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

No abstract available.
Nephrotic Syndrome*

Despite significant advances in obstetric and pediatric health care, Streptococcus agalactiae(Lancefield group B β-hemolytic Streptococcus, GBS) remains one 91 the most prevalent and devastating pathogens in peripartum women and their newborn infants. It may cause urinary tract infection, chorioamnionitis and endometritis, bacteremia, and cesarean wound infection in the peripartum period. It was Pasteur who first identified microbes in the blood and lorchia of septic women. After that, in 1938 the isolation of S. agalactiae from three mortally ill women was reported, thereby implicating it as another cause of puerperal sepsis. S. agalactiae is now one of the most common causes of neonatal sepsis and meningitis in the United States. However, in Korea there have been only twenty-three cases of neonatal meningitis and/or sepsis due to group B β-hemolytic streptococcus reported. Recent studies have noted other serious infections in adults, including bacteremia, pneumonia, cellulitis, osteomyelitis, meningitis, and endocarditis. In Korean adults no case of pneumonia due to S. agalactiae has been reported till now. As minimal inhibitory concentration of penicillin was reported to be higher for S. agalactiae than for S. pyogenes, minimal inhibitory concentration of penicillin for S. agalactiae should be tested. Herein we describe the course of a case of S. agalactiae pneumonia and bacteremia in a 74-year-old diabetic man, and we review the literatures.
Adult* ; Aged ; Bacteremia ; Cellulitis ; Chorioamnionitis ; Delivery of Health Care ; Endocarditis ; Endometritis ; Female ; Humans ; Infant, Newborn ; Korea ; Meningitis ; Osteomyelitis ; Penicillins ; Peripartum Period ; Pneumonia* ; Pregnancy ; Sepsis ; Streptococcus agalactiae* ; Streptococcus* ; United States ; Urinary Tract Infections ; Wound Infection

Computer-Assisted Instruction(CAI) improved the possibility of individualized learning by enhancing the learning efficacy related to the apptitude, competency, speed and perceptual style of each learner. The reason that I introduced the computer in teaching and learning process is based on the assumption that individual differences can be minimized by applying CAI. This has special meaning because in the current teaching and learning system we can not consider the individual differences of learners. Considering the importance of developing individualized learning program, the course of electrophysiology and pathology of K that requires typical memorization and repetition is made as a purpose to increase the efficacy of learning and thus improve the quality of nursing curriculum.
Curriculum ; Electrophysiology ; Individuality ; Learning ; Nursing ; Pathology