OBJECTIVE: This study was done to evaluate the risk factors associated with recurrence after first-ever stroke. METHOD: We retrospectively studied 256 first-ever stroke patients treated in Dong-Eui hospital from March 1997 to February 1998. Telephone or out-patient interviews were performed with these patients regarding stroke recurrence and treatment for hypertension and diabetes mellitus. These were divided into two groups, those with recurrence and those without. Evaluated risk factors for stroke recurrence were the following: history of diabetes mellitus, hypertension, heart disease, smoking, alcohol drinking, and transient ischemic attack; clinical findings at admission of hypertension, diabetes mellitus, hyperlipidemia, heart disease, type and location of stroke; treatment compliance for diabetes mellitus and hypertension after discharge. RESULTS: The recurrence rate after first-ever stroke was 12.9%. In univariate analysis, significant risk factors for stroke recurrence were history of smoking, clinical findings at admission of diabetes mellitus, atrial fibrillation, ischemic heart disease, and non-compliance with therapy for diabetes mellitus and hypertension after discharge (p<0.05). In multivariate analysis, significant risk factors for stroke recurrence were atrial fibrillation at admission (odds ratio=3.43) and non-compliance with therapy for hypertension after discharge (odds ratio=7.51)(p<0.05). CONCLUSION: History of smoking, clinical findings at admission of diabetes mellitus, atrial fibrillation, ischemic heart disease, and non-compliance with therapy for diabetes mellitus and hypertension after discharge are considered to be important factors for recurrence of stroke. So treatment and education for those factors associated with stroke recurrence are needed during rehabilitation program.
Alcohol Drinking ; Atrial Fibrillation ; Compliance ; Diabetes Mellitus ; Education ; Heart Diseases ; Humans ; Hyperlipidemias ; Hypertension ; Ischemic Attack, Transient ; Multivariate Analysis ; Myocardial Ischemia ; Outpatients ; Recurrence* ; Rehabilitation ; Retrospective Studies ; Risk Factors* ; Smoke ; Smoking ; Stroke* ; Telephone

This study was to develop the home care nursing network system for low income and vulnerable health people by utilizing wire- wireless network and mobile computing in order to record and send patients' data in real time, and connect the headquarter office and four local community health centers. The methods were the Method/1 and Prototyping were adopted to develop the main network system. Results were: 1) home care nursing standard guidelines for Diabetes, cancer and peritoneal-dialysis, dementia/mental disorder, and chronic arthritis were added in 12 domains of nursing problem field with nursing assessment/intervention algorithms. 2) upgrading PDA system by utilizing the machinery and tools where the PDA and the data transmission modem are integrated, CDMX - 1X base construction in order to reduce a transmission hour and the transmission failure.
Arthritis ; Community Health Centers ; Home Care Services* ; Modems ; Nursing*

Hoffa's disease refers to inflammation, subsequent hypertrophy and impingement of the infrapatellar fat pad, and this is all triggered by acute trauma or repetitive microtrauma. Patients with Hoffa's disease manifest with anterior knee pain and functional impairment. The chronic impingement of the infrapatellar fat pad, which contains many progenitor cells, may promote fibrocartilaginous formation and osteochondral metaplasia of adipose tissue, so osteochondroma is sometimes found in patients with advanced Hoffa's disease. We report here on an ossifying chondrolipoangioma as an advanced form of Hoffa disease that occurred in the infrapatellar fat pad.
Adipose Tissue ; Humans ; Hypertrophy ; Inflammation ; Knee ; Metaplasia ; Osteochondroma ; Stem Cells

OBJECTIVE: To investigate the clinical characteristics, risk factors and complications of stroke patients and their effect on the patient's functional outcomes at discharge. METHOD: We performed a prospective study during hospitalization on 1, 250 consecutive acute stroke patients discharged from Dong-Eui Hospital from June 2001 to May 2002. Glasgow outcome scale, status of upper extremity involved and status of ambulation were used to evaluate functional status. RESULTS: The variables of clinical characteristics identified as significant in functional status at discharge were the presence of occupation, interval between onset and visit to hospital arrival, type of first treatment after stroke, type of caregiver, type of stroke and location of infarction and intracranial hemorrhage. Positive functional outcomes were significantly related to a younger age, male, small amount of hemorrhage and short length of hospital stay. Among risk factors of stroke, abnormal ECG findings at admission and presence of previous stroke were negative prognostic factors. The complications influencing stroke outcome negatively were pneumonia, depression, urinary tract infection, myocardial infarction and recurrence of stroke in hospitalization. CONCLUSION: The results of this study should be considered during acute management and rehabilitation of stroke patients and are valuable as basic data of functional outcome after stroke.
Caregivers ; Depression ; Electrocardiography ; Glasgow Outcome Scale ; Hemorrhage ; Hospitalization ; Humans ; Infarction ; Intracranial Hemorrhages ; Length of Stay ; Male ; Myocardial Infarction ; Occupations ; Pneumonia ; Prospective Studies ; Recurrence ; Rehabilitation ; Risk Factors ; Stroke* ; Upper Extremity ; Urinary Tract Infections ; Walking

Two cases of esophageal small cell carcinoma were reported on for the first time in 1952. There have been only a few published series on the patients with esophageal small cell carcinoma, and only 19 cases have been reported in Korea. As in the case of small cell carcinoma of the lung, the esophageal small cell carcinoma is known to show rapid progression and early metastasis. Yet much remains to be uncovered about the clinical features, optimal treatment and natural history of this disease. We report here on a case of primary esophageal small cell carcinoma with intraperitoneal multiple lymph node metastasis. The size of the tumor was markedly decreased by combination chemotherapy.
Carcinoma, Small Cell* ; Drug Therapy, Combination ; Esophageal Neoplasms ; Humans ; Korea ; Lung ; Lymph Nodes* ; Natural History ; Neoplasm Metastasis*

Purposes: Although the standard management of limited stage small cell lung cancer is concurrent platinum-based chemotherapy with thoracic radiotherapy (TRT), the optimal timing of the TRT remains controversial. We investigated the feasibility of concurrent chemoradiation for the patients with limited stage small cell lung cancer after 2 cycles of combination chemotherapy with Etoposide/Cisplatin (EP). MATERIALS AND METHODS: EP consisted of Etoposide 100 mg/m2 on day 1 to 3 and Cisplatin 70 mg/m2 on day 1. Six cycles were given to the responders every 4 weeks. Total 55 Gy (1.8 Gy once-daily or 1.2 Gy twice-daily, 5 days per week) of TRT were given to the patients who showed at least a partial response after 2 cycles of EP. The other patients were treated by the physician's decision. The patients with complete remission were recommended to receive prophylactic cranial irradiation. RESULTS: Fifty patients were enrolled. Thirty-five (70%) of them showed responses (2 complete remissions and 33 partial remissions) after 2 cycles of EP. Thirty-three of the responders were given TRT starting with the 3rd cycle of EP. The nonresponders were treated with salvage chemotherapy and TRT. After completion of treatment for 50 patients, the overall response rate was 86% (29 complete remissions, 14 partial remissions). One patient (2%) showed stable disease, and 6 (12%) showed a progressive disease. The median progression free survival was 326 days and the median survival time was 410 days. One-, 2-, 3-, 4- and 5-year survival rates were 62%, 24%, 14%, 9% and 6%, respectively. As hematologic toxicities during chemoradiation, 35.1% with grade III/IV neutropenia and 18.9% with grade III/IV thrombocytopenia were noted. Grade II/III radiation pneumonitis and radiation esophagitis were noted in 5/1 and 13/1 patients (15.2%/ 3.0% and 39.4%/3.0%), respectively. One patient died of septicemia during chemoradiation. CONCLUSION: The concurrent EP and TRT after 2 cycles of EP was feasible in limited stage small cell lung cancer. Further study is required for the indentification of optimum timing of TRT during combination chemotherapy.
Chemoradiotherapy ; Cisplatin ; Cranial Irradiation ; Disease-Free Survival ; Drug Therapy ; Drug Therapy, Combination* ; Esophagitis ; Etoposide ; Humans ; Neutropenia ; Radiation Pneumonitis ; Radiotherapy* ; Sepsis ; Small Cell Lung Carcinoma* ; Survival Rate ; Thrombocytopenia

Nocardiosis is uncommon in healthy people, but occurs as an opportunistic infection in patients with connective tissue disease, solid organ transplantation, lung disease, malignancies, and the acquired immune deficiency syndrome (AIDS). Nocardia is a gram positive, variably acid-fast aerobic bacterium of the family Nocardiaceae characterized by branching and filamentous growth, with distinctive aerial hyphae. In systemic lupus erythematosus (SLE) patients, immunosuppressiion with cytotoxic drugs or corticosteroids, proteinuria, renal insufficiency, and active SLE itself are known as risk factors for serious bacterial infections and opportunistic infections. We report a case of pulmonary Nocardiosis in patient with lupus nephritis treated with cyclophosphamide and high dose corticosteroid.
Acquired Immunodeficiency Syndrome ; Adrenal Cortex Hormones ; Bacterial Infections ; Connective Tissue Diseases ; Cyclophosphamide ; Humans ; Hyphae ; Lung Diseases ; Lupus Erythematosus, Systemic ; Lupus Nephritis* ; Nocardia ; Nocardia Infections* ; Nocardiaceae ; Opportunistic Infections ; Organ Transplantation ; Proteinuria ; Renal Insufficiency ; Risk Factors ; Transplants

OBJECTIVE: To describe our initial experience with CT-guided percutaneous barium marking for the localization of small pulmonary nodules prior to video-assisted thoracoscopic surgery (VATS). MATERIALS AND METHODS: From October 2010 to April 2011, 10 consecutive patients (4 men and 6 women; mean age, 60 years) underwent CT-guided percutaneous barium marking for the localization of 10 small pulmonary nodules (mean size, 7.6 mm; range, 3-14 mm): 6 pure ground-glass nodules, 3 part-solid nodules, and 1 solid nodule. A 140% barium sulfate suspension (mean amount, 0.2 mL; range, 0.15-0.25 mL) was injected around the nodules with a 21-gauge needle. The technical details, surgical findings and pathologic features associated with barium localizations were evaluated. RESULTS: All nodules were marked within 3 mm (mean distance, 1.1 mm; range, 0-3 mm) from the barium ball (mean diameter, 9.6 mm; range, 8-16 mm) formed by the injected barium suspension. Pneumothorax occurred in two cases, for which one needed aspiration. However, there were no other complications. All barium balls were palpable during VATS and visible on intraoperative fluoroscopy, and were completely resected. Both the whitish barium balls and target nodules were identifiable in the frozen specimens. Pathology revealed one invasive adenocarcinoma, five adenocarcinoma-in-situ, two atypical adenomatous hyperplasias, and two benign lesions. In all cases, there were acute inflammations around the barium balls which did not hamper the histological diagnosis of the nodules. CONCLUSION: CT-guided percutaneous barium marking can be an effective, convenient and safe pre-operative localization procedure prior to VATS, enabling accurate resection and diagnosis of small or faint pulmonary nodules.
Adult ; Aged ; Barium Sulfate/*diagnostic use ; *Contrast Media ; Female ; Humans ; Lung Neoplasms/radiography/*surgery ; Male ; Middle Aged ; *Radiography, Interventional ; Solitary Pulmonary Nodule/radiography/*surgery ; *Thoracic Surgery, Video-Assisted ; *Tomography, X-Ray Computed

Background: and Purpose: Reportedly 30–50% of patients being treated for chronic illnesses do not adhere to their medication regimen. We assessed the impact of a nurse-led education program for caregivers of Korean de novo Alzheimer’s disease patients who had newly been prescribed donepezil. Methods: This multicenter study analyzed 93 participants in a caregiver education group and 92 participants in a caregiver no-education group. At every visit up to the end of the study (1 year), caregivers in the education group were given educational brochures regarding Alzheimer’s disease and the efficacy and adverse events of donepezil treatment. The primary endpoint was the discontinuation rate of donepezil treatment during the 1-year observation period. The secondary endpoints included the effect of education on compliance with donepezil treatment assessed at each visit using a clinician rating scale (CRS) and visual analog scale (VAS), and changes from baseline in cognitive assessment tests. Results: The donepezil discontinuation rates at 1 year were 5.38% (5/93) and 6.52% (6/92) in the caregiver education and no-education groups, respectively (p=0.742). No significant between-group differences in donepezil compliance rates on the CRS and VAS were observed, but significant changes were observed in some cognitive tests from baseline to the end of the study. Conclusions Caregiver education had no significant effect on treatment discontinuation, but this may have been due to the low severity of cognitive impairment among the included population at baseline. In addition, the low discontinuation rates meant that no significant difference in treatment compliance was observed.

Background: and Purpose: Reportedly 30–50% of patients being treated for chronic illnesses do not adhere to their medication regimen. We assessed the impact of a nurse-led education program for caregivers of Korean de novo Alzheimer’s disease patients who had newly been prescribed donepezil. Methods: This multicenter study analyzed 93 participants in a caregiver education group and 92 participants in a caregiver no-education group. At every visit up to the end of the study (1 year), caregivers in the education group were given educational brochures regarding Alzheimer’s disease and the efficacy and adverse events of donepezil treatment. The primary endpoint was the discontinuation rate of donepezil treatment during the 1-year observation period. The secondary endpoints included the effect of education on compliance with donepezil treatment assessed at each visit using a clinician rating scale (CRS) and visual analog scale (VAS), and changes from baseline in cognitive assessment tests. Results: The donepezil discontinuation rates at 1 year were 5.38% (5/93) and 6.52% (6/92) in the caregiver education and no-education groups, respectively (p=0.742). No significant between-group differences in donepezil compliance rates on the CRS and VAS were observed, but significant changes were observed in some cognitive tests from baseline to the end of the study. Conclusions Caregiver education had no significant effect on treatment discontinuation, but this may have been due to the low severity of cognitive impairment among the included population at baseline. In addition, the low discontinuation rates meant that no significant difference in treatment compliance was observed.