PURPOSE: To examine the effects of a case management program on self-efficacy, depression and anxiety in pregnant women with gestational diabetes mellitus. METHODS: Thirty-seven patients who enrolled in a diabetes outpatient clinic were randomly assigned to either an experimental group (n=19) or a control group (n=18). The experimental group received a 2-week intervention composed of a series of one face-to-face interactive interview and five telephone interviews based on the National standards for diabetes self-management education and Bandura's self-efficacy resources of performance accomplishment, vicarious experience, verbal persuasion, and emotional arousal. The effects of the intervention were assessed by completion of a 9-item self-efficacy questionnaire, a 20-item depression questionnaire and a 20-item anxiety questionnaire prior to, and after the intervention. The statistical significances were examined using t-test. RESULTS: The change in self-efficacy was significantly greater in the experimental group than in the control group. Depression and anxiety changes in the experimental group were significantly greater compared to those in the control group. CONCLUSION: The results of study suggest that a case management program improves self-efficacy, and decreases depression and anxiety in pregnant women with gestational diabetes mellitus.
Ambulatory Care Facilities ; Anxiety ; Arousal ; Case Management ; Depression ; Diabetes, Gestational ; Female ; Humans ; Interviews as Topic ; Persuasive Communication ; Pregnancy ; Pregnant Women ; Surveys and Questionnaires ; Self Care

Vulvar leiomyoma is a rare benign solid tumor of the vulva. Their incidence is not known as most reports are of a single case or small series, and their origin is not known exactly. Most cases are asymptomatic and local excision is recommended as initial therapy and also for recurrences. We have experienced vulvar leiomyoma (the labia majora and vestibule of the vagina) in a 51 years old woman and present it with a brief review of the literatures.
Female ; Humans ; Incidence ; Leiomyoma* ; Middle Aged ; Recurrence ; Vulva

OBJECTIVES: The purpose of this study was to examine the effects of positive psychological characteristics on posttraumatic stress symptoms after traumatic experiences. METHODS: The subjects were 97 firefighters (83 males and 14 females), who completed the Life Events Scale, the Rosenberg Self-Esteem Scale, the Connor-Davidson Resilience Scale, and the Impact of Event Scale-Revised Korean version. Pearson product-moment correlation coefficients were computed to examine the relationships among the variables, and Structural Equation Modeling was used to investigate the mediation process in the relationships among traumatic experiences, positive psychological characteristics, and posttraumatic stress. RESULTS: The results showed that self-esteem had a mediating effect on the relationship between traumatic experiences and posttraumatic stress symptoms. Traumatic experiences affected posttraumatic stress symptoms not only directly, but also through self-esteem to posttraumatic stress symptoms. Therefore the lower firefighters' self-esteem was, the more posttraumatic stress symptoms occurred. Resilience, however, apparently had no function as mediating variable in the relationship between traumatic experiences and posttraumatic stress symptoms. Traumatic experiences and resilience each seemed to affect posttraumatic stress symptoms directly. Hence, the lower firefighters' resilience was, the more posttraumatic stress symptoms occurred. CONCLUSION: This study showed that self-esteem had a mediating effect on the relationship between traumatic experiences and posttraumatic stress symptoms. We also found that resilience affects posttraumatic stress symptoms directly, regardless of the number of traumatic experiences. Likewise, these results showed that we should be concerned in positive psychological characteristics such as self-esteem and resilience in order to prevent posttraumatic stress symptoms.
Firefighters ; Humans ; Male ; Negotiating

OBJECTIVE: The Connor-Davidson Resilience Scale (CD-RISC) measures various aspects of psychological resilience in patients with posttraumatic stress disorder (PTSD) and other psychiatric ailments. This study sought to assess the reliability and validity of the Korean version of the Connor-Davidson Resilience Scale (K-CD-RISC). METHODS: In total, 576 participants were enrolled (497 females and 79 males), including hospital nurses, university students, and firefighters. Subjects were evaluated using the K-CD-RISC, the Beck Depression Inventory (BDI), the Impact of Event Scale-Revised (IES-R), the Rosenberg Self-Esteem Scale (RSES), and the Perceived Stress Scale (PSS). Test-retest reliability and internal consistency were examined as a measure of reliability, and convergent validity and factor analysis were also performed to evaluate validity. RESULTS: Cronbach's alpha coefficient and test-retest reliability were 0.93 and 0.93, respectively. The total score on the K-CD-RISC was positively correlated with the RSES (r=0.56, p<0.01). Conversely, BDI (r=-0.46, p<0.01), PSS (r=-0.32, p<0.01), and IES-R scores (r=-0.26, p<0.01) were negatively correlated with the K-CD-RISC. The K-CD-RISC showed a five-factor structure that explained 57.2% of the variance. CONCLUSION: The K-CD-RISC showed good reliability and validity for measurement of resilience among Korean subjects.
Depression ; Female ; Firefighters ; Humans ; Reproducibility of Results ; Resilience, Psychological ; Stress Disorders, Post-Traumatic

An 11-year-old girl was diagnosed with encephalitis due to Epstein-Barr virus(EBV). She was admitted to our hospital due to convulsion and decreased consciousness after several days of fever, sore throat and headache. Cerebrospinal fluid analysis showed lymphocyte-dominant pleocytosis and markedly elevated levels of protein. Magnetic resonance imaging(MRI) finding was normal, except for marked leptomeningeal enhancement. Even though she had signs and symptoms of infectious mononucleosis, EBV infection could not be considered as the underlying cause of the encephalitis until IgM for the viral capsid antigen of EBV had been detected in her blood. After treatment with acyclovir, a high dose of methylprednisolone and intravenous immunoglobulin, the neurological symptoms improved rapidly. She has not suffered from any neurological complications in the four months since being discharged. EBV infection should be considered as the main etiology in cases of childhood encephalitis, although there is no evidence of infectious mononucleosis existed.
Acyclovir ; Capsid ; Child ; Consciousness ; Encephalitis ; Epstein-Barr Virus Infections ; Fever ; Headache ; Herpesvirus 4, Human ; Humans ; Immunoglobulin M ; Immunoglobulins ; Infectious Mononucleosis ; Leukocytosis ; Magnetic Resonance Spectroscopy ; Methylprednisolone ; Pharyngitis ; Seizures

PURPOSE: To evaluate whether soft tissue surrounding the celiac axis, as seen on abdominal CT imaging after gastrectomy for gastric carcinoma, should be considered as the recurrence of carcinoma or postoperative change. MATERIALS AND METHODS: One hundred and forty-one abdominal CT examinations of 71 patients who had undergone subtotal or total gastrectomy for gastric carcinoma were included in our study. Conventional CT scans were obtained with 1 cm thickness and interval from the diaphragm to the kidneys after contrast enhancement. It was considered that carcinoma had not recurred if findings were negative on UGI series, endoscopy with biopsy and a normal level of carcinoembryonic antigen except for soft tissue surrounding the celiac axis on abdominal CT. We then divided subjects into a recurrence group (N = 20) and normal group (N = 51) and on initial follow-up CT (FU-CT), analyzed the incidence, margin, shape, extent, degree and pattern of attenuation of the soft tissue surrounding the celiac axis in both groups. Since the second FU-CT examination, we observed changes in the soft tissue surrounding the celiac axis. RESULTS: On initial follow-up CT, at mean 308 days after surgery, fifty-five percent(39/71) of total patients (70% (14/20) of the recurrence group and 49% (25/51) of the normal group) showed soft tissue surrounding the celiac axis. The margin was distinct in 12 (86%) of the recurrence group and indistinct in 21 (84%) of the normal group (P < 0.001). Twelve (86%) of the recurrence group showed a nodular or confluent nodular shape and 21 (84%) of the normal group showed a permeative shape (P < 0.001). Extent was unilateral in eight (57%) of the recurrence group and bilateral in 16 (64%) of the normal group. Attenuation was similar to that of the spleen and muscle in seven (50%) of the recurrence group and was similar to that of muscle in 18 (72%) of the normal group. The pattern of attenuation was homogeneous in 13 (93%) of the recurrence group and 21 (84%) of the normal group. There was no significant difference in extent, degree and pattern of attenuation between the two groups. Since the second FU-CT examination, soft tissue surrounding the celiac axis was seen to have changed. In one patient in the recurrence group it had a distinct margin, was nodular in shape, unilateral in extent and showed attenuation similar to that of the spleen. In one patient in the normal group, it had changed and had an indistinct margin, three patients showed a decrease in the amount of soft tissue and eight showed decreased attenuation. CONCLUSION: Follow-up abdominal CT is useful in the differentiation of cancer recurrence and postoperative change, and for observing changes in soft tissue surrounding the celiac axis.
Axis, Cervical Vertebra* ; Biopsy ; Carcinoembryonic Antigen ; Diaphragm ; Endoscopy ; Follow-Up Studies ; Gastrectomy* ; Humans ; Incidence ; Kidney ; Recurrence ; Spleen ; Tomography, X-Ray Computed

In the past few years a wide variety of fetal abnormalities have been successfully prenatal diagnosed by maternal sonography. Early excision of the choledochal cyst in the newborn is considered to be the optimal treatment and may pose less risk to the patient than delayed surgical exploration. We present a new case diagnosed a choledochal cyst at 23 weeks gestation by routine ultrasound scanning. At 38 weeks gestation a female infant was born by spontaneous delivery. At 7 weeks of age the patient underwent a laparotomy performed cyst excision with Roux-en-Y hepaticojejunostomy. We experienced a case of choledochal cyst at prenatal sonography and report our case with a brief review of literature.
Choledochal Cyst* ; Female ; Humans ; Infant ; Infant, Newborn ; Laparotomy ; Pregnancy ; Prenatal Diagnosis* ; Ultrasonography

BACKGROUND: Macrophage migration inhibitory factor (MIF) is a unique protein, participating in inflammation, immune response, and cell growth. Previous reports showed that MIF-polymorphisms are associated with an increased risk for various inflammatory diseases. OBJECTIVE: This study was designed to investigate the effect of MIF polymorphisms on Behcet's disease (BD). METHODS: A total of 362 patients with BD and 290 healthy controls were genotyped. We also performed RT-PCR analysis, ELISA, and immunohistochemical stain for MIF. RESULTS: We could not find statistically significant differences in the genotype frequencies of the MIF-794[CATT]5-8 repeat polymorphism or MIF-173 G>C polymorphism between BD patients and controls. Immunohistochemical analysis showed that MIF protein was diffusely distributed throughout epidermis and subcutaneous fat tissue from the skin lesions of patients with BD and erythema nodosum. CONCLUSION: Contrary to earlier reports, serum MIF levels were decreased in patients with BD, and the prescence of polymorphisms in the MIF promoter region was not associated with disease susceptibility. Nevertheless, MIF may play a role in cutaneous inflammation in BD.
Disease Susceptibility ; Enzyme-Linked Immunosorbent Assay ; Epidermis ; Erythema Nodosum ; Genotype ; Humans ; Inflammation ; Macrophages ; Promoter Regions, Genetic ; Skin ; Subcutaneous Fat

Two distinct hantaviruses have been isolated from Apodemus agrarius in 1976 and Rattus norvegicus in 1980 in Korea. Since our serosurveys conducted in 1994, a genetically distinct hantavirus from Apodemus peninsulae has been investigated. To isolate hantavirus from A. peninsulae captured in Korea, the lung homogenate of seropositive A. peninsulae inoculted Vero E6 cells. Viral antigen was detected in a progressively higher percentage of cells with subsequent passage after 80 days postinoculation. The new isolate from seropositive Apodemus peninsulae was designated Suchong virus after Suchong valley located in northeastern region of South Korea. Comparing with hantaan virus 76-118 strain, Suchong virus-1, 2, 3 and 4 showed the similarity of 71.0~91.8% at nucleotide and 90.9~94.8% at amino acid sequences in 231 nucleotides region of M segment, and the similarity of 75.1~81.0% at nucleotide and 97.5~100% at amino acid sequences in 237 nucleotides of S segment.
Amino Acid Sequence ; Animals ; Hantaan virus ; Hantavirus* ; Korea ; Lung ; Murinae* ; Nucleotides ; Population Characteristics* ; Rats

OBJECTIVE: We analyzed quantification of mitochondria DNA (mtDNA) to investigate the relationship of mitochondria and pathogenesis of PCOS. MATERIALS AND METHODS: Peripheral blood samples were collected from 28 patients with PCOS who were under the inclusion criteria for PCOS and from 28 healthy controls. Genomic DNA was used to analyze real-time PCR for mtDNA copy number quantification. The mtDNA copy number was compared between the control and PCOS groups. All data was expressed as mean +/- SD. Statistical analysis was assessed by t-test. RESULTS: In this study, the mtDNA CT was 11.67+/-0.422 in PCOS patients and 11.51+/-0.722 in control group, respectively. The mtDNA copy number was 1726410.71+/-407858.591 the patients of in PCOS and 2167887.51+/-252459.28 in control group (p=0.08), respectively. CONCLUSION: In our study, using real-time PCR, there was a tendency of lower mtDNA copy number in the patients of PCOS when comparing to the control group even though statistical difference was not significant. However, more extensive analysis is required to clarity relationship between mtDNA copy number and pathogenesis of PCOS.
DNA ; DNA, Mitochondrial* ; Humans ; Mitochondria ; Polycystic Ovary Syndrome* ; Real-Time Polymerase Chain Reaction