Among the erythrocyte membrane defects, hereditary spherocytosis is the most common. The erythrocyte membrane defect results from a deficiency of spectrin, the most important structural protein in red cell. Hereditary spherocytosis often presents with hemolytic anemia, jaundice, moderate splenomegaly. Diagnosis is established by the presence of spherocytes in the peripheral blood, reticulocytosis, an increased osmotic fragility, and a negative Coombs test. In children, splenectomy is usually performed after age 6 years but can be done at a younger age if warranted by the severity of the anemia and the need for frequent transfusions. In the period December 1987 to Agust 1993, 9 patients with hereditrary spherocytosis underwent splenectomy and the following results were obtained. 1. Nine patients were comprised of five males and four females. 2. Five patients(55.6%) had been admitted to our hospital during age 6-10 years. 3. Four of the nine patients had autosomal dominant inheritance with variable expression. The other five patients had no known inheritance. 4. The diagnosis of the spherocytosis was based on the increased osmotic fragility and increased autohemolysis of the erythrocytes, as well as on the appearance of spherocytes in the peripheral blood smear. 5. In all cases splenectomy was performed. Two patients had concomitant gall stones and choledocholithiasis, respectively. One patient with concomitant gall stones underwent simultaneous cholecystectomy and splenectomy. The other patients associated with choledocholithiasis underwent splenectomy, cholecystectomy, choledocholithotomy, and T-tube drainage. 6. Complete hematologic recovery was obtained by the splenectomy in all cases. 7. Postoperative complication was not occurred.
Anemia ; Anemia, Hemolytic ; Child ; Cholecystectomy ; Choledocholithiasis ; Coombs Test ; Diagnosis ; Drainage ; Erythrocyte Membrane ; Erythrocytes ; Female ; Gallstones ; Humans ; Jaundice ; Male ; Osmotic Fragility ; Postoperative Complications ; Reticulocytosis ; Spectrin ; Spherocytes ; Splenectomy* ; Splenomegaly ; Wills

BACKGROUND: Early reperfusion therapy with thrombolytic agents or primary PTCA is most important to salvage ischemic myocardium in acute myocardial infarction(AMI). Timely reperfusion of jeopardized myocardium clearly improves hemodynamics, decreases infarct size and improves survival. The extent of protection appears to be directly related to the rapidity of reperfusion after onset of coronary occlusion. Although the intravenous thrombolysis is a feasible therapy in the patients with evolving AMI, the benifit of thrombolytic therapy decreases because of the time delay after onset of symptom. This study was perfomed to analyze the factors time delay between onset of symptom and the thrombolytic therapy with retrospective and prospective questionaire in the patients with AMI. METHOD: Eighty one patients with AMI were included in this study who came to the emergency room(ER) of Chungnam National University Hospital(CNUH) from Feburary 1995 to October 1996. Delay between door and thrombolytic therapy was defined as hospital time delay. RESULTS: Thrombolytic therapy(rt-PA or urokinase iv) was done in 60 patients(74.1%) and mean prehopital time delay was significantly decreased in the patients with thrombolytic therpapy when compared with those without thormbolytic threapy(462+/-90 vs 1375+/-473 minutes, p=0.005). There were no singificant factors for prehospital time delay such as age, sex, redsidence, ER near residence, transfer time to ER near residence, family status, family history of AMI, severity of chest pain, presence of risk factors of cardiovascular disease(CVD), previous CVD, degree of education, history of other disease and routine check, transfer methods. The only 8 patients(9.8%) knew about AMI and 7 patients among these patient came to ER earlier and received thrombolytic therapy. From 57 referred patients, 40 patients(70.2%) received reperfusion therapy and only 30 patients(52.6%) had recored EKG in the referred hospital. In the analysis of hospital delay from patient's arrival to the thrombolytic therapy, the arrival time at weekdays and weekend had no differences, but hospital delay were significantly prolonged when patients arrived at ER in the night. CONCLUSION: Since prehospital time delay is a most important factor of time delay for the effective thrombolytic therapy in AMI, the pubic education program and effective transport system are needed. And routine record of EKG in patient with chest pain in the local hospital is very helpful to start effective thromolytic therapy at ER. The well designed prospective study with more patinets in our local region is essential to get more accurate information about transport system and to improve survival rate in patients with AMI.
Chest Pain ; Chungcheongnam-do ; Coronary Occlusion ; Education ; Electrocardiography ; Emergencies ; Fibrinolytic Agents ; Hemodynamics ; Humans ; Myocardial Infarction* ; Myocardium ; Prospective Studies ; Reperfusion ; Retrospective Studies ; Risk Factors ; Survival Rate ; Thrombolytic Therapy* ; Urokinase-Type Plasminogen Activator

For the treatment of coarction of aorta, surgical intervention has been known as a standard therapy.During last decade balloon angioplasty for coarctation of the aorta has been reported as a successful and safe procedure in about 300 cases. This angioplasty was done mainly in infants and children, and little cases in adults and adolescents. A 22 year-old adult with coarctation of aorta have recieved balloon angioplasty. He visited to emergency room due to severe headache and the blood presure of arm was 240/130mmHg at emergency room. The blood pressure at ward was 168/92mmHg in upper extremities, 104/82mmHg in lower extrimities. His aortogram showed coarctation of thoracic aorta below left subclavian artery. The pressure gradient beween ascending aorta and right femoral artery was decreased from 60mmHg to 0mmHg after balloon dilatation (2 times, balloon diameter 18mm). There were no significant complications. The follow-up magnetic resonance image in 4 month after balloon angioplasty showed no evidence of restenosis or saccular aneurysm. Initial hypertension turned to normal blood pressure in 4 months after balloon angioplasty. This adult case of successful balloon angioplasty for coarctation of aorta is the first case reported in Korea.
Adolescent ; Adult* ; Aneurysm ; Angioplasty ; Angioplasty, Balloon* ; Aorta ; Aorta, Thoracic ; Aortic Coarctation* ; Arm ; Blood Pressure ; Child ; Dilatation ; Emergency Service, Hospital ; Femoral Artery ; Follow-Up Studies ; Headache ; Humans ; Hypertension ; Infant ; Korea ; Subclavian Artery ; Upper Extremity ; Young Adult

PURPOSE: This study was conducted to evaluate clinical competency of nursing students and to examine the validity and reliability of the scale. METHODS: The Clinical Competency Scale was formed through modification of Lee's Clinical Competency Scale that was originally developed in 1990. The Clinical Competency Scale was applied to 203 nursing students. Construct validity, item convergent and discriminant validity, concurrent validity, and internal consistency reliability of the scale were evaluated. RESULTS: Exploratory factor analysis supported the construct validity with a five factor solution; that explained 63.6% of the total variance. Concurrent validity was demonstrated with the Nursing Competence Scale (r=.78, p < .001). Cronbach's α coefficient for the scale was .96. CONCLUSION: The results of this study suggest that the Clinical Competency Scale has relatively acceptable reliability and validity and can be used in clinical research to assess clinical competency for nursing students.
Clinical Competence ; Humans ; Mental Competency ; Nursing ; Psychometrics ; Reproducibility of Results ; Students, Nursing

The primary rhabdomyosarcoma of the brain is very rare. There are only 14 cases reported in the literatures till 1975, and the majority of them were arised in the cerebellum. The intracranial rhabdomyosarcomas may be originated from the multipotent mesenchymal cells of aberrent muscle tissue in the leptomeninges. The histological 3 types are adult pleomorphic, alveolar and embryonal type. The demonstration of cross-striation is confirmed for diagnosis of this tumor. All of these tumors tend to have a short clinical course, but the survival time seems to be slightly improved by surgical excision followed by radiotherapy. We have recently experienced one case of primary rhabdomyosarcoma in the left cerebellopontine angle of 9 year-old girl, which was confirmed by operation and complete autopsy.
Adult ; Autopsy ; Brain ; Cerebellopontine Angle ; Cerebellum ; Child ; Diagnosis ; Female ; Humans ; Radiotherapy ; Rhabdomyosarcoma*

Postmenopausal frontal fibrosing alopecia is a recently described, rare scarring alopecia. The disease is characterized by progressive frontal recession in postmenopausal women with clinical features of a fibrosing alpecia. The histologic findings are indistinguishable from those seen in lichen planopilaris. Postmenopausal frontal fibrosing alopecia is especially rare in Asian women. We describe a typical case of postmenopausal frontal fibrosing alpecia in a Korean woman with clinical and histologic features.
Alopecia* ; Asian Continental Ancestry Group ; Cicatrix ; Female ; Humans ; Lichens

PURPOSE: The purpose of this study was to investigate the risk factors related to prehypertension in Korean adults. METHODS: The data were obtained from the Korean National Health and Nutrition Examination Survey 2005. The ubjects of this study were 3,981 adults aged over 20 years of age. Demographic characteristics, alcohol drinking, smoking, physical activity, stress, BMI, serum lipid profiles and blood pressure were analyzed in this study. RESULTS: Prevalence of prehypertension was 38.9% in this study. As the result of multiple logistic regression, the risk of prehypertension in male, elderly and low income persons was increased. And the risk of prehypertension was increased in the case of problem drinking, alcohol abuse, formal smoker, overweight, obesity and hyperlipidemia in triglyceride. CONCLUSION: To decrease prehypertension prevalence, it is necessary to detect and manage the influencing risk factors of prehypertension such as alcohol drinking, smoking, obesity, physical activity, stress and serum lipid profiles.
Adult ; Aged ; Alcohol Drinking ; Asian Continental Ancestry Group ; Blood Pressure ; Humans ; Hyperlipidemias ; Hypertension ; Logistic Models ; Male ; Motor Activity ; Nutrition Surveys ; Obesity ; Overweight ; Prehypertension ; Prevalence ; Risk Factors ; Smoke ; Smoking

PURPOSE: This study was done to identify predictors differentiating the preparation stage, which is the stage that the smoker is ready to quit smoking, between adolescent smokers and adult smokers. METHOD: A survey was conducted with 376 adolescent smokers in 4 high schools and 451 adult smokers in community settings in South Korea from August 2003 to April 2005. To identify the predictors before and after preparation in stages of change of smoking, logistic regression was done. RESULTS: The predictors for before preparation in stages of change of smoking were process of change for smoking abstinence for adolescent smokers and depression for adult smokers. The predictors for after preparation in stages of change of smoking were self-efficacy for smoking abstinence for adolescent smoker and self-efficacy for smoking abstinence and smoking temptation for adult smokers. CONCLUSION: For each group, adolescent smokers and adult smokers, specific smoking intervention methods need to be developed based on the different ways individuals make the decision to quit smoking within their contexts.
Adolescent* ; Adult* ; Depression ; Humans ; Korea ; Logistic Models ; Smoke* ; Smoking*

Purpose: This study investigated the impact of nurse practice environment and organizational justice on nurses’job satisfaction. Methods: We identified the factors between nursing work environment and organizational justice to job satisfaction for 189 nurses working at a general hospital in city C. Data were collected from June 1st to 15th, 2023, and analyzed using descriptive statistics, t-test, ANOVA, Pearson’s correlation coefficients, and multiple stepwise regression, using IBM/SPSS 27.0 for the Windows program. Results: The mean job satisfaction was 3.24±0.55 points on a 5-point scale. Multiple stepwise regression revealed that the factors affecting nurses’job satisfaction included nursing foundations for quality of care (β=.26, p=.005), staffing and resource adequacy (β=.40, p<.001), collegial nurse-physician relations (β=-.24, p=.007), and distributive justice(β =.27, p<.001).These variables explained 55.0% of job satisfaction. Conclusion The research findings indicate that higher job satisfaction is associated with a better nurse practice environment and positive perceptions of organization justice. These findings indicate that it is necessary to enhance the nurse practice environment and improve organizational justice to enhance job satisfaction among nurses.