PURPOSE: The purpose of this study was to examine the effects of a cognitive behavioral stress management program on diabetic self-care and glycemic control with type 2 diabetic patients. METHODS: Thirty three diabetic patients who were older than 40 were recruited from a public health center and conveniently assigned into both experimental(n=16) and control groups(n=17). Participants in the experimental group had attended the weekly cognitive behavioral program for 8 weeks. Data were collected from June 2005 to August 2006 and analyzed by independent t-test using the SPSS WIN program. RESULTS: After an 8 week intervention, participants in the experimental group reported on increasement of diabetic self-care behaviors and an increasement of blood glucose levels, which were significantly different from those in the control group. CONCLUSION: On the basis of those findings, we concluded that the cognitive behavioral stress management program has positive effects on diabetic self-care and glycemic control for the patients with DM. Further research is needed to identify the long-term effects of the cognitive behavioral program.
Blood Glucose ; Diabetes Mellitus* ; Glucose ; Humans ; Public Health ; Self Care*

PURPOSE: To investigate the change of the Beta adrenergic system in the rat visual cortex and superior colliculus after visual deprivation during a critical period of postnatal development. METHODS: The changes of beta 1 and beta 2 adrenergic receptor mRNA were investigated by using northern blot analysis in the rat visual cortex and superior colliculus. The right eyelid of visually deprived rat was sutured at the 10th postnatal days. After visual deprivation for 4 weeks, the rat were sacrificed and the visual cortex and superior colliculus tissues were removed for analysis. RESULTS: Beta 1 and beta 2 adrenergic receptor mRNA expression was decreased in the contralateral visual cortex to the deprived eye. In the superior colliculus, beta 2 adrenergic receptor mRNA expression increased in both sides, but a much greater increase was shown in the ipsilateral superior colliculus than the contralateral side. CONCLUSIONS: These results suggests that visual deprivation during a critical period of postnatal development influences the beta adrenergic system in the rat visual cortex and superior colliculus.
Animals ; Blotting, Northern ; Critical Period (Psychology) ; Eyelids ; Rats* ; Receptors, Adrenergic ; RNA, Messenger* ; Superior Colliculi* ; Visual Cortex*

Purpose: Cardio-cerebrovascular diseases constitute the most common and fatal disease among menopausal women. However, the risk of cardio-cerebrovascular diseases in menopausal women compared to men has been underestimated, with insufficient related studies. Therefore, we examined the incidence and risk factors of cardio-cerebrovascular diseases among Korean menopausal women. Methods: A retrospective observational study design with secondary analysis was conducted using data from the Korean Genome and Epidemiology Study survey. We used the study’s data of 1,197 menopausal women, aged 40–64 years, who did not have cardio-cerebrovascular diseases at baseline and their related data from the biennial follow-ups over 14 years. Cardio-cerebrovascular diseases were defined as hypertension, coronary artery disease, or stroke. The incidence of cardio-cerebrovascular diseases was calculated per person-years, and multivariate Cox proportional hazards models were used to determine the predictors of cardio-cerebrovascular diseases during the follow-up period. Results: Of the 1,197 cases, 264 were early or surgical menopausal women. The overall incidence of cardio-cerebrovascular diseases was 18.75 per 1,000 person-years. Early or surgical menopause (HR = 4.32, p < .001), along with family history of cardiovascular disease (HR = 1.87, p = .024), elevated blood pressure (HR = 1.79, p < .001), abdominal obesity (HR = 1.37, p = .046), or duration of menopause at the same age (HR = 1.01, p = .001), were strong predictors of cardio-cerebrovascular diseases. Conclusion Based on the results of this study, it is necessary to identify and closely monitor women with early or surgical menopause for cardiovascular and cerebrovascular diseases prevention. Also, prevention of cardio-cerebrovascular diseases through blood pressure and abdominal obesity management is vital for menopausal women.

PURPOSE: This study was carried out to describe the process and evaluation of a critical thinking class for new community health practitioners. METHODS: The case study design was used to develop and evaluate a critical thinking class for 46 participants in the community health practitioners training program. The class was held two hours a week for 8 weeks. Critical thinking disposition was tested before and after the class and critical skill was graded according to the final test score. Data analysis was performed using descriptive statistics and paired t-tests using SPSS WIN 20.0. RESULTS: Clinical critical thinking competences were identified through the literature review. The case situations with questions guiding the problem-solving process were developed and used for group discussion. Critical thinking disposition of participants was determined to have increased slightly after having taken the class. 17.4% of the participants had a competency level high enough to solve a problem and half of them stayed at the level of understanding of critical thinking. Compared with the class's satisfaction with the relevance to their jobs, the satisfaction with the learning method and instructor was high. CONCLUSION: The findings of this research will serve as the basis for developing critical thinking classes for community health nurses in order to improve their critical thinking competence.
Education ; Learning ; Mental Competency ; Nurses, Community Health ; Primary Health Care ; Problem-Based Learning ; Statistics as Topic ; Thinking*

STUDY DESIGN: Retrospective study. OBJECTIVES: To evaluate the prevalence and associated factors of the concurrent lower thoracic lesions in patients who have a lumbar spine disease, using the extended lumbar MRI. SUMMARY OF LITERATURE REVIEW: There are no studies regarding the concurrent thoracic lesions with lumbar disease. MATERIALS AND METHODS: All the patients, who had visited the out-patient department (OPD) of orthopaedic surgery in our hospital and underwent lumbar spine MRI, were studied during 1 year. Totally, 750 patients were included. The extended lumbar spine MRI contained additional extended T2-weighted sagittal images that cover the lower thoracic vertebrae with 35 centimeters long. We analyzed the highest observable level, characteristics of detected thoracic lesions. Those lesions were classified according to the severity of compression of the spinal cord and investigation for associated factors of patients. Also, the times for additional tests were measured. RESULTS: Additional tests were able to observe up to the 7th thoracic vertebrae. In 257 cases (34.3%), the lower thoracic lesions were detected and increased with aging (p<0.001). A total of 48 patients (6%) had the lesion compressing the spinal cord and 28 patients needed further evaluation for the lower thoracic lesion. Further, 2 cases were treated surgically for lower thoracic lesions. Scanning extra time for additional test were 3 minutes. CONCLUSIONS: The prevalence of lower thoracic lesions accompanied with the lumbar disease was 34% in this study. Therefore, additional extended lumbar spine MRI is needed to check possible concurrent lesions in the lower thoracic spine.
Aging ; Humans ; Outpatients ; Prevalence ; Retrospective Studies ; Spinal Cord ; Spine ; Thoracic Vertebrae

Evidence-based studies have begun to identify the most promising interventions for use with disaster survivors. Interventions are provided in a staged sequence across a timeline. Relationship among agencies associated with a disaster, training professionals and prepared programs for disaster will be needed in pre-disaster stage. After a disaster, children's mental health needs range from support utilizing psychological first aid to psycho-education. The skills for psychological recovery, trauma focused cognitive behavioral therapy, and cognitive behavioral intervention for trauma school will also be needed when children and adolescents keep suffering from various psychiatric symptoms such as insomnia, anxiety, depressive mood, re-experience, and so on. Evaluation and consideration of the developmental needs of children and adolescents, as well as the needs of parents, families, and schools is also important. Domestic standardization of intervention and psychotherapeutic treatment should be performed for more effective interventions for a disaster in Korea.
Adolescent* ; Anxiety ; Child* ; Cognitive Therapy ; Disasters* ; First Aid ; Humans ; Korea ; Mental Health ; Parents ; Sleep Initiation and Maintenance Disorders ; Survivors

A 52-year-old woman with a history of general weakness, fatigue, weight loss, elevated serum levels of liver transaminase enzyme for three months underwent an F-18 FDG PET/CT scan to evaluate a cause of the hepatosplenomegaly found on abdominal ultrasonography. Initial PET/CT revealed markedly enlarged liver and spleen with intense FDG uptake. Otherwise, there were no areas of abnormal FDG uptake in whole body image. Histological evaluation by a hepatic needle biopsy demonstrated diffuse large B cell type lymphoma and final diagnosis for this patient was hepatosplenic B-cell lymphoma. She received five cycles of CHOP chemotherapy, and second PET/CT scan was followed after then. Follow-up PET-CT revealed normal sized liver with disappearance of abnormal FDG uptake. Hepatosplenic B-cell lymphoma is relatively rare and mostly presents as single or multiple nodules.1,2 Diffuse type hepatosplenic lymphoma is extremely rare and poorly recognized entity.3 The diagnosis is very difficult and complicated by the presence of misleading symptoms.4 In this rare hepatosplenic B-cell lymphoma case, F-18 FDG PET/CT scan provided a initial diagnostic clue of hepatosplenic lymphoma and an accurate chemotherapy response.
B-Lymphocytes ; Biopsy, Needle ; Body Image ; Fatigue ; Female ; Follow-Up Studies ; Hepatomegaly ; Humans ; Liver ; Lymphoma ; Lymphoma, B-Cell ; Middle Aged ; Spleen ; Weight Loss

PURPOSE: To investigate the peripapillary choroidal thickness (PCT) of polypoidal choroidal vasculopathy (PCV) and exudative age-related macular degeneration (AMD) and to evaluate their responses to anti-vascular endothelial growth factor (VEGF). METHODS: Thirty eyes with PCV and 25 eyes with exudative AMD who were treatment naïve were included in this study. PCT and subfoveal choroidal thickness were evaluated both before and after intravitreal anti-VEGF. RESULTS: The initial mean PCT of PCV (153.78 ± 56.23 µm) was thicker than that of exudative AMD (88.77 ± 23.11 µm, p < 0.001). Temporal, superior, nasal, and inferior PCTs of PCV were all thicker than those observedin exudative AMD (all p < 0.05). After anti-VEGF, the mean PCT of PCV was significantly reduced (134.17 ± 41.66 µm, p < 0.001), but the same was not true not in exudative AMD (86.87 ± 22.54 µm, p = 0.392). PCTshowed a similar tendency in all quadrants. CONCLUSIONS: PCV exhibits a thick choroid in the peripapillary region. PCT decreases after anti-VEGF in PCV but not in exudative AMD. In exudative AMD, subfoveal choroidal thickness decreased, but that in the peripapillary region did not.
Choroid* ; Endothelial Growth Factors* ; Macular Degeneration

STUDY DESIGN: A retrospective study. OBJECTIVES: To evaluate the clinical and radiological outcomes of anterior cervical fusion within Harms cage versus an iliac bone block graft. SUMMARY OF LITERATURE REVIEW: There is no current consensus regarding the optimal material for anterior cervical fusion. MATERIALS AND METHODS: This was a single-center study of 107 patients who either underwent anterior cervical fusion with an iliac bone block graft (n=56; group A) or a cancellous bone graft within the cervical Harms titanium cage (n=51; group B). Anterior plating occurred in all cases. Clinical outcomes and complications were evaluated using Visual Analogue Scale (VAS) scores and Odom's Criteria. Radiological outcomes were evaluated by the height of vertebral bodies, sagittal lordosis, the rate of bony union, and the subsidence of cage. RESULTS: The VAS of donor site pain was significantly higher in group A than in group B at the final follow-up. Sagittal lordosis was increased in both groups, but was significantly higher in group B than group A. The rate of bony union was 95% and 91% for both groups 6 months after surgery and reached 100% for both groups at the final follow-up. In terms of cage subsidence, the highest point of subsidence was at the inferior and posterior aspect of the cage and the average amount of subsidence was approximately 1.3 mm at final follow-up. CONCLUSIONS: Anterior cervical fusion using a cancellous bone graft within Harms titanium cage is a good method for anterior cervical fusion with iliac bone block.
Animals ; Consensus ; Follow-Up Studies ; Humans ; Lordosis ; Retrospective Studies ; Tissue Donors ; Titanium ; Transplants

PURPOSE: To evaluate the incidence and risk factors associated with osteoarthritis after a reconstruction of the anterior cruciate ligament (ACL) using a patellar tendon autograft after an average follow-up period of more than 10 years. MATERIALS AND METHODS: The study examined 56 cases that were selected from 118 cases who underwent an arthroscopic reconstruction of the ACL using a patella tendon autograft a minimum of 8 years ago and were available for follow up. The mean age at the time of the reconstruction was 31.3 years (19-58 years), and the average follow up period was 10.6 years (8.6-13.8 years). At the last follow up, the presence of osteoarthritis on the weight-bearing antero-posterior and lateral, and Merchant's radiographs, was assessed using the Kellgren and Laurence classification. The correlation between the development of osteoarthritis and the clinical results (Lysholm knee score, Lachman test, Pivot-shift test, return to preinjury activity), the radiological results (anterior laxity, persistent anterior subluxation), the interval from injury to the reconstruction, the patient age at the time of the reconstruction, the presence of an accompanying meniscal injury, and the patient's gender were examined. RESULTS: Among the 56 cases, osteoarthritis was detected in 23 (41%) (grade II, 18 cases; grade III, 5 cases), and in regard to the lesion sites, the medial compartment was detected in all cases, the lateral compartment in 12 cases and the patello-femoral compartment in 11 cases. Among them, 19 cases were accompanied with a meniscal injury (OR, 10.336; p = 0.001), and a significant increase in osteoarthritis was detected in those cases with a interval from the injury to the reconstruction of more than 6 months (OR, 4.611; p=0.030), and in those aged more than 26 years at the time of the reconstruction (OR, 5.038; p=0.023). However, there was no correlation between the development of osteoarthritis and the clinical outcome, radiological anterior laxity and continuous anterior subluxation, and genders (p>0.05). CONCLUSION: Osteoarthritis developed in 41% of cases, and developed more frequently in those cases with an accompanying meniscal injury, older patients at the time of the reconstruction, or in those with a longer interval from the injury to reconstruction.
Anterior Cruciate Ligament ; Anterior Cruciate Ligament Reconstruction ; Autografts* ; Classification ; Follow-Up Studies* ; Humans ; Incidence ; Knee ; Knee Joint ; Osteoarthritis* ; Patellar Ligament* ; Risk Factors ; Weight-Bearing