A Study of Validity and Reliability of a Spiritual Health Inventory (SHI) for Korean Patients with Cancer / 성인간호학회지

Spiritual health is an important indicator in the quality of life of patients with cancer. The purpose of this study was to validate a Spiritual Health Inventory (SHI) for patients with cancer developed by Highfield (1989). The SHI was translated into Korean, back-translated into English. The study sample was 96 patients with cancer. The data were collected from September, 1999 to February, 2000 for 6 months. Statistic analysis was done with the SPSS PC+ (Version 10.0) program: descriptive statistics, factor analysis, Pearson correlation coefficient, and one-way ANOVA. The results are as follows: 1. The reliability score was examined using Cronbach's alpha and found to be .79. 2. Construct validity was examined using factor analysis. Four factors were identified and named: Peace of mind (19.1% of variance), Hope (9.7%), Self-esteem (6.4%), Trust (6.0%). The total of 41.2 percent of the variance. 3. The Pearson correlation coefficient score of 4 factors was between r = .24~ .42. 4. SHI was identified as multidimension, that is The relationship with GOD, as absolute being, the relationship with others, the relationship within oneself. 5. There were differences in response in items especially related to GOD. The following recommendations can be made on the above findings: 1. Replicate with a minimum sample of 150 and test for concurrent validity. 2. Since spirituality is a dynamic concept, longitudinal study is also necessary. 3. Concept analysis using a qualitative study based on religious preference is recommended. 4. The items such as 12, 13, 15, 17, 19, 22, 24, 26 indicated conceptual ambiguity for Korean populations and further study is needed on item deletion or new items.

Comparison of the Costs of Care and Nursing Services for Terminally Ill Patients Receiving Home Hospice Care in Comparison to Institutional Care / 간호학회지

As cost pressures have escalated, policy makers, politicians, health care providers and families have tried to devise ways to reduce health care costs. While originally developed to enhance patient control and to provide better care at the end of life, hospice care has recently received significant attention as a mean of reducing health care costs. As a program providing care for patients who are dying at their homes, hospice has expanded slowly since the opening of the first hospice in Korea in 1963. Therefore, a variety of services that responds to the needs and concerns of many dying people and their families is limited The purpose of this study was to determine the potential cost savings at the end of life among patients who used home hospice compared with the patients who received institutional care in Korea. This study used a retrospective, descriptive design. The sample for this study included 46 patients who died of lung cancer: 25 patients who received home hospice care and 21 patients who received institutional care. Data on patient characteristics, kinds and frequencies of provided treatment and nursing services, and hospice and hospital charges during the last month before death were collected. Cost of care was measured by the average cost per patient per day in the last month of life. The results of the study indicated that there were significant differences in average cost of care between home hospice sample and institutional care sample (t=9.956, p<.001; home hospice sample: M=18,102 won, institutional care sample: M=317,578 won). The cost of the home hospice sample was approximately 6% of the cost of institutional care. The majority of the home hospice nursing services were education (35.7%) and supportive counseling (25.2%), followed by medication management (13.6%), assessment (12.1%), basic nursing (7.2%), treatment (5.5%) and others. In institutional care sample, basic nursing and treatment were more emphasized than education or supportive counseling among the nursing services provided. The results of this study showed the potential for hospice to reduce costs and implications for policymakers and clinicians to incorporate hospice program into the formal health care delivery system in Korea.

A Statisitical survey of Skin Tumors / 대한피부과학회지

The 447 cases of skin tumors were studied at the departments of dermatology and surgical pathology, National Medical Center in Seoul during the period of 18 years and 8 months from January, 1959 to August, 1977. The results were as follows: 1) the total number of specimens surveyed in the study was 447, among which benign tumors accoungted for 234 cases and malignant tumors for 213. 2) Male to female ratio for benign tumors was 1.2:1 and for malignant tumors 2.2:1. 3) Among the 234 cases of benign tumors, 67 cases were epidermal cyst. 53 cases of hemangioma and 34 cases of pigmented neni. 4) Among the 2 cases of malignant melanoma. 5) The peak age incidence for benign tumors were below the 2nd decade, The peak ago incidence for malignant tumors were 50th decade. 6) the sites of predilection of the epidermal cysts were trunk, face and neck. The sites of predilection of the hemangiomas and pigmented nevi were face. 7) The sites of peredilection of the squamaous cell carcinomas were penis(27.1%), lower extremities(25.7%) and face(21.5%) The sites of predilection of the basal cell carcinomas were face(83.3%) 8) The ratio of squamous cell carcinoma ws basal cell careinoma was 4:1. 9) The accuracy of clinical dianosis were 42.7% for benign tumors and 79.3% for malignant tumors.

Nitroblue Tetrazolium dye Reduction Test (NBT) in Patients with Pulmonary and Skin Tuberculosis / 대한피부과학회지

No abstract available.

A Study on Histopathology and NBT dye Reduction Test in Patients with Pustular Eruptions of Palms And soles / 대한피부과학회지

First rnany years there has been a great dea,l of disagreement about the classification and histology of recalcitrant pustular eruptions of the palms and soles and the rela.tion of this condition to psoriasis. It ia the purpose of this investigation to describe histological changes in fresh pustules from patients witb pustular eruptions of the palms and soles and compare these changes between patients with clinically preceding or co-existing psoriasis (4cases) and without clinically preceding or co-existing psoriasis (7cases). Nine biopsies of pustules were exarnined and the results were compared between two groups. Histopathological findings were otherwise uniform and typical intradermal well-delineated pustules. No significant differences were found bet.ween th two groups. In view of the uniforrn histology, the unknown etiology, and uncertain clinicaI classification, the authors prefer the clearly descreptive term pustulosis palrnaris et plantaris(PPP). Recent;ly the phagocytic ability of neutrophilic leukocytes was reported to be impaired in patients suffering from pustular eruptions of the palms and soles. In our study this ability was performed with the aid of the NBT. dye reduction test before and after administration of Descresept (aristolochic acid). The aim of the present study was to observe the effect of Descresept on NBT test in relation to the clinical acitivity of PPP. The results were as follows: l. In 6 of 11 patients, clinical improvement was accompanied with increasing NBT' scores. 2. In 2 of 11 patients, clinical aggravation was noted in spite of Descresept adrninistration. In these 2 cases, increase in dosage of Descresept made clinical improvement again with increasing NBT scores. 3. In 3 of the 11 patients, there was noted clinical improvement, but NBT scores were slightly decreased.

A Study of Effect on Topical Clocortolone ( Purantix ) in Psoriasis and Eczema / 대한피부과학회지

Clocortolone pivalate (Purantix') is a new dihalogenated corticosteroid for topical use, posessing powerful anti-inflammatory, anti-pruriginous, anti-allergic, anti-exudative and anti-proliferative activity. We are clinical trial to evaluate its efficacy and tolerance when used at a concentration of 0.1% in an oil-in-water base, in several dermatoses normally responsive to topical corticosteroids. In a study of 30 cases, Purantix' was shown to be highly effective in the treatment of various forms of eczema and dermatitis. It was also shown to be highly effective in most cases of atopic dermatitis, and outstanding benefit was obtained in the relief of pruritus in all conditions and highly significant for erythema, weeping, scaling and lichenification. Among these 30 cases, we observed excellent effects in 13 pts(48.3%), good effects in 11 pts (36.6%) and fair effects in 5 pts(16.6%). Namely among these 30 pts, 24 pts(80%) revealed excellent to good therapeutic effects on their skin conditions with Purantix'. No untoward side effect was noted in all subjects treated with Purantix'.

Therapeutic Trial of Dinitrochlorobenzene ( DNCB ) Sensitization in Patients with Warts / 대한피부과학회지

Warts are benign turnors caused by oncogenic human papovavirus which has been clearly identified on electronmicroscopy, although repeated atternpts at culture have not been successful. Various therapeutic modalities have been tried for the treatment of warts, however thete is no saisfactory method and the clinical course as well as the prognosis is always variable. Recently several authors have reported successful therapeutic results in the treatment of warts by DNCB sensitization method based on the findings that warts are often regressing spontaneously and that the spontaneous regression seems to depend on host's ability to mount an immune response against the wert virus. The present study was undertaken to evaluate the DNCB sensitization method for possible routine use in the treatment of warts. Fifteen cases including five verruca vulgaris and ten verruca plana juvenilis patients were sensitized with 1000ug of DNCB in acetone solution on either side of their inner forearms. Seven or ten days after sensitization, several warts, which were unintentionally selected, were challenged with 0.05 to 0.1ml of weaker DNCB solution(50ug-25ug/0.1ml)at weekly interval. Four patients with verruca vulgaris and three patients with verruca plana juvenilis did not return after 1 to 4 times of challenge, however six out of these 7 patients showed a slight decrease in size and number of the warts. One patient with verruca plana juvenilis developed marked irritative and delayed cutaneous hypersensitivity reaction to the 3 times of challenge, so that this patient was excluded from further study. The remaining 7 patients consisted of I verruca vulgaris and 6 verruca plana juvenilis patients showed complete disappearance of all warts including those which were never challenged, after 1 to 13 times of DNCB challenge application. The authors reviewed the possible therapeutic mechanism of DNCB sensitization in the wart patients, the possible advantage and disadvantage of this method and concluded that this method can be cautiously used in seleted patients with warts whose response to the conventional treatment methods are poor.

Therapeutic Trial of BCG in Patients with Psoriasis / 대한피부과학회지

There have been reported some important findings in immunology of psoriasis, such as lower than normal level of IgM, defective humoral immune, responsiveness to newly administered antigens during cytotoxic drug therapy, lower than normal incidence of active sensitization with DNCB, prolonged skin heterograft survival and presence of anti-IgG antibody in peripheral lymphocytes. These findings are strongly suggestive of some humoral as well as cellular immunne dysfunction in patients with psoriasis. The present study was undertaken to evaluate the therapeutic effectiveness of BCG, a potent nonspecific immune stimulator, in patierts with psoriasis. Total 41 cases of more than 2 years' duration of illness and with widespread involvement and having had history of various previous treatment were slelcted at the Department of Dermatology, National Medical Center during October, 1973 and October, 1974, Liquid BCG(manufactured by NIH, Korea) was administered intradermally in a starting dose of 0.1 ml(0.01 mg in dry weight) weekly. The dosage of BCG was increased to 0.3 or 0.5ml after 3 or 5 injections and this dosage was maintained until some clinical changes were observed. The mean injection time to each patient was 20. 7.The results were as follows: 1. Eighteen cases showed no therapeutic response or aggravation of the lesions. 2. Six cases showed good therapeutic effect, resulting in only a few small lesions remained on elbows, knees or scalp areas. 3. Fourteen cases showed excellent therapeutic effect, that is complete disappearance of the lesions. During 2 to 6 months'follow up period, 7 cases showed relapse and the remainders are still under observation. The mechanism of influence of BCG on the clinical course of psoriatic patients is not determined, however, possible mechanism was discussed.

Xerderma Pigmentosum: Report of a Case / 대한피부과학회지

A case of xeroderma pigmentosum complicated with squamous cell carcinoma is presented. A 15 year old male has had a history of a single walnut-sized tumorous growth of 6 months duration on tip of his nose and multiple light to dark brown pigmented macules on face, ears, neck, upper chest, extensor surface of both foreams and dorsal hands of about 14 years duration, recognizable photosensitivity of the cutaneous lesions and photophobia and lacrimation since early childhood. Xeroderma pigrnentosum was suspected under clinical background. Biopsy was performed on the facial pigmented lesions and on the tumorous mass on the nose, which revealed xeroderma pigmentosum and squamous cell carcinoma, respectively. The tumor was excised totally under local 2% procaine anesthesia, resulting in healing with scar formation and no recurrence was observed during 6 month's follow up. Dermabrasion of the entire face was done, with complete removal of the xerodermic skin lesions, but they all recurred after about 1 month.

A Case of Reiter's Syndrome with Moniliasis / 대한피부과학회지

A case of 23 years old male with Reiters syndrome was reported. The skin lesions were characterized by thick, britle and heavy keratotic crust formation on whole body with weakness, severe arthritis, ankylosis, on the feet, wrists, knees, ankle and finger joints. Histopathological examination showed a spongiform vesicopustules, acanthosis and parakeratosis, interpapillary process elongated in the epidermis hyperkeratosis, dilated. vessels with perivascular infiltrate in the dermis. He was treated with Arning's tincture, Nystatin ointment, coaltar ointment painting and oral administration of prednisolone, methotrcxate for 1 month, resulting favorable improvement.

A Case of Acrodermatitis Continua ( Hallopeau ) / 대한피부과학회지

A case of 24 years old male patient with Acrodermatitis continua(Hallopeau) is reported. Clinically, the skin lesions were characterized by the pustular eruption on digit of extremities. Diagnosis was conformed by characteristic clinical appearance, laboratory findings and histopathology finding. He has been treated with prednisolone 20 mg daily, antibiotics and symptomatic therapy and relieved temporaly.