Androgen insensitivity syndrome is a genetic syndrome characterized by complete or partial resistance of end organ to the peripheral effect of androgen. Patient have a male karyotype(46,XY) and bilateral testes. Appearance of external genitalia depend on the degree of androgen insensitivity. In the complete form, external genitalia is normal female but in the incomplete form, external genitalia figure varies hom that of a virilized female to that of an undervirilized male with a short penis and hypospadia. The gonads are able to be located along the descending course of the testis during development. The usual presenting symptom in complete type is primary amenorrhea or inguinal mass, but in incomplete type, the patient mainly present with ambiguous genitalia. Recently we experienced one case of this syndmme and removed the bilateral gonads, so we report it with brief review of literatures.
Amenorrhea ; Androgen-Insensitivity Syndrome* ; Disorders of Sex Development ; Female ; Genitalia ; Gonads* ; Humans ; Hypospadias ; Male ; Penis ; Testis

BACKGROUND: Epidural anesthesia is becoming an increasingly important aspect of anaesthetic practice because it has many advantages. To achieve the appropriate sedation, various methods have been described. The authors applied the ketamine for this purpose in subanesthetic dose and compared with the midazolam that has been most commonly used for intravenous sedation. METHODS: Fifty-seven adult patients undergoing lower abdominal and extremity surgery who were receiving epidural anesthesia were randomely enrolled into this clinical study. They were allocated to three groups to receive only normal saline (group C), midazolam 0.05 mg/kg (group M) and ketamine 0.5 mg/kg midazolam 0.05 mg/kg (group K) in normal saline 10ml, respectively. Hemodynamic and respiratory measurements were recorded at baseline, 1 minute, 3 minute, 5 minute, 10 minute, 20 minute and 30 minute after sedation. The degree of sedation was assessed by a blinded observer using sedation score. RESULTS: There were no significant differences for hemodynamic and respiratory parameters, but decrements of arterial pressure at 1 minute after sedation were most remarkable in the group M. Sedation was satisfactorily achieved by combination of ketamine and midazolam without significant emergence reaction. CONCLUSIONS: The combination of ketamine and midazolam was judged to be suitable alternative for sedation during epidural anesthesia.
Adult ; Anesthesia, Epidural* ; Arterial Pressure ; Extremities ; Hemodynamics ; Humans ; Ketamine* ; Midazolam*

OBJECTIVE: To examine the synergistic effects of both computer-assisted cognitive rehabilitation (CACR) and transcranial direct current stimulation (tDCS) on cognitive function in patients with stroke. METHODS: The current double-blind, sham-controlled study enrolled a total of 11 patients who were newly diagnosed with stroke. The patients of the tDCS group (n=6) completed sessions of the Korean computer-assisted cognitive rehabilitation program five times a week for 30 minutes a session during a mean period of 18.5 days concomitantly with the anodal tDCS over the bilateral prefrontal cortex combined with the CACR. The patients of the control group (n=5) also completed sessions of the sham stimulation during a mean period of 17.8 days. Anodal tDCS over bilateral prefrontal cortex (F3 and F4 in 10-20 EEG system) was delivered for 30 minutes at an intensity of 2 mA. Cathode electrodes were applied to the non-dominant arm. All the patients were evaluated using the Seoul Computerized Neuropsychological Test (SCNT) and the Korean Mini-Mental State Examination. RESULTS: Mann-Whitney U test revealed a significant difference between the two groups. The patients of the tDCS group achieved a significant improvement in the post/pre ratio of auditory continuous performance test and visual continuous performance test on the SCNT items. CONCLUSION: Our results indicate that the concomitant use of the tDCS with CACR to the prefrontal cortex may provide additional beneficial effects in improving the cognitive dysfunction for patients with stroke.
Arm ; Electrodes ; Electroencephalography ; Humans ; Neuropsychological Tests ; Pilot Projects* ; Prefrontal Cortex* ; Rehabilitation* ; Seoul ; Stroke*

The purpose of this study was to analyze the relationship among the health promoting behaviors, self-reported climacteric symptoms and depression on a cross-sectional survey design. The subjects were 108 middle-aged women who were non-hystrectomized and ranged in age from 40 to 60. They were selected in Seoul and Kyoung-ki province, Korea. Data were collected from Oct. 25 to Nov. 10, 1997 by a structured questionnaire. The instrument used for this study was the revised Health Promotion Lifestyle Profile(HPLP) developed by Walker, Sechrist and Pender, revised Climacteric Symptoms Scale developed by Chi, Sung Ai, and the Beck's Depression Inventory(BID). The data were analyzed by the SPSS/PC+ program using t-test, ANOVA and Scheffe test as a post hoc and Pearson Correlation Coefficient. The results of the study were as follows ; 1. The mean score of health promoting behaviors was low(2.42+/-0.35). There were statistically significant difference in the score of health promoting behaviors according to the educational background, family income, marital satisfaction, and whether or not taking a restorative food(t=-2.07, F=2.60~7.57, p<0.05). 2. The mean score of self-reported climacteric symptoms was 1.69 ; 99% of middle-aged women had symptoms. There were statistically significant difference in the score of middle-aged women's self-reported climacteric symptoms according to the age, number of children, educational background, occupation, family income, marital satisfaction, whether or not receiving hormone replacement therapy(HRT) or consultation experience with a professional, and perceived health status(t=-2.04~3.69, F=2.87~11.63, p<0.05). 3. The mean score of depression was 10.84. There were statistically significant differences in the score of the depression according to the age, number of children, educational background, occupation, marital satisfaction, whether or not receiving menopausal treatment of consultation by a professional, and perceived health status(t=-2.25~3.00, F=3.50~9.24, p<0.05). 4. Women's degree of health promoting behaviors was a negative correlation with the degree of climacteric symptoms(r=-0.19, p=0.03) and the degree of depression(r=-0.23, p=0.01). The degree of climacteric symptoms was a positive correlation with the degree of depression(r=0.64, p=0.01). In conclusion, health promoting behavior should be considered when developing nursing strategies for middle-aged women, especially when dealing with climacteric symptoms and depression.
Child ; Climacteric* ; Cross-Sectional Studies ; Depression* ; Female ; Health Promotion ; Humans ; Korea ; Life Style ; Menopause ; Nursing ; Occupations ; Surveys and Questionnaires ; Seoul

PURPOSE: This study was to identify the relationship among self-management, economic stability, self-esteem, self-achievement and predictor of the self-achievements in elders. METHODS: A total of 294 subjects aged between 60 and 92 were selected through convenient sampling. Data were collected by self-reported questionnaire from May to June, 2008. Collected data were analysed by the SPSS/WIN 15.0 program. RESULTS: Self-management, economic stability, self-esteem, self-achievement were positively correlated. The most significant predictor of self-achievement in elders were self-management and self-esteem. CONCLUSION: These findings suggest that self-achievement is influenced by self-management and self-esteem and needed for aged well.
Self Care ; Surveys and Questionnaires

The aim of this stud y was to compare the epidermal thinning properties of four corticosteroid ointments applied under occlusion, using histology and histometry. The results were surnmerized as follows: 1.The stratum corneurn was dramatically thinned, appearing as a wispy layer of horny cells as apposed to the norrnal basket-weave configuration. this effect was prominent at sites treated with clobestasol propionate, fluocinonide, and fluocinolone acetonide. 2. With the histometry, visible epidermal thickness wa.s markedly reduced. This effect w is prominent in the following ascending order: fluocinolone acetonide, fluocienonide, clobestasol-17-propionate. Hydrocortisone was the least atrophogenic. 3. Clohestasol-17-propionate and fluocinonide caused significant flattening of dermo-epidermal junction, Fluocinolone acetonide and hydrocortisone caused less pronounced cbanges. 4. Marked capillary dilation af papilly dermis is caused by clobestasol-17-propionate, fluocinonide and fluocinolone acetonide.
Adrenal Cortex Hormones* ; Atrophy* ; Capillaries ; Dermis ; Diethylpropion ; Epidermis* ; Fluocinolone Acetonide ; Fluocinonide ; Humans* ; Hydrocortisone ; Ointments

BACKGROUND: Antibiotics are used prophylactically in surgery to prevent postoperative infection. However, antibiotics administered in large doses can cause a bleeding diathesis as a result of platelet dysfunction. We wondered whether these antibiotics might impair platelet function by interfering with the initial step of platelet activation: the binding of agonists to their specific receptors on the platelet surface. METHODS: In 30 patients (male 18, women 12) undergoing primary elective knee arthroscopic surgery, the whole blood coagulation system was prospectively evaluated before, and 10 and 40 minutes after administration of 1 g of augmentin. All patients who had abnormal preoperative coagulation profiles or who received anticoagulant or antiplatelet, antibiotics therapy within 7 days prior to surgery were precluded. RESULTS: At 10 minutes after augmentin administration 25 of 30 patients had a significant impairment in all phases of whole blood coagulation as monitored by thromboelastography. In contrast, three of 30 patients had a significantly decreased coagulation time. Two of 30 patients had no significant changes of TEG variables. TEG variables were restored toward baseline in fourty minutes after augmentin administration. CONCLUSIONS: Augmentin can cause a significant but transient change in the viscoelastic properties of blood. Coagulation parameters of the TEG should be measured prior to augmentin administration to prevent and prospect a bleeding diathesis as a result of platelet dysfunction.
Amoxicillin-Potassium Clavulanate Combination ; Anti-Bacterial Agents ; Arthroscopy ; Blood Coagulation ; Blood Platelets ; Disease Susceptibility ; Female ; Hemorrhage ; Humans ; Knee ; Platelet Activation ; Prospective Studies ; Thrombelastography*

Background & PURPOSE:Since the 1970's the rate of breast-feeding has decreased significantly. The Korean National Institute of Health reported that the rate of breastfeeding was 68.9% in 1982 and 14.1% in 1997. There are many influencing factors including: the lack of education and information on breast feeding, lack of faith in breast feeding, increment of the rate of working, lack of encouragement by supporters in difficult situations, and nurses' low level of knowledge about breast feeding. Such a lack of knowledge and support of breast-feeding at home by family members create another dilemma to the problem of breast-feeding. If problems arise and family members are unable to provide assistance due to the deficiency of knowledge, mothers show a tendency to abandon breast-feeding. The purpose of this research is to find out the rate of breast-feeding practice by time sequence of 1 week, 6 weeks and 12 weeks after birth and influencing factors on breast-feeding practice centered on the postpartal women who were 3discharged from one hospital, which is located in Seoul and provides simple breast-feeding education and continuous postnatal telephone consultation. Methodology: The subjects of this research were 54 women who gave birth in a hospital located in Seoul from 1 March 2000 to 31 April 2000. After birth the subjects were educated individually about breast-feeding and telephone consultations were conducted. On the 1st week, 6th week, and 12th week, the subjects were surveyed about their breast-feeding practice rates and methods by telephone. Results: 1) Complete breast-feeding rate: Within one week after birth, the subjects showed 64.2% complete breast-feeding rate. Within 6 weeks, 39.6%, and 12 weeks, 34.1%. 2)Partial breast-feeding rate: Within one week after birth, the subjects showed 32.1% partial breast-feeding rate. Within 6 weeks, 39.6%, and 12 weeks 15.1%. 3)Complete bottle-feeding rate Within one week after birth, the subjects showed 1.9% complete bottle-feeding rate. Within 6 weeks of giving birth 15.1%, and 12 weeks 17.0%. These results show that individual education about breast-feeding and continuous postnatal telephone consultation influenced on the practice of breast-feeding. On considering the reality of the hospital situation in which nurses could not operate education program due to the work-load, it is necessary to find out selectively those mothers who are unable to breast feed and provide education individually and continuous support by telephone follow up. Futhermore, the active role of lactation nurse specialist and their efficient management of breast-feeding for the successful practice is required.
Breast ; Breast Feeding ; Education* ; Female ; Follow-Up Studies* ; Humans ; Lactation ; Mothers ; Parturition ; Referral and Consultation ; Seoul ; Specialization ; Telephone*

BACKGROUND: Direct wet mount examination of vaginal secretion, widely applied for the diagnosis of Trichomonas vaginalis infection in woman patients, is rapid and economical. However, the sensitivity of this technique is not so high. In this study enzyme-linked immunosorbent assay(ELISA) was employed for the detection of serum anti-T. vaginalis IgG antibodies from vaginal trichomoniasis patients. METHODS: Eighty sera from trichomonoasis patients who visited a Dr. Yoon Kyong's Obstetric & Gynecologic Clinic in Songnam and 30 non-infected healthy men were tested for detection of anti-T. vaginalis IgG antibody. Soluble lysate and excretory-secretory antigen prepared by mixing of six isolates of T. vaginalis, and lysate from one isolate(KT4) were used as antigen for ELISA. RESULTS: The sensitivity of ELISA using lysate of six isolates was 95.0%, and the sensitivity of the lysate from KT4 and mixed excretory-secretory antigen from 6 isolates were 86.4% and 76.3%, respectively. Specificities of ELISA by three 93.3%, 96.3% and 92.0%, respectively. CONCLUSION: It is suggested that ELISA using mixed lysate of T. vaginalis six isolates could be useful tools for the diagnosis of trichomoniasis.
Antibodies ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Female ; Gyeonggi-do ; Humans ; Immunoglobulin G* ; Male ; Trichomonas vaginalis ; Trichomonas*

The purpose of this phenomenological study was to explore and describe the experience of people with HIV/AIDS. Three men and three women with HIV/AIDS participated in the study. They were asked open-ended and descriptive questions in order for them to talk about their experience in their own terms. Interviews were audiotaped and transcribed to maintain data integrity and to reduce perceptual bias. The transcripts were analyzed by the Colaizzi method. Member checks from the participants were used to validate the emergent themes. Seven themes emerged from the analysis. 1. People with HIV/AIDS have a strong impact and emotional reaction when receiving positive HIV test results. 2. All people with HIV/AIDS attempt to conceal HIV infection because of fear of stigma or rejection. 3. After the initial brief traumatic reaction to HIV/AIDS diagnosis, all participants feel lonely because they had no one to express or share their own experiences. 4. People with HIV/AIDS reflect on their life, think about the death and dying process and they become depressed. 5. Most participants feel that the family members who know his/her diagnosis are a big source of support. 6. According to the normativeness of infection route of HIV, the degree of guilty feeling differs among participants. 7. Although all participants think medication is a lifeline, the adherence to medication is not maintained because of side effects, denial and concealment of HIV/AIDS. The results of this study may help nurses and other health care workers to implement more efficient nursing strategies for people with HIV/AIDS by more deeply understanding their experience.
Bias (Epidemiology) ; Delivery of Health Care ; Denial (Psychology) ; Diagnosis ; Female ; HIV ; HIV Infections ; Humans ; Male ; Nursing