PURPOSE: The purpose of this study was to describe how the rural elderly cope with experiences in multiple chronic diseases. METHOD: Data were collected through participant observation and in-depth interview using ethnography. The participants were 9 women and 2 men who aged over 65, were living in rural community, and had experienced two or more chronic diseases. RESULTS: According to the results of this study, those who had experienced multiple chronic diseases went through the stages of 'recognizing of revealed symptoms', 'discovering of disease', 'overcoming', 'neglecting', 'discovering another disease', 'being frustrated' and 'living with suffering'. CONCLUSION: The results of this study are expected to be utilized as basic materials to develop a nursing intervention program for effective management of chronic diseases.
Aged* ; Anthropology, Cultural ; Chronic Disease* ; Female ; Humans ; Male ; Nursing ; Rural Population

A 5-month-old male infantshowed greasy sealy papules on the scalp, dirty scaly papules on the trunk and scaly petechial papules on both the palms and soles since birth. When admitted to the hospital, the patient exhibited lymphadenopathy, hepatomegaly, abdominal distension, mild fever and skin eruption. The biopsy specimens from the skin and lymph node showed an infiltrate composed almost entirely of histiocytic cells with irregularly shaped nuclei and abundant, well demarcated cytoplasm. The histiocytic cells of the infiltrate were proved as Langerhans cells by electron microscopic examination and S-100 protein study. He was treated with methotrexate 30mg/m twice a week and prednisolone 40mg/m daily. Initially skin lesions and general condition were improved, but the patient expired. due to septicemia after 3 months.
Biopsy ; Cytoplasm ; Fever ; Hepatomegaly ; Humans ; Infant ; Langerhans Cells ; Lymph Nodes ; Lymphatic Diseases ; Male ; Methotrexate ; Parturition ; Prednisolone ; S100 Proteins ; Scalp ; Sepsis ; Skin

PURPOSE: This study was done to explore life stress and coping skills of boarding high school students. METHODS: Triangulation (quantitative and qualitative) research method was used through three stages. First, 47 high school students were interviewed to identify life stressors. Second, 208 students were surveyed via internet questionnaires to assess stress level for each stressor. Lastly, in order to survey stress coping skills, 61 students answered 10 subjective questions orally or in writing. RESULTS: Thirty-seven life stressors in five categories were identified through thematic content analysis of the interviews: dormitory life, appearance and self management, human relations, study, and other areas. Stresses from schoolwork were highest and participants also experienced stress from their dormitory life. The overall stress level was higher in girls than in boys, and students in their 2nd year perceived their stress as higher than those in other grades. Various stress coping skills were being used, and positive coping skills were commonly used. CONCLUSION: To improve quality of life of boarding high school students, various strategies are needed to reduce their life stress. Especially, girls are in need of special concern and care because of their vulnerability to stress.
Adaptation, Psychological* ; Female ; Humans ; Internet ; Quality of Life ; Questionnaires ; Self Care ; Stress, Psychological* ; Writing

Herpes zoster oticus (Ramsay Hunt syndrome) is characterized by facial nerve paralysis associated with vesticular eruptions and cochleovestibular symptoms. Many evidences have supported that it is caused by the reactivation of latent varicella-zoster virus in the geniculate ganglion. Recently we experienced a case 49-year-old man presented severe vertigo and a vesicular eruptions of auricle and external ear canal. It is an unusual variant of herpes zoster oticus that involves only vestibular nerve without facial nerve palsy and hearing loss. We believe this case results from reactivation of latent varicella zoster virus in the vestibular ganglion and report with a review of literatures.
Dizziness ; Ear Canal ; Facial Nerve* ; Ganglion Cysts ; Geniculate Ganglion ; Hearing Loss ; Herpes Zoster Oticus* ; Herpes Zoster* ; Herpesvirus 3, Human ; Humans ; Middle Aged ; Paralysis* ; Vertigo ; Vestibular Nerve*

Although a number of remedies like corticosteroids, retinoids, griseofulvin, PUVA, cyclosporine, antibiotics, dapsone, cyclophosphamide, surgery, methotrexate, radiation therapy, antimalarial drugs, psychotharapy and psychiatric medications have been used to treat lichen planus, there were no specific methods until now. We report herein an interesting case of lichen planus in which complete healing was achieved by griseofulvin administration. The patient was a 54-year-old male who for 3 months had variouly sized and shaped, flat-topped, scaly, violaceous papules and plaques on the whole of his body. We confirmed the patients disease as lichen planus by a histopathologic examination of a skin biopsy specimen and gave him 500mg ultramicronized griseofulvin daily in divided dosages. After 12 weeks of the medication nearly all of the skin lesions were regressed, and by 14 weeks all skin lesions had disappeared leaving hyperpigmentation. Up to now, l9 months after discontinuation of the medication, no recurrence of the disease has been noted.
Adrenal Cortex Hormones ; Anti-Bacterial Agents ; Antimalarials ; Biopsy ; Cyclophosphamide ; Cyclosporine ; Dapsone ; Griseofulvin* ; Humans ; Hyperpigmentation ; Lichen Planus* ; Lichens* ; Male ; Methotrexate ; Middle Aged ; Recurrence ; Retinoids ; Skin

No abstract available.
Hyperlipoproteinemias*

Adherence of Candida albicans(C. albicans) to the surface of a denture is believed to be an initial and essential step in the formation of denture-induced stomatitis. Previous studies have provided enormous infomation on the relationship between composition of palatine gland/parotid saliva and upper denture stomatitis. Relatively little information is available on the correlation between lower denture stomatitis and sublingual-submandibular(SLSM) saliva. The plaque samples were collected from the two sites(100mm2) on the inner surface of lower partial denture corresponding to the stomatitis and healthy region of the lower partial dentures of 12 denture stomatitis patients and 6 normal persons who wore lower partial dentures. The samples were plated to isolate C. albicans on a selective Saboraud's dextrose agar plate and the isolates were identified by germ tube test and gram staining. The subjects were divided into group I (stomatitis with C. albican), group II (lesion without C. albicans), group III (no lesion but C. albicans), and group IV (normal and healthy denture wearer). Individual SLSM saliva (20microgram of protein) was analyzed by SDS-PAGE(SDS-poly-acrylamide gel electrophoresis) with Coomassie brilliant blue and PAS(Periodic Acid Schiff) staining. The salivary proteins separated in the polyacryamide gels were subjected to immunoblot analysis using anti-lactoferrin, anti-sIgA, and anti-secretory component of sIgA. In this study using custom made acrylic denture resin beads(5mm in diameter) coated with stimulated individual SLSM saliva, the binding ability of individual C. albicans strains to the beads was observed. Levels of C. albicans adhered to the acrylic resin beads were determined by measuring the optical density of the bound C. albicans to the beads at 580nm. The results showed that a higher number of C. albicans was observed in the lesion site than health site. The saliva of group I contained more high molecular weight glycoprotein(mucin, MG1) as compared to group II, III, and IV. And lactoferrin and sIgA affected to the binding ability of C. albicans to acylic resin beads. Binding ability of individual C. albicans to the acrylic resin coated with respective individual saliva was found to be greater in group I than the other 3 groups. And when bound cells of C. albicans isolated from individual subject #2 to the saliva coated beads were used, binding ability of subject #2 saliva coated beads was founed to be greater than the other subjects. These results suggested that denture induced stomatitis is related to individual patient's salivary protein composition, especially MG-1. Future studies will be directed toward saliva examination of patients who have general disease and analysis of pellicles formed on prosthesis with respect to oral disease.
Agar ; Candida albicans* ; Candida* ; Denture, Partial ; Dentures* ; Gels ; Glucose ; Glycoproteins* ; Humans ; Immunoglobulin A, Secretory ; Lactoferrin ; Molecular Weight ; Prostheses and Implants ; Saliva ; Salivary Proteins and Peptides ; Stomatitis ; Stomatitis, Denture*

There are some emergency situations when untested fresh blood should be transfused. Emergency blood donor tests(EBDT) have been done as an effort to protect these blood recipients from contracting transfusion associated infections in Seoul National University, Hospital. EBDT includes HBsAg, anti-HlV, STS, and ALT test. Anti-HCV test is not included because of the absence of appropriate test kit. A total of 534 tests have been done from June 1993 to August 1995. Among these, 495 tests(92.7%) have been done for blood donor screening, and 39 tests(7.3%) for emergency organ transplantation. Sensitivity and specificiy of the emergency HBsAg test were 69% and 98%, respectively. There were two RPR reactive blood donors, but no anti-HIV positive cases. Among 458 blood donors, 37 donors(8.1%) showed increased ALT level(> 45IU/L). The percent of agreement in HBsAg, elevated ALT and anti-HIV tests between emergent and routine blood donor tests, were 97.0%, 98.9% and 100%, respectively. Although false positive and false negative EBDT result may is useful, although limited, we think that EBDT is useful in protecting blood recipient from transfusion associated infections.
Blood Donors* ; Emergencies* ; Hepatitis B Surface Antigens ; Humans ; Mass Screening ; Organ Transplantation ; Seoul ; Transplants

As a material of metal-ceramic prosthesis, nickel as a form of Ni-Cr alloy has been used for many dental prostheses in many cases. However, several problems in use of the alloy have been revealed (ex ; tissue stimulation, skin allergy, hypersensitivity, cytotoxicity and carcinogenecity). Little is known about nickel with respect to the relationship between Ni-prosthesis and gaining of Ni-resistance in oral microorganisms. The present study was undertaken to check wheather use of Ni-prosthesis leads to occurrence of Ni-resistant microorganisms. So this study may suggest the possible relationships between the oral microorganisms and nickel-resistance in oral enviroment. Bacteria were isolated from the gingival crevicular fluid on the patients wearing Ni-Cr prosthesis. The isolated bacteria were tested for their Ni-resistance in nickel containing media at different concentration from 3mM to 110mM. E. coli HB101 was used as control. The Ni-resistant bacteria were isolated and biochemically identified. The Ni-resistant bacteria were tested several biochemical, molecular-biological tests. Performed tests were ; measuring the growth curve, antibiotic test, growth ability test in liquid media, isolation of the chromosome and plasmid, digestion of DNA by restriction enzyme, electrophoresis of chromosome and plasmid DNA, identification of Ni-resistant genes by the DNA hybridization. The results were as follows: 1) The bacteria isolated from gingival crevicular fluid on the patients wearing Ni-Cr alloy prosthesis showed nickel-resistance. 2) The isolated microorganisms grew at nickel containing media of high concentrations (60mM-110mM). 3) Based on the biochemical tests, the isolated microorganisms were identified as Enterococcus faecalis(13 cases), Klebsiella pneumoniae(1 case) and Enterobacter gergoviae(1 case). 4) Enterococcus faecalis expressed not only nickel resistance but also the multi-drug resistanceto several antibiotics ; chloramphenicol, kanamicin, streptomycin, lincomycin, clindamycin. However all strain showed the sensitivity against the tetracycline. 5) DNA hybridization result suggest that there is no homology between the previousely known gene of nickel resistance in Klebsiella pneumoniae and chromosomal DNA Enterococcus faecalis.
Alloys* ; Anti-Bacterial Agents ; Bacteria* ; Chloramphenicol ; Clindamycin ; Dental Prosthesis ; Digestion ; DNA ; Electrophoresis ; Enterobacter ; Enterococcus ; Enterococcus faecalis ; Gingival Crevicular Fluid* ; Humans ; Hypersensitivity ; Klebsiella ; Klebsiella pneumoniae ; Lincomycin ; Nickel ; Plasmids ; Prostheses and Implants* ; Skin ; Streptomycin ; Tetracycline

PURPOSE: This study was done to evaluate the predictive value of aspects of the Transtheoretical model (TTM) of behavior change as applied to smoking cessation in a rural population. METHOD: A convenience sample was recruited from a public health center in a community. A total of 484 participants were recruited, including 319 smokers, 116 ex-smokers and 49 non-smokers. A cross-sectional and descriptive design was used in this study. Data was analyzed using descriptive statistics, frequency statistics, ANOVA and Logistic regression. RESULT: The major findings were 1) The participants were assessed at baseline for their current Stage of Change resulting in a distribution with 42.1% in Precontemplation, 24.1% in Contemplation, 9.7% in Preparation, 6.2% in Active, and 17.9% in the Maintenance stage. 2) There were statistically significant differences of processes of change, decisional balance and situational temptation across the stages of change. 3) The main factors that affect smoking cessation were age, number of years smoking, age when began smoking, self-liberation and negative/affective situations, which combined explained 33.2% of the smoking cessation. CONCLUSION: TTM variables measured prior to a smoking cessation program added little predictive value for cessation outcome beyond that explained by demographic and smoking history variables.
Tobacco Use Disorder/psychology/rehabilitation ; Smoking Cessation/*psychology ; Rural Population ; *Models, Psychological ; Middle Aged ; Male ; Korea ; Humans ; Female ; Aged ; Adult