PURPOSE: This study was to investigate the degree of body image, self esteem and quality of life, to identify general and disease of characteristics on influencing this factors with the intention of providing basal data for developing nursing intervention to promote body image, self esteem and quality of life. METHOD: Subjects of this study were 91 grown-up congenital heart patients over 18 years in 2 tertiary hospitals. The data on body image, self esteem and quality of life were collected through questionnaire from March to April 2004. The data were analyzed by descriptive statistics, t-test, Pearson's correlation, ANOVA and tukey test using SAS for Windows 8.1 program. RESULT: 1) The mean scores of body image, self esteem and quality of life were 63.01, 25.29 and 496.79. 2) Body image was correlated with age(p=.0239), educational level(p=.0182), diagnosis(p=.0066), number of operation(p=.0148), cyanosis(p<.0001), complication(p=.0096) and NYHA level(p=.0378). 3) Self esteem was correlated with education level(p=.0026), economic level(p=.0240), number of operation(p=.0113) and cyanosis (p=.0006). 4) Quality of life was correlated with age(p=.0432) and diagnosis(p=.0020), number of operation (p=.0063), duration of last operation(p=.0225), cyanosis(p<.0001), complication(p=.0090) and NYHA level(p<.0001). 5) There was significantly positive relationship between body image, self esteem and quality of life. Subjects with more positive body image had higher self esteem(r=.7897, p<.05) and subjects with higher self esteem had higher quality of life(r=.6091, p<.05).
Body Image* ; Cyanosis ; Education ; Heart* ; Humans ; Intention ; Nursing ; Quality of Life* ; Surveys and Questionnaires ; Self Concept* ; Tertiary Care Centers

BACKGROUND: When going into the intensive care unit (ICU), health care workers (HCWs) and visitors are required to put on cover-gowns and change into slippers, which is considered by some hospitals as one of the customary infection control practices. The purpose of this study was to evaluate the efficacy of cover-gowns and slippers in reducing nosocomial infections in the medical ICU (MICU). METHODS: The study was carried out in four periods. In the period-I (January to June, 2002), all HCWs and visitors put on cover-gowns when entering the MICU, but not in the period-II (July to December, 2002). They were required to change into slippers in the period-III (January to April, 2004), but not in the period-IV (May to August, 2004). RESULTS: Nosocomial infection rates during the period-I and period-II were 14.8 and 12.6 per 100 discharges (P>0.05) or 14.1 and 13.6 per 1,000 patient days (P>0.05), respectively. During the period-III and period-IV respective infection rates were 9.4 and 12.6 (P>0.05) or 10.2 and 15.7 (P>0.05). There were no statistical differences in device utilization ratios, device-associated infection rates, and site of infections (P>0.05) between the periods of I and II or between the periods of III and IV. CONCLUSION: These results showed that the intervention of cover-gown and slipper change is a non-effective factor in reducing nosocomial infections in the MICU; therefore, the infection control practice of cover-gown and slipper changes for HCWs and visitors entering the ICU should be eliminated.
Cross Infection* ; Delivery of Health Care ; Humans ; Infection Control ; Intensive Care Units* ; Critical Care*

BACKGROUND: The shelf life should be determined by health care facility's infection control program. The current standards for preserving the sterility can be changing. So, to measure and compare the recontamination time of sterile packs among wrappers and storage conditions, and develop a practical standard for the shelf life and storage conditions of sterile products. The purpose of this study was placed on measurement of the recontamination time in packs wrapped in all kinds of wrapping materials used in Il-San hospital and extra-costs. METHODS: The first phase study was from June to November 2002 and tile second phase study was planned to extend further the shelf life of the pouch bag from December 2002 to June 2003. Total 504 sterile sample packs containing cotton ball (5 cm-length) prepared and wrapped in four wrapping materials (randomized reprocessed two folds of lines, a fold of new craft paper, a fold of new nonwoven fabric, a fold of new pouch bag) and stored in three location (open shell of one of typical wards, open shelf of one of ICUs, open shelf of CSSD). Each type of packs were opened weekly and the cotton balls inoculated into thioglycollate broth at 35degrees C for seven days by infection control nurse. The temperature and relative humidity was monitored monthly. RESULTS: There was on growth found for any types of the pack and storage conditions studied. The temperature and relative humidity of storage locations were 24.8degrees C and 35.5 %. The extra-cost of reprocessing in Ethylene-Oxide gas sterilization was \32,800,000 and Steam sterilization was \36,900,000 by year. CONCLUSION: This study was conducted in attempt to identify the possibility of extending the current shelf life for sterile goods we use in a sense of cost effectiveness. It was possible to extend shelf life from four weeks to six months in the study hospital. We are going to continue this study and take all steps need to apply this new concept to our practice, and then trying to extend to other hospitals.
Cost-Benefit Analysis ; Costs and Cost Analysis* ; Delivery of Health Care ; Humidity ; Infection Control ; Infertility ; Steam ; Sterilization

Nineteen children found to have gallstones at Seoul National University of Children's Hospital from Jun. 1982 to Jun. 1992 were reviewed. The results were as follows: 1) The mean age was 10 years, with 9 boys and 10girls. Most of the cases(63%) were over 10 years of age. 2) Clinical manifestations were abdominal pain(14 cases), nausea and/or vomiting (5 cases), fever (2 cases), jaundice (2 cases) and fatty food intolerance (1 case). Five cases were asymptomatic. Of 14 cases with abdominal pain, only 5 cases showed typical biliary colic which suggests cholelithiasis. 3) Associated conditions in cholelithiasis were Wilson disease (5 cases), congenital hereditary spherocytosis (2 cases), choledochal cyst (2 cases), total parenteral nutrition following ileal resection (1 case). And the other conditions which had association with cholelithiasis are not certain, and they were nephrotic syndrome, histiocytic cytophathic panniculitis, meningococcal meningitis, portal vein thrombosis and cardiac cirrhosis. The remaining 4 cases showed no associated conditions or diseases. 4) Eleven of 19 patients with cholelithiasis (58%) showed cholecystitis. 5) Cholecystectomy was performed in 4 cases with frequently recurred abdominal pain or associated diseases which needed operative correction. Symptoms completely subsided after operation. In conclusion, cholelithiasis in children has a variety of associated conditions and nonspecific abdominal symptoms were nore common than classic biliary colic. Although cholelithiasis in pediatric population are uncommon problems, the possibility of gallstones should be considered in the evaluation of abdominal pain in children with associated conditions.
Abdominal Pain ; Child ; Cholecystectomy ; Cholecystitis ; Choledochal Cyst ; Cholelithiasis* ; Colic ; Fever ; Fibrosis ; Gallstones ; Hepatolenticular Degeneration ; Humans ; Jaundice ; Meningitis, Meningococcal ; Nausea ; Nephrotic Syndrome ; Panniculitis ; Parenteral Nutrition, Total ; Seoul ; Venous Thrombosis ; Vomiting

Fifty five children with endoscopically proven esophageal varices from Jul. 1987 to Dec. 1992 were analyzed for endoscopic and clinical characteristics. The results were as follows: 1) According to etiological classification of portal hypertension in 55 cases, 35 cases showed intrahepatic causes 964%) and 20 cases had extrahepatic causes (36%). The most common clinical manifestation on admission was hematemesis (42%) and abdominal mass (36%). 2) Portal vein thrombosis was the most common cause of portal hypertension. Patients with portal vein thrombosis showed more frequent bleeding than with intrahepatic portal hypertension. Most of them had the first bleeding episode before 7 years old of age. Progression of portal hypertension in portal vein thrombosis was more rapid and bleeding episode was earlier than that in most of intrahepatic causes of the portal hypertension. 3) Twenty patients showed gastritis (10 cases), duodenitis (4 cases), gastric ulcer (4 cases) and esophagitis (2 cases) besides varix on the endoscopic examination. In 4 cases, the cause of upper GI bleeding was found as duodenal ulcer (3 cases) or hemorrhagic errosive gastritis (1 case) with no variceal bleeding. 4) Among 36 cases with variceal bleeding, 20 cases had predisposing factors for bleeding such as medication for URI including Aspirin. 5) More than one episode of bleeding were noted in 36 cases (65%) of the patients with varix. Thirty-one cases were treated conservatively with success. The remaining 5 cases with severe bleeding were managed with IV pitressin, SB-tube insertion and emergency shunt operation. High mortality rate (40%) was found in these patients group. In conclusion, in patients with clinically suspected portal hypertension, regular endoscopic examination might be recommended for the earlier recognition and effective prevention of variceal bleeding. for bleeding varices, in addition to conservative management, active treatment such as pitressin, SB-tube, sclerotherapy, endoscopic variceal ligation and emergency shunt operation should be considered with the emergency endoscopy which can identify bleeding focus and predict the chance of rebleeding.
Aspirin ; Causality ; Child* ; Classification ; Duodenal Ulcer ; Duodenitis ; Emergencies ; Endoscopy ; Esophageal and Gastric Varices* ; Esophagitis ; Gastritis ; Hematemesis ; Hemorrhage ; Humans ; Hypertension, Portal ; Ligation ; Mortality ; Sclerotherapy ; Stomach Ulcer ; Varicose Veins ; Vasopressins ; Venous Thrombosis

The aim of the study was to explore the current status as well as personal views, attitudes, and beliefs regarding daily meal consumption (DM) and food supplement use (FS) in conjunction with the improvement of health condition of the women. Eight focus group interviews were performed and the interview material was condensed systematically with the aim to extract core meanings related to DM, FS, and menopause-associated health. Participants were 40 in number and showed ages ranging from 45 and 60 years with various menopausal status. Current status and beliefs about DM, resources of purchase motivation of FS, types of FS that are currently used, and perceived effects and personal beliefs about FS are discussed. Theme content analysis revealed 3 themes for beliefs about DM, 5 themes for beliefs pertaining FS, and 4 themes for the association between DM and FS. Non-dietary factors such as positive mental attitude and exercise appeared to be also important to maintain good health. The bottom line message from this study may be that proper nutrition through daily meals is essential for good health, while food supplement are used merely to supplement the diet. Findings from this study may deepen our understanding of how women who translate their lifespan through "menopause" perceive the roles and meaning of DM and FS, suggesting health professionals need to monitor and evaluate DM and implement strategies targeting the improvement of daily meal quality of middle and older aged women.
Aged ; Climacteric ; Diet ; Dietary Supplements ; Female ; Focus Groups ; Health Occupations ; Humans ; Meals ; Motivation ; Organothiophosphorus Compounds

No abstract available.
beta-Thalassemia*

OBJECTIVES: This study was designed to evaluate the problems of pre-hospital Emergency medical care system (EMS) in workplace. We analysed 25 fatal work-place injuries during the recent 4 years and the work-place EMS of 8 enterprises located in Masan-city, Changwon-city and Kuje-island. METHODS: The safety managers and the members of Dept. of safety in the labor unions were interviewed about the work-place EMS. And we investigated on the injury reports, the work-place medical-room records and the medical records of emergency center for fatal 25 cases. RESULTS: The enterprises had the at-risk machines and processes, volatile materials and high-altitude working processes. There were duty doctors in only 3 enterprises but a few duty nurses or health-care providers in the others. The time spent for the education to the workers on safety was 24hrs/yr in 3 enterprises in 1998 but less than Bhrs in the others. There were medical service center in all enterprises but the ambulances in three. The time for activation of the ambulance was ranging from 5 minutes to 10 minutes in 6 enterprises, and from 10 minutes to 30 minutes in two. The patient transportation to the emergency center was possible within 30 minutes in all enterprises but there were no equipments for airway maintenance and shock management in all enterprises. The 15 (60%) fatal injuries were occurred at one enterprise. The 64% of casualties had the duration of job-employment more than 10yrs and the 68% were suffered the typical type of work-place injury as descending injuries, collisions and falls. Most of all primary calls for rescue were concentrated on the fire-service agencies. But in 85% of fatal injtories, the tome for the activation of ambulance was more than 10 minutes and no emergency care was taken in the field in 48 percent of casualtles. The transportation time to the emergency center was more than 30 minutes in 50 percent. It toolk from injury to death was less than one hour in the 40 percent of all cases, and from one hour to four in the 50 percent. The causes of death in the 68 percent were the head-and-neck injuries or thoracic injuries. CONCLUSIONS: We found that there was Insufficiency of the education associated with work-place injury for workers, manpower and facilities, equipments related to the work-place EMS, the problems of the delay in transportation system.
Ambulances ; Cause of Death ; Education ; Emergencies* ; Emergency Medical Services* ; Humans ; Labor Unions ; Medical Records ; Shock ; Thoracic Injuries ; Transportation

To evaluate the clinical efficacy of emergency cervical cerclage in the treatment of advanced cervical incompetence, a prospective clinical trial was performed in 18 patients with advanced cervical incompetence at 20 to 25 weeks gestation. Modified McDonalds operation with or without transabdominal amniocentesis was used for cervical cerclage. Pregnancy was prolonged for a sufficient time to deliver viable fetuses in 56.3% of patients. The median procedure-to-delivery interval was 8.6 (range 0.1 to 20.5) weeks for the entire group, and 13.9 (range 6.5 to 20.5) weeks for 9 patients who achieved live birth. The median gestational age at delivery was 38.6 (range 28.3 to 41.0) weeks for the live infants. The median birthweight of the live infants was 3062 g (range 1050 to 3620 g). The lack of significant matemal morbidity combined with the results for the fetus-infant supports further efforts in this area.
Amniocentesis ; Cerclage, Cervical ; Emergencies* ; Fetus ; Gestational Age ; Humans ; Infant ; Live Birth ; Pregnancy ; Prospective Studies

Krukenberg tumor, which can account for 30-40% of metastatic cancers to the ovaries, arises in the ovarian stroma and is usually metastatic from the gastrointestinal tract, especially from the stomach. The pathognomonic feature is the presence of signet ring cells, which may be arranged in acini or appear as individual cells. We experienced a Krukenberg tumor which was bilateral and associated with left ovarian dermoid cyst. This patient was treated for a primary gastric carcinoma(Stage II) about 3 years ago. After bilateral salpingoophorectomy, she received adjuvant chemotherapy. But, she died about fow months after operation.
Chemotherapy, Adjuvant ; Dermoid Cyst* ; Female ; Gastrointestinal Tract ; Humans ; Krukenberg Tumor* ; Ovary ; Stomach