PURPOSE: The study aimed to explore the health consequences that women experienced after miscarriage and the factors related to them. METHODS: A convenience sample consisting of 102 women who had miscarried within 2 years was used. Women were recruited from hospitals and enterprises in Seoul and Gyeong-Gi Province. Participants completed a self-administered questionnaire containing a physical and psychological symptoms checklist developed for this study. RESULTS: More than 40% of the miscarriages occurred after 9 weeks of pregnancy and 35% of women were found to have had a previous miscarriage prior to this study. Psychological symptoms were more prevalent and prolonged than the physical symptoms, furthermore, the frequencies of the symptoms experiencedwere not consistent with the duration of symptoms. Employed women and women with early miscarriages complained of more physical symptoms; however, psychological symptoms were not different according to women's characteristics. Employment was a significant factor affecting physical symptoms. CONCLUSION: Health care professionals need to inform and educate women and the family of the potential health changes during the recovery after the miscarriage. Health consequences due to miscarriages also need to be incorporated in women's reproductive health care. Nursing care should consider factors of maternal age, employment status, and obstetrical conditions upon the apparent social changes.
Abortion, Spontaneous ; Checklist ; Delivery of Health Care ; Employment ; Female ; Humans ; Maternal Age ; Nursing Care ; Pregnancy ; Surveys and Questionnaires ; Reproductive Health ; Social Change

PURPOSE: To evaluate the clinical significance of the multiple increased uptake lesions other than in femoral heads as seen on whole body bone scan in patients with avascular necrosis of femoral heads. MATERIALS AND METHODS: One hundred and seventy three patients with clinical diagnosis of avascular necrosis of fthe emoral head underwent a bone scan using Tc-99m MDP. Increased uptake lesions other than in femoral heads were evaluated, including frequency and common sites of involvement, and correlated with clinical information and plain radiographic findings. Two hundred patients without AVN, who had undergone a bone scan, were included as a control group. RESULTS: Increased uptake lesions in extrafemoral head locations were found in 36 of 173 patients(20.8% ; the location of 79 lesions was other than the femoral head, This result is statistically different from patients without avascular necrosis of femoral head(p<0.0001). The most common site of involvement was the knee joint area(62.5%). Other lesions were located in the mid-shafts of the long bones of the lower extremities, calcaneus, proximal humerus, etc., in order of decreasing frequency. Plain radiographs of 17 lesions were nonspecific, except for three lesions showing definite changes associated with avascular necrosis. The risk factors included alcoholism, the prolonged use of steroids, renal transplantation, herbal medication and working as a working as deep-sea diver. Most patients did not complain of pain, except for two with irreversible osteonecrotic changes as seen on plain radiograph. CONCLUSION: in patients with avascular necrosis of the femur, increased uptake lesions other than in the femoral head as seen on bone scan, may represent the early stage of osteonecrosis, which shows a characteristic appearance on bone scan. In order to avoid possible misdiagnoses of multiple extrafemoral lesions as bony metastasis or traumatic lesions, in patients with avascular necrosis of the femur these should be carefully evaluated.
Alcoholism ; Calcaneus ; Diagnosis ; Diagnostic Errors ; Femur ; Head* ; Humans ; Humerus ; Kidney Transplantation ; Knee Joint ; Lower Extremity ; Necrosis* ; Neoplasm Metastasis ; Osteonecrosis ; Risk Factors ; Steroids ; Technetium Tc 99m Medronate*

PURPOSE: To evaluate the clinical significance of the multiple increased uptake lesions other than in femoral heads as seen on whole body bone scan in patients with avascular necrosis of femoral heads. MATERIALS AND METHODS: One hundred and seventy three patients with clinical diagnosis of avascular necrosis of fthe emoral head underwent a bone scan using Tc-99m MDP. Increased uptake lesions other than in femoral heads were evaluated, including frequency and common sites of involvement, and correlated with clinical information and plain radiographic findings. Two hundred patients without AVN, who had undergone a bone scan, were included as a control group. RESULTS: Increased uptake lesions in extrafemoral head locations were found in 36 of 173 patients(20.8% ; the location of 79 lesions was other than the femoral head, This result is statistically different from patients without avascular necrosis of femoral head(p<0.0001). The most common site of involvement was the knee joint area(62.5%). Other lesions were located in the mid-shafts of the long bones of the lower extremities, calcaneus, proximal humerus, etc., in order of decreasing frequency. Plain radiographs of 17 lesions were nonspecific, except for three lesions showing definite changes associated with avascular necrosis. The risk factors included alcoholism, the prolonged use of steroids, renal transplantation, herbal medication and working as a working as deep-sea diver. Most patients did not complain of pain, except for two with irreversible osteonecrotic changes as seen on plain radiograph. CONCLUSION: in patients with avascular necrosis of the femur, increased uptake lesions other than in the femoral head as seen on bone scan, may represent the early stage of osteonecrosis, which shows a characteristic appearance on bone scan. In order to avoid possible misdiagnoses of multiple extrafemoral lesions as bony metastasis or traumatic lesions, in patients with avascular necrosis of the femur these should be carefully evaluated.
Alcoholism ; Calcaneus ; Diagnosis ; Diagnostic Errors ; Femur ; Head* ; Humans ; Humerus ; Kidney Transplantation ; Knee Joint ; Lower Extremity ; Necrosis* ; Neoplasm Metastasis ; Osteonecrosis ; Risk Factors ; Steroids ; Technetium Tc 99m Medronate*

A series of clinical studies on the psychiatric aspects of hemodialysis and kidney transplantation were done with Korean patients, kidney donors, their families and unit nurses. All subjects were interviewed and evaluated for their psychiatric reactions and symptoms and for the underlying causes. Depression was the most common reaction, although the clinical features were somewhat different between groups studied. In addition, a unique and episodic psychotic syndrome was found in four patients. Depression and psychotic episodes seemed to reflect the psychodynamic components such as instinctual frustration, physical, familial and financial loss, dependency on a machine, sensory deprivation and the so-called fear of death and fear of life. These seemed to follow the unique features of hemodialysis and transplantation. The main defense mechanism seemed to be denial. The possible role of psychiatrists was discussed for evaluation, treatment, and prevention of these reactions and for the support of the family and the treatment team.
dult ; Aged ; Female ; Human ; Kidney Transplantation* ; Korea ; Male ; Middle Age ; Renal Dialysis/psychology* ; Transplantation, Homologous/psychology*

PURPOSE: Apoptosis is a process of active cell death which has been suggested to be part of hippocampal cell loss caused by kainic acid (KA). Immature rats showed higher susceptibility and mortality to KA but did not develop recurrent seizure, long term behavioral or neuropathologic changes. We investigated whether this was due to age-dependent resistance, and elucidated the molecular mechanics which mediate P53-induced apoptosis, identifying bax and bcl-2 as P53 protein expressions that serve as a paradigm on how the balance of bcl-2 to bax is differentially altered by apoptotic stimuli. METHODS: Sprague-Dawley rats were classified into postnatal age (P) 10, 15, 20 and 30 days and given specific doses of i.p. KA (P10; 3mg/kg, P15; 4mg/kg, P20; 8mg/kg, P30; 10mg/kg). Only rats that achieved continuous clonic seizure were selected and decapitated at 24, 48, and 72h (n=15 each age). We analysed P53, bax and bcl-2 protein expressions by immunohistochemistry as well as apoptosis by TUNEL in each group. RESULTS: KA-induced hippocampal cell death first appeared in P20. Remarkable expressions of apoptosis, P53 and bax, while bcl-2 proteins were suppressed were observed at 48 hours following KA in P20 and the most prominently affected areas were hippocampal CA1 and CA3 neurons. Similar results were obtained in P30. CONCLUSOIN: A Induction of P53, a growth regulatory gene which has been implicated in apoptosis and the changes in bcl-2 to bax ratio may be important to KA mediated excitotoxicity of specific regions during the critical period of developing rat brain.
Animals ; Apoptosis* ; Brain ; Cell Death ; Critical Period (Psychology) ; Genes, Regulator ; Hippocampus* ; Immunohistochemistry ; In Situ Nick-End Labeling ; Kainic Acid ; Mechanics ; Mortality ; Neurons ; Rats* ; Rats, Sprague-Dawley ; Seizures*

No abstract available.
Sepsis*

Ectopia cordis is defined as a congenital malposition of the heart partially or completely outside the thorax and often associated with sternal and congenital heart defects:surgical repair is generally unsuccessful because of the magnitude of the deformity and the associat-ed intracardiac anormalies. Four types of ectopia cordis are described : cervical, thoracic, abdominal and thoracoa- bdominal. Cervical and thoracic type are often fatal within days, because the heart is expo- sed and malformed. Abdominal type carries a better prognosis because cardiac abnormalities are less often found. The prognosis of thoraco-abdominal type mainly depends on the pre- sence of intracardiac abnormalities. We have experienced a case of thoracic ectopia cordis at 25 weeks' gestation by ultra- sonography, so present the case and the review with literature briefly.
Congenital Abnormalities ; Ectopia Cordis* ; Heart ; Pregnancy ; Prenatal Diagnosis* ; Prognosis ; Thorax

PURPOSE: We wanted to evaluate the clinical and radiological results after performing arthroplasty for an intertrochanteric fracture in patients 70 years of age or older, and we used a new fixation technique of the greater trochanter. MATERIAL AND METHODS: From January, 2004 to August 2007, we treated 21 cases (M/F: 3/18) of intertrochanteric fracture with hemiarthroplasty with modified double tension band wiring. All the cases were above type 2 (AO/OTA A1.3) according to the Jensen modification of the Evans classification, and all the patients were elderly. The fractures were evaluated for the fracture pattern by using simple radiography and 3D computed tomography. We analyzed the clinical and radiological results at a minimum of 12 months (range: 12~36 months). RESULTS: We performed hemiarthroplasty with modified double tension band wiring. Two cases (9.5%) among the 21 cases developed loss of reduction due to an additional injury and one of them underwent reoperation using a greater trochanter reattachment device (GTRD). The greater trochanters were well maintained without displacement and excellent union was seen at the fracture site of 19 cases. CONCLUSION: The modified double tension band wiring technique, along with several other fixation methods, should be considered to easily obtain rigid fixation in an unstable intertrochanteric fracture.
Aged ; Arthroplasty ; Displacement (Psychology) ; Femur ; Hemiarthroplasty ; Humans ; Reoperation

PURPOSE: To distinguish the spiral CT findings of Borrmann type IV adenocarcinoma from those of gastric lymphoma with diffuse gastric wall thickening. MATERIALS AND METHODS: We retrospectively reviewed the spiral CT scans of 30 patients with Borrmann type IV adenocarcinoma and nine with gastric lymphoma with diffuse gastric wall thickening. In all patients the respective condition was pathologically confirmed by gastrectomy. CT scanning was performed after peroral administration of 500-700ml of water. A total of 120-140ml bolus of nonionic contrast material was administered intravenously at a flow rate of 3ml/sec and two-phase images were obtained at 35-45 sec(early phase) and 180 sec(delayed phase) after the start of bolus injection. Spiral CT was performed with 10mm collimation, 10mm/sec table feed and 10mm reconstruction. We evaluated the degree and homogeneity of enhancement of thickened entire gastric wall, and the enhancement pattern of gastric inner layer, as seen on earlyphase CT scans. On early and delayed views, the thickness of gastric wall and the presence of perigastric fat infiltration were determined. The enhancement patterns of gastric inner layer were classified as either continuous or discontinuous thick enhancement, thin enhancement, or nonenhancement. RESULTS: The thickness of gastric wall was 1.2-3.5cm(mean 2.2cm) in cases of adenocarcinoma and 1.2-7.6c m (mean 4cm) in lymphoma. Perigastric fat infiltration was seen in 24 patients with adenocarcinoma(80 %) and four with lymphoma(44%). In those with adenocarcinoma, the degree of enhancement of entire gastric wall was hyperdense in fifteen patients(50%) and isointense in eleven (37 %). Seven patients with lymphoma(78 % ) showed hypodensity. In those with adenocarcinoma, continuous thick enhancement of gastric inner layer was seen in 18 patients(60 %) and discontinuous thick enhancement in nine(30%). In lymphoma cases, no thick enhancement was observed. Thin enhancement of gastric inner layer was demonstrated in three patients with adenocarcinoma( 10 %) and two with lymphoma(22 %). In seven patients with lymphoma(78 %), there was no enhancement. CONCLUSION: The following early-phase findings are highly suggestive of gastric lymphoma: a gastric wall thickness of more than 3 cm; no or minimal perigastric fat infiltration, hypodense enhancement of thickened entire gastric wall; and no or thin enhancement of gastric inner layer.
Adenocarcinoma* ; Gastrectomy ; Humans ; Lymphoma* ; Retrospective Studies ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed ; Water

PURPOSE: The purpose of this study was to analyze effects of a community-based case management program for clients with hypertension living in the community. METHODS: The research design was a one group pre and post-test design with 30 participants with hypertension who agreed to participate in the 8-12 week case management program provided by case managers from the National Health Insurance Corporation in 2002. Data were collected three times, before and after the case management services, and 6 months later. Outcomes included changes in blood pressure, knowledge of hypertension and daily life practices, including alcohol consumption, smoking, exercise, and medication adherence. RESULTS: Repeated-measures ANOVA and post-hoc tests of means revealed significant differences before and after service for systolic blood pressure, daily life practices (monitoring body weight and BP, low salt and cholesterol and high vegetable diet, and stress-relief practices), and exercise. The goal for medication adherence was attained after service. Significant improvements from baseline to 6 months after service were observed in measures of salt and vegetables in diet. There were no significant differences on hypertension knowledge, alcohol consumption or smoking behavior between before service and after, and at 6 months. CONCLUSION: The findings provide preliminary evidence that case management intervention can have positive outcomes on BP control, daily life practices, exercise, and medication adherence for clients with hypertension. However, additional interventions are needed to sustain long-term effects.
Activities of Daily Living ; Aged ; Alcohol Drinking/prevention & control/psychology ; Blood Pressure ; Case Management/*organization & administration ; Community Health Services ; Diet, Sodium-Restricted ; Female ; Humans ; Hypertension/psychology/*therapy ; Korea ; Male ; Medication Adherence/psychology ; Middle Aged ; Patient Education as Topic ; Smoking Cessation/psychology