PURPOSE: This ethnograpy was done to explore patterns of health care behavior in patients with chronic health problems. METHODS: The participants were 15 patients with chronic hepatitis B and 2 family members. Among the patients 4 had progressed to liver cirrhosis and liver cancer. Data were collected from iterative fieldwork in a department of internal medicine of I hospital. Data were analyzed using text analysis and taxonomic methods. RESULTS: Illness and disease, relationship between health care givers and clients, and communication patterns between health professions and clients were discussed as the context of health care behavior. Health care behavior of the participants was categorized by its focus: every day work centered, body centered, organ centered, and pathology centered. CONCLUSION: Participants' health care behavior was guided by folk health concept and constructed in the sociocultural context. Folk etiology, pathology, and interpretation of one's symptoms were influencing factors in illness behavior. These findings must be a cornerstone of culture specific care for the chronic diseases.
Activities of Daily Living ; Adult ; Aged ; Asian Continental Ancestry Group ; Attitude to Health ; Communication ; Family Relations ; Female ; *Health Behavior ; Hepatitis B, Chronic/complications/*psychology ; Humans ; Interviews as Topic ; Liver Cirrhosis/etiology ; Liver Neoplasms/etiology ; Male ; Middle Aged ; Physician-Patient Relations ; *Qualitative Research ; Republic of Korea

The National Institute of Health(NIH) under the Ministry of Health and Welfare of the Korean Government was established in 1963 integrating four institutes; National Institute of Health National Chemical Laboratories National Laboratory of Herb Medicine and National Institute of Public Health Training The root however goes down to the Bacteriology Laboratory opened in 1912 with the function for microbiological testing and pox vaccine development which was absorbed into the former National Institute of Health in 1948 when the government of the Republic of Korea was inaugurated. The Institute opened a satellite office the Masan Branch in 1977 and was further expanded adding the Divisions of AIDS and Biotechnology in 1988. In 1996 as a part of restructuring the Government organizations Korea Food and Drug Administration(KFDA) was founded by expanding the Toxicology Research Institute to which all the functions of testing and certifying foods and drugs were transferred Simultaneously a new department the Department of Biomedical science was organized which currently consists of five divisions; the Divisions of Cancer Research Degenerative Diseases Cardiovascular Diseases Metabolic Diseases and Genetic Diseases. In 1999 in order to provide a rapid and effective disease control the Department of Communicable Diseases was newly founded merging the Division of Disease Control and Prevention from the Ministry of Health and Welfare. With these steady and significant changes the NIH together with the training of health manpower has become the national organization for research prevention and control of various diseases of public health importance in Korea.
Academies and Institutes/*history ; English Abstract ; Government Agencies/*history ; History of Medicine, 20th Cent. ; History of Medicine, 21st Cent. ; Korea ; Public Health Administration/*history ; Research/*history

OBJECTIVES: The purpose of this study was to investigate client satisfaction with mental health services across sociodemographical and service utilization characteristics and to identify the predictors for quality of life for schizophrenic patients who registered in community mental health center. METHODS: One hundred five schizophrenic patients who had received intensive or continuing care completed questionnaires, which included Consumer Satisfaction Scale and the Korean version of World Health Organization Quality of Life Assessment Instrument-Brief (WHOQOL-BREF). Subject's sociodemographic and service utilization characteristics were compared using t-test or one-way analysis of variance. To examine the influence of these variables on quality of life, stepwise multiple regression was conducted. RESULTS: Consumer satisfaction scores differed significantly depending on the length of contact with a current mental health staff. In a stepwise multiple regression model, service relevance and occupation together explained 20.5% of variance in quality of life. CONCLUSION: The results suggest that continuity in contact with a current mental health staff was important in consumer satisfaction. Service relevance and occupation had an impact on quality of life.
Consumer Satisfaction ; Humans ; Mental Health Services* ; Mental Health* ; Occupations ; Quality of Life* ; Surveys and Questionnaires ; Schizophrenia* ; World Health Organization

PURPOSE: This ethnography was done to explore the meaning of illness in Korean Americans with chronic hepatitis B. METHODS: The participants were 6 patients with chronic hepatitis B and 6 general informants who could provide relevant data. Data were collected from iterative fieldwork with ethnographic interviews within Korean communities in two cities in the United States. Data were analyzed using causal chain analysis developed by Wolcott. RESULTS: The analyses revealed three meanings for the illness: hidden disease, intentionally hidden disease, and inevitably hidden disease. The contexts of meaning of illness included characteristics of the illness, social stigma, structure of health care system and communication patterns and discourse between health care providers and clients. CONCLUSION: The meaning of illness was based on folk illness concepts and constructed in the sociocultural context. Folk etiology, pathology and interpretation of one's symptoms were factors influencing illness behavior. These findings could be a cornerstone for culture specific care for Korean Americans with chronic hepatitis B.
Aged ; *Asian Americans ; Delivery of Health Care ; Female ; Health Personnel ; Hepatitis B, Chronic/*ethnology/etiology/psychology ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Republic of Korea/ethnology ; Social Stigma

Sixty-three patients with permanent sigmoid colostomy were surveyed to evaluate their satisfaction and complications with the "irrigation technique" and the "atural evacuation" of the colostomy management (irrigation technique; 32 patients, natural evacuation; 31 patients). All patients had colostomy for at least 12 months without disease recurrence. Each patient was interviewed in addition to standard questionnaire. The irrigation was not associated with any major complication including colonic perforation. The irrigation was used younger age group than the natural evacuation (53+/-10 vs. 62+/-12, P=0.01). The frequency of bowel movement was lower in the irrigation than in the natural evacuation (5.1+/-2.5/wk vs. 10.8+/-9.0/wk, P=0.04). Five patients (16%) of the irrigation experienced spontaneous bowel action but only one patient suffered from it. The time spent for managing irrigation was 59+/-13 minutes. Twenty-three patients (74%) of the natural evacuation suffered from one or moreproblems such as expensive apparatus, leakage, skin irritation or odor. Sixteen patients (52%) of the natural evacuation and 2 patients (6%) of the irrigation were restricted in social activity (P=0.0001). Thirteen patients (42%) of the natural evacuation and 1 patient (3%) of the irrigation were dissatisfied with colostomy management (P=0.002). Thus, the irrigation technique seems to be more effective and satisfactory method for managing colostomy without compromising patient's social activity when it is performed in appropriately selected patients.
Colon ; Colon, Sigmoid ; Colostomy* ; Humans ; Odors ; Surveys and Questionnaires ; Rectal Neoplasms ; Recurrence ; Skin

No abstract available.
Dandy-Walker Syndrome* ; Prenatal Diagnosis* ; Trisomy*

Cortex mori (Morus alba L.: Sangbaikpi), the root bark of mulberry tree, has been used as an antiphlogistic, diuretic, and expectorant in herbal medicine. Previous studies have demonstrated that the phenolic extract of Cortex mori have hypotensive, hypoglycemic, antifungal, antiviral, antiinflammatory, and anticancer effects, and the hot water extract from Cortex mori has inhibitory effects on compound 48/80- induced mast cell degranulation and histamine release from rat peritoneal mast cells (RPMCs). This study was perforrned to investigate the effects of polysaccharide fraction from Cortex mori (PFCM) on compound 48/80-induced degranulation, histamine release, calcium influx, changes of intracellular cAMP and cGMP level, and morphological changes of RPMCs. The results were summarized as follows. 1) Compound 48/80-induced cytomorphological changes such as swelling, degranulation, intracellular vacuoles, and interrupted cell boundary were significantly inhibited by pretreatment with either hot water or polysaccaride fractions frorn Cortex mori (PFCM), 2) the compound 48/80-induced histamine release from RPMCs pretreated with PFCM was significantly inhibited, compared to that of control without PFCM pretreatment, 3) the PFCM inhibited remarkably the compound 48/80-induced calcium influx into the RPMCs, 4) the PFCM increased significantly the intracellular cAMP levels and decreased the intracellular cGMP levels of RPMCs, compared to those of normal control, and 5) the compound 48/80-induced cAMP levels of RPMCs pretreated with PFCM were significantly increased, compared to those of positive control without PFCM, and the compound 48/80-induced cGMP levels of RPMCs pretreated with PFCM were remarkably decreased, compared to those of positive control without PFCM. From the above results, it is suggested that PFCM have an activity to inhibit the compound 48/80-induced mast cell activation.
Animals ; Calcium ; Herbal Medicine ; Histamine Release ; Mast Cells* ; Morus ; Phenol ; Rats ; Trees ; Vacuoles ; Water

The wandering spleen is a rare condition, in which the spleen is located in other than the left upper quadrant of the abdomen. The clinical manifestation is variable from asymptomatic to abdominal catastrophy due to torsion of the splenic pedicle. We experienced a case of torsion of wandering spleen in 8-year-old girl who admitted with fever, vomiting, abdominal pain, palpable left abdominal mass. She was diagnosed preoperatively with the aid of abdominal sonography and C.T. scanning. A splenectomy was performed and she made uneventful recovery. The case report illustrates some of the diagnostic and therapeutic considerations pertaining to wandering spleen with a brief review of related literature.
Abdomen ; Abdominal Pain ; Child ; Female ; Fever ; Humans ; Spleen ; Splenectomy ; Vomiting ; Wandering Spleen*

The Sertoli-Leydig cell tumor is a gonadal tumor of sex-cord stromal type, similar to that seen in of the various phases of testicular development in the male. This tumor is exceedingly rare, accounting for only 0.1% to 0.5% of all primary ovarian neoplasms. It occurs predominantly in the second and third decades(mean age about 25 years), less than 10% after menopause. We investigated a case of poorly differentiated Sertoli-Leydig cell tumor of right ovary, occured in a 76-year-old woman. Grossly, the tumor measured 2, 100 gm in weight and 25 x 19 x 8 cm in dimensions. The outer surface was smooth and glistening without rupture of the capsule. Cut sections revealed a multilobulated brown solid mass with multiple cystic change. Microscopically, it showed the typical findings o a Sertoli-Leydig cell tumor. The characteristic feature is hemangiopericytoma paftem of sarcomatoid spindle cells. Therefore, we present it with a brief review of the literature.
Female ; Humans

158 cases of pulmonary metastasis having satisfactory histological proof of the primary malignant tumor, the frequency and pattern of which were analysed by conventional radiologically. The results are as follows: 1. The frequency of pulomonary metastasis according to the primary sites was 24%(38/158) hepatobiliary system,19.6%(31/158) gastrointestinal tract, 18.9%(30/158) uterine cervix and 12%(13/158) head and neck. 2. Pulmonary metastatic pattern showed nodular type 74% (117/158), granular type 10.1%(16/158), streaky type 9.5%(15/158),hilar enlargement 3.8%(6/158), patchy type 1.9% (3/158) and others 0.6%(1/158). Of all these type, nodular type was predominant. 3. The nodular type of pulmonary metastasis was classified into less than 10 nodules56.4%(66/17), 10-50 nodules 25.6%(30/117), more than 50, 17.9%(21/117), less than 1cm 12.8%(15/117) and more than5cm in 5.2%(1/117) of the cases. 4. The size of nodule was 1-3cm 36.6%(43/117), 2-3cm 20.5%(24/117), less than 1cm12.8%(15/117) and more than 5cm in 5.2%(1/117) of the cases. 5. Most cases of pulmonary metastasis involved bothlung fields 69.2%(110/58). Others were right lung field only 17.7% (28/158), left lung only 12.7%(20/158). 6. Theages between 40 and 70 represented 79.8%(126/158) of the cases and the raio of male and female was about 1.5:1.
Cervix Uteri ; Female ; Gastrointestinal Tract ; Head ; Humans ; Lung ; Male ; Neck ; Neoplasm Metastasis