PURPOSE: This study was to examine the effects of foot reflexology on ADL and fatigue in stroke patients. METHOD: The subjects were 31 stroke patients hospitalized in the Oriental Medicine Hospital of D University from June to November, 2002. Foot reflexology was applied to the experimental group twice a week for 6 weeks, 40 minutes each. For the data analysis, chi2-test was conducted to verify the homogeneity of general characteristics and clinical characteristics, and t-test was done to verify the homogeneity of ADL and fatigue. To examine the relative efficacy of the intervention, ANOVA and ANCOVA were conducted. RESULTS: After foot reflexology, the subjects in the experimental group showed significant improvement in ADL. They also had less physical, psychological, and neurosensory fatigue, which are three areas of fatigue. CONCLUSION: The results suggest that foot reflexology is an effective intervention that helps the body work efficiently, eases stress and strain, and enhances the homeostasis of the body through stimulating the reflex zone of internal organs in the body. Therefore, it is necessary to develop foot reflexology as an unique nursing intervention.
Activities of Daily Living* ; Fatigue* ; Foot* ; Homeostasis ; Humans ; Massage* ; Medicine, East Asian Traditional ; Nursing ; Reflex ; Statistics as Topic ; Stroke*

PURPOSE: The purpose of this animal and clinical study was to compare intra-arterial(IA) scintigraphy withangiography in the localization of gastrointestinal (GI) bleeding. MATERIALS AND METHODS: After sedation withintramuscularly administered ketamine, lower GI bleeding was induced in ten rabbits. Using inguinal cut-down, anarterial femoral 3F catheter was placed in the proximal mesenteric artery. Following abdominal incision to exposethe bowel, lower GI bleeding was caused by incising the antimesenteric border of the small bowel wall. Initialangiography was performed, and this was followed by Tc-99m pertechnetate IA scintigarphy. Tc-99m RBC IAscintigraphy involved two patients who had undergone selective mesenteric arterial catheterization for theevaluation of acute lower GI bleeding. RESULTS: Ten rabbits, bleeding at a mean rate of 0.7g/min, were studied.IA scintigraphy was superior to angiography in four cases and equal in six. The sensitivity of angiography was40%(4/10), and IA scintigraphy 80%(8/10). In one patient, Tc-99m RBC was administered directly into the superiormesenteric artery and ulcer bleeding in the transverse colon was identified. Prior to conventional angiography,the bleeding had been occult. In a second patient, in whom angiography had revealed a hypervascular mass,selective injection of Tc-99m RBC into the superior mesenteric artery revealed tumor(leiomyoma) bleeding in thejejunum. CONCLUSION: Selective IA scintigraphy was valuable for detecting intestinal bleeding, occult duringconventional studies and may be useful for detecting acute bleeding at the time of negative angiography.
Angiography ; Animals ; Arteries ; Catheterization ; Catheters ; Colon, Transverse ; Hemorrhage* ; Humans ; Ketamine ; Mesenteric Arteries ; Mesenteric Artery, Superior ; Rabbits ; Radionuclide Angiography ; Radionuclide Imaging* ; Sodium Pertechnetate Tc 99m ; Ulcer

BACKGROUND: Osteoporosis of transplanted/grafted bone is well known in the immediate post bone transplantation/bone grafting period. In limb transplantation, the growth plates in the transplanted limbs retain their longitudinal growth properties. However, there is a paucity of reports on what happens to the bone and the growth potential of the growth plate when limb transplantation between a juvenile donor and an adult recipient is performed. MATERIALS AND METHODS: Ten juvenile to juvenile hind limb transplants and five juvenile to adult hind limb transplants were performed in male syngeneic Lewis rats. Osteoporosis in the isochronograft as well as the heterochronograft limbs was measured by 3D micro-CT. In addition, the increase in tibial length, after transplantation was measured and compared with the increase in the tibial length of the opposite non-operated limbs. RESULTS: The 3D CT parameters indicate a significantly inferior bone quality in the heterochronografts compared with the isochronografts. After transplantation, the increase in the tibial length of the isochronografts was similar the increase in length of the opposite juvenile non operated tibiae and the heterochronograft tibias. CONCLUSION: Age is a significant factor that affects the bone quality, resulting in post transplant osteoporosis in heterochronografts compared with isochronografts. However, the growth plate after transplantation remains unaffected by the difference in age and continues to grow at its own inherent rate in adult recipients as it does in the juvenile recipients.
Adult ; Animals* ; Extremities* ; Growth Plate* ; Humans ; Male* ; Osteoporosis ; Rats* ; Tibia ; Tissue Donors ; Transplantation ; Transplants

This study set out to evaluate the impact of personalized nutritional counseling (PNC) on the nutritional status of hemodialysis (HD) patients. This was an intervention study for 10 months at 2 hospitals. Anthropometric, biochemical, dietary, and body composition parameters were measured at baseline and after 3 and 6 months of PNC. A total of 42 patients (23 men and 19 women) were included. Intake of dietary protein, serum albumin, and cholesterol levels had increased significantly from baseline to month 6 (p < 0.05). Among the bioelectrical impedance analysis (BIA) parameters, both the body cell mass (BCM) and the fat free mass (FFM) had significantly reduced at month 3 compared to baseline (p < 0.05). However, there was no difference between baseline and month 6. We assessed the nutritional status of the subjects using the malnutrition inflammation score (MIS), and divided them into an adequately nourished (AN) and a malnourished (MN) group at baseline. In the subgroup analysis, serum levels of albumin and cholesterol had increased significantly, particularly from baseline to month 6 in the MN group (p < 0.05). This study suggests that consecutive PNC contributed to the improvement of the protein intake, serum levels of albumin, cholesterol and to the delay of muscle wasting, which could also have a positive impact on the nutritional status, particularly in malnourished patients receiving HD treatment.
Body Composition ; Cholesterol ; Counseling* ; Diet Therapy ; Dietary Proteins ; Electric Impedance ; Humans ; Inflammation ; Male ; Malnutrition ; Nutrition Assessment ; Nutritional Status* ; Protein-Energy Malnutrition ; Renal Dialysis* ; Serum Albumin

BACKGROUND: Postoperative nausea and vomiting (PONV) is a long standing problem in both surgical patients and anesthesiologists, and the treatment of this problem is very important.The purpose of this study was to evaluate the effect of multimodal approach with combination of antiemetics and total intravenous anesthesia (TIVA) on PONV in very high risk patients identified by the Korean predictive model. METHODS: Between March 2008 and February 2009, we evaluated 96 patients who were considered to be at very high risk of PONV according to the Korean predictive model.Among the patients, those who received antiemetic combination of dexamethasone and ondansetron were allocated to treatment group (T) and, those who underwent operation without antiemetics were placed in control group (C).All patients were anesthetized using propofol and remifentanil.We evaluated the incidences of PONV in two groups during the first 24 hours after surgery. RESULTS: The overall incidence of PONV was 14 (29.17%) in C group and 4 (8.33%) in T group, respectively (P = 0.027). CONCLUSIONS: The overall incidence of PONV in T group was significantly lower than that of C group.This study shows that multimodal approach with combination of antiemetics and TIVA was effective in preventing PONV in patients with very high risk.
Anesthesia, Intravenous ; Antiemetics ; Dexamethasone ; Humans ; Incidence ; Ondansetron ; Postoperative Nausea and Vomiting ; Propofol

In order to determine the current infection status of pond smelts, Hypomesus olidus, and other freshwater fishes with trematode metacercariae, a total of 4,861 pond smelts and 18 other freshwater fishes, collected from the Soyang and Uiam Lakes in Gangwon-do, the Unam Lake in Jeollabuk-do, the Jangseong Lake in Jeollanam-do, the Uirim-ji (lake) in Chungcheongbuk-do, and the Andong Lake in Gyeongsangbuk-do, were individually digested with 1% pepsin-HCl and examined under a dissecting microscope. In all pond smelts caught from the 6 lakes, we were unable to detect any known human infectious trematode metacercariae in Korea. However, in other freshwater fishes, such as, Squalidus japonicus coreanus (Unam Lake), and Zacco platypus (Jangseong Lake) and Opsariichthys uncirostris amurensis (Jangseong Lake), metacercariae of human-infecting trematodes, i.e., Clonorchis sinensis and Metagonimus sp. were detected, respectively.
Trematode Infections/*veterinary ; Osmeriformes/*parasitology ; Korea ; Humans ; Fresh Water ; Fish Diseases/*parasitology ; Animals

BACKGROUND: Hyaluronic acid (HA) is a mucopolysaccharide that occurs naturally throughout the human body, where it attaches to collagen and elastin to form cartilage, and also helps maintain the strength and flexibility of the cartilage that cushions joints. A decline in HA synthesis may lead to a variety of symptoms, ranging from joint discomfort, to wrinkles. Cross-linked HA is a viscoelastic solid that resists in vivo degradation by hyaluronidase for much longer than endogenous HA, and which is also a key ingredient in various cosmetics. OBJECTIVE: To describe our experience with three kinds of Elravie(R) fillers. METHODS: We obtained images of filler shape using a folliscope. Scanning electron microscopy (SEM) was used to compare particle sizes. Hydrophilic filler is a hydroxyl, and for this reason, we mixed the filler with water. Next, PARKER ink was added to the mixture, and viscosity and elasticity were measured using a rheometer. RESULTS: Among the tested fillers, particle size was largest in the Restylane(R) SubQ. Elravie(R) ultra volume filler was greater in volume than Elravie(R) deep line, and Elravie(R) light fillers. We confirmed Elravie(R) fillers to be hydrophilic. Elravie(R) ultra volume filler was found to have the highest viscosity and elasticity, whilst Elravie(R) light filler had the lowest. CONCLUSION: All three kinds of Elravie(R) fillers were found to be suitable for human cosmetic use.
Cartilage ; Collagen ; Elasticity ; Elastin ; Human Body ; Humans ; Hyaluronic Acid ; Hyaluronoglucosaminidase ; Ink ; Joints ; Microscopy, Electron, Scanning ; Particle Size ; Pliability ; Viscosity ; Water

BACKGROUND: Conventional pacemaker implantation induces left ventricular (LV) dyssynchrony, which might affect the LV function. We sought to evaluate the impact of different right ventricular (RV) pacing sites on the LV dyssynchrony and performance. METHODS: Comprehensive echocardiographic evaluation including the atrio-ventricular, inter- and intra-ventricular dyssynchrony based on M-mode, conventional Doppler and tissue Doppler imaging (TDI) was done before and immediately after (< 7 days) pacemaker implantation. For the LV performance, LV ejection fraction, longitudinal peak systolic velocity at the mitral annulus (S') annular or mean longitudinal velocity of the 6 basal segments (Sm) were used. These results were compared with those of 15 age matched controls. RESULTS: A total of 79 patients (48 females, mean age 63 +/- 12 years) underwent RV pacing at the apex (n = 45, group I) or the septum (n = 34, group II). After pacemaker implantation, the QRS duration was significantly increased in both groups, but the change was greater in group I (57.1 +/- 28.3 versus 32.8 +/- 40.5 msec). Both the S' and Sm were lower in pacing groups than those in controls and Sm was significantly higher in group II (4.2 +/- 1.0 versus 4.9 +/- 1.3 m/sec) than group I despite a similar LV ejection fraction. The aortic pre-ejection time and septal to posterior wall motion delay in patients with pacemaker were longer compared to normal controls, but there were no significant differences. Both the TDI velocity and strain analysis showed no difference of the dyssynchrony indices between the two groups, despite a higher tendency of Doppler strain dyssynchrony indices in the RV apical pacing group compared to those of the control. CONCLUSION: Despite the marked increase of the QRS duration after pacing, M-mode, Doppler and TDI failed to demonstrate any difference according to the pacing sites. The long-term effect of the longitudinal contraction being less affected and a smaller increase of the QRS duration in the RV septal pacing group needs to be confirmed in a longitudinal follow-up study.
Contracts ; Echocardiography ; Female ; Humans ; Prospective Studies ; Sprains and Strains

PURPOSE: Sudden, unexpected pediatric death triggers acute grief in most survivors. In this study, we analyzed the pediatric death in emergency room in order to find out the factors for minimized unexpected pediatric death and increase awareness of these conditions. METHODS: We performed a review on the records of 63 patients under the age of 16 years who died before and after admission to the emergency room of Yeungnam University Hospital during a 5 year period from January 1996 to December 2000. RESULTS: Among the total of 63 patients who died, 33 were male(52.4%) and 30 were female (47.6%). The most prevalent age group was between 1 month and 1 year of age(38%). We classified 3 categories by the direct cause of death, disease 21 cases(33%), accident 19 cases(30%), unknown 23 cases(37%) respectively. Among 23 cases of unknown cause of death, 13 cases(56.5 %) had been placed under medical attention for underlying diseases : these were 7 cases of neurologic disorder(30.4%) 5 cases of congenital heart disease 5 cases(21.7%) and 1 case of metabolic disease(4.4%). The most common types of accident were traffic accident(10 cases; 52.6%) and the next were drowning(4 cases; 21%), asphyxia(3 cases; 15.8%). CONCLUSION: In unexpected pediatric death, among unknown causes of death, the number of patients who had an underlying disease was greater than these patients who did not. We conclude, more attention needs to be paid to underlying disease, especially congenital heart disease and neurologic disease. A parents teaching program is necessary emergency for situations. This would decrease cases of unexpected pediatric death.
Cause of Death ; Emergencies* ; Emergency Service, Hospital* ; Female ; Grief ; Heart Defects, Congenital ; Humans ; Parents ; Survivors

BACKGROUND: Hyaluronic acid (HA) is a carbohydrate, occurring naturally throughout the human body. With linear polysaccharide structure, it is (HA) found in soft connective tissues, cartilage and joinfluids. Hyaluronic acid filler is used for treatment of depth of the fold or volume of filler needed and performed for wrinkle improvement and cosmetic. We did property of matter for the Perfectha(R) fillers. OBJECTIVE: Our purpose is to describe and comment on our experiences with two kinds of Perfectha(R) fillers. METHODS: We obtained image of the shape of fillers using a folliscope, VC98 and particle size using the Scanning electron microscope (SEM). We tested to make sure that affinity both fillers with water. We mixed the fillers and distilled water. We the PARKER ink added to the mixture. Viscosity and elasticity were measured using a rheometer. RESULTS: The test revealed that a particle sized Perfectha(R) derm deep is bigger than a Perfectha(R) derm. We were confirmed as hydrophile. While Perfectha(R) derm deep filler has high viscosity and elasticity, Perfectha(R) derm filler has high viscosity only, not elasticity. CONCLUSION: Two kinds of Perfectha(R) fillers act as space filler by binding to water and thus keeping the skin wrinkle-free.
Cartilage ; Connective Tissue ; Elasticity ; Human Body ; Hyaluronic Acid ; Ink ; Particle Size ; Skin ; Viscosity ; Water