This study is aimed at developing a cardiac rehabilitation program and enlightening the effects of the program on patient's health behavior compliance, cardiovascular functional capacity, and quality of life. Using a quasi-experimental approach the nonequivalent control group pretest - posttest design was accepted for this study. The subjects of this study consisted of 55 patients with ischemic heart disease at the Cardiac Center of 'G' Hospital located in Inchon from May 1, 1998 to April 30, 1999. The patients were divided into two groups: the experimental group, which participated in the cardiac program with 30 patients and 25 patients of a control group were not involved in the program. There were two phases in the cardiac rehabilitation program: the first phase was a team approach education. It focused on reducing the risk of ischemic heart problems. The second phase was individual training by using a home based exercise program, which was comprised of 8 weeks, three sessions per week, 40-60 minutes per session, and followed by consultation. Every session involved 20-40 minutes of aerobic exercise at 40-60% of heart rate reserve, 11~13 RPE and 10 minutes of warm-up and 10 minutes of cool-down exercises. The experimental tools for the study were the health behavior compliance scale developed by Lee, Yoon-hee (1992), and quality of life scale developed by McGirr et al.(1990). RPPsubmax were measured by the treadmill. The collected data was processed by SPSS and analyzed by X2test and t-test. The results of this study were as follows: 1. The health behavior compliance in experimental group was significantly increased (t=5.091, p=.000) when compared to the control group. 2. RPPsubmax also decreased significantly in the experimental group when compared to the control group(t=-2.109, p=.040). 3. The quality of life significantly improved in the experimental group (t=3.853, p=.000) as compared to the control group. As the above results of this study revealed, the effectiveness of the cardiac rehabilitation program of the study was confirmed. It increased the health behavior compliance for reducing the risk of further coronary events, enhanced the cardiovascular functional capacity, and eventually improved the patient's quality of life.
Compliance* ; Cool-Down Exercise ; Education ; Exercise ; Health Behavior* ; Heart ; Heart Rate ; Humans ; Incheon ; Myocardial Ischemia* ; Quality of Life* ; Rehabilitation*

This study is aimed at developing a cardiac rehabilitation program and enlightening the effects of the program on patient's health behavior compliance, cardiovascular functional capacity, and quality of life. Using a quasi-experimental approach the nonequivalent control group pretest - posttest design was accepted for this study. The subjects of this study consisted of 55 patients with ischemic heart disease at the Cardiac Center of 'G' Hospital located in Inchon from May 1, 1998 to April 30, 1999. The patients were divided into two groups: the experimental group, which participated in the cardiac program with 30 patients and 25 patients of a control group were not involved in the program. There were two phases in the cardiac rehabilitation program: the first phase was a team approach education. It focused on reducing the risk of ischemic heart problems. The second phase was individual training by using a home based exercise program, which was comprised of 8 weeks, three sessions per week, 40-60 minutes per session, and followed by consultation. Every session involved 20-40 minutes of aerobic exercise at 40-60% of heart rate reserve, 11~13 RPE and 10 minutes of warm-up and 10 minutes of cool-down exercises. The experimental tools for the study were the health behavior compliance scale developed by Lee, Yoon-hee (1992), and quality of life scale developed by McGirr et al.(1990). RPPsubmax were measured by the treadmill. The collected data was processed by SPSS and analyzed by X2test and t-test. The results of this study were as follows: 1. The health behavior compliance in experimental group was significantly increased (t=5.091, p=.000) when compared to the control group. 2. RPPsubmax also decreased significantly in the experimental group when compared to the control group(t=-2.109, p=.040). 3. The quality of life significantly improved in the experimental group (t=3.853, p=.000) as compared to the control group. As the above results of this study revealed, the effectiveness of the cardiac rehabilitation program of the study was confirmed. It increased the health behavior compliance for reducing the risk of further coronary events, enhanced the cardiovascular functional capacity, and eventually improved the patient's quality of life.
Compliance* ; Cool-Down Exercise ; Education ; Exercise ; Health Behavior* ; Heart ; Heart Rate ; Humans ; Incheon ; Myocardial Ischemia* ; Quality of Life* ; Rehabilitation*

Functional aphonia is a disease in which normal vocal ability is suddenly lost. When voice therapy is started at an early stage, the prognosis is good. However, if the functional aphonia persists for a long time, there is a possibility that the voice disorder may become fixed, though reports of these characteristics are rare. The authors experienced a patient with functional aphonia that occurred in adolescence and lasted for 7 months and reported the result of treatment.

PURPOSE: To evaluate the effect of preoperative keratometric value on corneal flap dimensions, records of 81 eyes of 45 patients who had LASIK were analyzed retrospectively. METHOD: Corneal thickness and diameter , and keratometric value were measured preoperatively. RESULTS: In this study, SCMD Turbokeratome was set for making a corneal flap with 150 micron thickness and 8.25 mm diameter. In reality, however, the mean corneal flap thickness was 110.7+/-15.7 micron and the mean corneal flap diameter was 7.89+/-0.33 mm. The lower mean preoperative keratometric value, the thicker(r=-0.325, p=0.003) and the smaller(r=0.460, p=0.009) diameter flap was made. When we divided eyes into three groups according to their keratometric values, eyes with keratometric values lower than 42.5 D resulted in corneal flap with 116.70+/-12.6 micron thickness and 7.65(0.28mm diameter as opposed to 102.16+/-13.41 micron thickness and 8.05+/-0.37 mm diameter flap in corneas having keratometric values above 44.5 D(p<0.05). CONCLUSION: When a LASIK flap was made using SCMD manual keratome, steeper corneas tend to have larger and thinner corneal flaps. In conclusion, for making the corneal flap according to the intended thickness and diameter in LASIK, preoperative keratometric value should be considered carefully.
Cornea ; Humans ; Keratomileusis, Laser In Situ* ; Retrospective Studies

Variable systemic diseases affect larynx and vocal fold and result in voice change. Asthma and chronic obstructive pulmonary disease make increase of intra-abdomimal pressure followed by reflux of gastric acid, which stimulate vagal-bronchopulomary reflex aggravating cough and respiratory disturbance. Fungal laryngitis in the general population is extremely rare, but can occur in immunocompromised AIDS patients. Although, initially, empirical antifungal therapy for candidiasis is often given without biopsy, diagnostic direct laryngoscopy and biopsy is imperative if a substantial clinical response is not rapidly achieved. In the highly active anti-retroviral therapy era, HIV-positive patients are living longer and are at higher risk for developing non-AIDS-defining malignancies. The incidence of head and neck cancer (HNC) which is related with human papilloma virus infection has increased. The survival is significantly lower among the AIDS-HNC patients with CD4 counts ≤200 cells/µL. Rheumatoid arthritis (RA) cause voice disturbance by developing cricoarytenoid joints fixation or nodule on vocal fold. Post-menopausal voice disorder (PMVD) is caused by decreased secretion of estrogen-progesterone resulting in decrease of fundamental frequency (F0). Hormonal replacement therapy is helpful to reduce F0 decrease. RA and PMVD result in slight voice change, but it could crucial in professional voice user.
Arthritis, Rheumatoid ; Asthma ; Biopsy ; Candidiasis ; CD4 Lymphocyte Count ; Cough ; Gastric Acid ; Head and Neck Neoplasms ; Humans ; Incidence ; Joints ; Laryngitis ; Laryngoscopy ; Larynx ; Papillomaviridae ; Pulmonary Disease, Chronic Obstructive ; Reflex ; Vocal Cords ; Voice Disorders* ; Voice*

Amitraz is used as farm-animal insecticide. Its side effects in humans are related to its pharmacological activity on alpha 2-adrenergic receptors. The case describes a previously healthy 46-year-old woman who intentionally ingested approximately 250mL of liquid amitraz. She presented with vomiting, altered mental status, miosis, dry mouth, hypopnea, metabolic and respiratory acidosis, hypotension, hypothermia, polyuria, metabolic acidosis, elevated serum aminotransferase and abdominal distension. Supportive treatments including mechanical ventilation, hydration, dopamine infusion, bicarbonate infusion and gastric decompression resulted in improvement. By hospital day 3, she recovered with resolution of abdominal distension. It is paramount to recognize amitraz poisoning when apesticide-intoxicated patient presets with signs and symptoms consistent with organophosphate intoxicated patients but with greater alpha 2-adrenergic related symptoms such as decreased bowel motility and xerostomia.
Acidosis ; Acidosis, Respiratory ; Decompression ; Dopamine ; Eating ; Female ; Humans ; Hypotension ; Hypothermia ; Intention ; Middle Aged ; Miosis ; Mouth ; Polyuria ; Respiration, Artificial ; Toluidines ; Vomiting ; Xerostomia

PURPOSE: The improvement of testicular volume, testosterone levels and sperm concentration was suggested to be significantly associated with the number of internal spermatic veins (ISVs) ligated during varicocelectomy. Herein, we investigated preoperative color Doppler ultrasonography (CDU) findings as potential preoperative predictors of the number of ISVs requiring ligation during microsurgical subinguinal varicocelectomy. MATERIALS AND METHODS: In a prospective evaluation of 40 patients, maximal vein size and maximal reflux velocity were measured, while the total cross-sectional area of the affected testicular veins during a Valsalva maneuver was calculated using CDU by a single uroradiologist. Microsurgical subinguinal varicocelectomies were performed by one urologist. RESULTS: Among the semen parameters, semen morphology showed significant improvement (p=0.033), which was much clearer in the patients with a higher number of ISVs ligated than a lower number of ISVs ligated. Among the various preoperative variables, maximal reflux velocity and total cross-sectional area on CDU were related to the number of ISVs ligated (r=-0.442, p=0.004; r=0.594, p=0.000, respectively). Furthermore, univariate and multivariate linear regression analyses showed that maximal reflux velocity and total cross-sectional area on CDU were independent predictive factors of the number of ISVs ligated. CONCLUSION: Maximal reflux velocity and total cross-sectional area on CDU were related to the number of ISVs ligated. This means that the maximal reflux velocity and total cross-sectional area measured by preoperative CDU can predict the number of ISVs requiring ligation during microsurgical subinguinal varicocelectomy, which might be related to significant improvement of semen parameters after varicocelectomy.
Adolescent ; Adult ; Humans ; Male ; Middle Aged ; Prospective Studies ; Semen/metabolism ; Testicular Diseases/ultrasonography ; Ultrasonography, Doppler, Color/*methods ; Varicocele/pathology/*ultrasonography ; Veins/*ultrasonography ; Young Adult

Favre-Racouchot syndrome is a disease of senile or actinic processes and another name is nodular elastosis with cysts and comedones. Clinically, facial skin shows, especially lateral to the eyes, multiple open and cystically dilatated comedones and can be defined as cutaneous disturbances characterized by a degenerative process of the dermis associated with cysts and comedones. Sunlight is a strong causative factor and dermal degenerative processes result in this condition. We report the case of a 78-year-old man who showed multiple yellowish papules on both sides of cheeks, the periorbital and, malar areas. He had had this condition for 25-years. His job used to involve physical labor and much exposure to sunlight. An excisional biopsy specimen from the facial malar lesion showed cystically dilated comedones with basophilically degenerated dermal tissue. We performed a therapeutic excision on the two large nodular lesions on both malar areas and applied topical tretinoin. The Patients clinical appearance was much improved 2 months later.
Actins ; Aged ; Basophils ; Biopsy ; Cheek ; Dermis ; Facial Dermatoses* ; Humans ; Skin ; Sunlight ; Tretinoin*

During the past decade, rates of Clostridium difficile infection (CDI) increased worldwide. Hypervirulent strains of C. difficile such as NAP1/BI/027 and PCR ribotype 078 have emerged that have changed the epidemiology of CDI. Especially, CDI rates also have increased in the community, in children previously thought to be at low risk. Recently, the use of gastric acid suppressant that facilitates intestinal transit of the bacteria and presence of inflammatory bowel disease has been reported as risk factors. Treatment for CDI usually relies on metronidazole or vancomycin, but recurrence rates remains high. New treatment options for multiple recurrence are challenging. In this article, we reviewed recent epidemiological changes, current knowledge of virulence factors, reasonable approach to the diagnosis, and optimal treatment of CDI. But, clinical guidelines for pediatric C. difficile disease have not been defined. It seems that the consensus and recommendations for managing pediatric CDI are urgently needed.
Bacteria ; Child ; Clostridium ; Clostridium difficile ; Consensus ; Gastric Acid ; Humans ; Inflammatory Bowel Diseases ; Metronidazole ; Polymerase Chain Reaction ; Recurrence ; Ribotyping ; Risk Factors ; Vancomycin ; Virulence Factors

PURPOSE: Air bubbles developed during phcoemulsification procedure are known to be harmful to corneal endothelial cells and balanced salt solution(BSS) contained within plastic bag(Bag BSS) has been thought to be more prone to the air bubble formation than the one encased within bottle(Bottle BSS). For the above reason, we tried to see whether there is any difference in corneal endothelial cell changes between two groups of patients who underwent phacoemulsification using Bag BSS and Bottle BSS respectively. METHODS: 85 cataract eyes of 60 patients were randomly assigned to two groups of Bag BSS(43 eyes) and Bottle BSS(42 eyes), on which phacoemulsification was performed through scleral tunnel incision followed by silicone PCL placement. Corneal endothelial cells were examined using specular microscopy postoperatively at 1 month and compared with preoperative specular microscopic data. RESULTS: The percent loss of corneal endothelial cell density at postoperative 1 month for the Bag BSS group(13.02+/-0.7%) was not significantly different from the Bottle BSS group(12.8+/-8.1%)(p>0.05). Coeffcient of variation in cell size(p>0.05) and mean endothelial cell size(p>0.05) also showed no significant difference between the two groups. CONCLUSION: In conclusion, Bag BSS and Bottle BSS have similiar protective effect on the corneal endothelial cell damage during phocoemulsification.
Cataract ; Corneal Endothelial Cell Loss ; Endothelial Cells ; Humans ; Microscopy ; Phacoemulsification ; Plastics* ; Silicones