Mediation Effect of Self-Efficacy on the Relationship between Perceived Self-Management Support and Health-Related Quality of Life among Cancer Survivors / 간호학회지

PURPOSE: This study aimed to examine the levels of perceived self-management support, self-efficacy for self-management, and health-related quality of life (HRQoL) in cancer survivors, and to identify the mediating effect of self-efficacy in the relationship between perceived self-management support and HRQoL. METHODS: This study used a descriptive correlational design. Two hundred and four cancer survivors who had completed treatment participated in the study. Measurements included the Patient Assessment of Chronic Illness Care Scale, the Korean version of the Cancer Survivors' Self-Efficacy Scale, and the Medical Outcomes Study Short Form-36. Data were analyzed using descriptive statistics, Pearson's correlation coefficient analysis, and multiple regression analysis using Baron and Kenny's method for mediation. RESULTS: The mean score for perceived self-management support was 3.35 out of 5 points, self-efficacy was 7.26 out of 10 points, and HRQoL was 65.90 out of 100 points. Perceived self-management support was significantly positively correlated with self-efficacy (r=.29, p<.001) and HRQoL (r=.27, p<.001). Self-efficacy was also significantly correlated with HRQoL (r=.59, p<.001). Furthermore, self-efficacy (β=.55, p<.001) had a complete mediating effect on the relationship between perceived self-management support and HRQoL (Z=3.88, p<.001). CONCLUSION: The impact of perceived self-management support on HRQoL in cancer survivors was mediated by self-efficacy for self-management. This suggests that strategies for enhancing self-efficacy in cancer survivors should be considered when developing self-management interventions for improving their HRQoL.

Mediation Effect of Self-Efficacy on the Relationship between Perceived Self-Management Support and Health-Related Quality of Life among Cancer Survivors

PURPOSE@#This study aimed to examine the levels of perceived self-management support, self-efficacy for self-management, and health-related quality of life (HRQoL) in cancer survivors, and to identify the mediating effect of self-efficacy in the relationship between perceived self-management support and HRQoL.@*METHODS@#This study used a descriptive correlational design. Two hundred and four cancer survivors who had completed treatment participated in the study. Measurements included the Patient Assessment of Chronic Illness Care Scale, the Korean version of the Cancer Survivors' Self-Efficacy Scale, and the Medical Outcomes Study Short Form-36. Data were analyzed using descriptive statistics, Pearson's correlation coefficient analysis, and multiple regression analysis using Baron and Kenny's method for mediation.@*RESULTS@#The mean score for perceived self-management support was 3.35 out of 5 points, self-efficacy was 7.26 out of 10 points, and HRQoL was 65.90 out of 100 points. Perceived self-management support was significantly positively correlated with self-efficacy (r=.29, p<.001) and HRQoL (r=.27, p<.001). Self-efficacy was also significantly correlated with HRQoL (r=.59, p<.001). Furthermore, self-efficacy (β=.55, p<.001) had a complete mediating effect on the relationship between perceived self-management support and HRQoL (Z=3.88, p<.001).@*CONCLUSION@#The impact of perceived self-management support on HRQoL in cancer survivors was mediated by self-efficacy for self-management. This suggests that strategies for enhancing self-efficacy in cancer survivors should be considered when developing self-management interventions for improving their HRQoL.

Ileal anisakiasis: A report of two cases

Anisakiasis is a parasitic disease of the gastrointestinal tract caused by ingestion Of raw or undercooked fish containing the marine nematode larvae belong to the subfamily Anisakinae. The adult worms are intestinal parasites of marine mammals. Eggs are passed in the feces of these mammals and develop to the second stage larvae in the sea water. They are eaten by crustaceans in which the larvae develop to the third stage. When fish or squid eat the infected crustaceans the larvae migrate to the body cavity or the muscle. The infected fish or squid is eaten by marine mammals the larvae attach to the wall of the stomach and then undergo adult worm. In Korea, human anisakiasis is not rare. The clinical manifestations are variable and depend on the involving site of gastrointestinal tract. The frequent sites are stomach and small intestine, and large intestine is rarely involved. Recently we experienced two cases of ileal anisakiasis occurred in 54-year-old female and 46-year-old female patients. The symptoms were upper and lower abdominal pain, nausea, and vomiting. The resected ileums in case I and 2 measured 12.5 x 2.5 cm and 15.0 x 2.0 cm, respectively. The mucosa and submucosa were thickened. In case 1, submucosal penetration of a white thread-like parasite was seen. The ileum showed submucosal edema, and extensive infiltration of eosinophils, neutrophils, lymphocytes, histiocytes, and plasma cells from mucosa to mesentery with or without mucosal ulceration. The Anisakis larvae are found in the submucosa and propria muscle. They have thick multilayered smooth cuticle, many somatic muscle cells, triradiated esophagus with numerous tall columnar cells, renette cell, and Y-shaped lateral chords. Reproductive organ is absent. In Korea, the previously reported 14 cases and present 2 cases of the intestinal anisakiasis mainly involved ileum, but the cause was not mentioned.

A study of PCNA Expression in Gastric Adenoma and Adenocarcinoma / 영남의대학술지

A monoclonal antibody to PCNA, which can be used on routinely processed tissue, was applied to 25 cases of gastric adenomas and 64 cases of gastric adenocarcinomas in order to diffentiate adenoma and adenocarcinoma and also to evaluate the prognostic value in adenocarcinoma. The results were summerized as follows: The PCNA labelling index was 29.14+/-12.77% in control, 44.09+/-17.11% in adenoma and 80.15+/-10. 69 in adenocarcinoma, resulting in significant increase in adenocarcinoma compared to adenoma. In adenocarcinoma, no significant correlation was observed between PCNA labelling index and histologic grade, and there -was increased tendency of PCNA labelling index in proportion to depth of invasion without statistical significance. The PCNA index was significantly increased in advanced adenocarcinoma compared to early gastric carcinoma, and also in positive nodal metastasis group than in negative group. From above results, the PCNA stain will be able to provide a helpful method for the differential diagnosis between gastric adenoma and adenocarcinoma, and could be a useful prognostic factor in adenocarcinoma if other factors are considered together.

Expression of p53 Protein and c-erbB-2 Oncoprotein in Breast Carcinoma

This study was conducted to evaluate the expression of p53 and c-erbB-2 using immuno-histochemical methods in 145 primary breast carcinomas and to correlate it with other histo-pathological prognostic factors. Invasive ductal carcinoma represented 129 of the cases. Expression of p53 protein and c-erbB-2 oncoprotein was present in 48% (62/129) and 30% (39/129) of invasive ductal carcinomas, respectively. The expression of p53 protein was stongly associated with a high score of degree of differentiation (p<0.05), nuclear pleomorphism (p<0.05), mitotic index (p<0.05), SBR grade (p<0.05) and MSBR grade (p<0.05), but it was not associated with patient's age, size of tumor or axillary node metastasis. The overexpression of c-erbB-2 C-erbB-2 oncoprotein was strongly associated with a high score of nuclear pleomorphism and a high SBR grade (p<0.05), but not associated with patient's age, size of tumor, axillary node metastasis, degree of differentiation, mitotic index or MSBR grade. An inverse relationship between the expression of p53 protein and estrogen receptor status was found, but the expression of c-erbB-2 was not associated with estrogen receptor status. It is concluded that p53 protein and c-erbB-2 oncoprotein are important prognostic factors in breast cancers, and that the aberrant expression of p53 protein is the most useful prognostic factor becausd of strong association of known histopathological prognostic factors and negative estrogen receptor status.

The Aberrant Expression of p53 Protein in Liver Cell Carcinoma

This study was carried out to evaluate the aberrant expression of p53 protein using immunobistochemical method in 54 surgically resected liver cell carcinomas and to correlate it with clinical and pathological findings. Twenty five out of 54 cases(46%) showed positive reaction in the nucleus of liver cell carcinoma and negative reaction in associated 30 cases of cirrhosis, one case of adenoma and two cases of adenomatous hyperplasia. The p53 protein expression was associated with alpha-FP level(p<0.05), but not associated with HBsAg positivity. It was significantly associated with WHO classification, Edmondson-Steiner grade and nuclear grade p53(p<0.05), but not associated with tumor size, capsule formation, portal vein invasion, cirrhosis in surrounding tissue, Eggel classification, special cell type and mitosis. In conclusion, our results suggest that the aberrant expression of p53 protein can be an advisory factor, at least, for prognosis evaluation.

A Histopathological Analysis on 73 Cases of Enucleated Eyeballs

A total of 73 enucleated eyeballs is reviewed and analyzed clinicopthologically. These eyeballs were selected among the enucleated spceimens that had been removed at the Yeungnam University Hospital during a period of 10 years beginning from 1983 to 1992. Following results were obtained. 1) When the eyeballs were classified according to me direct cause of removal, the neoplasm was the most common single cause accounting for 26 cases(35.6%) out of 73 cases, followed by phthisis bulbi l6 cases(21.9%), trauma 10 cases(13.7%), glaucoma 8 cases(10.9%), inflammation 5 cases(6.8%), staphyloma 4 cases(5.5%), retinal detachment 1 cases(1.4%), Coat's disease 1 cases(1.4%), corneal disease 1 cases(1.4%) and choroidal hemorrhage 1 cases(1.4%). 2) 39 cases(53.4%) were male and 34(46.6%) were female. 23 cases(31.5%) were below 10 years of age, which was the highest rate. 3) The neoplastic lesion included retinoblastoma 20 cases(76.9%) in 26 neoplasms, malignant melanoma 4 cases(15.3%), hemagioblastoma of optic disc 1 cases(3.9%), adenocarcinoma of Meibomian gland 1 cases(3.9%). 4) Retinoblastoma was the commonest intraocular tumor accounting for 20 out of 26 cases, In growth pattern, 80.0% of the tumor grew endophtytically. True rosette were seen 60% of the retinoblastoma.

Intraoperative Pathologic Consultation / 영남의대학술지

No abstract available.

Fine structure and detoxification kinetics in kupffer cells after injection of endotoxin in rats / 영남의대학술지

The aim of this study was to clarify the role of Kupffer cells in the mechanism of endotoxin-induced liver injury. The study on fine structure of Kupffer cells was performed after the injection of endotoxin. The endotoxin(Escherichia soli lipopolysaccharide 026: B6, 1.5mg/100 g of body weight) was intraperitoneally injected in Sprague-Dewley rats. Animals were sacrificed at 1/4, 1/2, 1, 2, 4, 8, 16, 24, 72 and 120 hours after the injection of endotoxin. Livers were extirpated and processed to be examined by light and electron microscopy. The results obtained were summerized as follows: Early changes observed in liver after endotoxin injection included the increased number and hypertrophy of Kupffer cells, infiltration of neutrophils and presence of fibrin thrombi within the sinusoids. The coritinuous increase of the Kupffer cells in number with hypertrophy, congestion and infiltration of inflammatory cells within the sinusoids were observed. Hepatocytes showed* fatty change and occasional necrosis. At 72 hours the congestion decreased. At 120 hours the number of Kupffer cells was increased, but the morphology of Kupffer cells became similar to that of the control group. The numbers and sizes of primary and secondary lysosomes and amount of euchromatin of Kupffer cells increased. Swellings and increase in number of mitochondria, Golgi complex, smooth endoplasmic reticulum, rough endoplasmic reticulum were evident. Microthrombi were present within the sinusoids. The swelling of rough endoplasmic reticulum and mitochondria, decrease of glycogen particles, fatty change, hypoxic vacuoles, pyknotic nuclei and occasional necrosis were observed in hepatocytes. At 72 hours the number of secondary lysosomes in Kupffer cells decreased. At 120 hours the morphology of Kupffer cells became similar to that of the control group. According to these results, it was postulated that the endotoxin was initially taken up by pinocytosis into Kupffer cells and degraded in secondary lysosomes of activated Kupffer cells. Kupffer cells may play an important role in the defense mechanism of liver during endotoxemia. The dysfunction of Kupffer cells and ischemia by sinusoidal microthrombi may cause liver injury.

Histopathologic consideration of hepatocellular carcinoma / 영남의대학술지

Hepatocellular carcinoma represents approximately 90% of the primary liver cancers. Recently, its incidence tends to be increased. Thirsty seven cases from 1986 to 1991 diagnosed as hepatocellular carcinoma by resection were analyzed to know their histopathologic feature and related clinical findings. The average age at the time of resection was 53.1 years, with frequent occurrence in third and fourth decades. Microscopically, the trabecular type was the most frequent growth pattern (35.1%) and classic hepatocyte-like cell type was the most frequent cell type (75.7%). The tumors are mainly moderately differentiated and frequently associated with liver cirrhosis. In comparison of cytological differentiation with liver cirrhosis, there was a tendency for well-differentiated tumors to arise in cirrhotic livers more often than poorly differentiated tumors, and the tendency was statistically significant. But differentiation and tumor size did not show significant correlation. Also statistically significant correlations were not observed between the level of alpha-fetoprotein and tumor size, and between the level of alpha-fetoprotein and differentiation.

Ultrastructural changes of fat-storing cells in experimental hepatic fibrosis / 영남의대학술지

Hepatic fibrosis was induced in Sprague-Dawley rate to evaluate the ultrastructural changes of fat-storing cells (Ito cells). For experimental induction of liver fibrosis, the rats were administered intraperitoneally with 0.5 ml of 50% Ccl4 solution per Kg body weight, twice weekly for 12 weeks. The rats were sacrificed every week. The liver tissues were examined under light and electron microscopes. And the immunohistochemical study of desmin was also performed. The results were summarized as follows: Light microscopic findings: The cellular infiltrations was inflammatory cells and Kupffer cells developed from 1 week after Ccl4 injection, and were the most severe in 4 weeks. The strong immunoreactivity for desmin was also evident in 4 weeks. The centrilobular necrosis and fibrosis developed from 2 weeks after injection, and the necrosis persisted until 8 weeks. The progress of fibrosis was accompanied by decreases in cellular infiltration and reactivity for desmin, and increased gradual nodular formation was also observed. The cirrhosis was developed after 10 weeks. Electron microscopic findings: An increase in number of fat-storing cells was observed from 1 week after injection. Transitional cells characterized by a depletion of lipid droplets and a hypertrophy of the rER appeared after 2 weeks. The number of transitional cells with abundant collagen fibers in the extracellular spaces increased in 4 weeks. With progression of fibrosis the number of fat-strong cells decreased and proliferating fibroblasts with dilated rER were observed. According to these results it was revealed that there was an apparent transition from fatstrong cells to transitional cells and to fibroblasts. These cells had a few similar characteristics and may belong to the same cell population. Thus it was suggested that fatstrong cells might play an important role in hepatic fibrosis.

Effect of phenobarbital pretreatment on the hepatotoxicity of carbon tetrachloride in rat / 영남의대학술지

The purpose of this study was to evaluate the influence of phenobarbital (PB) on hepatotoxic effect of carbon tetrachloride (CCI4) which induces centrilobular necrosis in liver. Rats were injected intraperitoneally CCI4 dissolved in olive oil by a dose of 0.4 mg/kg. For change related to PB pretreatment, rats were injected CCI₄ 0.4mg/kg after PB pretreatment. The liver samples were taken in 6, 12, 24, 48, 72 and 120 hours after CCI₄ and/ or PB injection. Extracted liver tissue was examined with light and electron microscopes. The results were summarized as follows: 1. Light microscopic findings: In CCI₄ group, centrilobular necrosis developed from 6 hours after injection, was the most severe in 48 hours, and recovered after 72 hours. In addition to necrosis, fatty change and pale cell change were accompanied. In PB-CCI4 group, necrosis occurred from 6 hours after CCI₄ injection and continued to 72 hours, and the degree of necrosis was more severe than that of CCI₄ group and pale cell change was decreased. 2. Electron microscopic findings: In CCI4 group, the early principal change was clumping and vesicular dilatation of endoplasmic reticulum. In PB-CCI₄ group, the degenerative change of endoplasmic reticulum was aggravated and the mitochondria also revealed severe degenerative change. According to the results, it was revealed that CCI₄ hepatotoxicity primarily began with the damage of endoplasmic reticulum, then damage of other cell organelles and cell necrosis followed, and these cytotoxic effects were aggravated by PB pretreatment.

Computerization of Surgical Pathology Reporting by Personal Computer

The authors have been developed a menu-driven FoxBASE system for surgical pathology reporting and automatic encoding in Systematized Nomenclature of Medicine. The system requires no prior knowledge of FoxBASE and is readily installed on any IBM or it's compatible personal computer. Working sheet generation is automatically accompanied by data from previous cases on the same patient. Important data which include patient name, age, sex, surgical number, hospital unit number and encoded diagnoses, are stored on the hard disk permanently; complete reports are saved on floppy diskettes. Cases can be retrieved by patient name, surgical number, hospital unit number and SNOMED codes within 0.1 second. Daily work lists and listings of incomplete cases are easily obtained. This FoxBASE system has been in use for 1 year and 6 months and resulted in increased efficiency of retrieval and gathering of basic information for specific study, cost effectiveness, markedly diminished workload of typist and very short wasting time during complete restoration of data file for hard disk failure.

Nucleolar organizer regions in glioma / 영남의대학술지

Nucleolar organizer regions (NOR) are loops of ribosomal DNA (rDNA) which are transcribed by RNA polymerase I. They produce ultimately ribosome and protein. Thus they are believed to reflect nuclear activity. We applied silver colloid staining technique to human glioma to examine relationship between the mean number of Ag-NOR and histopathological grading. The mean number of Ag-NOR (±S. E of the mean) were 1.17±0.07 in normal brain, 1.53±0.25 in astrocytoma, 2.37±0.71 in malignant astrocytoma. And 2.88±0.41 in glioblastoma multiforme. And there was a statistically significant difference among these. The results show that Ag-NOR technique is a rather simple and rapid method and will become a helpful tool for estimation of the proliferative potential of glioma.

Metastatic tumors in supraclavicular lymph node: pathological analysis of 125 cases / 영남의대학술지

Supraclavicular lymph nodes are unique in that they can attract metastases from almost anywhere in the body and most common sites of metastasis from an unknown primary source. 125 cases which had been diagnosed as metastatic supraclavicular lymph node during the period between May 1983 and August 1991, were analyzed pathologically, and following distinctive characteristics could be outlined: 1) The most frequent sites of metastasis from primary lesions are lung (43%), stomach (23%), lymphoreticular (6%), biliary (5%), esophagus (2%), and pancreas (2%). 2) Histologic examination of metastatic supraclavicular lymph node revealed adenocarcinoma (57%), squamous cell carcinoma (12%), undifferentiated carcinoma (9%), small cell carcinoma (7%), malignant lymphoma (6%), malignant melanoma (1%) and undetermined carcinoma (8%). 3) In cases that histologic types were squamous cell carcinoma, undifferentiated carcinoma, small cell carcinoma and undetermined carcinoma, the most frequent primary site was lung.

Histopathological study of gastric adenoma / 영남의대학술지

A total of 53 gastric adenomas from endoscopically biopsied gastric mucosa were examined histopathologically. The average age at the time of endoscopic biopsy was 59 years, and gastric adenomas were found to be more frequent in the aged, particularly above the age of 50. The majority of adenomas occurred at the antrum. Concerning the shape of the adenomas, Yamada type II was more frequent (55%). All adenomas were accompanied by varying degree of intestinal metaplasia, and this findings suggest that gastric adenoma develops from intestinal metaplasia. In adenomas with severe atypia (grade III), endocrine cells (argyrophil and argentaffin cells) were markedly decreased or absent. Gastric adenocarcinomas coexistent with adenoma were seen in 5 (9.4%) out of 53 cases, and were more frequent in male than female patients (sex ratio, 4:1) and the average age was 61.4 years. It is suggested that there is a necessity of thorough follow-up study for definitive correlation between gastric adenoma and adenocarcinoma.

Effects of carbon tetrachloride on structures in hepatocytes following DMN induced hepatotoxicity / 영남의대학술지

The purpose of this study was to evaluate the influence of high dose carbon tetrachloride (CCI4) on the hepatotoxic effect of dimethylnitrosamine (DMN) which induces acute hemorrhagic necrosis in liver. Rats were injected intraperitoneally DMN dissolved in physiologic saline by a dose of 40 mg/kg. For changes related to CCI⁴ pretreatment, rats were injected intraperitoneally CCI⁴ dissolved in olive oil by a dose of 0.4 mg/kg, and then injected DMN. The livers were extracted from the rats 3, 6, 12, 24, 48, 72, and 120 hours after CCI⁴ and/ or DMN injection. Liver tissues were examined with light and electron microscopes. The results were summarized as follows; Light microscopic findings: Severe centrilobular hemorrhagic necrosis developed from 12 hours after injection of DMN and continued to 120 hours. On injection of DMN after CCI4 pretreatment, Massive necrosis occurred early. But active regenerative changes were produced in 24 hours. In 120 hours, the liver recovered in almost normal appearance. The degree of necrosis in pretreated group was similar to that in DMN injection only, and the time of recovery was faster in pretreated group. Electron microscopic findings: The early change was mainly disorganization of RER in DMN injection, and clumping and vesicular dilatation of ER in injection of CCI4. In pretreatment group, the early change was similar in appearance with CCI4 group, but severer in degree. According to the results, it was revealed that acute toxic effect of DMN was recovered more rapidly in pretreatment group. Thus it was suggested that CCI4 had protective effect in DMN hepatotoxicity.

Ependymoma in Pelvic Cavity : A case report

A case of ependymoma originated in pelvic cavity is reported. Metastasis to regional lymph nodes and abdominal cavity developed. This tumor is thought to arise from heterotopic ependymal rests. The patient was 32 year old woman. A 10.0x7.0x7.0 cm sized mass was located between the uterus and rectum, which was attached to the rectal wall. It was a well circumscribed tumor with massive hemorrhage and necrosis. Histologically, tumor showed variegated appearance. Plump oval or round cells were arranged oval of elongated cells with fibrillary cytoplasmic process. Occasionally perivascular pseudorosette and ependymal rosette were seen. Immunohistochemical staining for GFAP showed intense positivity. Ultrastructural examination showed intracytoplasmic microfilaments, cilia, microvilli, and blepharoplasts.

A Comparative Study between Localization of IgA and Secretory Component in Gastric Disease

The purpose of this study is to evaluate the change of mucosal immunity in gastric diseases. A quantative analysis of IgA and secretory component(SC) in gastric diseases by immunohistochemical method was performed in 110 specimens. The results are as follows: 1) In normal gastric mucosa, all of 10 cases revealed a negative reaction to antihuman SC but 4 cases were positive for IgA. 2) In chronic superficial gastritis and chronic atrophic gastritis with intestinal metaplasia, the metaplastic cells except for the goblet cells were positive for both IgA and SC. 3) The dysplastic cells were also positive for both IgA and SC, and the regenerating cells in ulcer as well. 4) All of the well differentiated or moderately well differentiated adenocarcinomas showed positive reactions to antihuman IgA and antihuman SC, and the intensity appeared to be stronger in the former. However, among 10 cases of poorly differentiated adenocarcinoma SC was not demonstrated in 5 cases, and no IgA was present in one case. In 10 cases of signet ring cell carcinoma, 6 cases revealed a negative reaction to antihuman IgA and 6 cases to antihuman SC. The above results suggest that the secretory immunity is not essential in normal gastric mucosa. The intestinal metaplasia in chronic gastritis is considered as an adaptive response to chronic inflammation. The degree of differentiation in adenocarcinoma may be related to the mucosal immunity.

A Human Case of Hepatic Fascioliasis Accompanied by Egg Granulomas in Common Bile Duct Lymph Node

A 32-year-old housewife who resides in Taegu was admitted in Yeungman University Hospital due to right upper quadrant abdminal pain of 2 mounths'duration. An abdomical CT and ultrasonography revealed a relatively well demarcated low density mass in the right lobe of liver. Right hepatic lobectomy was performed on the clinical impression of hepatoma. On the light microscopic study, the lobulated liver mass showed extensive central necrosis and fibrosis, with large numbers of pseudotubercles therein. The pseudotubercles have distorted helminthic eggs frequently. The submitted common bile duct lymph node also showed a few pseudotubercles. The eggs recovered from the tissue homogenate measured 140~152 micrometer by 75~85 micrometer in size and were unembryonated and light yellow to brown. The eggs were determined as those of Fasciola species. We reported the present case as 11th one of human fascioliasis in korea.