No abstract available.
Gastrectomy* ; Humans ; Quality of Life* ; Stomach Neoplasms*

No abstract available.
Female ; Humans ; Pregnancy ; Pregnancy Trimester, Second*

No abstract available.
Humans ; Pregnancy, Twin* ; Twins*

PURPOSE: This study was to determine the mediator or moderator role of social support in the relationship between stress and depression among family caregivers of older adults with dementia. METHOD: Sixty nine family caregivers were randomly selected from health care centers in P city and a face-to-face interview was conducted using questionnaires from January to May of 2002. Data were analyzed with descriptive statistics, Pearson correlation, and hierarchical multiple regression using SPSS program. RESULT: Family caregivers of older adults with higher dependency in ADLs and higher problematic behaviors, provided care to the older adults for a longer period of time, and perceived less social support reported higher depression. Social support showed mediating effects between stress and depression, while did not show moderating effects. Elderly dependency on ADLs and caregiving duration decreased perceived social support and decreased social support increased depression. CONCLUSION: To increase family and social support to the caregivers of more functionally impaired elderly, family education to increase emotional support and physical assistance to the caregivers and broader and flexible application of social support such as increasing accessibility to the elderly daycare service with lower price may prove beneficial.

PURPOSE: The thickening of the gallbladder wall is a valuable finding for the diagnosis of cholecystitis, butmay be seen in non-cholecystic disease as well as in acute or chronic cholecystitis. The purpose of this study isto determine the value of color Doppler sonography in differentiating the causes of thickened gallbladder wall. MATERIALS AND METHODS: Ninety eight patients with thickened gallbladder wall(more than 3mm) which was not due to gallbladder cancer were prospectively evaluated with color Doppler sonography. Sixty-six cases, confirmed bypathologic reports and clinical records, were analyzed for correlation between thickened gallbladder wall andcolor flow signal according to the underlying causes. RESULTS: Of the 66 patients, 28 cases were cholecystitisand 38 cases had non-cholecystic causes such as liver cirrhosis, ascites, hepatitis, pancreatitis, renal failure,and hypoalbuminemia. Of the 28 patients with cholecystitis(12 acute, 16 chronic), 23(82%) had color Doppler flowsignals in the thickened gallbladder wall. Of the 38 patients with non-cholecystic causes, eight(21%) had color Doppler flow signals. There was a statistically significant difference of color Doppler flow signals between the cholecystitis and non-cholecystic groups(p=0.0001). No significant difference of color Doppler flow signals was found between cases of acute and chronic cholecystitis. Of the 23 patients with color Doppler flow signals in 28cases of cholecystitis, 18(78.3%) showed a linear pattern and five(21.7%) showed a spotty pattern. Of the eight patients with color Doppler flow signals in the 38 non-cholecystic cases, four(50%) showed a linear pattern andfour(50%) showed a spotty pattern. In cholecystitis, a linear color Doppler flow signal pattern is a much more frequent finding than a spotty pattern. CONCLUSION: Color Doppler sonography is a useful and adequate method for determining whether a thickened gallbladder wall is the result of cholecystitis or has non-cholecystic causes.
Ascites ; Cholecystitis ; Diagnosis ; Gallbladder* ; Hepatitis ; Humans ; Hypoalbuminemia ; Liver Cirrhosis ; Pancreatitis ; Prospective Studies

OBJECTIVES: This study examined job satisfaction, empowerment, job stress, and burnout among tuberculosis management nurses and physicians in public healthcare institutions. METHODS: This was a cross-sectional study analyzing survey data collected from 249 nurses and 57 physicians in 105 public health centers, three public tuberculosis hospitals, and one tertiary hospital. The survey questionnaire comprised general characteristics, work-related characteristics, and four index scales (job satisfaction, empowerment, job stress, and burnout). The two-sample t-test was used to estimate the mean differences in the four index scales. Multiple regression analysis was used to determine whether general and work-related characteristics affected the four index scales. RESULTS: The job satisfaction and empowerment scores of the nurses were lower than those of the physicians. Except for the tuberculosis-specialized hospitals alone, the average job satisfaction scores of nurses were higher than those of physicians. Moreover, the nurses reported more job stress and burnout than did the physicians in tuberculosis departments in public healthcare institutions in Korea; in particular, the burnout reported by nurses was significantly higher than that reported by physicians at the National Medical Center. Marital status, nursing position, number of coworkers, the average number of days of overtime work per month, self-rated health, and hospital type were associated with the four index scales. CONCLUSIONS: Overall, nurses were more vulnerable to job stress and burnout than physicians. Reducing the workload of nurses by ensuring the presence of sufficient nursing staff and equipment, as well as by equipping facilities to prevent tuberculosis infections, should be considered priorities.
Cross-Sectional Studies ; Delivery of Health Care ; Hospitals, Chronic Disease ; Humans ; Job Satisfaction* ; Korea ; Marital Status ; Nursing ; Nursing Staff ; Power (Psychology) ; Public Health ; Tertiary Care Centers ; Tuberculosis* ; Weights and Measures

Neuroblastoma is the most common extracranial solid tumor in children, and accompanies various clinical symptoms including hypertension. Hypertension is associated with catecholamines secreted from the tumor, and is usually not severe. We report one case of malignant hypertension with cardiac failure in a patient with adrenal neuroblastoma, successfully treated with adrenalectomy. A 3 year-old boy complained of protrusion of the chest wall. Physical examination revealed severe hypertension with cardiac failure. The levels of metabolites of catecholamine were increased in blood (norepinephrine >2000 pg/mL) and urine (norepinephrine 1350.5 ug/day). Abdominal CT showed a 7 cm-sized solid mass arising from the right adrenal gland. After stabilizing the hemodynamics with oral phenoxybenzamine, right adrenalectomy was performed. Pathological diagnosis was a ganglioneuroblastoma. The hypertension and cardiac failure were resolved after tumor removal.
Adrenal Glands ; Adrenalectomy ; Catecholamines ; Child ; Ganglioneuroblastoma ; Heart Failure ; Hemodynamics ; Humans ; Hypertension ; Hypertension, Malignant ; Neuroblastoma ; Phenoxybenzamine ; Physical Examination ; Polyenes ; Thoracic Wall

Splenic cystic lesion is uncommon in children, and cystic lymphangioma of the spleen has not been reported in Korean pediatric patients. Here we report a case of cystic lymphangioma arising from the spleen in a 16 year-old male. The patient presented with left flank pain for 5 days after blunt trauma to the same site. On physical examination, left abdominal tenderness and a palpable spleen were noted. Abdominal ultrasound and MRI revealed multiple septated macro-cystic mass abutting to the spleen medially, suggestive of cystic lymphangioma of the spleen. Laparotomy revealed a 20 cm sized cyst in the spleen, and 2,000mL of dark-brownish fluid was aspirated from the cyst. Splenectomy was performed. Pathological examination revealed the cystic lymphangioma. Post-operative recovery was uneventful, and the patient was discharged at 7 days after surgery.
Child ; Flank Pain ; Humans ; Laparotomy ; Lymphangioma, Cystic ; Male ; Physical Examination ; Spleen ; Splenectomy

Myofascial pain syndrome is defined as the sensory, motor and autonomic symptoms caused by the myofascial trigger points. The sternocleidomastoid muscle is a complex muscle that frequently contains multiple trigger points. These trigger points cause symptoms that are easily misdiagnosed as other conditions. Earache of unexplained origin is likely to be caused by trigger points in the clavicular division of the sternocleidomastiod muscle. The authors report a case of earache caused by a trigger point in the sternocleidomastoid muscle. A 34 year-old woman had earache without any history of trauma or infection. The patient did not have any abnormal finding by otolaryngologic testing, except for an earache, which had not subsided. On physical examination, trigger points in the clavicular division of the sternocleidomastiod muscle were found, and the earache was successfully treated by trigger point injections.
Adult ; Earache* ; Facial Neuralgia ; Female ; Humans ; Myofascial Pain Syndromes ; Pain, Referred ; Physical Examination ; Trigger Points*

PURPOSE: This study was undertaken to evaluate the long-term treatment of esophageal strictures in children with corrosive esophagitis and to determine the effect of self-bougienage on recurrent strictures. MATERIALS AND METHODS: We reviewed the medical records of nine children that were treated for corrosive esophageal strictures from May 2000 to May 2008. Six males and three females were included and their average age was 30 months. Six patients had ingested acids, two patents had ingested alkali, and one ingested an unknown agent. RESULTS: The interval between caustic ingestion and esophageal stricture ranged from one to eight weeks. The average length of the esophageal strictures was 3.8 cm (range, 1 to 9.2 cm). Four patients had a long segment stricture (longer than 5 cm) and one patient had multiple strictures. The most common site of involvement was the upper third followed by the mid third of the esophagus. Eight patients received repeated dilatation using a balloon catheter or bougie dilator. Among the eight patients, two patients had complete resolution of symptoms and six patients required surgery. Among five patients that developed restenosis of the esophageal anastomosis site, three patients had improved symptoms after self-bougienage and two patients had improved symptoms with repeated balloon dilatation or endoscopic bougienage. There were no complications in these patients. CONCLUSION: Although a small number of patients were studied, self-bougienage was safe, less invasive, and effective for the management of esophageal restenosis in patients who required frequent dilation after surgery.
Adult ; Aged ; Balloon Dilatation/adverse effects ; Esophageal Stenosis/*therapy ; Female ; Humans ; Male ; Middle Aged ; Self Care/*instrumentation ; Young Adult