No abstract available.
Glycemic Index ; Humans

No abstract available.
Autopsy* ; Hydrops Fetalis*

PURPOSE: The purpose of this survey was to investigate clinical nurses' understanding of delirium and their educational need of delirious patient care. METHOD: A survey questionnaire regarding nurses' general perception and understanding of delirium, experience with delirious patients and educational need was developed and conducted with 179 clinical nurses in a university hospital in Seoul. Data was analyzed using descriptive statistics. RESULTS: Nurses thought that delirium was one of the most important nursing problems and they considered it to be more treatable than to be preventable. However, the majority of nurses were not confident in caring for delirious patients. Nurses reported that delirium happened most often after surgery, and that possible contributing factors could be changes in physical environment and anxiety/stress, as well as medication and long-term isolation. Thirteen nursing interventions were identified but half of the nurses utilized only one or two of the thirteen. The most frequently used intervention was reorienting the patient followed by medication and emotional support, presenting family, and close observation. 99.5% of nurses addressed the importance of professional education on delirium care, especially in the area of intervention and management. CONCLUSION: The results support the strong need for development of a multi-component educational program on delirium care.
Adult ; Delirium/*nursing/psychology ; Female ; Hospitals, University ; Humans ; Male ; Models, Nursing ; Nursing Staff, Hospital/education/*psychology ; Program Evaluation ; Qualitative Research ; Questionnaires

BACKGROUND/AIMS: A self-report questionnaire is frequently used to measure symptoms reliably and to distinguish patients with functional gastrointestinal disorders (FGIDs) from those with other conditions. We produced and validated a cross-cultural adaptation of the Rome III questionnaire for diagnosis of FGIDs in Korea. METHODS: The Korean version of the Rome III (Rome III-K) questionnaire was developed through structural translational processes. Subsequently, reliability was measured by a test-retest procedure. Convergent validity was evaluated by comparing self-reported questionnaire data with the subsequent completion of the questionnaire by the physician based on an interview and with the clinical diagnosis. Concurrent validation using the validated Korean version of the Short Form-36 Health Survey (SF-36) was adopted to demonstrate discriminant validity. RESULTS: A total of 306 subjects were studied. Test-retest reliability was good, with a median Cronbach's alpha value of 0.83 (range, 0.71-0.97). The degree of agreement between patient-administered and physician-administered questionnaires to diagnose FGIDs was excellent; the kappa index was 0.949 for irritable bowel syndrome, 0.883 for functional dyspepsia and 0.927 for functional heartburn. The physician's clinical diagnosis of functional dyspepsia showed the most marked discrepancy with that based on the self-administered questionnaire. Almost all SF-36 domains were impaired in participants diagnosed with one of these FGIDs according to the Rome III-K. CONCLUSIONS: We developed the Rome III-K questionnaire though structural translational processes, and it revealed good test-retest reliability and satisfactory construct validity. These results suggest that this instrument will be useful for clinical and research assessments in the Korean population.
Dyspepsia ; Gastrointestinal Diseases* ; Health Surveys ; Heartburn ; Humans ; Irritable Bowel Syndrome ; Surveys and Questionnaires*

BACKGROUND: Elastic recoil contributes to the residual lumen reduction immediately after PTCA. We evaluated the factors to influence on immediate elastic recoil after the successful PTCA. METHODS: 88 patients(96 lesions) were studied by quantitative angiography. Angiograms were obtained in two identical near orthogonal projection before PTCA and immediately after the last balloon deflation. RESULTS: Immediately after PTCA, minimal luminal diameter increased from 0.7+/-0.6mm to 1.9+/-0.6mm and percent diameter stenosis was reduced from 77+/-20 to 34+/-21%. The calculated mean elastic recoil was 0.5+/-0.7mm in diameter and % elastic recoils were lesser both in calcified(3+/-23 vs 23+/-24%, p=0.04) and thrombotic(9+/-20 vs 23+/-35%, p=0.02) lesions. The elastic recoil increased significantly according to the inflation diameter of balloon(r=0.32, p<0.01. No significant correlation between the immediate elastic recoil and age, sex, risk factors, eccentricity and lesion length was shown. CONCLUSION: The elastic recoil immediately after a successful PTCA was dependent on the existance of calcium and thrombus on the target lesion and on the balloon size at the maximal inflation.
Angiography ; Angioplasty, Balloon, Coronary* ; Calcium ; Constriction, Pathologic ; Inflation, Economic ; Phenobarbital ; Risk Factors ; Thrombosis

A 21-year-old woman found to be hypertensive was referred for hypertension. On examination, blood pressure was 170/110mmHg in the right arm, 160/100mmHg in left arm,and 120/70mmHg in legs. A grade 2/6 systolic ejection murmur was present at the left upper sternal border, and a chest x-ray revealed a rib notching on the inferior margin of 4th rib. Two-dimensional echocardiogram showed the coarctation of aorta beyound the origin of the left subclavian artery. Biplane TEE demonstrated a discrete narrowing of the descending aorta at the site of coarctation. The blood pressure was 169/86mmHg in ascending aorta and 118/84mmHg in descending aorta. Aortogram showed a localized coarcted aortic segment of 7mm in diameter and 5mm long just distal to the left subclavian artery. Balloon coarctation angioplasty was performed with 7F 30x15mm pediatric balloon dilatation catheter. Balloon position was confirmed on fluoroscopy by the hourglass appearance of the balloon inflation and thereafter, the balloon was inflated until the waist of the balloon disappeared. After procedure, a pull back pressure tracing across the coarctation of aorta revealed no pressure gradient between ascending and descending aorta with 141/90mmHg. Aortogram showed an increase in diameter of the coarctation of aorta to 18mm with aneurysmal formation. 3 months later, follow up aortogram showed no significant change in diameter of coarctation of aorts or aneurysmal formation. Nonsurgical balloon coarctation angioplasty appears to be an alternative therapy for the coarctation of aorta in adults.
Adult* ; Aneurysm ; Angioplasty* ; Angioplasty, Balloon ; Aorta ; Aorta, Thoracic ; Aortic Coarctation* ; Arm ; Blood Pressure ; Catheters ; Dilatation ; Female ; Fluoroscopy ; Follow-Up Studies ; Humans ; Hypertension ; Inflation, Economic ; Leg ; Ribs ; Subclavian Artery ; Systolic Murmurs ; Thorax ; Young Adult

BACKGROUND: The clacification of the wall and narrowing of the lumen of the coronary artery is closely related to the process of atherosclerosis and its severity. Thus, the present study of calcified coronary artery lesions by analysis of cineangiography is attempt to define the incidence and factors to affect the coronary artery calcification. METHODS: Our report concerns a consecutive series of 513 patients who underwent coronary angiography between January 1, 1991 and September 30, 1993. We determined the relationship between the coronary artery calcification and sex, age, risk factors, serum calcium, BUN, creatinine, lesional lumen stenosis and severity of coronary artery disease. RESULTS: Among patients with significant coronary artery disease, 22%(62/282 cases) had the coronary artery calcification by cineangiography. Patients with calcification were older(62+/-8 years) than those without calcification(56+/-10 years)(p=0.0001). The distribution of calcified coronary artery was 35 lesions in LAD, 17 in LCX, 16 in RCA and 4 in LM. The calcification rate was 38%(40/104 cases) for patients with multi-vessel disease, compared to 12%(22/178 case) for those with single vessel disease(p=0.0001). Patients with calcification significantly had the long lesion(22.4+/-13.4mm), compared to those without calcification(18.0+/-11.3mm)(=0.012). Coronary artery calcification was correlated with smoking habits. CONCLUSION: Coronary artery calcification was seen in 22 percent and strongly correlated with age, smoking habits, the severity of disease and length of lesion.
Atherosclerosis ; Calcium ; Cineangiography* ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels* ; Creatinine ; Humans ; Incidence* ; Risk Factors ; Smoke ; Smoking

PURPOSE: To report the anti-inflammatory effect and best-corrected visual acuity (BCVA) response after oral glucosamine (Glucosamine Sulfate 750(R), General Nutrition Companies, Inc.) and aspirin (Aspirin protect(R), Bayer) therapy in patients with uveitis. METHODS: Twenty-seven patients (43 eyes) with uveitis, not easily managed with conventional therapy, were treated with oral glucosamine 750 mg and aspirin 100 mg daily, and underwent BCVA testing and slit-lamp examination of anterior chamber inflammation. Changes in the dose of previously-used oral steroids and immunosuppressants were recorded at baseline, every 2 weeks for the first 2 months, and once every month thereafter. RESULTS: The mean follow-up period was 15.0+/-3.69 weeks and inflammation started to improve within 4.6 weeks. The change in visual acuity was not statistically significant, but grade of inflammation decreased by as much as 1.02+/-1.28, significantly (p<0.01) after treatment. In 12 patients (19 eyes, 44.2%) the dosage of systemic steroids and immunosuppressants could be Reduced. 7 patients (10 eyes, 23.3%) experienced aggravation of uveitis and the dosage of glucosamine and aspirin was increased. CONCLUSIONS: Concurrent oral administration of glucosamine and aspirin could not completely inhibit the recurrence of inflammation nor control it, but consistent use of these drugs may help to reduce inflammation without serious side effects. A longer prospective control study with larger sample size is required to further evaluation of the efficacy of the medication.
Administration, Oral ; Anterior Chamber ; Aspirin ; Eye ; Follow-Up Studies ; Glucosamine ; Humans ; Immunosuppressive Agents ; Inflammation ; Recurrence ; Sample Size ; Steroids ; Uveitis ; Visual Acuity

Pulmonary benign metastasizing leiomyoma (PBML) is defined as metastasis of a leiomyoma to lung tissue. It was first reported in 1937. P BML is known as a benign disease, but can undergo malignant transformation. Only 1 case of the malignant transformation of PBML to leiomyosarcoma has been reported previously. In this report, we present a case of malignant transformation of PBML.
Leiomyoma* ; Leiomyosarcoma ; Lung ; Lung Neoplasms ; Neoplasm Metastasis

A retrogpective review of hematologic rnonitoring involving aggressive chemotherapy was careiyd out ta assese whetber there ia a predictable relatiorship between the white blood ce11 count end the platelet count as a refleetion of bone marrow toxicity and when maximum myeloauppression occur during a treatment program. This data revealed that the white blood cell and granulocyte levels are closely related and that myeloeuppression can oceur during any course of CAP(cyclophosphamide, adriamycin, and cisplatin), VBP(vinblastine, bleomycin, and cisplatin) chemotherspy in gynecological cancer. Thus, for these treatment regimena in gynecoldgical malignancies, the white blood cell and granulocyte count is sufficient for momtoing toxicity and adjusting future courses of chemotherapy. There are no bone merrow depresaions by the treatment regirnens for the gestational trophoblastic disease.
Bleomycin ; Bone Marrow ; Doxorubicin ; Drug Therapy* ; Equidae ; Gestational Trophoblastic Disease ; Granulocytes ; Humans ; Leukocytes ; Platelet Count