This study was designed to identify the relationship between the perceived burden that is felt by family caregivers of hemodialysis patients and the quality of life of these caregivers. The subjects for this study were 102 family caregivers of patients who received hemodialysis regularly in the hemodialysis units of 4 hospitals located in Chonbuk. The data was collected during the period from February 17 to March 28, 1997 through interviews and by distributing a structured questionnaire to family caregivers through hemodialysis patients, and by mail service. The instruments used for this study are as follows : The burden instrument was the Burden Questionnaire developed by Lee Sook-Ja by referring to the Burden Scale developed by Novak & Guest(1989) and Zarit et al.(1980). The quality of life instrument was the Andrews' Scale that was treanslated and proof-read by Jeong Chu-Ja and partially amended by the author of this study. The collected data was analyzed by descriptive statistics, ANOVA, the Scheff test, Pearson's correlation and Stepwise Multiple Regression using the SAS PC+ program. The results of this study are as follow : 1. Hypothesis 1 : "The higher the perceived burden, the lower the quality of life of family caregivers of hemodialysis patients" was supported(r=-0.463, p=.000). 2. Hypothesis 2 : "The burden of family caregivers of hemodialysis patients will differ depending on the demographic characteristics of hemodialysis patients and family caregivers" was partially supported-age of family caregiver(F=3.04, p=.020), educational level of family caregiver(F=3.81, p=.012), marital status of family caregiver(F=5.82, p=.004), relationship with hemodialysis patient(F=2.74, p=.016), sex of hemodialysis patient(F=6.79, p=.010). 3. Hypothesis 3 : "The quality of life family caregivers of hemodialysis patients will differ depending on the demographic characteristics of hemodialysis patients and family caregivers" was partially supported-age of family caregiver(F=2.82, p=.029), educational level of family caregiver(F=4.64, p=.004), marital status of family caregiver(F=6.62, p=.002), monthly total income of family(F=5.61, p=.001), age of hemodialysis patient (F=3.42, p=.011), occupation change of hemodialysis patient(F=3.54, p=.032). 4. Stepwise Multiple Regression Analysis indicated that the six variables-the perceived burden of family caregiver, monthly total income of family, religion of family caregiver, occupation of family caregiver, marital status of hemodialysis patient, education level of family caregiver-were significantly predictive of the quality of life of family caregivers of hemodialysis patients. The six variables explained 41.7% of the variance in quality of life. In conclusion, this study revealed that the perceived burden is an important factor related to the quality of life of family caregivers of hemodialysis patients. Therefore, nurses must recognize family caregivers as well as hemodialysis patients as important care receivers and incorporate an intervening plan that reduces the burden and promotes the quality of life, taking into account the demographic characteristics of hemodialysis patients and their family caregivers.
Caregivers* ; Education ; Humans ; Jeollabuk-do ; Marital Status ; Occupations ; Postal Service ; Quality of Life* ; Renal Dialysis* ; Surveys and Questionnaires

Resorcin is widely being used in the fields of the therapeutics, cosmetics, industry, but allergic contact dermatitis is an infrequent adverse reaction. We have experienced a case of allergic contact dermatitis to resorcin. A 59-year-old male with Kaposi's sarcoma on the right foot developed linear erythematous vesicular eruption along the marking areas 4 days after application of Castellanis paint, used as a skin marking solution for radiation therapy. He showed patch test positive reaction to Castellani's paint as well as its individual components, resorcin and phenol.
Dermatitis, Allergic Contact* ; Dermatitis, Contact ; Foot ; Humans ; Male ; Middle Aged ; Paint ; Patch Tests ; Phenol ; Sarcoma, Kaposi ; Skin*

Nonpigmenting fixed drug eruption is a form of fixed drug eruption which heals without pigmentation. To leave no traces makes the diagnosis difficult. A 37-year-old man pressented the erythematous patches on both wrists and the left thigh. Several hours before the eruption, he had taken oral drugs for the treatment of osteomyelitis. He had had the same eruptions which were diagnosed as an allergic contact dermatitis, 8 months ago. The patch tests with medicated drugs were negative, but oral provocation with etodolac brought the same eruptions.
Adult ; Dermatitis, Allergic Contact ; Diagnosis ; Drug Eruptions* ; Etodolac* ; Humans ; Osteomyelitis ; Patch Tests ; Pigmentation ; Thigh ; Wrist

The aims of this study were to investigate the present status of skeletal maturation and to compare body composition parameters on the basis of the levels of skeletal maturity in boys aged 9 ~12 years. The subjects participated consisted of 258 elementary school boys. Anthropometric characteristics included body weight, height, sitting height, bone widths, circumferences, and skinfold thicknesses. Skeletal maturation was assessed by the Tanner -Whitehouse II method. Skeletal age was determined by RUS scores (radius, ulna, and short bones). Body composition variables were evaluated by bioelectrical impedance analysis (BIA Model 310). Means and standard deviations were calculated by descriptive statistics. To compare body composition variables among skeletal maturity groups one -way analysis of variance (ANOVA) was applied and Duncan's a posteriori tests. The results showed that RUS scores varied from 298.2 for 9 years to 482.6 for 12 years. TW2 -20 scores were 569.2 for 9 years, 628.8 for 10 years, 701.8 for 11 years, and 814.5 for 12 years. Skeletal ages were 9.7 for 9 years, 10.5 for 10 years, 11.7 for 11 years, and 13.6 for 12 years. It indicates that chronological age was lower than skeletal age in all age groups. Although no significant difference was found in 12 years for body composition according to the levels of skeletal maturity, in general advanced boys had higher body composition variables than retarded boys. In 9 years there were significant differences (p 0.05) among skeletal maturity groups for body mass index, WHR, and WTR. Also, differences were found in 10 years for percent body fat, fat -free mass, and body mass index. In 11 years advanced children (40.4 kg) have statistically significant (p 0.05) higher fat -free mass than retarded children (32.2 kg).
Adipose Tissue ; Body Composition* ; Body Mass Index ; Body Weight ; Child ; Electric Impedance ; Humans ; Skinfold Thickness ; Ulna

OBJECTIVE: A reference terminology is essential to achieve semantic interoperability and enhance the quality of health care. Reference terminologies that have achieved common acceptance contain many concepts that clinicians would not want in healthcare, which preclude their practical use in documentation of patient information. To solve the problems, this document proposes a reference terminology model which contains concepts that physicians can use satisfactorily. METHODS: We analyzed the structures of the UMLS and SNOMED CT. We also analyzed health care terms which had been collected by the Korea National Health Information Standard Committee. Based on the results of the analysis, we developed an object-oriented reference terminology model. And, we designed database schema with the model. RESULTS: Eight components of the UMLS and six components of the SNOMED CT were analyzed. The collected terms had various properties and mapping vocabularies according to the characteristics of their respective domains. A reference terminology model was developed from a three-level view using UML. A database schema was developed using ERD. CONCLUSION: This study mainly focuses on reference terminology modeling. It is hoped that this reference terminology modeling helps the semantic interoperable exchange of clinical documents as the basis of common EMR.
Delivery of Health Care* ; Hope ; Humans ; Korea ; Quality of Health Care ; Semantics ; Systematized Nomenclature of Medicine ; Unified Medical Language System ; Vocabulary

Aphasia is defined as "the loss of ability to communicate orally, through signs, or in writing, or the inability to understand such communications; the loss of language usage ability." Aphasia is present in 21~38% of acute stroke patients and is associated with high morbidity, mortality and expenditure. The evidence based challenges was described that occurred when carrying out systematic reviews of language therapy for aphasia following stroke. Language therapy in treating aphasia is efficacious when provided intensely for the first 3 months. There is strong evidence that computer-based aphasia therapy results in improved language skills. Constraint induced language therapy can result in improved language function and everyday communication in chronic aphasics. Treatment with rTMS may be associated with improved naming performance in patients with non-fluent, chronic aphasia. But, further investigation is required. Several placebo-controlled trials suggest that piracetam is effective in recovery from aphasia when started soon after the stroke. Drugs acting on catecholamine systems (d-amphetamine) have shown varying degrees of efficacy when combined with language therapy. Data from single-case studies, case series and an open-label study suggest that donepezil may have beneficial effects on chronic poststroke aphasia. Preliminary evidence suggests that donepezil is well tolerated and its efficacy is maintained in the long term. Significant language and communication gains have been demonstrated following the use of memantine in conjunction with constraint-induced language therapy.

Tuberculosis of the duodenum is rare event in patients with pulmonary or intestinal tuberculoais. It is very difficult to diagnose duodenal tuberculosis because of inconaiatent symptoms and nonspecific duodenal lesioa. Although fiberoptic endoscopy has been used, there is the limitation of fiberoptic endoscopy ia diagnosingthis disease and the diagnoais require laparotomy with biopsy. Recently we experienced a case of duodenal tuberculosis with duodenoscopic findings of the submucosal tumor of duaidenum. We report a case with review of literatures.
Biopsy ; Duodenum* ; Endoscopy ; Humans ; Laparotomy ; Tuberculosis*

OBJECTIVES: Lipocortin-1 (LC-1), a member of annexin family of calcium-binding proteins induced by corticosteroid, originally evoked interest as one of the secondary messengers in the antiinflammatory action of corticosteroid, But the exact mechanism of LC-1 responsible for antiinflammatory effect is still unclear. We investigated the potential role of LC-1 in the effect of corticosteroid on amelioration of collagen induced arthritis (CIA) in mice. METHODS: Four groups of DBA/1j mice were immunized by intradermal injection of 5mg/kg of type 2 collagen with complete Freunds adjuvant which was boostered on day 21 and 42. Group 1 received no treatment and group 2 received 1mg/kg dexamethasone intraperitoneally twice weekly from day 21. Group 3 and 4 were treated with 50 and 0.5microgram/kg of anti LC-1 monoclonal antibody subcutaneously and dexamethasone from day 21 twice weekly, respectively. The prevalence of arthritis and arthritis score were assessed twice weekly. At week 10, we measured serum anticollagen antibody levels and splenic mononuclear cell stimulation indices (SI) to collagen. RESULT: CIA started to develop after 4 weeks of collagen treatment in all groups. All mice of group 1 developed arthritis by the 9 week. Treatment with dexamethasone markedly inhibited arthritis development (P<0.05). Cotreatment of anti LC-1 monoclonal antibody and dexamethasone abolished the antiinflammatory effect of dexamethasone (P<0.05). But there was no significant difference in the serum levels of anticollagen antibody or splenic mononuclear cell SI among the groups. CONCLUSION: These findings support the hypothesis that LC-1 is involved, at least in part, in the antiinflammatory actions of corticosteroid in chronic inflammation, although the mechanism of which is unclear.
Animals ; Arthritis* ; Calcium-Binding Proteins ; Collagen* ; Dexamethasone ; Freund's Adjuvant ; Humans ; Inflammation ; Injections, Intradermal ; Mice ; Prevalence

Valproate is widely used because of broad spectrum of action, but it can produce an encephalopathy resulting from hyperammonemia even at the therapeutic range of valproate and is called as valproate-induced encephalopathy (VHE). Delay in recognition of VHE can result in the development of potentially life-threatening complications. Fortunately, it is reversible with discontinuing valproate. A 65-year-old man became progressively lethargic with impaired gait and poor cognitive function while taking valproate as alternative to zonisamide. Routine investigations of admission profiles were performed but revealed no abnormalities. Next, we checked serum ammonia level to identify other possible causes and detected hyperammonemia despite the therapeutic range of valproate in the absence of any abnormalities in liver enzymes. On cessation of valproate, he has achieved dramatic clinical improvement including the reversal of hyperammonemia. We confirmed the diagnosis of VHE. This emphasizes the importance of rapid diagnosis and proper management of VHE in order to prevent the neurological damage and minimize complications.
Aged ; Ammonia ; Gait ; Humans ; Hyperammonemia ; Isoxazoles ; Liver ; Valproic Acid

Stroke is the second leading cause of death, and the leading cause of acquired disability in adults. Survivors of stroke are at risk of a recurrent event, which is often more disabling than first-ever stroke. Recurrent strokes continue to account for 25~30% of all strokes. That represents the needs of successful secondary prevention. Appropriate secondary prevention of recurrent stroke needs rapid diagnosis and treatment and prompt identification of the underlying cardiovascular cause. Some epidemiological data suggest that a substantial proportion of strokes can be attributed to unhealthy lifestyle behaviors. This review summarizes the evidence for optimum secondary prevention of recurrent ischemic stroke as integral part of physical medicine and rehabilitation.
Adult ; Cause of Death ; Diagnosis ; Humans ; Life Style ; Physical and Rehabilitation Medicine ; Rehabilitation* ; Secondary Prevention* ; Stroke* ; Survivors