The syndrome of postural headache associated with low CSF pressure usually occurs after a dural puncture, myelography, or spinal anesthesia. However, it can also develop spontaneously or after minor trauma. Although the clinical and MRI findings of this syndrome are well described, radionuclide cisterno-graphic findings have not yet been clearly characterized. We report four patients presenting with postural headache associated with very low or unmeasurable CSF pressure. Three patients developed after minor trauma, while one developed spontaneously. Brain MRI revealed symmetric pachymeningeal enhancement in all four patients. Radionuclide cisternography demonstrated delayed migration of tracer to the cerebral convexity at 6 and 24 hours in three patients, and early soft tissue uptake suggestive of CSF leakage in one. We suggest that these radionuclide cisternographic findings are supportive evidences for the presence of intracranial hypotension and may provide useful information for appropriate treatment.
Anesthesia, Spinal ; Brain ; Headache ; Humans ; Intracranial Hypotension* ; Magnetic Resonance Imaging ; Myelography ; Punctures

Among the complications of Clostridium difficile (C. difficile) infection, rectal prolapse has been very rarely reported in children. We report a 29-month-old girl who presented with rectal prolapse complicated with C. difficile-associated pseudomembranous colitis following 3-week course of oral amoxicillin/clavulanic acid for treatment of acute otitis media. The patient complained of fever, abdominal pain and mucoid bloody diarrhea. She also showed a protruded and everted rectal mucosa with discrete white-yellowish exudative plaques. Abdominal CT scan revealed a diffuse wall thickening with mucosal enhancement of the rectosigmoid colon. Both stool culture and toxin assay for C. difficile were positive. Her symptoms were completely improved with oral metronidazole treatment. C. diffile-associated pseudomembranous colitis should be considered as a rare but possible cause of rectal prolapse in children who have recently received antibiotic therapy.
Abdominal Pain ; Child* ; Child, Preschool ; Clostridium difficile ; Colon ; Diarrhea ; Enterocolitis, Pseudomembranous* ; Female ; Fever ; Humans ; Metronidazole ; Mucous Membrane ; Otitis Media ; Rectal Prolapse* ; Tomography, X-Ray Computed

OBJECTIVE: User satisfaction of nursing information system and its user interface were measured in the S general hospital which new electronic medical record system had been introduced to. The new system had been developed based on nursing job's analysis. METHODS: 487 nurses who were working in the S hospital joined to survey through QUIS (Questionnaire for User Interface Satisfaction) about satisfaction of system they used. There were 4 categories-convenience, rapid response, content/configuration, accuracy of information. Those 4 categories were used analytical factors to know how the users were satisfied with its interface and function through the selected 13 system interfaces. RESULTS: With 9 scales of satisfaction score, we measured the satisfaction that the hardware provided. Terminology and system information got the highest score, and user friendly interface, easiness of learning, system performance in high score order. As like as above, we defined 5 scales of user interface satisfaction score. Content, configuration, information accuracy, convenience, rapid responses were identified as analytic categories. With interface satisfaction aspect, the pages which were reconfigured from physician order page to nurse interface got the highest score. And content and page configuration were acknowledged as the highest place. CONCLUSION: This study showed the nurses were satisfied with nursing information system. Also the trend of system development can be revealed.
Electronic Health Records ; Hospitals, General ; Information Systems* ; Learning ; Nursing* ; Weights and Measures

This study's purpose was to compare the treatment efficacy and the effects on the patients' quality of life of the pelvic floor muscle (PFM) exercise and the functional electrical stimulation (FES)-biofeedback method. Ninety female incontinence patients were randomly selected and evenly divided into three groups: control, intensive PFM exercise, and FES-biofeedback groups. They were treated for 6 weeks. The subjective changes in the severity of incontinence and discomfort in daily and social life were measured using a translated version of Jackson's Bristol female urinary symptom questionnaire. Objective changes of pelvic muscle contraction force were measured by perineometer. Pre and post-treatment maximal pelvic floor muscle contractile pressure (PMC pressure) among the three groups showed statistically significant differences (p < 0.001). Especially the FES-biofeedback group showed significantly increased maximal PMC pressure compared with other groups (p < 0.001). From the questionnaire, pre and post-treatment changes in the severity of urinary incontinence and discomfort due to incontinence showed significant differences among the three groups (p < 0.001). The level of discomfort in daily life, social activity, physical activity, personal relations and discomfort due to urinary symptoms had largely changed and the FES-biofeedback group, in particular, showed a significant decrease after treatment. In conclusion, when PFM exercise and FES-biofeedback were compared in terms of their effects on the patients' quality of life, FES-biofeedback proved to be more effective than verbal explanation or simple PFM exercise.
Adolescence ; Adult ; Aged ; Electric Stimulation ; Exercise* ; Female ; Human ; Middle Age ; Pelvis/physiology* ; Prospective Studies ; Quality of Life* ; Urinary Incontinence, Stress/prevention & control*

We undertook this work to compare the treatment efficacies and the changes of quality of life after pelvic floor muscle (PFM) exercise and the functional electrical stimulation (FES)-biofeedback treatment, both of which are being widely used as conservative treatment methods for female urinary incontinence. We randomly selected 60 female incontinence patients who visited our department and divided them evenly into two groups. They were treated for a period of 6 weeks. The subjective changes in the severity of incontinence and discomfort in daily and social life were measured using a translated version of the questionnaire by Jackson. Objective changes of pelvic muscle contraction force were measured using a perineometer. Pre- and post-treatment maximal pelvic floor muscle contractile (PMC) pressure and changes in the severity of urinary incontinence and discomfort of the two groups showed statistically significant differences (p>0.001). In particular the FES-biofeedback group showed significantly increased maximal PMC pressure and a decreased severity of urinary incontinence and discomfort compared to the intensive PFM exercise group (p>0.001). In conclusion, FES-biofeedback proved more effective than simple PFM exercise.
Activities of Daily Living ; Biofeedback (Psychology)* ; Exercise Therapy*/methods ; Female ; Human ; Muscle Contraction ; Muscles ; Pelvic Floor ; Treatment Outcome ; Urinary Incontinence, Stress/therapy* ; Urinary Incontinence, Stress/psychology ; Urinary Incontinence, Stress/prevention & control ; Urinary Incontinence, Stress/physiopathology

We undertook this work to compare the treatment efficacies and the changes of quality of life after pelvic floor muscle (PFM) exercise and the functional electrical stimulation (FES)-biofeedback treatment, both of which are being widely used as conservative treatment methods for female urinary incontinence. We randomly selected 60 female incontinence patients who visited our department and divided them evenly into two groups. They were treated for a period of 6 weeks. The subjective changes in the severity of incontinence and discomfort in daily and social life were measured using a translated version of the questionnaire by Jackson. Objective changes of pelvic muscle contraction force were measured using a perineometer. Pre- and post-treatment maximal pelvic floor muscle contractile (PMC) pressure and changes in the severity of urinary incontinence and discomfort of the two groups showed statistically significant differences (p>0.001). In particular the FES-biofeedback group showed significantly increased maximal PMC pressure and a decreased severity of urinary incontinence and discomfort compared to the intensive PFM exercise group (p>0.001). In conclusion, FES-biofeedback proved more effective than simple PFM exercise.
Activities of Daily Living ; Biofeedback (Psychology)* ; Exercise Therapy*/methods ; Female ; Human ; Muscle Contraction ; Muscles ; Pelvic Floor ; Treatment Outcome ; Urinary Incontinence, Stress/therapy* ; Urinary Incontinence, Stress/psychology ; Urinary Incontinence, Stress/prevention & control ; Urinary Incontinence, Stress/physiopathology

The purpose of this study was to compare food habits and nutrient intakes among high school students with different obesity indexes who are residing in Seoul and Kyunggi-do. a total of 533 subjects were assigned to one of the following groups based on BMI : underweight, normal-weight and overweight. Food habits and nutrient intakes were evaluated based on questionnaires and 24hr-dietary record. The results were as follows. There was no significant differences in the general environmental characteristics of subjects with different BMI. However, the father's BMI was significantly higher in overweight female students compared to underweight or normal weight subjects. The menarch age was significantly decreased as the obesity increased. The self-satisfaction score for physical type was decreased as the BMI increased. The overweight group skipped dinner more frequently the other groups among male students. There was no significant difference in the scores of nutrition knowledge, nutritional attitude, and self -satisfaction of subjects with different BMI. The nutrient intakes of overweight group were the lowest among the three groups. In conclusion, obesity among female students may be related to family member's obesity. Also overweight students tend to have lower self satisfaction for their body image and undesirable food habits. Therefore, proper nutrition education is required to maintain desirable food habits for overweight students.
Body Image ; Education ; Female ; Food Habits* ; Gyeonggi-do* ; Humans ; Male ; Meals ; Obesity* ; Overweight ; Seoul* ; Thinness ; Surveys and Questionnaires

BACKGROUND: Factor VII:C (FVII:C) has been shown to be a risk factor of ischemic heart disease (IHD) and plasma levels are reported to be associated with polymorphisms of the FVII gene. Cerebrovascular disease (CVD) shares many of the risk factors associated with IHD but few studies about the relationship between FVII and CVD have been investigated. In this study, we sought to determine the relationship between FVII gene polymorphisms and cerebral infarct in the population below 50 years old. METHODS: The subjects were 78 patients with cerebral infarct who had been admitted between March and December 1999 and 70 controls, matched with age and sex. FVII R353Q and hypervariable region 4 (HVR4) polymorphisms were analyzed with allele specific PCR and restriction enzyme treatment. FVII:C assay was performed on the STAGO Compact analyzer. Total cholesterol and triglycerides were also measured. RESULTS: There was no significant difference in FVII:C, total cholesterol and triglycerides between patients and controls. The distribution of the FVII R353Q genotype and the HVR4 genotype also showed no differences in patients, compared to controls. But both polymorphisms were significantly associated with FVII:C levels in the patients and controls. CONCLUSIONS: The level of FVII:C was related to FVII gene polymorphisms but there is no significant difference of FVII gene polymorphisms in the cerebral infarct population, compared to controls. Our study supports that neither FVII:C levels nor FVII genotypes are independently involved in the pathogenesis of cerebral infarct. In conclusion, the FVII genotype is a major predictor of plasma FVII:C levels but may not play an important role in the development of cerebral infarct.
Alleles ; Cholesterol ; Factor VII* ; Genotype ; Humans ; Middle Aged ; Myocardial Ischemia ; Plasma ; Polymerase Chain Reaction ; Risk Factors ; Stroke* ; Triglycerides

No abstract available.
Duodenal Ulcer* ; Humans ; Recurrence*

Lupus anticoagulant (LA) and anticardiolipin antibody (aCL) are circulating immunoglobulins against phospholipids which can result in prothrombotic conditions We present our experience of 45 LA and/or aCL positive stroke patients. I A was tested with a combination of aPTT mixing test, thromboplastin inhibition test, and kaolin clotting time. aCL was measured with ELIZA. There were 33 males and 12 females with their ages ranging from 20 to 76(mean 518) Fifteen patients did not have risk factors for stroke, while 13 had a single, and 17 had multiple risk factors. Hypertension (20 cases) and smoking (14 cases) were the important risk factors while cardiac diseases were found in 9 patients. All patients underwent head CT and/or MRI, which showed multiple infarcts in 18, single infarct in 22, intracerebral hemorrhages in 4, cortical venous infarct in 1 and sagittal sinus thrombosis in 1. Among patients with cerebral infarct, 23 had infarcts in carotid territory, only 7 of whom had large infarcts involving the cerebral cortex. Eleven had strokes in vertebro-basilar territory, and 6 had in both. Overall, 22 patients had relatively small infarcts in carotid territory. Angiogram was performed in 23 patients, which showed normal findings in 14 (most did not have risk factors), internal carotid narrowing or occlusion in 2, proximal MCA narrowing in 2, occlusion of vertebral artery in 1, multiple MCA and ACA occlusion in 1, and venous occlusion in interestingly, one patient showed occlusion of proximal branches of aorta consistent uith Takayasu's disease We conclude that relatively small multiple or single ischemic lnfarcts with negative angiographic findings are the most characteristic findings of antiphospholipid antibody associated stroke, while occasionally observed marked angiographic abnormalities or large cerebral embolic strokes are usually associated with other risk factors Antiphospholipid antibodies seem to play a role in the dlevelopment of cerebrovascular diseases in Korean patients especially in the young age.
Antibodies, Anticardiolipin ; Antibodies, Antiphospholipid* ; Aorta ; Cerebral Cortex ; Cerebral Hemorrhage ; Female ; Head ; Heart Diseases ; Humans ; Hypertension ; Immunoglobulins ; Kaolin ; Lupus Coagulation Inhibitor ; Magnetic Resonance Imaging ; Male ; Phospholipids ; Risk Factors ; Sagittal Sinus Thrombosis ; Smoke ; Smoking ; Stroke ; Thromboplastin ; Vertebral Artery