OBJECTIVE: In view of the facts that education about diseases and realization of the need for drugs can improve compliance of the patients, we assessed the knowledge about drugs and medication compliance in psychiatric outpatients. In addition, we investigated factors that influence patients' compliance to develop a model of medication compliance. METHODS: One-hundred twelve male and eighty female psychiatric outpatient were asked about drug information using questionnaires. We developed a model that predicts medication compliance using chi square tests and multiple regression analysis. RESULTS: More than a hart of the patients knew at least one of the names and the effects of the drugs they had taken, but many of them didn't know the side effects of drugs. About eighty percent of the patients showed good compliance. Knowledge of side effects, belief in the benefits of drugs, and level of education could predict medication compliance reliably. CONCLUSIONS: Because education level could not be managed by physician, we could enhance compliance through education about drug side effects and benefits of medications.
Compliance ; Education ; Female ; Humans ; Male ; Medication Adherence* ; Outpatients* ; Surveys and Questionnaires

BACKGROUND: In a health examination program, advice from physician for change of health-related behavior and distribution of health educational pamphlets is routine. This study was done prospectively to analyze factors such as personal general characteristics, results of health examination, health examination satisfaction that relate to change of health promotion attitudes and compliance towards overweight, smoking, heavy drinking, elevated blood pressure, dyslipidemia, chronic diseases such as diabetes, hypertension. METHODS: The subject population was 689 cases from May 1997 to June 1997 in a general hospital health examination center. After health examination, 60.2%(415 cases) showed personal satisfaction by questionnaire. Three to four months later 78.4%(540 cases) responded to the telephone survey on change of health beliefs, health-related attitudes and compliance. RESULTS: In the telephone survey, 239 cases(46.0%) comprised high compliance group that had positive attitudes toward abnormal health examination results, 145 cases(27.9%) were mid compliance group, and 135cases(26.0%) were low compliance group. In males there was higher frequency of high compliance group than females(p<0.05). According to age, the older, the higher frequencies of high compliance group(p<0.05). In educational level group, the higher the educational level, the lower the frequencies of high compliance group(p<0.01). There was no difference in frequency of each compliance group between symptom motive and non-symptom motive group with each satisfaction group(p>0.05). In positive responders to the correspond advice of physician or health educational pamphlets, the frequencies for quit smoking, reduction of drinking amount, regular exercise, Compliance with taking antihypertensives, blood sugar control, diet control for dyslipidemia, taking antihyperlipidemics were higher(p<0.01). CONCLUSIONS: Health examination service includirg advice of physician and education changed health belief and influenced positively to health promotion attitudes. Health examination is not only important for early detection of disease but also to promote positive change of health-related behavior. Further studies are needed to understand the changing process of management of health and disease.
Antihypertensive Agents ; Blood Glucose ; Blood Pressure ; Chronic Disease ; Compliance ; Diet ; Drinking ; Dyslipidemias ; Early Diagnosis ; Education ; Health Education ; Health Promotion ; Hospitals, General ; Humans ; Hypertension ; Hypolipidemic Agents ; Male ; Overweight ; Pamphlets ; Personal Satisfaction ; Prospective Studies ; Smoke ; Smoking ; Telephone ; Surveys and Questionnaires

BACKGROUND: Metabolic syndrome (MS) and homocysteine (Hcy) are known to contribute to developing atherosclerothrombosis in ischemic stroke. However, there have been controversies regarding the relationship between insulin resistance and plasma Hcy levels in healthy subjects. Our aim was to determine the possibility of a relationship between MS and elevated Hcy in ischemic stroke patients. METHODS: We investigated demographic features and risk factors in 221 patients from Gachon Stroke Registry between March 2003 and February 2004. The stroke subtypes were categorized as large artery atherosclerosis (LAA), small artery occlusion (SAO) and cardioembolism (CE). MS was defined as the followings; impaired fasting glucose, impaired glucose tolerance or IDDM with two or more among 1) hypertension (antihypertensive treatment and/or BP 160/90 mmHg), 2) dyslipidemia (TG >or=150 mg/dL and/or HDL-C (<35 in men, <39 mg/dL in women)), 3) obesity (BMI >or=25 kg/m2 or waist circumference 90 in men, 80 cm in women). RESULTS: Hcy, total cholesterol, and fibrinogen levels were higher in MS(+) than in MS(-) (p=0.026, 0.021 and 0.025). The Hcy level was higher in LAA patients than in SAO and CE patients (14.1 +/- 6.8, 12.0 +/- 6.2, 11.0 +/- 4.3 mol/L, p=0.009). It was significantly higher in MS(+) than is MS(-) in SAO patients (15.4 +/- 9.5 vs 10.5 +/- 2.9 mol/L, p=0.016), while not observed in LAA or CE patients. Among the MS(+), LAA was more prevalent (48.6%) than SAO (36.1%) and CE (15.3%). CONCLUSIONS: Elevated Hcy level may be associated with ischemic stroke with MS. Further studies remain to be investigated to clarify whether lowering the elevated Hcy can be an another important asset in reducing the risk not only for stroke, but also for MS.
Arteries ; Atherosclerosis ; Cholesterol ; Diabetes Mellitus, Type 1 ; Dyslipidemias ; Fasting ; Fibrinogen ; Glucose ; Homocysteine* ; Humans ; Hypertension ; Insulin Resistance ; Male ; Obesity ; Plasma* ; Risk Factors ; Stroke* ; Waist Circumference

Cases showing memory disturbances with isolated retrograde memory without any definitive brain lesions are classified as dissociative amnesia. Improvements in imaging techniques have allowed the organic causes of this disease to be identified in several recent cases. Several studies have diagnosed cases of memory disorders as pure retrograde amnesia (PRA). The patient reported here had no psychiatric disorder and had normal MRI results, but showed hypometabolism in PET that met the criteria for PRA.
Amnesia ; Amnesia, Retrograde ; Brain ; Humans ; Memory ; Memory Disorders

PURPOSE: The purpose of this study was to identify the factors influencing parenting stress in primiparas. METHOD: The participants in this study were 198 primiparas of infants aged 1-6 months who visited well baby clinics in 5 hospitals. The data were collected from April 15 to June 15, 2003. RESULTS: The mean score for parenting stress was 2.4 of a possible 5 and thus considered average. The score for parenting stress was significantly correlated with the level of maternal perception of the infant and the level of social support. The score for parenting stress was significantly different according to the education level of the primiparas and prenatal management. For the primiparas, social support(20%) and maternal perception of the infant(9%) were significant predictors explaining parenting stress. CONCLUSIONS: Nursing interventions to improve maternal perception of the infant and increase social support should be provided for primiparas in order to reduce parenting stress.
Education ; Humans ; Infant ; Nursing ; Parenting* ; Parents* ; Child Health

BACKGROUND: Carotid artery intima-media thickness (IMT) is an early structural marker of the atherosclerotic process and an elevated total homocysteine level is an early biochemical marker of atherosclerosis. But there are few reports about serum homocysteine level and carotid IMT between ischemic stroke, hypertensive intracerebral hemorrhage (HICH) and control group. METHOD: We studied about 173 patients with ischemic stroke, HICH and control group. Carotid IMT was defined as the mean of IMT measured by B-mode ultrasonography. Serum homocysteine level was measured by fluorescence polarization immunoassay method in fasting state. We compared serum homocysteine level and carotid IMT between ischemic stroke, HICH and control group. In statistics, One-Way ANOVA was used. RESULTS: A significant increase in carotid IMT was noted in ischemic stroke and HICH compared with that in the control group (p<0.05), whereas there was no significant differences in carotid IMT between ischemic stroke and HICH. The serum homocysteine level of ischemic stroke was significantly higher than that of control group (p<0.05). But there were no significant differences between HICH and control group, HICH and ischemic stroke. CONCLUSIONS: In our study, we thought a carotid IMT of ischemic stroke, HICH and serum homocysteine level in ischemic stroke can be used as early diagnostic marker. Therefore, our results address the need of further prospective clinical studies in patients with ischemic stroke and HICH in order to evaluate a possible diagnostic ability of carotid IMT and serum homocysteine level.
Atherosclerosis ; Biomarkers ; Carotid Arteries ; Carotid Intima-Media Thickness* ; Cerebral Hemorrhage ; Fasting ; Fluorescence Polarization Immunoassay ; Homocysteine* ; Humans ; Intracranial Hemorrhage, Hypertensive* ; Stroke* ; Ultrasonography

PURPOSE: The purpose of this study was to analyze opinions about the action plan for implementation of clinical performance exam as part of the national nursing licensing examination and presents the expected effects of the performance exam and aspects to consider regarding its implementation. METHODS: This study used a mixed-methods design. Quantitative data were collected by a questionnaire survey, while qualitative data were collected by focus group interviews with experts. The survey targeted 200 nursing professors and clinical nurses with more than 5 years of work experience, and the focus group interviews were conducted with 28 of professors, clinical instructors, and nurses at hospitals. RESULTS: First, nursing professors and clinical specialists agreed that the current written tests have limitations in evaluating examinees' ability, and that the introduction of a clinical performance exam will yield positive results. Clinical performance exam is necessary to evaluate and improve nurses' work ability, which means that the implementation of a performance exam is advisable if its credibility and validity can be verified. Second, most respondents chose direct performance exams using simulators or standardized patients as the most suitable format of the test. CONCLUSION: In conclusion, the current national nursing licensing exam is somewhat limited in its ability to identify competent nurses. Thus, the time has come for us to seriously consider the introduction of a performance exam. The prerequisites for successfully implementing clinical performance exam as part of the national nursing licensing exam are a professional training process and forming a consortium to standardize practical training.
Focus Groups ; Humans ; Korea* ; Licensure* ; Licensure, Nursing ; Nursing* ; Specialization ; Surveys and Questionnaires

BACKGROUND: EEG shows a sequence of progressive changes in status epilepticus (SE). Timely antiepileptic drug treatment is an important factor for the prognosis of SE. Here we investigated the effect of treatment according to EEG staging in a lithium-pilocarpine SE rat model. METHODS: By analyzing the on-going EEG of SE, we injected propofol (PF) or propofol and valproate (PF+VA) on each defined EEG stage [early period, merging stage; middle period, continuous stage; late period, early periodic epileptiform discharges stage (ePED)]. We measured the duration of each stage after the treatment and the number of principal cells at three hippocampal areas (CA1, CA3, dentate gyrus] after SE. RESULTS: Both PF- and PF+VA-treated groups showed lower mortality rate in the merging stage-treated subgroup than in ePED-treated subgroup. Seizure duration was significantly shortened in the merging stage of both PF- (p<0.005) and PF+VA-treated groups than in untreated group (p<0.002). The durations of the continuous stage and ePED were shortened in the merging stage-treated subgroup, but ePED duration did not decrease in ePED-treated subgroup. The shortening of the continuous stage and ePED was more prominent in the PF+VA-treated group than in PF-treated group. Neuronal loss in both PF- and PF+VA-treated groups was so severe that CA1 and CA3 neuronal loss was decreased more markedly in the ePED-treated group than in the merging stage-treated group (p<0.01). CONCLUSIONS: Early therapy based on the defined EEG staging might be an effective option for shortening duration of SE and decreasing neuronal damage at the hippocampus. Early combination therapy adopting PF+VA requires further investigation for new treatment option.
Animals ; Electroencephalography ; Hippocampus ; Neurons ; Pilocarpine ; Prognosis ; Propofol ; Rats ; Secondary Prevention ; Seizures ; Status Epilepticus ; Valproic Acid

Penile metastases are rare, and usually secondary to other genitourinary primary tumors. Bladder, prostate and renal tumors are the main sources of penile metastasis. Rectal and respiratory neoplasms also metastasize to the penis. However, metastatic penile cancer originating from the pancreas is extremely rare. Here, a case of pancreatic cancer, with penile metastasis, is reported.
Male ; Neoplasm Metastasis ; Pancreas* ; Pancreatic Neoplasms ; Penile Neoplasms* ; Penis ; Prostate ; Urinary Bladder

A lymphoma of the prostate is very rare, and is usually incidentally discovered. Malignant lymphomas can be divided into either primary or secondary according to their origin. Secondary involvement of the gland is the most common presentation. Most non-Hodgkin's lymphomas that affect the prostate are of the B-cell type, and present with non-specific obstructive symptoms. A variety of methods have been used for their, including prostatectomy, radiotherapy or combinations of chemotherapy and radiotherapy. However, the prognosis remains poor, regardless of the patient's age, histological type, treatment or clinical stage at presentation. Here, the case of a patient with a B-cell lymphoma, who presented with symptoms of a bladder outlet obstruction, is reported. The patient has been in complete remission following the completion of 6 cycles of doxorubicin-based chemotherapy and accompanying radiotherapy.
B-Lymphocytes* ; Drug Therapy ; Drug Therapy, Combination* ; Humans ; Lymphoma ; Lymphoma, B-Cell* ; Lymphoma, Non-Hodgkin ; Prognosis ; Prostate* ; Prostatectomy ; Radiotherapy* ; Urinary Bladder Neck Obstruction