PURPOSE: For the early diagnosis of Henoch-Schonlein purpura(HSP) presenting with acute abdominal pain preceding skin rash. METHODS: The clinical, endoscopic and radiological records of 23 cases of HSP, presenting with gastrointestinal symptoms preceding skin rash were reviewed. RESULTS: The intervals from the onset of abdominal pain to the development of the skin rash were one day to 30 days(median five days), most of them were within two weeks. The presenting abdominal symptoms were abdominal pain(23 cases), vomiting(16 cases), hematochezia or melena(eight cases) and hematemesis(three cases). The abnormal endoscopic findings include coalescing erythematous lesions, areas of submucosal hemorrhage and superficial erosions and ulcers. The upper gastro intestinal endoscopy showed the abnormalities in 21 of 23 cases, which were observed in the duodenum(21 cases), the stomach(12 cases) and the esophagus(one case). Duodenitis with hemorrhage and/or erosions in the descending duodenum was the sole endoscopic abnormality in two cases and was the most marked finding in three cases. Sigmoidoscopy showed the abnormalities in six of eight cases. The abdominal ultrasonogram showed abnormalities in 12 of 17 cases, which included small bowel wall thickening(eight cases) and intramural hemorrhage(three cases). Recurrences after three months of symptom free intervals developed in four cases; three of them had persistent nephritis beyond one year. CONCLUSION: The erosive hemorrhagic duodenitis in the descending duodenum in the upper endoscopy and the small bowel wall thickening in the abdominal ultrasonogram can be useful findings in the diagnosis of HSP presenting with acute abdomen.
Abdomen, Acute ; Abdominal Pain* ; Diagnosis ; Duodenitis ; Duodenum ; Early Diagnosis ; Endoscopy ; Exanthema* ; Gastrointestinal Hemorrhage ; Hemorrhage ; Nephritis ; Purpura* ; Recurrence ; Sigmoidoscopy ; Skin* ; Ulcer ; Ultrasonography

PURPOSE: This study examined relationships among stress, stress coping strategies, and somatization in mothers-in-law from multi-cultural families in a rural area. METHODS: Elderly mothers-in-law (n=227) living with foreign daughters-in-law completed a self-reporting questionnaire. Data were collected from April to August 2009. Questions related to stress (Visual Analog Scale, VAS), coping strategies (Coping Strategy Scale) for stress, and somatization (Symptom Check List 90, Revised). SPSS/WIN 12.0 program was used for descriptive analysis, t-test, one-way ANOVA, Pearson correlation, and multiple regression analyses. RESULTS: Subjects had a moderate level of stress (5.03). There were significant differences in stress level according to age, educational level, religion, chronic disease, health status, number of children, agreement of an international marriage of her sons, satisfaction in living with a foreign daughter-in-law, and family conflict. Stress showed a significant positive correlation with offensive coping strategy, passive strategy, and somatization. Stress, offensive coping strategy, and passive coping strategy affected the level of somatization. CONCLUSION: In a family situation involving co-habitation of mother- and foreign daughter-in-law, increased stress experienced by the mother-in-law can lead to increased offensive and passive coping strategies, and increased somatization. More effective means of stress reduction are needed for mothers-in-law from multi-cultural families.
Adaptation, Psychological ; Aged ; Child ; Chronic Disease ; Family Conflict ; Humans ; Marriage ; Somatoform Disorders ; Surveys and Questionnaires

No abstract available.
Bacteria* ; Ulsan*

PURPOSE: The purpose of this study is to investigate levels of stress, self-esteem, and powerlessness in Korean husbands married to foreigner wives. METHODS: The subjects were 183 Korean men who were living with foreigner wives in the Gwangju, Jeonnam and Jeonnbuk areas. Data were collected from January to May 2012 and analyzed by descriptive statistics, t-test, one-way ANOVA, Scheffe test, Pearson's correlation coefficient, and backward multiple regression with the SPSS PC WIN version 18.0. RESULTS: The average level of stress was 4.48, with difficulties in international marriage experienced by the subjects due to differences in language and culture. The average reported self-esteem score was 29.69, and the average powerlessness score 117.76. There were significant differences in perceived powerlessness depending on the employment statuses, income levels, and nationalities of the participants' wives, and their perceived levels of satisfaction with living with a foreigner wife. Powerlessness was positively correlated with stress (r=.41, p<.001), and negatively correlated with self-esteem(r=-.63, p<.001). The factors affecting the perceived powerlessness included self-esteem (beta=-.54, p<.001), stress (beta=.28, p<.001), lower income (beta=.13, p=.016), and working wife (beta=.12, p=.036). CONCLUSION: Healthcare providers need to explore strategies to improve self-esteem and powerlessness in Korean men married to foreigner wives.
Emigrants and Immigrants ; Employment ; Ethnic Groups ; Health Personnel ; Humans ; Male ; Marriage ; Spouses

Purpose: This study explored the level of Rehabilitation Adherence (RA) in patients with stroke receiving rehabilitation treatment and identified the impact of health literacy and illness perception on RA. Methods: A total of 163 patients with stroke were recruited during hospitalization for rehabilitation treatment in a descriptive cross-sectional study. Data were collected from August 25, 2018 to October 30, 2018 using self-report structured questionnaires and analyzed using descriptive statistics and hierarchical regression analysis with SPSS/WIN 26.0 program. Results: The mean score for RA in participants was 3.02±0.49 (range 1~4). Men (t=2.12, p=.035), family caregiver (F=6.59, p=.002), hemorrhagic stroke (t=-2.78, p=.006), shorter period in disease diagnosis (≤12 month) (F=7.49, p=.001) and need of someone’s help for activities of daily living (F=5.20, p=.006) were associated with higher RA. Hierarchical regression analysis showed that health literacy and emotional illness perception explained RA by additional 26%p and 3%p, respectively. Higher health literacy, higher perception about concern and emotional response about disease were effective factors of higher RA in stroke patients. Health literacy was the strongest variable to explain RA among patients with stroke. Conclusion The study provides insight into how health literacy and emotional illness perception promote RA in stroke patients. It suggests that health literacy and illness perception need to be considered in developing a nursing intervention to increase RA for patients with stroke receiving rehabilitation treatment.

Bisphosphonates are the most widely prescribed medications for the treatment of osteoporosis. However, bisphosphonate-related osteonecrosis of the jaw (BRONJ) is recently recognized as a serious complication among patients receiving bisphosphonate therapy. Most reports relate to BRONJ result from intravenous bisphosphonate or dental procedure. We report a case of mandible osteonecrosis related with oral bisphosphonate medication. A-63-year old woman suffered from toothache, cheek swelling and heating sense visited our dental clinic. She had taken oral alendronate and antihypertensive agents for 4 years because of osteoporosis and hypertension. Dental physical examination, radiologic study and pathologic study showed the severe inflammation and osteonecrosis of the mandible. Therefore we diagnosed the patient as having BRONJ and she stopped to take bisphosphonate and received surgical treatment with bone curettage. After surgical treatment and stopping bisphosphonate, her symptoms were improved.
Alendronate ; Antihypertensive Agents ; Bisphosphonate-Associated Osteonecrosis of the Jaw ; Cheek ; Curettage ; Dental Clinics ; Diphosphonates ; Female ; Heating ; Hot Temperature ; Humans ; Hypertension ; Inflammation ; Mandible ; Osteonecrosis ; Osteoporosis ; Physical Examination ; Polymethacrylic Acids ; Toothache

To evaluate of the relationship between basal ganglia lesion and portal-systemic encephalopathy, eleven patients who had clinically proved liver cirrhosis with superior mesenteric vein larger than 10mm in diameter on ultrasonogram underwent brain MR imaging. No evidence of clinical or neuropsychiatric disturbance was observed in any patient at the time of the MR examination. Brain MR imaging revealed basal ganglia lesion characterized by bilateral, symmetric, high signal intensity without edema or mass effect on spin echo T1-weighted images in nine patients which included three patients with the past history of portal-systemic encephalopathy. It was concluded that excepted in the circumstances of other causes of the high signal intensity in basal ganglia on T1-weighted images such as fat, methemoglobin, melanin, neurofibromatosis, dense calcification, and parenteral nutrition, bilateral and symmetric high signal intensity lesion, in basal ganglia would be a useful MR finding of subclinical portal-systemic encephalopathy in liver cirrhosis patients with no clinical or neuropsychiatric symptoms and larger than 10mm diameter of superior mesenteric vein in ultrasonography.
Basal Ganglia* ; Brain ; Edema ; Hepatic Encephalopathy* ; Humans ; Liver Cirrhosis* ; Liver* ; Magnetic Resonance Imaging* ; Melanins ; Mesenteric Veins ; Methemoglobin ; Neurofibromatoses ; Parenteral Nutrition ; Ultrasonography

BACKGROUND: This study aimed to develop feasible and detailed infection control guidelines (ICG) and audit protocols for health care workers and auditors in postpartum care centers (PCC). METHODS: PCC ICG and audit protocols were developed in several steps: 1) review of previous ICG for PCCs; 2) establishment of frameworks for updating guidelines and audit protocols; 3) review of new ICG, regulations, etc.; 4) drafting of PCC ICG and audit protocols and revision based on feedback from the research committee; 5) Delphi survey to solicit opinions from infection control, infant care, and maternal care professionals as well as PCC health care workers; 6) re-revision after discussion with the research committee; and 7) finalization of PCC ICG and audit protocols. RESULTS: We developed ICG with 4 categories and 26 sub-categories, and internal and external audit protocols with 163 and 85 items, respectively. CONCLUSION: The ICG and audit protocols are valid and feasible; we recommend their utilization as auditing tools, baseline data for the development of national infection control policies, and as educational materials for PCC healthcare workers.
Checklist ; Delivery of Health Care ; Humans ; Infant ; Infant Care ; Infection Control* ; Postnatal Care* ; Postpartum Period* ; Social Control, Formal

BACKGROUND: Most studies on the incidence rate (IR) and post-exposure reporting rate (RR) of needle-stick injuries (NSIs) were performed using retrospective surveillance, which is vulnerable to recall bias. This study aimed to identify the agreement between IRs and RRs obtained from prospective and retrospective surveillance. METHODS: The prospective surveillance was performed with 716 nurses working at 3 hospitals from August to September in 2012. They prospectively reported when they experienced the NSIs, and the investigator retrospectively calculated the RR from records in the infection control unit or health care unit during the same periods when they reported the number of NSIs. The retrospective surveillance was carried out with 312 nurses who participated in the prospective surveillance. They retrospectively answered the question on the number of NSIs and post-exposure reporting after recalling the experienced NSI from August to September in 2012. RESULTS: The IR of NSIs was 9.8 per 100 nurses by the prospective surveillance and 36.4 per 100 nurses by the retrospective surveillance, which was statistically significantly different (P<0.001). The RR of NSIs was 14.3% by the prospective surveillance and 8.5% by the retrospective surveillance, which was not statistically significantly different. CONCLUSION: We recommend using a prospective approach for calculating the IR of NSIs to reduce the risk of recall bias. However, the RR of NSIs can be calculated using both prospective and retrospective approaches.
Bias (Epidemiology) ; Delivery of Health Care ; Humans ; Incidence* ; Infection Control ; Memory ; Needlestick Injuries* ; Prospective Studies* ; Research Personnel ; Retrospective Studies*

Hypomelanosis of Ito is a congenital neurocutaneous syndrome with a particular pattern of streaks, patches and swirling hypopigmentation over variable portions of the body surface. Multiple extracutaneous abnormalities involving the central nervous system, musculoskeletal structures and the eyes occur in over two-thirds of the cases. This report describes a patient with typical unilateral cutaneous lesions associated with extracutaneous features, including hypertrophy of the cerebral hemisphere contralateral to the cutaneous hypopigmentation. Chromosomal analysis of fibroblasts of depigmented skin obtained from the patients showed mosaicism.
Central Nervous System ; Cerebrum ; Fibroblasts ; Humans ; Hypertrophy ; Hypopigmentation* ; Malformations of Cortical Development* ; Mosaicism ; Neurocutaneous Syndromes ; Skin