BACKGROUND: Whether the changes of risk factors (hypertension, diabetes mellitus, smoking, alcohol) can precipitate stroke remains unknown, and antecedent infection and psychologic stress are described insufficiently as predisposing risk factors for cerebral infarction. Therefore, we attempted to examine the roles of recent infection, psychologic stress, and the changes of risk factors as potential precipitants in each stroke subtypes. We also tested the temporal relationship between preceding exposure to coldness and stroke onset. METHODS: In this case-control study, 113 consecutive patients with acute cerebrovascular disease (38 small vessel disease, 43 large vessel disease, 11 cardiogenic infarction, 4 infarction of undetermined cause, and 17 intracerebral hemorrhage) and 23 control subjects were evaluated. Changes of the risk factors (and their management) were interviewed. A sign/symptom based questionnaire was used to characterize the prevalence of recent prior infection and exposure to coldness. Psychologic stress was measured with the use of Social Readjustment Rating Scale. RESULTS: The negative change of alcohol drinking was significantly higher in the stroke group. However, there was no significant difference between stroke and control groups in the changes of the other risk factors. The prevalence of previous (within 1 month) infection was significantly higher in the stroke group compared with control subjects (p=0.03). However, there were no significant differences among the stroke subtypes in the prevalence of infection(p=0.08). Upper respiratory tract infections constituted the most common type of infection. The exposure to coldness was significantly higher in the stroke group compared with control subjects (p=0.002). The level of stress within the prior 1 month/1 year was significantly higher in the stroke group than control group (p=0.01). CONCLUSION: Our data suggest that preceding infection, exposure to coldness, psychologic stress, and the negative change of alcohol drinking may be com.
Alcohol Drinking ; Case-Control Studies ; Cerebral Infarction ; Diabetes Mellitus ; Humans ; Infarction ; Prevalence ; Surveys and Questionnaires ; Respiratory Tract Infections ; Risk Factors* ; Smoke ; Smoking ; Stress, Psychological* ; Stroke*

No abstract available.
Congenital Abnormalities* ; Knee* ; Osteoarthritis* ; Osteotomy*

PURPOSE: The purpose of this study was to examine the effects of music therapy on anxiety of patients in emergency room. METHODS: The study was designed using a noneqivalent control group nonsynchronized design. For 20 minutes, the experimental group(22 patients) had listened to music and the control group(23 patients) had bed rest. A six-item state anxiety scale developed by Marteau and Bekker, which was based on Spielberger's State-Trait Anxiety Inventory, blood pressure and pulse rate were measured to all study participants before and after the intervention. The data was analyzed by the SPSS 12.0 program. RESULTS: 1) The experimental group's state anxiety level were significantly lower than the control group's(t=2.220, p=.032). 2) There were no significant differences in both group's diastolic(t=-.495, p=.623) and systolic blood pressure(t=831, p=.411). 3) The experimental group's pulse rate was significantly lower than the control group's(t=2.363, p=.023). CONCLUSION: Music therapy may be applied as a nursing intervention to decrease anxiety in emergency room.
Anxiety ; Bed Rest ; Blood Pressure ; Emergencies ; Emergency Nursing ; Heart Rate ; Humans ; Music ; Music Therapy

PURPOSE: The purpose of this study was to investigate the relationship among stress, depression, and satisfaction to clinical practice in nursing students. METHODS: Three hundred forty-five nursing college students were selected by convenient sampling and data were collected from October to November, 2011. RESULTS: The nursing students experienced moderate stress level. The most severe stressors were adjustment to school and clinical practice. Also, they experienced more than moderate level of satisfaction on clinical practice. The most satisfiable factors were clinical practice circumstance and practice hours. The sophomore had more severe stress and depression and had lower clinical practice satisfaction than the junior. Satisfying with major in nursing as well as clinical practice had a significantly negative correlation with stress and depression. CONCLUSION: Based on this results, we need to develop programs for increasing satisfaction to clinical practice and major in nursing. The program will enhance adaptation ability to clinical practice.
Depression ; Humans ; Students, Nursing

BACKGROUND: The cardiac troponin I (cTnI), one of the subunits of the troponin regulatory complex, binds to actin and inhibits interactions between actin and myosin. cTnI is highly sensitive and specific marker for myocardial injury and is useful in diagnosis and detection of reperfusion in acute myocardial infarction (AMI). In this study, we measured the serum concentration of cTnI according to serial time after chest pain in patients with AMI and compared serum concentration of cTnI with CK-MB and echocardiographic data to evaluate the significance of measuring serum concentration of cTnI in AMI. SUBJECTS AND METHODS: The study was carried out on 16 patients with first attack of AMI within 6 hours of chest pain. All patients were performed thrombolytic therapy and reperfusion was confirmed by coronary angiography. Blood samples for measuring of CK-MB and cTnI were collected at 4-h intervals during the first 24 h, 12-h intervals until 48 h, and 24-h intervals until fourth days after hospitalization. Echocardiography were performed before thrombolytic therapy in all patients. RESULTS: 1) The mean age of subjects was 63.6+/-11.5 years (range:44 - 84 years) and 11 patients were men and 5 patients were women. The site of infarction was anterior in 11 patients and inferior in 5 patients. 2) The peak concentrations of CK-MB and cTnI were reached from 4-h to 12-h after admission in all patients (7.3+/-2.6-h, and 9.0+/-3.1-h, respectively), but there was no significant difference in peak time. 3) Serum concentration of CK-MB was normalized at 72-h after admission, but cTnI was remained in increased state until 96-h after admission. The numbers of the patients with above cutoff value of CK-MB and cTnI at different time after admission were significantly different after 72-h (p<0.05). 4) The peak cTnI and sigma cTnI level were significantly correlated with peak CK-MB and sigma CK-MB level, respectively (r 2 =0.7955, p<0.0001 and r 2 =0.6378, p=0.0002, respectively). 5) The ejection fraction was not correlated with peak cTnI concentration (r 2 =0.0948, p=0.2461) and sigma cTnI (r 2 =0.1867, p=0.0946). 6) The wall motion score index was not correlated with peak cTnI concentration (r 2 =0.2135, p=0.0716), but significantly correlated with sigma cTnI (r 2 =0.2540, p=0.0465). CONCLUSION: The serum concentration of cTnI was useful in late diagnosis of AMI and cTnI release in patients with AMI was correlated with myocardial infarct size.
Actins ; Chest Pain ; Coronary Angiography ; Delayed Diagnosis ; Diagnosis ; Echocardiography ; Female ; Hospitalization ; Humans ; Infarction ; Male ; Myocardial Infarction* ; Myosins ; Reperfusion ; Thrombolytic Therapy ; Troponin I* ; Troponin*

Painting probe for HSRs in IMR-32 Neuroblastoma, a pediatric malignant neoplasm of neural crest origin, has a wide range of clinical virulence. The mechanisms contributing to the development of neuroblastomas are largely unclear, but non-random chromosomal changes identified over the past years suggest the involvement of genetic alterations. Amplification of the human N-myc proto-oncogene is frequently seen either in extrachromosomal double minutes or in homogeneously staining regions(HSRs) of aggressively growing neuroblastomas. N-myc maps to chromosome 2 band 24, but HSR have never been observed at this band, suggesting transposition of N-myc during amplification. We have constructed and analyzed the region-specific painting probe for HSR in neuroblastoma IMR-32 to determine the derivative chromosomes. Microdissection was performed on HSR using an inverted microscope with the help of microglass needles and an micromanipulator. We pretreated the microdissected fragments with Topoisomerase I which catalyzes the relaxation of supercoiled DNA, and performed two initial rounds of DNA synthesis with T7 DNA polymerase followed by conventional PCR to enable the reliable preparation of Fluorescent in situ hybridization probe from a single microdissected chromosome. With this method, it was possible to construct the region-specific painting probe for HSR. The probe hybridized specifically to the HSRs of IMR-32, and to 2p24, 2p13 of normal chromosome. Our results suggest there was coamplification of N-myc together with DNA of the chromosome 2p24 and 2p13. Moreover, the fluorescent signals for the amplified chromosomal regions in IMR-32 cells were also easily recognized at a Thus this painting probe can be applied to detect the similar amplification of N-myc in neuroblastoma tissue, and the probe pool for HSR may be used to identify the cancer-relevant genes.
Cell Line* ; Chromosomes, Human, Pair 2 ; DNA ; DNA Topoisomerases, Type I ; DNA, Superhelical ; Genes, myc ; Humans* ; In Situ Hybridization, Fluorescence ; Microdissection ; Needles ; Neural Crest ; Neuroblastoma* ; Paint* ; Paintings* ; Polymerase Chain Reaction ; Relaxation ; Virulence

BACKGROUND/AIMS: The distribut ion of HCV genotypes varies with geographical area, and genot ypes can affect t he nat ur al course of HCV infection, but adequate genot yping data were not accumulat ed in Korea. This study was des igned to det ermine the pattern of distribution of HCV genotypes in Korea and it's clinical implications. METHODS: 100 cons ecut ive anti- HCV( +), RT-PCR(+) cases were recruited. Genotype specific oligonucleotide primers were made according to the sequence variation of NS5 region of HCV genome. Heminested PCR with mixed primersets was per formed, and genotype specific PCR products of different size were verified. Sequencing of cloned PCR products was done in cases with representative genotypes. Clinical profiles of genotype 1b and 2a were compared. RESULTS: Genotyping was done in 78 among 100 cases. Genotype 1b (48/ 78, 57.7%) and 2a (25/ 78, 32.1%) were most prevalent , and 1a (1/ 78, 1.3%) and mixed form (7/ 78, 9.0%) were also found. Milder cases with persistent normal ALT levels were more frequently seen in genotype 2a ( 9/ 25, 36.0%) than in genot ype 1b (3/ 45, 6.7%) (p< 0.01). CONCLUSIONS: Genotype 1b and 2a were major ones in anti- HCV( +) Korean adults, and the tendency of milder clinical course of genotype 2a was suggested.
Adult ; Clone Cells ; DEET ; DNA Primers ; Genome ; Genotype ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Humans ; Korea ; Polymerase Chain Reaction*

PURPOSE: To evaluate the clinical aspects of severe endogenous endophthalmitis requiring evisceration,particularly underlying disease, causative microorganisms, and infection focus, and to assess the outcome of evisceration. METHODS: The records of 13 patients who were diagnosed with endogenous endophthalmitis requiring evisceration and treated at Yeungnam University Hospital from July 1994 to April 2007 were retrospectively reviewed. RESULTS: Of the 13 patients, all patients had diabetes mellitus, five had advanced liver disease, and one had aplastic anemia. Infection foci were pyelonephritis, pneumonia, and liver abscess. Five cases were confirmed with positive culture of lebsiella pneumoniae. Ten cases underwent evisceration with hydroxyapatite implantation, and three cases were treated conservatively because the patient was in poor systemic condition. Of the 10 patients who underwent evisceration, ocular implants were exposed in five cases. CONCLUSIONS: This study suggests that evisceration with primary orbital implant insertion for endogenous endophthalmitis involves the risk of implant exposure, but after secondary repair, all patients have stable clinical courses.
Anemia, Aplastic ; Diabetes Mellitus ; Durapatite ; Endophthalmitis ; Humans ; Liver Abscess ; Liver Diseases ; Orbital Implants ; Pneumonia ; Pyelonephritis ; Retrospective Studies

PURPOSE: This study was performed to evaluate the usefulness of compression of radiologic images by using personal computer(PC) and the clinically acceptable compression ratio for personal archiving. MATERIALS AND METHODS: The 300 images of total 60 cases including 10 cases each of plain radiograph, angiography, barium study, US, CT, and MRI were obtained from video camera recorder and were digitalized at image board of PC with 628 x430 matrix and archived to 8 bit gray scale for BMP, TIFF, PCX, GIF, 16 bit color for TGA, and 8 bit gray scale and 24 bit color for JPEG. We compared the image quality on each of the 6 image file formats and various compression ratios by using a ROC(receiver operating characteristic) analysis. RESULTS: The file size order was TGA, BMP, PCX, TIFF, GIF, and the smallest JPEG. The excution time for compression and decompression of images ranged from 10 to 20 seconds and from 4 to 7 seconds, respectively. The compression ratio for TGA and TIFF, PCX, and GIF was less than 1.5:1 whereas it was more than 3:1 for JPEG. The higher the compression ratio of JPEG, the more degradation of image quality occurred although compression ratio below 20:1 made no considerable difference. In the remainder, the image quality was same before and after the compression. The digital images of US, CT, and MR showed lower degradation of image quality than plain radiograph, angiography, and barium study. CONCLUSION: The clinically acceptable limiting compression ratio of JPEG was 20: 1 which would be adequate for managing the large volume of image database on a PC-based digital imaging system.
Angiography ; Archives* ; Barium ; Decompression ; Humans ; Magnetic Resonance Imaging

BACKGROUND: Single pass lead VDD pacing preserves atrioventricular synchrony with a single lead system which incorporates floating atrial electrodes. The objectives of this study were to measure whether different body postures and physical activities cause significant changes of the atrial electrogram amplitudes and to evaluate the effectiveness of its atrial sensing, ventricular sensing and pacing. METHOD: Prospective study was done in 7 patients with high degree AV block and normal sinus node function in whom a single lead VDD pacing system was implanted. The P wave amplitude was been measured in different condition during follow-up period. RESULTS: 1) During follow-up period, the P wave amplitude showed variation with changes in posture and respiration, but there was no consistent increase or decrease in amplitude. The lowest P wave amplitude was above the minimal atrial sensing value of 0.2 mV. 2) The percentage of atrial synchronous ventricular pacing recorded in Holter ECG and during Treadmill exercise test was more than 99%. 3) Atrial oversensing or VA cross sensing were not observed in any of the patients. CONCLUSIONS: Despite floating atrial electrode, the single pass lead VDD pacing maintains reliable atrial sensing and ventricular pacing in different body position and physical activity, so it may offer an excellent alternative in patients with high grade AV block and intact sinus node function.
Atrioventricular Block ; Electrocardiography ; Electrodes ; Electrophysiologic Techniques, Cardiac ; Exercise Test ; Follow-Up Studies ; Humans ; Motor Activity* ; Posture ; Prospective Studies ; Respiration ; Sinoatrial Node