PURPOSE: The purpose of this study was to identify related factors of stress, social support and rehabilitation motivation of stroke survivors and analyze their relationship. METHOD: A sample of 106 stroke survivors completed face-to-face interviews. The levels of stress, social support and rehabilitation motivation were measured by the Neuman's stress, Multidimentional Scale Perceived Social Support and Han's Rehabilitation Motivation, respectively. The t-test, ANOVA, and Pearson correlation were conducted using the SPSS 17.0. RESULTS: The mean scores of stress, social support and rehabilitation motivation were 3.3 (SD=0.76), 3.2 (SD=0.88), and 3.4 (SD=0.49) respectively. Compared to stroke survivors who had no spouses, those with spouses had a lower level of stress (t=9.52, p=.003), a higher level of social support (t=7.32, p=.008) and a higher level of rehabilitation motivation (t=15.39, p=.001). The rehabilitation motivation was significantly higher in stroke survivors with higher education (F=5.00, p=.001), more monthly income (F=15.39, p=.001), greater income satisfaction (F=3.80, p=.026), shorter duration of disease (F=3.64, p=.030) and absence of dysarthria (t=6.81, p=.010). Stress, social support and rehabilitation motivation are significantly related with each other. CONCLUSION: The findings suggest that these significant factors should be considered when caring for stroke survivors.
Dysarthria ; Humans ; Motivation ; Spouses ; Stroke ; Survivors

PURPOSE: The role of plain, abdominal radiography in childhood constipation has not been fully evaluated. The aim of this study was to determine the accuracy and reliability of scoring systems assessing a fecal load on plain, abdominal radiographs in children with functional constipation. METHODS: Plain, abdominal radiographs from 38 constipated children and 39 control children were examined by four independent inspectors, pediatric residents. Four inspectors independently scored the radiographs according to three different scoring systems Barr, Blethyn, and Leech. No clinical information about the patients was available to the inspectors. Each abdominal radiograph was evaluated on two separate occasions, one week apart. Kappa coefficients were calculated as indicators of inter-and intra-inspector variability, coefficients < 0.20, 0.21~0.40, 0.40~0.60, 0.60, 0.61~0.80 and 0.81~1.00 were considered to indicate poor, fair, moderate, good, and very good agreement, respectively. RESULTS: The Leech score showed the highest reproducibility: the inter-inspector agreement was uniformly very good on two separate occasions (kappa values of 0.88, 0.91, 0.92, 0.86 in the first time and 0.81, 0.88, 0.89, 0.84 in the second time). Agreement using the Barr score was good (kappa values of 0.66, 0.67, 0.69, 0.66 in the first time and 0.68, 0.65, 0.71, 0.68 in the second time). However, agreement for the Blethyn score was the lowest of the three scoring systems. The Leech scoring system had the highest sensitivity and specificity compared to the Barr scoring system for the diagnosis of functional constipation by plain, abdominal radiographs. CONCLUSION: The Leech score appeared to be a more accurate and reliable method because of its high sensitivity and specificity for evaluating the fecal load on plain, abdominal radiographs in children with functional constipation. Therefore, the Leech scoring system was found to be the most useful for assessment for the degree of constipation on plain, abdominal radiographs in children.
Child ; Constipation* ; Diagnosis ; Humans ; Radiography ; Radiography, Abdominal ; Sensitivity and Specificity

No abstract available.
Dermoscopy* ; Diagnosis

BACKGROUND: The purpose of this prospective study is to define the effect of cardiopulmonary bypass (CPB) on the concentration of thyroid hormones and metabolites. METHODS: Blood samples were obtained from 15 patients undergoing open heart surgery at 1) pre-induction, 2) after heparinization, 3) during CPB, 4) 2 hours after CPB, 5) 24 hours after CPB and 6) 48 hours after CPB. Thyroid stimulating hormone, albumin, thyroxine (T4), free thyroxine (FT4), triiodothyronine (T3), free triiodothyronine (FT3) and reverse T3 (T3) were measured. RESULTS: Concentration of T3 significantly decreased after infusion of heparin and maintained at the decreased level until postbypass 24 hours. Concentration of FT3 significantly increased after heparin administration but maintained at a control level during CPB and decreased after postbypass 24 , 48 hours (p<0.05). Reverse T3 increased at 24 and 48 hours after CPB (p<0.05). Thyroxine decreased during CPB and return to control level after CPB. Free thyroxine did not change significantly. Thyroid stimulating hormone was significantly depressed at 24 hours after CPB (p<0.05). CONCLUSIONS: This result suggest that the thyroid function is depressed until 48 hours after CPB and it seems to be associated with abnormal metabolism of thyroid hormones.
Cardiopulmonary Bypass ; Heart* ; Heparin ; Humans ; Metabolism ; Prospective Studies ; Thoracic Surgery* ; Thyroid Gland* ; Thyroid Hormones ; Thyrotropin ; Thyroxine ; Triiodothyronine

PURPOSE: It has been reported that children with chronic pain have higher levels of anxiety than age-matched controls. Therefore, this study was designed to determine the relationship between anxiety and recurrent abdominal pain in elementary school children. METHODS: In 2005, we surveyed 1,254 elementary school children (592 boys and 662 girls) whose ages ranged from 7 to 12 years. The degree of trait and state anxiety was compared between agroup suffering from intermittent abdominal pain, a group suffering from recurrent abdominal pain and a normal control group following the Korean version of Spielberger's State-Trait Anxiety Inventory YZ form (STAI-YZ). RESULTS: 709 (56.5%) and 69 (5.5%) of the patients reported intermittent abdominal pain and and recurrent abdominal pain, respectively, during the 12 month period before this study was conducted, and trait and state anxiety values for each of these groups was 116 (9.3%) and 63 (5.0%), respectively. In addition, the State-Trait Anxiety score was significantly higher in the group with intermittent abdominal pain and RAP than the anxiety score of the normal control group. Additionally, the STAI-YZ score increased in proportion to the severity of abdominal pain, but was not correlated with the duration, frequency, onset time or location of abdominal pain. Furthermore, the proportion of the group with abdominal pain in the group that had trait or state anxiety was significantly higher than the proportion of the group that did not have trait and state anxiety. CONCLUSION: Recurrent abdominal pain during childhood is correlated with state and trait anxiety, therefore, psychological factors, such as anxiety duringtreatment, must also be considered when determining the cause of recurrent abdominal pain.
Abdominal Pain* ; Anxiety* ; Child* ; Chronic Pain ; Humans ; Psychology

PURPOSE: It has been reported that children with chronic pain have higher levels of anxiety than age-matched controls. Therefore, this study was designed to determine the relationship between anxiety and recurrent abdominal pain in elementary school children. METHODS: In 2005, we surveyed 1,254 elementary school children (592 boys and 662 girls) whose ages ranged from 7 to 12 years. The degree of trait and state anxiety was compared between agroup suffering from intermittent abdominal pain, a group suffering from recurrent abdominal pain and a normal control group following the Korean version of Spielberger's State-Trait Anxiety Inventory YZ form (STAI-YZ). RESULTS: 709 (56.5%) and 69 (5.5%) of the patients reported intermittent abdominal pain and and recurrent abdominal pain, respectively, during the 12 month period before this study was conducted, and trait and state anxiety values for each of these groups was 116 (9.3%) and 63 (5.0%), respectively. In addition, the State-Trait Anxiety score was significantly higher in the group with intermittent abdominal pain and RAP than the anxiety score of the normal control group. Additionally, the STAI-YZ score increased in proportion to the severity of abdominal pain, but was not correlated with the duration, frequency, onset time or location of abdominal pain. Furthermore, the proportion of the group with abdominal pain in the group that had trait or state anxiety was significantly higher than the proportion of the group that did not have trait and state anxiety. CONCLUSION: Recurrent abdominal pain during childhood is correlated with state and trait anxiety, therefore, psychological factors, such as anxiety duringtreatment, must also be considered when determining the cause of recurrent abdominal pain.
Abdominal Pain* ; Anxiety* ; Child* ; Chronic Pain ; Humans ; Psychology

PURPOSE: The aim of this study was to assess changes in neuropeptide Y (NPY) immunoreactivity in the hypothalamus and interstitial cells of Cajal (ICC) in the small intestine of rats fed high-fat diets (HFD). METHODS: Male Sprague-Dawley rats (200~250 g body weight) were randomly divided into two groups, which were the control group (normal chow diet for 6 weeks), and the HFD group (rodent diet with 60% kcal fat for 6 weeks). The immunoreactivity of NPY in the hypothalamus and ICC in the small intestine was evaluated after every feed for 6 weeks. RESULTS: NPY immunoreactivity was observed strongly in the hypothalamic nuclei in the HFD group compared to the control group. The numbers of NPY-immunoreactive (IR) cells were significantly higher in the paraventricular hypothalamic nucleus in the HFD group than in the control group. In the region of Auerbach's plexus (AP) of small intestine, the staining intensity of the ICC-IR cells was reduced in the HFD group compared to the control group. The numbers of ICC in the small intestine with HFD, including ICC in the inner circular and outer longitudinal muscle were significantly lower than in the control group. CONCLUSION: This study suggested that increasing NPY-IR cells in the hypothalamus may reflect resistance of NPY action after a HFD, and decreasing ICC-IR cells in the small intestine after a HFD is functionally significant in gastrointestinal motility.
Animals ; Diet ; Diet, High-Fat ; Gastrointestinal Motility ; Humans ; Hypothalamus ; Interstitial Cells of Cajal ; Intestine, Small ; Male ; Muscles ; Myenteric Plexus ; Neuropeptide Y ; Neuropeptides ; Paraventricular Hypothalamic Nucleus ; Rats ; Rats, Sprague-Dawley

We compared the result of 6 patients[group A]treated with high dose steroid only with the result of 14 patients[group B]treated with optic canal decompression after at least 24 hours of high dose steroid therapy without improvement. 4 of 6 patients[66%]in group A and 7 of 14 patients[50%]in group B improved in visual acuity.But 1 of 6 patients[17%] in group A and 6 of 14 patients[43%]in group B had marked improvement in visual function[above 0.02].Of 5 patients with optic canal fracture in orbit CT in group B, all had improved visual function and 4 had marked improvement in visual function. If CT demonstrates bony fragments impinging on intracanalicular optic nerve, or if vision deteriorates or fails to improve during the first 24 hours of high dose steroid and initial visual acuity is no light perception, optic canal decompression is considered effective and valid treatment modality in TON.
Decompression* ; Humans ; Optic Nerve ; Optic Nerve Injuries* ; Orbit ; Visual Acuity

The abnormalities in Hypothalamic-pituitary-adrenal(HPA) axis are associated with many psychiatric symptoms including depression. We present a report of a 71 year old man who was admitted to the psychiatric department presenting symptoms of headache, avolition, loss of energy, psychomotor retardation, poor appetite, insomnia, anxiety resulting from adrenal insufficiency and hypopituitarism. Hypothyroidism and electrolyte disturbance were managed and headache, insomnia, anxiety, GI symptoms were improved. But he remained in anergic state. After discharge, he was readmitted to infection department with high fever and drowsy mentality. Adrenal insufficiency was recognized and he was treated with corticosteroid replacement therapy. Finally his diagnosis was made as panhypopituitarism and overall symptoms were resolved. In this case, we showed how the atypical symptoms resulting from hypopituitarism develop and progress. Hypothyroidism, adrenal insufficiency, and growth hormone deficiency resulting secondarily from panhypopituitarism were associated with various nonspecific symptoms such as loss of energy, fatigue, insomnia, weight loss, decreased appetite etc. In clinical situation, differential diagnosis with depression is needed when clinicians were met a patient with these nonspecific symptoms. It is important that laboratory tests and differential diagnosis with endocrine diseases should be conducted, especially in geriatric patients with nonspecific symptoms like anergia, fatigue, poor appetite and so on.
Adrenal Insufficiency ; Anxiety ; Appetite ; Axis ; Depression ; Diagnosis, Differential ; Endocrine System Diseases ; Fatigue ; Fever ; Growth Hormone ; Headache ; Humans ; Hypopituitarism ; Hypothyroidism ; Sleep Initiation and Maintenance Disorders ; Weight Loss

PURPOSE: To determine the effects of hand massage on nausea and vomiting, and anxiety in children with lymphocytic leukemia receiving high dose chemotherapy. METHOD: The children were assigned to an experimental group(15) or a control group(15). All of the children were diagnosed with acute lymphocytic leukemia and admitted for high dose chemotherapy at C University Medical Center in Seoul. The hand massage was performed for 10 minutes twice a day over three days. To measure the effects of hand massage, the Index of Nausea and Vomiting by Rhodes et al. and the State-Trait Anxiety Inventory for children by Spielberger were used. The level of anxiety was measured by systolic blood pressure, diastolic blood pressure, and pulse rate. RESULTS: The score for nausea and vomiting decreased in the experimental group. State anxiety for the experimental group was significantly more positive than for the control group at the 2nd measurement. There was a significant difference in systolic blood pressure between the two groups. The level of diastolic blood pressure in the two groups decreased significantly over time. CONCLUSION: Hand massage could be effective in decreasing nausea and vomiting, state anxiety, pulse rate and blood pressure in children with acute leukemia receiving high dose chemotherapy.
Academic Medical Centers ; Anxiety* ; Blood Pressure ; Child ; Drug Therapy* ; Hand* ; Heart Rate ; Humans ; Leukemia* ; Leukemia, Lymphoid ; Massage* ; Nausea* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Seoul ; Vomiting* ; Child Health