Allergic contact dermatitis is a prototype of delayed hypersensitivity reaction. Langerhans cells, keratinocytes and T lyrnphocytes play major roles in the pathogenesis of allergic contact dermatitis. We observed Langerhans cells and keratinocytes in contact sensitized epidermal sheets of mice and performed mixed epidermal cell lymphocytes reaction with normal epidermal cells and contact sensitized epidermal cells to determine the lymphocyte stimulating capacity of contact sensitized epidermal cell. We obtained following results : 1. The Langerhans cells were decreased in number and morphologically damaged in contact sensitized epidermis. 2. Ia antigen expression on keratinocytes was detected in almost all contact sensitized epidermal sheets. 3. The allogeneic lymphocyte stimulating capacity of contact sensitized epidermal cells was greater than that of normal epidermal cells. 4. The allogeneic lymphocyte stimulating capacity of contact sensitized epiderrnal cells was lost after treatment of epidermal cells with anti Ia antibody and complement. From these results, it is conceivable that the contact sensitized epidermal cells can amplify the immune reactions by stimulating the lynphocytes which are infiltrated in contact sensitized epidermis.
Animals ; Complement System Proteins ; Dermatitis, Allergic Contact ; Epidermis ; Histocompatibility Antigens Class II ; Hypersensitivity, Delayed ; Keratinocytes ; Langerhans Cells ; Lymphocytes ; Mice*

Pigmented Bowen's disease (PBD) is a rare variant of Bowen's disease(BD). Most of the reported cases showed pigmented patches or thin plaques. Thus its clinical manifestations may simulated other various pigmented skin lesions. We experienced 2 cases of PBD in patients with multiple BD developed after taking Korean proprietary pills (KPP, "Hwan-Yak"), which were suspected to contain certain amount of arsenics. Both patients also showed arsenical keratosis on their palms and soles. The darker pigmentation of the PBL led us to differentiated them from melanoma.
Bowen's Disease* ; Humans ; Keratosis ; Melanoma ; Pigmentation ; Skin

BACKGROUND: Compliance with self-care and lifestyle modification is recommended for all patients with acute coronary syndrome to prevent a secondary attack. Data is limited regarding the association between compliance with self-care and restenosis. This study was conducted to examine the association between compliance with self-care and restenosis and to determine the predicting factors for restenosis and low compliance with self-care. METHODS: A total of 166 acute coronary syndrome patients (64.2+/-10.8 years) hospitalized for an angiogram during routine follow-up or symptom management were conveniently recruited from a university hospital cardiovascular care unit. Self-administered questionnaires were used to evaluate the level of compliance with self-care and symptom-related satisfaction. RESULTS: In-stent restenosis was found in 40.4% of the subjects and 36.1% were persistently smoking. There was no significant relationship between low compliance with self-care and restensosis. A lower symptom-related satisfaction significantly predicted restenosis and low compliance with self-care. A longer period after initial diagnosis predicted restenosis and a shorter period after initial diagnosis predicted low compliance with self-care. Persistent smoking was independently associated with low compliance with self-care. CONCLUSIONS: Patients who continued to smoke and had lower symptom-related satisfaction with daily living showed a stronger tendency for lower compliance with self-care and lifestyle modification. Effective educational strategy focusing on smoking cessation is needed to increase compliance with self-care in patients with ACS, especially during admission with a first heart attack.
Acute Coronary Syndrome ; Compliance ; Coronary Artery Disease ; Follow-Up Studies ; Heart ; Humans ; Life Style ; Patient Compliance ; Self Care ; Smoke ; Smoking ; Smoking Cessation ; Surveys and Questionnaires

PURPOSE: This study was designed to identify meaningful themes related to the recognition of lifestyle risk factors and barriers in seeking treatment following an acute event of first-time acute myocardial infarction. METHODS: A methodological mixed method of thematic content analysis and a quantitative analysis was used. The sample consisted of 120 male patients < 65 years of age who agreed to be in the study were interviewed using a semi-structured during 2008-2009. Data were analyzed according to the procedure of thematic content analysis and the meaningful themes were coded into SPSS data for quantitative analysis. RESULTS: Pre-hospital delay greater than three hours reported by 58.3% (n=70) of the sample and similarly 63.3% had no recognition about their symptoms as cardiac in origin. The mean number of risk factors was 3.9+/-1.8 out of 11 when lifestyle and psychosocial factors were included. From the interview data among the 70 patients delayed greater than three hours, thirty-five themes categorized into 12 main themes influenced the delayed decision which was identified according to personal-cognitive, socio-cultural, and contextual factors. CONCLUSION: Health care providers should consider these themes in designing individual interventions to make lifestyle changes and to facilitate more prompt decisions to seek care.
Health Personnel ; Humans ; Life Style ; Male ; Myocardial Infarction ; Risk Factors

PURPOSE: This study was conducted to examine effects of a small group-based cardiocerebrovascular disease (CVD) prevention education program on knowledge, stage of change and health behavior among male bus drivers with CVD risk factors. METHODS: A non-equivalent control group pretest-posttest design was used. Participants were 68 male bus drivers recruited from two urban bus companies. Participants from the two groups were selected by matching age, education and risk factors. Experimental group (n=34) received a small group-based CVD prevention education program 8 times over 6 weeks and 3 times through telephone interviews at 2-week intervals. Data were collected between December, 2010 and March, 2011, and were analyzed using chi-square test, t-test, and repeated measure analysis of variance with SPSS/Win18.0. RESULTS: Experimental group showed significantly higher scores in CVD prevention knowledge (p<.001) and health behavior (p<.001) at 6 and 12 weeks after intervention. Participants in pre-contemplation and contemplation stages made progress to contemplation and action. This was significantly better at 6 and 12 weeks after intervention (p<.001). CONCLUSION: Results suggest that small group-based education programs for CVD prevention are effective in increasing knowledge, stage of change, and health behavior to prevent CVD among male bus drivers with CVD risk.
Adaptation, Psychological ; Adult ; Aged ; Alcohol Drinking ; Automobile Driving/*psychology ; Cardiovascular Diseases/*prevention & control ; Dietary Fats ; Exercise ; Health Behavior ; *Health Education ; Health Knowledge, Attitudes, Practice ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Program Development ; *Program Evaluation ; Risk Factors ; Smoking ; Time Factors

PURPOSE: This study was to measure and identify the differences of perceived confidence in practice of core basic nursing skills performed by new graduate nurses in Korea. METHODS: The tool used in this study was a questionnaire for measuring the confidence in 20 items of core basic nursing skills which was structured based on Korean Accreditation Board of Nursing Education tool. 231 new graduate nurses participated in this study. The reliability of this questionnaire had Cronbach's alpha .918. RESULTS: Subjects who experienced simulation education and standard patient education were 86.6% and 35.9%, respectively. Item enema intervention, tracheostomy care, and blood transfusion showed low practice confidence level. These items showed significant differences on whether the subjects experienced simulation and clinical practicum or not. CONCLUSION: Developing and managing clinical education program under deep cooperation between practicum agency and clinical instructor are needed. Simulation practicum will complement insufficient core basic nursing skills between newly graduated nurses before they allocate at the clinical department.
Accreditation ; Blood Transfusion ; Clinical Competence ; Complement System Proteins ; Education ; Education, Nursing ; Enema ; Korea ; Nursing* ; Patient Education as Topic ; Surveys and Questionnaires ; Tracheostomy

This study has been conducted for the purpose of identifying the levels of knowledge and attitude about dementia, and exploring the degrees of practice and the relationship among these variables in nursing assistants caring institutionalized demented elders. The subjects were 87 formal caregivers from 3 dementia-specialized nursing facilities, 2 dementia-specialized hospitals, 1 general psychiatric hospitals, and 3 general nursing homes. The data were gathered from July 10th to August 5th, 1998 through interviews by questionnaires. The measuring instruments of this study were developed by the researcher and proven for their reliability and validity. The collected data were analyzed using SAS program. 1) The lowest score among 6 sub-areas about practice showed on this subarea of maintenance of remained ADL function, offering stimuli and activities to demented elders was the second. 2) The third hypothesis of "the higher the attitude score they have, the higher the practice score they do" was supported (r=.370, p=.025). 3) The influencing factors significantly on knowledge were educational status, learning experience about taking care of patients, learning experience about dementia during last a year. 4) A factor of the period of taking care demented elders have significantly influenced on the attitude about dementia. 5) The influencing factors significantly on practice were age, marital status, learning experience about taking care of patients, learning experience about dementia during the last a year. 6) The most difficult situation the subjects perceived in taking care of demented elders was managing the aggressive and resistive behaviors of demented elders.
Activities of Daily Living ; Caregivers ; Dementia* ; Educational Status ; Hospitals, Psychiatric ; Humans ; Learning ; Marital Status ; Nursing Homes ; Nursing* ; Reproducibility of Results ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to evaluate the effects of a risk factoretailored small group education on anxiety and depressive symptoms, self-efficacy and self-care compliance in patients with first-time acute coronary syndrome (ACS) for 12-month follow-up. METHODS: A quasi-experimental pretest and post-test design was used. Patients were recruited from a national university hospital from 2010 to 2011 in Korea. The group education consisted of a 60-minute long video developed using multimedia contents including voice-recorded texts, flash animation, and video clips, with nurses' dialogue. The intervention group (n = 34) participated in group education using the multimedia video in a small group of patients with similar risk factors, and received periodic telephone counseling and text messages. The control group (n = 40) received usual care and counseling upon request. RESULTS: Depressive symptoms decreased, and self-efficacy and self-care compliance in the areas of medication, exercise, and healthy diet practice significantly increased in patients in the intervention group, compared with those in the control group. CONCLUSIONS: Risk factoretailored small group education and periodic text message were an effective strategy for decreasing depression, and increasing self-efficacy and long-term compliance with lifestyle changes in patients with first-time ACS. We suggested that risk factoretailored small group education need to be given for first-time ACS patients for psychological support and behavioral change in clinical practice. It is also comparable to individual approach to encourage psychological and behavioral change.
Acute Coronary Syndrome/*nursing/*psychology ; Adaptation, Psychological ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; *Multimedia ; *Patient Education as Topic ; Patient-Centered Care/methods ; Republic of Korea ; Risk Factors ; Self Care/*methods ; Self Efficacy ; Stress, Psychological/*nursing ; Teaching/*methods

BACKGROUND AND OBJECTIVES: To determine the level of knowledge of stroke and heart attack (HA) symptoms and risk factors of cardiovascular disease (CVD) in rural elderly people who are at risk for CVD. SUBJECTS AND METHODS: A total of 444 adults over the age of 60 living in a rural province of Korea with at least one CVD risk factor participated in this survey. RESULTS: A total of 72.5% of the participants had hypertension and 28.4% had diabetes, whereas approximately 40% exhibited over two CVD risk factors. The mean knowledge scores for HA symptoms (4.3/9) were lower than scores for stroke symptoms (5.8/9), and the mean knowledge score for risk factors was 7.3/11. Stepwise multiple regression analyses showed that old age, low level of education, and low income level were the determining factors for low knowledge levels of stroke and HA symptoms as well as CVD risk factors. A low perceived risk of stroke or HAs also predicted a low knowledge of CVD risk factors. CONCLUSION: Community-wide public campaigns are needed, which are designed to help elderly people in rural areas with low education levels and socioeconomic status at risk for CVD to improve the awareness of stroke and HA.
Adult ; Aged ; Cardiovascular Diseases ; Heart ; Humans ; Hypertension ; Korea ; Risk Factors ; Social Class ; Stroke ; Surveys and Questionnaires

BACKGROUND: High dose fentanyl for cardiac surgery in neonates, infants and children can cause severe bradycardia and chest wall rigidity that result in decreased cardiac output and oxygen desaturation due to fixed stroke volume in pediatric patients. To ameliorate the effects of fentanyl, it is common to administer neuromuscular blocking drugs with wanted cardiovascular side effects. This study was designed to compare the cardiovascular variables and oxygen saturation among different muscular relaxants in high dose fentanyl anesthesia. METHODS: Thirty pediatric cardiac patients were allocated randomly into three muscle relaxant groups treated with 0.2 mg/kg pancuronium (n=10), 0.2 mg/kg vecuronium (n=10) or 0.2 mg/kg pipecuronium (n=10) after receiving an initial bolus dose of 25 g/kg of fentanyl. Changes of heart rate (HR), mean arterial blood pressure (MAP), rate-pressure-product (RPP) and oxygen saturation (SpO2) were observed. The same cardiovascular variables were also observed 1 and 2 minutes after the second bolus dose of 25 g/kg fentanyl and compared to the results among muscle relaxants. RESULTS: HR, MAP and RPP decreased significantly (p<0.05) 1 and 2 minutes after injection of the 1st fentanyl, which returned to levels above the control value after administration of pancuronium, vecuronium or pipecuronium. Among muscle relaxants, pancuronium caused the most rapid and significantly high level compared to the control value in HR and MAP. Next was pipecuronium and then vecuronium. In clinical setting, SpO2 was decreased after the 1st fentanyl injection and increased after the injection of muscle relaxants, but not significant statistically. CONCLUSION: In view of hemodynamic changes, pancuronium is most efficient and rapid in returning the hemodynamic variables that was decreased after high dose fentanyl anesthesia in neonates, infants and children whose cardiac output was dependent on HR due to relatively fixed stroke volume.
Anesthesia* ; Arterial Pressure ; Bradycardia ; Cardiac Output ; Child* ; Fentanyl* ; Heart Rate ; Hemodynamics ; Humans ; Infant* ; Infant, Newborn* ; Neuromuscular Blockade ; Oxygen ; Pancuronium* ; Pipecuronium* ; Stroke Volume ; Thoracic Surgery ; Thoracic Wall ; Vecuronium Bromide*