No abstract available.

No abstract available.
Emergencies* ; Humans

OBJECTIVES: The present study proposed to evaluate 1st-month and 3rd-month health status, depression, self-efficacy and medical expenses of a community-based health promotive self-management program for old Koreans. METHOD: Participants in the CDSMP were selected from elders in a community health center through convenient sampling. The program included a 3-hour session per week for 14 weeks. Outcomes of evaluation in the 1st month and the 3rd month included modified Self-rated Health Status Scale, Center for Epidemiologic Studies Short Depression Scale, Self-Efficacy for Managing Chronic Disease 6-item Scale, and 1-item Medical Expenses Scale. RESULTS: Self-rate health scores increased significantly just after the intervention (16.22), in the 1st month (17.57) and in the 3rd month (19.04) (chi2=32.06, p=.000); Depression scores (reversed) also increased significantly just after the intervention (6.04), in the 1st month (7.75) and in the 3rd month (8.39) (chi2=29.92, p=.000); Self-efficacy score increased significantly just after intervention (12.87) but it decreased in the 1st month (12.73) and in the 3rd month (12.04). But all of the three scores were still higher than those before the intervention (8.65) (chi2=32.42, p=.000): Medical expense score decreased at the end of the intervention (1.57) but the cost score increased in the 1st month (2.48) and in the 3rd month (2.39) (chi2=7.81, p=.050). CONCLUSION: CDSMP is effective in increasing self-rate health and self-efficacy and in decreasing depression in the Korean elderly. However, no significant effect of the program was observed in decreasing the medical cost of the Korean elderly.
Aged* ; Chronic Disease* ; Community Health Centers ; Depression ; Epidemiologic Studies ; Humans ; Korea ; Self Care*

Adverse reactions to latex are various from localized skin problem to systemic anaphylaxis, even causing death. There are few reports on latex glove hypersensitivity in Korea, even though clinically the adverse reactions to latex sporadically have been reported. The purpose of this study was to survey the prevalence rate of adverse reactions to latex glove and compare the rate of allergy to ordinary latex glove with those 4 types of hypoallergenic gloves. Data on adverse reaction to latex gloves and symptoms as well as risk factors were collected from 63 operating room nurses using a questionnaire and direct observation of skim prick test. Questionnaire was used to survey the adverse reactions including the type I and IV, skin prick test was used to survey latex allergy defined type I. Among respondents, 25 nurses with adverse reaction to latex gloves were selected for the skin prick and exposure test with 5 latex gloves ( 1 ordinary glove, 4 hypoallergenic gloves) using the repeated measures design of the counterbalancing method. The results were followed : 1) The response rate of questionnaire was 96.8%, and the prick test was performed in 61 out of 63 nurses. 2) Common symptoms of adverse reactions to latex gloves were rash (49.2%), skin itching (44.3%), dizziness (31.3%), and eye itching (26.2%). 3) The prevalence rate of adverse reactions to latex glove was 80.3%. 4) The prevalence rate of latex allergy was 9.8%. The relationship between the latex allergy and atopy was significant, i.e. the atopic persons had more latex allergy than the non-atopics. 5) In 5 latex gloves, the prevalence rate of latex allergy by skin prick test and skin exposure test was follows : 16%, 24% for skin angel gloves, 8%, 24% for hypoallergenic HAG glove, 12%, 4% for hypoallergenic SmooTer-R glove, 8%, 0% for hypoallergenic Candle glove, 8%, 24% for hypoallergenic Neutralon glove respectively. There was no difference in prevalence rate of latex allergy among gloves by skin prick test. As the results of skin exposure test, the usual latex gloves had higher prevalence rate of latex allergy than the hypoallergenic gloves (p<0.0001).
Anaphylaxis ; Dizziness ; Exanthema ; Humans ; Hypersensitivity ; Korea ; Latex Hypersensitivity ; Latex* ; Operating Rooms ; Prevalence ; Pruritus ; Risk Factors ; Skin ; Surveys and Questionnaires

Skin atrophy is one of the most common side effects of topical steroid use and results from decreased skin proalphaI collagen mRNA production due to specific alterations in collagen gene transcription or from reduced collagen mRNA stability. This report describes a case of a 8 year-old-girl who visited our hospital with a complaint of ambiguous genitalia. She was observed to have atrophic labia majora and atrophic striae resembling scrotal rugae. However, her serum levels of FSH, LH, 17-KS, 17-OHCS, 5-DHT, DHT and DHEA-S were all in normal range and her karyotype was 46,XX. Abdominal and pelvic ultrasonogram showed a normal uterus and ovaries. Careful history taking revealed frequent use of steroid ointment due to vulvar pruritus for 2 years and she was finally diagnosed to have atrophy of external genitalia induced by long-term use of topical steroid.
Atrophy* ; Collagen ; Disorders of Sex Development ; Female ; Genitalia* ; Karyotype ; Ovary ; Pruritus ; Reference Values ; RNA Stability ; RNA, Messenger ; Skin ; Ultrasonography ; Uterus

PURPOSE: There is increasing awareness of the clinical importance of early detection and treatment of posterior cruciate ligament(PCL) injury. We evaluate the usefulness of Magnetic resonance(MR) imaging in the diagnosis of PCL injury. MATERIALS AND METHODS: We retrospectively analysed the MR images of 140 cases with clinically suspected knee injury. Arthroscopic or surgical correlation was available in 63 cases. We observed the finding and extent of PCL injury and other associated abnormalities. The frequency of anterior and posterior meniscofemoral ligament was evaluated. RESULTS: Eleven PCL injuries were observed, six midsubstance tears, two tibial attachment tears, two fernoral attachment tear, one laxity. The sensitivity, specificity and accuracy of MR imaging diagnosis are 100%, 98.1%, 98.4%. MR findings of PCL injury are discontinuity and focal mass formation, irregular increased signal intensity, detachment or redundancy of the ligament with avulsed bony fragment. In all cases of injured PCL, other associated abnormalities of adjacent structures were observed. Accessory anterior and posterior meniscofemoral ligaments were observed in 67.4%(87/129). CONCLUSION: MR imaging is useful in evaluation of presence or absence of PCL injury, accurate extent of PCL injury and other important associated abnormalities of adjacent structures.
Diagnosis ; Knee Injuries ; Ligaments ; Magnetic Resonance Imaging* ; Posterior Cruciate Ligament* ; Retrospective Studies ; Sensitivity and Specificity

Intracranial vasculitis is a rare and disastrous complication of tuberculous meningitis if not treated properly. Focal neurologic deficits according to the vessels involved are common manifestation. Here, we report a 29-year-old man who suffered abrupt, bizarre behavioral changes caused by vasculitis complicating tuberculous meningoencephalitis. The diagnosis of tuberculous meningitis is based upon both the CSF findings and a chest X-ray. His systemic symptoms disappeared by after being administered antituberculous medication but various psychotic features such as hypersomnia, hyperphagia and aggressivebehavior continued. A brain MRI showed multiple small parenchymal tuberculous nodules, and the brain MR angiography revealed a narrowing of the proimal middle cerebral arteries and a reduced visualization of the cerebral vessels, suggesting widespread vasculitis. Intravenous dexamethasone successfully ameliorated his behavioral changes. In addition both the follow up brain MRI and angiography showed a normalization of the previous findings.
Adult ; Angiography ; Brain ; Dexamethasone ; Diagnosis ; Disorders of Excessive Somnolence ; Follow-Up Studies ; Humans ; Hyperphagia ; Magnetic Resonance Imaging ; Meningoencephalitis* ; Middle Cerebral Artery ; Neurologic Manifestations ; Thorax ; Tuberculosis ; Tuberculosis, Meningeal ; Vasculitis

A 16-month-old girl with acute lymphoblastic leukemia expired during Hickman catheter insertion. She had undergone chemoport insertion of the left subclavian vein six months earlier and received five cycles of chemotherapy. Due to malfunction of the chemoport and the consideration of hematopoietic stem cell transplantation, insertion of a Hickmann catheter on the right side and removal of the malfunctioning chemoport were planned under general anesthesia. The surgery was uneventful during catheter insertion, but the patient experienced the sudden onset of pulseless electrical activity just after saline was flushed through the newly inserted catheter. Cardiopulmonary resuscitation was commenced aggressively, but the patient was refractory. Migration of a thrombus generated by the previous central catheter to the pulmonary circulation was suspected, resulting in a pulmonary embolism.
Anesthesia, General ; Cardiopulmonary Resuscitation ; Catheterization* ; Catheters* ; Central Venous Catheters ; Child* ; Drug Therapy ; Female ; Hematopoietic Stem Cell Transplantation ; Humans ; Infant ; Pediatrics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Pulmonary Circulation ; Pulmonary Embolism* ; Subclavian Vein ; Thrombosis

No abstract available.

PURPOSE: Sasang constitutional medicine is Korea's creative medical science, that has attracted public attention. But for lack of indices in objectifying constitutions, there are difficulties for most of health professionals in approaching Sasang medicine. The purpose of this study was to compare the results of clinical diagnostic data according to the type of Sasang constitution. METHOD: The subjects were 195 examinees who had a general health check-up at A hospital. The instrument used for this study were Questionnaire of Sasang Constitution Class II(QSCCII) program for personal computer developed by Kim Sun Ho et al. RESULT: The distribution of constitutions of the subjects were the So-eum 46.7%, the Tae-eum 36.9% and the So-yang 16.4%. The level of body composition- related indices(body weight, obesity) of the Tae-eum were significantly higher than those of other constitutions. In heart-related indices, systolic BP were the highest in the Tae-eum. In liver-related indices, the level of triglyceride, SGPT were significantly higher in the Tae-eum. But the hematologic indices and lung-related indices were not showed significantly difference among any constitutions. CONCLUSION: The results of this study showed that there were significant difference of clinical diagnostic data according to Sasang constitutions, especially in the Tae-eum. So, to understand the human nature of nursing clients, nurses need to apply the oriental based medical theory, like Sasang constitution, to the discipline of nursing.
Alanine Transaminase ; Classification* ; Constitution and Bylaws* ; Health Occupations ; Human Characteristics ; Microcomputers ; Nursing ; Solar System ; Triglycerides ; Surveys and Questionnaires