PURPOSE: The objective of the study was to identify the effects of the meridian massage therapy on hand edema and hand functions in patients with hemiplegia. METHOD: The experiment was conducted in the Oriental Medical ward of "K" hospital during the period of 2000. 12. 15 - 2001. 03. 15. Fifty five subjects with hemiplegia following a stroke participated in the study. Volumetric size of the hand and the circumference of the index finger of each patient was measured and functional points were recorded for pre and post experiment. RESULT: 1. Apparent decrease in volumetric size of the hand and the circumference of the index finger(p=.022. p=.021), and higher functional points(p=.003) in the experimental group in comparison to the control group. 2.Volume of hands & their functions appeared to be irrelevant(r=-.195, p=.154). 3. Circumference of the index finger & their functions also turned out to be irrelevant (r=-.110, p=.424). CONCLUSION: Meridian massage is an effective nursing interventional therapy to relieve hand edema and improve hand functions in hemiplegic patients and has great potential for use in a wide range of medical fields as an efficient supplementary treatment for stroke rehabilitation.
Edema* ; Fingers ; Hand* ; Hemiplegia ; Humans ; Massage* ; Nursing ; Rehabilitation ; Stroke

A three year old girl with a left renal teratoid Wilms tumor is reported. The tumor was located both inside and outside the kidney parenchyme, to form a well encapsulated mass containing two lobulated solid and cystic masses. The tumor consists predominantly of otherwise typical Wilms tumor irregularly mixed with teratoid tissue elements such as intestinal tract, mucous glands with argentaffin cells, goblet cells and transitional epithelium. These heterologous elements were regarded as diverse epithelial differentiation of totipotent cells in certain nephrogenetic period, and this tumor was considered to be hest called "teratoid Wilms tumor".

Objective: Menstruation is a great part as the procedure for physiological, psychological development and physical growth, and menstrual disorders are very common problems in adolescence period. these problems can be resolved by interview or appropriate education of normal pubertal development. However unlike other developed countries, systematic report or appropriate education for menstruation may not be performed in our country. Therefore. our pediatric department investigated for menstruation of normal pubertal age women as an information educating adolescence. Methods: In cross-sectional study (ex, questionnaire), 4112 junior high and high school girl students (12~18 years old) in Ansan, Kyungki-do were investigated for menarcheal age, menstrual cycle, duration, amount, premenstrual syndrome, dysmenorrhea and relation to family history. Resulta: 1) Mean Menarcheal age was 12.9+/-1.2 years. According to menarcheal age by present age, menarcheal age was younger when present age was young as menarcheal age 11.8+/-0.6 years at 12 years, 13.3+/-1.1 years at 16 years, and 13.7+/-1.1 years at 18 years, respectively (p<0.001). 2) The month during which menarche occurs most frequently was August (14.7%), followed by July, December and January. 3) Considering menstrual cycle, mixed type (regular and irregular cycle) was most common (39.0%), and menstrual cycle became regular after mean 8.8+/-8.4 months. 4) In women having regular menstrual cycle, most women (53.l0%) had menstrual cycles between 26 and 30 days, next was 21~25 days and 31~35 days according to frequency. 5) Menstrual duration was 5~6 days by 49.6% of the women. 6) Premenstrual syndrome was noted in 56.0% of the women, in that 42.5% experienced occasionally and 13.5% always, respectively. 7) Dysmenorrhea was showed in 85.0% of the women. A total of 63.7% of the respondents suffered from dysmenorrhea was unaffected on daily activity as grade l and was needed no medication to relieve pain. Grade 2 (20.5%) was defined that limited daily activity and was needed medication to relieve pain. Grade 3 (0.9%) was defined that inhibited daily activity seriously, and was unimproved by analgesics. 8) The prevalence of dysmenorrhea was 78.0% at 12 years, 85.9% at 15 years and 94.0% at 18 years, respectively. Getting older, frequency of dysmenorrhea was increasing. 9) Dysmenorrhea was experienced for the first time during the first year after the menarche by 65.3% of the women. The amount of menstrual bleeding was significantly correlated to the severity of dysmenorrhea (P<0.001), and dysmenorrhea reported by the women was singificantly correlated to maternal dysmenorrhea (p<0.01) and to sisters with dysmenorrhea (p<0.001). Conclusions: We found that Korean adolescent girls had earlier menarcheal age than past period, and they had many problems for menstruation. This study suggested that it may be needed adolescent education and appropriate treatment of menstrual disorders.
Adolescent ; Analgesics ; Cross-Sectional Studies ; Surveys and Questionnaires ; Developed Countries ; Dysmenorrhea ; Education ; Female ; Female* ; Gyeonggi-do* ; Hemorrhage ; Humans ; Menarche ; Menstrual Cycle ; Menstruation* ; Premenstrual Syndrome ; Prevalence ; Siblings

BACKGROUND: This study aimed to investigate bradycardia as an adverse effect after administration of dexmedetomidine during 33degrees C target temperature management. METHODS: A retrospective study was conducted on patients who underwent 33degrees C target temperature management in the emergency department during a 49-month study period. We collected data including age, sex, weight, diagnosis, bradycardia occurrence, target temperature management duration, sedative drug, and several clinical and laboratory results. We conducted logistic regression for an analysis of factors associated with bradycardia. RESULTS: A total of 68 patients were selected. Among them, 39 (57.4%) showed bradycardia, and 56 (82.4%) were treated with dexmedetomidine. The odds ratio for bradycardia in the carbon monoxide poisoning group compared to the cardiac arrest group and in patients with higher body weight were 7.448 (95% confidence interval [CI] 1.834-30.244, p = 0.005) and 1.058 (95% CI 1.002-1.123, p = 0.044), respectively. In the bradycardia with dexmedetomidine group, the infusion rate of dexmedetomidine was 0.41 +/- 0.15 microg/kg/h. Decisions of charged doctor's were 1) slowing infusion rate and 2) stopping infusion or administering atropine for bradycardia. No cases required cardiac pacing or worsened to asystole. CONCLUSIONS: Despite the frequent occurrence of bradycardia after administration of dexmedetomidine during 33degrees C target temperature management, bradycardia was completely recovered after reducing infusion rate or stopping infusion. However, reducing the infusion rate of dexmedetomidine lower than the standard maintenance dose could be necessary to prevent bradycardia from developing in patients with higher body weight or carbon monoxide poisoning during 33degrees C targeted temperature management.
Atropine ; Body Weight ; Bradycardia* ; Carbon Monoxide Poisoning ; Dexmedetomidine* ; Diagnosis ; Emergency Service, Hospital ; Heart Arrest ; Humans ; Hypothermia, Induced ; Logistic Models ; Odds Ratio ; Retrospective Studies

PURPOSE: The purpose of this study was to investigate the effects of case-based learning (CBL) on learning motivation and learning satisfaction of nursing students in a human physiology course. METHODS: The development and application of CBL scenarios was conducted from February to June, 2013. Nursing students (n=142) who registered for a human physiology course were assigned into either a control or CLB group. The control group received traditional lectures for 14 weeks. The CBL group received the same 14-week lectures and an additional 5 CBL sessions. The learning motivation and satisfaction were measured by questionnaires at the beginning and the end of the semester. Seven students in the CBL group were randomly selected for a focus-group interview. Quantitative data were analyzed by chi2-test and t-test, and qualitative data were analyzed by content analysis. RESULTS: The learning motivation and learning satisfaction were not significantly different between the two groups. However, 59% of the CBL group answered with a positive impression on the CBL approach as it helped them to feel a sense of achievement, excitement, to form their identity as nursing students, and so on. CONCLUSION: These findings suggest that the CBL could be a challenging but useful learning method in a physiology course for nursing students. Further studies with guidance, such as instructors' questions and feedback design are needed to utilize CBL more effectively.
Humans ; Humans* ; Learning* ; Lectures ; Motivation* ; Nursing* ; Physiology* ; Students, Nursing*

Open discectomy is one of usual treatment for herniated intervertebral disc. We may expect the reduction of height of intervertebral disc due to decreased volume by partial resection of herniated disc. But the effect of decreased height of intervertebral disc space to posterior joint and spinal canal has not been identified, and the correlation between the amount of reduced height and the changes of range of motion has been undetermined. Thus, we analyzed radiologic changes of disc height and segmental motion by the flexion-extension view in 20 patients who had undergone discetomy for prolapsed intervertebral disc from June 1989 to January 1991 who could be followed up for 3 years or more. As a result, lumbar discetomy associates with 1) significant decrement of disc height (average 14%), 2) decreased disc motion of involved segment without hypermobility (average 34%), 3) hypermobility of adjacent segment, 4) and posterior facet overriding consistent with recurred low back pain.
Diskectomy ; Humans ; Intervertebral Disc ; Intervertebral Disc Displacement ; Joints ; Low Back Pain ; Range of Motion, Articular ; Spinal Canal

Tumors of the sacrum are relatively uncommon. The diagnosis is difficult, especially in the early phase of the disease, because the clinical manifestations are nonspecific, the clinical signs may be vague and the radiologic changes are needed to differentiate from intestinal gas shadow. The clinical features are sacral pain, sensory change on perineum, urination difficulty, constipation, and sciatica. Seven cases of sacral tumor were treated at the Department of Orthopaedic Surgery, Kyung Hee University, from October 1981 to October 1992, and the results were as follows: 1. Because of the variability of the sacral tumor, we cannot define the most common tumor. 2. There is difficult in early diagnosis of the tumor, because the symptoms of tumor are similar to that of lumbar disc herniation and the radiologic findings are subtle. 3. CT and MRI are very effective methods to detect the tumor in the sacrum. 4. Curettage, excision, resection, sacrectomy and internal fixation were done according to the kinds of tumors and the amount of bony destruction.
Constipation ; Curettage ; Diagnosis ; Early Diagnosis ; Magnetic Resonance Imaging ; Perineum ; Sacrum ; Sciatica ; Urination

BACKGROUND/AIMS: Several randomized controlled studies have shown that responders who had treated with interferon alpha for chronic hepatitis B had better rate of sustained loss of HBeAg and HBV DNA than non-esponders. These studies also showed that non-esponders had higher rates of liver related complication and mortality. But there is very little data on how well sustained responders are and whether the responders eventually lose HBsAg in Korea. The aims of this study were to better define the long term remission of chronic hepatitis B induced by interferon alfa therapy and compare the clinical outcome among the interferon responders and non-esponders in Korea. METHODS: Sixty-ight patients with chronic hepatitis B who were treated with interferon alfa between 1987 and 1998 were followed up for serologic status (HBsAg, HBeAg, HBV DNA), biochemical tests and liver related complication or mortality. RESULTS: Among 68 patients with chronic hepatitis B who were treated with interferon alfa, 28 (41%) responded to treatment with loss of HBeAg within 1 year of starting treatment. Up to 129 months (mean 58 months) after therapy, responders had higher rate of cumulative clearance of HBeAg at five years than non-esponders (100% vs 35.1%, p<0.05). Responders had maintained the normal serum ALT than nonresponders at five years (94% vs 55.6%, p<0.05). Loss of HBsAg was not different between responders and non-esponders (5% vs 4%, NS). The rates of liver related complication and mortality did not differ between both groups. Delayed clearance of HBeAg occured in twelve out of forty non-esponders (30%). There were no differences in age, baseline ALT, histologic finding of liver biopsy, HBV DNA at the end of first year after study with IFN therapy between the non-esponders with and without delayed clearance of HBeAg. CONCLUSION: Remission in chronic hepatitis B induced by alfa interferon maintained in long duration. But clinical outcomes such as liver related complication, mortality and the elimination of HBV infection have no differences between responders and non-esponders. Further studies are needed for the role of interferon therapy in long-erm clinical outcome for chronic hepatitis B.
Biopsy ; DNA ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Interferon-alpha* ; Interferons* ; Korea ; Liver ; Mortality

BACKGROUND/AIMS: Thrombopoietin (TPO) is an important cytokine for megakaryocyte maturation and platelet production. Because the main site of its production is liver, the failing liver may have a role in thrombocytopenia in chronic liver disease. The aims of this study were to determine the serum TPO levels in cirrhotic patients with thrombocytopenia and clarify the relation between the serum TPO levels and liver function impairment. METHOD: Cirrhotic paitents with thrombocytopenia (LC, n=57, Child class A/B/C; 20/13/24), chronic hepatitis patients (CH, n=24), oncologic patients with thrombocytopenia induced by chemotherapy (HO, n=7), acute viral hepatitis patients (AVH, n=5) and healthy controls (HC, n=5) were enrolled. Serum TPO was measured by an ELISA method. RESULTS: Although the mean platelets counts of LC (69+/-32, x103/ul: mean+/-SD) were lower than those of HC (229+/-29, x103/ul), serum TPO levels in LC (108+/-63 pg/ml: mean+/-SD) were not significantly different from HC (122+/-24 pg/ml). In HO, serum TPO was significantly higher than LC (623+/-746 vs 108+/-63 pg/ml, p<0.05) inspite of comparable platelets counts. In LC, serum TPO level was not significantly different among Child class groups. It was not correlated with serum ALT, serum albumin levels, prothrombin time, serum bile acid, Child class, Child score and partial thromboplastin time, but weakly correlated with serum total bilirubin (p=0.038, r=0.288) and platelet counts (p=0.041, r=0.287). CONCLUSIONS: Although impaired hepatic production of TPO seems to be the main cause of low serum TPO levels in thrombocytopenic cirrhotic patients, there was no correlation between serum TPO level and the severity of liver dysfunction. The role of other factors such as megakaryocyte mass in bone marrow, portal hypertension and hypersplenism may be necessary to explain the putative mechanism between TPO and platelet numbers in liver cirrhosis with thrombocytopenia.
Bile ; Bilirubin ; Blood Platelets ; Bone Marrow ; Child ; Drug Therapy ; Enzyme-Linked Immunosorbent Assay ; Hepatitis ; Hepatitis, Chronic ; Humans ; Hypersplenism ; Hypertension, Portal ; Liver ; Liver Cirrhosis ; Liver Diseases ; Megakaryocytes ; Partial Thromboplastin Time ; Platelet Count ; Prothrombin Time ; Serum Albumin ; Thrombocytopenia* ; Thrombopoietin*

BACKGROUND: Forty percent of solar irradiation arriving on the ground surface is infrared rays (IR). However, these have received little attention. Chronic experimental exposure to IR has been found to cause degenerative changes to dermal connective tissue and an accumulation of ground substances, which is similar to changes which occur by photoaging. OBJECTIVE: To investigate the effects of persistent heat exposure on the cutaneous aging symptoms such as wrinkles, dyspigmentation and telangiectasia. METHODS: A total of 306 male volunteers, aged between 26-68 years, were recruited from steel factories with a torrid working environment. Each volunteer was interviewed for demographic information, cumulative sunlight exposure levels and their smoking history. Skin examination and measurement of erythema/pigmentation levels were also performed on the crow's feet area of the face and/or the upper inner arm. RESULTS: 1. The group of males, aged 50years or over, who had been exposed to high temperatures for more than 10years showed a tendency to have severer wrinkles (5.1+/-1.5) than an age-matched control group (3.7+/-0.1). 2. There was no correlation between dyspigmentation and heat exposure. 3. Erythema indices decreased and were found to be dependent on the duration of heat exposure to the face in the group of males over 40years of age, and to the upper inner arm in the group of males over 50years of age. CONCLUSION: Chronic heat exposure might contribute to the development of skin wrinkles and shows the possibility of potentiation of extreme ultraviolet effects.
Aging ; Arm ; Connective Tissue ; Epidemiologic Studies* ; Epidemiology ; Erythema ; Foot ; Hot Temperature ; Humans ; Infrared Rays ; Male ; Skin Aging* ; Skin* ; Smoke ; Smoking ; Steel ; Sunlight ; Telangiectasis ; Volunteers