PURPOSE: The purposes of this study were to examine the effectiveness of a behavioral intervention program combining pelvic floor muscle exercise with bladder training for urinary incontinence and also to conduct follow-up assessment after self-training. METHODS: This study was conducted using a non-equivalent control group, pretest-posttest design. The subjects were 60 middle-aged women (control group, n=30; intervention group, n=30) who experienced an episode of urinary incontinence at least once a week. The program was run over a 4 week period (once a week) and composed of urinary incontinence education, pelvic floor muscle exercise, and bladder training. RESULTS: Overall, there was a significant difference in urinary incontinence symptoms and psycho-social wellbeing related to urinary incontinence between the treatment and control group. Of the variables, weekly leakage frequencies, leakage amounts on each occasion, leakage index, frequencies of nocturia, and quality of life were significantly different between the groups. Follow-up assessment (9th week) indicated that overall incontinence symptoms and psycho-social well-being were significantly different between the posttest and follow-up assessments. Most variables of incontinence symptoms and psycho-social well-being were significantly improved at follow-up assessment versus posttest. CONCLUSIONS: The program was overall effective in terms of relieving symptoms and improving psycho-social well-being related to urinary incontinence, and this effect continued after a 4-weeks self-training period. In the respect that this is a community-based application study, the results can be meaningful and applicable.
Urinary Incontinence/*rehabilitation ; *Pelvic Floor ; Multivariate Analysis ; Middle Aged ; Humans ; Female ; Exercise Therapy/*methods ; Behavior Therapy/*methods ; Adult

PURPOSE: This study was conducted to compare the recovery state of 6 month between s-ICH and s-SAH patients. The patients' recovery state was measured with 2 dimensions: functional and cognitive. METHODS: Non-experimental prospective design was adopted by including 108 hemorrhagic stroke patients(s-ICH: 52 vs s-SAH: 56) admitted to Intensive Care Unit of one university hospital. RESULTS: The study results showed that overall functional recovery state of s-SAH patients was better than that of s-ICH patients, and s-SAH patients also showed better recovery states in all of the sub-dimensions of functional recovery, such as feeding, grooming, and toileting, than those of s-ICH in 6 month. On the contrary, the study results showed that overall cognitive recovery states of 6 month between two groups were not significantly different. However, according to the results comparing the sub-dimensions of cognitive recovery, s-SAH patients' recovery states on attention, communication and memory were significantly better than those of s-ICH patients, while recovery states on problem solving, safety behavior, and social behavior between 2 groups were not significantly different. CONCLUSION: From the study results, it was noted that s-SAH patients showed better recovery states in cognitive dimension as well as in functional dimension compared with s-ICH patients.
Animals ; Cerebral Hemorrhage ; Grooming ; Humans ; Intensive Care Units ; Memory ; Problem Solving ; Prospective Studies ; Social Behavior ; Stroke ; Subarachnoid Hemorrhage

No abstract available.
Angioplasty* ; Budd-Chiari Syndrome* ; Heart Ventricles* ; Stents*

Intestinal pseudo-obstruction (IPO) is a rare and poorly understood manifestation of systemic lupus erythematosus (SLE), especially in children. The characteristic clinical feature of IPO is obstruction without an identifiable obstructive lesion. The authors a 13-year-old girl whose first symptom of SLE was IPO. The patient presented with a 3-day history of nausea, bilious vomiting, abdominal distention, and no bowel movement. Simple abdominal radiographs revealed mild dilatation with partial air-fluid levels in the small intestine. Abdominal CT and methylcellulose small bowel studies showed massive ascites, engorgement of the small mesenteric vessels, pleural effusion, and diffuse bowel wall thickening of the gastric antrum, duodenum. and jejunum. The delayed passage of contrast for 15 days after the methylcellulose small bowel studies was suggestive of decreased bowel motility. Laboratory findings were positive for ANA, anti-double-stranded DNA, anti-Smith and lymphopenia. After 10-day treatment with high-dose corticosteroids, the symptoms improved. IPO associated with SLE should be considered in the differential diagnosis for patients presenting with symptoms of intestinal obstruction. Early recognition of IPO in SLE and appropriate therapy are important for prevention of complications and unnecessary surgery. This case raises awareness among pediatricians that although rare, IPO can be the presenting symptom of SLE in children.
Adolescent ; Adrenal Cortex Hormones ; Ascites ; Child ; Diagnosis, Differential ; Dilatation ; DNA ; Duodenum ; Humans ; Intestinal Obstruction ; Intestinal Pseudo-Obstruction ; Intestine, Small ; Jejunum ; Lupus Erythematosus, Systemic ; Lymphopenia ; Methylcellulose ; Nausea ; Pleural Effusion ; Pyloric Antrum ; Unnecessary Procedures ; Vomiting

The purpose of this study was to investigate the effect of manganese (Mn) supplementation on bone status and calcium balance in ovariectomized rats according to the calcium intake levels. Total of 50 Sprague Dawley female rats (6 weeks) were divided into 5 groups and bred for 12 weeks: sham operated control group (SACa), OVX Ca deficiency group (OLCa) with Ca deficiency diet (0.1% Ca modified AIN-93N diet), OVX Ca deficiency & Mn supplement group (OLCaMn), OVX adequate Ca group (OACa; 0.5% Ca AIN-93N diet) and OVX adequate Ca & Mn supplement group (OACaMn). BMD (bone mineral density) of the femur was increased by Mn supplementation in OVX adequate Ca group. However, BMDs of spine, femur and tibia were lowered in OLCa compared to the OLCaMn group. Bone strength of tibia in OLCaMn group was significantly lower than OLCa group. Serum ALP (alkaline phosphatase) and CTx (C-telopeptide of collagen cross-links) levels were significantly higher in ovariectomized rats than those in the sham group, but they were not changed by Mn supplementation. Ca retention rate and Ca absorption rate did not differ among the experimental groups. Urinary Ca excretion was increased by Mn supplementation in Ca deficiency rats. In summary, Mn supplementation resulted in positive effects on bone mineral density ovariectomized rats with which intake adequate Ca. However, Mn supplementation on Ca deficiency ovariectomized rats resulted in decrement of BMD and bone strength by increasing Ca excretion. Therefore, it is encouraged to consider calcium intake levels in supplementation of manganese in order to prevent postmenopausal osteoporosis and to keep bone healthy.
Absorption ; Animals ; Bone Density ; Calcium ; Collagen ; Diet ; Female ; Femur ; Humans ; Manganese ; Osteoporosis, Postmenopausal ; Ovariectomy ; Rats ; Retention (Psychology) ; Salicylamides ; Spine ; Tibia

PURPOSE: The purpose of this study is to evaluate the knowledge and attitudes of oncology ward nurses toward cancer pain management and to find ways to improve the educational program for nurses. METHOD: A total of 209 nurses working at the oncology ward of three hospitals in Seoul and a Gyenggi Province. The survey instrument used was the 32-item scale for evaluating nurses knowledge and attitudes originally developed by McCaffery and Ferrell'(1990), that was by Kim'(1997). RESULTS: In terms of the nurses knowledge of pain management, the result showed that the nurses scored an average of 67.8 out of 100 for phamacokinetics of opioids, 84.8 for classification of analgesics, 60.1 for pain assessment, and 70.7 for drug administration. 18.2% of the nurses hesitate to inject the narcotic agent because of concerns regarding the drug's potential side effects. there was significant difference in the knowledge of pain management according to the general characteristics of pain in terms of the nurses age(p=.001), position (p=.016), years of experiences(p=.002), experience of cancer pain education(p=.001). CONCLUSION: The also showed that nurses working at cancer ward lack knowledge. It is important to provide intensive education to nurses about cancer pain management.
Analgesics ; Analgesics, Opioid ; Classification ; Education ; Pain Management* ; Pain Measurement ; Seoul

PURPOSE: The purpose of this study is to evaluate the knowledge and attitudes of oncology ward nurses toward cancer pain management and to find ways to improve the educational program for nurses. METHOD: A total of 209 nurses working at the oncology ward of three hospitals in Seoul and a Gyenggi Province. The survey instrument used was the 32-item scale for evaluating nurses knowledge and attitudes originally developed by McCaffery and Ferrell'(1990), that was by Kim'(1997). RESULTS: In terms of the nurses knowledge of pain management, the result showed that the nurses scored an average of 67.8 out of 100 for phamacokinetics of opioids, 84.8 for classification of analgesics, 60.1 for pain assessment, and 70.7 for drug administration. 18.2% of the nurses hesitate to inject the narcotic agent because of concerns regarding the drug's potential side effects. there was significant difference in the knowledge of pain management according to the general characteristics of pain in terms of the nurses age(p=.001), position (p=.016), years of experiences(p=.002), experience of cancer pain education(p=.001). CONCLUSION: The also showed that nurses working at cancer ward lack knowledge. It is important to provide intensive education to nurses about cancer pain management.
Analgesics ; Analgesics, Opioid ; Classification ; Education ; Pain Management* ; Pain Measurement ; Seoul

BACKGROUND: Vagal cardiac function plays an important role in cardiovascular homeostasis. The purpose of this study was to investigate the association between vagal cardiac function and changes in blood pressure induced by phenylephrine and by thigh cuff deflation after low-dose atropine (LDA)(2microgram/kg) administration. METHODS: Beat-to-beat changes in R-R intervals (RRI) and systolic blood pressures (SBP) were measured in 33 healthy volunteers during spontaneous and controlled (15 min-1) breathing before and after LDA administration. The RMSSD (root mean square of successive differences of RRI), pNN50 (proportion of successive RRI > 50 ms in relation to the total RRI), standard deviation 1 (SD1) from Poincare plots, power spectral densities of heart rate variability (HRV) and SBP variability, and spontaneous baroreflex sensitivity (BRS) by transfer function analysis were assessed. Acute hypertension was induced by phenylephrine (2 microgram/kg), whereas acute hypotension was induced by thigh cuff deflation. RESULTS: RMSSD, pNN50, SD1 of Poincare plots, and the high frequency (HF) power of HRV increased after LDA administration as did spontaneous BRS. Moreover, acute hypertension induced by phenylephrine was significantly attenuated (15.9 +/- 1.9 to 10.8 +/- 3.1 mmHg, P = 0.004) after LDA administration. However, acute hypotension induced by thigh cuff deflation was not significantly changed (13.4 +/- 3.9 to 11.9 +/- 4.2 mmHg, P = 0.62) after LDA administration. Changes in SBP during acute hypertension induced by phenylephrine were significantly correlated with changes in the HF power of HRV (r = -0.60, P < 0.001). CONCLUSIONS: Increasing vagal cardiac function induced by LDA attenuated increased SBP during acute hypertension induced by phenylephrine, but not decreased SBP during acute hypotension induced by thigh cuff deflation in healthy awake subjects.
Atropine* ; Baroreflex ; Blood Pressure ; Healthy Volunteers ; Heart Rate ; Homeostasis ; Hypertension ; Hypotension ; Phenylephrine ; Respiration ; Thigh

The QTc interval is a complex quantitative trait and a strong prognostic indicator of cardiovascular mortality in general, healthy people. The aim of this study was to identify non-genetic factors and quantitative trait loci that govern the QTc interval in an isolated Mongolian population. We used multiple regression analysis to determine the relationship between the QTc interval and non-genetic factors including height, blood pressure, and the plasma lipid level. Whole genome linkage analyses were performed to reveal quantitative trait loci for the QTc interval with 349 microsatellite markers from 1,080 Mongolian subjects. Among many factors previously known for association with the QTc interval, age, sex, heart rate, QRS duration of electrocardiogram and systolic blood pressure were also found to have influence on the QTc interval. A genetic effect for the QTc interval was identified based on familial correlation with a heritability value of 0.31. In a whole genome linkage analysis, we identified the four potential linkage regions 7q31-34, 5q21, 4q28, and 2q36.
Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Blood Pressure/genetics ; Body Height/genetics ; Cardiovascular Diseases/*genetics/mortality/pathology/*physiopathology ; Child ; Child, Preschool ; Chromosomes, Human/genetics ; *Electrocardiography ; Female ; *Genome-Wide Association Study ; Heart Rate/genetics ; Humans ; Male ; Microsatellite Repeats/*genetics ; Middle Aged ; Mongolia/epidemiology ; Quantitative Trait Loci/*genetics ; Sex Factors

BACKGROUDN: The ratio of mitral inflow (E) and annular velocity (E') to stroke volume (E/E'/SV) has been used as an index of diastolic elastance (Ed). However, its change during exercise has not been evaluated. We hypothesized that Ed values obtained during exercise would be abnormal in patients with apical hypertrophic cardiomyopathy (ApHCM). METHODS: Ed was measured at rest and during graded supine bicycle exercise (25 Watts, 3 minute increments) in 15 patients with ApHCM (12 male; mean age, 57 years) and in 15 age- and gender-matched control subjects. RESULTS: Ed was not significantly different at rest and during 25 W of exercise. However, Ed was significantly higher at 50 W of exercise in patients with ApHCM compared to control subjects (0.21+/-0.05 vs. 0.15+/-0.04 cm/s, p=0.0059). There was significant positive correlation between the magnitude of change in proBNP levels during exercise and the change of Ed from rest to 50 W of exercise (r2=0.69, p<0.0001). CONCLUSION: Noninvasively-determined Ed was similar at rest and during mild exercise between patients with ApHCM and control subjects. However, Ed was significantly higher during moderate exercise in ApHCM patients, suggesting a dynamic change in LV stiffness during exercise in these patients.
Cardiomyopathy, Hypertrophic* ; Humans ; Male ; Stroke Volume