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*

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

Congenital long QT syndrome (LQTS) is an inherited disease characterized by prolonged QT intervals and polymorphic ventricular tachycardia. The clinical manifestations vary from sudden cardiac death by ventricular arrhythmia to asymptom throughout life. In 1957, Jervell and Lange-Nielsen reported a syndrome of congen-ital sensory deafness associated with a prolonged QT interval in four children. The affected children had multiple syncopal episodes, and three died suddenly. The mode of inheritance is autosomal recessive. Affected persons are susceptible to recurrent syncope, and they have a high incidence of sudden death and short life expectancy. We report a case and review the literature on long QT syndrome diagnosed in a 30-year-old female with a history of convulsion and loss of consciousness during delivery.
Adult ; Arrhythmias, Cardiac ; Child ; Deafness* ; Death, Sudden ; Death, Sudden, Cardiac ; Female ; Humans ; Incidence ; Jervell-Lange Nielsen Syndrome ; Life Expectancy ; Long QT Syndrome* ; Seizures ; Syncope* ; Tachycardia, Ventricular ; Unconsciousness ; Wills

BACKGROUND: The electrocardiogram may provide valuable information regarding the identity of the culprit coronary artery and the location of obstructing lesion within the artery, which may be of guidance in selecting the therapeutic modality. Previous studies have concluded that changes in lateral leads (I, aVL, V5, V6) are predictive of left circumflex coronary artery obstruction in inferior wall acute myocardial infarction. Elect-rocardiographic criteria for determining the location of the obstructing lesion, however, have not been well established. The purpose of this study is to investigate the patterns of ST segment depression in lateral leads in inferior wall acute myocardial infarction and the obstruction site of culprit artery according to ST segment depression in lateral leads. METHODS: We examined 78 patients with inferior wall acute myocardial infarction analizing their electrocardiogram and coronary angiography which performed during acute hospitalization. RESULTS: Of the fifty-five patients in which the culprit artery could be determined, 1)in 41 the culprit artery was the right coronary artery (19 proximal to the right ventricular branch and 22 distal), and in 14 the left circumflex coronary artery (7 proximal to the first obtuse marginal branch or involving a high first obtuse marginal branch, and 7 with distal obstruction). 2)Significant ST depression (ST< or =1 mm) in leads I and aVL was more common in right coronary artery obstruction (p<0.05 and p=0.01 respectively) than left circumflex artery. 3)It was difficult to define the location of obstruction with ST segment change of lateral precordial leads (V5, V6). CONCLUSIONS: In acute inferior wall myocardial infarction, ST segment depression in lateral limb leads (I, aVL) can be indicative of the right coronary artery obstruction and the ST segment depression pattern in lateral precordial leads was not indicative of the site of obstruction.
Arteries ; Coronary Angiography ; Coronary Vessels ; Depression* ; Electrocardiography ; Extremities ; Hospitalization ; Humans ; Inferior Wall Myocardial Infarction ; Myocardial Infarction*

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*

The purpose of this study was to evaluate marginal fit of four all-ceramic crown systems 1) conventional In-Ceram, 2) copy-milled In-Ceram using Celay system, 3) IPS Empress, 4) OPC(Optimal Pressable Ceramic). All ceramic crowns were made on epoxy dies. The fabricated crowns were sandblasted, cleaned with ultrasonic cleansing, silanated, and cemented with Bistite composite resin cement. The selected marginal areas of the crowns were the labial, lingual, mesial, and distal surface. Each selected area of surface was 0.6Xl.6mm in dimension. The image of each marginal area was captured to computer files using DT-55 Frame Grabber and light microscope connected CCD camera. The marginal gaps were measured every 70mm using computer image analysis program. The results obtained were summarized as follows : 1. The marginal fit of four all-ceramic crowns were significantly different from each other(p<0.01), and mean marginal fit values obtained were 31.42 +/- 16.52mm in conventional In-Ceram, 55.45 +/- 27.90mm in copy-milled In-Ceram using Celay-system, 44.36 +/- 24.59mm in IPS Empress, 47.21 +/- 20.42mm in OPC. 2. In the marginal fit of conventional In-Cerani and copy-milled In-Ceram crowns using Celay-system there was no significant difference between mesiodistal and buccolingual surface. but in the marginal fit of IPS Empress and OPC crowns, there was significant difference between mesiodistal and buccolingual surface(p <0.01). 3. The marginal fit of four hinds of all-ceramic crowns was clinically acceptable.
Ceramics ; Crowns* ; Resin Cements ; Ultrasonics