PURPOSE: This study was done to investigate the probability of stroke, knowledge of stroke, and health-promoting lifestyle among stroke risk groups. METHOD: A descriptive correlational design was used. Data for 110 patients were analyzed. The probability of stroke was calculated using the Stroke Risk Profile from the Framingham Heart Study (2013), knowledge of stroke was measured using a questionnaire developed by Yoon et al. (2001), and health-promoting lifestyle was measured using the HPLP-II, developed by Walker et al. (1995). RESULTS: The average probability of stroke was 11.74, knowledge of stroke, 67.88, and health-promoting lifestyle, 2.27. Probability of stroke showed significant differences according to gender. Knowledge differed according to patients' salaries. Health-promoting lifestyle showed significant differences according to gender. There were no significant correlations between probability of stroke and knowledge of stroke or probability of stroke and health-promoting lifestyle, but there was a significant correlation between knowledge of stroke and health-promoting lifestyle. CONCLUSION: Results indicate the necessity of active education to increase knowledge related to stroke which will contribute to an increase in health-promoting behaviors and make primary prevention a reality in the reduction of risk of stroke among stroke risk groups.
Education ; Health Behavior ; Heart ; Humans ; Life Style* ; Primary Prevention ; Surveys and Questionnaires ; Salaries and Fringe Benefits ; Stroke*

PURPOSE: We compared prophylactic effects and complications of intravesical instillation of the Connaught and Tice strains bacillus Calmette-Guerin (BCG) in patients with stage pT1 bladder cancer. MATERIALS AND METHODS: A total of 98 patients with stage pT1 bladder cancer were treated with transurethral resection (TUR) between January 1992 and April 1998. Of the 98 patients, 51 received the Connaught strain BCG (81mg), 27 the Tice strain BCG (12.7mg) and 20 patients underwent TUR alone. The patients were followed-up for 18-78 months (mean 42.5months). The recurrence and progression rates, mean months to tumor recurrence, recurrence free survival rate, using Kaplan-Meier curve, and complications, were compared between the two BCG strain groups. RESULTS: The overall recurrence rate was 27.5% in the Connaught strain BCG group, 29.6% in Tice strain BCG group and 65% in TUR alone group. The mean months to tumor recurrence, and the recurrence free survival rate, showed that both BCG strain drugs were superior to TUR alone. Although the prophylactic efficacy of the Connaught strain BCG was a little higher than that of the Tice strain BCG, there were no significant differences in the recurrence rates and recurrence free survival rates between the two drugs. The incidences of complications were 94.1 and 85.2% in the Connaught strain BCG and Tice strain BCG groups, respectively. CONCLUSIONS: Both the Connaught and Tice BCG strains were superior to TUR alone in the prophylaxis of the recurrence in stage pT1 bladder cancer. There was no significant difference in the complication rates between the two groups. Therefore, both the Connaught and Tice BCG strains may be regarded as alternative treatments.
Administration, Intravesical ; Bacillus* ; BCG Vaccine ; Humans ; Incidence ; Mycobacterium bovis ; Recurrence ; Survival Rate ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Rigid ureteroscopy is now an established technique for the management of ureteral stones and the diagnostic procedure of ureteral lesions. The results of ureteroscopic stone removal were reviewed in 153 patients (1 patient ; bilateral). From October 1989 to August 1990, 163 patients underwent ureteroscopic removal of ureter stones. There were 53 female and 100 male patients between 17 and 72 years old. In all patients with ureteral stones surgical intervention was indicated for the obstruction with deteriorating kidney function, infection or severe and prolonged pain. All procedures were performed under epidural anesthesia. Stones were extracted, using grasping forceps or stone baskets with or without electrohydraulic lithotriptor (EHL) under direct visual control. Success of ureteroscopic removal was related to the location of the calculus : 98.2% in the distal, 88.2% in mid and 79.2% in the proximal ureter (overall success rate was 94.2% ). The associated number of complications was low, with most patients being treated conservatively. We conclude that ureteroscopic removal of ureteral stone under direct vision can be done safely and be the first choice of management for the ureteral calculi.
Aged ; Anesthesia, Epidural ; Calculi ; Female ; Hand Strength ; Humans ; Kidney ; Male ; Surgical Instruments ; Ureter* ; Ureteral Calculi ; Ureteroscopy

The aim of this study was to evaluate the efficacy of intravenous immunoglobulin treatment for recurrent spontaneous abortion. Immunologic causes in either alloimmune or autoimmune type have been suggested for more than 80% of these patients. Various immunotherapy including paternal leukocyte transfusion has been used, but there is controversy on its efficacy and side-effects. The proposed immunomodulatory mechanism of intravenous immunoglobulin includes passive transfer of blocking or anti-idiotype antibody, blockade of Fc receptors, enhancement of supressor T-cell function, down regulation of B cell function. In this study, we used intravenous immunoglobulin for the prevention of spontaneous abortion. Five patients with a history of two or more spontaneous abortions were enrolled in this study. Other etiologic factors such as anatomical, chromosomal, hormonal factors were excluded. Three of them were positive for anti-cardiolipin antibody (ACA). When the pregnancy was diagnosed at about five weeks of gestation, 30 g intravenous immunoglobulin was administered and continued up to 28 weeks with three weeks. Ongoing pregnancy beyond 20 weeks was considered successful. Four among five patients (80%) was successful in maintaining pregnancy now ongoing 20, 31, 33, 39 weeks. One patient with ACA positive had abartion due to anembryonic pregnancy. No adverse reaction was observed during the treatment. From these preliminary data, it is suggested that intravenous immunoglobulin treatment may be effective in maintaining pregnancy in patients with unexplained recurrent spontaneous abortion, Further studies are needed to clarify the its immunomodulatory mechanism and establish a more simplified protocol limiting the use at certain critical period of time.
Abortion, Spontaneous* ; Critical Period (Psychology) ; Down-Regulation ; Female ; Humans ; Immunoglobulins* ; Immunotherapy ; Leukocyte Transfusion ; Pregnancy ; Receptors, Fc ; T-Lymphocytes

BACKGROUND: The Sewol ferry disaster caused national shock and grief in Korea. The present study examined the prevalence and associated factors of post-traumatic stress disorder (PTSD) symptoms among the surviving students 20 months after that disaster. METHODS: This study was conducted using a cross-sectional design and a sample of 57 students (29 boys and 28 girls) who survived the Sewol ferry disaster. Data were collected using a questionnaire, including instruments that assessed psychological status. A generalized linear model using a log link and Poisson distribution was performed to identify factors associated with PTSD symptoms. RESULTS: The results showed that 26.3% of participants were classified in the clinical group by the Child Report of Post-traumatic Symptoms score. Based on a generalized linear model, Poisson distribution, and log link analyses, PTSD symptoms were positively correlated with the number of exposed traumatic events, peers and social support, peri-traumatic dissociation and post-traumatic negative beliefs, and emotional difficulties. On the other hand, PTSD symptoms were negatively correlated with psychological well-being, family cohesion, post-traumatic social support, receiving care at a psychiatry clinic, and female gender. CONCLUSION: This study uncovered risk and protective factors of PTSD in disaster-exposed adolescents. The implications of these findings are considered in relation to determining assessment and interventional strategies aimed at helping survivors following similar traumatic experiences.
Adolescent ; Child ; Disasters* ; Female ; Grief ; Hand ; Humans ; Korea* ; Linear Models ; Prevalence ; Protective Factors ; Shock ; Stress Disorders, Post-Traumatic ; Survivors

PURPOSE: The management of pediatric trauma is substantially derived from the results of adult trauma patient. Despite the increasing of pediatric renal trauma, the management of them still remains controversial. The aim of this study is to evaluate our experience with the expectant conservative management of blunt trauma in children. MATERIALS AND METHODS: We retrospectively studied 45 pediatric patients with renal trauma between 1995 and 2007. We reviewed medical records for clinical symptoms, mechanism of injury, assigned grade of renal injury, associated injuries, indication of surgery, and treatment outcomes. We graded renal injuries according to the American Association for the Surgery of Trauma Organ Injury Scale. RESULTS: All patients of grade I, II, III, and IV were managed conservatively at beginning, if the hemodynamic state is stable. Among them, 2 patients of grade IV were done delayed operation. One patient underwent delayed renorrhaphy for persistent anemia and hypotension, and the other patient needed delayed nephrectomy because of persistent fever and worsening abdominal pain with significant urinary extravasation. All patients of grade V were undergone early nephrectomy. CONCLUSIONS: Except for persistent fever with significant extravasation and grade V injury, initial conservative management of blunt renal trauma in children is effective and recommendable at beginning, if the hemodynamic state is stable. Prospective larger randomized controlled trials will be needed.
Abdominal Pain ; Adult ; Anemia ; Child ; Fever ; Hemodynamics ; Humans ; Hypotension ; Kidney ; Medical Records ; Nephrectomy ; Pediatrics ; Retrospective Studies ; Treatment Outcome

PURPOSE: Percutaneous nephrolithotomy (PCNL) is the procedure of choice for treating large renal stones. Pneumatic lithotripsy (Lithoclast(R)) is effective regardless of the stones' composition, and ultrasonic lithotripsy allows the aspiration of small debris during lithotripsy. We investigated the efficacy and safety of PCNL via Lithoclast(R) alone or combined with ultrasonic lithotripsy. MATERIALS AND METHODS: Thirty-five (group A) and 39 (group B) patients underwent Lithoclast(R) PCNL and combination therapy, respectively, from May 2001 to March 2010, and the two groups were compared in terms of stone size, location, and composition; operative time; average number of treatments; hospital days; hemoglobin loss; ancillary procedures; rate of device failure; and initial and total stone-free rates. RESULTS: The two groups did not differ significantly in preoperative stone size, location, or composition; the average number of treatments; or the initial and overall stone-free rates. However, combination therapy was associated with a significantly lower operative time (181+/-50 vs. 221+/-65 min, respectively, p=0.004), number of hospital days (11.6+/-3.8 vs. 14.2+/-4.4 days, respectively, p=0.009), and average hemoglobin loss (1.12+/-0.61 vs. 1.39+/-1.02 g/dl, respectively, p=0.013). Transfusions were required in 6 patients (4 and 2 in each group, respectively), but there were no significant complications related to percutaneous access. There were 2 (5.7%) mechanical failures (Lithoclast(R) probe fracture) in the group A and 5 (12.8%) in the group B (2 cases of suction tube obstruction, 3 cases of overheating). CONCLUSIONS: The combination of ultrasonic lithotripter and Lithoclast(R) is more effective than Lithoclast(R) alone because it significantly decreases operative time, hemoglobin loss, and the hospital stay. This may reflect the superior power of Lithoclast(R) and the ability to aspirate the debris during ultrasonic lithotripsy.
Hemoglobins ; Humans ; Kidney Calculi ; Length of Stay ; Lithotripsy ; Nephrostomy, Percutaneous ; Operative Time ; Suction ; Ultrasonics

In spite of today's striking development of radiologic studies, the differential diagnosis of acute scrotal diseases is difficult. We studied 14 cases of appendix testis torsion that had visited our hospital from May 1991 to October 1994 in order to be diagnosed accurately and made appropriate treatment. The torsion of appendix testis occurred during prepubertal ages, and ages of our 14 cases were from 3 to 13, and average age was 9.6 years old. In all of our cases the chief complaint was scrotal pain. The localized pain and palpable tender mass of testicular upper pole were present in only 8 of 14 cases and 5 cases had blue dot sign. These were very helpful in diagnosis of torsion of appendix testis. Doppler ultrasonography was done in 9 cases and radionuclide scrotal imaging was done in 3 cases, but none of these studies were diagnosed as torsion of appendix testis definitely. But in 8 cases that had positive blue dot sign and/or localizing tender mass in upper pole of testis, we could diagnose torsion of appendix testis certainly. We operated 11 of l4 cases( scrotal exploration and excision of torsed appendix testis) and treated conservatively 3 of 14. Most 11 operated cases were revealed that scrotal pains were relieved within 24 hours of postoperative period and secondary complications did not occurred in 3 cases treated conservatively. In summary, the early surgical exploration is necessary to improve maximal testicular salvage when testis torsion cannot be ruled out completely in acute scrotal diseases. But if testis torsion can be ruled out completely, conservative treatment may be considered in torsion of appendix testis.
Appendix* ; Diagnosis ; Diagnosis, Differential ; Postoperative Period ; Strikes, Employee ; Testis* ; Ultrasonography, Doppler

PURPOSE: The aim of this study was to evaluate possible predictive variables for the outcome of shock wave lithotripsy (SWL) of renal stones in a single center. MATERIALS AND METHODS: Between March 2008 and March 2010, a retrospective review was performed of 115 patients who underwent SWL for solitary renal stones. The patients' characteristics and stone size, location, skin-to-stone distance (SSD), and Hounsfield units (HU) of stone were reviewed. The impact of the possible predictors on the disintegration of the stones was evaluated by logistic regression analysis. Receiver operator characteristic (ROC) curves were generated to compare the predictive powers of the variables. RESULTS: Seventy-nine patients (68.7%) had successful outcomes, whereas 36 patients (31.3%) had residual stones. Significant differences were found in the mean size and mean HU of the stones (size: 8.34+/-3.58 mm vs. 13.57+/-5.41 mm, p<0.001; HU: 675.29+/-254.34 vs. 1,075.00+/-290.41, p<0.001). In the unadjusted model, age, stone size, and stone density were significant predictors. In the reduced model, stone density and size were significant predictors for the outcome of SWL. The area under the ROC curve (AUC) was significantly higher for stone density and size than for the other parameters, but the AUC between stone density and size did not differ significantly (stone density: 0.874, stone size: 0.827, p=0.388). CONCLUSIONS: Stone density and size were significant predictors of the outcome of SWL for renal stones less than 2.0 cm in diameter. We should consider HU and stone size when making decisions on the treatment of renal stones.
Area Under Curve ; Humans ; Kidney Calculi ; Lithotripsy ; Logistic Models ; Retrospective Studies ; ROC Curve ; Shock ; Tomography, X-Ray Computed

Leiomyoma of the urethra is a rare condition, which is more common in female than in male subjects. A case of leiomyoma of female urethra in a twenty-two years old female arising from anterior lip of the external urethral meatus is presented. The presenting symptoms were painless mass on the anterior lip of the external urethral meatus and voiding difficulty. The mass was easily removed by surgical resection and confirmed as leiomyoma histologically.
Female* ; Humans ; Leiomyoma* ; Lip ; Male ; Urethra*