The concept of caring as the core value of nursing has been widely explored in many researchers. However, a clear conceptualization of what caring in nursing does not yet exist. The purpose of this study is to examine the attributes of caring by content analysis of journaling and to provide basic information for developing the theory of caring and teaching the humanism centered education. The study design was descriptive survey design. Data was colleged 82 cases of journaling which came from 26 junior and 30 senior nursing students from Oct. 1995 to June 1996. The collected data were analyzed using the content analysis by Ko, and et als.(1989) and Polit & Hngler(1987). To improve the validity two researchers examined the significant statements extracted from original contents. The results are as follows: The emphasized contents clusters of caring were 12 categories- , , , , , , , , , , , . , elements of the caring emerged new attributes of caring and the <> element of the caring was mentioned with high frequency as strongest element. The emphasized contents clusters of non caring were 9 categories - , , , , , , , , .
Education ; Humanism ; Humans ; Nursing* ; Students, Nursing*

Although many approaches have been attempted in the evaluation of liver size such as measurement of length,area and volume, the linear measurements have been used most frequently because of simplicity. We measured theliver size using 4 linear measurements for evaluation of hepatic pliability on plain abdominal film in the erectand the supine position. Our cases consisted of 125 persons who have no symptom or signs clinically and havenormal liver function test. The results were as follows: 1. The measurements of the liver size using diagonaldiameter(DD), oblique diameter of right lobe(OD), midline vertical diameter(MD) and height of right dome of theliver(HD) were ; 19.6+-1.8cm, 13.7+-1.6cm, 2.03+-0.4cm in the supine position; and 20.5+-2.1cm, 21.9+-2.1cm,15.4+-2.1cm, 1.87+-0.4cm in the erect position, respectively. 2. The differences of each diameter between erectand supine position were 0.9+-1.0cm in DD, 0.9+-1.0cm in OD and 1.7+-1.4cm in MD, and they were longer in thesupine position (p<0.001). 3. The HD was slinghtly longer in the supine position than in the erect position(p<0.001). 4. Among the 4 measurements, the largest difference of linear diameter between the erect and the supineposition was by MD. 5. We found the change or size and shape of the normal liver in the different position.
Humans ; Liver ; Liver Function Tests ; Pliability ; Supine Position

Bronchiolitis obliterans is a distinct pathologic entity, characterized by the accumulation of pigmented macrophages within respiratory bronchioles and adjacent to air spaces, and thickening of the peribronchial interstitium. It has been reported to be associated with viral infection, drug, toxic fume, bone marrow transplantation, and connective tissue disorders such as rheumatoid arthritis. The etiology of bronchiolitis obliterans in the post-renal transplantation state is not yet clear, although several possibilities such as drug toxicity, graft-versus-host disease or postinfectious condition have been postulated. We presented three patient who had bronchiolitis obliterans, as a complication following renal transplantation. Chest radiograph showed bilateral perihilar reticular infiltration or ground glass appearances that progressed to either diffuse alveolar consolidations or solitary nodule. The main finding in each lung biopsy was the presence of macrophages within respiratory bronchioles as well as in the neighboring alveolar ducts and alveoli. Alveolar septa in these areas often showed nonspecific thickening by fibrosis, mild chronic inflammatory cell infiltrate, and hyperplasia of alveolar lining cells and type II pneumocytes.
Arthritis, Rheumatoid ; Biopsy ; Bone Marrow Transplantation ; Bronchioles ; Bronchiolitis Obliterans* ; Bronchiolitis* ; Connective Tissue ; Drug-Related Side Effects and Adverse Reactions ; Fibrosis ; Glass ; Graft vs Host Disease ; Humans ; Hyperplasia ; Kidney Transplantation ; Lung ; Macrophages ; Pneumocytes ; Radiography, Thoracic

The trachea is a cartilagenous and membranous tubular midline structure with parallel walls. Tracheal deviation may be caused either by traction toward the diseased hemithorax or by compression toward the normal side. Unless an obvious mass is observed radiographically, occasionally it can be difficult to decide whether the trachea has been pushed or pulled from its normal position in the mediastinum. We studied the differences between tracheal deviation patterns in 23 patients with fibroatelectatic pulmonary tuberculosis and 35 patients with elongated and dilated aortas. In cases of retraction of the trachea by fibroatelectatic pulmonary tuberculosis, the diameter of the deviated segment was greater than that of the normal segment and deviation of the wall adjacent to the fibroatelectasis from its normal position was greater than that of the opposite wall. In cases of compression of the trachea by the elongated and dilated aorta, the diameter of the diviated segment was smaller than that of the normal segment and deviation of the wall adjacent to the aortic arch from its normal position was greater than that of the opposite wall. We conclude that these differences between tracheal deviation patterns are useful signs for discriminating retraction from compression. Thus when the trachea is retracted, the deviation of the juxtalesional wall is greater than that of the lesion-free wall, and vice versa.
Aorta ; Aorta, Thoracic ; Diagnosis, Differential* ; Humans ; Mediastinum ; Trachea* ; Traction* ; Tuberculosis, Pulmonary

PURPOSE: This study is to examine how dementia day care service affects fatigue, depression and life satisfaction of caregiver. METHODS: The study was conducted using a convenient sampling method from 6 Dementia Day Care Center in Incheon. Thirty nine primary caregivers answered the questionnaires. Pre-test was done before demented elders start using the dementia day care center and post-test was done five months after. Data were analyzed by using descriptive statistics and paired t-test. RESULTS: There was a significant difference in caregivers' fatigue level after using dementia day care service(t=2.188, p=.035). Results of subcategories were as follows; There was a significant difference in caregivers' physical fatigue level(t=2.270, p=.029) and psychological fatigue level(t=2.277, p=.029) after using dementia day care service. However, there was not significant difference in caregivers' neurological fatigue level(t=1.312, p=.197). There was a significant difference in caregivers' depression level(t=3.066, p=.004) and life satisfaction(t=-2.131, p=.040) after using dementia day care service. CONCLUSION: The results indicated that dementia day care service is helpful for family with demented elders. Therefore it is necessary to expand dementia day care center in terms of its size and numbers in order to support increasing number of demented elders and their families.
Caregivers ; Day Care, Medical ; Dementia ; Depression ; Fatigue ; Humans ; Surveys and Questionnaires

No abstract available.
Otitis Media* ; Otitis*

Disparity among cholangiograms is rarely observed. The causes of disparity include spontaneous disappearance of gall stone, incomplete filling of smaller branch, technical problems, interpretative errors, and overriding of evidence. 5pontaneous disappearance of gall stone is rare but has been well documented in both radioligic and clinical literatures. Recently we have experienced spontaneous disappearance of a large stone in the common bile duct and this formsthe basis of the present case report. The patient, 53-year-old female, was admitted on January 18, 1982 to 5t. Mary's Hospital, Catholic Medical College because of repeated episodes of pain in the epigastrium and the right upper quadrant for the past 2 months. On admission, physical examination revealed tenderness in the epigastrium and the right μpper quadrant. Laboratory tests revealed bilirubin 2.2 mgfdl and alkaline phosphatase 76 .5 KA/dl. A percutaneous transhepatic cholagiogram(PTC} performed 2 days later revealed a large stone measuring 16 × 26mm in size in the distal CBD. The CBD and CHD proximal to the stone were moderately dilated. Most of the intrahepatic ducts were well delineated without fi lJ ing defect or evidence of stone. However, the in ferior segment of the posterior branch of the right intrahepatic duct (IPRH) was not delineated. The ending of the nonvisualized segment was rather abrupt. The patient suffered severe abdominal pain 2 days after PTC, and was treated with Buscopanø compositum. The attack ceased 20 hours after the onset of colicky abdominal pain. An operation was performed 4 days after PTC. To our surprise there was no stone in the distal CBD. The gallbladder was resected and a T-tube has been placed. A table cholangiogram confirmed disappearance of the stone, but IPRH was agin not opacified except for a short ditance just after bifurcation from the main branch. Eight days after surgery a follow-up T-tube cholangiogram was performed. No residual stone was found in the extrahepatic bile duct. However, IPRH which was not opacifled until then became distinctly visualized demonstrating multiple intra-ductal radiolucent stones, There was a diaphragm-like structure obstructing the lumen and confining the stones located proximally to the site obstructed in the precedent cholangiograms, The radiologic and clinical importances of our observation in this case are four fold: 1. Gall stone up to the diameter of 14 × 23mm can pass through the papilla spontaneously, 2. Repeat diagnostic imaging is imperative when patient became asymptomatic after severe colicky abdominal pain before the intended operation, 3. Without optimal delineation of intrahepatic biliaη radicles, residual stone or stones cannot be exciuded in the cholangiograms, 4. And finally, to avoid misdiagnosis a comprehensive knowledge of normal anatomy of cholangiogram is required.
Abdominal Pain ; Alkaline Phosphatase ; Bile Ducts, Extrahepatic ; Bilirubin ; Common Bile Duct ; Diagnostic Errors ; Diagnostic Imaging ; Diaphragm ; Female ; Follow-Up Studies ; Gallbladder ; Gallstones ; Humans ; Middle Aged ; Physical Examination

After a lobectomy the apearance of the chest roentgenogram may return so nearly to normal that it isfrequently very difficult to tell which lobe has been moved without refering to the thoracic surgeon's record. Thereriew of literature failed to disclose previous articles concerning the differential diagnosis between upper andlower lobectomy. Clues of a lobectomy may be found in the rib cage, hilar shadows, pleura and disphragms, but they do not specifically incidate which lobe has been removed. In the present study we anlaysed anatomico-spatialchanges of the pulmonary basal arteries, hilar point, vascular redistribution, diaphragm and rib cage on the plainchest films taken before and after a lobectomy in 33 cases seen at the Dept. of Radiology, St. Mary's Hospoital, Catholic Medical College. Firstly we observed the pulmonary basal artery after a lobectomy on plain chest film. In 12 cases of upper lobectomy the pulmonary basal artery was easily identified in every case. However in all of 21cases of lower lobectomy, the pulmonary basal artery was not identified. Next, a shift of the hilar point waschecked after a lobectomy. Regarding to vascular redistribution, the blood vessels was counted at upper and lowerlung fields by simon's method before and after a lobectomy, respectively. Finally, the level of the diaphragm wascompared in the pre. and post-opeative films and resected rib was scrutinized. The present study revealed that themost reliable sign to indicate specifically which lobe has been resected is persistence or disappearance of thepulmonary basal artery. Then i.e. in upper lobectomy the pulmonary basal artery was easily identified, but inlower lobectomy the pulmoanry basal artery was not dectable. Other findings such as vascular redistribution,elevated diaphragm and resected rib were not specific.
Arteries ; Blood Vessels ; Diagnosis, Differential ; Diaphragm ; Methods ; Pleura ; Ribs ; Thorax

Multiple small air bubbles were introduced into the gallbladder (GB) during the endoscopic retrogradecholangio-pancreatography(ERCP). Prolonged appearance of movable small round filling defects in the GB weredetected for more than 18 hours in the GB. The importance of delayed GB films after ERCP and the differentiationbetween the stones and air bubbles are discussed.
Cholangiopancreatography, Endoscopic Retrograde ; Gallbladder

A 69-year-old man was admitted to the hospital because of flu-like symptoms and fatigue for 2 weeks. Computed tomography revealed ground glass opacity and consolidation in both the lungs as well as pleural effusion. The patient was diagnosed with pneumonia and was hospitalized. At the time of hospitalization, he complained of shortness of breath and coughed-up blood-tinged sputum. Two days after admission, he died suddenly. An autopsy was performed; cardiomegaly was noted, and further examination revealed that the aortic valve had been destroyed by multiple, irregular vegetations. Herein, we report an autopsy case of infective endocarditis with a review of the relevant literatures.
Aged ; Aortic Valve ; Autopsy* ; Cardiomegaly ; Dyspnea ; Endocarditis* ; Fatigue ; Glass ; Hospitalization ; Humans ; Lung ; Pleural Effusion ; Pneumonia ; Sputum