This study was conducted to evaluate the effect of prolonged treatment in children with chronic hepatitis B with combination of alpha-interferon and acyclovir. The study population consisted of 7 patients with chronic hepatitis B who showed histological findings compatible with chronic active hepatitis (4 cases) or chronic persistent hepatitis (3 cases) on liver biopsy and had elevated AST and ALT with positive HBsAg, HBeAg and HBV-DNA for more than 6 months. Recombinant interferon-alpha-2 was given in a dose of 3 million IU/m2 daily for 3 months with acyclovir in a dose of 15mg/Kg of body weight every 12 hours for 7 days of each month for 3 months. Then, the same dose of interferon was given thrice a week for 9 more months. One patient who had vertically transmitted hepatitis B from her mother had received only 6 months of treatment in total as she did not show any effect after 6 months of treatment. Among 6 patients who had positive HBV-DNA on entry to the study, 4 patients (66.7%) showed conversion of HBV-DNA to negative. HBeAg was converted to negative in 3 patients (42.9%). AST and ALT became normal in 6 cases but HBsAg remained positive in all cases. prolonged treatment in children with chronic hepatitis B with combination of alpha interferon and acyclovir seems to be beneficial but the proper dosage and duration of therapy need to be determined with further and controlled study.
Acyclovir* ; Biopsy ; Body Weight ; Child* ; Hepatitis B ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Interferon-alpha* ; Interferons ; Liver ; Mothers

No abstract available.
Arthrogryposis* ; Humans ; Siblings*

PURPOSE: This study was done to evaluate validity and reliability of the Korean version of the expanded nursing stress scale (ENSS). METHODS: Forward-backward translation of ENSS from English to Korean was conducted. The translated instrument was pilot-tested and administrated to 285 nurses who worked in five general hospitals in Korea. Internal consistency reliability was assessed using Cronbach's alpha and composite reliability. Validity was evaluated through construct validity with confirmatory factor analysis, convergent and discriminant validity. RESULTS: The Korean version of ENSS showed a reliable internal consistency with Cronbach's alpha .95 and composite reliability .99. Model fit indexes for 46 items were validated by confirmatory factor analysis(goodness of fit index .82, Tucker-Lewis index .92, root mean square error of approximation .04), indicating suitable construct validity. Factor loading of the 48 items (.47~.88) and average variance extracted out of nine factors (.52~.71.) indicated satisfactory convergent validity. Some values of square of the correlation coefficient between factors (.12~.89) were higher than average variance extracted values of each factor (.52~.71) so that it partly satisfied discriminant validity. CONCLUSION: Findings show that the Korean version ENSS has good reliability and suitable validity; therefore, can be used to assess and identify Korean nurses' job stress.
Factor Analysis, Statistical ; Hospitals, General ; Korea ; Nursing* ; Reproducibility of Results* ; Stress, Psychological ; Translations

BACKGROUND: Because systolic and diastolic dysfunction frequently coexist in acute myocardial infarction(AMI), we hypothesize that a combined measure of ventricular performance using Doppler echocardiography may be more sensitive and time-saving diagnostic tool for the evaluation of patients presenting with cardiogenic chest pain. METHOD AND RESULTS: Seventy-one patients with AMI (47 male, 59+/-11 years) and 45 patients with normal coronary artery (29 male, 52+/-11 years) were included in the study for measurement of cardiac performance index and established parameters of ventricular function using conventional echo-Doppler methods. a new derived index of cardiac performance: (ICT+IRT)/ET, was obtained by subtracting ejection time(ET) from the interval between cessation and onset of the mitral inflow velocity to give the sum of isovolumic contraction time(ICT) and isovolumic relaxation time(IRT). The mean value of the index was significantly different between normal and AMI(p<0.01). The degree of inter-group overlap was smaller for the index compared to other parameters. within functional groups, the value of the index did not appear to be related to heart rate, mean arterial pressure and the degree of mitral regurgitation. CONCLUSION: cardiac performance index is a conceptually new, simple and reproducible Doppler index of combined systolic and diastolic myocardial performance, and it is useful as screening test for patients with cardiac dysfunction due to AMI.
Arterial Pressure ; Chest Pain ; Coronary Vessels ; Echocardiography, Doppler ; Heart Rate ; Humans ; Male ; Mass Screening* ; Mitral Valve Insufficiency ; Myocardial Infarction* ; Relaxation ; Ventricular Function

No abstract available.
Intestinal Obstruction*

Erythr odysesthesia syndrome is a. peculiar toxic reaction due to anti-cancer drug. lt is characterized by a painful, purple-colored patch on the palms and soles, and may form bullae. We report a case of erythrodysesthesia syndrome in a 46-year-old woman. 5-FU and leucovorin were administered for 5 days because of her colon cancer. Two weeks after anti-cancer therapy, purple-colored erosive patch appeared on the face, and 10 days later, purple-colored vesicular patches were seen on both palms and soles, accompanied with pain. Histopathologic examination reveals a severe epidermal necrosis. Individual keratinocyte shows cytologic atypia and apoptotic body.
Colonic Neoplasms ; Female ; Fluorouracil* ; Humans ; Keratinocytes ; Leucovorin ; Middle Aged ; Necrosis

PURPOSE: Recent studies suggest that the symptomatic improvement in benign prostatic hyperplasia significantly related with transition zone volume (TZV). The purpose of this study was to determine the clinical significance of TZV and transition zone index (TZI) in changes of prostate volume (PV) and clinical parameters following finasteride therapy. MATERIALS AND METHODS: 140 patients over 50 years of age with symptomatic benign prostatic hyperplasia were treated with finasteride (5mg/d) for 12 months and underwent transrectal ultrasound evaluation of PV and TZV prior to initiating therapy and after 12 months. Patients were grouped according to the results of PV (> OR =40ml or <40ml), TZI (> OR =0.45 or <0.45) and PSA level (> OR =2.5 or <2.5). The responders was determined as improvement in peak flow rate more than 3mL/sec. RESULTS: PV decreased by 14.11% in patients with TZI less than 0.45, while the decrease was 19.25% for men with TZI greater than 0.45 (p<0.01). In addition, PV was significantly decreased by 16.72% in patients with PV less than 40cc and TZI greater than 0.45 (p<0.01). PV decreased by 17.37% in patients with PSA less than 2.5, while the decrease was 18.92% in men with PSA greater than 2.5. In responders, only TZI was significantly different among PSA, PV and TZI (p<0.05). CONCLUSIONS: Treatment effect of finasteride on symptomatic benign prostatic hyperplasia patients was increased in proportion to enlarged PV, increased TZI, increased PSA. TZI was a useful proxy for predicting clinical outcomes in initiating finasteride therapy on benign prostatic hyperplasia.
Finasteride* ; Humans ; Male ; Prostate ; Prostatic Hyperplasia* ; Proxy ; Ultrasonography

Introduction: Several investigators demonstrated that routine nasogastric decompression after abdominal surgery was unnecessary and can be safely eliminated. Some authors suggested that early feeding could be tolerated by the majority of patients after elective colorectal surgery. PURPOSE: The aim of our study was to prospectively assess the safety and tolerability of early oral feeding after colorectal surgery. METHODS: This trial included 69 patients who underwent an colon or rectal operation between April 1997 and August 1998. Patients were randomized after the operative procedure into one of two groups. Group 1: early oral feeding-all patents received a clear liquid diet on the first postoperative day followed by a regular diet as tolerated. Group 2: delayed feeding-all patients were treated in the traditional way with feeding only after the resolution of their postoperative ileus. Both groups had intraoperative nasogastric tubes that were removed at the end of surgery. The patients were monitored for vomiting, nasogastric tube reinsertion, time of regular diet consumption, complication, and length of hospitalization. The nasogastric tube was reinserted if two or more episodes of vomiting of more than 100 ml occurred in the absence of bowel movement. RESULTS: Sixty-nine consecutive patients were studied, 34 patients in group 1 (12 males and 22 females, mean age 58.1+/-12.7), and 35 patients in group 2 (16 males and 19 females, mean age 58.5+/-12.7). Significant differences were not noted in age and type of procedures. No significant differences were seen in rates of vomiting and overall complications. However, early feeding group well tolerated a regular diet (postoperative period to take regular diet of group 1: 5.4+/-4.0 days, group 2 : 8.1+/-4.6 days, p=0.013), and were discharged from hospital significantly earlier than the delayed feeding group(group 1: 14.0+/-5.1 days, group 2: 19.1+/-8.6 days, p=0.004). CONCLUSION: Early feeding after colorectal surgery is successfully tolerated by the majority of patients and led to earlier hospital discharge.
Colon ; Colorectal Surgery* ; Decompression ; Diet ; Female ; Hospitalization ; Humans ; Ileus ; Male ; Prospective Studies ; Research Personnel ; Surgical Procedures, Operative ; Vomiting

Hantavirus is a genus of the Bunyaviridae family consisting following serotype groups: Hantaan, Seoul, Puumala, Prospect Hill, Thailand, Belgrade, Thotta palayam, Sin Hombre. Most of Hantavirus group have been associated with many clinically similar disease known collectively as hemorrhagic fever with renal syndrome (HFRS). Hantaan virus is the prototype of the genus hantavirus, originally isolated from Apodemus agrarius. Bat was found as a natural host for Hantaan virus in Lee's lab for the first time. Then, Hantaan-like virus was isolated Hantaan-like virus from bat. To identify hantaviruses that are present in Korea among bats, bats were collected from Jeong-Sun, Won-Joo, Chung-Ju and Hwa-Cheon area, RNA was isolated from lung and serum. RT-PCR was performed with a universal primer from M segment. Nested RT-PCR was carried out to differentiate Hantaan, Seoul and Puumala virus using serotype specific primers. As we expected, Hantaan viruses were detected in bats and Seoul virus was not detected. Interestingly, Puumala viruses were also detected in bats from won-Ju, but not in other areas. Puumala virus is originally isolated from Clethrinomys glareolus, and cause light HFRS. Recently, Paradoxomis webbiana, a wild bird turn out to be a reservoir for Puumala virus in Korea. These data indicate that bat is a new natural reservoir of Puumala virus.
Animals ; Birds ; Bunyaviridae ; Chiroptera* ; Chungcheongbuk-do ; Gangwon-do ; Hantaan virus* ; Hantavirus ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Korea* ; Lung ; Murinae ; Puumala virus ; RNA ; Seoul ; Seoul virus ; Thailand

PURPOSE: The purpose of this study was to understand the meaning of experiences in home visiting nursing service among the elderly in community provided by nursing students. METHOD: This is a phenomenological study to investigate the experience of community-based patients. Data were collected through in-depth interviews from the 4th of March to the 15th of December 2003. Individual interviews were conducted with 8 patients on subjective experiences. Data were analyzed through Colaizzi's method, in which meaningful statements were extracted. RESULT: Four categories were identified from nine theme clusters. The four categories were 'thankfulness', 'dependence', 'sorrowfulness' and 'the sense of being'. CONCLUSION: These results show the importance of visiting nursing service for the elderly in community.
Aged* ; House Calls* ; Humans ; Life Change Events ; Nursing Services* ; Qualitative Research ; Students, Nursing