PURPOSE: This ethnograpy was done to explore patterns of health care behavior in patients with chronic health problems. METHODS: The participants were 15 patients with chronic hepatitis B and 2 family members. Among the patients 4 had progressed to liver cirrhosis and liver cancer. Data were collected from iterative fieldwork in a department of internal medicine of I hospital. Data were analyzed using text analysis and taxonomic methods. RESULTS: Illness and disease, relationship between health care givers and clients, and communication patterns between health professions and clients were discussed as the context of health care behavior. Health care behavior of the participants was categorized by its focus: every day work centered, body centered, organ centered, and pathology centered. CONCLUSION: Participants' health care behavior was guided by folk health concept and constructed in the sociocultural context. Folk etiology, pathology, and interpretation of one's symptoms were influencing factors in illness behavior. These findings must be a cornerstone of culture specific care for the chronic diseases.
Activities of Daily Living ; Adult ; Aged ; Asian Continental Ancestry Group ; Attitude to Health ; Communication ; Family Relations ; Female ; *Health Behavior ; Hepatitis B, Chronic/complications/*psychology ; Humans ; Interviews as Topic ; Liver Cirrhosis/etiology ; Liver Neoplasms/etiology ; Male ; Middle Aged ; Physician-Patient Relations ; *Qualitative Research ; Republic of Korea

PURPOSE: This ethnography was done to explore the meaning of illness in Korean Americans with chronic hepatitis B. METHODS: The participants were 6 patients with chronic hepatitis B and 6 general informants who could provide relevant data. Data were collected from iterative fieldwork with ethnographic interviews within Korean communities in two cities in the United States. Data were analyzed using causal chain analysis developed by Wolcott. RESULTS: The analyses revealed three meanings for the illness: hidden disease, intentionally hidden disease, and inevitably hidden disease. The contexts of meaning of illness included characteristics of the illness, social stigma, structure of health care system and communication patterns and discourse between health care providers and clients. CONCLUSION: The meaning of illness was based on folk illness concepts and constructed in the sociocultural context. Folk etiology, pathology and interpretation of one's symptoms were factors influencing illness behavior. These findings could be a cornerstone for culture specific care for Korean Americans with chronic hepatitis B.
Aged ; *Asian Americans ; Delivery of Health Care ; Female ; Health Personnel ; Hepatitis B, Chronic/*ethnology/etiology/psychology ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Republic of Korea/ethnology ; Social Stigma

Gestational trophoblastic tumor is one of the curable disease, but metastatic trophoblastic tumor still shows high mortality rate because of resistance to the chemotherapy. Choriocarcinoma may occur after an any type of human pregnancy. The incidence of choriocarcinoma following term pregnancy is very uncommon, and such tumor appears to follow a more aggressive course with more extensive metastatic spread and is less responsive to chemotherapy resulting in a poorer prognosis. Choriocarcinoma presenting as postpartum hemorrhage, and spontaneous tumor perforation with intra-abdominal hemorrhage is even rarer, requiring emergency laparotomy. We had experienced one case of metastatic choriocarcinoma following term pregnancy that required emergency total abdominal hysterectomy due to uterine perforation and hemorrhage. So, we report this case with brief review of literatures.
Choriocarcinoma* ; Drug Therapy ; Emergencies ; Female ; Hemorrhage ; Humans ; Hysterectomy ; Incidence ; Laparotomy ; Mortality ; Postpartum Hemorrhage ; Pregnancy ; Pregnancy* ; Prognosis ; Trophoblastic Neoplasms ; Uterine Perforation*

PURPOSE: The purpose of this study was to investigate knowledge related to child obesity of child daycare center workers. METHODS: The participants in this study were 360 child daycare center workers in 2 cities in South Gyeongsang Province. Data were collected from February to June, 2011, using self-report questionnaires including questions about the general characteristics of the daycare center workers and their knowledge related to child obesity. Frequency, percentage, arithmetic mean, standard deviation, t-test and ANOVA were used to analyze the data with the SPSS WIN 16.0 program. RESULTS: The knowledge scores of child daycare center workers about child obesity averaged 74.8. The domains of diet (0.87 points) and prevention (0.86 points) had high scores, while, the domains of general characteristics (0.64 points) and diagnosis (0.59 points) had low scores. CONCLUSION: These results indicate that obese education programs for child daycare center workers should be developed in order to identify and teach children with obesity appropriately.
Child ; Child Day Care Centers ; Diet ; Humans ; Obesity ; Child Health ; Surveys and Questionnaires

PURPOSE: It is expected that there will be a difference in job stress between special unit (operating room, anesthesia room) nurses and general ward nurses in general hospitals, but factors influencing job stress have not been examined. This study reports on research to examine the sources of verbal abuse in the workplace. METHODS: Participants were 243 nurses (special unit 112, general ward 132) working in a hospital in I city. Data collection period was March 18 to March 25, 2016 and questionnaires were used to collect data. Comparison of differences in influence of verbal abuse on job stress between special unit and general ward nurses was analyzed with multiple hierarchical regression. RESULTS: In special unit nurses, verbal abuse from doctors and/or nurses influenced their job stress (Adj. R²=.545). In general ward nurses, verbal abuse from patients and/or care-givers influenced their job stress (Adj. R²=.241). CONCLUSION: Findings indicate a need to campaign for increase respect among nurse-doctor, nurse-nurse, and nurse-patients/care givers because verbal abuse from doctors, nurses, and patients/care-givers causes negative attitudes in nurses. General ward nurses in particular should provide sufficient explanation to patients about nursing services because verbal abuse from patients/care-givers is related to their complaints about nursing care.
Anesthesia ; Data Collection ; Hospitals, General* ; Humans ; Nursing Care ; Nursing Services ; Patients' Rooms*

No abstract available.
Child* ; Humans ; Pheochromocytoma*

Slipped capital femoral epiphysis is a rare disease in Korea, but the incidence has being increased according to the changes of body contour and life style. Now we have more concern about slipped capital femoral epiphysis, especially the factors which contribute to the final result of treatment. Many factors such as severity of slip, stability of slipped epiphysis, whether closed reduction was done or not, whether severe complication like avascular necrosis or chondrolysis has occurred or not have effect on the result. We analyzed 20 cases of slipped capital femoral epiphysis, which occurred in 16 adolescence in view of which factors contributed to the final satisfactory result. In our study, the difference in the duration of symptoms, instability of slipped epiphysis, patients age, association with obesity or acute trauma and the number of pins had much effect on the final results and whether the reduction was done or not, the kinds of pins and association with endocrinopathy made a little difference. But further studies are necessary because the number of cases is not sufficient and the length of follow up period is not long.
Adolescent ; Epiphyses ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Life Style ; Necrosis ; Obesity ; Rare Diseases ; Slipped Capital Femoral Epiphyses*

BACKGROUND: We prospectively compared the response to blind and ultrasound-guided glenohumeral injection of corticosteroids for treatment of shoulder stiffness. METHODS: A total of 77 patients with shoulder stiffness between April 2008 and March 2012 were recruited. Patients were randomized to receive either a blind (group 1, n=39) or ultrasound-guided (group 2, n=38) glenohumeral injection of 40 mg triamcinolone. The clinical outcomes and shoulder range of motion (ROM) before injection, at 3, 6, and 12 months after injection and at the last follow-up were assessed. The same rehabilitation program was applied in both groups during the follow-up period. RESULTS: There was no significant difference in demographic data on age, sex, ROM, and symptom duration before injection between groups (p>0.05). There were no significant differences in ROM including forward flexion, external rotation at the side, external rotation at 90o abduction, and internal rotation, visual analogue scale for pain and functional outcomes including American Shoulder and Elbow Surgeons score, Simple Shoulder test between the two groups at any time point (p>0.05). CONCLUSIONS: Based on the current data, the result of ultrasound-guided glenohumeral injection was not superior to that of blind injection in the treatment of shoulder stiffness. We suggest that ultrasound-guided glenohumeral injection could be performed according to the patient's compliance and the surgeon's preference. Once familiar with the non-imaging-guided glenohumeral injection, it is an efficient and reliable method for the experienced surgeon. Ultrasound could be performed according to the surgeon's preference.
Adrenal Cortex Hormones* ; Compliance ; Elbow ; Follow-Up Studies ; Humans ; Prospective Studies ; Range of Motion, Articular ; Rehabilitation ; Shoulder Joint* ; Shoulder* ; Triamcinolone ; Ultrasonography*

BACKGROUND: The polymerase chain reaction(PCR) assay is rapid, sensitive analytical technique but has problem of high false-positive rate. We applied dUTP-UDG PCR (dU-PCR) method to prevent carryover contamination major source of high false positive in PCR assays, for detection of Mycobacterium tuberculosis. METHODS: The PCRs for detection of M. tuberculosis were performed with P1 and P2 primers based on IS6110 repeated sequence. FTC-2000 was used for capillary PCR and Uno-Thermoblock was used for heating block PCR. In order to evaluate the effect of dU-PCR controlling carryover contamination, PCRs were performed in the presence of UDG and the absence of UDG. To compare the sensitivity of usual dT-PCR with dU-PCR, chromosomal DNA of M. tuberculosis ranging 500pg to 0.5fg were amplified by dT-PCR and dU-PCR method using two different thermocycler, capillary and heating block type, respectively. RESULT: The dU-PCR using UDG prevented carryover contamination by amplicon DNA up to 500pg. By capillay PCR method, the lower limits of detectability of dT-PCR and dU-PCR were 0.5fg and 500fg, respectively, which indicates the sensitivity of dU-PCR was lower than dT-PCR. But by heating block method, the lower limits of detectability of both method of dU and dT-PCR were 0.5fg. So the sensitivity of dU-PCR was same as dT-PCR. CONCLUSION: The dU-PCR by heating-block method was sensitive test for detection of M. tuberculosis that effectively prevent carryover contamination by amplicon.
Capillaries ; DNA ; Heating ; Hot Temperature ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymerase Chain Reaction* ; Tuberculosis

OBJECTIVE: To evaluate the effectiveness of aromatase inhibitor (AI) for ovulation induction in polycystic ovary syndrome (PCOS) patients with thin endometrium, hyper-responsiveness after clomiphene citrate (CC) treatment. MATERIAL AND METHODS: A prospective study was performed in 43 PCOS patients (50 cycles) with ovulatory dysfunction between March 2004 and September 2004. AI group (total 36 cycles) included the patients 1) with thin endometrium below 6 mm on hCG day after CC (n=17), 2) with more than 5 ovulatory follicles after 50mg of CC (n=4), 3) who do not want multiple pregnancy (n=14). Patients were treated with Letrozole 2.5mg for days 3 to 7 of the menstrual cycle. CC group (total 14 cycles) were treated with CC 50~100 mg. RESULTS: In PCOS patients, ovulation was occurred 97.2% after AI use. Between AI group and CC group, there was no significant difference in the mean age, duration of infertility, interval of menstruation, basal FSH, prior treatment cycles, and the day of hCG administration. But, the number of mature follicles (> or =15 mm) was lower in the AI group (1.08+/-0.45 vs. 1.64+/-0.75) (p=0.018), and the thickness of endometrium (mm) was significantly thicker in the AI group (10.35+/-1.74 vs. 9.23+/-1.61) (p=0.044), and E2 (pg/ml) concentration on hCG day was lower in the AI group (116.9+/-75.8 vs. 479.5+/-300.8) (p=0.001). Among the AI group, patients with prior thin endometrium (below 6 mm) during CC treatment showed 10.6+/-1.6 mm in the endometrial thickness and 106.6+/-66.8 pg/ml in E2 concentration. Patients with more than 5 ovulatory follicles after CC showed decreased follicle number (1.25+/-0.5) compared to prior CC cycle. CONCLUSIONS: In PCOS patients, AI group showed significantly thicker endometrium, lesser number of mature follicles, and lower E2 concentration on hCG day than CC group. AI might be useful alternative treatment for ovulation induction in PCOS patients with thin endometrium and hyper-responsiveness after CC treatment.
Aromatase* ; Clomiphene* ; Endometrium ; Female ; Humans ; Infertility ; Menstrual Cycle ; Menstruation ; Ovulation ; Ovulation Induction ; Polycystic Ovary Syndrome* ; Pregnancy ; Pregnancy, Multiple ; Prospective Studies