PURPOSE: This study was conducted to develop a teacher-efficacy scale which is adequate for heath education teachers. METHOD: A preliminary questionnaire was made based on the hypothetical factors. A total of 364 health education teachers answered to the preliminary test, and the potential factors of teacher-efficacy were checked out by exploratory factor analysis (EFA). In the main test 378 health education teachers answered, the factor structure was drawn by EFA, and confirmatory factor analysis (CFA) was conducted to test and the fitness of the factor model. RESULTS: Through the preliminary test, 5 potential factors were found, which were instruction, health-service, administrative task, interpersonal relationship, and community connection. Also, 48 items were reduced to 31 items. Through the main test, from the 34 items were extracted 4 factors with 24 items, And then teacher-efficacy scale was developed, which included the subscales of instruction efficacy, health-service efficacy, task-interpersonal efficacy, and community connection efficacy. CONCLUSION: Different from that for other subject teachers, the factor structure for health teachers had 4 factors with 24 items. The scale developed in this study is consistent with health teachers' work areas, and for this reason, has significance as a adequate and valid scale to measure teacher-efficacy of health education teachers.
Education ; Health Education* ; Weights and Measures ; Surveys and Questionnaires

Post transplant lymphoproliferative disorder is a serious complication after renal transplantation. Although the precise etiology is unknown, the Ebstein-Bar virus and immunosuppressive agents appear to be risk factors. The presentation of PTLD is diverse. Many patients develop symptoms in head and neck, which make diagnosis difficult. We experienced 3 cases of PTLD successively one or three months apart during year 2002. Before 2002, PTLD was very rare in our center. The incidence of PTLD in renal transplants in our center is 0.7% (5 out of 752), which is similar to that of other reports. But the incidence is very high during year 2002. This seems to be intensified immunosuppression recently adopted. EBV monitoring is necessary for early detection of PTLD in renal transplants.
Diagnosis ; Head ; Herpesvirus 4, Human ; Humans ; Immunosuppression ; Immunosuppressive Agents ; Incidence ; Kidney Transplantation ; Lymphoproliferative Disorders* ; Neck ; Risk Factors

Acute gastric dilatation leading to gastric necrosis is rare but potentially fatal condition that can occur in patients with bulimia. It usually develops after a bulimic episode and it is not diagnosed with sufficient rapidity it may lead to gastric perforation followed by peritonitis, sepsis, shock, and death. Because of the rarity of this condition and the patients in whom it occurs, the clinician must maintain a high degree of suspicion when treating patients with eating disorders who present with abdominal pain after a binge. This case report describes a 24-year old woman with acute gastric dilatation due to binge eating, who had the gastrotomy and died of complications such as gastric necrosis and disseminated intravascular coagulation.
Abdominal Pain ; Bulimia ; Disseminated Intravascular Coagulation ; Feeding and Eating Disorders ; Female ; Gastric Dilatation ; Humans ; Necrosis ; Peritonitis ; Sepsis ; Shock

Measurements of the diameter of the coronary artery (left main, left anterior descending branch, left circumflex branch, right) and the length of the coronary artery (left main, left anterior descending) were performed in 77 cases obtained from corpses with normal and mild atherosclerosis of coronary artery. Fifty-six males and 21 females were studied whose ages ranged from 15 -78 years old. The diameter of the coronary artery exponentially increased in accordance with the increase of age (left main coronary artery: lumen diameter=1.847+0.216 X age, R2=0.632, p<0.01; left anterior descending branch: lumen diameter=1.513 +0.241 X age, R2=0.539, p<0.01; right coronary artery:lumen diameter=1.830 +0.193 X age, R2=0.513, p<0.01; left circumflex branch: lumen diame-ter= 1.470+0.159 X age, R2=0.502, p<0.01). The lumen diameter of the left main coronary artery, the length of the left anterior descending branch and the thickness of the left anterior descending branch exponentially increased in accordance with the increase of the heart weight(left main coronary artery: lumen diameter=1.721+0.031 X heart weight, R2=0.338, p<0.01; left anterior descending branch: length=7.114+0.103 X heart weight, R2=0.313, p<0.01; left anterior descending branch: wall thickness=0.226+0.009 X heart weight, R2=0.256, p<0.01). But no significant difference was observed between the diameter, length of the coronary artery and various body indices, and heart weight. Microscopic and immunohistochemical studies on coronary arteries of 77 cases showed high frequency of diffuse intimal thickening with many smooth muscle cells and scanty macrophages and fragmentation of internal elastic lamina in arteries without atherosclerosis. These results indicate that the lumen diameter of coronary artery is closely correlated with age but not with various body indices and heart weight, and the length of the anterior descending branch is closely correlated with heart weight but not with age and various body indices. The results of the microscopic and immunohistochemical studies indicate that the early event of the atherosclerosis of the coronary artery is intimal thickening and fragmentation of internal elastic lamina.
Arteries ; Atherosclerosis ; Cadaver ; Coronary Vessels* ; Female ; Heart ; Humans ; Macrophages ; Male ; Myocytes, Smooth Muscle

The authors analysed 53 cases of sudden cardiac death(SCD) without prominent structural abnormalies of heart out of witnessed 300 cases. Thirty four cases were associated with sleep and 19 with activity or rest. Twenty one cases were classified as having normal hearts, and the rest as structurally mild abnormal ones. Male was predominant, and almost of the victims were suffered in their twenties or thirties. All cases collapsed instantaneously or in very short time with various and not specific terminal symptoms. Inducing or trigger factors are not clarified in almost of the cases. Mechanisms or causes of death could not be defined clearly. We concluded that careful heart examination with detailed clinical history under the appropriate postmortem investigation system is only effective approach for the true mechanism and cause of death.
Adult* ; Cause of Death ; Death, Sudden, Cardiac* ; Heart* ; Humans ; Male

Central venous catheterization is used to provide a large amount of fluid, total parenteral nutrition and to administer antitumor agents with few complications reported. We report an uncommon case of pleural effusion that occurred after central venous catheterization. In many cases, the mechanism for the pleural effusion after central venous catheterization occurs through an injury to the superior vena cava by the continuous mechanical force of the catheter tip, the flow of large amount of fluid and an osmotic injury to the wall of the vein. This case is somewhat different in that the central catheter was placed in an aberrant vessel resulting in the pleural effusion. A post-placement chest roentgenogram and the correct approach of catheterization are important for preventing this complication.
Antineoplastic Agents ; Catheterization ; Catheterization, Central Venous ; Catheters ; Central Venous Catheters* ; Parenteral Nutrition, Total ; Pleural Effusion* ; Thorax ; Veins ; Vena Cava, Superior

Thymolipoma is rare benign tumor of the thymic gland and mostly occurs at anterior mediastinum. Thymolipoma comprises 2~9% of thymic tumor and less than 1% of mediastinal mass. Therefore, thymolipoma should be differentiated from anterior mediastinal tumor such as thymoma, germ cell tumor and lymphoma. These tumors resemble cardiomegaly, pleural effusion, basal atelectasis, pericardial tumor and cyst, pleural tumor, lung cancer and pulmonary sequestration, and differentiated from above mentioned diseases. Though most cases are asymptomatic, there can be dyspnea with compression of adjacent organ by mass effect, and myasthenia gravis. We experienced a thymolipoma simulating cardiomegaly and report the case with the review of literatures.
Bronchopulmonary Sequestration ; Cardiomegaly* ; Dyspnea ; Lung Neoplasms ; Lymphoma ; Mediastinum ; Myasthenia Gravis ; Neoplasms, Germ Cell and Embryonal ; Pleural Effusion ; Pulmonary Atelectasis ; Thymoma ; Thymus Neoplasms

Although medication errors in hospital are common, medication errors that result in death rarely occur. We report a case of inadvertent intravenous injection of SMECTA(TM), a kind of oral antidiarrheal, in a 4-year-old boy, who underwent orthopedic surgery of foot to correct congenital malformation. After this medical accident seizure suddenly developed, mental change, and disseminated intravascular coagu-lopathy followed. The diagnostic confirmation of this fatal error was made after thrombi and foreign materials were identified the histopathologic examination in the lung, as well as by analyzing the components of the antidiarrheal such as magnesium, aluminum etc. We propose to make it a rule to keep the strategies, for examples, oral liquids should not be put in Luer-lock syringes for IV administration, avoid drugs with similar names or packages form placing in the same area to reduce errors.
Aluminum ; Child, Preschool ; Foot ; Humans ; Injections, Intravenous* ; Lung ; Magnesium ; Male ; Medication Errors ; Orthopedics ; Seizures ; Syringes

PURPOSE: We wanted to assess the technical feasibility and clinical efficacy of the placement and retrieval of a Gunther Tulip filter for the prevention of fatal pulmonary embolism during the management of patients with a free floating thrombus in their inferior vena cava (IVC). MATERIALS AND METHODS: Six patients having a free floating thrombus in their IVC (three patients with an isolated free floating thrombus in the IVC that resulted from immobilization due to traumatic liver injury or cerebral infarction, two patients with coexisting deep vein thrombosis in the left lower extremity that was caused by May-Thurner syndrome, and one patient with coexisting deep vein thrombosis in the right lower extremity that was due to nephrotic syndrome and immobilization after hip joint replacement) underwent placement and retrieval of a Gunther Tulip filter. The placement of the filter was performed through the right internal jugular vein to prevent the risk of detachment of the thrombus during the procedure. Retrieval of filter was performed after the free floating thrombus of the IVC had disappeared on follow-up CT because of anticoagulation therapy, aspiration thrombectomy or catheter directed Urokinase thrombolysis. RESULTS: The Gunther Tulip filter was successfully placed in the IVC in all six patients and it was retrieved after the management of the free floating thrombus. The mean duration of the placement of the filter was 11 days (range: 7-25 days). Two patients underwent placement of an iliac vein stent for the management of May-Thurner syndrome. Detachment of the free floating thrombus in the IVC and the subsequent thrombus entrapment in the filter were documented during aspiration thrombectomy or Urokinase thrombolysis in four patients. Recurrent thrombus didn't occur during the follow-up period (range: 3-20 months) in five of the six patients. In one patient, a recurrent thrombus due to the discontinuance of anticoagulation therapy was identified at the filter detachment site of the IVC on the follow-up CT 10 days after the filter retrieval, but it disappeared 15 days after proper anticoagulation therapy was done. CONCLUSION: Temporary Gunther Tulip filter placement is technically feasible and efficacious for the prophylaxis of pulmonary embolism in those patients with a free floating thrombus in the IVC, and particularly in those patients who will have subsequent aspiration thrombectomy or catheter directed Urokinase thrombolyis performed.
Catheters ; Cerebral Infarction ; Follow-Up Studies ; Hip Joint ; Humans ; Iliac Vein ; Immobilization ; Jugular Veins ; Liver ; Lower Extremity ; May-Thurner Syndrome ; Nephrotic Syndrome ; Pulmonary Embolism ; Stents ; Thrombectomy ; Thrombosis* ; Tulipa* ; Urokinase-Type Plasminogen Activator ; Vena Cava, Inferior* ; Venous Thrombosis

When the circumstance of a death seems to be related with electric shock, most of the forensic pathologists tend to diagnose the cause of death as electrocution if they see the electric mark(s) with the notincompatible histology, and find no other definite causes of death at autopsy. But admittedly forensic pathologists know that the so-called electric mark(s) and its histology is not pathognomonic to diagnose electrocution, so the diagnosis should be confirmed by the appropriate investigation of the death scene and the electric devices. We present a case of a man who had a likely current mark that could be diagnosed as natural by ruling out the possibility of electrocution with the examination of the electric lamp which had been under the dead body at the scene. This case gives us the importance of appropriate probe about scene evidences supplied by forensic science in diagnosing and ruling out the electrocution.
Autopsy ; Cause of Death ; Diagnosis ; Forensic Sciences ; Shock