The purpose of this study was to identify the effect of body positioning on PaO2, SpO2, systolic blood pressure, diastolic blood pressure, pulse, and respiration(above all defined physiologic index), of patients with unilateral lung disease. The subjects for this study were eleven patients admitted to I.C.U. of K.H.M.C. with a diagnosis of unilateral lung disease confirmed by chest X-ray and the attending doctor, from January 30th. to April 20th. 1999. A quasi-experimental repeated-measures cross-over design was used to compare three body positions(semi-Fowler's, lateral decubitus with good lung dependent, and lateral decubitus with diseased lung dependent). Each subject spent 30 minutes in semi-Fowler's position and 2 hours in good lung dependent position and diseased lung dependent position. Starting in the semi-Fowler's position, then in the lateral position with the good lung dependent or the diseased lung dependent as assigned in random order. Thirty minutes after each positioning, arterial blood sample was analyzed. Measurements of all physiologic index were recorded at the specified intervals(0, 30, 60 90, and 120 minutes) in good lung dependent and diseased lung dependent position. Statistical comparison of PaO2 value was done using the Wilcoxon Signed Rank Test, and Multivariate repeated-measures analysis of variance was performed to analyse the within-subject effect of two dependent position for 2 hours on the five dependent variables: 1. PaO2 2. SpO2 3. systolic blood pressure 4. diastolic blood pressure 5. pulse. The results obtained were as follows: 1. The PaO2 value in the good lung dependent position was significantly higher than the PaO2 value in the diseased lung dependent position(Z=-2.8451, p=.002). 2. The PaO2 value in the good lung dependent position was significantly higher than the PaO2 value in the semi-Fowler's position (Z=-2.6673, p=.003). 3. The difference between the PaO2 value in the semi-Fowler's position and the PaO2 value in the diseased lung dependent position was not significant(Z=-1.2448, p=.10). 4. There were no statistically significance in the trends of physiologic index in the good lung dependent position and the diseased lung dependent position. From the results, it may be concluded that the good lung dependent position is the most effective position for patients with unilateral lung disease that improve oxygenation. Identification of positioning over time may be need further studies.
Blood Pressure ; Cross-Over Studies ; Diagnosis ; Humans ; Lung Diseases* ; Lung* ; Oxygen ; Thorax

Thrombomodulin (TM) is thrombin receptor present on the luminal surface of endothelial cells. Because the thrombin-TM complex acts as an anticoagulant, the functional variants or deficiency of TM may lead to increment of thrombotic tendency. In this study, we screened the genetic variants of the TM gene in patients with myocardial infarction (MI) and analyzed the genotype to elucidate the effects of genetic variations of TM gene on the development of the MI. We screened a promoter region and coding sequence of the TM gene using single strand conformation polymorphism-heteroduplex analysis and identified three common genetic variants: those were TM G-33A, TM Ala455Val, and TM C1922T. The genotype frequencies were investigated in the patients with MI (n=234) and control subjects (n=291) by the method of allele-specific oligomer hybridization. The frequencies of mutant genotypes (TM -33A, TM 455Val, and TM 1922T) were higher in patient group compared to the control subjects in males while there were no significant differences in females. In the multiple logistic regression analysis, TM 455Val and TM 1922T alleles were independent risk factors for MI (OR[95% CI: 1.799[1.125-2.878] p=0.014 and 5.624[1.019-31.025], p=0.048, respectively) in males. However, the genetic variations were not independent risk factors for MI in females. There were significant linkage disequilibriums among three genetic variants. These linkage disequilibriums explain the similar effects of three genetic variants on the development of MI. To investigate the effect of the TM G-33A mutation on TM promoter activity, the two TM promoter constructs (pTM-355 and pTM-125, bearing TM -33G or TM -33A) containing of firefly luciferase gene were transfected into HepG2, BAE, and CHO cells. The promoter activities were higher in the promoter constructs with TM -33G compared to the constructs with TM -33A in pTM-355. These results suggest the possibility of the positive predisposing effect of TM -33A allele on MI in males. The functional study for TM Ala455Val and TM C1922T should be followed to elucidate the genotype effects of these mutations on the development of MI. In this study, we identified three genetic variants of TM gene and showed the significant associations between genetic variants and MI in males. These results proposed that TM gene is an attractive candidate for genetic risk factor for MI in Koreans.
Alleles ; Animals ; CHO Cells ; Clinical Coding ; Cricetinae ; Endothelial Cells ; Female ; Fireflies ; Genetic Variation ; Genotype ; Humans ; Linkage Disequilibrium ; Logistic Models ; Luciferases ; Male ; Myocardial Infarction* ; Phenobarbital ; Promoter Regions, Genetic ; Receptors, Thrombin ; Risk Factors* ; Thrombomodulin

PURPOSE:The most important regulatory factor for IGF-I and IGFBP-3 known so far GH and food intake. Poor nutrition in children with acute lymphocytic leukemia(ALL) increase morbidity during treatment. The aim of this study was to assess the changes of serum IGF-I and IGFBP-3 concentration during induction chemotherapy in 13 children with acute lymphocytic leukemia. METHODS:13 children aged between 1.6 and 13.5 years with ALL were studied the changes of serum IGF-I and IGFBP-3 concentration before, at 2 and 4 weeks after induction chemotherapy. Serum IGF-I and IGFBP-3 were measured using radioimmunoassay. Results : 1) Mean serum IGF-I and IGFBP-3 concentration before induction chemotherapy in ALL patient was significantly lower than the those of normal control(p<0.05). 2) Mean serum IGF-I and IGFBP-3 concentration at 2 weeks of induction chemotherapy were significantly higher than the those of the basal levels (p<0.05). 3) Mean serum IGF-I and IGFBP-3 concentration at 4 weeks after induction chemotherapy were significantly higher than the those of the basal levels (p<0.05). Conclusion : Concentration of serum IGF-I and IGFBP-3 in patients with ALL were significantly increased during induction chemotherapy. These results are probably related to improvement of nutritional status following induction chemotherapy.
Child* ; Eating ; Humans ; Induction Chemotherapy* ; Insulin-Like Growth Factor Binding Protein 3* ; Insulin-Like Growth Factor I* ; Nutritional Status ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Radioimmunoassay

The purpose of this study was to develop and test the validity of standardized Korean nomenclature of the Home Health Care Classification(HHCC), developed by Saba at the University of Georgetown. The four phases of the study were : (1) Two professors and 15 graduate students, who were taking a nursing intervention course, translated the HHCC into Korean. (2)12 nurses with various clinical backgrounds reviewed each nomenclature taking into consideration of the definition and activities, and the Delphi method was used to determine the best appropriate nomenclature for each term; (3)20 academic and clinical experts in nursing were given a questionnaire to rate the validity of each Korean nomenclature using a 5 point Likert scale ranging from very inappropriate to very appropriate; (4) Five members of the Korean Nurses Association Research Committee reviewed the survey results and determined the most appropriate Korean nomenclature for each term of the HHCC. Most of the nomenclatures had a score of more than 4.0, but several terms had a score lower than 4.0. They are Ambulation therapy(3.1.1), Anticipatory grieving(3.11), Sexual patterns alteration(3.17), Nursing care coordination(3. 22), Physical therapist service(3.22), Regular diet(3.33), and Instrumental activities of daily living(3.44). These research results will be included in the nursing vocabulary dictionary to be published by the Korean Nurses Association.
Classification* ; Delivery of Health Care* ; Humans ; Nursing ; Nursing Care ; Physical Therapists ; Vocabulary ; Walking ; Surveys and Questionnaires

No abstract available.
Biopsy ; Carcinoma, Merkel Cell

OBJECTIVE: Microsatellite alteration such as loss of heterozygosity (LOH) has been reported to be a novel mechanism for the inactivation of tumor suppressor gene and related to carcinogenesis in many malignant tumors. E-cadherin protein coded by gene on chromosome 16q22.1 may play a principal role for tumor suppression. However LOH of E-cadherin has been rarely studied in endometrial carcinoma. The purpose of this study was to investigate the loss of heterozygosity (LOH) of E-cadherin in endometrial carcinoma and endometrial hyperplasia and to correlate their results with various clinicopathological factors. METHODS: LOH of E-cadherin on the chromosome 16q22.1 analysis was performed by using polymerase chain reaction (PCR) for three polymorphic microsatellite markers (D16S419, D16S3106, D16S498) and automatic laser fluorescent DNA sequencer in 30 cases of endometrioid endometrial adenocarcinomas and in 20 cases of endometrial hyperplasias. The relationship between LOH of E-cadherin and clinical profile was analyzed. RESULTS: Increased LOH of E-cadherin was found in endometrial carcinomas (50%) compared to endometrial hyperplasias (5%) (P=0.01, Fisher's exact test). The incidence of LOH of E-cadherin in endometrial carcinomas also showed significantly lower in stage below Ia. (P=0.034, Fisher's exact test) LOH of E-cadherin was not associated with histologic grade and lymph node metastasis. (P=0.42, P=0.5, Fisher's exact test) CONCLUSIONS: These results suggests that LOH of E-cadherin may contribute to the development of endometrial carcinoma, especially in above stage Ib.
Adenocarcinoma ; Cadherins ; DNA ; Endometrial Hyperplasia ; Endometrial Neoplasms ; Female ; Genes, Tumor Suppressor ; Incidence ; Loss of Heterozygosity ; Lymph Nodes ; Microsatellite Repeats ; Neoplasm Metastasis ; Polymerase Chain Reaction

Objective: We conducted this study to address the incidence and prevalence of schizophrenia and similar psychosis in South Korea with Health Insurance Review and Assessment (HIRA) database. Methods: We used HIRA database, which includes diagnostic information of nearly all Korean nationals to collect number of cases with diagnosis of schizophrenia and schizophrenia-similar disorders (SSP), including schizophreniform, acute/transient psychotic disorders, schizoaffective disorders, and other/unspecific nonorganic psychosis (ICD-10 codes F20/23/25/28/29) between 2010 and 2015. The annual prevalence and incidence were calculated using the population data from the Korean Statistical Office. Results: The 12-month prevalence of SSP of Korea between 2010 and 2015 were 0.48–0.66%. The 12-month prevalence of schizophrenia were 0.40–0.52%; The annual incidence rates (IR) of SSP between 2010 and 2015 were 118.8–148.7 per 100,000 person-year (PY). For schizophrenia, IR per 100,000 PY were 77.6–88.5 between 2010 and 2015. Conclusion The 12-month prevalence found in the present study was higher than that reported in community-based epidemiologic studies in South Korea but similar to those from other countries. The annual incidence of SSP and schizophrenia was found to steadily increase and was higher than that of other countries. The high incidence rate observed in the current study needs to be studied further.

BACKGROUND: Molluscum contagiosum is a commom benign viral disease of the skin characterized by discrete, 2-5 mm, flesh colored, slightly umbilicated, dome-shaped papules with frequent grouping. But atypical presentation of site, number and size is recently not rare, it may give rise to difficulty in diagnosis. OBJECTIVE: The purpose of this study was to investigate the clinical and histopathological characteristics of various atypical molluscum contagiosa. METHODS: We reviewed medical records, clinical photographs, and histopathologic findings in biopsy specimens of 17 patients with molluscum contagiosa diagnosed at Korea Veterans Hospital from January 1990 to June 2001. The ratio of male to female patients was 3:1, and the mean age at diagnosis was 30 years(range: 3-67). RESULTS: 1. Most commonly involved sites were trunk(80%), extremities(30%), and perianal(12%). 2. The duration of the lesion is 15 days to 3 years. 3. The size of lesion is 2 mm to 50 mm. 4. The number of lesions is one to over a hundred. 5. The clinical features were multiple papules without umbilication(9 cases, 53%) and giant tumor(2 case), pyogenic granuloma-like lesion(2 cases), solitary papule with flat surface(2 cases). 6. The combined disease are atopic dermatitis(1 case), epidermal cyst(1 case), and liver cirrhosis(1 case), diabetes mellitus(1 cases). CONCLUSION: This study shows various atypical molluscum contagiosa in immunocompetent patients. Histopathological examination in atypical molluscum contagiosa is necessary for the proper diagnosis and treatment.
Biopsy ; Diagnosis ; Female ; Hospitals, Veterans ; Humans ; Korea ; Liver ; Male ; Medical Records ; Molluscum Contagiosum ; Skin ; Virus Diseases

OBJECTIVES: Previous studies have shown the relationship between recognition of facial expressions and psychiatric symptoms. This study investigated how healthy young adults recognize neutral faces and which psychological distresses and symptoms relate to their recognition of neutral faces. METHODS: One hundred forty-three healthy volunteers participated in this study. We used neutral facial pictures, selected from the Japanese and Caucasian Facial Expressions of Emotion (JACFEE) photo set, to evaluate participants' facial expression recognition and the State-Trait Anxiety Inventory, Beck Depression Inventory, Toronto Alexithymia Scale, Conner-Davidson Resilience Scale, and Temperament and Character Inventory (TCI) to measure and examine their psychological characteristics. RESULTS: There were significant positive correlations between the recognition rate of neutral expressions as contempt and trait-anxiety level (r=0.21 ; p=0.01) and depression (r=0.20 ; p=0.02). This contempt-recognition was significantly negatively correlated with resilience score (r=-0.22 ; p=0.01) and the TCI self-directedness subscale (r=-0.29 ; p=0.00). Also, the TCI's harm avoidance subscale score was significantly positively correlated with the contempt recognition rate (r=0.21 ; p=0.01). CONCLUSION: These finding suggests recognition of neutral faces as contempt may be related to psychological distress, including trait and temperament characteristics. This negative bias toward neutral emotion (expressions) may affect interpersonal relations and social functioning in a healthy population.
Affective Symptoms ; Anxiety ; Asian Continental Ancestry Group ; Bias (Epidemiology) ; Depression ; Facial Expression ; Humans ; Interpersonal Relations ; Polymethacrylic Acids ; Temperament ; Young Adult

Recently, we have encountered an increasing number of patients who have obtained topical steroids to self-treat various dermatosis. Tinea incognito has been used to describe a dermatophyte infection modified by corticosteroid treatment. Lesions are often atypical appearing and the diagnosis can be delayed or missed. We report a case of tinea incognito with ill-defined erythematous patch and nodules on the right upper eyelid and taken intermittently application with corticosteroid ointment over a period of l year. Mycologic studies including KOH mount and fungus culture were positive for hyphae and colonies of Trichophyton mentagrophytes. The lesion was treated with of itraconazole and cured 3 weeks later.
Arthrodermataceae ; Diagnosis ; Eyelids ; Fungi ; Humans ; Hyphae ; Itraconazole ; Skin Diseases ; Steroids ; Tinea* ; Trichophyton*