PURPOSE: The purpose of this study was to identify motivational factors that may influence health behaviors of patients with coronary artery disease. METHODS: Structured questionnaires were used with a convenience sample of 164 subjects who were discharged from the hospital. The subjects were recruited for an interview at outpatient clinic in hospitals. The tools for the study were the motivational factors and health behaviors measure for the Elderly with cardiovascular disease. The data were analyzed using frequency, t-test, ANOVA, sheffe, Pearson correlation coefficient and stepwise multiple regressions. RESULTS: There were significant correlations between motivational factors and health behaviors, ranging from r=.192 to .692. Stepwise multiple regression analyses indicated that 51% of variance in health behaviors was explained by self-efficacy and perceived benefits among four motivational factors(F=34.988, p<.01). Self-efficacy contributed the greatest amount of variance in health behaviors(beta=.467), followed by perceived benefits(beta=.235). CONCLUSIONS: The results of the study indicate that motivation, especially self-efficacy, was very important in predicting health behaviors of patients with coronary artery disease. Thus it would be necessary to include motivational factors in designing rehabilitation program for people with coronary artery disease.
Aged ; Ambulatory Care Facilities ; Cardiovascular Diseases ; Coronary Artery Disease* ; Coronary Vessels* ; Health Behavior* ; Humans ; Motivation ; Surveys and Questionnaires ; Rehabilitation

In this paper, we examined the depression of stroke patient's caregivers and analyzed influencing factors of the depression. The subjects were 215 caregivers who have takencare of stroke survivors in their home. The conceptual model of this study consisted of the caregiver's depression, perceived burden, illness intrusiveness, and patient's ADL. Modified Korean CES-D, modified subjective and objective Burden Scale, Illness intrusiveness(II), and Instrumental Activity of Daily Living(IADL) were used to measure concepts. Path analysis was used to test the model of this study. The results were as follows: 1. The mean depression score was 11.6 which was below the cut-off score of the CES-D. This score indicates that the subjects were higher than normal adults' mean score but not depressive. Eighty-six out of 215 caregivers(40%) were above the cut-off score. This finding was different from previous research results, and the reason might be the patients' capability of ADL. In a group of low capability patient's activities of daily living, caregiver's depression score was 15.5. 2. Caregiver's depression was positively related to caregiver's burden and illness intrusiveness, but negatively related to patient's activities of daily living. 3. The caregiver's perceived burden and illness intrusiveness directly influenced on their depression. Furthermore, the and caregiver's illness intrusiveness led to depression indirectly through their burden. A patient's activities of daily living didn't influence directly on depression but indirectly through caregiver's illness intrusiveness and burden.
Activities of Daily Living ; Caregivers* ; Depression* ; Humans ; Stroke* ; Survivors

Predicting factors of post-stroke depression were investigated. The subjects were 254 stroke patients who had been discharged and visited regularly the outpatient clinic for follow up care. The influencing factors were classified into five categories: demographic, disease-related, current state, social support, and illness intrusiveness. Sex, age, job, and educational level were defined as the demographic factor. The disease-related factors included stroke type, illness duration, attack frequency, and NIH score. ADL, cognitive function, and social activity were considered as the current state factors. The social support was measured as the perceived amount of social support. Illness intrusiveness means the perceived illness induced life style disruptions. Demographic, disease-related, current state, and social support were hypothesized to directly and indirectly affect post-stroke depression through illness intrusiveness. The illness intrusiveness was hypothesized to directly affect post-stroke depression. The hierarchial multiple regression was used to identify significant factors. The result showed that this model explained 43.3% of variance of post-stroke depression. And the prevalence of post-stroke depression was 38.8%. Among the demographic factors, job was identified as a main contributor to indirectly increase the post-stroke depression. Among the disease-related factors, stroke type, attack frequency, and NIH score were found to indirectly affect the post-stroke depression. Among the current state factors, ADL and social activity indirectly affected the post-stroke depression through illness intrusiveness. Social support and illness intrusiveness were identified to directly affect the post-stroke depression. This study has proved the factors likely to be implicated in the development of post-stroke depression. Based upon these results, it is recommended that the nurses who take care of post-stroke patients consider the risk factors such as social support, illness intrusiveness et al. Also programs which decrease the illness intrusiveness and increase the social support to reduce post-stoke depression recommended to be developed.
Activities of Daily Living ; Ambulatory Care Facilities ; Demography ; Depression* ; Follow-Up Studies ; Humans ; Life Style ; Prevalence ; Risk Factors ; Stroke

Behcet's syndrome has been known as a disease which has the triple symptoms such as recurrent orogenital ulceration and eye inflammation. The syndrome is now recogninized as a multisystem disease involving mucocutaneaous, cardiovascular, central nervous system, renal, articular and gastrointestinal system. The vascular involvement in Behcet's disease has been reported since Mischima first described the case in 1961, four types of vascular lesion are recognized ; arterial occlusion ; aneurysm ; venous occlusion ; and varices. Venous occlusion are frequently observed, most commonly in the inferior or superior vena cava. We report a case of Behcet's disease manifested as superior vena cava syndrome due to thrombus on both brachiocephalic veins.
Aneurysm ; Behcet Syndrome* ; Brachiocephalic Veins ; Central Nervous System ; Inflammation ; Superior Vena Cava Syndrome* ; Thrombosis ; Ulcer ; Varicose Veins ; Vena Cava, Superior*

Midgut volvulus secondary to intestinal malrotation usually presents within the first month of life. Diagnostic delay may result in midgut infarction and mortality. In this retrospective study, we review seventeen cases of midgut volvulus to assess the importance of early recognition for midgut volvulus in pediatric patients of any age.. These patients were diagnosed as having a midgut volvulus by operation at Ewha Womans University Hospital. Eleven patients (64.7 %) were less than 1 month of age, and fifteen were boys (88.2 %). The mean gestational age was 38.3 weeks and the birth weight was 3.1 kg. Eight patients (47.1 %) had one or more combined anomalies such as heart malformation, brain ischemia, Down's syndrome or duodenal atresia. Vomiting was the most common symptom. Only thirteen patients underwent preoperative diagnostic procedures; 13 abdominal sonography demonstrated the whirlpool sign in 8 patients, upper gastrointestinal tract roentgenography showed a cork-screw pattern in 7 patients, and barium enema or small bowel series demonstrated positive findings in 7 patients. A Ladd's procedure was was formed on all patients.. There was no mortality or severe morbidity such as short bowel syndrome. Midgut volvulus should be included in the differential diagnosis in any infant or child who presents with the symptoms of acute abdomen, especially with vomiting.
Abdomen, Acute ; Barium ; Birth Weight ; Brain Ischemia ; Child* ; Diagnosis, Differential ; Down Syndrome ; Enema ; Female ; Gestational Age ; Heart ; Humans ; Infant ; Infarction ; Intestinal Volvulus* ; Mortality ; Radiography ; Retrospective Studies ; Short Bowel Syndrome ; Upper Gastrointestinal Tract ; Vomiting

BACKGROUND: Laparoscopic cholecystectomy has substituted open cholecystectomy for cholelithiasis during the last decades. In the past, biliary surgeons have performed the intraoperative bile culture during open cholecystectomy and have used the culture results as a guideline of postoperative antibiotic therapy. The prophylactic antibiotic treatment for cholecystectomy have been needed in the elderly population and the high risk patients, but the effect of antibiotics in laparoscopic cholecystectomy has not been confirmed. The authors performed bile culture during laparoscopic cholecystectomies to evaluate the relationship between the bile culture results and the postoperative infectious complications. METHODS: We analyzed the 57 patients who had undergone laparoscopic cholecystectomy, 53 for cholelithiasis, 4 for gallbladder polyp and an intraoperative bile culture for 6 months period. RESULTS: Positive culture results were found in 12 cholelithiasis patients (22.6%). The most common pathogen was E.coli (8.8%), enterococcus (7.0%); others were Pseudomonas, Strenotrophomonas maltophilia, Klebsiela, ect. The results of the bile culture in 4 patients with gallbladder polyps were negative. Nine patients had severe inflammation of gallbladder and four of them had positive culture results. Risk factors, such as old age and hyperbilirubinemia were significant variables. CONCLUSIONS: Intraoperative bile culture is an easy and simple procedure in a laparoscopic cholecystectomy and offers much informations to the surgeon about biliary bacteriology and postoperative management. The rate of wound infection is very low in laparoscopic cholecystectomy and the necessity of prophylactic antibiotics in laparoscopic cholecystectomy is less than it is in open surgery. Prophylactic antibiotics during laparoscopic cholecystectomy should be reserved for only high-risk patients.
Aged ; Anti-Bacterial Agents ; Bacteriology ; Bile* ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Cholelithiasis ; Enterococcus ; Gallbladder ; Humans ; Hyperbilirubinemia ; Inflammation ; Polyps ; Pseudomonas ; Risk Factors ; Wound Infection

PURPOSE: Hepatoprotective effect of prostaglandin E1 (PGE1) has been verified in numerous animal experiments but not so apparent in clinical trials. Although the reason for this discrepancy in clinical results is still unknown, one possible explanation is the instability of PGE1. In this study, the hepatoprotective effect of lipo-PGE1, which is known to be stable during pulmonary circulation and have more targeting effect, was investigated in canine partial liver allotansplantation. In order to reckon in the possible injury during harvest of partial liver, lipo-PGE1 was infused from the start of living graft harvest procedure. METHODS: Mongrel dogs weighing about 25 kg were divided into control (n=6) and lipo-PGE1 (n=6) group. Partial liver allotransplantation was performed. In lipo-PGE1 group, lipo-PGE1 was slowly infused through splenic venous cannulation during the donor liver harvesting procedure (50 mg) and continuously infused (60 mg/day) for 48 hrs after reperfusion. The aspartate aminotransferase (AST), alkaline phosphatase (ALP), and lactate dehydrogenase (LDH) were monitored. RESULTS: The AST and ALP levels of the lipo-PGE1 group were significantly lower than that of the control group at both 1 hour and 48 hours after reperfusion. The LDH level in lipo-PGE1 group was lower at 1 hour and 48 hours after reperfusion, but no significant differences were shown between two groups. CONCLUSION: This study demonstrated the hepatoprotective effect of the lipo-PGE1 against ischemia-reperfusion injury in canine partial liver allotransplantation.
Alkaline Phosphatase ; Allografts* ; Alprostadil* ; Animal Experimentation ; Animals ; Aspartate Aminotransferases ; Catheterization ; Dogs ; Humans ; L-Lactate Dehydrogenase ; Liver Transplantation ; Liver* ; Pulmonary Circulation ; Reperfusion ; Reperfusion Injury ; Tissue Donors ; Transplants

PURPOSE: This study investigated interleukin (IL)-17-secreting cell involvement in sterile inflammation, and evaluated the effect of mesenchymal stem cells (MSCs) on IL-17-secreting cell immunologic profiling. METHODS: Twenty mice were sacrificed at time points of 6 hours, 1 day, 1 week, and 3 weeks (each group, n = 5) after the cornea was chemically injured with 0.5N NaOH; IL-17 changes in the cornea were evaluated using enzyme-linked immunosorbent assay. Further, IL-17 secreting cells were assessed in the cervical lymph nodes by a flow cytometer. Rat MSCs were applied intraperitoneally in a burn model (n = 10), IL-17-secreting T helper 17 (Th17) cell and non-Th17 cell changes were checked using a flow cytometer in both cornea and cervical lymph nodes at 1week, and compared with those in the positive control (n = 10). RESULTS: IL-17 was highest in the cornea at 1 week, while, in the cervical lymph nodes, IL-17-secreting cells showed early increase at 6 hours, and maintained the increase through 1 day to 1 week, and levels returned to the basal level at 3 weeks. Specifically, the non-Th17 cells secreted IL-17 earlier than the Th17 cells. When the MSCs were applied, IL-17 secretion was reduced in CD3(+)CD4(-)CD8(-), CD3(+)CD4(+)CD8(-), and CD3(+) CD4(-)CD8(+) cells of the cervical lymph nodes by 53.7%, 43.8%, and 50.8%, respectively. However, in the cornea, IL-17 secretion of CD3(+)CD4(-)CD8(-) cells was completely blocked. CONCLUSIONS: The results indicated that both IL-17-secreting non-Th17 and Th17 cells were involved in the chemical burn model, and MSCs appeared to mainly modulate non-Th17 cells and also partially suppress the Th17 cells.
Animals ; Burns, Chemical/*immunology/metabolism/pathology ; Cells, Cultured ; Disease Models, Animal ; Enzyme-Linked Immunosorbent Assay ; Eye Burns/*immunology/metabolism/pathology ; Flow Cytometry ; *Immunity, Cellular ; Interleukin-17/*secretion ; Male ; Mesenchymal Stromal Cells/immunology/pathology/*secretion ; Mice ; Mice, Inbred C57BL

No abstract available.
Child ; Choledochal Cyst ; Humans

PURPOSE: The excision of breast lesion with using ultrasound-guided Mammotome(R) is currently used for both the treatment and diagnosis of benign lesions. However sonographic evidence for tumor removal by Mammotome(R) excision does not confirm histological clearance of the resection margin. The purpose of this study was to evaluate the efficacy of ultrasound-guided Mammotome(R) for the removal of fibroadenomas by performing histological examination of an additional margin biopsy. METHOD: From March 2003 to May 2005, percutaneous removals of fibroadenoma with using ultrasono-guided Mammotome(R) biopsy were performed for 167 fibroadenomas in 154 women. Margin biopsies were additionally done after complete excision was achieved via ultrasonography. Histological evaluation was performed for these specimens. The patients were scheduled for follow-up ultrasound examination at 6 months. RESULTS: The mean tumor diameter was 1.32+/-0.54 cm. 45 (26.9%) lesions of the 167 lesions showed histological remained fibroadenoma on margin biopsies. The risk factors for remnant lesions were the age of a patient and the size of a lesion. No further ultrasonographic evidence of tumors was noted for 96.9% of the lesions at 6 months CONCLUSION: Although the breast fibroadenoma is a common benign breast tumor, the treatment and follow-up for these lesions is still debatable. We suggest that excision of breast lesion using ultrasound-guided Mammotome(R) can be used as minimally invasive surgery for fibroadenoma. If a lesion is larger than 2cm in a young woman, the physician should be careful to achieve enough excision for a complete removal of tumor.
Biopsy ; Breast Neoplasms ; Breast* ; Diagnosis ; Female ; Fibroadenoma* ; Follow-Up Studies ; Humans ; Risk Factors ; Surgical Procedures, Minimally Invasive ; Ultrasonography