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

BACKGROUND: This study aimed at identifying the effects of improved methods of endotracheal suction and hand washing on incidence of nosocomial pneumonia (NP) in the neurosurgical ICU. METHOD: Repeated training of nurses about hand washing and adherence of the single use of suction catheter and sterile normal saline of endotracheal suction was provided. Then hand washing compliance of nurses before and after training was investigated. and the incidence of NP in all patients hospitalized for more than 72 hours in the neurosurgical ICU was investigated from Sep 1, 2000 to Jan 31, 2001 (2nd surveillance). The NP rate of that period was compared with the incidence of the 1st surveillance period, from Sep 1, 1999 to Jan 31, 2000. The data were analyzed with chi-square-test. Fisher's exact test and logistic regression analysis by SAS 8.0. RESULT: The proportion of hand washing performance increased from 15.6% to 46.8%. The rates of NP per patient during 1st surveillance and 2nd surveillance were 10.3%, 3.9%(p=0.01) patient-days rates of NP were 10.0 cases/1,000 patient days, 4.1 cases/1,000 patient days(p=0.04), and ventilator-days rates of NP were 67.6 cases/1.000 ventilator days, 16.2 cases/1,000 ventilator days(p=0.00) respectively. Out of 29 isolates, 18 were methicillin-resistant Staphylococcus aureus, which was the most frequently isolated microorganism. The risk factors associated with incidence of NP were age, length of stay, Glasgow coma scale, diabetes mellitus, duration of intubation, insertion of endotracheal tube, duration of tracheostomy, presence of tracheostomy, duration of ventilator, use of ventilator, and insertion of nasogastric tube. CONCLUSION: These results showed that single use of suction catheters and sterile normal saline and increased compliance of hand washing were important factors to decrease the incidence of NP.
Catheters ; Compliance ; Diabetes Mellitus ; Glasgow Coma Scale ; Hand Disinfection* ; Hand* ; Humans ; Incidence* ; Intensive Care Units* ; Critical Care* ; Intubation ; Length of Stay ; Logistic Models ; Methicillin-Resistant Staphylococcus aureus ; Pneumonia* ; Risk Factors ; Suction* ; Tracheostomy ; Ventilators, Mechanical

OBJECTIVE: We investigated the expression of uPA and uPAR in eutopic endometrium of advanced stage endometriosis and control patients. METHODS: The 33 endometriosis patients and 32 controls were enrolled. Endometrial samples were obtained from 65 premenopausal women aged 29~44 years, undergoing laparoscopic surgery or hysterectomy for non-malignant lesions. Sufficient samples were collected from 33 patients with endometriosis stage III and IV and 32 controls without endometriosis confirmed by laparoscopic surgery. The mRNA expression of uPA and uPAR from eutopic endometrium were analyzed by RT-QC PCR. RESULTS: The mRNAs of uPA and uPAR were expressed in eutopic endometrium from endometriosis and normal controls throughout the menstrual cycle. Uterine endometrium from women with endometriosis expresses significantly (p<0.05) higher levels of u-PA mRNA than endometrium from normal women without endometriosis in the proliferative phase. There were no significant differences in expression of uPAR in eutopic endometrium between controls and endometriosis patients. CONCLUSION: These results suggest that eutopic endometrium from endometriosis patients may be more invasive and prone to peritoneal implantation because of greater u-PA mRNA expression than endometrium from women without endometriosis. Thus, increased proteolytic activity may be one etiology for the invasive properties of the endometrium resulting in the development of endometriosis.
Endometriosis* ; Endometrium* ; Female ; Humans ; Hysterectomy ; Laparoscopy ; Menstrual Cycle ; Polymerase Chain Reaction ; Proteolysis ; RNA, Messenger* ; Urokinase-Type Plasminogen Activator

BACKGROUND: The external jugular vein (EJV) is a useful intravenous (IV) cannulation site for anesthesiologists, although it has a relatively high failure rate. Unlike other central veins, visualization of the EJV is important during IV cannulation, and the Valsalva maneuver distends the jugular venous system. However, the relationship between the maneuver and EJV visibility remains unknown. This study compared EJV visibility before and after the Valsalva maneuver. METHODS: This was a prospective observational study that included 200 participants. After the induction of anesthesia, EJV visibility grade, depth from the skin to the EJV superficial surface (EJV depth), and EJV cross-sectional area (CSA) before the Valsalva maneuver were measured. The same parameters were measured after the Valsalva maneuver was performed. The EJV visibility grade was defined as grade A: good appearance and good palpation, grade B: poor appearance and good palpation, and grade C: poor appearance and poor palpation. RESULTS: Patient body mass index and EJV depth affected the EJV visibility grade before the Valsalva maneuver (p < 0.05), although EJV CSA did not. The Valsalva maneuver distended EJV CSA and reduced EJV depth, although these changes were not correlated with EJV visibility grade. With regard to EJV visibility, 34.0% of grade B cases and 20.0% of grade C cases were improved by the Valsalva maneuver. CONCLUSIONS: Although the Valsalva maneuver improved EJV CSA and EJV depth, it did not greatly affect EJV visibility grade.
Anesthesia ; Body Mass Index ; Catheterization ; Humans ; Jugular Veins* ; Observational Study ; Palpation ; Prospective Studies ; Skin ; Ultrasonography ; Valsalva Maneuver* ; Veins