OBJECTIVES: The purpose of this study was to investigate client satisfaction with mental health services across sociodemographical and service utilization characteristics and to identify the predictors for quality of life for schizophrenic patients who registered in community mental health center. METHODS: One hundred five schizophrenic patients who had received intensive or continuing care completed questionnaires, which included Consumer Satisfaction Scale and the Korean version of World Health Organization Quality of Life Assessment Instrument-Brief (WHOQOL-BREF). Subject's sociodemographic and service utilization characteristics were compared using t-test or one-way analysis of variance. To examine the influence of these variables on quality of life, stepwise multiple regression was conducted. RESULTS: Consumer satisfaction scores differed significantly depending on the length of contact with a current mental health staff. In a stepwise multiple regression model, service relevance and occupation together explained 20.5% of variance in quality of life. CONCLUSION: The results suggest that continuity in contact with a current mental health staff was important in consumer satisfaction. Service relevance and occupation had an impact on quality of life.
Consumer Satisfaction ; Humans ; Mental Health Services* ; Mental Health* ; Occupations ; Quality of Life* ; Surveys and Questionnaires ; Schizophrenia* ; World Health Organization

BACKGROUND: The recently developed nucleic acid amplification methods may provide us with very sensitive, specific and rapid tests for the detection of M. tuberculosis. So the aim of this study was to compare the commercial Amplicor M. tuberculosis kit and our in-house polymerase chain reaction (PCR) with the conventional culture and direct AFB staining method. Materials and METHODS: Among the total of 2,340 clinical specimens, 1,314 sputum samples were tested for the presence of M. tuberculosis by Amplicor PCR and 1,026 sputum samples were tested by in-house PCR performing with resin matrix preparation and DNA extraction, synthesized primer pair, detection using agarose gel electrophoresis. RESULTS: One hundred-seventeen specimens were positive by Amplicor PCR, 105 were positive by in-house PCR, 185 were positive by culture. The sensitivity of the Amplicor PCR for all of the specimens and for smear-positive and smear-negative specimens was 92.9%, 97.9% and 88.2%, respectively after discrepant analysis. The sensitivity of the in-house PCR for all of the specimens and for smear-positive and smear-negative specimens was 80.0%, 93.6% and 65.5%, respectively after discrepant analysis. The specificity of the Amplicor PCR and in-house PCR for all of the specimens was 97.9% and 99.0%, respectively. CONCLUSIONS: Amplicor PCR was more sensitive than in-house PCR, but there was another problems such as high false positive rate and high cost. So PCR may certainly become very useful in microbiological laboratories if PCR method is selected according to the laboratory conditions.
DNA ; Electrophoresis, Agar Gel ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Sputum* ; Tuberculosis

No abstract available.
Pregnancy*

Diffuse alveolar hemorrhage (DAH) is associated with severe outcomes. We report a case of acute respiratory failure that required mechanical ventilation and was clinically and pathologically diagnosed as DAH related to exposure to organic dust. A 39-year-old man, who had visited a warehouse to grade beans for purchase, was referred to our hospital for impending respiratory failure. His initial radiographic examinations revealed diffuse bilateral ground-glass opacities in his lungs and bronchoalveolar lavage resulted in progressively bloodier returns, which is characteristic of DAH. He underwent bedside open lung biopsy of his right lower lobe in the intensive care unit. Biopsy results revealed DAH and organization with accumulation of hemosiderin-laden macrophages and a few fibroblastic foci. The patient was treated with empirical antibiotics and high-dose corticosteroids and successfully weaned from mechanical ventilation. DAH might be considered in the differential diagnosis of patients with acute respiratory failure after exposure to organic particles.
Adrenal Cortex Hormones ; Adult ; Anti-Bacterial Agents ; Biopsy ; Bronchoalveolar Lavage ; Diagnosis, Differential ; Dust* ; Fibroblasts ; Hemoptysis ; Hemorrhage* ; Humans ; Intensive Care Units ; Lung ; Macrophages ; Respiration, Artificial ; Respiratory Insufficiency*

PURPOSE: This study was performed to measure hospital nurses' perceived patient safety culture and their safety care activities, and to investigate the relationship between these two factors. METHOD: This study was a cross-sectional survey. The participants were 301 nurses working at 4 general hospitals, and data collection was done from June 22 to June 30, 2009 by self-administrated questionnaires. RESULTS: With a possible score of 5 points, the average score for nurses' perceived patient safety culture was 3.34, and for their safety care activities, 4.25. There were perceived differences in patient safety culture and safety care activities according to age, position, length of work experience and number of patient safety education sessions attended. All sub-factors in patient safety culture had a positive relationship with safety care activities. Factors influencing nurses' safety care activities were number of patient safety education sessions attended, hospital environment, and supervisor/manager. These factors explained 58.2% of the variance. CONCLUSION: The findings indicate that patient safety education is very important to improve nurses' safety care activity. So nursing supervisors/ managers should develop strategies encourage patient safety education, and make nurses' working environment safer.
Cross-Sectional Studies ; Surveys and Questionnaires ; Hospitals, General ; Humans ; Medical Errors ; Organizational Culture ; Patient Safety

A monoclonal antibody to PCNA, which can be used on routinely processed tissue, was applied to 25 cases of gastric adenomas and 64 cases of gastric adenocarcinomas in order to diffentiate adenoma and adenocarcinoma and also to evaluate the prognostic value in adenocarcinoma. The results were summerized as follows: The PCNA labelling index was 29.14+/-12.77% in control, 44.09+/-17.11% in adenoma and 80.15+/-10. 69 in adenocarcinoma, resulting in significant increase in adenocarcinoma compared to adenoma. In adenocarcinoma, no significant correlation was observed between PCNA labelling index and histologic grade, and there -was increased tendency of PCNA labelling index in proportion to depth of invasion without statistical significance. The PCNA index was significantly increased in advanced adenocarcinoma compared to early gastric carcinoma, and also in positive nodal metastasis group than in negative group. From above results, the PCNA stain will be able to provide a helpful method for the differential diagnosis between gastric adenoma and adenocarcinoma, and could be a useful prognostic factor in adenocarcinoma if other factors are considered together.
Adenocarcinoma* ; Adenoma* ; Diagnosis, Differential ; Neoplasm Metastasis ; Proliferating Cell Nuclear Antigen* ; Stomach

Regardless of the any cause leg ulcers are painful and inconvenient to patients and present clinical and economic problems due to their chronicity. Conventional skin grafts, cultured allogenic epidermis, and cultured autologous epidermis have been used for the treatment of leg ulcers. In a twenty-year-old woman with leg ulcers, autologous pure epidermal sheets were obtained from the lower chest by means of suction blisters and grafted to the leg ulcers. All lesions were healed completely in 20 days after grafting. The donor sites showed slight postinflammatory hyperpigmentations without scars. The autologous epidermal graft using suction blisters appears to be a useful method for the treatment of leg ulcers, with no immunologic rejection, no need for cultivation and anesthesia, no desiccation, and no scars on the donor sites.
Anesthesia ; Blister* ; Cicatrix ; Desiccation ; Epidermis ; Female ; Humans ; Leg Ulcer* ; Leg* ; Methods ; Skin ; Suction* ; Thorax ; Tissue Donors ; Transplants*

It has suggested that a significant proportion of intraepithelial lesion of the cervix may be related to the influence of human papillomaviurs (HPV). Its etiological relation with cervical intraepithelial neoplasia (CIN) and cervical squamous cell carcinoma has recently been proposed. The 131 cases of CIN and 6 condyloma acuminata were stained by immunoperoxidase technique for HPV anigen. The results are as follows: The 18 cases (13.1%) exhibited positive staining, localized in nuclei of koilocytotic cells confined to superficial and intermediate layer of epithelium. HPV antigen was found in 1 case (16.7) of 6 condyloma acuminata, 4 cases (12.5%) of 32 mild dysplasia, 3 cases (13.6%) of 22 moderate dysplasia, 2 cases (14.3%) of 14 severe dysplasia and 8 cases (12.7%) of 63 carcinoma in situ. In the positive cases of mild and moderate dysplasia, HPV antigen was localized directly within the lesion, while those cases of severe dysplaia and carcinoma in situ contained positive cells in areas of mild or moderate dysplasia adjacent to the lesion. Of three distinct morphologic patterns, flat type was most common and papillary type was least. Histologically condylomatous lesions were present in 67 cases (51.1%) out of 131 cases of CIN. The histological and cytological feature encountered most frequently was koilocytotic arypia. Other main histological features are bi- or multinucleation, exocytosis of inflammatory cells, acanthosis, mitotic figures, dyskeratosis and epithelial pearl. On the cervical smear, the evidence of condyloma was proved in 50.0%. Cytologically in the condyloma with high degree of CIN, the nuclear atypia was so prominent that the differentiation from dysplasia or carcinoma in situ was very difficult, although the chromatin appeared somewhat smudged. The mean age of 18 cases was 42.4 years which is older than previous study. The results of this study provide common association with HPV and CIN and add great weight to the suggestion that the infection with HPV plays an important part in genesis of cervical cancer.
Humans

Hepatic fibrosis was induced in Sprague-Dawley rate to evaluate the ultrastructural changes of fat-storing cells (Ito cells). For experimental induction of liver fibrosis, the rats were administered intraperitoneally with 0.5 ml of 50% Ccl4 solution per Kg body weight, twice weekly for 12 weeks. The rats were sacrificed every week. The liver tissues were examined under light and electron microscopes. And the immunohistochemical study of desmin was also performed. The results were summarized as follows: Light microscopic findings: The cellular infiltrations was inflammatory cells and Kupffer cells developed from 1 week after Ccl4 injection, and were the most severe in 4 weeks. The strong immunoreactivity for desmin was also evident in 4 weeks. The centrilobular necrosis and fibrosis developed from 2 weeks after injection, and the necrosis persisted until 8 weeks. The progress of fibrosis was accompanied by decreases in cellular infiltration and reactivity for desmin, and increased gradual nodular formation was also observed. The cirrhosis was developed after 10 weeks. Electron microscopic findings: An increase in number of fat-storing cells was observed from 1 week after injection. Transitional cells characterized by a depletion of lipid droplets and a hypertrophy of the rER appeared after 2 weeks. The number of transitional cells with abundant collagen fibers in the extracellular spaces increased in 4 weeks. With progression of fibrosis the number of fat-strong cells decreased and proliferating fibroblasts with dilated rER were observed. According to these results it was revealed that there was an apparent transition from fatstrong cells to transitional cells and to fibroblasts. These cells had a few similar characteristics and may belong to the same cell population. Thus it was suggested that fatstrong cells might play an important role in hepatic fibrosis.
Animals ; Body Weight ; Collagen ; Desmin ; Extracellular Space ; Fibroblasts ; Fibrosis* ; Hypertrophy ; Kupffer Cells ; Lipid Droplets ; Liver ; Liver Cirrhosis ; Necrosis ; Rats ; Rats, Sprague-Dawley

The purpose of this study were to find out the practical way to enlarged child-raising knowledge and to enhance their satisfaction with out-patient care by evaluating how effectively the education is done by nurses for mothers with ill-child and how their satisfaction with out-patient care changed. This study was designed as a Nonequivalent Control Group study. The subjects studied were consisted of the experimental and control group. Each consisted of 50 mothers with ill-child in pediatric department at one university hospital in Seoul. The period of this study is from May 20, 1996 to June 28, 1996. The first data were collected fro both of experimental and control groups in which mothers with ill-child come to the hospital for the first time. After this being done, the experimental group had been educated by the planned program and then the second data were collected from them. On the contrary, as for the control group, there had been no education and the second data were collected on the same method. The data analysis was done by SPSS program. The results of this study are as follow, 1. The child-raising knowledge level of mothers with education was higher than that of with no education.(t=18.84, df=49, p=0.000) 2. The satisfaction with out-patient care level of mothers with education was higher than that of no education.(t=10.51, df=49, p=0.000) Based on these results, I suggest as follow, 1. The research on the patients and their family should be made not only in pediatric department, but in every out-patient department. 2. For more effective education, it is required for all out-patient nurses to research the education demand of patients and their family. 3. To increase the effect of education, there must be the consultation room in out-patient department. 4. The meetings with the mothers with ill-child of the same illness have to be established and periodical education must be executed. 5. Audio-visual education programs like video tapes are needed to make use of waiting time for the medical treatment. 6. On-line consulting program are needed.
Education ; Humans ; Mothers* ; Outpatients* ; Seoul ; Statistics as Topic ; Child Health