The purpose of this study was to test psychometric properties Health-Related Hardiness Scale(HRHS) for Korean elderly. HRHS has been developed by Pollock to measure the effect of hardiness in individuals with actual health problems. Items were generated to measure dimensions based on theoretical definitions of health-related control, commitment, and challenge. In 1990, Pollcok and Duffy revised HRHS to be 34 items. In this study, 34-item HRHS(Pollock & Duffy, 1990) was translated into Korean and administered to 193 elderly involving in 95 hospitalized patients and 98 outpatients or healthy people. The subjects were 80 women and 112 men with an age range of 65 to 95 years(M=71 years) in whom 82.6% classified themselves as moderate or pretty active. Most subjects(80.2%) had education of elementary school or less. The 34-item HRHS consists of three subscales: control, commitment, and challenge, and was measured with 1(strongly disagree) to 6(strongly agree) Likert scale. The higher the score is, the higher people's hardiness. Factor analysis was performed to confirm whether the scale represents three sub-areas as suggested in the literature. Two factors were isolated, using principle components analysis. Two factor solution was accepted for the study since Pollock described the possibility of classifying sub-areas into two divisions. These two factors, commitment/challenge and control accounted for 31.9% of variance of the scale. Factor loadings were string, ranging from .41 to .77. The moderate correlation with task self-efficacy scale also supported the validity(r=.35, p<.05). The scale was found to be internally consistent, showing Cronbanch;s alpha of .90 for the total items with the range of .82 and .90 for three subscales. The findings revealed the potential applicability of HRHS to nursing intervention studies for elderly.
Aged* ; Clinical Trial ; Education ; Female ; Humans ; Clinical Trial ; Male ; Nursing ; Outpatients ; Psychometrics*

The coagulation cascade and inflammatory process are known to be associated with the pathophysiology of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). We retrospectively investigated laboratory values indicating coagulopathy obtained within 24 hr from diagnosis of ALI/ARDS in 79 children who received mechanical ventilation between 2008 and 2009 and their final outcomes. Prothrombin time (PT) (P = 0.001) and activated partial thromboplastin time PTT (APTT) (P = 0.001) were more prolonged in non-survivors than survivors (mean; 1.57 vs 1.33; 63 vs 57). In multivariate analysis with stratification by oxygenation-index (< 14.5, > or = 14.5), prolonged PT (> or = 1.46 international normalized ratio, [INR]) (hazard ratio; 2.043, 1.027-4.064) was associated with lower non-pulmonary-organ-failure-free survival rate (FFS), and prolonged APTT (> or = 50 seconds) (2.062, 1.031-4.121; 2.422, 1.227-4.781) was associated with lower overall survival rate (OS) and lower FFS. In stratification by ventilation-index (< 40, > or = 40), prolonged PT (2.232, 1.095-4.540; 2.177, 1.092-4.342) and prolonged APTT (2.574, 1.230-5.386; 3.089, 1.500-6.360) were associated with lower OS and lower FFS. Prolonged PT and APTT are associated with mortality in mechanically ventilated children with ALI/ARDS. We suggest PT and APTT as prognostic factors of ALI/ARDS in children.
Acute Lung Injury/*etiology/mortality ; Adolescent ; Blood Coagulation Disorders/*complications ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Multivariate Analysis ; Partial Thromboplastin Time ; Prognosis ; Prothrombin Time ; Respiratory Distress Syndrome, Adult/*etiology/mortality ; Retrospective Studies ; Survival Rate ; Young Adult

We report a case of severe status asthmaticus in a 3-year-old boy who required mechanical ventilatory support. He initially presented with rapidly progressing respiratory distress and spontaneous air leaks. Although he was intubated and received mechanical ventilation, dynamic hyperinflation and air leaks were aggravated. We applied the volume control mode, providing sufficient tidal volume (10 ml/kg), a reduced respiratory rate (25/minute), and a prolonged expiratory time (1.8 seconds) to overcome dynamic hyperinflation. After allowing full expiration of trapped air, his over-expanded lung volumes were decreased and the air leaks resolved. He made a complete recovery without sequelae. Dynamic hyperinflation in asthmatic patients occurs from incomplete exhalation throughout narrowed airways. Controlled hypoventilation or permissive hypercapnia is an important lung-protective ventilator strategy and is beneficial in reducing dynamic hyperinflation. We suggest a controlled hypoventilation strategy with a prolonged expiratory time for patients in severe status asthmaticus with dynamic hyperinflation.
Asthma ; Exhalation ; Humans ; Hypercapnia ; Hypoventilation ; Lung ; Positive-Pressure Respiration, Intrinsic ; Preschool Child ; Respiration, Artificial ; Respiratory Rate ; Status Asthmaticus ; Tidal Volume ; Ventilators, Mechanical

PURPOSE: This study aims to investigate the additive effect of the Hedera helix (HH) and Rhizoma coptidis (RC) extracts mixture on antitussive and expectorant activities in animals. MATERIALS AND METHODS: The expectorant assay was performed with phenol red secretion in mice trachea. Mice or guinea pigs were randomly divided into groups of 8 each, including negative and positive control groups. After gastric administration of the test extracts in mice, 2.5% phenol red solution (0.2 mL) was intraperitoneally injected. Trachea was dissected and optical density of tracheal secretion was measured. After gastric administration of the test extracts in guinea pigs, the antitussive activities were assessed using a citric acid-induced cough measurement. RESULTS: The extracts of HH and RC significantly increased tracheal secretion and inhibited cough. The mixture of HH and RC extracts in a 1:1 concentration at a dose of 200 mg/kg showed a more potent effect on phenol red secretion (25.25+/-3.14) and cough inhibition (61.25+/-5.36) than the individual use of each extracts [phenol red secretion; HH 13.39+/-4.22 (p=0.000), RC 20.78+/-2.50 (p=0.010), cough inhibition; HH 9.89+/-4.14 (p=0.010), RC 30.25+/-7.69 (p=0.000)]. A 3:1 ratio mixture of HH to RC demonstrated an optimal expectorant effect (p<0.001), and this mixture showed expectorant and antitussive effects in a dose-dependent manner. CONCLUSION: This study provides evidence for antitussive and expectorant effect of a 3:1 mixture of HH and RC, which may be a useful therapeutic option for respiratory diseases.
Animals ; Antitussive Agents/*administration & dosage/pharmacology/therapeutic use ; *Behavior, Addictive ; Cough/*drug therapy ; Drugs, Chinese Herbal/*administration & dosage/pharmacology/therapeutic use ; Ethanol ; Expectorants/*administration & dosage/pharmacology/therapeutic use ; Guinea Pigs ; Hedera/*chemistry/metabolism ; Male ; Mice ; Phytotherapy ; Plant Extracts/*pharmacology ; Plant Roots/chemistry ; Trachea/drug effects/metabolism

Scedosporium(S). apiospermum is the asexual stage of Pseudallescheria boydii. This ubiquitous fungus causes not only mycetoma but also infection of a variety of body sites including the skin. Localized skin infection without grain production due to this organism is much rarer than mycetoma. We report a case of cutaneous S. apiospermum infection which occured in a 75-year old female. She had multiple suppurative nodules with pustules on a dark red plaque at the dorsum of the right forearm. Cultural isolation for definitive diagnosis showed typical S. apiospermum. The patient was treated successfully with oral terbinafine 250mg daily for 1 week and oral itraconazole 200mg daily for 3 weeks.
Aged ; Edible Grain ; Diagnosis ; Female ; Forearm ; Fungi ; Humans ; Itraconazole ; Mycetoma ; Pseudallescheria ; Scedosporium* ; Skin*

Hodgkin's disease (HD) is a hematologic malignancy which shows common features regardless of race, but racial differences may be considered with certain clinical characteritcs. HD in Korea shows somewhat different characteristics when compared to cases in Western countries. We evaluated the clinical and histopathologic characteristics of HD, the outcomes of various chemotherapy regimens, and prognostic factors of HD in Korea. One hundred and five patients with initial histopathologic diagnosis of Hodgkin's disease were retrospectively reviewed 20 years after diagnosis at Yonsei University College of Medicine. Nodular sclerosis was the most common histopathogic subtype (41%) and mixed cellularity was nearly as common (40%). The overall complete remission rate (CR) was 87.6%. The disease-free survival (DFS) and overall survival (OS) rate were 79.2% and 84.8% at 5-years, 70% and 79.2% at 10- and 20-years. There were no significant differences in CR rate and DFS, but OS rates were significantly higher in m-BACOP and ABVD regimen. Univariate analysis revealed that age, B-symptom, ECOG scale, Ann Arbor stage, international prognostic index, and serum beta2-microglobulin level were significant prognostic factors for both DFS and OS. Multivariate analysis demonstrated that age, B symptoms, and ECOG scale were significant prognostic factors for OS only. In conclusion, the survival rates of HD patients in our center were superior to those of previous reports in Korea and Western countries. Considering the higher OS rate and decreased incidence of side effects, the ABVD regimen may be recommended for the initial treatment of Hodgkin's disease.
Treatment Outcome ; Remission Induction ; Prognosis ; Middle Aged ; Male ; Korea ; Humans ; Hodgkin Disease/mortality/*therapy ; Follow-Up Studies ; Female ; Disease-Free Survival ; Child, Preschool ; Child ; Antineoplastic Agents/*pharmacology ; Aged, 80 and over ; Aged ; Adult ; Adolescent

The incidence of Giant Condyloma Acuminata of the penis is unknown but considered rare. They are similar to condyloma acuminata, histologically and grossly similar to squamous cell ca. Most authorists consider that they get the real possibility of malignant change and they had been first described by Buschke in the German literatures in l896 as a variant of condyloma acuminata. A case of malignancy of the penis which has apparently transformed from Giant Condyloma Acuminata of the penis is herein presented with review of related literatures.
Incidence ; Male ; Penile Neoplasms* ; Penis

BACKGROUND: Many implants are being used for the reconstruction of orbital wall fractures. The effect of the choice of implant for the reconstruction of an orbital wall fracture on the surgical outcome is under debate. The purpose of this article is to compare the outcomes of orbital wall reconstruction of small orbital wall fractures on the basis of the implants used. METHODS: The authors conducted a retrospective study using electronic databases. Between March 2001 and December 2012, 461 patients with orbital wall fractures were included in this study. Among them, 431 patients in whom the fracture size was less than 300 mm2 were analyzed. The fracture size was calculated using computed tomography scans of the orbit in the sagittal and coronal images. Cases in which the fracture size was less than 300 mm2 were included in this study. RESULTS: One hundred and twenty-nine patients were treated with silastic sheets; 238 patients were treated with titanium meshes; and absorbable meshes were used in the case of 64 patients. Overall, 13 patients required revision, and the revision rate was 3.0%. The revision rate of the silastic sheet group was 5.4%. In the multivariable analysis, the revision rate of the group reconstructed with silastic sheets was highly statistically significant (P=0.043, odds ratio=3.65). However, other factors such as age, sex, fracture type, and fracture size were not significant. CONCLUSIONS: Reconstruction of orbital wall fractures with silastic sheets may cause more complications than that with other materials such as titanium meshes and absorbable meshes.
Humans ; Orbit* ; Orbital Fractures ; Retrospective Studies ; Silicones ; Titanium

A case of telangiectatic focal nodular hyperplasia (FNH) was detected at birth and was surgically removed. Grossly, the lesion was a solitary nodule and showed vague nodularity, appearing as an adenoma-like mass with fine fibrous septa, but having no macroscopic scar. On microscopic scale, the mass typically had neither fibrous central scar nor hyperplastic nodules different from the usual FNHs. The hepatic plates were separated by sinusoidal dilatation, sometimes alternating with areas of marked ectasia. Instead of large fibrous scar, thin fibrous septa were often found, and contained abnormal tortuous large arteries. These high-pressure vessels were connected directly into the adjacent sinusoids and made marked dilation of sinusoids. Bile ductular proliferation was also noted in the thin fibrous septa. To our knowledge, this is considered to be the first reported case of telangiectatic FNH detected at birth.
Focal Nodular Hyperplasia/*congenital/*diagnosis/radiography ; Human ; Hyperplasia ; Infant ; Liver/pathology ; Liver Neoplasms/congenital/*diagnosis/radiography ; Male ; Tomography, X-Ray Computed

I-123 labelled fatty acids are suitable for investigation of regional myocardial metabolism, so they are on the clinical trial. However, the precise properties of these materials are not characterized yet. We have synthesized phenylpentadecanoic acid and labeled this compound with I-123. The purpose of this study was to examine the stability, biodistribution, metabolism and SPECT imaging of [I-123]15-(p-iodophenyl)pentadecanoic acid(I-123-IPPA) that we made. The stability test of I-123-IPPA in serum of rat, mouse and human showed no free I-123 after 1 hour. In biodistribution study in mice for various time intervals after injection(5, 10, 15, 30, 60 minutes), uptake in myocardium was 14.5%ID/g(5 min), and 1.9%ID/heart(5 min), while uptake in muscles was 2.6%ID/g(5 min). Myocardium to blood ratio and myocardium to lung ratio increased for 5 min after injection and then decreased rapidly. Chromatographic data of rat blood and urine showed that little PPA was found in blood and urine 15-20 min after injection. The myocardial I-123-IPPA SPECT images of a dog with myocardial infarction showed defects similar to those of Tc-99m-MIBI and F-18-FDG. These data suggest that I-123-IPPA is quite stable in vitro and shows favorable biodistribution in mice. SPECT imaging with I-123-IPPA demonstrated infarct zone as photon defect in dog model of myocardial infarction. I-123-IPPA may be used for the evaluation of fatty acid metabolism in clinical trials in Korea.
Animals ; Dogs ; Fatty Acids ; Humans ; Korea ; Lung ; Metabolism* ; Mice ; Muscles ; Myocardial Infarction ; Myocardium ; Rats ; Tomography, Emission-Computed, Single-Photon