BACKGROUND: Recently in Europe, some epidemiologic studies reported that various physical symptoms and social, psychological wellbeing are related to low blood pressure. But in Korea, none has been studied on symptoms related to low blood pressure yet. In this study, we would like to see if the somatic symptoms and social, psychological wellbeing shown t,o be related to low SBP is truly associated with it. METHODS: Questionnaire interview was done to the people who have visited Department of family practice in two university hospitals and two health promotion center from April, 1996 to August, 1996. Seven somatic symptoms and Psychosocial Wellbeing Index(PWI) for the evaluation of social, psychological health status were included in the questionnaire. SAS statistics packages was used in statistical precess. We used logistic regression to see the frequency of somatic symptoms related to the systolic blood pressure(SBP) group and the confirmation of confounding variables was done by ANOVA. RESULTS: Total of 304 completed the questionnaire. Average age was 44 years old and average SBP was 115.4+/-16.4. 84 of them (27.6%) felt that they had a low BP & 69 were women compared to 21 men, being meaningfully more common. 107(35.2%) people answered that they had heard that their blood pressure was low and 66% were from doctors. Only 32(38.1%) of the group who felt of having hypotensive symptoms and 38 of the group who heard of having hypotension actually had SBP of below 100 mmHg. Vocation, income, smoking & alcohol history, present illness, marital status were not significant as a confounding variable. SBP of 100 or below group had a less presentation of fatigue & significantly higher PWI than the group of above 100mmHg (p<0.05). The group who felt that they had a low BP had more complaints of fatigue, dizziness, palpitation, cold hands and feet and had significnatly higher PWI than the group who didnt. CONCLUSIONS: SBP of 100mmHg or below group has more frequent manifestion of fatigue and low level of sociopsycholgiacl health index than the above 100mmHg group. But most of the people who complained of hypotensive symptoms didnt have low blood pressure and a lot of them misunderstand of having low blood pressure and after checking blood pressure by doctors, so great deal of caution is called for when seeing patients.
Adult ; Blood Pressure* ; Confounding Factors (Epidemiology) ; Dizziness ; Epidemiologic Studies ; Europe ; Family Practice ; Fatigue ; Female ; Foot ; Hand ; Health Promotion ; Hospitals, University ; Humans ; Hypotension ; Korea ; Logistic Models ; Male ; Marital Status ; Occupations ; Smoke ; Smoking ; Surveys and Questionnaires

BACKGROUND: In order to improve the quality of life of dying patients so that they may die with dignity, they need to receive not only the physical, psychological, social, and spiritual care, but also systematic and continuous care. However, their is no adequate medical service at present. We studied terminal cancer patients'behavior patterns of health care utilization, the problems of caring for the patient, and medical services that bereaved families suggested for terminal cancer patients and their families. METHODS: From 271 patients'families who participated in our hospice program from March 1991 to February 1996, 108 bereaved families whom we able to had been contact were interviewed by three student nurses with a structured questionnaire. RESULTS: The terminal cancer patients received their medical care through admission to hospital(45.4%), outpatient clinic(22.2%), emergency room(16.7%), and oriental medicine(12.0%). But during their terminal phase of the illness, 32.4% of patients never received medical care including oriental medicine, and 28.7% received alternative medicine care such as intake of mushroom and elm tree. 26 bereaved families(24.1%) pointed out the indifference of the medical team as a problem receiving proper hospital care, and 22 bereaved families(20.4%) emphasized emotional strain of their helplessness with the patient's suffering as a problem of caring for the patient at home. Over 90% of bereaved families from their experience suggested needs of continuous care, hospice care, home care, and 24hr telephone service. CONCLUSIONS: There were inappropriate behavior patterns of health care utilization which resulted in large proportion of terminal cancer patients received alternative medicine never receiving proper medical care. Therefore, there is a need to develop the continuous and comprehensive care for terminal cancer patients and their family, such as hospice.)
Agaricales ; Complementary Therapies ; Delivery of Health Care* ; Emergencies ; Home Care Services ; Hospice Care ; Hospices ; Humans ; Medicine, East Asian Traditional ; Outpatients ; Quality of Life ; Telephone ; Ulmus ; Surveys and Questionnaires

PURPOSE: To investigate pathophysiological consequences and spontaneous recovery after cavernous nerve crush injury (CNCI) in a rat model. MATERIALS AND METHODS: Twenty 4-week-old male Sprague-Dawley rats were divided into the following groups: sham-operated group (n=10) and bilateral CNCI groups (n=10) for two different durations (12 and 24 weeks). At both time points, CN electrical stimulation was used to assess erectile function by measuring the intracavernous pressure. The expression of hypoxia inducible factor (HIF)-1alpha and sonic hedgehog (SHH) was examined in penile tissue. Immunohistochemical staining was performed for nerve growth factor (NGF), endothelial nitric oxide synthase (eNOS), neuronal nitric oxide synthase (nNOS), and smooth muscle alpha-actin. RESULTS: CNCI significantly decreased erectile function at 12 weeks (51.7% vs. 71.9%, mean ICP/BP ratio, p<0.05) and increased the expression of HIF-1alpha and decreased the expression of eNOS, nNOS, and SHH. At 24 weeks, erectile function in the CNCI group was improved with no significant difference versus the sham group (70.5% vs. 63.3%, mean ICP/BP ratio, p<0.05) or the CN group at 12 weeks (51.7% vs. 63.3%, mean ICP/BP ratio, p<0.05). By RT-PCR, the increase in HIF-1alpha and decrease in SHH mRNA was restored at 24 weeks. By immunohistochemistry, the expression of eNOS and nNOS was increased at 24 weeks. CONCLUSIONS: CN injury induces significantly impaired erectile function and altered gene and protein expression, which suggests that local hypoxic and inflammatory processes may contribute to this change. Significant spontaneous recovery of erectile function was observed at 6 months after CN crush injury.
Animals ; Anoxia ; Caves ; Electric Stimulation ; Erectile Dysfunction ; Hedgehog Proteins ; Hedgehogs ; Humans ; Immunohistochemistry ; Male ; Muscle, Smooth ; Nerve Crush ; Nerve Growth Factor ; Nitric Oxide Synthase Type I ; Nitric Oxide Synthase Type III ; Rats ; Rats, Sprague-Dawley ; RNA, Messenger ; Salicylamides

PURPOSE: To investigate pathophysiological consequences and spontaneous recovery after cavernous nerve crush injury (CNCI) in a rat model. MATERIALS AND METHODS: Twenty 4-week-old male Sprague-Dawley rats were divided into the following groups: sham-operated group (n=10) and bilateral CNCI groups (n=10) for two different durations (12 and 24 weeks). At both time points, CN electrical stimulation was used to assess erectile function by measuring the intracavernous pressure. The expression of hypoxia inducible factor (HIF)-1alpha and sonic hedgehog (SHH) was examined in penile tissue. Immunohistochemical staining was performed for nerve growth factor (NGF), endothelial nitric oxide synthase (eNOS), neuronal nitric oxide synthase (nNOS), and smooth muscle alpha-actin. RESULTS: CNCI significantly decreased erectile function at 12 weeks (51.7% vs. 71.9%, mean ICP/BP ratio, p<0.05) and increased the expression of HIF-1alpha and decreased the expression of eNOS, nNOS, and SHH. At 24 weeks, erectile function in the CNCI group was improved with no significant difference versus the sham group (70.5% vs. 63.3%, mean ICP/BP ratio, p<0.05) or the CN group at 12 weeks (51.7% vs. 63.3%, mean ICP/BP ratio, p<0.05). By RT-PCR, the increase in HIF-1alpha and decrease in SHH mRNA was restored at 24 weeks. By immunohistochemistry, the expression of eNOS and nNOS was increased at 24 weeks. CONCLUSIONS: CN injury induces significantly impaired erectile function and altered gene and protein expression, which suggests that local hypoxic and inflammatory processes may contribute to this change. Significant spontaneous recovery of erectile function was observed at 6 months after CN crush injury.
Animals ; Anoxia ; Caves ; Electric Stimulation ; Erectile Dysfunction ; Hedgehog Proteins ; Hedgehogs ; Humans ; Immunohistochemistry ; Male ; Muscle, Smooth ; Nerve Crush ; Nerve Growth Factor ; Nitric Oxide Synthase Type I ; Nitric Oxide Synthase Type III ; Rats ; Rats, Sprague-Dawley ; RNA, Messenger ; Salicylamides

Cholesterol polyps are the most common cause of the polypoid lesions of the gallbladder shown by ultrasonography (US). Cholesterol polyps are usually attached to the mucosal surface of the viscus with delicate, filammentous stalks so that they can be easily detached. Recently, laparoscopic cholecystectomy has been introduced to treat various gallbladder diseases. We have experienced four patients with ultrasonographically typical gallbladder polyps, that were not detected in the pathologic specimens removed by laparoscopic cholecystectomy. In each patients, intraluminal suction preceded the laparoscopic cholecystectomy, and the suction was presumed to have resulted in the detachment of cholesterol polyps having delicated and fragile stalks.
Cholecystectomy, Laparoscopic ; Cholesterol ; Gallbladder Diseases ; Gallbladder* ; Humans ; Polyps* ; Suction ; Ultrasonography

No abstract available.
Hepatitis* ; Myocarditis* ; Pancytopenia* ; Q Fever*

The purpose of the present study is to evaluate the stress distribution on the length and diameter of the miniscrew and cortical bone width. Three dimensional finite element models were made of diameter 1.2mm, 1.6mm, 2.0mm and length 6.0mm, 8.0mm, 10.0mm, 12.0mm and cortical bone width 1.0mm. Also, another three dimensional finite element models were made of diameter 1.2mm, 1.6mm, 2.0mm and length 8.0mm and cortical bone width 1.0mm, 1.5mm, 2.0mm, 2.5mm. Two-hundred grams horizontal force were applied on the center of the miniscrew head and at that stress distribution and its magnitude had been analyzed by ANSYS, which is three dimensional finite element analysis program. The obtained results were as follows : 1. The comparison of the maximum von-Mises stress in the miniscrew showed that as the diameter increases from 1.2mm to 2.0mm stress has been decreased, while on the same diameter stress was not changed regardless of the length change. 2. The comparison of the maximum von-Mises stress in the cortical and cancellous bone showed that as the diameter increases from 1.2mm to 2.0mm stress has been decreased, while on the same diameter stress was not changed regardless of the length change. 3. In the analysis of the stress distribution in the cortical and cancellous bone, the most of the stress had been absorbed in the cortical bone, and did not transmitted much to the cancellous bone. 4. In the analysis of the maximum von-Mises stress according to the cortical bone width, the same diameter of the miniscrew showed a constant stress value regardless of the cortical bone width change. The above results suggest that the maintenance of the miniscrew is more reliable on diameter than length of the miniscrew.
Finite Element Analysis ; Head

BACKGROUND: Bowenoid papulosis occurs primarily on the genitalia of young adults and this is characterized by multiple, apparently benign maculopapular lesions. Bowenoid papulosis shows the histopathological findings of a squamous cell carcinoma in situ, but it follows a largely benign clinical course. If it is misdiagnosed as malignant tumor, unnecessary excessive therapy may be performed. Therefore, exact recognition of this entity is important. OBJECTIVE: The purpose of this study is to examine the clinical and histopathologic features and outcomes of Bowenoid papulosis. METHODS: Twelve patients who had been diagnosed with Bowenoid papulosis between June 1996 and September 2007 were reviewed clinicopathologically. RESULTS: The mean age of the patients was 34.8 years (range: 23~57 years), and the mean duration of Bowenoid papulosis until presentation was 6.3 months (range: 5~48 months). Nine patients were males and 3 patients were females. Eleven patients (92%) had multiple lesions. The average size of the individual lesions was 1.4x0.6 cm in diameter. The colors of the papules were red to black. Seven of 9 male patients had lesions on the penile shaft, with 6 of those occurring at the proximal shaft. The other 2 male patients had lesions on the scrotum and perianal area, respectively. Three female patients had lesions on the labium major, labium major and clitoris, and perianal area respectively. Nine patients (75%) presented without symptom and 3 (25%) presented with mild pruritus. The histopathologic features were as follows: a rete ridge of approximately equal length and breadth throughout the entire lesion (100%), skipped areas of normal keratinocytes between zones of atypical keratinocytes (100%). necrotic keratinocytes (92%), parakeratosis (83%), mitotic figures (83%), vacuolated cells resembling owl's eyes (83%), multinucleated cells (67%), residual changes of typical condyloma acuminatum (17%), involvement of acrotrichia (100%) and involvement of acrosyringia (100%). Eleven patients were effectively treated with surgical excision (8 patients), CO2 laser (2 patients), diphenylcyclopropenone (DPCP) and immunotherapy (1 patient) and 1 patient underwent biopsy only. We followed 12 patients for an average 78.1 months (from 24 to 137 months). During this period, no recurrence or malignant transformation was observed. CONCLUSION: Bowenoid papulosis shows a form of squmaous cell carcinoma in situ for its histopathology, but it hardly ever progresses to squmaous cell carcinoma. On our long term follow-up, there was no malignant transformation. Thus, excessive treatment of Bowenoid papulosis by amputation of the external genitalia is not necessary. Therefore, a through understanding of the clinical and histopathologic features of this entity is necessary for making the diagnosis, the treatment planning and determining the prognosis.
Amputation ; Biopsy ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Clitoris ; Cyclopropanes ; Eye ; Female ; Follow-Up Studies ; Genitalia ; Humans ; Immunotherapy ; Keratinocytes ; Lasers, Gas ; Male ; Parakeratosis ; Prognosis ; Pruritus ; Recurrence ; Scrotum ; Young Adult

OBJECTIVES: The purpose of the study was to evaluate content coverage and data quality of the Clinical Data Dictionary (CiDD) developed by the Center for Interoperable EHR (CiEHR). METHODS: A total of 12,994 terms were collected from 98 clinical forms of a tertiary cancer center hospital with 500 beds. After data cleaning, 9,418 terms were mapped with the data items of the CiDD by the research team, and validated by 30 doctors and nurses at the research hospital. RESULTS: Mapping results were classified into five categories: lexically mapped; semantically mapped; mapped to either a broader term or a narrower term; mapped to more than one term and not mapped. In terms of coverage, out of 9,418 terms, 6,750 (71.7%) terms were mapped; 4,319 (45.9%) terms were lexically mapped; 2,431 (25.8%) were semantically mapped; 281 (3.0%) terms were mapped to a broader term; 43 (0.5%) were mapped to a narrower term; and 550 (5.8%) were mapped to more than one term. In terms of data quality, the CiDD has problems such as errors in concept namingand representation, redundancy in synonyms, inadequate synonyms, and ambiguity in meaning. CONCLUSIONS: Although the CiDD has terms covering 72% of local clinical terms, the CiDD can be improved by cleaning up errors and redundancies, adding textual definitions or use cases of the concept, and arranging the concepts in a hierarchy.
Data Accuracy

BACKGROUND: Increased resistance rates to macrolide-lincosamide-streptogramin B (MLSB) antibiotics among clinical isolates of staphylococci are considered as a consequence of an expanded use of these antibiotics in the treatment of Gram-positive infections. The proportion of MLSB resistance phenotypes of staphylococci is quite different by geographical variations and study periods. The aim of the present study was to determine the distribution of MLSB resistance phenotypes among clinical isolates of staphylococci in a university hospital. METHODS: The MLSB resistance phenotypes of clinical isolates of staphylococci were investigated by the double-disk diffusion test using erythromycin and clindamycin disks. RESULTS: Of 7,916 isolates, 55.7% exhibited a constitutive resistance phenotype (cMLSB) whereas 8.1% expressed an inducible resistance phenotype (iMLSB). Among 3,419 coagulase-negative staphylococci (CNS), 32.6% and 10.0% exhibited cMLSB and iMLSB resistance phenotypes, respectively. Of 4,497 Staphylococcus aureus isolates, 73.1% and 6.8% were cMLSB and iMLSB resistance phenotypes, respectively. cMLSB was detected among 90.2% of methicillin-resistant S. aureus (MRSA), 46.5% of methicillin-resistant CNS (MRCNS), 3.2% of methicillin-susceptible CNS (MSCNS), and 2.2% of methicillin-susceptible S. aureus (MSSA). iMLSB was detected among 16.5% of MSSA, 11.5% of MRCNS, 6.7% of MSCNS, and 4.4% of MRSA. CONCLUSION: MLSB resistance was more prevalent among S. aureus isolates than CNS strains. Although cMLSB was the most frequently detected resistance phenotype among the total staphylococcal isolates, methicillin-susceptible strains exhibited somewhat higher iMLSB resistance rates compared with methicillin-resistant strains.
Anti-Bacterial Agents ; Clindamycin ; Diffusion ; Erythromycin ; Methicillin Resistance ; Phenotype ; Staphylococcus aureus