Lymphocytic infiltration of the thyroid gland is a hallmark of the human thyroid autoimmune disease. Enhanced expression of immunoglobulin and adhesion molecules are consistently found in patients with autoimmune thyroid diseases. And cytokines are implicated in enhancing the expression of adhesion molecules.It has been suggested that adhesion-molecule expression within thyroid glands mediates lymphocyte homing events to the target of the autoimmune process. The expression of ICAM-1 was shown to be up-regulated on thyroidal perifollicular endothelial cells and thyrocytes in autoimmune thyroid diseases both in vitro and in vivo.Therfore, we investigated the correlation between thyroid hormone, TSH receptor antibodies, Interleukin-6 and soluble ICAM-1 in patients with Graves' disease before and 2 months after treatment with prophylthiouracil(PTU).Serum concentrations of soluble intercellular adhesion molecule-1(sICAM-1), T_3, T_4, TSH-receptor antibodies(TSH-R-Ab) and Interleukin-6(IL-6) of peripheral blood monocytes were measured in patients with Graves' disease.Serum levels of sICAM-1 were elevated in patients with Graves' disease before treatment with PTU, but serum levels of sICAM-1 did not correlate with the serum concentration of thyroid hormone and TSH-R-Ab before and after treatment. In addition, no correlation between serum levels of sICAM-1 and IL-6 of peripheral blood monocyte.We conclude that although the elevated serum levels of sICAM-1 may contribute to the autoimmune process in Graves' disease, we need more future studies for the role of sICAM-1 and correlation between adhesion molecule and thyroid hormone or cytokines in patients with Graves' disease.
Antibodies ; Autoimmune Diseases ; Cytokines ; Endothelial Cells ; Graves Disease ; Humans ; Immunoglobulins ; In Vitro Techniques ; Intercellular Adhesion Molecule-1 ; Interleukin-6 ; Lymphocytes ; Monocytes ; Receptors, Thyrotropin ; Thyroid Diseases ; Thyroid Gland ; Thyroid Hormones

BACKGROUND: Care for prehospital cardiac arrest is one of the major concerns of emergency medical services. But, in Korea, prehospital emergency medical service systems are not yet well established. We tried to offer one of the fundamental data for development of these systems. METHODS: After application of exclusion criteria, 183 patients who transferred to emergency center of our hospital after cardiac arrest in consecutive 24 months from Jan,1,1994 to Dec,31,1995 were included in this study. Retrospective review of the hospital charts of these patients was done. For statistical analysis, we divided patients to some categories. t-test or chi-square analysis was used. RESULTS: 24 patients of the 183 patients were secondary visitors(cardiac arrest was occurred during transfer from other hospitals), 159 patients were primary visitors. In the primary visitor group, only one third was ambulance visitors, and there is no statistical differences between arrest time of ambulance visitors and non-ambulance visitors(35+/-27 vs 37+/-24 min, p=NS). No organized bystander CPR was done. After arrival, 131 patients received CPR and 87 patients(66.4%) were not responded, 31 patients(23.1%) experienced transient ROSC, 13 patients(10.0%) survived until discharge, and only 2 patients(1.5%) were returned to their lives. CONCLUSION: We failed to find significant statistical survival differences between ambulance visitors and non-ambulance visitors, between presumed cardiac etiology group and non-cardiac etiology group. Survival rate was high in witnessed arrest group than unwitnessed arrest group(14.5% vs 2.1%, p=0.015).
Ambulances ; Cardiopulmonary Resuscitation ; Emergencies ; Emergency Medical Services ; Heart Arrest* ; Humans ; Korea ; Retrospective Studies ; Survival Rate

No abstract available.
Stress Disorders, Post-Traumatic* ; Thyroid Gland*

OBJECTIVES: Adult attachment is a relatively stable disposition, rooted in internal working models of self and relationship patterns. However, findings reported from recent research have suggested that levels of attachment anxiety, avoidance, and security are also affected by situational factors. The State Adult Attachment Measure (SAAM) was developed for the purpose of capturing temporary fluctuations in the sense of attachment security and insecurity. In this study, we examined the reliability and validity of the Korean version of the State Adult Attachment Measure (K-SAAM). METHODS: K-SAAM, Experiences in Close Relationships Questionnaire-Revised (ECR-R), Relationship Questionnaire (RQ), Korean version of Positive Affective and Negative Affect Schedule (K-PANAS), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Revised Dyadic Adjustment Scale (R-DAS), and Toronto Alexithymia Scale 20-K (TAS 20-K) were administered to 180 subjects in the community. Exploratory factor analyses and correlation analyses among related variables were conducted. RESULTS: Scores on the K-SAAM demonstrated high internal consistency, with corrected item-total correlations from .56 to .87. Results of exploratory factor analysis yielded three reliable subscales measuring state levels of attachment-related anxiety, avoidance, and security. Results of additional analyses demonstrated both convergent validity and discriminant validity of the K-SAAM. CONCLUSION: The results reported here are highly supportive of the reliability, validity, and utility of the K-SAAM as a state measure of attachment. This new measure will allow clinicians to assess various temporary changes in attachment levels and to examine the efficacy of attachment-based psychotherapy. The K-SAAM has the potential to advance the field in understanding of the dynamics of adult attachment.
Adult ; Affective Symptoms ; Anxiety ; Appointments and Schedules ; Depression ; Humans ; Psychotherapy ; Surveys and Questionnaires ; Reproducibility of Results

BACKGROUND: Sustained-release theophylline, which is generally prescribed as a twice-daily equal-dose regimen, is one of the more common asthma treatments. the development of a sustained-release drug delivery technology that enables improved control of the theophylline blood levels represents a significant advancement in both the efficacy and safety of dosing. METHOD: A crossover study was conducted with 25 adult chronic asthmatic patients requiring daily bronchodilator therapy. The study group included thirteen males and twelve females with ages ranging from 19 to 71 years. The overall approach was to place the patients first on the twice-daily preparation(Etheophyl®) for 28 days at 8 AM and 8 PM, and measure the pulmonary function and theophylline level on the 28th day. the patients were subsequently switched to the once-daily preparation(Uniphyl®) in the same daily dose at 8 PM on the 29th day and the same parameters were measured on the 56th day. RESULTS: the mean serum levels of theophylline were 8.18±1.66µg/ml in the Etheophyl®-treated period and 8.00±1.75µg/ml in the Uniphyl®-treated period. In addition, the FEV1 showed 71.40±7.48 percent in the Etheophyl®-treated and 69.18±9.00 percent in the Uniphyl®-treated period. Thus there were no significant differences between the once-daily and twice-daily preparation. CONCLUSION: The results indicated little clinical differences between the two medication. The two drugs are equally effective in controlling asthma over the four weeks of treatment.
Adult ; Asthma* ; Cross-Over Studies ; Female ; Humans ; Male ; Theophylline

No abstract available.

Pseudo-kaposi's sarcoma is a vasoproliferative disorder that may resemble Kaposi's sarcoma, clinically and histologically. In most cases, it has been associated with congenital or iatrogenic arteriovenous fistula and chronic venous insuffiency. We present a 36-year-old male patient with pseudo-Kaposi's sarcoma caused by a deed vein thrombosis in the absence of any detectable underlying etiologic factors.
Adult ; Arteriovenous Fistula ; Humans ; Male ; Sarcoma ; Sarcoma, Kaposi* ; Thrombosis ; Veins ; Venous Thrombosis*

The reliability of emergency ultrasonographic(US) detection of hemoperitoneum and solid organ injury in blunt abdominal trauma was evaluated retrospectively. From October 1,1995 to August 31,1996,90 patients were included in the study. Ultra- sonographic findings showed a sensitivity, specificity, and accuracy of 97.6%, 97.9%, and 98.1%, respectively, in detecting intraabdominal fluid collection. We believe that US in an emergency center is a quick, safe screening method in the evaluation of blunt abdominal trauma. In our department, US has replaced diagnostic peritonaeal lavage(DPL) and computed tomography(CT) as the screening study of first choice.
Emergencies* ; Hemoperitoneum* ; Humans ; Mass Screening ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography*

This case involved a pulmonary thromboembolism, which originated from the lower extremity. A 68-year-old female, with a femur neck fracture, underwent spinal anesthesia with 0.5% heavy bupivacaine 11 mg for total hip arthroplasty. Ten minutes after the induction of spinal anesthesia, dyspnea, tachycardia and hypotension appeared. Under the impression of a pulmonary embolism, intubation was done and dopamine and epinephrine were infused. The operation stopped and she was sent to the intensive care unit. On the spiral CT chest angiogram, a pulmonary embolism was found. Deep venous thrombosis was detected in the left lower extremity on the venogram. Heparin therapy was started at a rate of 800 U/hour with a bolus of 5000 U. A consultative operation for the removal of deep vein thrombosis was performed by a chest surgeon, and total hip arthroplasty was performed successfully under spinal anesthesia.
Aged ; Anesthesia, Spinal* ; Arthroplasty, Replacement, Hip ; Bupivacaine ; Dopamine ; Dyspnea ; Epinephrine ; Female ; Femoral Neck Fractures* ; Femur Neck* ; Femur* ; Heparin ; Humans ; Hypotension ; Intensive Care Units ; Intubation ; Lower Extremity ; Pulmonary Embolism* ; Tachycardia ; Thorax ; Tomography, Spiral Computed ; Venous Thrombosis

The purpose of this study was to develop a dental communication course in dental hygiene schools that included theory, practice, and skill for effective dental communication. Thirty-six senior dental hygiene students in a dental hygiene school took a dental communication course and responded to a questionnaire. The instrument used in the study was a modified form of Kim's communication skill self-assessment sheet. The self-assessment questionnaire about communication competencies was administered before and after the class, and the difference between scores at each time point was analyzed using the Wilcoxon signed rank sum test. Among seven elements of dental communication competencies, the competency of “information gathering” was significantly improved (p=0.008). Students' scores on perception of the importance (p=0.019) and necessity (0.016) of a communication course significantly increased after the course. Competencies in communication are essential requirement for dental hygienists. This study showed the possibility of communication skill training. An objective evaluation tool regarding students' communication competencies should be developed. Further studies with larger samples size are needed to develop a standardized comprehensive communication course in dental hygiene schools.
Curriculum ; Dental Hygienists ; Health Communication ; Health Education ; Humans ; Learning* ; Oral Hygiene* ; Self-Assessment