dmin, and 5 form factors of the nuclei by image analyzer (Zeiss Ibas 2000) using hematoxylin-eosin stained slides. All analytic factors of nuclear size and shape were significantly different between benign lesions and adenocarcinomas. Increased nuclear size was associated with nu- clear irregularity, presence of metastasis, advanced clinical stage, and high Gleason's grade and score of prostatic adenocarcinoma. On Kaplan-Meier method, survival was decreased with older age, no hormonal treatment, stage D, high Gleason's grade and stage as well as with larger size and irregular shape of the nuclei. In conclusion, morphometry of nuclei of the prostate can be a helpful tool to differentiate between benign and malignant lesions. Nuclear morphology is thought to be associated with prognosis of prostatic adenocarcinoma.
Adenocarcinoma ; Breast ; Fibroadenoma ; Hepatitis B e Antigens* ; Hepatitis B Surface Antigens* ; Hepatitis B* ; Hepatitis* ; Neoplasm Metastasis ; Prognosis ; Prostate ; Prostatic Hyperplasia

A case of diffuse malignant mesothelioma of peritoneum which was difficult to distinguish from metastatic anaplastic carcinoma or malignant melanoma was presented. The patient was a 50 year-old woman and complained of an abdominal pain and ascites for 20 days. Histologically, the tumor cells showed highly anaplastic appearance with sheet-like arrangement without any papillary or tubular structure. They stained Positive for cytokeratin and vimentin and negative for CEA, S-100 protein and melanoma associated antigen. A few cells within the tumor showed Positive reactivity to desmin. Ultrastructurally, the tumor cells had characteristic findings of mesothelioma such as long, exuberant, wavy microvilli with 10 to 12 of length/diameter ratio. The patient died 3 months after the diagnosis in spite of intraperitoneal chemotherapy.
Female ; Humans ; Neoplasm Metastasis

No abstract available.
Leukemia*

Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, KoreaCarbamazepine (CBZ) is the common antiepileptic drug prescribed for the management of neuropathic pain in patients with neurologic injury. CBZ can rarely be the causative agent to result in drug-induced hypersensitivity syndrome (DIHS), which is a life-threatening drug reaction. Delayed diagnosis of DIHS may occur in complicated clinical settings. We have reported a case of a 12-year-old girl whose initial manifestations of CBZ-induced DIHS were atypical due to concurrent administration of corticosteroids. After open biopsy of brainstem glioma, she was administered corticosteroids and CBZ to mitigate postoperative complications, including mild weakness of ankle dorsiflexion and otalgia. Not only fever but also elevation of liver enzymes and inflammatory markers were presented 1 month after CBZ initiation, without any skin rash or leukocytosis. A maculopapular rash on the whole body and leukocytosis developed afterward; consequently, the diagnostic criteria for DIHS were fulfilled. After discontinuation of CBZ, her fever and increased liver enzymes subsided and the rash slowly improved. This case indicates that typical signs, such as skin rash or leukocytosis, can be initially masked or delayed in CBZ-induced DIHS if it overlaps with corticosteroid administration. The atypical manifestations of DIHS should be considered if CBZ is concurrently administered with corticosteroids.

Aneurysmal benign fibrous histiocytoma, which is a rare variant of benign fibrous histiocytoma, usually occurs as a solitary nodule on the limbs of young to middle aged adults. The clinical diagnosis of fibrous histiocytoma is seldom considered in the differential disgnosis, which may include malignant melanoma, hemangioma, neurorfibroma, and nonspecific cyst. Histopathologically, aneurysmal benign fibrous histiocytoma is characterized by the presence of large blood-filled tissue space which is surrounded by histiocyte, fibroblast, hemosiderin pigment, and capillaries. We report a case of aneurysmal benign fibrous histiocytoma in a 15-year-old boy, who had a solitary nodular lesion on the left knee for a 2 year duration.
Adolescent ; Adult ; Aneurysm* ; Capillaries ; Diagnosis ; Extremities ; Fibroblasts ; Hemangioma ; Hemosiderin ; Histiocytes ; Histiocytoma, Benign Fibrous* ; Humans ; Knee ; Male ; Melanoma ; Middle Aged

A 63 year-old female was brought to our hospital with severe lower back pain. She received antihypertensive drugs for 2 years but her blood pressure was normal upon arrival. She could not stand up or even walk. The MRI showed a subdural hematoma at the thoracolumbar region, which was extremely rare. The treatment applied was decompression through a spinal tap without surgery. After this, her pain subsided considerably. Two weeks later, MRI confirmed that there was no hematoma in the same region. She was discharged and has enjoyed her daily activities free of pain. A spontaneous subdural hematoma is an extremely rare disease. The condition was treated successfully in a conservative manner.
Antihypertensive Agents ; Blood Pressure ; Decompression ; Female ; Hematoma ; Hematoma, Subdural ; Humans ; Low Back Pain ; Rare Diseases ; Spinal Puncture

PURPOSE: The axillary reverse mapping (ARM) technique to identify and preserve arm nodes during sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND) was developed to prevent lymphedema. The purpose of this study was to investigate the location and metastatic rate of the arm node, and to evaluate the short term incidence of lymphedema after arm node preserving surgery. METHODS: From January 2009 to October 2010, 97 breast cancer patients who underwent ARM were included. Blue-dye (2.5 mL) was injected into the ipsilateral upper-inner arm. At least 20 minutes after injection, SLNB or ALND was performed and blue-stained arm nodes and/or lymphatics were identified. Patients were divided into two groups, an arm node preserved group (70 patients had ALND, 10 patients had SLNB) and an unpreserved group (13 patients had ALND, 4 patients had SLNB). The difference in arm circumference between preoperative and postoperative time points was checked in both groups. RESULTS: The mean number of identified blue stained arm nodes was 1.4+/-0.6. In the majority of patients (92%), arm nodes were located between the lower level of the axillary vein and just below the second intercostobrachial nerve. In the arm node unpreserved group, 2 patients had metastasis in their arm node. Among ALND patients, in the arm node preserved group, the difference in arm circumference between preoperative and postoperative time points in ipsilateral and contralateral arms was 0.27 cm and 0.07 cm, respectively, whereas it was 0.47 cm and -0.03 cm in the unpreserved group; one case of lymphedema was found after 6 months. No difference was found between arm node preserved and unpreserved group among SLNB patients. CONCLUSION: Arm node preserving was possible in all breast cancer patients with identifiable arm nodes, during ALND or SLNB, except for those with high surgical N stage, and lymphedema did not develop in patients with arm node preserving surgery.
Arm ; Axillary Vein ; Breast ; Breast Neoplasms ; Humans ; Incidence ; Lymph Node Excision ; Lymphedema ; Neoplasm Metastasis ; Nitriles ; Pyrethrins ; Sentinel Lymph Node Biopsy

Chondrosarcoma is a very uncommon malignant primary bone tumor, especially, it occurs extremely rare in the spine. A 52-year-old man was admitted to the emergency room with sudden paraplegia. Twelve hours prior to a paraplegic event, he visited an outpatient clinic with discomfort and tenderness around the medial border of the right scapular, and his neurologic status was absolutely intact. Magnetic resonance imaging showed a lobulated soft tissue mass from T3 to T5, which extended to the epidural space. Computed tomography scans showed soft tissue mass on the spinal posterior arch and osteolytic change of the adjacent bony structures. Emergent surgery was performed and the lesion was removed. Dark reddish blood and gel-like material were encountered around the dura and posterior arch during the operation. Multiple pulmonary nodules were found on a chest CT scan and a biopsy of one of them had been proven to be a metastasis of chondrosarcoma. The histologic examination showed dedifferentiated chondrosarcoma. The patient's neurologic deficit was improved slowly from ASIA A to ASIA D. Chondrosarcoma in the spine is extremely rare, even more with acute hemorrhage and sudden expansion into the epidural space. We named it chondrosarcoma apoplexy. We should consider the possibility of a hemorrhagic event when the patient's neurologic deficit worsens suddenly with spinal bone tumor.
Ambulatory Care Facilities ; Asia ; Biopsy ; Chondrosarcoma ; Emergencies ; Epidural Space ; Hemorrhage ; Magnetic Resonance Imaging ; Multiple Pulmonary Nodules ; Neoplasm Metastasis ; Neurologic Manifestations ; Paraplegia ; Spine ; Stroke ; Thorax