Injury is a serious problem that not only causes death but also significantly degrades the quality of life of the people and causes loss of socioeconomic opportunities and costs. Damage occurs as a result of an accident. Among them, natural disasters and artificial disasters take lives of many people in a short time and threaten their physical and mental health. The United States has responded to the disaster by establishing relevant laws and regulations and a response system with the recognition that health is recognised soon to be as national security in the wake of the 9/11 terrorist attacks and the Katrina disaster. It is necessary to build a knowledge infrastructure to train disaster response experts in public health area and to have health competence to cope with disasters.
Bioterrorism ; Disasters ; Jurisprudence ; Mental Competency ; Mental Health ; Public Health ; Quality of Life ; Security Measures ; Social Control, Formal ; United States

PURPOSE: The purpose of this study was to identify characteristics of serum ferrum, TIBC and ferritin's circadian rhythm in normal adults and to prepare a standard to determine the examination material extraction time. METHOD: Nine women and ten men made up the convenience sample for this study. they were from the staff of D university hospital and students in D medical School located in K city who met the qualifications for inclusion in the sample. The value of serum ferrum, TIBC and circadian rhythm were calculated as follows; First, each variable's amplitude, the acrophase and average were measured for a 24 hour cycle using the cosinor method, and then each person's rhythm was analyzed. RESULTS: There were significant serum iron circadian rhythm for both men and women (p<.05). For the men, mesor was 105.91 microgram/dl, amplitude was 29.52 microgram/dl, and the acrophase was 9.76 hour. For the women, mesor was 108.17 microgram/dl, amplitude was 28.09 microgram/dl, and the acrophase was 11.42 hour. The rhythm change of TIBC was only significant for the women (p<.05), mesor was 383.39 mg/dl, amplitude was 60.29 mg/dl, and the acrophase was 14.93hour. As for the circadian rhythm of the ferritin, there are no diurnal variation in either sex, men were between 134.0 ng/ml and 137.4 ng/ml, and women, between 29.1 ng/ml and 30.1 ng/ml. CONCLUSION: To help diagnose the boundary line between normal or deficiency in iron, measurement should be carried out at a fixed time in the morning and evening, or a more proper time would be in the afternoon at the time when the width of amplitude is the least.
Adult* ; Circadian Rhythm* ; Female ; Ferritins ; Humans ; Iron ; Male ; Schools, Medical

Cytomegalovirus (CMV)-associated esophageal ulcer is rare in immunocompetent infants. The presence of inclusion bodies and immunohistochemical staining for CMV in biopsy specimens obtained during esophagogastroduodenoscopy (EGD) indicate that such ulcers occur because of CMV infection. A 7-week-old female infant who experienced frequent vomiting and feeding intolerance was diagnosed with a massive CMV-associated ulcer in the distal esophagus. The ulcer improved after conservative treatment using proton-pump inhibitors; however, ganciclovir was not administered. In a follow-up EGD biopsy specimen, no CMV inclusion bodies were present, and immunohistochemical staining results for this virus were negative. The presence of CMV inclusion bodies indicates active viral replication. If persistent inclusion bodies or positive immunohistochemical staining for CMV is observed in follow-up biopsy specimens, ganciclovir may be used to treat CMV-associated esophageal ulcers.
Biopsy ; Cytomegalovirus ; Endoscopy, Digestive System ; Esophagus ; Female ; Follow-Up Studies ; Ganciclovir ; Humans ; Inclusion Bodies ; Infant ; Ulcer ; Viruses ; Vomiting

A 3-year-old boy with purulent otitis media received a chest radiograph as the part of a routine work up. The patient was normal appearing, in no acute distress. The patient's lung and heart sounds were clear and normal. The patient's abdomen was soft, non-distended, and non-tender. An anterior cardiophrenic mass was incidentally identified on the lateral chest radiograph. A computed tomography scan demonstrated a diaphragmatic hernia with bowel loops in the retrosternal space. An exploratory operation revealed a diaphragmatic defect (4 cm in diameter) on the left side of the falciform ligament, through which transverse colon was protruded. There was no hernia sac, and the defect was closed with interrupted No. 2 silk sutures. The child was discharged on the 8th postoperative day without any complications. During 6 months of follow-up period, recurrence was not noticed.
Abdomen ; Child ; Child, Preschool* ; Colon, Transverse ; Follow-Up Studies ; Heart Sounds ; Hernia* ; Hernia, Diaphragmatic ; Humans ; Ligaments ; Lung ; Male* ; Otitis Media, Suppurative ; Radiography, Thoracic ; Recurrence ; Silk ; Sutures

PURPOSE: This study was performed to evaluate the clinical significance of abnormal cervical cytology in pregnancy and the effectiveness of cytologic and colposcopic surveillance of these women. METHODS: A retrospective analysis was conducted in pregnant women referred to the colposcopic clinic with abnormal cervical cytologic results above ASCUS between Jan. 2002 and Dec. 2007. The Initial colposcopy was performed at the end of 1st trimester. Cervical cytology and colposcopy were repeated once or twice during remaining period of pregnancy and at postpartum 6~8 weeks. Colposcopy directed cervical biopsies were taken in case of colposcopic abnormalities. Without evidence of invasion, no invasive procedure was attempted during pregnancy. Above CIN2 patients were treated postnatally. The postpartum diagnoses were compared to the worst antepartum impressions and initial cytologies. RESULTS: One hundred three pregnant women were referred to colposcopic clinic for 5 years. There was no invasive cervical cancer antenatally. After delivery, 53 patients were followed up and 17 patients above CIN2 lesions treated. Two microinvasive squamous cell carcinoma and 1 invasive adenocarcinoma were found postnatally. In 33 initial ASCUS cytologies, there were 7 CIN2,3 lesions and 3 invasive cancers. One CIN3 was found in 13 LSIL cytologies. All 7 HSIL patients had CIN3 lesions. There were 2 microinvasive cancers postnatally in 17 antenatal CIN2,3 patients. CONCLUSION: ASCUS cervical cytologic results in pregnancy have 30% possibility of CIN2,3 and cancer. LSIL results are normal in 85% and HSIL group 100% CIN3. Even though there is 12.5% risk of microinvasion in antenatal CIN2,3 lesions, noninvasive conservative management is reasonable.
Adenocarcinoma ; Biopsy ; Carcinoma, Squamous Cell ; Colposcopy ; Female ; Humans ; Postpartum Period ; Pregnancy ; Pregnant Women ; Retrospective Studies ; Uterine Cervical Neoplasms

PURPOSE: The purpose of this study was to estimate the effects of a video low intensity exercise program provided during hemodialysis on fatigue, activity of daily living, positive psychological capital and blood pressure of patients being treated. METHODS: A non-equivalent control group pre-post test design was used. Participants were 85 hemodialysis patients assigned to either the experimental group (n=41) or the control group (n=44). The experimental group exercised for about 25 minutes 3 times a week for 8 weeks. Data analyses involved descriptive statistics, χ2 test, t-test, multiple regression and repeated measure ANOVA using SPSS/WIN 23.0. RESULTS: The exercise intervention significantly reduced post hemodialysis fatigue and significantly increased positive psychological capital. There was a significant interaction effect on time by group in blood pressure. Systolic blood pressure changes in the experimental group were stable but, changes in the control group tended to increase gradually. CONCLUSION: To reduce fatigue and increase positive psychological capital for hemodialysis patients, providing exercise during hemodialysis is recommended. Furthermore individualized exercise in terms of intensity, time, duration, etc should be developed and tested. Also, to reduce drastic blood pressure changes during hemodialysis, exercise should be provided.
Blood Pressure ; Evaluation Studies as Topic ; Fatigue ; Humans ; Renal Dialysis ; Statistics as Topic

BACKGROUND AND OBJECTIVES: Acoustic neuroma (AN) is commonly encountered in the cerebello-pontine angle (CPA) and AN arises principally from the vestibular division of the nerve, which can show not only hearing disturbance but also various vestibular symptoms and laboratory findings by affecting central and peripheral vestibular system. Vestibular testing is reported not to be a useful screening test for AN, but can be helpful in defining whether the tumor arises from the superior or inferior division and identifying the cause of dizziness or vertigo. MATERIALS AND METHOD: We are presenting four patients with CPA tumors accompanied by various abnormal findings of vestibular function tests including head-shaking nystagmus, vibration-induced nystagmus, hyperventilation- induced nystagmus and vestibular evoked myogenic potential and subjective visual vertical, which can enable us to understand the pathomechanism of the abnormal results. RESULTS: All patients presented hearing loss and mild dizziness. Caloric test, head thrust test and vibration-induced nystagmus was helpful in localizing the disease, but head-shaking nystagmus and hyperventilation-induced nystagmus was less helpful. Otolith tests did not always show abnormal results. CONCLUSION: We should consider abnormal results of the vestibular function tests in a whole to estimate the status of vestibular compensation in patients with CPA tumors.
Caloric Tests ; Compensation and Redress ; Dizziness ; Head Impulse Test ; Hearing ; Hearing Loss ; Humans ; Mass Screening ; Neuroma, Acoustic ; Otolithic Membrane ; Vertigo ; Vestibular Function Tests*

PURPOSE: This study identified and compared influential variables on intention and action to quit smoking between adolescent smokers and adult smokers. METHODS: For the selection of variables, the transtheoretical theory was used. A survey was conducted with 376 adolescent smokers in 4 high schools and 451 adult smokers in community settings in South Korea. Discriminant analysis was used for data analysis RESULTS: The variables of adolescent smokers that predicted an intention to quit smoking were: smoking temptation, self re-evaluation, counter conditioning and stimulus control. The variables that predicted an action to quit smoking were: self-efficacy for smoking abstinence, pros for smoking, self reevaluation, and self liberation. The variables of adult smokers that predicted an intention to quit were: smoking temptation, pros for smoking, cons for smoking, self reevaluation. The variables that self liberation and predicted an action to quit smoking were: self efficacy for smoking abstinence, smoking temptation, and counter conditioning. CONCLUSIONS: Developing stage specific smoking intervention methods based on different ways of how individuals make a decision to quit smoking within their contexts needs to be done.
Smoking Cessation/*psychology ; Smoking/*psychology ; Self Efficacy ; *Models, Psychological ; Male ; Intention ; Humans ; Female ; Adult ; Adolescent

Concurrent medical problem is common in dementia patients and critical to their care. Despite its importance, there was no bedside global rating scale for the seriousness of medical comorbidity. Lykestos et al. newly developed a reliable bedside scale, the General Medical Health Rating(GMHR). The objective of this study was to standardize the GMHR in form of Korean version(KGMHR). The study population consisted of 35 dementia patients in nursing home. Rating was performed by 1 physician and 2 nurses. Forty percent(14/35) of patients had one or more unstable medical illnesses. KGMHR ratings no more than 3 were 71.5%(25/35) of patients. The value of interrater reliability coefficient alpha was 0.9121. Correlations between KGMHR ratings and number of unstable medi-cal illnesses were high(r=-0.487, p<0.01). KGMHR ratings were also correlated with number of medications being taken for comorbid conditions(r=-0.542, p<0.01). In conclusion, KGMHR is a very reliable and simple rating scale for medical comorbidity in dementia patients. So the KGMHR could be a useful tool for evaluation of comorbidity in dementia patients. To verify the prognostic value of KGMHR, further large sized long-term study are needed.
Comorbidity ; Dementia* ; Humans ; Nursing Homes

Salivary gland tumors usually appear in solitary mass in single salivary gland. The coexistence of tumors with different histological types occurring within a unilateral parotid gland is an extremely rare event. We experienced a case which two different types of malignant tumors developed at different time points in same gland; metachronous tumors. The second tumor was excised widely and reconstruction was performed by free tissue transfer. Sensory and motor nerve to the left cheek appeared to be intact, and circulation was adequate. This rare case was presented in this article.
Adenocarcinoma ; Cheek ; Neoplasms, Second Primary ; Parotid Gland ; Salivary Glands