The purpose of the study was to investigate two areas as a basis for providing an educational program for pulmonary rehabilitation. A) the learning needs about chronic obstructive pulmonary disease in patients with chronic obstructive pulmonary disease and B) the perception of nurses of the same learning needs. The subjects consisted of 57 patients, with chronic obstructive pulmonary disease, at the general hospital in Seoul and 71 nurses, who were working in the medical ward. Data was obtained from a "learning need" questionnaire between October 29 and November 19, '99. Data was analyzed using SAS program for t-test, ANOVA, Scheff test. The result were as follows: 1. The learning needs of the nurses(mean 4.36 +/- .38) were higher than those of the patients (mean 3.56 +/- .83). (t=6.78, P=.001) 2. The highest ranked patient education needs were as follows ; a)"how to control dyspnea", b)"cause for activating dyspnea", and c)"how to minimize the necessity of oxygen in daily living": and nurses' learning needs were ; a)"how to cope with the risk situation", b)"management after discharge", and c)"how to control dyspnea". 3. In the patient group, those who had a college degree or higher education and paid their own hospital expenses were higher in the learning needs. According to the above results, we should consider an educational program which is realistic and effective for patients by evaluating the items the patients really want to learn about and how much they know about the evaluated items.
Education ; Hospitals, General ; Humans ; Learning* ; Oxygen ; Patient Education as Topic ; Pulmonary Disease, Chronic Obstructive* ; Rehabilitation ; Seoul ; Surveys and Questionnaires

In 1908 Leiner described the peculiar skin condition among infants to which he applied the name erythroderma desquamativa. The four cardinal features of Leiners disease are generalized seborrheic dermatitis, intractable severe diarrhea, recurrent local and systemic infections usually of gram negative etiology, and marked wasting and cyst rophy. A 2-month-old female presented to our clinic with generalized seborrheic erythrodermic eruption and intractable diarrhea. She had sufferd from these symptoms since birth. Her body weight was 3.4kg (below 3rd percentile). Her scalp was covered with thick yellowish crsts. There was generalized erythroderma covered vith scales and crusts. Laboratory result; revealed gram negative sepsis and DIC. Chest X-ray showed the findings of minimal aspir ition pneumonia in the right upper lobe. She expired on the following day.
Body Weight ; Dacarbazine ; Dermatitis, Exfoliative ; Dermatitis, Seborrheic ; Diarrhea ; Female ; Humans ; Infant ; Parturition ; Pneumonia ; Scalp ; Sepsis ; Skin ; Thorax ; Weights and Measures

Polyarteritis nodosa (PAN) is a necrotizing angitis that predominantly affects small-and medium-sized arteries in which microaneurysm or occlusion of the visceral arteries can be seen by arteriography. Patients with PAN may have non-specific symptoms at the beginning of their illness, but progression can be sudden and result in severe, even life threatening, complications. These include central nervous system hemorrhages, gastrointestinal hemorrhages or perforation, acute appendicitis, liver infarcts, acute renal failure, renal perirenal hematomas, and cardiac failure. A diagnosis of PAN should be considered when multiple small-sized aneurysms are detected by angiography, even if a biopsy is negative. Involvement of gastrointestinal and renal arteries is frequent in polyarteritis nodosa. The most common complications of gastrointestinal involvement are mucosal ulceration, bowel infarction, perforation, cholecystitis and hepatitis. Another rare but potentially life-threatening complication is perirenal hematoma caused by spontaneous rupture of renal aneurysm. Because of this possibility, rapid evaluation of these patients is necessary to make early diagnosis and treatment possible. We describe an extremely rare case of polyarteritis nodosa with development of spontaneous perirenal hematoma due to rupture of renal aneurysm, which was evaluated with immediate angiography and treated by coil embolization.
Acute Kidney Injury ; Aneurysm* ; Aneurysm, Ruptured ; Angiography ; Appendicitis ; Arteries ; Biopsy ; Central Nervous System ; Cholecystitis ; Diagnosis ; Early Diagnosis ; Embolization, Therapeutic ; Emergencies* ; Emergency Service, Hospital* ; Gastrointestinal Hemorrhage ; Heart Failure ; Hematoma ; Hemorrhage ; Hepatitis ; Humans ; Infarction ; Liver ; Polyarteritis Nodosa* ; Renal Artery* ; Rupture* ; Rupture, Spontaneous ; Ulcer

Background: Korea is no longer safe from the risk of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL); the first reported case was a Korean woman in her 40s who had a 7-year-history of receiving an implant-based augmentation mammaplasty using a textured implant. We conducted this study to discuss the emerging crisis of stakeholders in implant-based augmentation mammaplasty and to propose a multi-disciplinary approach to early detection of its complications. Methods: We analyzed medical examination data that was collected from patients who visited us between August 12 and September 27, 2019. We evaluated a total of 114 women (n = 114) in the current study. They were evaluated for whether they were in healthy condition. Moreover, their baseline characteristics were also examined; these included age, gender, height (cm), weight (kg), duration since surgery (years), possession of a breast implant card, the site of surgical incision, side of symptoms and reasons for outpatient visit. Furthermore, the patients were also evaluated for their subjective awareness of the manufacturer, surface and shape of the breast implant. Potential complications include malrotation, folding, seroma, capsule thickening, upside-down rotation, rupture, capsule mass and breast mass. Results: A majority of the patients had a past history of receiving textured implants. The corresponding percentage was 78.95% (90/114) and 85.09% (97/114) based on their subjective awareness of a breast implant and sonographic findings, respectively. That is, it was slightly increased with the use of a breast ultrasound. Conclusion Here, we propose the following approaches. First, patient data should be prospectively collected. By tracking outcomes and complications of an implant-based augmentation mammaplasty, both high-quality care and patient safety can be ensured. Second, stakeholders in implant-based augmentation mammaplasty should collaborate with customers and regulatory authorities. Third, surgeons should consider applying imaging modalities for early detection of postoperative complications.

A clinico-pathologic study with an immunohistochemical examination for c-erbB-2 expression in 54 cases of ductal carcinoma in situ and 16 cases of Paget's disease of the breast was performed. c-erbB-2 oncoprotein overexpression was observed in 45% (24/54) and 88% (14/16) of ductal carcinoma in situ and Paget's disease, respectively. The overexpression of c-erbB-2 oncoprotein was significantly correlated with the nuclear grade of tumors and inversely with the status of the estrogen receptor. c-erbB-2 was positive in 4 out of 5 patients with metastasis to axillary lymph nodes and 3 out of 4 patients who died of the disease. Prognostic significance of c-erbB-2 oncoprotein in ductal carcinoma in situ was highly suggested. The expression of c-erbB-2 oncoprotein in Paget's disease was well correlated with coexisting infiltrating or in situ ductal carcinoma. The high positive rate of c-erbB-2 oncoprotein in ductal carcinoma with Paget's disease could be understood with a recent hypothesis that c-erbB-2 oncoprotein is involved in promotion of cell motility and the spread of carcinoma cells.
Neoplasm Metastasis

BACKGROUND: The major serious risk of blood transfusion is post-transfusion hepatitis. Currently HBsAg, anti-HCV and serum alanine aminotransferase (ALT) assays are screened for potential blood donors to prevent transfusion associated hepatitis in Korea. But the effectiveness of serum ALT as a surrogate marker for the screening of non-A, non-B hepatitis is controversial. The present study was designed to evaluate the prevalence of hepatitis markers in Korean blood donors and the usefulness of ALT as a surrogate marker. METHODS: The prevalence rates of anti-HCV and HBsAg were analyzed by age, sex and ALT cut-off level in 405,931 blood donors. The current anti-HCV EIA (LG HCD 3.0 ) comparing to anti-HCV confirmatory immunoblot assay (LG HCD confirm ) and ALT test were evaluated. RESULTS: The positive rate of HBsAg was 3.32% and higher in male across all age group (p<0.01). The rate increased as age increases up to thirties and decreased thereafter. The positive rate of anti-HCV was 0.24% in EIA, and higher in female across all age group except for teenage group (p<0.01). The rate increased as age increases up to fifties (p<0.01). Results of immunoblot assay showed 64% disaccordance with that of EIA and the rate of disaccord was high in female and young age group. The rate of mixed infection of hepatitis B and C was 0.003%. ALT level was within normal range in 95.2% of donors, and the prevalences of HBsAg and anti-HCV were higher as ALT increased above normal level (p<0.01). The sensitivity of ALT in identifying hepatitis C was 34.5% at 45 IU/L, and 22.8% at 65 IU/L. The most accurate cut-off level of ALT for hepatitis C was 23 IU/L in Receiver-Operating Characteristic (ROC) plot and the sensitivity and specificity were 65.5% and 79.9% at that level. CONCLUSION: In contrast to HBsAg, the prevalence rate of anti-HCV showed different pattern in that it was higher in female and continuously increased up to fifties. Confirmatory assay for hepatitis C should be done for the high false positivity of current anti-HCV EIA. The sensitivity and positive predictive value of ALT was so poor that ALT was not found to be useful as a surrogate marker for hepatitis C, but the discontinuance of ALT testing of blood donors needs to be evaluated by further studies.
Alanine Transaminase ; Biomarkers* ; Blood Donors ; Blood Transfusion ; Coinfection ; Female ; Hepatitis B ; Hepatitis B Surface Antigens ; Hepatitis C ; Hepatitis* ; Humans ; Korea ; Male ; Mass Screening ; Prevalence* ; Reference Values ; Sensitivity and Specificity ; Tissue Donors* ; Volunteers*

BACKGROUND: Currently in Korea, the blood supply for transfusion is almost covered by whole blood donation. But, because the number of participants of the plasmapheresis is limited, the supply of plasma for the production of plasma fractionations depends on a considerable amount of plasma imported. For this reason, a facilitation of plasmapheresis is in an urgent need via stable donors' participation. This survey research was conducted to improve services for donors based on their sound understandings on plasmapheresis. METHOD: The subjects were 1,132 donors who participated plasmapheresis between August and September of 1996 and agreed on the research purposes. RESULTS: Students and employees under 30 years old composed the major part of those who participated in plasmapheresis in major metropolitan areas including Seoul. The gender distribution was about 6:4. Most of the donors had a voluntary motivation to help others, but 47% of them did not know that blood donation is not related to HIV infection. Subjects responded that the environment for plasmapheresis was satisfacftory (92%). Factors that were related to unsatisfactory experience included boredom while pheresis (30%), scared feeling for the pain at the site of injection (28%), and uncomfortable feeling of blood flow (18%). 76% of the donors responded that they will participate in the plasmapheresis again, and the correlation between the level of satisfaction and intention of repeated participation was significant (p<0.01). Reasons for the refusal of repeated participation included the length of pheresis time (52%) and the pain at the site of injection (19%). 82% of the subjects thought the nurses were kind and 18% thought they were moderately kind. While 62% of the subjects who thought nurses were kind expressed their intention to participate in apheresis, while 59% of the subjects who thought the kindness was moderate said that they will not participate in apheresis. The correlation between the kindness of nurses and the level of understandig about plasmapheresis, and the level of uncomfortableness, and intention for repetitive participation were all significant (p<0.01). CONCLUSION: Based on our survey we could concluded that the followings are of great importance for the facilitation of plasmapheresis: continual promotion for the lack of relationship between blood donation and HIV infection, kindly explanation of palsmapheresis by nurses, nurses' skillful operation of plasmapheresis, improvement of audio-visual environment in order not to make donors boring during aphresis.
Adult ; Blood Component Removal ; Blood Donors ; Boredom ; Disulfiram ; HIV Infections ; Humans ; Intention ; Korea ; Motivation ; Plasma ; Plasmapheresis* ; Seoul ; Tissue Donors* ; Volunteers*

A 4-year-old girl developed acute motor, sensory impairment, lower abdominal pain and urinary dysfunction after URI. In acute stage of disease, MRI showed diffuse spinal cord swelling and high signal intensity on T2WI below T2 body level. The patient did not improved and one month later, follow-up MRI showed diffuse spinal cord atrophy and syrinx formation as sequelae of ATM on T1WI below T9 level. To our knowledge, this is the first case showing the sequelae of acute transverse myelitis seen in Korea.
Abdominal Pain ; Atrophy* ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Korea ; Magnetic Resonance Imaging ; Myelitis, Transverse* ; Spinal Cord*

Blindness or serious visual impairment is a common and well known sequela of methanol intoxication in man, while other manifestations such as focal neurological deficits and abnormal brain CT scan are reported rarely. We experienced a case of acute methanol intoxication, which showed not only visual impairment but also bulbar symptoms and characteristic bilateral symmetrical hypodensity area in basal ganglia, especially putamen on brain CT scan. We tried 'pulse therapy'-continuouis dripping of methyl prednisolone (Solumedrol 1gm/day) for 5 days-with transient improvement of visual impairment, but bulbar symptoms were stationary. One month later, visual impairment was recurred, and the 'pulse therapy' was tried again but without benefit. On follow-up brain CT scan, the size of previous hypodensity area in basal ganglia was decreased.
Basal Ganglia ; Blindness ; Brain* ; Bulbar Palsy, Progressive* ; Follow-Up Studies ; Methanol* ; Prednisolone ; Putamen ; Tomography, X-Ray Computed* ; Vision Disorders

PURPOSE: The purpose of this study was to examine the effects of hand massage on fatigue, sleep satisfaction and blood pressure of the aged in a long-term care facility. METHODS: The data were collected from June to August 2008. The subjects were randomly recruited from a long-term care facility in Junnam Providence and were randomly assigned to the experimental group (n = 22) or control group (n = 22). Hand massage was carried out every other day in the evening for two weeks. Massage was administered to each forearm and hand for 10 minutes. Descriptive statistics, x2-test and t-test were performed using SAS program. RESULTS: In the experimental group, the fatigue (p = .017) was significantly lower and the sleep satisfaction (p = .043) was significantly higher than for the control group. CONCLUSION: On the basis of the results of the study, hand massage can be recommended for the elderly with sleep disturbance to reduce fatigue.
Aged ; Blood Pressure ; Fatigue ; Forearm ; Hand ; Humans ; Long-Term Care ; Massage ; Phenothiazines