PURPOSE: The purpose of this study was to investigate the present status of falls among inpatients in general hospitals and to identify the fall risk factors that reflect the characteristics of domestic hospitals. METHODS: Data were collected between December 15, 2016 and January 15, 2017 from 32 Korean hospitals having 500 or more beds. First, 42 risk factors were extracted based on literature review and expert opinions. Then the importance of each factor was evaluated by 223 nurses from medical and surgical adult ward and intensive care units in 40 hospitals. RESULTS: The incidence rate of falls in 18 hospitals was 3.87 per 1,000 total discharged patients and 0.55 per 1,000 patient-days, and the rate of injury-related falls was 40.5%. Major risk factors for falling were identified as the following: being over 65 years of age, history of falls during admission, physical mobility disorders requiring assistance, physical factors (dizziness or vertigo, unstable gait, general weakness, walking aids, visual problems), cognitive factors (delirium, lack of understanding on limitations), neurological disease, CNS medications CONCLUSION: The findings provide information that can be in the development of a fall risk assessment tool for inpatients in general hospitals in Korea.
Accidental Falls ; Adult ; Audiovisual Aids ; Expert Testimony ; Gait ; Hospitals, General ; Humans ; Incidence ; Inpatients ; Intensive Care Units ; Korea ; Risk Assessment ; Risk Factors ; Vertigo ; Walking

OBJECTIVE: This study was designed to evaluate the effect of nasogastric tube on swallowing function in stroke patients with dysphagia. METHOD: Twelve stroke patients with dysphagia were included in this study. We evaluated the Functional Dysphagia Scale using videofluoroscopic swallowing study. Swallowing tasks were composed of swallowing 5 cc of thick food and same volume of fluid on nasogastric tube insertion state and then nasogastric tube removal state. RESULTS: As the result of measuring oral phase score before and after removing nasogastric tube, all of 12 patients showed no significant difference. There was statistically significant increase in score of residue in piriform sinuses on thick food swallowing after removing nasogastric tube (p<0.05). After removing nasogastric tube, aspiration was decreased on fluid swallowing in cases of 2 patients, while aspiration on thick food swallowing was increased in cases of 2 patients, compared with nasogastic tube insertion state. CONCLUSION: As the result of this study, the stroke patients with dysphagia on nasogastric tube were increased on fluid aspiration due to rapid descending and inhibition of epiglottic closure compared with the removal state of nasogastric tube. And there was significant increased in scores of residue in piriform sinuses on thick food swallowing and aspiration pneumonia after removing nasogastric tube.
Deglutition Disorders* ; Deglutition* ; Humans ; Pneumonia, Aspiration ; Pyriform Sinus ; Stroke*

The purpose of this comparative study is to find out women and their spouses' sexual life and the factors affecting on their sexual life after women's hysterectomy. The data were the 110 questionaires which were collected from the participants, the 55 women who had undergone a hysterectomy due to gynecologic disease or benign tumor of genital organs and their spouses from January 1, 1999 to January 30, 2002 in one general hospital located in Seoul, Korea. Questionnaires were mailed to couples, who agreed to participate on the study and self reported questionnaires returned in the pre-stamped envelopes. And personal visits were made for those couples who did not respond. Tools for Sexual life and characteristics of sexual activities were reconstituted by the author based on Kim(1996) and Chang(1988)'s tools and were reviewed by a nurse specialist. Data analysis was done by SPSS 10.0 program using frequency, percentage, mean, S.D. Pearson correlation coefficient, t-test, oneway ANOVA and multiple regression. The results of this study are as follows; 1.Of all female subjects, 80% had experienced hysterectomy below the age of 50. 2.72.8% of female subjects and 67.3% of male subjects did not receive any sexual education & counseling before and after the surgery. More than 60% of both female and male subjects answered that it was necessary to have a sexual counseling. And 40% wanted to receive sexual counseling from a professional sexual counselor. 3.More than half of couples started their first coitus within 4 weeks after the surgery. And 88.9% of females and 85.2% of males answered that they were experiencing orgasms with their sexual relationship. 4. Influencing factors on the satisfaction level of sexual life were couple's intimacy and sexual discomfort in women and couple's intimacy and sexual knowledge in spouses. These factors explained the 33% and 24% of total variance respectively. In conclusion, the result suggests that it is necessary for couples to receive a professional sexual education and counseling to improve couples' quality of life. It is also necessary for institutions to use prepared nurses by receiving sexual counseling and education program as a professional sexual counselors or educators so as to provide individualized sexual education and counseling for their clients.
Coitus ; Counseling ; Education ; Family Characteristics ; Female ; Genital Diseases, Female ; Genitalia ; Hospitals, General ; Humans ; Hysterectomy* ; Korea ; Male ; Orgasm ; Postal Service ; Quality of Life ; Surveys and Questionnaires ; Self Report ; Seoul ; Sexual Behavior ; Specialization ; Spouses* ; Statistics as Topic

BACKGROUND: It is important to evaluate the patient presenting with non-traumatic chest pain in emergency department, and it is also difficult to classify appropriately. The purpose of this study is to predict probability of acute myocardial infarction(AMI) and assess the group for low probability of AMI that is target for observation-unit of chest pain in emergency department. METHODS: A prospective, clinical study was performed from March 1998 to August 1998 at the department of emergency medicine, Ewha Womans University Mokdong hospital. We classified high-probability group and low-probability group of AMI according to Goldman's algorithm and then compared with the final diagnosis. RESULTS: The study included 218 patients. 84 patients(39%) was the high-probability group and 134 patients(61%) was the low-probability group of AMI. As compared with final diagnosis, AMI was 47 patients(56%) among the high-probability group and 1 patient(0.7%) among the low-probability group. We observed sensitivity of 98%, specificity of 78% in predicting AMI. CONCLUSION: The classification according to Goldman's algorithm may be useful predictor of AMI and improve triage for emergency department patient with chest pain. It is also helpful for management of observation-unit of chest pain in emergency department.
Chest Pain* ; Classification ; Diagnosis ; Emergencies* ; Emergency Medicine ; Emergency Service, Hospital* ; Female ; Humans ; Prospective Studies ; Sensitivity and Specificity ; Thorax* ; Triage

PURPOSE: The purpose of this study was to determine the effects of music therapy and rhythmic exercise on health related quality of life, blood pressure and upper extremity muscle strength in the institution-dwelling elderly women. METHODS: The study was designed using a nonequivalent control group pretest-posttest design. The participants consisted of 35 elders (18 in the experimental group and 17 in the control group). The music therapy and rhythmic exercise were developed by the investigators. The experimental group took part in this program twice a week for 8 weeks. The Short Form 36 health survey questionnaire, blood pressure and grasp power scale were used as instruments. The data were analyzed using SPSS 14.0. RESULTS: Repeated measures ANOVA revealed that music therapy and rhythmic exercise had positive effects on quality of life, especially on vitality, general health and mental health. Also, there were statistically significant differences in diastolic blood pressure and upper extremity muscle strength between the pretest and posttest in the experimental group. CONCLUSION: The study suggests that this program can be applied for older women in long-term facilities to improve quality of life, blood pressure and upper extremity muscle strength.
Aged ; Aged, 80 and over ; Blood Pressure/*physiology ; *Exercise Therapy ; Female ; Health Status ; Humans ; Muscle Strength/*physiology ; *Music Therapy ; Nursing Homes ; Program Evaluation ; *Quality of Life ; Questionnaires ; Upper Extremity

We report a case of 64-year-old female patient who has had factitious skin lesions for 20 years. She complained formification sense and severe itching on her face. These symptoms were improved with squeezing and bleeding. There were scuare shaped ulcerated nodule on the right cheek and white depressed scar on the left cheek. She was treated with wet dressing and occlussive dressing, and skin lesions were nearly cleared within 3 weeks, but new lesion appeared. Pimozide 2mg #1 p.o were given under the diagnosis of delusion of parasitosis from June, 1984. Her symptoms were improved without recurrence till now. Treatment with pimozide in monosymptomatic hypochondriacal syndrome is discussed.
Bandages ; Cheek ; Cicatrix ; Delusions ; Dermatitis* ; Diagnosis ; Female ; Hemorrhage ; Humans ; Middle Aged ; Pimozide* ; Pruritus ; Recurrence ; Skin ; Ulcer

The extensor plus finger is a rare condition, in which there is such tension of the extensor hood mechanism that simultaneous, complete flexion of the metacarpophalangeal joint and the interphalngeal joint is impossible. Full flexion of the metacarpophalngeal joint compels the interphalngeal joints to extend and vise versa. This condition is a severe handicap to grasp. The extensor plus state is produced by any condition which shortens the excursion of the extensor hood mechanism over the metacarpophalngeal joint and proximal phalanx. When the extensor hood (central extrinsic extensor and sagittal band) is the villain of the extenaor plus state, stretching out the hood by tenotomies of the central extrinsic extensor restored normsl function immediately. We experienced four cases of the extensor plus finger of a patient with severe crushing open forearm bone fracture, and treated the cases by staggered tenotomies or complete tenotomies of the central extrinsic extensor and division of the sagittal band, and obtained a satisfactory result.
Fingers ; Forearm ; Fractures, Bone ; Hand Strength ; Humans ; Joints ; Metacarpophalangeal Joint ; Tenotomy

PURPOSE: This study was to evaluate the effects of a comprehensive life style modification program on glycemic control and stress response in type 2 diabetes. METHOD: The participants(n=34) with type 2 diabetes were divided into either a usual care(control) or treatment(experimental) group. The experimental group(n=21) received a program that was based on a comprehensive life style modification protocol at a weekly meeting for 16 weeks. They also participated in individually prescribed exercise and diet along with stress management and self monitoring. The participants were followed for 6 months, during which postprandial glucose, HbA1C, and stress response inventory were measured. RESULT: The experimental group showed a significant lower postprandial glucose and stress response compared to those of the control group. However, there was no significant change in the HbA1C value in either group. CONCLUSIONS: These results suggest that a type 2 diabetes comprehensive lifestyle modification program may lead to clinical improvement in glycemic control and reduce the stress response.
Aged ; Counseling/*methods ; Demography ; Diabetes Mellitus, Type 2/diet therapy/psychology/*therapy ; Dietary Sucrose/*therapeutic use ; Female ; Hemoglobin A, Glycosylated/metabolism ; Humans ; Life Style ; Male ; Middle Aged ; Multivariate Analysis ; Program Evaluation ; Stress, Psychological/*therapy

OBJECTIVE: During the follow-up period of extrahepatic malignancy, one may encounter a solitary hepatic metastasis on CT scan which may be difficult to differentiate from hepatic abscess in an ambiguous clinical setting. It was our intention to copmare the radiological similarities and differences between two disease entities from which differentiation can be attempted. MATERIALS AND METHODS: Thirty-six cases of solitary heaptic meastesis and 23 cases of liver abscess were included in this study. Two radiologists interpreted the CT without knowledge of the clinical informations. CT pattern was categorized and the frequency of various findings were compared between the two groups. CT findings of the mass were analysed in misinterpreted cases. RESULTS: Without the clinical informations, the diagnostic accuracy of the mass was 72-76% without pattern analysis. Homogeneous masses were seen in both groups, but all masses larger than 4cm were metastases. In heterogeneous masses, metatases more frequently accompanied high attenuation in central or peripheral portion of the mass and showed thick intermediate zone, Irregular trabecular pattern or septations were more frequently observed in abscesses. Biliary dilatation or stone, pleural effusion, air in mass or biliary tree were more frequently seen in abscesses. The false diagnosis was encountered most frequently when the mass possessed any of the followings; homogeneous attenuation, mosaic pattern in the mass with inhomogeneous attenuation and thin intermediate attenuation area. CONCLUSION: Pattern analysis of the various CT character will be helpful to differentiate hepatic abscess and solitary hepatic metastasis in the equivocal clinical settings. However, similar pattern can be seen in both entities ;in this cases, corrdination of CT pattern and secondary findings is needed for better differentiation.
Abscess ; Biliary Tract ; Diagnosis ; Dilatation ; Follow-Up Studies ; Intention ; Liver Abscess* ; Neoplasm Metastasis ; Pleural Effusion ; Tomography, X-Ray Computed

High-protein anti-D reagents prepared from pools of human serum have been used for routine RhD typing but, low-protein, saline reactive anti-D reagents formulated predominantly with monoclonal antibodies are in current use. Because some of the high-protein reagents contain macromolecular additives that may cause red cells coated with immunoglobulin to aggregate spontaneously, antisera with these additives may produce a false-positive reaction. A four-day old male was admitted due to severe jaundice. Initially, the RhD type of the newborn using a high-protein reagent was D-positive and then, using two low-protein reagents, it was D-negative. The blood type of the mother was B, CDe, and that of the newborn was B, CcdEe. The direct antiglobulin test on the newborn's RBC was positive. Anti-E and anti-c were identified in the mother's serum and anti-E only was identified in the newborn's serum. The newborn was treated with phototherapy for 10 days and discharged as recovered. We present a case of hemolytic disease of the D negative newborn, which showed a discrepancy between high protein anti-D and low protein anti-D. With a review of literature, the newborn was possibly misinterpreted as D positive.
Antibodies, Monoclonal ; Coombs Test ; Humans ; Immune Sera ; Immunoglobulins ; Indicators and Reagents ; Infant, Newborn* ; Jaundice ; Male ; Mothers ; Phototherapy