BACKGROUND: This study was performed to evaluate the therapeutic effects of sympathetic block in management of reflex sympathetic dystrophy (RSD); renamed complex regional pain syndrome (CRPS) Type I, according to the duration of RSD, and to evaluate predictable factors responding to sympathetic block in patients suffering from RSD. METHODS: Prospectively designed this study was divided thirty patients with upper extremity RSD into three groups according to the duration of RSD; Group I (< or = 3 months), Group II (4 to 6 months) and Group III (>or = 7 months). All patients were received repeated stellate ganglion blocks (SGB) with 12 ml of 0.2% bupivacaine by paratracheal approach. We compared the therapeutic effects of SGB between the groups and the clinical signs on initial examination to receive the first SGB at pain clinic. RESULTS: Response rates to SGB were 84.6% in Group I, 62.5% in Group II and 44.4% in Group III. The early treatment less than 6 months was better prognosis (p<0.05). Presence of edema (p<0.001), temperature differences between both hands (hot>cold>no difference, p<0.001), and allodynia (p<0.05) were favorable prognostic factors responding to sympathetic block. Especially, warm skin and edema in RSD were near-perfect predictors of sympathetic blocks. CONCLUSIONS: We conclude that SGB is effective in management of upper extremity RSD, and the duration and the clinical signs of RSD are important to the prognosis and responsibility to sympathetic block. If patients suffering from RSD visit pain clinic before 6 months, and they have edematous warm hands with allodynia, majority of them will be improved from their pain after sympathetic block.
Bupivacaine ; Edema ; Hand ; Humans ; Hyperalgesia ; Pain Clinics ; Prognosis ; Prospective Studies ; Reflex Sympathetic Dystrophy* ; Reflex* ; Skin ; Stellate Ganglion* ; Upper Extremity*

The study was undertaken to evaluate the alteration of thermal enhancement ratio as a function of timeintervals between two split dose hyperthermias followed by irradiation. For the experiments, 330 mice were dividedinto 3 groups; the first, 72 mice were used to evaluate the heat reaction by single dose hyperthermia and heatresistance by split dose hyperthermia, the second, 36 mice were used to evaluate the radiation reaction byirradiation only, and the third, 222 mice were used for TER observation by comibination of single dosehyperthermia and irradiation , and TER alteration by combination of split dose hyperthermia and irradiation. Foreach group the skin reaction score of mouse tail was used for observation and evaluation of the results of heatand irradiation. The results obtained are summarized as follows; 1. The heating time resulting 50% necrosis(ND 50)was 101 minutes in 43degrees centigrade and 24 minutes in 45degrees centigrade hyperthermia, which indicated thatthere is reciprocal proportion between temperature and heating time. 2. Development of heat resistance wasobserved by split dose hyperthermia. 3. The degree of skin reaction by irradiation only was increasedporportionally as a function of radiation dose, and calculated radiation dose corresponding to skin score 1.5(D1.5) was 4,137 rads. 4. Obtained thermal enhancement ratio by combination of single dose hyperthermia andirradiation was increased proportionally as a function of heating time. 5. Thermal enhancement ratio was decreasedby combination of split dose hyperthermia and irradiation , which was less intense and lasted longer thandevelopment of heat resistance. In summary, these studies indicate that the alteration of thermal enhancementratio has influence on heat resistance by split dose hyperthermia and irradiation.
Animals ; Fever ; Heating ; Hot Temperature ; Mice ; Skin ; Tail

PURPOSE: The purpose of this study was to examine differences in awareness and practice of oral health care in pregnant women with and without oral health care education experience. METHODS: Participants in the survey for this study were 221 pregnant women in female exclusive hospitals located in B city and G city. Data were collected from October to December, 2014 using self-report structured questionnaires and analyzed using SPSS/Win 21.0 program. RESULTS: The number of pregnant women experienced in oral health education was 36.2%. The oral health care awareness of pregnant women experienced in oral health education total score was 15.14±1.96, and inexperienced pregnant women total score was 14.14±2.63 (t=3.26, p=.001). The oral health care practice of pregnant women experienced in oral health education total score was 12.90±2.48, and inexperienced pregnant women total score was 10.95±4.06 (t=3.89, p<.001). The relationship between the awareness and practice of oral health care was positively correlated. CONCLUSION: Based on this study outcomes, considering the importance for oral health education in the antenatal care program when the pregnant women visiting the hospital for medical check-up.
Education* ; Female ; Humans ; Oral Health* ; Pregnant Women*

PURPOSE: This study was to examine the effect of postpartum exercise on mental health. Mental health comprises a 9 symptom dimension of Somatization, Obsessive-Compulsive, Interpersonal Sensitivity, Depression, Anxiety, Hostility, Phobic anxiety, Paranoid Ideation, and Psychoticism. METHOD: A non-equivalent pre-test, post-test control group study was conducted. Fifty-two puerperal women who were admitted to a postpartum ward of a mother-baby clinic in Pusan were recruited; 26 women were assigned to the experimental group and 26 women to the control group. Postpartum exercise was applied to the experimental group from postpartum day 3 for a period of 8 weeks while no exercise program was applied to the control group. Mental health with SCL-90-R was measured before and after exercise. Data was analyzed using mean, x2-test, t-test, and ANOVA by SPSS 10.0. RESULT: The mental health status in the exercise group did not show a statistically significant decrease when compared to that of the control group. CONCLUSION: There is no effect of postpartum exercise on women's mental health during the first 8 weeks of the postpartum period. Further studies are needed for randomized clinical trials with a larger sample size.
Anxiety ; Busan ; Depression ; Female ; Hostility ; Humans ; Mental Health* ; Postpartum Period* ; Sample Size

This study was carried out to observe the ultrastructure of tongue mast cells in frog, Bombina orientalis. In the light microscopy, mast cells were round, oval, spindle-like and irregular shape and occasionally had one or more tail-like long cytoplasmic processes. Mast cells had many red granules stained with toluidine blue in the cytoplasm. In the electron microscopy, mast cells had membrane-bounded granules and poorly developed organelles. The granules were composed of two parts, low and dense electron density. In high magnification the dense part in the middle region of granule had honey comb-like crystalline structure.
Anura* ; Crystallins ; Cytoplasm ; Honey ; Mast Cells* ; Microscopy ; Microscopy, Electron ; Organelles ; Tolonium Chloride ; Tongue*

Demand for high quality medical care has recently been increasing in step with high level of income and education. Patients prefer the use of large general hospitals to small community hospitals. Large hospitals, usually located at urban area, expand their capacities to cope with the increasing demand, therefore, they easily secure revenue necessary for growth and development of hospitals. However, small community hospitals are facing with serious financial difficulties caused from the reduction of patients in one hand and the inflation of cost in another. If small rural hospitals were closed, the closure would have negative impacts on local economies in addition to the decrease in access to medical care. Community leaders should have an insight on the contribution of community hospitals to local economies. They could make a rational decision on the hospital closure only with the understanding of hospital's contribution to the community. This study is designed to develop an economic model to estimate the contribution of rural hospital to local economies, and also to apply this model with a specific hospital. The contribution of a hospital to local economies consists of two elements, direct effect and multiplier effects. The direct impacts include hospital's local purchasing power, employee's local purchasing power, and the consumption of patients coming from outside the community. The direct impact induces multiplication effect in the local economy. The seed money invested to other industries grows through economic activities in the economy. The seed money invested to other industries grows through economic activities in the region. This study estimated the direct effect with the data of expenditure of the case hospital. The total effect was calculated by multiplied the direct effect with a multiplier. The multiplier was drown from the ratio of marginal propensity of income and expenditure. Beside the estimation of the total impacts, the economic effect from the external resources was also analyzed by the use of the ratio of patients coming outside the region. The results are as follows. 1. The direct economic contribution of the hospital to the local economy is 1,104 million won. 2. The value of multiplier in the region is 2.976. 3. The total economic effect is 3,286 million won, and the multiplication effect is 2,182 million won. 4. The economic contribution from the external resources is 245 million won which is 7.5% of the total economic effect.
Education ; Growth and Development ; Hand ; Health Expenditures ; Health Facility Closure ; Hospitals, Community ; Hospitals, General ; Hospitals, Rural* ; Humans ; Inflation, Economic ; Models, Economic

No abstract available.
Blood Transfusion* ; Female ; Humans

To evaluate the clinical and histopathological significance of electron dense deposits on capillary in IgA nephropathy, we reviewed and compared the clinical, laboratory, and pathological features of the patients with IgA nephropathy without loop extension of electron dense deposits(Group I, 91 cases) and IgA nephropathy with loop extension(Group II, 17cases) by ultrastructural examination using transmission electron microscope. IgA nephropathy associated with liver disease, Henoch-Schonlein purpura, systemic lupus erythematosus and the other IgA nephropathies associated with systemic diseases were excluded. The results were as follows; 1) There was no significant difference in age distribution. 2) Generalized edema was more common in group II. 3) Nephrotic ranged proteinuria(>3 g/24hr urine) was more prominent in Group II(52.9%) than Group I(8.8%). 4) Among the groups, segmental or mild deposits on the loops were noted in 13 cases, and severe and generalized deposits in 4 cases. Subendothelial deposits were noted in 6 cases, subepithelial deposits in 3 cases, subendothelial with intramembranous deposits in 1 case, subendothelial with subepithelial deposits in 1 case, intramembranous with subepithelial deposits in 2 cases, and subendothelial, subepithelial and intramembranous deposits in 4 cases. 5) The other associated ultrastructural changes of group II were diffuse effacement of foot processes with microvillous transformation, swelling or vacuolar degeneration of podocytes and glomerular endothelium. 6) According to the WHO morphologic criteria, the grade of Group II was significantly higher than Group I. From the above results, it can be concluded that the extension of electron dense deposits along the capillary loops in the cases of IgA nephropathy is highly correlated with proteinuria in the nephrotic ranged. It seems to be a poor prognostic indicator in view of the facts that it correlats with high histopathologic grading.

The technique of radial artery cannulation and its complications are well documented, but serious complications are rare. This is a report of one case of amputation of wrist due to finger necrosis developed from the radial artery cannulation in patient who had craniectomy surgery. This 52-year-old 79 kg male underwent subdural hematoma removal surgery. Right radial artery cannulation was carried out percutaneously using 22 gauge Teflon extracath needle after modified Allen's test appeared to be positive. It was intermittently flushed by heparinized solution. His arterial blood pressure was maintained 100/70-110/80 mmHg and 5 units of banked whole blood and 1 unit of fresh frozen plasma were transfused during 8-hours operation. Cannula was removed on the 9th hour after operation because that was obstructed. On the 12th hour after removal of cannula, his right hand noted to be cool and cyanotic. So, warm towel and hot bag applied continuously on the right hand and the right stellate ganglion block was carried out every day for 4 times. However, on the 10th day after removal of cannula, necrotic change of all fingers of the right hand became worse and skin of fingers were shrunken. Therefore, disarticulation of the right wrist carried out on the 71th day of his hospitalization.
Amputation* ; Arterial Pressure ; Catheterization* ; Catheters ; Disarticulation ; Extremities* ; Fingers ; Hand ; Hematoma, Subdural ; Heparin ; Hospitalization ; Humans ; Male ; Middle Aged ; Necrosis ; Needles ; Plasma ; Polytetrafluoroethylene ; Radial Artery* ; Skin ; Stellate Ganglion ; Wrist

Before beginning the extracorporeal circulation, perfusionists should supply oxygen into the oxygenator and establish blood flow through the blood line of the heart-lung machine. But these manipulation can induce severe hypocarbic state of priming solutions due to wash out of CO2 gas in the solution. This study was carried out to examine the relationship of blood gas changes between hypocarbic priming solutions and body circulation in 15 patients undergoing open heart surgery with extracorporeal circulation. PaCO₂, pH, buffer base and PaO2 were measured from priming solutions before and 15 minutes after the extracorporeal circulation. The results were as follows; 1) Before the extracorporeal circulation, mean PaCO₂ level was 12.1±7.8 mmHg in the priming solution. However, 15 minutes after extracorporeal circulation, the PaCO₂ level was maintained at 35.7±5.7 mmHg. 2) pH in the priming solution was variable from 6.93 to 7.99 (mean 7.45±0.29), but after 15 minutes it was ranged from 7.28 to 7.42 (mean 7.35±0.05). 3) Mean buffer base level in the priming solution was 7.9±3.5 mmol/l. but after 15 minutes, it was 19.6±1.2 mmol/l. 4) Mean PaO₂ level in the priming solution was 667.1±45.6 mmHg, but after 15 minutes, it was 280.7±131.7 mmHg.
Extracorporeal Circulation* ; Heart* ; Heart-Lung Machine ; Humans ; Hydrogen-Ion Concentration ; Oxygen ; Oxygenators ; Thoracic Surgery*