No abstract available.
B-Lymphocytes* ; Lymph Nodes* ; Pertussis Toxin* ; Whooping Cough*

This study was conducted to provide the basic data necessary for the improvement of the teaching method for basic nursing practice as well as the effectiveness of the practice by examining the students' competency in cleansing enema after doing the self study instead of the traditional education. To examine the competency in cleansing enema after the self study, this study is an one group pretest-posttest design that subjects did the enema practice through the self study. The subjects were 89 sophomore students at Y University, College of Nursing. In basic nursing lab practice class, cleansing enema self study module was given to the students which was developed by the researcher based on the literature review and asked them to finish doing the pre study and checking the self study evaluation criteria after reading the goal, learning activities and theoretical guideline. After watching the video tape, students practiced the process in the module by themselves. For the competency in cleansing enema, repeated autonomous practices were done during the open lab other than the regular class. Whenever the practice was done, the frequency and time were measured and documented. When the student felt confident through repeated practices, the competency was evaluated by the researcher and two assistants based on the evaluation criteria. And the process was repeated till the student could perform all the items on evaluation criteria completely. The data were collected for 42 days from Oct. 15 to Nov. 26 in 1996. Collected data were analyzed by frequency, percentage, Pearson correlation coefficient and variance analysis. The results are summarized as follows; 1. 43.2% of the students were favorable to nursing and 63.6% like lecture, but 71.6% like practice. So they were more interested in practice than in lecture. 2. 62.3% of the students scored high in written test, 97.8% scored high in practice. So the practice score was better. 3. The frequency of repeated practice to pass the test ranged from 1 to 4 and the average is 2.2. 4. The average time needed in preparation and the performance was nearly the same regardless of the frequency. It took 5 to 38 minutes for those who passed the test after practicing once and the average was 16 minutes. 5 to 60 minutes were taken for those who practiced twice to pass the test and the average was 21 minutes. Those who passed the test after three practices needed 8 to 30 minutes and the average was 15 minutes, which was similar to the time that the students who passed the test for the first trial. Only one student passed the test after 4 practices and it took 10 minutes. 5. 64% of the students agreed that the context and the content of the module were appropriate for the self study and 68.2% were satisfied. And 71.9% said that the module helped them to practice the enema self study. 6. Though only 42% of the students were satisfied with the video, 50.6% said that it was helpful for the self study. 7. 52.3% of the students were satisfied with the self study method, and 86.6% obtained self-confidence when performing the enema. 8. The lower the student's practice score was, the more practices were needed for them to pass the test(r=-0.213, p<0.05). As a result, for performing the enema practice competently, two or more practice opportunities were needed to be given. And it is possible to obtain the less complex nursing skills through the self study, when enough learning resources and assistance such as learning guidance or video tapes are provided. Based on this study, I want to suggest that, 1. There must be college policy that can support the new method instead of the traditional learning method for the students to attain the proficiency in basic nursing skills. 2. The assistant materials should be developed as soon as possible to promote the self study of basic nursing skills.
Education ; Enema* ; Humans ; Learning ; Nursing* ; Teaching

Kienbock's disease is a rare disease that is suspected to be caused by the circulatory impairment or/and trauma to the lunate. The various modes of etiology, progression and the treatment have been suggested without any definite ones. The authors report 13 cases of the Kienbock's disease and the results are as follows:1. The male(10 of 13 patients) and the dominate hand(10 of 13 hands) were the more prevalent. 2. Eight cases had a definite history of trauma and the 5 of them were injured by the hyperextension of the wrist. 3. Eight cases were stage III B according to the Lichtman's classification. 4. Nine cases(69%) showed ulna minus variant, which was thought to have certain significant relation with the cause of this disease.
Classification ; Clinical Study ; Osteonecrosis ; Rare Diseases ; Ulna ; Wrist

Septic shock is one of the leading cause of death in hospitalized patients and mortality rates of up to 50 % have been reported. Despite all efforts, no regimen today seems to be successful in the treatment of septic shock. The endogenous opioid system (EOS) includes three major families of peptides: dynorphins, endorphins and enkephalins. Several lines of evidence indicate that EOS is implicated in the pathophysiology of anaphylactic and endotoxic shock. An opioid receptor blocker naloxone has been used extensively in studies for the role of EOS or endogenous opiod peptides (EOP). However, there have been few, if any, detailed investigative studies regarding the effect of naloxone on TNF-a production and the lethality in response to endotoxin, and tumorigenesis. ...continue...
Carcinogenesis* ; Cause of Death ; Dynorphins ; Endorphins ; Enkephalins ; Humans ; Melanoma ; Mortality ; Naloxone* ; Nitric Oxide ; Peptides ; Receptors, Opioid* ; Shock, Septic*

Using the 8 strains of Vibrio vulnificus isolated from the patients with primary sepsis, the viability of Vibrio vulnificus were studied in the various range of hydrogen ion concentration. The opitimal pH range of growth was 7-9, and survived between pH 3. 6 and 12. 5 when incubated at 37C for one hour.
Humans ; Hydrogen* ; Hydrogen-Ion Concentration* ; Protons* ; Sepsis ; Vibrio vulnificus* ; Vibrio*

We found an error in this article.

The most common causes of conjugated hyperbilirubinemia after the first or second week of life are neonatal hepatitis and biliary atresia. Since these entities represent variable expressions of same pathologic process and have similar clinical, biochemical, and histologic features, differential diagnosis is extremely difficult. We prospectively studied 28 jaundiced infants by sonography and hepatobiliary scintigraphy. Final diagnoses included 12 biliary atresia and 16 neonatal hepatitis. Visualization of a normal-sized common bile duct or gallbladder was compatible with the diagnosis of neonatal hepatitis. Non-visualized or atrophic gallbladder no sonography coupled with non-visualization of bowel activity on scintigraphy was highly suggestive of biliary atresia. We believe that sonography plays valuable role in the initial evaluation of the infants with persistent neonatal jaundice. The combined use of sonography and hepatobiliary scintigraphy provides the most valuable in formation in suspected biliary atresia for prompt surgical treatment.
Biliary Atresia ; Common Bile Duct ; Diagnosis* ; Diagnosis, Differential ; Gallbladder ; Hepatitis ; Humans ; Hyperbilirubinemia ; Infant ; Infant, Newborn ; Jaundice, Neonatal* ; Prospective Studies ; Radionuclide Imaging*

No abstract available.
Child* ; Humans

Variant angina is characterized by repeated attack at rest associated with ST-segment elevation on ECG and caused by the spasm of coronary artery. But, the pathogenesis of spasm is not well known. A 44-year old man was transferred for the management of intramural hematoma at descending thoracic aorta and uncontrolled hypertension. We started to control hypertension with nitroprusside, propranolol, amlodipine, and doxazocin. At 4th hospital day, severe chest pain, dizziness, and diaphoresis were developed, and ECG showed not only ST-segment elevation on lead II, III, aVF but also 2 degree AV block(Mobitz type II). CK-MB revealed 52.3 ng/dl. When coronary angiography performed emergently, it showed total occlusion of right coronary artery (RCA) and diffuse minimal narrowing of left anterior descending coronary artery (LAD). After nitroglycerin was infused via right coronary catheter, the RCA was opened completely, and reperfusion arrhythmia was developed. Medication were changed to nifedipine, diltiazem, nicorandil, isosorbide mononitrate and he had no more chest pain.
Adult ; Amlodipine ; Aorta, Thoracic ; Arrhythmias, Cardiac ; Catheters ; Chest Pain ; Coronary Angiography ; Coronary Vessels ; Diltiazem ; Dizziness ; Electrocardiography ; Hematoma* ; Humans ; Hypertension ; Isosorbide ; Myocardial Infarction* ; Nicorandil ; Nifedipine ; Nitroglycerin ; Nitroprusside ; Propranolol ; Reperfusion ; Spasm

BACKGROUND: Peripheral T cell lymphoma (PTCL), a prevalent form of non Hodgkin lymphomas in East Asia, can manifest fever, hepatomegaly, lymphadenopathy, pancytopenia and hemophagocytic histiocytosis (HPH). Similar clinicopathologic findings are also frequently encountered in reactive hemophagocytic syndrome (HPS) and malignant histiocytosis (MH) , thus diagnoses could be confused among them. With recent advancement of immunohistochemlal techniques, diagnostic accuracies have been improved and most cases of MH could have been reclassified as PTCL. In this study, we intended to delineate the lineage of atypical malignant cells in bone marrow of subjects which were previously diagnosed as MH or HPS with immunohlstochemical analysis and characterize clinlcophathologic findings of PTCL associated with HPH in the bone marrow. METHODS: Five cases dignosed as HPS, 3 as MH, 3 as presumed MH, and 7 as PTCL on bone marrow examination were enrolled in this study. We performed immunohistochemical stain for CD45, CD3, CD43, CD2O and CD68, then revised the diagnoses and summarized the clinical and morphologic features of PTCL associated with HPH. RESULTS: Eleven out of 18 cases were confirmed as PTCL which were previously diagnosed as MH(1), presumed MH(3) and PTCL(7). Eight cases of 11 PTCL showed HPH mimicking MH with infiltration of the atypical malignant cells, even if the proportion of atypical malignant cells was small on bone marrow aspirates. They manifested fever and hepatomegaly but didn't have lymphadenopathy at the early stage of disease. Subtypes of PTCL with HPH were PTCL, unspecifed (3), angioimmunoblastic T cell lymphoma (1) and undetermined (4). They showed poorer outcome in 3-month survival rate (25%) than in those with PTCL without HPH(100%). CONCLUSION: These results suggest that PTCL associated with HPH should be excluded from MH by immunohistochemical analysis. Considering that prognosis of PTCL with HPH is very poor, accurate and rapid diagnosis is needed for prompt treatment.
Bone Marrow ; Bone Marrow Examination ; Diagnosis ; Far East ; Fever ; Hepatomegaly ; Histiocytic Sarcoma* ; Histiocytosis* ; Lymphatic Diseases ; Lymphohistiocytosis, Hemophagocytic ; Lymphoma, Non-Hodgkin ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Peripheral* ; Pancytopenia ; Prognosis ; Survival Rate