PURPOSE: The purpose of this study was to explore the experiences of young adults with hypertension, using phenomenology in order to describe the essence of such experiences and to understand them from the patients' point of view. METHODS: Participants in this study were 4 hypertension patients with ages ranging from 20 to 35 years old, living in Seoul city. Data were collected from in-depth interviews done from October to November in 2005. Colazzi method(1978) was used to analyze the data. RESULTS: The 12 themes were extracted in this study ; 'Discovery by accident', 'Denial of the diagnosis', 'A disease unworthy of the young men', 'Guilty feeling toward their parents', 'Fear of death', 'Unconvinced reason', 'Worry about the future', 'Attribute all symptoms to the disease', 'Will of not life-long medication', 'Concern for fertility problem', 'Not convinced with current treatment method', 'Becoming unimportant'. CONCLUSION: The results of this study show that the young adult with hypertension will be in a high risk group of non compliance, so helpful program for them should be developed and the nurses need to pay more attention to the psychosocial aspect of nursing.
Adult ; Compliance ; Fertility ; Humans ; Hypertension* ; Nursing ; Qualitative Research ; Seoul ; Young Adult*

PURPOSE: The prognosis of non-Hodgkins lymphoma (NHL) in elderly patients seems to be poorer than that in patients aged less than 60 years. This may be due to the lower tolerance for combination chemotherapy in the elderly. Aggressive combination chemo-therapy, which is the treatment of choice in intermediate and high grade NHL of adulthood, may be associated with unpredictab1y severe and lethal toxicity and worsened quality of life in the elderly. We investigated the treatment responses, toxicities and prognostic factors of NHL in elderly patients treated with combination chemotherapy. MATERIALS AND METHODS: We treated 116 elderly (>60 yrs) patients with NHL between January 1986 and June 1996 with adriamycin-containing regimens, such as CHOP (cyclo- phosphamide, adriamycin, vincristine, prednisolone), BACOP (bleomycin, adriamycin, cyclophosphamide, vincristine, prednisolone), and mBACOP (methotrexate, bleomycin, adriamycin, cyclophosphamide, vincristine, prednisolone). Patients in this study ranged from 60 to 81 (median 67) years of age. Fifty-five percent of patients were in stage I or II and the rest (45%) were in stage III or IV. The histologic grade was predominantly (91%) of intermediate and high grade type. RESULTS: The treatment responses were complete (CR) in 55% and partial (PR) in 25%. The median durstion of CR was 32 (3-132) months. The CR rate was significantly higher in patients treated with RDI (relative dose intensity) > 75% than that in the patients treated with RDI < 75% (p 0.003), but there was no significant difference in CR rate between treatment regimens (p-0.38). At a median follow up of 48-months (range, 12 to 132 months), the estimated 5-year ovetall survival was 46%. Ann Arbor Stage (I, II vs III, IV), ECOG performance (0-1 vs 2-3), RDI (>75% vs <75%) and the treatment response were important prognostic factors in the univariate analysis, and the treament response (CR vs non-CR) was the only independent prognostic parameter in the multivariate analysis. The most frequent and severe toxicity associated with chemotherapy was infection with or without neutropenia. The rate of severe infection was significantly decreased in the patients supported with G/GM-CSF but not in the dose-reduction group (RDI<75% vs >75%). CONCLUSION: Our data suggests that achievement of the CR after combination chemotherpy is the most important prognostic factor in the elderly patients with NHL. Suboptimal chemotherapy (RDI<75%) reduced the complete remission rate without reducing the likelihood of developing severe toxicities. Optimal chemotherapy with supportive cares involving the use of hematopoietic growth factors may be needed to improve the treatment response and the survival in the elderly patients with aggressive NHL.
Aged ; Bleomycin ; Cyclophosphamide ; Dimethoate ; Doxorubicin ; Drug Therapy ; Drug Therapy, Combination ; Follow-Up Studies ; Hodgkin Disease* ; Humans ; Intercellular Signaling Peptides and Proteins ; Lymphoma, Non-Hodgkin ; Multivariate Analysis ; Neutropenia ; Prognosis* ; Quality of Life ; Vincristine

No abstract available.
Pancreatic Neoplasms

Rheumatoid nodules are the most common extra-articular presentations of rheumatoid arthritis. Although rheumatoid nodules can develop anywhere in the body, they develop most commonly in the subcutaneous region, where they are easily exposed to repetitive trauma or pressure. However, an infrascapular presentation has not yet been reported. We report a case of giant bilateral rheumatoid nodules that developed in the infrascapular area, complicating its distinction from elastofibroma dorsi on radiological examination.

Lymphangioma circumscriptum is a benign disorder of lymphatic channels. The pathologic findings consist of a collection of deep, sequestered subcutaneous lymphatic cisterns which are encircled by smooth muscle. The lymphatic cisterns are communicating with superficial clusters of vesicles through dilated lymphatic channels. The etiology of this lesion is unclear ; however, lymphatic obstruction has been suggested as a possible cause. It is characterized clinically by grouped vesicles, some of which may be filled with serosanguinous fluid. It is an unpleasant, but benign condition conventionally managed by wide local excision, which provides symptom control and often prevents recurrence. Neither long term complication nor association with squamous cell carcinoma has been previously documented. Some cases were reported following mastectomy and radiation therapy or radiation therapy for squamous cell carcinoma of the cervix. We present a 17-year-old patient with lymphangioma circumscriptum developed on buccal mucosa, which developed 3 months after innervated serratus anterior muscle free flap for functional reconstruction of cheek. We suppose that it was caused not only by lymphatic blockage resulted from wide operation but also by chronic masticating local irritation. In review of literatures, we didn't have found any report of lymphangioma circumscriptum developed on buccal mucosa.
Adolescent ; Carcinoma, Squamous Cell ; Cervix Uteri ; Cheek ; Female ; Free Tissue Flaps ; Humans ; Lymphangioma* ; Mastectomy ; Mouth Mucosa* ; Muscle, Smooth ; Recurrence

Lymphangioma circumscriptum is a benign disorder of lymphatic channels. The pathologic findings consist of a collection of deep, sequestered subcutaneous lymphatic cisterns which are encircled by smooth muscle. The lymphatic cisterns are communicating with superficial clusters of vesicles through dilated lymphatic channels. The etiology of this lesion is unclear ; however, lymphatic obstruction has been suggested as a possible cause. It is characterized clinically by grouped vesicles, some of which may be filled with serosanguinous fluid. It is an unpleasant, but benign condition conventionally managed by wide local excision, which provides symptom control and often prevents recurrence. Neither long term complication nor association with squamous cell carcinoma has been previously documented. Some cases were reported following mastectomy and radiation therapy or radiation therapy for squamous cell carcinoma of the cervix. We present a 17-year-old patient with lymphangioma circumscriptum developed on buccal mucosa, which developed 3 months after innervated serratus anterior muscle free flap for functional reconstruction of cheek. We suppose that it was caused not only by lymphatic blockage resulted from wide operation but also by chronic masticating local irritation. In review of literatures, we didn't have found any report of lymphangioma circumscriptum developed on buccal mucosa.
Adolescent ; Carcinoma, Squamous Cell ; Cervix Uteri ; Cheek ; Female ; Free Tissue Flaps ; Humans ; Lymphangioma* ; Mastectomy ; Mouth Mucosa* ; Muscle, Smooth ; Recurrence

Aneurysms of the ascending aorta are relatively uncommon disorders which are located in ascending portion of the thoracic aorta. The commenest cause of aneurysms of the ascending aorta is arteriosclerosis, but syphilis, marfan syndrome, cystic medial necrosis, trauma, and aging of the aorta must also be noted as causes. We report a case with a aneurysm of the ascending aorta, 23 years old female, who was performed the open heart surgery because of ventricular septal defect with aortic insufficiency about 10 years ago.
Aging ; Aneurysm* ; Aorta* ; Aorta, Thoracic ; Arteriosclerosis ; Female ; Heart Septal Defects, Ventricular ; Heart* ; Humans ; Marfan Syndrome ; Necrosis ; Syphilis ; Thoracic Surgery* ; Young Adult

Chemistry, Clinical ; Diagnostic Tests, Routine ; Hemoglobin A, Glycosylated ; Humans

Gastric schwannoma is a very rare gastrointestinal mesenchymal tumor. Schwannoma in the gastrointestinal tract is usually not symptomatic, and preoperative abdominal CT or endoscopic evaluation cannot distinguish it from gastrointestinal stromal tumor. Surgical resection of this tumor is adequate to achieve a good prognosis. We performed laparoscopic gastric wedge resection in two patients who had the preoperative diagnosis of gastric gastrointestinal stromal tumor. In both cases, the postoperative immunohistochemistry staining was positive for S-100 protein and it was negative for CD34, which is consistent with gastric schwannoma. We report here on two cases of gastric schwannoma along with a review of the literatures.
Diagnosis ; Gastrointestinal Stromal Tumors ; Gastrointestinal Tract ; Humans ; Immunohistochemistry ; Laparoscopy* ; Neurilemmoma* ; Prognosis ; S100 Proteins ; Tomography, X-Ray Computed

No abstract available.
Osteoblasts* ; Treponema denticola* ; Treponema*