PURPOSE: Infrared thermometers are increasingly used as a convenient, non-invasive assessment method for febrile children. However, the diagnostic accuracy of the infrared thermometer for children has been questioned, particularly in relation to sensitivity and specificity. The aim of this study was to evaluate diagnostic accuracy of infrared thermometers in febrile children. METHODS: Articles published between 1966 and 2012 from periodicals indexed in the Ovid Medline, Embase, CINAHL, Cochrane, KoreaMed, NDSL, KERIS and other databases were selected, using the following keywords: 'infrared thermometer'. The QUADAS-II was applied to assess the internal validity of the diagnostic studies. Selected studies were analyzed using meta-analysis with MetaDisc 1.4. RESULTS: Nineteen diagnostic studies with high methodological quality, involving 4,304 children, were included. The results of meta-analysis showed that the pooled sensitivity, specificity and AUC (Area Under the Curve) of infrared tympanic thermometers in children over 1 year were 0.80 (95% CI 0.78, 0.81), 0.94 (95% CI 0.93, 0.95) and 0.95 respectively. However the diagnostic accuracy of infrared tympanic thermometers in children with hyperthermia was low. CONCLUSION: The diagnostic accuracy of infrared tympanic thermometer was similar to axillary and rectal thermometers indicating a need for further research to substantiate these findings in children with hyperthermia.
Adolescent ; Area Under Curve ; Body Temperature ; Child ; Child, Preschool ; Databases, Factual ; Fever/*diagnosis ; Humans ; Infant ; Infant, Newborn ; Infrared Rays ; Odds Ratio ; ROC Curve ; Sensitivity and Specificity ; Thermometers/*standards

BACKGROUND: This study was carried out to examine the trends of government-supported health promotion research projects conducted in Korea over the past 12 years. METHODS: Research type, area of interest, organization, and expense of 726 research projects conducted from 1998 to 2009 were examined and the health promotion content analyzed. RESULTS: In Korea, 361 health policy researches (HPR) and 365 general health researches (GHR) were supported by the government during the defined time period. A total of 60.5 health promotion research were conducted annually with a total amount of 27.1 billion won provided (2.26 billion won per year). With the average research project lasting 8.5 months, HPR (7.7 months) projects were completed sooner than GHR (9.2 months). Those who majored in preventive medicine completed 177 research (24.4%), the most number of research projects, followed by public health (22.5%), and family medicine (15.6%). There were 641 health promotion research projects done mostly on policies, legal systems, and grasping current conditions, and only 85 (11.7%) clinical test research on the development or effects of health promotion programs. CONCLUSIONS: HPR have been increasing annually. However, our study could not be certain of how close the studies were to the government's health promotion policies. Furthermore, the main health promotion area, 'healthy living', was not researched as often as should be. Additionally, to improve applicability of the research projects, interdisciplinary cooperation should be promoted.
Hand Strength ; Health Policy ; Health Promotion ; Humans ; Korea ; Preventive Medicine ; Public Health

We report the results of field operation of TELEACE system between Kyung-Pook National University Hospital and Ul-Jin Goon Health Care Medical Center from December, 1990 to September, 1991, which had been operated as a kind of Integrated Services Digital Nework projects by KOREA TELECOMMUNICATION Inc. Ul-Jin Goon Health Care Medical Center transmitted 414 plain radiographs to our hospital in speed of 9600BPS. Each image was composed of 1024X1024 pixelsX8 bits/pixel. In our hospital, the image files were displayed on high resolution monitor (1280×1024 pixets). Text files of image interpretations were transmitted to the health care medical center. The two radiologists who had interpreted the transmitted images, went to the health care medical center and read radiographic film with blind test method. We obtained the following results: false negative rate of 6.3%, false postitve rate of 2.4%, mean sensitivity of 81.4%, mean specificity of 96.3%, and mean accuracy of 91.3%. In predictive value of 0.05, there was no significant difference between results of these two types of radiographs. In conclusion, TELEACE system was valuable to the clinicians isolated from services of radiologists.
Delivery of Health Care ; Korea ; Methods ; Sensitivity and Specificity ; Telecommunications ; X-Ray Film

Objective: Peripheral arterial disease (PAD) reduces functional activity and increases the rate of cardiovascular death in the elderly. Our study aimed to determine whether the presence of PAD in stroke patients affected the progression of disability or death one year after discharge. Methods: From April 2012 to March 2013, consecutive first stroke patients above 50 years of age without known PAD were enrolled. PAD was defined as a low ankle-brachial index (less than 0.9) measured by an automatic device. Clinical data associated with the stroke were collected from medical records. Disability in stroke patients was evaluated with the modified Rankin scale (mRS) on discharge day and one year after the index stroke. Progression of disability was defined as an increase in mRS more than one level at one year. Results: Among the 526 patients, 238 had ischemic strokes and underwent ankle-brachial index (ABI) measurement. Of them, 192 patients were included. In univariate analysis, age, dyslipidemia, discharge mRS, low-density lipoprotein cholesterol, D-dimer, homocysteine, internal carotid artery stenosis, posterior cerebral artery stenosis, and PAD were factors associated with worsening mRS. After adjustment for these factors in the logistic regression analysis, PAD was an independent factor associated with worsening mRS. In the analysis of one-year mortality, patients with PAD had a higher death rate, but PAD was not an independent factor after adjusting for other variables. Conclusions: The presence of PAD in stroke patients suggests a chance of disability progression, but may not be a predictor of death after one year.
Atherosclerosis ; Peripheral arterial disease ; Stroke

There have been many reports regarding complications associated with cardiopulmonary resuscitation(CPR) and it may be true that there are many unrevealed complications. Although it is used to say that 'any CPR is better than no CPR', inadvertent or inadequate CPR may insult in serious organ injury. This report describes a 64-year-old woman who suffered Mallory-Weiss tear resulting from inadvertent cardiopulmonary resuscitation by a bystander who had never been trained. Possible mechanisms of gastric injuries caused by CPR are suggested, and importance of adequate CPR training are emphasized in this report.
Cardiopulmonary Resuscitation* ; Female ; Humans ; Mallory-Weiss Syndrome* ; Middle Aged

Calcific tendinitis is most common seen within the rotator cuff of the shoulder, although it may develop around the hip, wrist, elbow, knee, forefoot, and neck. However, there has been no report in the medical literature regarding calcific tendinitis of the common extensor tendon. We present a case of a 26-year-old woman who had calcific tendinitis of the common extensor tendon. Intraoperatively, partial rupture and calcific deposit at the insertion of the common extensor tendon were seen. We were removed calcific deposit and ruptured tissue of common extensor tendon, and then ruptured common extensor tendon was sutured. The patient showed excellent result two years postoperatively with return to range in a degree of activity levels.
Adult ; Elbow ; Female ; Hip ; Humans ; Knee ; Neck ; Rotator Cuff ; Rupture ; Shoulder ; Tendinopathy ; Tendons ; Wrist

PURPOSE: This study investigated evidence for the use of relaxation therapies as interventions to decrease irritable bowel syndrome (IBS) symptoms and severity as well as reduce anxiety and improve quality of life in IBS patients. METHODS: A search of electronic bibliographic databases (e.g., Medline Ovid, Embase, KoreaMed, and National Discovery for Science Leaders) was conducted to identify randomized controlled trials that included relaxation exercise programs for adults (>18 years old) with IBS. Of the 486 publications identified, 8 studies met inclusion and exclusion criteria, and all studies were used in the meta-analysis. We used Cochrane's risk of bias to assess study quality. RESULTS: The results showed that IBS symptoms decreased significantly, 6.19 (95% confidence interval [2.74, 14.02]) and there was no heterogeneity. Symptom severity and anxiety decreased by 0.38 (95% confidence interval [-1.41, 0.65]) and -0.08 (95% confidence interval [-0.38, 0.23]) due to relaxation therapies, but theses scores were not statistically significant. CONCLUSION: This review revealed positive effects of relaxation therapy on IBS symptoms in adult patients with IBS. However, these results should be interpreted with caution due to the small number of studies examined and the associated methodological problems. Further studies are needed to ascertain the longterm effects of relaxation therapy and the underlying psychosocial mechanisms leading to anxiety reduction and improved quality of life.
Adult ; Anxiety ; Bias (Epidemiology) ; Databases, Bibliographic ; Humans ; Irritable Bowel Syndrome* ; Population Characteristics ; Quality of Life ; Relaxation ; Relaxation Therapy*

PURPOSE: The purpose of this study was to determine whether upright position is effective in labor through systematic review in randomized controlled trials. METHODS: We established the PICO (Patient-Intervention-Comparator-Outcome) strategy, and reviewed 282 literatures from national and international electronic databases, and finally selected 9 references based on inclusion and exclusion criteria. We evaluated the quality of references and carried out a meta-analysis. RESULTS: The maternal outcomes showed that the duration of their second-stage labor was 2.29 minutes shorter than that of the women in the recumbent position, and were less likely to have episiotomy. The other outcomes, including the mode of delivery, blood loss, hemoglobin level, use of oxytocin, use of analgesics, and perineal laceration, did not differ between the groups. The fetal heart rate abnormality occurred less than in the control group. The Apgar scores of the groups did not differ. CONCLUSION: There is evidence that an upright position in the second stage of labor reduces the duration of the second stage of labor, the incidence of episiotomy, and an abnormal fetal heart rate.
Analgesics ; Electronics ; Electrons ; Episiotomy ; Female ; Heart Rate, Fetal ; Hemoglobins ; Humans ; Incidence ; Lacerations ; Oxytocin ; Postpartum Period ; Posture ; Pregnancy

The bioactive sphingolipid metabolite sphingosine 1-phosphate (S1P), recently was reported to induce apoptosis of some cancer cells and neurons, although it generally known to exert mitogenic and antiapoptotic effects. In this study, we investigated the effects of S1P on the cell growth, melanogenesis, and apoptosis of cultured B16 mouse melanoma cells. In results, S1P was found to induce apoptosis in B16 melanoma cells in a dose- and time-dependent manner, but exerted minimal effects on melanogenesis. Although receptors of sphingosine 1-phosphate (endothelial differentiation gene 1 [Edg]/S1P1, Edg5/S1P2, Edg3/S1P3) were expressed in B16 melanoma cells, they were shown not to be associated with S1P-induced apoptosis. In addition, pertussis toxin did not block the apoptotic effects of S1P on B16 melanoma cells. S1P induced caspase-3 activation and the extracellular signal-regulated kinase (ERK) activation. Interestingly, the ERK pathway inhibitor, UO126, reversed the apoptotic effects of S1P on B16 melanoma cells. These results suggest that S1P induced apoptosis of B16 melanoma cells via an Edg receptor-independent, pertussis toxin-insensitive pathway, and appears to be associated with the ERK and caspase-3 activation.
Sphingosine/administration & dosage/*analogs & derivatives ; Signal Transduction/drug effects ; Mice ; Melanoma/*enzymology/*pathology ; Lysophospholipids/*administration & dosage ; Extracellular Signal-Regulated MAP Kinases/*metabolism ; Enzyme Activation/drug effects ; Cell Line ; Caspase 3/*metabolism ; Apoptosis/*drug effects ; Animals

PURPOSE: This study was done to investigate evidence of exercise programs as interventions to decrease depression, anxiety symptoms and stress as well as to improve physical status and self-esteem in adolescents. METHODS: A search of electronic bibliographic database of Medline Ovid, Embase, KoreaMed and NDSL etc. was carried out to identify studies of randomized controlled trials that included exercise programs for adolescent. Of 679 publications identified, 10 studies met inclusion and exclusion criteria, and all studies were used in the meta-analysis. For Quality assessment of studies, Cochrane's Risk of Bias was used. RESULTS: The effectiveness of exercise therapy in adolescents showed that depression symptoms and stress decreased significantly, -0.50 (95% CI: -0.73~-0.27), -1.65 (95% CI: -3.19~-0.12) respectively, but there were some heterogeneity. Self-esteem increased 0.19 (95% CI: -0.22~0.60) due to exercise therapy but theses scores were not statistically significant. CONCLUSION: Based on these findings, there is evidence that exercise programs in adolescents are effective in improving depression symptoms, stress, and self-esteem. Therefore, the priority task is to develop tailored exercise programs for Korean adolescents and make efficient use of these programs.
Adolescent ; Anxiety ; Bias (Epidemiology) ; Databases, Bibliographic ; Depression ; Electronics ; Electrons ; Exercise Therapy ; Humans ; Population Characteristics