Illness is a situational crisis which affects entire family members. Children have different experiences and responses when their sibling has a cancer. There are many studies on sibling experiences to childhood cancer which have many problems in the USA. The main purpose of this study is to describe sibling experiences to childhood cancer accurately and coprehensively by collecting data from sibling to provide the data to develop nursing interventions for the families with childhood cancer. The data was collected from October 1 to November 6, 1995. A total of ten siblings with childhood cancer were interviewed. The meaningful contents were classified and categorized to four areas. Theses areas include knowledge and perception related to illness, changes in family life, changes in school life, and siblings' marturation. The results of this study were as follows : 1. Knowledge and perception related to childhood cancer : Children had limited knowledge about illness and expressed the desire to know more about sibling's illness. 2. Changes in family and school life : Children expressed loneness, emptiness, sadness, depression about separation with the mother and sibling, family mood change, leisure activities and financial difficulties. Many children reported that their school performance had suffered since sibling's illness. 3. Maturation of children : Some positive outcomes related to having a sibling with a cancer are maturation, increased affection for the sibling, empathy for their parents. The results of this study indicate that it is important to develop comprehensive nursing intervention programs for the families with a childhood cancer.
Child* ; Depression ; Empathy ; Humans ; Leisure Activities ; Mothers ; Nursing ; Parents ; Siblings* ; Child Health

Variable methods have been using for reconstruction of soft tissue defect of feet and legs. Skin graft, local flap, and free flap have been using for this purpose. But, skin graft produced secondary contracture of recipient site and increased in donor site scarring. Local flap was limited its donor site and remained severe deformities of recipient site. Free flap was required prolonged operation time and secondary operation. Acelluar human dermal allograft, AlloDerm, was removed cellular elements of the epidermis and dermis. It was relatively immunologically inert. From August 1997 to April 1998, we have grafted acellular human dermal allograft with thin split-thickness skin graft on soft tissue defect of feet and legs in 7 cases. We concluded that cryopreserved acelluar human dermal allograft has been proposed as the solution to problems of skin graft, local flap, and free flap.
Allografts ; Cicatrix ; Congenital Abnormalities ; Contracture ; Dermis ; Epidermis ; Foot* ; Free Tissue Flaps ; Humans ; Leg* ; Skin ; Tissue Donors ; Transplants

PURPOSE: This study was conducted to test the reliability and validity of Family Burden Questionnaire. METHOD: The subjects were 156 caregivers of children with acute or chronic disease. To test the reliability, internal consistency using Cronbach's alpha coefficient was analyzed, and factor analysis, known-group technique, and concurrent validity were utilized for validity test. RESULT: Cronbach's alpha coefficient of the tool was .89. Six factors were identified and explained 58.7% of the total variance. Through analysis using known-group technique, the difference of family burden between acute and chronic disease groups was statistically significant(t= -4.09, p <.001). Correlations with mood state, other family burden score by Family Burden Interview Schedule, quality of life, and health symptoms were also relatively high and statistically significant. CONCLUSION: Family Burden Questionnaire showed a relatively high validity and reliability to measure the burden of caregivers caring patients with various chronic conditions in Korea. For the further study, it may be reconsidered to identify the factor structure of the Family Burden Questionnaire with the various subjects from different age groups.
Appointments and Schedules ; Caregivers ; Child ; Chronic Disease ; Humans ; Korea ; Quality of Life ; Reproducibility of Results* ; Child Health ; Surveys and Questionnaires

Pneumosinus Dilatans consists of an abnormal dilatation of the paranasal sinuses which contain air only and lined by normal mucosa. It is a rare condition, the etiology of which is unclear. A 16 year old male complained frontal bossing which developed slowly. Simple X-ray and CT showed abnormal distension of frontal sinus. Another 19 year old male complained slowly growing left cheek mass. Simple X-ray and CT showed abnormal distension of anteromedial wall of maxillary sinus. In view of the cosmetic appearance, operations were performed. Distended sinuses walls were removed and reconstructed using Medpore(R). I report 2 cases of pneumosinus dilatans which developed in frontal and maxillary sinuses and the literature reviewed.
Cheek ; Cosmetics ; Dilatation ; Frontal Sinus ; Humans ; Male ; Maxillary Sinus ; Mucous Membrane ; Paranasal Sinuses

This study was done to recognize the importance of errors in measurements of cephalometric radiograph and to find the anatomical structures those need special care to select as a reference points through the detection of the systematic errors and estimation of random errors. For this purose, 100 cephalometric radiographs were prepared by usual manner and 61 reference points, and 130 measurement variables were established. Measurement errors were detected and estimated by the comparison of the 25 randomly-selected samples for repeated measurements with the main sample. The following results were obtained: 1. In comparison of the repeated measurements, there were statistical significant differences in 24 variables which were 18.4% of 130 total variables. 2. The frequency of the difference in identification of the reference points between the repeated measurements was very high in the root apex of upper incisor(as), the most posterior wall of maxilla(tu), soft tissue nasion(n'), soft tissue frontal eminence(ft), and adl in airway. 3. After correction of reference points marking until the level of below 59,6 significance, the range of random errors were from 0.67 to 1.71 degree or mm. 4. The variable shown the largest random error was the intenncisal angle(ILs-lLi). 5. Measurement errors were mainly caused by the lack of precision in anatomic definitions and obscure radiographic image. From the above results, the author could find the high possibility of errors in cephalometric measurements and from this point, we should include error analysis in all the studies concerning measurments. In is essential to have a concept of error analysis not only for the investigator but also for a reader of other articles.
Activities of Daily Living ; Humans ; Research Personnel

Basal cell nevus syndrome (BCNS), also known as basal cell carcinoma nevus syndrome, Gorlin syndrome, Gorlin-Goltz syndrome, and nevoid basal cell carcinoma, is a rare autosomal dominant disorder with a prevalence of approximately 1/60,000. A lower prevalence rate of 1/13,939,393 has also been reported in Korea. We report the case of a 40-year-old male patient with multiple black pigmented macules on the face that first appeared when he was a teenager. His clinical features of jaw cysts, bifid ribs, and calcification of the falx cerebri were fitting within the criteria for the diagnosis of BCNS. We excised all suspected macules and sent permanent biopsy. Most of the histological examinations of the biopsy samples taken during surgical excision of the face masses showed basal cell carcinomas. Ten months after the surgery, the patient has remained free from symptoms and is undergoing follow-up observation.

Basal cell nevus syndrome (BCNS), also known as basal cell carcinoma nevus syndrome, Gorlin syndrome, Gorlin-Goltz syndrome, and nevoid basal cell carcinoma, is a rare autosomal dominant disorder with a prevalence of approximately 1/60,000. A lower prevalence rate of 1/13,939,393 has also been reported in Korea. We report the case of a 40-year-old male patient with multiple black pigmented macules on the face that first appeared when he was a teenager. His clinical features of jaw cysts, bifid ribs, and calcification of the falx cerebri were fitting within the criteria for the diagnosis of BCNS. We excised all suspected macules and sent permanent biopsy. Most of the histological examinations of the biopsy samples taken during surgical excision of the face masses showed basal cell carcinomas. Ten months after the surgery, the patient has remained free from symptoms and is undergoing follow-up observation.

PURPOSE: Surgical site infections(SSIs) are the third most frequently reported nosocomial infection. Of these SSIs, mostly were confined to the incision associated with underlying disease as diabetes, cigarette smoking, systemic steroid use, obesity, operating room environment, suture and surgical technique. This study has been planned to reduce the SSIs by using Vicryl plus(R)(Ethicon, USA) which contains triclosan, a broad-spectrum antibacterial agent, into the infected wound to evaluate whether or not Vicryl plus(R)(Ethicon, USA) is effective to nosocomial bacteria using a zone of inhibition assay. METHODS: We did a comparison of Vicryl plus(R) suture(with triclosan) size 2-0, 5-0 with Vicryl(R) suture(without triclosan) size 4-0 each as treatment and control group, applied in Mueller-Hinton agar infected by following mircroorganisms: Methicillin-sensitive Staphylococcus aureus (MSSA), Methicillin-resistant Staphylococcus aureus (MRSA), Acinetobacter baumanii, Escherichia coli, Enterobacter faecalis, Pseudomonas aeruginosa, Candida albicans. Cultures were made of the selected mircroorganisms, seeding the study strain in agar plates for 24 and 48-hour period in an oven at 37degrees C followed by zone of inhibition assay. RESULTS: Vicryl plus(R) group has demonstrated to create a zone of inhibition against MRSA, MSSA and A. baumanii, but no effect on E. faecalis, P. aeruginosa, C. albicans. Vicryl plus(TM) suture size 2-0 also had antibactericidal effect while Vicryl plus(R) suture size 5-0 did not. Vicryl(R) group had no zones of inhibition showing colonization at all mircroorganisms. CONCLUSION: Our results seem to warrant the use of Vicryl plus(R) as absorbable buried suture when concerning SSIs as a prophylaxis against surgical nosocomial infection.
Acinetobacter ; Agar ; Bacteria ; Candida albicans ; Colon ; Cross Infection ; Enterobacter ; Escherichia coli ; Methicillin-Resistant Staphylococcus aureus ; Obesity ; Operating Rooms ; Polyglactin 910 ; Pseudomonas aeruginosa ; Seeds ; Smoking ; Sprains and Strains ; Staphylococcus aureus ; Sutures ; Triclosan

PURPOSE: Cleidocranial dysostosis is a rare hereditary disorder affecting bones that develop by intramembranous formation. The typical features include excessive growth of transverse diameter of the skull, hypoplastic clavicles, low height and characteristic facial features. METHODS: A 28-year-old female patient visited by frontal area depression. The diagnosis was performed by computed tomographic study and radiographic imaging. The patient had widely opened anterior fontanelle, partial fused metopic suture, multiple wormian bone and supernumenary impacted teeth. Under the coronal incision, we exposed depressed frontal area and corrected with Medpor block carving. RESULTS: Postoperatively frontoparietal skull was aestheticlly improved and satisfied the patient. CONCLUSION: Authors report a case of cleiodocranial dysostosis who underwent correction of abnormal skull shape by Medpor(R) insertion.
Adult ; Clavicle ; Cleidocranial Dysplasia ; Cranial Fontanelles ; Depression ; Dysostoses ; Female ; Frontal Bone ; Humans ; Polyethylenes ; Skull ; Sutures ; Tooth, Impacted

PURPOSE: Dandy-Walker syndrome is a rare congenital brain malformation that occurs one in every 25,000-35,000 live births, mostly in females. It is characterized by cystic enlargement of the fourth ventricle, agenesis or hypogenesis of the cerebellar vermis and enlargement of the posterior fossa. In this report, the authors aimed to address a rare case of a 14-months-old female Dandy-Walker syndrome patient that is presented with submucous cleft palate. METHODS: A 14-months-old female patient admitted to our outpatient clinic, via the department of pediatrics, with the complaints of nasal regurgitation, choking and breathing difficulties. She was diagnosed as Dandy-Walker syndrome by magnetic resonance imaging evaluation, at another hospital and underwent a shunt operation for the hydrocephalus continuing treatments. On physical examination, she had structural abnormality of bifid uvula, and palpable notch in the posterior surface of the hard palate. Her submucous cleft palate was corrected, which used a double opposing Z-plasty under general anesthesia. RESULTS: In a follow-up period of 2 months, no complications, such as wound dehiscence, necrosis and infection occurred, which shows satisfactory results. She consulted with pediatric neurologists and physical therapists for further evaluation and management of the abnormalities in the central nervous system. CONCLUSION: Dandy-Walker syndrome patient with a cleft palate is a very rare case to find, which only a few cases are reported around the world. Authors would like to share this case of Dandy-Walker syndrome patient, with submucous cleft palate, who underwent a double opposing Z-plasty that shows satisfactory results.
Airway Obstruction ; Ambulatory Care Facilities ; Brain ; Cleft Palate ; Dandy-Walker Syndrome ; Female ; Follow-Up Studies ; Fourth Ventricle ; Humans ; Hydrocephalus ; Live Birth ; Magnetic Resonance Imaging ; Necrosis ; Palate, Hard ; Pediatrics ; Physical Examination ; Physical Therapists ; Respiration ; Uvula