PURPOSE: This study was conducted in order to investigate changes in the physical, psychosocial and spiritual health of people with mental disorder in community participating in the Integrated Health Care Program (IHCP). METHODS: This study applied the non-equivalent control group pretest-posttest quasi-experimental design. The participants were 37 chronic psychiatric patients who had been clinically diagnosed with mental disorder and visiting a mental rehabilitation center located in S City (17 in the experimental group, and 20 in the control group). The experimental group participated in the IHCP consisting of 24 sessions for eight weeks. RESULTS: After the intervention, only the participants in the experimental group reported significant improvement in physical (body mass, triglyceride), psychosocial (mental symptoms, depression, self-esteem, ability of problem solving), and spiritual wellbeing when compared with those in the control group. CONCLUSION: These results indicate that IHCP is effective in improving the physical, psychosocial, and spiritual wellbeing of people with mental disorder. Therefore, IHCP developed in this study is considered a useful nursing intervention for raising the comprehensive health level of people with mental disorder in community.
Complementary Therapies ; Delivery of Health Care* ; Depression ; Health Status ; Humans ; Mental Disorders* ; Mind-Body Therapies ; Nursing ; Psychiatric Nursing ; Rehabilitation Centers ; Sensory Art Therapies

No abstract available.
Female* ; Humans

No abstract available.
Duodenum* ; Pigmentation*

Gastric mucosa-associated lymphoid tissue (MALT) lymphoma is the most common form of primary extranodal lymphomas. In most cases, it is developed as multifocal and mucosal lesions, and its initial diagnosis is made by biopsy of suspicious lesions on endoscopy. However, when gastric MALT lymphoma afflict submucosal site without typical mucosal lesion, further procedures are necessary for diagnosis, such as endoscopic mucosal resection and endoscopic ultrasonography. We recently experienced two cases of submucosal tumor-like gastric MALT lymphoma. Both cases were without any mucosal lesion. One case was confirmed by endoscopic mucosal resection, and the latter was by wedge resection. Treatment modalities included endoscopic mucosal resection, surgery, H. pylori eradication, and/or chemotherapy. Both cases achieved complete remission until our 18 months' and 16 months' follow up.
Anti-Bacterial Agents/therapeutic use ; Endosonography ; Female ; Gastric Mucosa/*pathology ; Gastroscopy ; Helicobacter Infections/drug therapy ; Helicobacter pylori ; Humans ; Lymphoma, B-Cell, Marginal Zone/*diagnosis/pathology/surgery ; Male ; Middle Aged ; Stomach Neoplasms/diagnosis

Most of the basal cell carcinomas (BCCs) are effectively treated using standard conventional therapeutic modalities, but the complete removal of the tumor is difficult if the subclinical extension of BCCs is deep and wide. These difficulties are solved by Mohs micrographic surgery which provides the highest possible cure rates and the lowest normal tissue loss. Mohs micrographic surgery is an ideal method for the treatment of skin cancer in that it provides unsurpassed cure rates and maximum preservation of normal tissue by complete surgical margin control. We studied 40 patients with 40 basal cell carcinomas (22 primary, 18 recurrent) treated by Mohs micrographic surgery from January, 1992 through October, 1995 at Dong-A University Hospital. We evaluated the depth and lateral margins of excision by Mohs microgrphic surgery according to the anatomic locations, histologic type, size, and primary/recurrent state of basal cell carcinomas. There was no recurrence during follow-up period up to 3 years. We can draw the guidelines for complete surgical margin control out of our results. The guidelines are as follows. 1. The frist excision should be done with lateral safety margin of 2 mm in primary BBCs. 2. The frist excision should be done with lateral safety margin of 4 mm in recurrent BBCs. 3. The frist excision should be done with lateral safety margin of 4 mm in longer than 15 mm-sized BBCs. 4. The additional excision should be done with the every 2 mm lateral safety margin until the tumor completely removed. 5. The frist excision should be done with the surgical depth to periosteum, perichondrium especially in BBCs on nose.
Carcinoma, Basal Cell* ; Follow-Up Studies ; Humans ; Mohs Surgery* ; Nose ; Periosteum ; Recurrence ; Skin Neoplasms

PURPOSE: Percutaneous ethanol injection therapy has been used in the treatment of the benign thyroid diseases. Although the reported side-effects of the therapy was mild and transient, some side-effects including local or radiating pain are troublesome to the patients. Radioactive iodine also has been effectively and safely used for management of the benign thyroid diseases. So we developed the percutaneous intranodular injection therapy of radioactive iodine as an alternative of percutaneous ethanol injection therapy. METHODS: From December 1998 to October 1999, we treated 29 outpatients (25 women and 4 men, mean age: 47±12 years). Inclusion criteria were follows; age > 30 years, cytologically benign, with normal thyroid function, cold nodule on thyroid scintigram, solid or mixed natured nodules in sonographical evaluation. Nodular volume was estimated by sonography according to the ellipsoid formula. Radioactive iodine (0.1 mCi/ml) was administered in a single dose injection. Follow-up studies every 3 months consisted of full history, thyroid function test, and sonography. We determined the therapeutic response is effective if the volume reduction of the nodule occurred above 30%. ESULTS: RAfter at least 3 months follow-up, 11 patients showed effective response, 12 patients showed minimal or unchanged response and 6 patients showed progression. Although side-effects such as injection pain, febrile reaction, and hormonal changes were absent, an infectious complication in injection site was developed from 1 case. CONCLUSION: Although we need a more prolonged follow-up to evaluate the delayed sequelae, we can suggest that percutaneous intranodular injection therapy of radioiodine may be an attractive non-surgical treatment in selected cases of benign thyroid nodules.
Ethanol ; Female ; Follow-Up Studies ; Humans ; Iodine ; Male ; Outpatients ; Thyroid Diseases ; Thyroid Function Tests ; Thyroid Gland* ; Thyroid Nodule*

The prevalence of gastoesophageal reflux disease (GERD) has been rapidly increased in Korea during last 20 years. However, there has been no systematic review regarding this disease. The aim of this article was to provide a review of available diagnostic modalities for GERD. This review includes proton pump inhibitor (PPI) test, endoscopy, ambulatory pH monitoring, impedance pH monitoring, and esophageal manometry in order to provide a basis for the currently applicable recommendations in the diagnosis of GERD in Korea. With weekly heartburn or acid regurgitation, the prevalence of GERD has been reported as 3.4% to 7.9%, indicating an increase of GERD in Korea. As the prevalence of Barrett's esophagus has been reported to be low, the screening endoscopy for Barrett's esophagus is not recommended. Several recent meta-analyses re-evaluated the value of the PPI test in patients with typical GERD symptoms and non-cardiac chest pain. That is, the PPI test has been proven to be a sensitive tool for diagnosing GERD in patients with non-cardiac chest pain and in some preliminary trials regarding extraesophageal manifestations of GERD. Ambulatory pH monitoring of the esophagus helps to confirm gastroesophageal reflux in patients with persistent symptoms (both typical and atypical) in the absence of esophageal mucosal damage, especially when a trial of acid suppression has failed. Impedance pH test is useful in refractory reflux patients with primary complaints of typical GERD symptoms, but this value has not been proved in patients with non-cardiac chest pain or extraesophageal symptoms. This systematic review is targeted to establish the strategy of GERD diagnosis, which is essential for the current clinical practice.
Barrett Esophagus/diagnosis ; Esophageal pH Monitoring ; Gastroesophageal Reflux/*diagnosis/epidemiology ; Humans ; Manometry ; Proton Pump Inhibitors/metabolism ; Risk Factors

The prevalence of gastoesophageal reflux disease (GERD) has been rapidly increased in Korea during last 20 years. However, there has been no systematic review regarding this disease. The aim of this article was to provide a review of available diagnostic modalities for GERD. This review includes proton pump inhibitor (PPI) test, endoscopy, ambulatory pH monitoring, impedance pH monitoring, and esophageal manometry in order to provide a basis for the currently applicable recommendations in the diagnosis of GERD in Korea. With weekly heartburn or acid regurgitation, the prevalence of GERD has been reported as 3.4% to 7.9%, indicating an increase of GERD in Korea. As the prevalence of Barrett's esophagus has been reported to be low, the screening endoscopy for Barrett's esophagus is not recommended. Several recent meta-analyses re-evaluated the value of the PPI test in patients with typical GERD symptoms and non-cardiac chest pain. That is, the PPI test has been proven to be a sensitive tool for diagnosing GERD in patients with non-cardiac chest pain and in some preliminary trials regarding extraesophageal manifestations of GERD. Ambulatory pH monitoring of the esophagus helps to confirm gastroesophageal reflux in patients with persistent symptoms (both typical and atypical) in the absence of esophageal mucosal damage, especially when a trial of acid suppression has failed. Impedance pH test is useful in refractory reflux patients with primary complaints of typical GERD symptoms, but this value has not been proved in patients with non-cardiac chest pain or extraesophageal symptoms. This systematic review is targeted to establish the strategy of GERD diagnosis, which is essential for the current clinical practice.
Barrett Esophagus/diagnosis ; Esophageal pH Monitoring ; Gastroesophageal Reflux/*diagnosis/epidemiology ; Humans ; Manometry ; Proton Pump Inhibitors/metabolism ; Risk Factors

BACKGROUND/AIMS: Differentiation of an extraluminal compression from a true subepithelial tumor (SET) in the esophagus by using endoscopy alone is often difficult. EUS is known as the best method for differentiating an extraluminal compression from a true SET. Extraluminal compression in the esophagus is occasionally observed, but its clinical significance has been rarely reported. Therefore, we aimed to evaluate the clinical significance of extraluminal compression in the esophagus according to the location of the lesion. MATERIALS AND METHODS: Sixty-one patients were diagnosed as having an extraluminal compression in the esophagus by using EUS between January 2006 and March 2014. Some patients underwent chest computed tomography for accurate diagnosis. RESULTS: The extraluminal compression was located at the mid-esophagus in 26 cases, lower esophagus in 22 cases, and upper esophagus in 13 cases. Of the 61 cases, 55 were caused by normal structures and 6 were caused by pathological lesions. The causes of the normal structures were the aorta, vertebra, trachea, left main bronchus, azygos vein, and diaphragm. The causes of the pathological lesions were engorged vessels and calcified lymph nodes. The posterior wall was the most frequent location of the extraluminal compression. However, the lesions in the anterior and right walls showed a higher frequency of pathological lesions than those in other sites. CONCLUSIONS: If the extraluminal compression is found in the anterior and right walls of the esophagus, more careful evaluation should be performed considering the high frequency of pathological lesions in the site.
Aorta ; Azygos Vein ; Bronchi ; Diagnosis ; Diaphragm ; Endoscopy ; Endosonography ; Esophagus* ; Humans ; Lymph Nodes ; Methods ; Spine ; Thorax ; Trachea

PURPOSE: There are many methods to reduce massive bleeding during total knee arthroplasty (TKA). In our study, tranexamic acid and neutral drainage were used to decrease total blood loss. MATERIALS AND METHODS: The study was performed on 97 TKA patients from March 2012 to January 2013. In the study group, tranexamic acid was administered and neutral drainage was applied. The study group had group I (unilateral, n=29) and group III (bilateral, n=17). The control group had group II (unilateral, n=35) and group IV (bilateral, n=16). RESULTS: In group I, the drainage volume on the 1st and 2nd postoperative days and the total drainage decreased with statistical significance (p<0.05). Between group III and group IV, group III had less drainage volume. In group III, the drainage volume on the 1st postoperative day and total drainage volume decreased statistically significantly (p<0.05). Between groups I and II, total blood loss showed no statistically significant difference, whereas between groups III and IV, the value was significantly different. CONCLUSIONS: Intravenous administration of tranexamic acid with neutral drainage for 3 postoperative hours is a recommendable method because it can be helpful in reducing total blood loss in bilateral TKA.
Administration, Intravenous ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Drainage ; Hemorrhage ; Humans ; Knee ; Methods ; Tranexamic Acid