The Recovery Experience of Young Adults and Middle Aged Stroke Patients / 성인간호학회지

PURPOSE: The purpose of this study was to determine an increase in the number of younger and middle-aged people who have a stroke and the differences in their recovery experience compared with older people. METHODS: The research question for this study was "What is the recovery experience of young adults and middle-aged people who suffer a stroke?". In order to answer the question, the grounded theory method was utilized. The data was collected through individual in-depth interviews of six participants, their age ranged from 36 to 45 years old. RESULTS: After comparative analysis, the core category was "standing up for oneself with limit". The experience process were categorized into four stages: 'Facing Reality stage', 'Motivation stage', 'Desire Recovery stage', 'Self-Overcoming stage'. CONCLUSION: Most of the research for the recovery process was prognostic in nature and the results. This study was demonstrated certain indicators which can be useful in further research.

Plasma Adiponectin and Insulin Resistance in Korean Type 2 Diabetes Mellitus

Insulin resistance, which implies impairment of insulin signaling in the target tissues, is a common cause of type 2 diabetes. Adipose tissue plays an important role in insulin resistance through the dysregulated production and secretion of adipose-derived proteins, including tumor necrosis factor-alpha, plasminogen activator inhibitor-1, leptin, resistin, angiotensinogen, and adiponectin. Adiponectin was estimated to be a protective adipocytokine against atherosclerosis, and also to have an anti-inflammatory effect. In this study, the relationship between fasting plasma adiponectin concentration and adiposity, body composition, insulin sensitivity (ITT, HOMAIR, QUICK), lipid profile, fasting insulin concentration were examined in Korean type 2 diabetes. The difference in the adiponectin concentrations was also examined in diabetic and non-diabetic subjects, with adjustment for gender, age and body mass index. 102 type 2 diabetics and 50 controls were examined. After a 12-h overnight fast, all subjects underwent a 75gram oral glucose tolerance test. Baseline blood samples were drawn for the determinations of fasting plasma glucose, insulin, adiponectin, total cholesterol, triglyceride, LDL-cholesterol, and HDL-cholesterol. The body composition was estimated using a bioelectric impedance analyzer (Inbody 2.0). The insulin sensitivity was estimated using the insulin tolerance test (ITT), HOMAIR and QUICK methods. In the diabetic group, the fasting adiponectin concentrations were significantly lower in men than in women. They were negatively correlated with BMI (r=-0.453), hip circumference (r=-0.341), fasting glucose concentrations (r=-0.277) and HOMAIR (r=-0.233). In addition, they were positively correlated with systolic blood pressure (r=0.321) and HDL-cholesterol (r= 0.291). The systolic blood pressure and HDL-cholesterol were found to be independent variables, from a multiple logistic regression analysis, which influenced the adiponectin concentration. Compared with the non-diabetic group, the adiponectin concentrations were significantly lower in the diabetic group, with the exception of obese males. In conclusion, the plasma adiponectin concentrations were closely related to the insulin resistance parameters in Korean type 2 diabetic patients.

A case of hyperthyroidism presented as diabetic ketoacidosis / 대한내과학회지

Diabetic ketoacidosis is an acute complication of diabetic mellitus. The most common triggering factors are infection, insulin therapy omission and the onset of the disease, but if these are excluded, other less frequent etiologic factors must be ruled out. We report a case of 22-year-old woman with Graves' disease presented as diabetic ketoacidosis. She was diagnosed type 1 diabetes mellitus at 13 years old and continually has been treated with insulin therapy until now. She typically showed tachycardia at rest in spite of correction of metabolic acidosis. Hyperthyroidism worsens glycemic control in diabetic patients and may precipitate diabetic ketoacidosis. Hyperthyroidism always should be investigated in diabetic patients presenting diabetic ketoacidosis without obvious triggering factors.

A case of respiratory bronchiolitis-associated interstitial lung disease / 결핵

Respiratory bronchiolitis-associated interstitial lung disease has been described among current or former smokers and has features consistent with interstitial lung disease. Symptoms include cough, dyspnea on exertion. Lung pathology is characterized by the accumulation of pigmented macrophages within respiratory bronchioles and adjacent air spaces associated with mild thickening of the peribronchiolar interstitium. It must be separated from the other interstitial lung disease because of marked differences in treatment and prognosis. Recently we experienced a case of respiratory bronchiolitis -associated interstitial lung disease in a 48-year-old man. As far as we know, this is the first case in Korea.

The Effect of Aerobic Exercise on Body Composition, Cardiopulmonary Function, Serum Lipid and Antioxidants of Obese College Female Students / 기본간호학회지

The purpose of this research is to analyze the effects of aerobic exercise on body composition, cardiopulmonary function, serum lipid level and antioxidants of obese and normal college female students. The subject group was made up of 13 normal students (below 30% body fat ratio ) and 12 obese students(above 30% body fat ratio). After a pretest, the subjects were given an 8-week aerobic program. Then the subjects were given a posttest and analyzed of body composition, serum lipid level, antioxidants and cardiopulmonary function after the 6th and the 8th week of the program, The program schedule was made up of 4 days per week, 60 minutes per day. Test includes B. W., subscapular and triceps subcutaneous fat thickness. change of respiratory gas, and two blood sampling before treadmill exercise and post all out state, which analyzed serum lipid and antioxidants. The subjects performed treadmill exercise starting with 4km/hr of walking and then gradually increase the speed of 1km/hr per minute until all out state. The obtained data were analyzed using SAS program. The statistical methods employed here were one-say ANOVA with repeated measure, Duncan Multiple range test, paired-t test and t-test. The test results and conclusion go this research were as follows. 1. The effects of aerobic exercise on body composition were as follows ; Percent body fat was significantly reduced 6 weeks after the program and lean body mass was significantly increased 8 weeks after the program in both groups(obese group : F=3.44 P=.044, normal group: F=3.30 P=.048). subscapular skinfold of the obese group showed a remarkable decrease after the 6th week(F=4.3 P=.21) triceps skinfold of the normal group showed a remarkable decrease after the 6th and 8th week(F=4.55 P=.017) compared with readings before the aerobic program, the aerobic program made a bigger difference concerning body fat, lean body mass, subscapular skinfold in the obese group than in the normal group(t=2.41 P=.024 p=.025, t=2.43 p=.028). 2. The effects of aerobic exercise on cardiopulmonary function were as follows : Maximal O2 uptake/kg was significantly increased 6 weeks after the program in the obese group(F=3.20 P=.054), but not much difference was observed in the normal group. maximal pulse rate was significantly reduced in both groups after 6 weeks of the program(obese group : F=2.77 P=.087, normal group : F=7.17 P=.001). 3. The effects o aerobic exercise on serum lipid level were as follows : In a resting period, total cholesterol, Triglyceride, and LDL-cholesterol were slightly higher in the obese group than in the normal group, but HDL-cholesterol was higher in the normal group. But with the aerobic program, total-cholesterol, Triglyceride, LDL-cholesterol were reduced gradually and HDL-cholesterol got increased in both groups, but not much change was noticed in the normal group. However, in the obese group, serum HDL-cholesterol level got increased significantly(F=5.12 P=.012). 4. The effects of aerobic exercise in serum antioxidants were as follows ; In a resting period, the obese group's serum Free Radical and GSSG content were higher than the normal group's and the normal group's serum GSH content was higher than the obese group's. After 6 weeks of the aerobic program, Free Radical was reduced significantly in both groups(obese group : F=13.87 P=.000, normal group: F=18.60 P=.000) In the obese group, 8weeks after the program, GSH was increased significantly(F+13.78, P=.000). In the normal group, 6 weeks after the program GSH was reduced but increased again after 8 weeks(F=6.07 P=.005). Plasma GSSG was significantly increased after 8 weeks of exercise in both groups(obese group: F=19.75 P=.000, normal group: F=2.42 P=.000). Compared with readings before the aerobic program, the aerobic program made a bigger difference serum GSH in the normal group than in the obese group(t=3.37 p=.003) As this results shows, It is known that the regular aerobic exercise improves cardiopulmonary function, body composition, serum lipid effectively and through the serum Free Radical reduction and antioxidant system activation, oxidant stress was suppressed. This effect was high in the obese group than in the normal one. At least 6 weeks exercise period need for improvement of body composition, cardiopulmonary function and activation of antioxidant system, This result suggest that improvement of serum lipid profile was needed longer than 8 weeks exercise period.

A case of pulmonary diffuse alveolar amyloidosis localized in the lung / 대한내과학회지

Primary pulmonary diffuse alveolar amyloidosis is a rare form among the pulmonary amyloidosis. Especially in primary form diffuse alveolar type is much more rare disease. the patient was checked simple chest X-ray for the purpose of routine screening test, he had no respiratory symptoms and signs and he had no complaint of other organ symptoms, while in chest roentgenogram it was found bilateral diffuse interstitial infiltration of the lung, but any other organs which commonly involved in amyloidosis were not involved in laboratory and other specific diagnostic procedures. We report a case of pulmonry diffuse alveolar amyloidosis only localized in lung which was confirmed by transbronchial lung biopsy.

A Case of Diffuse Alveolar Damage Induced by Cyclophosphamide / 결핵

Approximately 100 drugs have been reported to affect the lungs adversely. Among these, pulmonary toxicity caused by antieneoplastic agent is being recognized more frequently. Cyclophosphamide is an immunosuppressive alkylating agent used for the treatment of a wide variety of malignant and nonmalignant diseases. The incidence of pulmonary toxicity is probably less than 1 percent The first case was reported in 1967. Since then, more than 20 well-documented cases of pulmonary toxicity associated with cyclophosphamide have been reported in the literature. In Korea, three patients were identified with cyclophosphamide-induced lung disease. The typical features of toxicity include dyspnea, fever, cough, new parenchymal infiltrates, gas exchangs abnormalities on pulmonary function tests, and pleural thickening on chest roentgenogram. The best approach to management is early diagnosis, discontinuation of the offending drug and administration of corticosteroid therapy. Recently, we experienced a case of diffuse alveolar damage induced by cyclophosphamide. The patient presented with early-onset pulmonary toxicity and died of repiratory failure despite early use of corticosteroid.

A Case of Rendu-Osler-Weber Disease: Hereditary Hemorrhagic Telangiectasia / 대한소화기내시경학회지

Hereditary hemorrhagic telangiectasia, also knawn as Rendu-Osler-Weber disease, is a rare autosomal dominant condition characterized by telangiectases, arteriovenous fistulas, and aneurysms involving the skin and mucosa, as well as blood vessels of the lung, liver, and central nervous system. The most common clinical manifestations are epistaxis and gastrointestinal bleeding. Arteriovenous shunting leads to hepatic congestion, and congestive heart failure may occur. We report a casie of Rendu-Osler-Weber disease which revealed typical clinical symptoms and radiologic findings with a review of relevant literatures.

The Effect of Deep Breathing Method on Pulmonary Ventilatory Function of Patients Who experiened Upper-abdominal surgery / 기본간호학회지

The purpose of this study was to examine the effect of deep breathing exercise with Incentive Spirometer on the pulmonary ventilatory function of postoperative patients. This experiment was operated by quasi-experimental design which was compared pre-experimental measures with post-experimental ones. The subject of this study was 46 inpatients who were scheduled for elective upper abdominal surgery under the general anesthesia in P National University Hospital in Pusan and classified into the experimental group(23 patients) and control group(23 patients) by using Incentive Spirometer or unusing one. The data were collected from November, 1, 1993, to December, 31, 1993. The effects of the deep breathing exercise on the pulmonary ventilatory function were compared between experimental group who were received deep breathing exercise with Incentive Spirometer and control group who were received same method without Incentive Spirometer. The Forced Vital Capacity(FVC) and the First Second Forced Expiratory Volume (FEV1) were represented as index of the pulmonary ventilatory function and those were measured by Vitalograph Compact. The collected data were analysed by SPSS/PC+ (percentage, average, standard deviation, chi-square test, t-test, and ANOVA). The results were as follow : (1) The FVCs of the experimental group were significantly increased in course of time, 24, 48, 72 hours after surgery(F=3.53, P=0.035). (2) The FVCs and FEV1s of the control group were significantly increased in course of time, 24, 48, 72 hours after surgery(FVCs :F=3.480, P=0.037, FEV1s:F=6.153, P=0.004). (3) The FVC which was measured at 72 hours after surgery was significantly higher in the experimental group than in the control group(t=2.620, P=0.013). (4) The FEV1s which were measured at 24 and 72 hours after surgery were significantly higher in the experimental group than in the control group(24hr. : t=2.530, P=0.017, 72hr. : t=2.540, P=0.016). (5) Among general characteristics, sex was significant variable which influenced to effect of pulmonary ventilatory function. In conclusion, this study showed that the deep breathing exercise with Incentive Spirometer was more effective to recover the pulmonary ventilatory function after surgery than the deep breathing exercise without Incentive Spirometer.