PURPOSE: The purpose of this study was to identify type of anger expression and mental health in middle aged women. METHODS: From August to October 2005, survey data were collected by using the State Trait Anger Expression Inventory and Symptom Check List-90-Revision (SCL). Participants (1,442) were classified into four types of anger expression by K-mean cluster analysis. For collecting interview data for content analysis, 18 participants (4-5 participants from each type of anger expression) were recruited. The interview data were collected between March and September 2006. RESULTS: The average score of the state anger of middle-aged women was 11.95, and that of the trait anger was 18.75. The average anger expression scores were 12.72 for Anger-In, 13.45 for Anger-Out, and 18.51 for Anger-Control. The average SCL scores were 45.03 for somatization, 42.23 for obsessive-compulsiveness, 42.44 for interpersonal sensitivity, 42.45 for depression, 42.40 for anxiety, 42.62 for hostility, 44.44 for phobic anxiety, 43.65 for paranoid ideation, and 43.08 for psychoticism. The anger expression types identified in this study were 1) anger-out in secret, 2) anger-control with a patience, 3) anger-out with suppression, and 4) low anger expression type. The psychosomatic symptom scores were the highest in type III (anger-out with suppression), and the lowest in type IV (low anger expression type). CONCLUSION: This study can be helpful in assisting middle aged women to control their anger effectively and may contribute to the improvement of their mental health.
*Anger ; Anxiety ; Cluster Analysis ; Depression ; Expressed Emotion ; Female ; Hostility ; Humans ; Interviews as Topic ; *Mental Health ; Middle Aged

The objectives of the study were to provide the basic informations needed in the development of balanced medical services throughout the nation. As the national health care system was expanding rapidly along with the economic growth, quantitative re-evaluation of the system is of great need. For that reason, characteristics of the admitted patients were analyzed for the case-mix and patients' flow within and through regions. Materials were 421,530 cases of inpatients, who were reported through Medical Insurance Corporation(KMIC) for insurance claim, during the period of March 1, 1985 through February 28, 1987. Korean Diagnosis Related Groups(K-DRGs) classification system was adopted for the study of case-mix and 189 cities and countries were classified into 5 district groups by factor analysis results of K-DRGs. The major findings of this study were as follows ; 1) Factor analysis of case-mix, employing K-DRG system, revealed 5 distinct functional district groups. Group A(18 district) was prominent for tertiary medical care. In group B(36 districts), rather simple procedures were prevalent. Group C(26 districts) was distinctive for the medical care of well organized internal medicine practices with qualified clinical laboratories. Group D(17 districts) was characterized by relatively high balanced medical care. Group E (92 districts) was with very low level of medical care. 2) Analysis of the case-flow through the districts showed 3 types of flow patterns ; inflow, outflow, and balanced types. Inflow type of case-flow was found in Group A, C and D while Group B and E showed outflow type. Inflow was most prominent in Group A and Group E was of typical outflow type. Group B was consistently the outflow type except for Major Diagnostic Category XX regardless of the disease treaders, but Group C and D were inflow or outflow types according to the disease tracers.
Classification ; Delivery of Health Care* ; Diagnosis ; Economic Development ; Factor Analysis, Statistical ; Humans ; Inpatients* ; Insurance ; Internal Medicine ; Rationalization

The incidence of spinal tuberculosis has been decreased because of the development of anti-tuberculosis drugs, the use of radical surgical procedures and the improvement in the nations general hygiene. The anterior fusion is the most frequently used surgical measure in the treatment of spinal tuberculosis. One-hundred-eighty cases of spinal tuberculosis were treated by surgery during the 5 years from 1976 to 1980 at Presbyterian Medical Center with the following results: 1. The age distribution showed the peak incidence to be in the third decade. 2. The predilection site was the lumbar area and the percentage was 43.3. 3. In 17.2% of the cases, anti-tuberculosis drug was ingested before surgery. 4. Paraplegia was present in 16.1% of spinal tuberculosis. 5. In paraplegia, most of the location of the involved bodies was in the thoracic and the thoracolumbar vertebrae and the percentage was 79.3. 6. In paraplegia, complete recovery was 82.8%, and incomplete recovery was 10.3%. 7. In 90% of the patients, anterior fusion was done and the union rate was 91%. 8. Kyphosis was the most common in late complication.
Age Distribution ; Clinical Study ; Humans ; Hygiene ; Incidence ; Kyphosis ; Paraplegia ; Protestantism ; Spine ; Tuberculosis, Spinal

Metastatic malignant tumors involving the spine cause destruction of vertebral body, kyphosis and neural deficit. Irradiation relieves the pain and decreases the tumor mass, but sometimes the spine is progressively destroyed and becomes unstable. Traeatment of metastatic tumor involving the spine is difficult. Replacement of the vertebral body with bone cement and high dosage of radiation therapy was recommended by Harrington. The advantages are excision of the tumor mass, firm immobilization and enough irradiation not to recur. Two cases of metastatic carcinoma involving cervical spine were treated by anterior decompression, bone cement fixation and irradiation. One case died seventeen days after surgery due to severe pleural effusion. Another case was treated with irradiation (6,000 rads) after surgery and the pain was relieved. The spine is stable one year after surgery. There is no local recurrence.
Decompression ; Immobilization ; Kyphosis ; Pleural Effusion ; Recurrence ; Spine

PURPOSE: This study was done to investigate the level of nursing students' awareness, attitude, safety climate, and performance of infection control, and to identify factors influencing performance. METHODS: The sample consisted of 239 nursing students from 5 nursing schools. Data were collected from November 15 to December 11, 2013 and analyzed by frequency, t-test, ANOVA, Pearson correlation coefficients, and multiple stepwise regression with SPSS/WIN 21.0. RESULTS: Of the participants, 216 (90.4%) had experienced contact with infectious diseases. The performance of personal hygiene was scored the highest followed by standard precautions, transmission precautions, and vaccination. There were significant correlations between awareness, attitude, safety-climate and performance. Awareness, safety-climate, attitude, contents of infection control education, and direct exposure to infectious disease collectively explained 30% of the variance in performance, and awareness was the most influential factor. CONCLUSION: The results indicate that performance of infection control by nursing students can be increased if awareness, safety climate, attitude, and contents of infection control education are improved, and exposure to infectious disease is decreased. These findings can be utilized to improve performance by developing education programs for infection control.
Climate ; Communicable Diseases ; Education ; Humans ; Hygiene ; Infection Control* ; Nursing* ; Schools, Nursing ; Students, Nursing ; Vaccination

The purpose of this study was to compare the marginal fit of provisional restorations by differentiating the removal time and setting temperature during resin polymerization. After mixing autopolymerizing methyl metharcrylate resin, the material was placed in a preformed resin shell crown. The crown was seated on a die with 1mm shoulder margin. Crowns were removed after 3,4,5,6 minutes and polymerization was continued under the following conditions : 25degrees C air,30degrees C, 40degrees C, 50degrees C,60degrees C,70degrees C water. After polymerization, the crown was sectioned. The marginal & occlusal discrepancies were measured. The mean marginal discrelpancies at 3 minutes, 4 minutes, 5 minutes and 6 minutes of removing time were 96.6micrometer,84.6micrometer, 86.7micrometer and 105.6micrometer.The mean occlusal discrepancies at 3 minutes, 4 minutes, 5 minutes and 6 minutes of removing time were 106.7micrometer, 89.3micrometer, 98.6micrometer and 127.7micrometer.There was significant difference between 4 minutes group and 6 minutes group in occlusal discrepancies. The mean marginal & occlusal discrepancies for crowns polymerized in 25degrees C air were 98.2micrometer and 124.1micrometer. The crowns polymerized in 50degrees C water demonstrated the smallest marginal & occlusal discrepancies. The mean value of marginal & occlusal discrepancies in 50degrees C water were 73.1micrometer and 77.5micrometer. These values were smaller than that of 25degrees C air.There were significant differences in the occlusal discrepancies between 25degrees C air and water conditions of 50degrees C water (alpha=0.05) but, no significant differences in marginal discrepancies. There was no significant difference in the interaction between time and temperature. 4 minutes waiting time & 50degrees C water polymerizing condition produces the best fit at the margin of the provisional crown.
Crowns* ; Polymerization* ; Polymers* ; Shoulder ; Water

PURPOSE: The measurement of radiation absorbed dose is useful to predict the response after I-131 labeled metaiodobenzylguanidine (MIBG) therapy and determine therapy dose in patients with unresectable or malignant pheochromocytoma. We estimated the absorbed dose in tumor tissue after high dose I-131 MIBG in a patient with pheochromocytoma using a gamma camera and Medical Internal Radiation Dose (MIRD) formula. MATERIALS AND METHODS: A 64-year old female patient with pheochromocytoma who had multiple metastases of mediastinum, right kidney and periaortic lymph nodes, received 74 GBq (200 mCi) of I-131 MIBG. We obtained anterior and posterior images at 0.5, 16, 24, 64 and 145 hours after treatment. Two standard sources of 37 and 74 MBq of I-131 were imaged simultaneously. Cummulated I-131 MIBG uptake in tumor tissue was calculated after the correction of background activity, attenuation, system sensitivity and count loss at a high count rate. RESULTS: The calculated absorbed radiation dose was 32-63 Gy/ 74 GBq, which was lower than the known dose for tumor remission (150-200 Gy). Follow-up studies at 1 month showed minimally reduced tumor size on computed tomography, and mildly reduced I-131 MIBG uptake. CONCLUSION: We estimated radiation absorbed dose after therapeutic I-131 MIBG using a gamma camera and MIRD formula, which can be peformed in a clinical nuclear medicine laboratory. Our RESULTS suggest that the measurement of radiation absorbed dose in I-131 MIBG therapy is feasible as a routine clinical practice that can guide further treatment plan. The accuracy of dose measurement and correlation with clinical outcome should be evaluated further.
3-Iodobenzylguanidine ; Female ; Follow-Up Studies ; Gamma Cameras ; Humans ; Kidney ; Lymph Nodes ; Mediastinum ; Middle Aged ; Neoplasm Metastasis ; Nuclear Medicine ; Pheochromocytoma

Primary aldosteronism is in most cases due either to a unilateral adrenal adenama or to a bilateral hyperplasia of the adrenal cortex. But, a few of bilateral adrena1 tumors in primary aldosteronism also have been reported. In these cases, it is important to differentiate the bilateral aldosterone producing adenomas from the unilateral aldosteronoma in the presence of a contralateral nonhmctioning adenoma for marking a treatment plan. We report a case of primary aldosteronism due to a unilateral aldosteronoma in the presence of a contralateral nonfunctioning adenoma. Abdominal CT sean revealed bilateral adrenal tumors, of which the functioning one was successfully localized using adrenal scintigraphy and selective adrenal venous sampling.
Adenoma ; Adrenal Cortex ; Aldosterone* ; Hyperaldosteronism* ; Hyperplasia ; Radionuclide Imaging ; Tomography, X-Ray Computed

It is not the best way to treat a hopeless patient with life-sustaining medical devices until the heart beats stop. Advanced medical technology may prolong the life for a significant period without recovery from the disease. However, it would give an unbearable economic burden to the family and the society. In 2006, we decided not to operate 9 patients with traumatic intracranial hematomas. We examined those patients with special references to possible legal and ethical problems. It is reasonable to withhold a treatment after documentation that the family never wants any life sustaining treatment when the treatment does not guarantee the meaningful life.
Craniocerebral Trauma* ; Decision Making ; Head* ; Heart ; Humans ; Intracranial Hemorrhage, Traumatic ; Medical Futility ; Resuscitation Orders ; Withholding Treatment

BACKGROUND: Microalbuminuraia is a strong prognostic factor for cardiovascular morbidity and mortality in type I and II diabetics. Recent data suggest that microalbuminuria predicted cardiovascular disease independent of hypertension in one of two large-scale studies performed in non-diabetics. Additional possibilities could be a previously documented association with other major and interconnected cardiovascular risk factors, such as insulin resistance, and elevated cardiac mass, abnormal circulation lipid levels, and overweight. The object of this study os to investigat the incidence of microalbuminuria, and to define the pathophysiologic mechanism of microalbuminuria to contribute coronary heart disease in non-diabetic patients with angiographiclly documented coronary artery disease(CAD). METHODS: The study group comprised 31 patients(M;21, mean age 60+/-30 year) with angiographically documented CAD and 15 normal control(m;9, mean age 62+/-7 year). Urinary albumin excretion, blood pressure, echocardiographic left ventricular mass indes, plasma abdominal/hip circumference ratio, fasting glucose, insulin, and c-peptide were studied. The microalbuminuria was defined urinary albumin more than 20ug/min. RESULTS: 1) Six of 31 patients with CAD(19.4%) and none of 15 normal control had microalbuminuria. Hypertension were documented 13 of 31 patients with CAD, and none of 15 normal control(p<0.01). Five of 6 patients with CAD and microalbuminuria and 8 of 25 patients with non-microalbuminuric aptients had hypertension (p<0.05). 2) In the microalbuminuric subjects with CAD, body mass index(29.0+/-3.2vs 24.8+/-3.5), systolic blood pressure(138+/-31 vs 118+/-15mmHG), lipoprotein(a) (69+/-31vs 32+/-32mg/dl), fastion C-peptide(5.5+/-2.2 vs 2.7+/-1.6ng/ml), and microalbumin(221+/25 vs 9.6+/-7.9mg/day)were significantly greater than in normal control(p<0.05). But no difference in left ventricular mass, lipid profile, and abdominal/hip circumference ratio existed between the microalbminuric patients with CAD and normal control. 3) Between the microalbuminuric patients with CAD and without CAD, no signficant difference were noted excepr lipoprotein(a) lever(69+/-31 vs 29+/-29mg/dl), fasting C-peptide(5.5+/-2.4 vs 2.5+/-1.2ng/ml), and microalbumin(221+/-247 vs 8.6+/-6.7mg/day). CONCLUSION: Microalbuminuria was associated with history of hypertension or concurrent antihypertension therapy and insulin resistance in non-diabetics with CAD. But left ventricular cardiac mass, central obesity inedw, and lipid profile were not related with microalbuminuria. The underlying presence of a major risk factor such as hypertension and insulin resistance might be explain the previously reported predictive value of microalbuminuria for cardiac events.
Blood Pressure ; C-Peptide ; Cardiovascular Diseases ; Coronary Artery Disease* ; Coronary Disease ; Coronary Vessels* ; Echocardiography ; Fasting ; Glucose ; Humans ; Hypertension ; Incidence ; Insulin ; Insulin Resistance ; Lipoprotein(a) ; Mortality ; Obesity, Abdominal ; Overweight ; Plasma ; Risk Factors