The purpose of this study was to identify the effect of social support revealed in the time duration of sick role behavior compliance on the patients with hypertension using Quasi- experimental research design. Data collection was made through the interview survey technique from the hypertensive patients who received social support intervention (experimental group, n=41) and from those who were not exposed to the intervention(control group, n= 34). The subjects were registered in the cardiovascular outpatient clinic at the Chonnam National University Hospital from June 3, 1996 to November 30, 1997. X2-test or t- test, Repeated measures ANOVA were utilized in the data analysis. The results were as follows: 1. The effect of social support intervention on sick role behavior compliance was significant in 1 month(F=69.17, p=.000), 6 months (F=11.51, p=.001), and 12 months(F=.07, p=.789) and between two groups(1 month; F=153.70, p=.000, 6 months; F=13.94, p=.000, 12 months; F=6.72, p= .011). 2. The effect of social support intervention on blood pressure was not significant through all the periods of time (F=1.21, p=.274) between the two groups(F=.12, p=.732). In conclusion, it was showed that social support had an effect on sick role behavior compliance and the effect of social support continued for twelve months(F= 10.03, p=.002) However, the score of compliance tends to decrease after 6 months of intervention. Therefore, this study indicated that social support re-intervention would be needed between six and twelve months.
Ambulatory Care Facilities ; Blood Pressure ; Compliance ; Data Collection ; Humans ; Hypertension* ; Jeollanam-do ; Research Design ; Sick Role ; Statistics as Topic

BACKGROUND: Diagnosis of AMI in the patients presenting with chest pain of an atypical nature or with a nondiagnostic ECG requires the evaluation of certain biochemical markers. Biochemical markers most often used for the early detection of myocardial damage are CK-MBact, troponin, and myoglobin. The clinical value of measuring serum myoglobin was compared to that of troponin and CK-MBact in the patient with acute chest pain syndrome. METHOD: We studied timed, sequential measurements of serum myoglobin, CK-MBact and troponin-T obtained from 72 patients who were admitted for the evaluation of suspected AMI within 12 hours after the chest pain onset. Patients with a history of recent trauma, cardiogenic shock, renal failure, or who had received recent cardiopulmonary resuscitation were excluded. We calculated the sensitivity, specificity, negative predictive value, and positive predictive value. Data were analyzed with the Chi-square test for differences in proportion. A value of p<0.05 was considered statistically significant. RESULT: 1) The mean time from symptom onset to arrival at the emergency department was 3.5+/-0.6 hours. 2) There were no statistical differences in age, sex and risk factors between AMI, angina pectoris and atypical chest pain group. 3) The negative predictive value of myoglobin was significantly higher than those of CK-MBact and troponin-T from 3 to 6 hours after the onset of chest pain. 4) The time to peak of myoglobin level was shorter than those of CK-MBact and troponin-T in AMI patients. CONCLUSION: Within 3 to 6 hours after the onset of symptoms, myoglobin is a better marker than CK-MBact or troponin-T in ruling out AMI for the patient with acute chest pain syndrome.
Angina Pectoris ; Biomarkers* ; Cardiopulmonary Resuscitation ; Chest Pain ; Diagnosis ; Electrocardiography ; Emergency Service, Hospital ; Humans ; Myocardial Infarction* ; Myoglobin* ; Renal Insufficiency ; Risk Factors ; Sensitivity and Specificity ; Shock, Cardiogenic ; Troponin ; Troponin T

This study was done using a Quasi-experimental research design to determine the effects of social support on compliance with sick role behavior in hypertensive patients and to know if the effect of the social support on compliance lasted for at least 6 months. The subjects consisted of 81 hypertensive patients who were registered in the Cardio-Vascular OPD at Chonnam National University Hospital. They were divided by random sampling into 42 people for the experimental group and 39 for the control group. Data were gathered from June 3, 1996 to June 10, 1997 through individual interviews using a structured questionnaire. The results of the study were summarized as follows : 1. Compliance with sick role behaviors in hypertensive clients was significantly increased in the experimental group who received social support from the nurse as compared to the control group who did not receive social support(t=15.99, p<.001). 2. The effect of social support on compliance with sick role behaviors in hypertensive clients lasted for 6 months(t=7.99, p<.001). 3. Four of six people stopped smoking in experimental group after the intervention of social support, but none of the five in control group were able to stop smoking. Fisher's Exact test showed a significant difference between the experimental and control group(x2=4.385, p<.05). Mantel Haenszel test showed that the effect of social support on stopping smoking in the experimental group lasted for six months because there were no significant differences between one month after the social support and six months after, in the number of subjects who stopped smoking(x2=1.154, p>.05). Finally, social support was effective on compliance with sick role behaviors and stopping smoking in the hypertensive clients, and the effect of social support on compliance lasted for 6 months.
Compliance* ; Humans ; Jeollanam-do ; Surveys and Questionnaires ; Research Design ; Sick Role* ; Smoke ; Smoking

Transarterial chemoembolization (TACE) is an effective treatment for unresectable hepatocellular carcinoma (HCC). It is considered relatively safe. However, fatal complications such as pulmonary edema and liver abscesses can occur. Spinal infarction due to local embolism of the central nervous system after TACE is a very rare, but fatal complication. Here, we report a case of spinal cord infarction after TACE for ruptured HCC. Paraplegia occurred at the T10 sensory level 6 hours after the procedure. The patient received steroid megadose therapy but died 5 days later due to exacerbation of metabolic acidosis and blood loss. This case demonstrates the need for a comprehensive and extensive study of arterial blood flow prior to angiography.

Objective: Subdural hygroma (SDG) is a complication of traumatic brain injury (TBI). In particular, the outcome and outpatient treatment period may vary depending on the occurrence of SDG. However, the pathogenesis of SDG has not been fully elucidated. Therefore, this study aimed to identify the risk factors associated with the occurrence of SDG after mild TBI. Methods: We retrospectively analyzed 250 patients with mild TBI admitted to a single institution between January 2021 and December 2021. The SDG occurrence and control groups were analyzed according to the risk factors of SDG, such as age, history, initial computed tomography (CT) findings, and initial laboratory findings. Results: The overall occurrence rate of SDG was 31.6% (n=79). A statistically significant association was found between preoperative diagnoses and the occurrence of SDG, such as subarachnoid hemorrhage (odds ratio [OR], 2.36; 95% confidence interval [CI], 1.26–4.39) and basal skull fracture (OR, 0.32; 95% CI, 0.12–0.83). Additionally, age ≥70 years (OR, 3.20; 95% CI, 1.74–5.87) and the use of tranexamic acid (OR, 2.12; 95% CI, 1.05–4.54) were statistically significant factors. The prognostic evaluation of patients using the Glasgow Outcome Scale (GOS) did not show any statistical differences between patients with and without SDG. Conclusion SDG was not associated with the prognosis of patients assessed using the GOS. However, depending on the occurrence of SDG, differences in patient symptoms may occur after mild TBI. Therefore, the early evaluation of patients with mild TBI and determination of the probability of developing SDG are important.

PURPOSE: We conducted this research to make an earlier diagnosis and identify better treatment for Kikuchi-Fujimoto disease (KFD) by comparing clinical findings with nonspecifically enlarged cervical lymph nodes in children. METHODS: Nineteen patients were diagnosed with KFD by tissue pathology from a fine needle aspiration biopsy and/or excisional biopsy and were compared with the clinical, radiological, and pathological findings of reactive hyperplasia. RESULTS: The average onset age of onset for patients with KFD was 11.8+/-3.61 years, and the male to female ratio was 1:1.1, whereas patients with reactive hyperplasia were 11.8+/-5.96 years, and the male to female ratio was 1.7:1. Patients with KFD suffered more from fever than patients with reactive hyperplasia (68% vs. 13%, P=0.002). Patients with KFD showed perinodal infiltration (P=0.001) and necrosis on computed tomography, whereas patients with reactive hyperplasia did not show any of these findings. Ultrasonographic findings were similar between the two study groups. In contrast, the histopathological examinations of biopsied cervical lymph nodes were enormously helpful for distinguishing the findings of KFD from those of patients with reactive hyperplasia. CONCLUSION: We recommend a histopathological examination to distinguish KFD from reactive hyperplasia in children with significantly enlarged cervical lymph nodes.
Age of Onset ; Biopsy ; Biopsy, Fine-Needle ; Child ; Discrimination (Psychology) ; Female ; Fever ; Histiocytic Necrotizing Lymphadenitis ; Humans ; Hyperplasia ; Lymph Nodes ; Lymphadenitis ; Male ; Necrosis

Objective: This study investigated the change in the number of patients with head trauma according to the trauma mechanism among severely injured patients transferred to the emergency department of Wonju Severance Christian Hospital before and during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Medical records (sex, age, diagnosis, trauma mechanism, and injury severity score) of patients referred to the emergency room between January 2018 and December 2019 and January 2020 and December 2021 were retrospectively reviewed, verified, and compared. Results: Between 2020 and 2021, the number of patients with traumatic brain injury decreased by 251 (32%). No significant differences were observed in sex, age, or time of accident. From 2020 to 2021, among the trauma mechanisms, the number of cases involving rolling down slightly reduced compared with those involving other mechanisms.Furthermore, cerebral contusions among intracranial lesions significantly increased during the COVID-19 pandemic. Conclusion Partial restrictions on social activities owing to COVID-19 are ongoing. Further investigation of the clinical characteristics of trauma patients over a longer period is required.

Primary retroperitoneal mucinous cystadenocarcinoma is a rare tumor. Only about 30 such cases have been reported in the worldwide literature, and a few Korean cases have been reported. The pathogenesis is not clear, and coelomic metaplasia of the retroperitoneal mesothelium has gained wide support. There is no consensus on the appropriate treatment, but surgical exploration is needed for the diagnosis and treatment, and adjuvant chemotherapy may be recommended following complete surgical excision. The long-term prognosis has not been established. We report here on a 32-year-old woman who was diagnosed as having a retroperitoneal mucinous cystadenocarcinoma with mural nodules of sarcomatoid change. Tumor excision and adjuvant chemotherapy were done and the patient is doing well without any evidence of recurrence at 42 months postoperatively.
Adult ; Cystadenocarcinoma, Mucinous/*diagnosis/pathology/surgery ; Female ; Humans ; Retroperitoneal Neoplasms/*diagnosis/pathology/surgery

Malignant eccrine poroma is a rare skin appendage tumor, originating from the intraepidermal and upper dermal eccrine ducts. It is a locally aggressive neoplasm with a high propensity to metastasize. A 47-year-old woman was admitted to the hospital because of dyspnea. One and half years before admission, she had been diagnosed porocarcinoma of left sole and treated with wide local excision. One months after excision, examination had revealed an inguinal lymph node metastasis and she had been treated with lymph node resection and radiotherapy. During the two weeks before admission, the patient had increasing exertional dyspnea, which was accompanied by Rt-sided chest wall pain. On admission right pleural effusion and multiple nodular densities were noted at initial chest radiograph. A computed tomographic (CT) scan of the chest showed lymphatic and hematogenous lung metastasis with pleural seeding of unknown primary tumor. Fine-needle aspiration biopsy of the pleura revealed typical cytologic findings of porocarcinoma. She was treated with therapeutic thoracentesis and pleurodesis with bleomycin. Because porocarcinoma is resistant to chemotherapy and radiotherapy, she has been treated with conservative treatment.
Biopsy, Fine-Needle ; Bleomycin ; Drug Therapy ; Dyspnea ; Eccrine Porocarcinoma* ; Female ; Humans ; Lung* ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis* ; Neoplasms, Unknown Primary ; Pleura ; Pleural Effusion ; Pleurodesis ; Radiography, Thoracic ; Radiotherapy ; Skin ; Thoracic Wall ; Thorax

Fox transcription factors play a critical role in the regulation of a variety of biological processes. While FoxM1 behaves like the oncogenic transcription factor, FoxO3a is known as a tumor suppressor by inhibiting FoxM1. This study aimed to investigate the clinicopathological significance of FoxM1 and FoxO3a expression in breast cancer. Expression of FoxM1 and FoxO3a were analyzed by immunohistochemical staining on tissue microarray sections from 236 breast cancer patients, and correlated with various clinicopathological characteristics. Overexpression of FoxM1 correlated with adverse clinicopathological features, such as larger tumor size, lymph node metastasis, advanced tumor stage, and lymphovascular invasion. The Kaplan-Meier survival curves revealed no prognostic significance of FoxM1 expression. However, in subgroup analyses with patients of estrogen receptor (ER) positive breast cancers, FoxM1 overexpression associated with poor disease free and overall survival. No association was found between FoxO3a and FoxM1 expression. Regarding clinicopathological variables, the only association between histologic grade and FoxO3a was observed. In conclusion, FoxM1 overexpression was significantly associated with aggressive phenotypes and poor prognosis of ER-positive breast cancer. These findings suggest the possible role of FoxM1 as a prognostic biomarker and putative target of anti-cancer therapy.
Breast Neoplasms/chemistry/mortality/*pathology ; Female ; Forkhead Transcription Factors/*analysis ; Humans ; Phenotype ; Prognosis ; Receptor, ErbB-2/analysis ; Receptors, Estrogen/*analysis