The purpose of this study was to the relationship between powerlessness, self-efficacy and quality of life in hemodialysis patients. The subjects were compromised of 198 hemodialysis patients from Pusan, Kyung-Sang Namdo and Kyung-Sang Bukdo 6 hemodialysis clinics. There were significant positive correlation between self-efficacy and quality of life(r= .512, p .00l). Data were collected by questionnaires from Sep. 19 to Oct. 27, 2001. The instrument used for study were the Powerlessness Behavioral Assessment Tool (Miller, 1983) and self-efficacy developed by Kim, Ju-Hyun(1995) and quality of life developed by Kim, Ok-Soo(1993). Collected data were analyzed by frequency, percentage, mean, standard deviation, t-test, ANOVA, Scheffe test, pearson correlation The results were as follows. 1. The mean score of powerlessness was 52.41+/-.93, mean mark 3.28+/-.43, and the mea score of self-efficacy was 45.44+/-.75, mean mark 2.87+/-.49, and the mea score of quality of life was 121.27+/-3.81. mean mark 2.96+/-.58. 2. There were significant differences in the level of powerlessness according to sex (1,=2.148, p= .033), occupation(t=3.682, p=.000), economic status(F=3.094, p=.048), experience of hospitalization (1,=-2.002. p= .047). 3. There were significant differences in the level of self-efficacy according to age(F=3.271. p=.013), economic status (F=5.759, p=.004), religion(F=2.667, p= .048), hemodialysis period(F=2.991. p =.032), hemodialysis frequency(t = 9.045, p = .003), experience of hospitalization (1,=4.40, p=.037). 4. There were significant differences in the level of quality of life according to occupation(t=3.796, p=.053), economic status(F=11.478, p=.000), hemodialysis frequency(t=7.573, p=.006). 5 There were significant negative correlation between powerlessness and self-efficacy (r=- .401. p .001), powerlessness and quality of .life(r=- .562, p .001),
Busan ; Hospitalization ; Humans ; Quality of Life* ; Surveys and Questionnaires ; Renal Dialysis*

Clinical professionals gain new information to assist in patient care when they read the medical literature. Similarly, in clinical preventive medicine, medical science documents that have previously published can be searched and evaluated in order to confirm the scientific support for the clinical preventive medical service offered in order to prevent chronic disease. This paper introduces the medical informatics techniques for knowledge extraction that can become the basis for clinical practice. Particularly, it discusses the clinical document retrieval and knowledge discovery tools that can search for extracting the knowledge which the medical expert desires with data mining techniques. For example, Clinical medical personnel and medical researchers can locate the information from the latest literature rapidly or find and evaluate the scientific basis for the treatment and prevention of infection. This study can be used when they analyze the correlation between accumulated and different type of data and contributes to the detection of new knowledge. Recently, the concern about the visualization of massive data and information is high as the importance of big data has received greater attention. Contributions to this technique and decision support tools will increase gradually due to the way support for decision-making through scientific evidence for the pattern changing disease is evaluated or as one of the clinical practice guidelines is accepted.
Artificial Intelligence ; Chronic Disease ; Data Mining ; Decision Support Techniques ; Evidence-Based Medicine ; Information Storage and Retrieval ; Medical Informatics ; Medical Informatics Computing ; Patient Care ; Preventive Medicine

Though basal cell carcinoma is the most frequent and increasing malignant tumor of the skin in Korea, its pathological analysis has been done only on the small numbers. So, we did a comprehensive pathologic study on the 283 patients with basal cell carcinoma diagnosed in the Department of Pathology, Seoul National(233cases) and Chung-Ang(50cases) University Hospital during 1975-1992. The age distribution was ranged from 15 to 84 years with highest incidence rate in the age group of 5th-8th decades and 83.7% of all patients were over 40 years of age. Sex difference was not noted. The most common site was face occuring in 235 out of 283cases(83.0%) especially in the eyelid(25.5%), nose(17.9%) and cheek(16.6%). The most frequent histopathologic type was solid type(54.0%) followed by mixed(23.9%), adenoid(7.5%), and metatypical(4.7%). Among 51 mixed type, all showed solid components with adenoid(51.0%) followed by morphea(25.5%) and metatypical type(13.7%). And among 14 recurrent cases, solid type is found in 50% of cases. The characteristic clinicopathological findings are solid arrangement of tumor cells with various histological pattern and predominant occurence on the face.
Incidence

Malignant tumors of the small bowel are uncommon by comparison with those in other parts of the gastrointestinal tract. Adenocarcinomas account for about half of the malignant tumors of the small intestine, which account for 1% to 2% of the gastrointestinal neoplasma. Small-bowel tumors are often asymptomatic and without clinical significance, and later became symptomatic and are eventually fatal. Patient's with regional enteritis, especially those who have had segments of the intestine surgically by passed, have an increased incidence of small-bowel cancer. The author experienced a case of an adenocarcinoma at the jejunostomy site (Braun anastomosis) which was treated by using a B II type subtotal gastrectomy for stomach cancer. That case of a jejunostomy site adenocarcinoma is reported and the literature on small-bowel malignancy is reviewed.
Adenocarcinoma* ; Crohn Disease ; Gastrectomy ; Gastrointestinal Tract ; Incidence ; Intestine, Small ; Intestines ; Jejunostomy ; Stomach Neoplasms

Spinal epidural abscesses were evaluated using Gadolinium-enhanced magnetic resonance imaging (MRI) in 19 surgically and clinically confirmed cases, including 13 with tuberculous spondylitis and 6 with pyogenic spondylitis. We observed rim enhancement patterns in 10 patients and diffuse enhancement patterns in 9 patients. The spread patterns were localized to ventral or dorsal epidural space and encircled entire epidural space. We conclude that rim enhancement indicates abscess and diffuse enhancement indicates granulation tissue and fibrosis. Tuberculous epidural abscess spreads to ventral epidural space and pyogenic epidural abscess encircles entire epidural space.
Abscess ; Epidural Abscess* ; Epidural Space ; Fibrosis ; Granulation Tissue ; Humans ; Magnetic Resonance Imaging* ; Spondylitis

OBJECTIVES: Clinical Practice Guidelines (CPGs) are an effective tool for minimizing the gap between a physician's clinical decision and medical evidence and for modeling the systematic and standardized pathway used to provide better medical treatment to patients. METHODS: In this study, sentences within the clinical guidelines are categorized according to a classification system. We used three clinical guidelines that incorporated knowledge from medical experts in the field of family medicine. These were the seventh report of the Joint National Committee (JNC7) on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure from the National Heart, Lung, and Blood Institute; the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults from the same institution; and the Standards of Medical Care in Diabetes 2010 report from the American Diabetes Association. Three annotators each tagged 346 sentences hand-chosen from these three clinical guidelines. The three annotators then carried out cross-validations of the tagged corpus. We also used various machine learning-based classifiers for sentence classification. RESULTS: We conducted experiments using real-valued features and token units, as well as a Boolean feature. The results showed that the combination of maximum entropy-based learning and information gain-based feature extraction gave the best classification performance (over 98% f-measure) in four sentence categories. CONCLUSIONS: This result confirmed the contribution of the feature reduction algorithm and optimal technique for very sparse feature spaces, such as the sentence classification problem in the clinical guideline document.
Adult ; Cholesterol ; Data Mining ; Heart ; Humans ; Hypertension ; Information Storage and Retrieval ; Joints ; Knowledge Bases ; Learning ; Lung ; Machine Learning

PURPOSE: It is known that single umbilical artery is frequently associated with gastrointestinal or urogenital anomaly, however, routine renal sonography has been debated in healthy neonate with isolated single umbilical artery. This study is designed to determine the usefulness of routine renal sonography in apparently healthy infants with an isolated single umbilical artery. METHODS: Thirty healthy neonates with a single umbilical artery without a major anomaly from January 1995 to July 2002 were enrolled. The authors investigated the clinical background of babies and their mothers after renal sonography after 72 hours of age. When the abnormalities were found at the first renal sonography, the severity of hydronephrosis and degree of obstruction and renal function were analyzed by follow up renal sonography, voiding cystourethrography(VCUG) and technetium-99m-dimercaptosuccinic acid(DMSA) scan or technetium-99m-mercaptoacetyl-triglycerine (MAG3) scan. RESULTS: Among the 30 healthy patients with isolated single umbilical artery, five patients(16.7%) showed abnormalities on first renal sonography with one major(3.3%) and four(13.4%) minor renal anomaly(minimal or mild hydroneohrosis). One major renal anomaly(severe hydronephrosis) showed severe decreased renal function on MAG3 scan without reflux, and the other four minor regressed spontaneously on follow up study. CONCLUSION: The value of routine early renal sonograpy for detecting renal anomaly in healthy infants with an isolated single umbilical artery remained unclear because most of the anomalies would regress spontaneously in the follow up study.
Follow-Up Studies ; Humans ; Hydronephrosis ; Infant* ; Infant, Newborn ; Mass Screening* ; Mothers ; Single Umbilical Artery*

PURPOSE: The purpose of this study was to analyze the prevalence of allergic disease among elementary school students in rural and urban areas. METHODS: In this study, 1,513 elementary students (1,163 in urban areas, 350 in rural areas) were surveyed. Data were analyzed using frequency, percentage of allergic symptoms and chi2 test was used to identify differences in the prevalence of allergic symptoms between urban and rural area students. The SAS program was used in the data analysis. RESULTS: There were significant differences in the prevalence of allergic disease according to whether there was a family member with a prior history of allergy symptoms. 48.7% of surveyed students (49.4% in urban, 46.3% in rural) had allergic symptoms. Allergic rhinitis was the most frequent allergic symptom in both urban and rural students. CONCLUSION: These results suggest that there is a need to prevent and manage allergies among elementary students. The family history should be considered an important factor when a program for allergy prevention and management is developed. Interventions are needed in both areas, especially for students with allergic rhinitis.
Humans ; Hypersensitivity ; Phenothiazines ; Prevalence ; Rhinitis ; Rhinitis, Allergic, Perennial ; Child Health

PURPOSE: The purpose of this study was to analyze the effects of a health education program to improve knowledge about environmental health and allergy symptoms among elementary school students. METHODS: This study has nonequivalent control group pre-post test design. Participants of this study were 60 elementary students (30 experimental and 30 control) who agreed to participate in the study. The education program consisted of information on environmental health and allergies, the atmosphere, indoor environments, food and allergies, and activities with parents. The program was carried out one time (50 minutes) per week during 6 weeks. Knowledge and symptoms of allergies were recorded before and after the program among both groups. The collected data were analyzed by ANCOVA and t-test using SAS program. RESULTS: There was a significant increase in knowledge about allergies in the experimental group compared to the control group, but allergic symptoms were similar in the two groups. CONCLUSION: These findings suggest that environmental health education programs are effective in the area of school health nursing for increasing knowledge about environmental health and allergies. Further research is needed to develop programs for reducing allergic symptoms as an environment health problem among children.
Atmosphere ; Child ; Environmental Health ; Evaluation Studies as Topic ; Health Education ; Humans ; Hypersensitivity ; Parents ; Phenothiazines ; School Health Services

BACKGROUND: Non-small cell lung cancer is one of the most frequent cause of death due to cancer in men, and its incidence among women is rapidly increasing. Although there has been a recent surge of interest in combined modality therapy for stage III non-small cell lung cancer(NSCLC), the optimal treatment is still not well established. Thoracic irradiation has long been the gold standard for locally advanced unresectable NSCLC. However, although conventional radiotherapy(XRT) can palliate symptom and improve local control of disease, it huts at most only a modest effect on survival. Recently, cisplatin(cia-diamminedichloroplatinum ) has been reported to enhance the cell-killing effect of radiation For patients with unresectable NSCLC, cisplatin-based concurrent chemoradiotherapy(CCRT) had the advantage of therapeutic response over XRT alone and therapeutic side effect more commonly occurred in CCRT group in EORTC(European Organization for Research and Treatment of Cancer) and other trials. Objectives : We compared therapeutic response, compliance, and side effects between CCRT and XRT in patients with advanced NSCLC. Patients and METHOD: Thirty patients with biopsy-proven inoperable NSCLC were randomized to one of two treatment arms. Arm A consisted of XRT, radiotherapy for 4~6 weeks(1.8 Gy given 20~33 times, in five fractions a week), and arm B consisted of CCRT, radiotherapy for 2 weeks(3 Gy given 10 times, in five fractions a week), followed by 3 week rest period and then radiotherapy 2 more weeks(2.5 Gy given 10 timed in five fractions a week), combined with 6mg cisplatin per square meter, given daily before radiotherapy. We evaluate therapeutic response, compliance, change of performance status, side effects, and radiation pneumonitis by using the author's made scoring system. RESULTS: There was no significant difference in therapeutic response and compliance. But there was a significantly lower laboratory complication and radiation pneumonitis in CCRT group (p<0.05). There's significant negative correlation between stage and therapeutic response score in both groups(R=0.353, p<0.05). In both groups, patients with squamous cell carcinoma had a tendency to higher therapeutic response score than those with adenocarcinoma. CONCLUSION: There was. no difference between CCRT and XRT in respect to therapeutic response and compliance. But CCRT had a advantage of decreased side effects.
Adenocarcinoma ; Arm ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Cause of Death ; Chemoradiotherapy* ; Cisplatin ; Combined Modality Therapy ; Compliance ; Female ; Humans ; Incidence ; Lung Neoplasms* ; Lung* ; Male ; Radiation Pneumonitis ; Radiotherapy*