In order to investigate the factors influencing QOL and life satisfaction of the physically disabled, the author interviewed, by using structuralized questionnaire, 440 individuals among the physically disabled who were participated in Health Examination from April to July, 1997. The questionnaire consisted of the general characteristics(sex, age, marital status, family number, etc), the Reintegration to Normal Living Index(RNLI) to assess QOL, and the single item of five-likert scale to evaluate life satisfaction. The means of RNLI were 16.2+/-4.8 in total score, 12.2+/-3.4 in daily functioning and 4.0+/-2.1 in perception of self. The respondents were less reintegrated toward social activities and relationships than impairments or disabilities. While the satisfied group was 47.3%, the dissatisfied group was 52.7%. As the results of multiple regression and logistic regression analysis, the significant predictors of QOL were age, education, job, grade of disability and subjective health status. The life satisfaction were related to economic status, job and subjective health status. To improve QOL and life satisfaction of the physically disabled, it is important that we improve their basic socioeconomic status by getting a job through rehabilitation education and induce them to have positive self-assessment by extending the opportunity of social participation.
Daegu* ; Surveys and Questionnaires ; Disabled Persons* ; Education ; Humans ; Logistic Models ; Marital Status ; Surveys and Questionnaires ; Rehabilitation ; Self-Assessment ; Social Class ; Social Participation

PURPOSE: Occupational stress can have a negative effect on the worker such as physical, emotional, and psychological health. Although it is well reported that health service staff tend to have a high level of minor psychiatric disorder, only a few studies have been reported in Korea. Intern and Residency (residents) are very vulnerable periods of stress and other psychiatric disorders. In this study, we describe occupational stress of interns and residents and relationship between occupational stress and depression. METHODS: The participants of this study were interns and residents trained in a tertiary hospital in Korea. The occupational stress scale was used for measurement of occupational stress. In addition, the Korean version of the Beck depression scale was used to evaluate the prevalence of depression. Statistical analyses were performed using SPSS v. 18.0; p-value less than 0.05 was considered statistically significant. RESULTS: Female doctors showed higher occupational stress than male. Interns and chief residents demonstrated higher occupational stress than other grades. Astonishingly, most participants showed depressive mood. Compared with the general population, job demand and culture of the workplace are in the first upper quartile. It is indicated that compared with general populations, physicians have a higher workload and patience is required in order to cope with the harsh culture of the workplace. Depressive mood was evaluated with various factors and only occupational stress was statistically significant. CONCLUSION: Overwhelming occupational stress of residents could result in both medical and social problems. Therefore, recognition of occupational stress is essential and aggressive interventions are required.
Burnout, Professional ; Depression ; Female ; Health Services ; Humans ; Internship and Residency ; Korea* ; Male ; Prevalence ; Seoul* ; Social Problems ; Tertiary Care Centers*

The incidence of myocardial ischemia and silent myocardial infarction are higer in diabetic than in nondiabetic patients. We had a case of a disbetic, myocardial ischemic female patient, 54years old, who had cardiac arrest during an emergency surgery. The patient was admitted via emergency room with the diagnosis of rupture of basilar artery aneurysm. During the dissection for the exposure of the artery. The aneurysm ruptured. causing massive hemorrhage. At this time, cardiac arrest was revealed at the monitoring EKG, cardiopulmonary resuscitation with DC shock were performed to reverse venticular fibriliation but the EKG monitor showed T wave inversion and sinus tachycardia in several leads. And the blood pressure was hardly audible with systolic of about 50mmHg. So nitroglycerin 0.05mg, intravenous bolus injection was given twice and the systolic went up to 110mmHg with a diastolic of 80mmHg. So the operation proceeded and finished. The patient was sent to the ICU. On the third postoperative day, the patient again had cardiac arrest but this time could not be resuscitated. We experienced the dramatic effect of nitroglycerin on this ischemic patient during cardio pulmonary resuscitation and we would like to share this experience with our colleagues.
Aneurysm ; Arteries ; Blood Pressure ; Cardiopulmonary Resuscitation* ; Diagnosis ; Electrocardiography ; Emergencies ; Emergency Service, Hospital ; Female ; Heart Arrest ; Hemorrhage ; Humans ; Incidence ; Intracranial Aneurysm ; Myocardial Infarction ; Myocardial Ischemia ; Nitroglycerin* ; Rupture ; Shock ; Tachycardia, Sinus

BACKGROUND: Wilms tumor, the most common primary malignant renal tumor of childhood, has relatively good prognosis among solid tumors occurring in childhood because of the improved operation skill, proper selection of chemotherapeutic agents, and combined radiotherapy on the primary and distant metastatic sites after nephrectomy. However, successful therapy has been associated with long-term toxicity occurring years or decades later. So it is important to identify and understand the possible late effects of treatment for Wilms tumor. METHODS: We reviewed 73 cases of Wilms tumor who were diagnosed and treated from Mar., 1983 to Nov., 1996 and calculated the survival rate. In addition, 42 cases were investigated to see the late effects of treatment for Wilms tumor since Feb., 1993, especially with predesigned indices such as blood pressure, blood urea nitrogen(BUN), serum creatinine(S-Cr), 24 hour urine protein/creatinine(24 HU Pr/Cr), 24 hour urine microalbumin(24 HU MA), 24 hour urine beta2-microglobulin/creatinine(24 HU beta2-MG/Cr). RESULTS: Overall survival rate of Wilms tumor was 86% in 5 years. There was significant difference in survival between stage I, II, III group and stage IV, V group(90% vs 72%, P=0.032), and survival rate of favorable histology group was higher than that of unfavorable histology group(92% vs 73%, P=0.043). Of the 42 cases in our study of late effects, no patient has presented significant late sequelae causing morbidity, and there were one case of transient hypertension, three cases of microalbuminuria, three cases of proteinuria, one case of asymptomatic microscopic hematuria, one case of radiation hepatitis and two cases of nut-cracker syndrome. No abnormality was noted in BUN, S-Cr, or 24 HU beta2-MG/Cr. CONCLUSION: Wilms tumor in our center have an excellent prognosis and no significant late sequelae that might affect long-term morbidity were found. But thorough and further longer follow-up is mandatory to understand the possible late effects fully, so that cope with properly and improve the quality of life.
Blood Pressure ; Follow-Up Studies ; Hematuria ; Hepatitis ; Humans ; Hypertension ; Nephrectomy ; Prognosis ; Proteinuria ; Quality of Life ; Radiotherapy ; Survival Rate* ; Urea ; Wilms Tumor*

In the initial published version of this article, there was a mistake in the title. The correct title should be “Impact of Day 14 Peripheral Blood Chimerism after Allogeneic Hematopoietic Stem Cell Transplantation on the Treatment Outcome of Non-Malignant Disease”.

The purpose of this study was to develop a new bite force measurement device with a force sensing resistor (FSR), and to evaluate its usefulness in the diagnosis of periapical disease. The principle of this device is based on a decrease in resistance when force is applied to the sensor. The resistance is changed into voltage, processed and displayed on an LCD monitor. The relationship between the force applied to the device and the output value was analyzed using the U-Mechanics Analyser (IB Systems, Seoul, Korea). The bite forces of teeth with apical periodontitis and those without periodontitis on the opposite side were measured and compared. The output value was expressed as a logarithmic function of force, or the force was represented as an exponential function of output value. Teeth with apical periodontitis showed relatively lower bite force, and the reduction rate ranged from 18.5% to 40.7%. Based on these results, it is suggested that the newly developed bite force measurement device can quantitatively measure the bite force of individual teeth, and can be useful in the diagnosis of periapical disease.

Airway perforation is a rare but potentially fatal complication following laser surgery. A 66 years old man was admitted for surgery of tracheal stenosis. He had undergone 2 prior anesthesia for similar surgery and had diabetes mellitus due to chronic steroid therapy. 2 hours after surgery, tracheal perforation lead to pneumomediastinum, tension pneumothorax and perforation of innominate artery with potential risk to injury, which lies in the close proximity to perforation site of trachea. Arterial wall was so weak and fragile that it was difficult to repair the ruptured site. During the procedure, hemorrhage persisted and cardiac arrest developed. Immediate CPR(cardiopulmonary resuscitation) with internal cardiac massage was done but the patient did not recover. We believe that in patient with history of multiple operations, chronic steroid therapy and diabetes mellitus, the vascular structure of thin and fragile should be approached with greater caution when using CO2 laser during surgery.
Aged ; Anesthesia ; Brachiocephalic Trunk ; Diabetes Mellitus ; Granulation Tissue* ; Heart Arrest ; Heart Massage ; Hemorrhage ; Humans ; Laser Therapy ; Lasers, Gas* ; Mediastinal Emphysema ; Metabolism ; Pneumothorax ; Trachea ; Tracheal Stenosis

Bronchopulmonary lavage using a double-lumen endotracheal tube is an accepted modality for treatment of pulmonary alveolar proteinosis which characterized by filling of alveolar space with periodic acid-schiff positive proteinaceous material. Massive bronchopulmonary lavage is not without hazard. Improper positioning and inadequate cuff inflation of the endotracheal tube may lead drowning. So correct placement of double-lumen endotracheal tube and confirming complete seperation of the two lungs is important to prevent drowning. And periods of tidal drainage are accompanied with reperfusion to the non-ventilated lung and cause potentially dangerous levels of hypoxemia. One must investigate maneuvers to minimize perfusion to non-ventilated lung and to maximize gas exchange during unilateral lung lavage. The distribution of pulmonary blood flow during unilateral lung lavage can be manipulated by nonocclusive inflation of an ipsilateral pulmonary artery balloon. We report a case of sequential bronchoalveolar lavage in a patient with pulmonary alveolar proteinosis performed safely with pulmonary arterial catherter insertion.
Anoxia ; Bronchoalveolar Lavage* ; Drainage ; Drowning ; Humans ; Inflation, Economic ; Lung ; Perfusion ; Pulmonary Alveolar Proteinosis* ; Pulmonary Artery ; Reperfusion

Munchausen syndrome by proxy(MBP) is the act of one person fabricating or inducing an illness in another to meet his or her own emotional needs through the treatment process. MBP is thought to be rare. We report the case of 11-year-old girl who presented with general weakness, dizziness, headache, and nausea and she was suspected of Munchausen syndrome by proxy.
Child ; Dizziness ; Headache ; Humans ; Mothers ; Munchausen Syndrome ; Munchausen Syndrome by Proxy ; Nausea

PURPOSE: Anticonvulsants have a number of side effects and some of them may be attributed to a disturbance of serum trace metal homeostasis. Although they are minor building components in tissues, they play important functional roles in the peripheral and central nervous system. We measured serum copper and zinc levels in epileptic children who were treated with anticonvulsants to know the effects of anticonvulsants on serum copper and zinc levels. METHODS: Serum copper and zinc levels were determined in 64 epileptic patients receiving anticonvulsant therapy in Chungnam National University Hospital, and in 20 normal controls. Sixty-four epileptic patients were divided into three groups:16 patients who were treated with valproic acid monotherapy; 26 patients who were treated with valproic acid in addition to other anticonvulsants; and 22 patients who were treated with anticonvulsants except for valporic acid. RESULTS: All patients receiving anticonvulsants had significantly lower serum copper levels(80.21+/-19.42 microgram/dL) in comparison to the normal controls(102.12+/-32.8 microgram/dL). Serum zinc levels in patients receiving anticonvulsants(79.78+/-21.88 microgram/dL) were not statistically different from those of controls (85.26+/-29.81 microgram/dL). There were no significant difference of serum copper and zinc levels among the three groups. CONCLUSION: In this study, we clearly showed that anticonvulsants decreased serum copper levels. Although we did not observe any clinical findings related to copper deficiency, we should pay attention to potent copper deficiency in patients with anticonvulsant treatment.
Anticonvulsants* ; Central Nervous System ; Child ; Chungcheongnam-do ; Copper* ; Epilepsy ; Homeostasis ; Humans ; Valproic Acid ; Zinc*