PURPOSE: This study was conducted to investigate the effects of self-efficacy promoting program on self-efficacy, self-care behavior and psychosocial adaptation in patients with a colostomy. METHOD: A non-equivalent control group pre test post test design was used. The self efficacy promoting programs was composed of a CD image program based on varicaious experience, education and telephone coaching program based on verbal persuasion, and Stoma care practice, and Self care performance based on performance accomplishment. This study was carried out from July 2, 2005 to April 20, 2006 and 21 patients with a colostomy at one of 2 hospitals participated. Descriptive statistics, chi-square-test, and Mann-whitney U test were used to analyze the data. RESULTS: There were significantly different for specific self efficacy, self care and psychosocial adaptation between the experimental group and control group. CONCLUSION: The self efficacy promoting program for patients with stomas was effective in improving degree of specific self efficacy, self care and psychosocial adaptation.
Colostomy* ; Education ; Humans ; Persuasive Communication ; Self Care* ; Self Efficacy* ; Telephone

Objective: Schizophrenia-spectrum disorders and posttraumatic stress disorder (PTSD) share common clinical manifestations, genetic vulnerability, and environmental risk factors. We aimed to conduct a systematic review and meta-analysis of the comorbid prevalence of PTSD among schizophrenia-spectrum disorders. Methods: We performed a meta-analysis to identify possible contributing factors to the heterogeneity among these studies. We systematically searched electronic databases with no restrictions on language of articles. Results: We extracted 24 samples (18 for current prevalence and 6 for lifetime prevalence) from 22 studies and used a random effects model to estimate the pooled prevalence of PTSD among schizophrenia-spectrum disorders. The current and life prevalence of comorbid PTSD was 10.6% (95% confidence interval [CI]=6.3%–17.3%) and 13.0% (95% CI=5.3%–28.6%), respectively. Studies assessing psychotic experiences/involuntary admission reported the highest prevalence of comorbid PTSD (57.1%, 95% CI=43.6%–59.7%), whereas those assessing various anxiety disorders reported the lowest prevalence (1.1%, 95% CI=1.0%–5.5%). Heterogeneities of the subgroup analysis by similar objectives were largely homogeneous (I2=7.1–34.1). In the qualitative assessment, only two studies (9.1%) were evaluated as having a low risk of bias. Conclusion Our results showed that a careful approach with particular attention to assessing PTSD is essential to reliably estimate the prevalence of PTSD comorbid with schizophrenia-spectrum disorders. The reason for the wide discrepancy in the prevalence of comorbid PTSD among the four groups of studies should be addressed in future research.

BACKGROUND/AIMS: Abdominal ultrasonography is useful for the detection and diagnosis of nonalcoholic fatty liver disease (NAFLD). The aims of this study were to establish a predictive model for the selection of subjects for abdominal ultrasonography for the diagnosis of NAFLD and to assess validity of the model. METHODS: The subjects included 901 people who visited the health examination center of the Busan Medical Center. We conducted multiple logistic regression analyses of potential risk factors to identify independent risk factors for NAFLD, and developed an index system. RESULTS: Four independent risk factors were identified. The index system was developed by assigning 1 clinical scoring point to approximately 0.7 logistic regression coefficients to each factor as follows: alanine aminotransferase/aspartate aminotransferase ratio >1.5 (odds ratio [OR], 2.22; 95% confidence interval [CI], 1.21-4.07; P=0.010), 1 point; gamma-glutamyl transpeptidase >50 (OR, 2.15; 95% CI, 1.13-4.07; P=0.019), 1 point; triglyceride >150 mg/dL (OR, 1.92; 95% CI, 1.14-3.24; P=0.015), 1 point; 23 kg/m2< or =BMI<25 kg/m2 (OR, 3.68; 95% CI, 2.05-6.63; P<0.001), 2 points; and BMI 25 kg/m2 (OR, 7.65; 95% CI, 4.29-13.62; P<0.001), 3 points. The area under the receiver operating characteristics curve was 0.797 (95% CI, 0.751-0.842), and when 3 points was used as a cut-off value, the sensitivity and specificity were 71.7% and 75.9%, respectively. CONCLUSIONS: NAFLD can be predicted through the clinical application of the index system established herein. If abdominal ultrasonography is used for high-risk patients, NAFLD will be diagnosed and managed in its early stage.
Adult ; Aged ; Alanine Transaminase/blood ; Area Under Curve ; Aspartate Aminotransferases/blood ; Body Mass Index ; Fatty Liver/*diagnosis/ultrasonography ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Predictive Value of Tests ; Risk Factors ; Sensitivity and Specificity ; Severity of Illness Index ; gamma-Glutamyltransferase/blood

PURPOSE: Myelodysplastic syndrome (MDS) in children needs to be elucidated in terms of clinical characteristics, natural history, the most effective treatment and prognostic factors, as the disease is very rare and its definition and classification has not reached a consensus by many physician. This study was aimed to describe the characteristics and the disease courses of Korean children with MDS, and to analyze the usefulness of prognostic scoring systems in the prediction of transformation to acute myelogenous leukemia (AML) and overall survival among subgroups. MATERIALS AND METHODS: Fourteen children with MDS seen at Chonnam University Hospital and additional 59 patients identified by the review of Korean literature were evaluated to define clinical characteristics and disease courses. Kaplan-Meier (K-M) probability of leukemic transformation and overall survival were plotted. FAB subtypes, subgroups by Boumemouth Scoring System (BSS), and International Prognostic Scoring System (IPSS) risk groups were compared to predict transformation to AML and overall survival. RESULTS: The median age of 14 patients was 36.5 months. The sex ratio was 3.7:1 (M: F). The frequency of FAB subtypes in Korea was similar to that of other countries except for higher proportion of RA (37%). K-M 3-yr probability of AML transformation and survival for Korean patients were 54.7%, and 49.8%, respectively. Although FAB system, BMS and IPSS were all capable of discriminating subgroups in the prediction of AML transformation and survival, they did not reach the significant level possibly due to small number of patients assigned to each subgroup. CONCLUSION: The clinical characteristics of Korean children with MDS were not different from those of other countries. This study showed the high rate of AML transformation and poor survival in children with MDS.
Child ; Classification ; Consensus ; Humans ; Jeollanam-do ; Korea ; Leukemia, Myeloid, Acute ; Myelodysplastic Syndromes* ; Natural History ; Prognosis ; Sex Ratio

Background: Spontaneous pneumopericardium is a very rare condition. Spontaneous pneumothorax and pneumomediastinum have been reported to be associated with an idiopathic pulmonary fibrosis (IPF). However, spontaneous pneumopericardium has not yet been reported in association with IPF. Here we report a case of spontaneous pneumomediastinum and pneumopericardium in a patient with acute exacerbation of IPF with a review of the relevant literature.
Humans ; Idiopathic Pulmonary Fibrosis* ; Mediastinal Emphysema* ; Pneumopericardium* ; Pneumothorax

The long-term clinical issues in Kawasaki disease are concerned with the coronary artery lesions that result in aneurysmal formation, thrombotic occlusion, progression to ischemic heart disease, and premature atherosclerosis. We here report a 3 month old infant with Kawasaki disease complicated by giant coronary aneurysm with thrombosis. After urokinase(10,000 IU/kg) and heparin(400 IU/kg) were injected for two days as thrombolytic agents, thrombi were successfully dissolved. Even though long-term oral anticoagulation with low-dose aspirin, dipyridamole and coumadin were administered, thrombosis of the left main coronary artery was slowly increased. five years later, coronary angiography showed nearly total occlusion of the left anterior descending artery and collaterals from the right posterior branch and radionuclide scan demonstrated complete reversible perfusion defect of several portions of the left ventricle.
Aneurysm ; Arteries ; Aspirin ; Atherosclerosis ; Child* ; Coronary Aneurysm* ; Coronary Angiography ; Coronary Vessels ; Dipyridamole ; Fibrinolytic Agents ; Follow-Up Studies* ; Heart Ventricles ; Humans ; Infant ; Mucocutaneous Lymph Node Syndrome* ; Myocardial Ischemia ; Perfusion ; Thrombolytic Therapy* ; Thrombosis* ; Warfarin

Recently, the increasing use of antenatal high resolutional ultrasonographic studies, and the increasing expertise of sonographers have contributed to the more frequent prenatal detecton of fetal hepatic calcification. Fetal hepatic calcification can arise from peritoneal, ischemic, infectious, neoplastic, and idiopathic causes. There are many reports that the prognosis is good in isolated fetal hepatic calcification without chromosomal aberrations, associated congenital malfomations or other organ abnormalities. We report one case of fetal hepatic calcification diagnosed by prenatal ultrasonography at gestational age of 27 weeks, without chromosomal abnormalities or other associated organ abnormalities, showing good prognosis.
Chromosome Aberrations ; Fetus ; Gestational Age ; Prognosis* ; Ultrasonography, Prenatal

PURPOSE: The aim of this study was to determine the survival rates of implants placed in grafted maxillary sinuses and compare the results obtained with graft materials, implant surfaces and timing of implant placement. MATERIALS AND METHODS: Between January 1996 and December 2005, 391 implants were placed in 161 patients who underwent sinus grafting treatment simultaneously or separately at Ewha Womans University Hospital. According to inclusion criteria, 272 implants were placed in 102 patients with 112 sinus grafts (30 females, 72 males), aged 26 to 88 years (mean age 49.0+/-9.7). The follow-up period ranged from 12 to 134 months (mean F/U 47+/-32). Survival rates were evaluated according to graft material, implant surface and timing of implant placement. The Kaplan-Meier procedure and the log rank (Mantel-Cox) test were used to estimate survival rates and test for equality of survival rates between different groups of patients. RESULTS: Ten-year cumulative survival rate for implants placed in the grafted sinuses was 90.1%. The survival rates for autogenous bone, combination and bone substitutes were 94.6%, 85.9% and 100%, respectively (p > 0.05). According to implant surface, survival rates were 84.8% in machined group and 97.5% in rough group (p < 0.05). The survival rates were 92.9% in delayed group and 86.0% in simultaneous group (p > 0.05). CONCLUSION: Ten-year cumulative survival rate for implants placed in the grafted sinuses was 90.1%. Rough-surfaced implants have a higher survival rate than machined-surfaced implants when placed in grafted sinuses (p < 0.05).
Aged ; Bone Substitutes ; Female ; Follow-Up Studies ; Humans ; Maxillary Sinus ; Retrospective Studies ; Survival Rate ; Transplants

PURPOSE: The aim of this study was to evaluate adhesion and gene expression of the MC3T3-E1 cells cultured on machined titanium surface (MS) and anodized titanium surface (AS) using MTT test, Scanning electron micrograph and cDNA microarray. MATERIALS AND METHODS: The MTT test assay was used for examining the proliferation of MC3T3-E1 cells, osteoblast like cells from Rat calvaria, on MS and AS for 24 hours and 48 hours. Cell cultures were incubated for 24 hours to evaluate the influence of the substrate geometry on both surfaces using a Scanning Electron Micrograph (SEM). The cDNA microarray Agilent Rat 22K chip was used to monitor expressions of genes. RESULTS: After 24 hours of adhesion, the cell density on AS was higher than MS (p<0.05). After 48 hours the cell density on both titanium surfaces were similar (p>0.05). AS had the irregular, rough and porous surface texture. After 48 hours incubation of the MC3T3-E1 cells, connective tissue growth factor (CTGF) was up-regulated on AS than MS (more than 2 fold) and the insulin-like growth factor 1 receptor was down-regulated (more than 2 fold) on AS than MS. CONCLUSION: Microarray assay at 48 hours after culturing the cells on both surfaces revealed that osteoinductive molecules appeared more prominent on AS, whereas the adhesion molecules on the biomaterial were higher on MS than AS, which will affect the phenotype of the plated cells depending on the surface morphology.
Animals ; Cell Count ; Cell Culture Techniques ; Connective Tissue Cells ; DNA ; DNA, Complementary ; Electrons ; Gene Expression ; Oligonucleotide Array Sequence Analysis ; Organothiophosphorus Compounds ; Osteoblasts ; Phenotype ; Rats ; Skull ; Titanium

A congenital hernia into the base of the umbilical cord is known as an exomphalos and when the size of the defect is 5 cm or less and containing only bowel, it is called as exomphalos minor. We present a case of a newborn with an exomphalos minor within a Meckel diverticulum. He underwent surgical resection of the Meckel diverticulum and repair of the abdominal wall defect. To our knowledge, this is the first reported case of Meckel diverticulum in an exomphalos minor in Korea.
Abdominal Wall ; Hernia ; Hernia, Umbilical* ; Humans ; Infant, Newborn ; Korea ; Meckel Diverticulum* ; Minors ; Umbilical Cord