BACKGROUND: When one of family members must be treated, the others are required to get various forms of changes including modification of their proper roles in the family. Particularily when he or she can not perform his or her activities of daily living(ADL) owing to functional impairment by himself or herself, there seems to be greater dependence upon his or her family. Accordingly, we tried to give help in the treatment of patients through the comparative analysis concerning functional impairment in both groups on the assumption that there is difference of family function between two family groups which have a patient in family, or not. METHODS: This study was carried out to 83 inpatients in Sun Hospital in Dae Jeon and local rehabilitation clinics in Iksan from 1. July. 1995 to 31. Jun. 1996. We evaluated activites of daily living by using modified Barthel Index(MBI) and classified them into dependent group with 60 points or less(6roup I ), and independent group with more than 60 points(Group II). We also used Family APGAR score and FACES III to evaluate their family functions. RESULTS: MBI scores to evaluate ADL were 42.9+/-15.6 in Group I and 82.1+/-17.9 in Group II. Family APGAR scores were 6.93+/-2.52 in Group I and 7.24+/-17.9 in Group II but there was no significance between two groups. Types of family according to Family APGAR score were highly functional, morderate dysfunctional, and severly dysfunctional one in order of frequency in both groups, but there was no significance in their frequencies in both groups. Types of Family in view of cohesion was disengaged, separated, connected, and enmeshed one in order of frequency in Group I, and separated, disengaged, connected, and enmeshed one in order of frequency in Group II but there was no significance between two groups. Types of family in view of adaptability were rigid, chaotic structured,and flexible one in order of frequency in Group I, and were flexible, structured, rigid, and chaotic one in orders in Group II, which showed significance between two groups. Extremal types of family structure were large in numbers in Group I, but it didnt show significance. CONCLUSIONS: Assuming that there were large numbers of rigid and chaotic family in Group I, it is considered that tne family which has a patient with severely impaired function seems to have weaker adaptability to their family stresses than otherwise. Therefore, it is desirable that physicians who take charge of such patients provide continuous and comprehensive medical care for them including their family with greater concerns and through analysis and assessment of their family functions.
Activities of Daily Living ; Apgar Score ; Daejeon ; Humans ; Inpatients* ; Jeollabuk-do ; Rehabilitation* ; Solar System

BACKGROUND: This study was designed to investigate the relationship between psychiatric disease and systemic Internal Medical disease in psychiatric inpatients who were consulted to department of Internal Medicine and was directed to assess the physical problems and possible ways to resolve them in a closed psychiatric unit. METHOD: Through evaluation of medical records of 1549 inpatients who had consulted in department of internal medicine in Seoul National(mental) Hospital from January 1, 2002 to December 31, 2002. We classified the Physical illness according to ICD-9-CM and psychiatric disease according to DSM-IV RESULTS: The results were as follows: 1) In age and sex distribution, male was 64.4% and 45.9% of the subject was 4th and 5th decades. 2) The most systemic diagnosis were disease of respiratory system, disease of digestive system and endocrine system. 3) schizophrenia showed the highest rate in respiratory disease. Rate of digestive disease was the highest in alcohol use disorder. Disease of respiratory system and disease of digestive system were the most frequent in mood disorder 4) In 1st decade, Digestive system digease was the most frequent, others were respiratory system disease. 5) onset age of psychiatric disease was the oldest in circulatory disease. In genitourinary system disease, duration of psychiatric disease was the longest CONCLUSION: The clinical characteristics of psychiatric disease influenced to get systemic disease in psychiatric patients.
Age of Onset ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Digestive System ; Endocrine System ; Humans ; Inpatients* ; Internal Medicine ; International Classification of Diseases ; Male ; Medical Records ; Mood Disorders ; Respiratory System ; Schizophrenia ; Seoul ; Sex Distribution ; Urogenital System

Hemolytic property is a specific feature of bacteria to obtain iron which is essential for its survival in host tissues. Therefore, it is thought to be one of several factors of virulence. The purpose of this study was to investigate the hemolytic properties of Prevotella nigrescens isolated from the teeth diagnosed as pulp necrosis and apical periodontitis under the presence of hemolysin inhibitors such as NaN3 and dithiothreitol, heat, various pH and cultural conditions. The results were as follows; 1. Clinically isolated P. nigrescens strains and standard P. nigrscens ATCC 33563 showed hemolytic activity. 2. P. nigrescens showed higher hemolytic activity against human erythrocytes than sheep or horse erythrocytes. 3. NaN3 and dithiothreitol (DTT) reduced the hemolytic activity of P. nigrescens in a dose dependent manner (p < 0.05). 4. Optimal pH for the maximum hemolytic activity of P. nigrescens was 4.0 and the hemolysin was stable under the 50degrees C, but the hemolytic activity was significantly decreased at 95degrees C. 5. P. nigrescens cultured in 10% CO2 condition showed higher hemolytic activity than the bacteria cultured in the anaerobic condition.
Bacteria ; Dental Pulp Necrosis ; Dithiothreitol ; Erythrocytes ; Horses ; Hot Temperature ; Humans ; Hydrogen-Ion Concentration ; Iron ; Periapical Periodontitis ; Prevotella nigrescens* ; Prevotella* ; Sheep ; Sodium Azide ; Tooth ; Virulence

No abstract available.
Cleft Palate ; Humans ; Mass Screening

Isolated ACTH deficiency is a uncommon disorder causing secondary adrenocortical insufficiency. Less than 200 cases have been reported in the world. The major clinical manifestations are hypoglycemia, weight loss, hypotension, anemia, weakness, nausea, inability to excrete water load, and hyponatremia. A 56-year-old male was admitted because of weakness, fatigue, nausea and vomiting. He was pallor and not associated with hyperpigmentation. The basal plasma ACTH and cortisol levels were 8.30 pg/ml and 0.6 ug/dl. The serum cortisol did not response to rapid ACTH stimulation test. On combined pituitary stimulation test, the cortisol did not response to insulin-induced hypoglycemia. Other anterior pituitary hormones showed normal responses except elevated prolactin level. Six months after glucocorticoid replacement therapy, the elevated basal prolactin level returned to normal. Brain MRI did not show any anatomic abnormalities of the sellar and suprasella area. We report a case of isolated ACTH deficiency accompanied by hyperprolactineia, which respond to glucocorticoid replacement therapy.
Adrenal Insufficiency ; Adrenocorticotropic Hormone* ; Anemia ; Brain ; Fatigue ; Humans ; Hydrocortisone ; Hyperpigmentation ; Hyperprolactinemia* ; Hypoglycemia ; Hyponatremia ; Hypotension ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Nausea ; Pallor ; Pituitary Hormones, Anterior ; Plasma ; Prolactin ; Vomiting ; Water ; Weight Loss

BACKGROUND: Intrathecal (IT) neostigmine produces analgesia in animal and human. This study was designed to evaluate the efficacy and safety of IT neostigmine for post-cesarean section analgesia. METHODS: Forty-five women undergoing cesarean section under spinal anesthesia were randomly assigned into 3 groups to receive; normal saline 0.2 ml, or neostigmine 12.5 microgram, or neostigmine 25 microgram intrathecally with 0.5% hyperbaric bupivacaine 12 mg. Degrees of sensory and motor blocks, maternal hemodynamic changes, and side effects were recorded. Apgar scores and umbilical vein blood gas analysis (UVBGA) were checked for evaluation of fetal status. Postoperative analgesia was provided by intravenous patient-controlled analgesia (PCA) using fentanyl 500 microgram and ketorolac 150 mg in 100 ml. Pain scores with 10-cm visual analogue scale (VAS), time to first PCA use, cumulative PCA consumptions, and side effects were assessed at 1, 2, 4, 8, 12, 24, and 48 hr after IT injection. RESULTS: There were no significant differences among the three groups in characteristics of spinal anesthesia, maternal blood pressure and heart rate, Apgar scores, and UVBGA data. Compared to saline group, IT neostigmine significantly prolonged time to first PCA use and decreased 24 hr- and 48 hr-PCA consumptions (P<0.05). Pain scores in neostigmine groups were significantly lower than those in saline group for first 4 hr after which there were no differences among the three groups. There were significantly higher incidences of nausea and vomiting in neostigmine groups than in saline group. CONCLUSIONS: These data indicate that IT neostigmine can be an alternative postoperative analgesic without adverse fetal effects for cesarean section. However, high incidence of nausea and vomiting seem to limit its clinical usefulness. Further studies are necessary to enhance its analgesic effects and to decrease its adverse effects.
Analgesia* ; Analgesia, Patient-Controlled ; Anesthesia, Spinal ; Animals ; Blood Gas Analysis ; Blood Pressure ; Bupivacaine ; Cesarean Section ; Female ; Fentanyl ; Heart Rate ; Hemodynamics ; Humans ; Incidence ; Ketorolac ; Nausea ; Neostigmine* ; Passive Cutaneous Anaphylaxis ; Pregnancy ; Umbilical Veins ; Vomiting

No abstract available.
Anemia* ; Erythropoietin* ; Humans*

PURPOSE: It is well known that a high proportion of patients with cerebral palsy have neurogenic bladder. However, cystometry performed to determine the presence and type of neurogenic bladder is an invasive procedure. We evaluated the validity of uroflowmetry and postvoid residual urine volume as a screening tool for neurogenic bladder in children with cerebral palsy. MATERIALS AND METHODS: 34 children with cerebral palsy (range 6-13 years) were randomly selected for this study. Uroflowmetry and residual urine volume were deter mined at least twice in 22 children. Uroflow curve pattern was classified into normal, tower, plateau and staccato type. All patients underwent cystometry with sphincter elec tromyography. We analyzed relationship between the results of uroflowmetry and cystometry. RESULTS: Of the 34 patients, 23 (67.6%) children displayed upper motor neuron lesion of bladder. 11 (32.4%) had uninhibited contraction, 9 (26.5%) small capacity and con comitant detrusor-external sphincter dyssnergia was found in 3 (8.8%). Of 22 children who performed uroflowmetry, 13 showed abnormality. Staccato, tower, and plateau type of pattern was seen 11 (84.6%), 1 (7.7%), and 1 (7.7%) patient, respectively. The re maining 9 (40.9%) children were normal. Eleven of the 13 children with abnormal uroflow curve on uroflowmetry showed upper motor neuron lesion of bladder. Among 13 children with abnormal cystometric results, 11 reveal abnormal uroflow curves. 2 children (22.2%) displayed upper motor neuron lesion of bladder among the 9 children with normal uroflow curve. So, uroflowmetry reveal sensitivity 84.6%, specificity 77.8% for neurogenic bladder in cerebral palsied children. CONCLUSIONS: These results show a high rate of neurogenic bladder in children with cerebral palsy as in previous reports. Abnormalities on uroflow curve correlated well with abnormal cystometry findings. We believe that uroflowmetry is a viable noninvasive screening tool for the detection of neurogenic bladder in children with cerebral palsy.
Cerebral Palsy* ; Child* ; Humans ; Mass Screening* ; Motor Neurons ; Sensitivity and Specificity ; Urinary Bladder ; Urinary Bladder, Neurogenic* ; Urodynamics

In effort to determine whether aircraft noise can have health effects such as hearing loss, hypertension and psychological stress, a total of 111 male professors and administrative officers working a college near a military airport in Korea(exposed group) and a total of 168 males and 112 females matched by age groups(control groups) were analyzed. Personal noise exposure and indoor and outdoor sound level of jet aircraft noise were measured at the exposed area. And pure tone, air conduction test and measurement of blood pressure were given to the exposed(males) and matched control groups(males and females). BEPSI(Brief Encounter Psychological Instrument) and psychological response to aircraft noise were examined for the exposed group. The noise dosimetry results revealed time-weighted averages(TWAs) that ranged from 61 to 68 dBA. However the levels encountered during taking off jet airplanes reached 126 dBA for two half minutes time period. The audiometric test showed that mean values of HTL(hearing threshold level) in exposed group at every frequency(500, 1,000, 2,000, 4,000, and 8,000 Hz were much lower than them of male and female control groups. And in old age groups, interaction of age and noise was observed at 8,000 Hz in both ears(p< 0.05). Conclusively, aircraft noise does not appear to induce hearing loss directly, but may decreased hearing threshold level by interaction of aging process and noise exposure. However, difference of mean values of exposed and control groups on blood pressure was not significantly. In psychological test, annoyance was the most severe psychological response to noise in exposed group, but mean value of BEPSI was not correlated with job duration in exposed group
Aging ; Aircraft* ; Airports ; Blood Pressure* ; Female ; Hearing Loss* ; Hearing* ; Humans ; Hypertension ; Male ; Military Personnel ; Noise* ; Presbycusis ; Psychological Tests ; Stress, Psychological*

PURPOSE: To determine the relationship of postoperative enophthalmos with preoperative soft tissue herniation, fracuture size, time interval between trauma and surgery in inferior orbital wall fracture. METHODS: 37 patients operated for pure blowout fractures of the orbital floor from March 2001 through August 2002 were reviewed retrospectively. Fractures were classified as either A or B, based on the degree of soft tissue herniation, and also categorized as type I (less than one-fourth floor fractured and trapdoor fracture), type II (between one-fourth and one-half floor fractured) and type III (greater than one-half floor fractured) in preoperative coronal computed tomography. Preoperative and postoperative enophthalmos was quantified by Hertel exophthalmometry. The interval between trauma and surgery was also considered. RESULTS: Among the patients with postoperative enophthalmos less than 0.5 mm, 18 patients were type A and 12 patients were type B. 14 patients were categorized as type II and 16 as type III. Among the patients with postoperative enophthalmos of 1.0 mm , 3 patients were type A and 2 patients were type B. 3 patients were classsified as type II and 2 as type III. Among the patients with postoperative enophthalmos of 1.5 mm, each one patient was type A and type B. 2 patients were categorized as type III, but there was no type II. CONCLUSIONS: The degree of postoperative enophthalmos is not related with the degree of soft tissue herniation and fracture size. However, it is negatively associated with time interval between trauma and surgery(p=0.006).
Enophthalmos* ; Humans ; Orbit* ; Retrospective Studies