This descriptive study was conducted between October 1, and December 31, 1998 in order to provide basic data for understanding the emotional states of patients with systemic lupus erythematosus and their compliance with a medical regimen. Data was collected by using questionnaires administered to 100 lupus inpatients and outpatients at the Kangnam St. Mary's Hospital. Frequencies, percentage, average, standard deviation, t-test, ANOVA, Duncan's multiple range test, Pearson correlation coefficients, and stepwise multiple regression were applied to the data using the SAS program. The results of study are summarized below. The mean compliance score was 91.21. The highest compliance score was found in "risk factor management", followed by "taking medicine", "follow-up care", "daily life management", "stress management", "diet", "activity and rest" in that sequence. The mean depression score was 43.58. 24% for subjects who showed more than mild depression. The compliance score of depressed subjects was significantly lower than that of the subjects without depression. The mean score of anxiety was 44.01. 36% for subjects who had scores lower than 40 points, 37% for those between 41-50 points, and 27% for those with more than 51 points. As for compliance scores according to anxiety levels, the compliance scores for those with anxiety scores of below 40 significantly higher than that of those of the above 51 group. There was a negative correlation between compliance and depression and between compliance and anxiety. In addition, a strong positive relationship was found between depression and anxiety. The major variable affecting compliance was anxiety, accounting for 13.6%. We concluded that when we care for the patients with lupus, we have to consider the outcomes of this study because emotional status affects the lupus patients' compliance. In addition, it is necessary to develop nursing interventions in order to alleviate the lupus patient's depression and anxiety.
Anxiety ; Compliance* ; Depression ; Humans ; Inpatients ; Lupus Erythematosus, Systemic* ; Nursing ; Outpatients ; Surveys and Questionnaires

This study was conducted between October 1, 1998, and December 31, 1998, in order to provide basic data to develop better self-management educational programs for systemic lupus erythematosus (lupus) patients. In the study, the extent of each patients knowledge on the disease and their learning needs about it were examined for 100 lupus inpatients and outpatients at the Kangnam St. Marys Hospital. Data were collected by using questionnaires to those patients. Frequencies, percentage, average, standard deviation, t-test, ANOVA, and Duncans multiple range test were examined through the SAS program. The result of study follows: 1) The average score of patients knowledge on the disease was 15.7 (range, 7-20; standard deviation, 2.74). Subjects scored higher as far as the extent of their knowledge in the following categories : management of daily life, diet, characteristics of the disease, risk factors, and medication. Two categories shared the highest percentage of correct answers: 99% of subjects correctly identified that fatigue and stress aggravate symptoms of lupus and symptoms of lupus vary among individuals in range and type. However, when subjects were asked if patients should get a regular examination by an ophthalmologist every 4-6 months while they are on medication to treat rashes, lupus can be completely cured, and contraceptives that include a female hormone (estrogen) are good as contraceptive methods, the percentages of correct answers were low (32%, 31%, and 20%, respectively). In terms of subjects knowledge about the disease by their general characteristics, single subjects had more knowledge about the disease than married subjects did (t=2.14, p=0.0353). The extent of knowledge also varied by monthly income (F=4.96, p=0.0097). Those with more formal education had more knowledge about lupus than those who had less formation education did (t=2.95, 0.0039). Additionally, those who were satisfied with their education about the disease had better knowledge about it than those who were dissatisfied with their education did (t=2.71, p=0.0090). 2) The extent to which lupus patients wanted to be educated about the disease was, on average, 64.5 (range, 46-75; standard deviation, 7.91). Areas for which patients requested education are listed here in order : risk factors, sexual lives and patients associations. Patients who had been hospitalized demonstrated wanting more education than those who had not been did (t=3.73, p=0.0003). The extent to which they wanted the information was different by the number of educational sessions they had (F=3.98, p=0.0249). In conclusion, the results above would be considered when the education programme is planned for SLE patients.
Contraception ; Contraceptive Agents ; Diet ; Education ; Exanthema ; Fatigue ; Female ; Humans ; Inpatients ; Learning* ; Lupus Erythematosus, Systemic* ; Outpatients ; Surveys and Questionnaires ; Risk Factors ; Self Care

Congenital myotonic dystrophy (CMD) which is transmitted in an autosomal-dominant manner, can also be observed in newborns born to asymptomatic parents who have a myotonic dystrophy type 1 or premutation allele, especially from the mother. A mother with myotonic dystrophy could be subfertile and the pregnancy could be complicated with the risk of a preterm birth. Newborns with CMD may demonstrate symptoms such as hypotonia and poor motor activity, as well as respiratory and feeding difficulties. Additionally, CMD has a high mortality rate at birth. Detection of the signs and symptoms during pregnancy is helpful for a prenatal diagnosis of CMD in cases where the family history is not known.
Alleles ; Genetic Counseling ; Humans ; Infant, Newborn ; Mortality ; Mothers ; Motor Activity ; Muscle Hypotonia ; Myotonic Dystrophy* ; Parents ; Parturition ; Postpartum Period ; Pregnancy ; Premature Birth ; Prenatal Diagnosis

Hemophagocytic lymphohistiocytosis (HLH) is a fatal, systemic inflammatory syndrome that characteristically presents hemophagocytic histiocytes infiltrating into various organs. Common features of HLH are abrupt onset of high fever, malaise, lymphadenopathy, hepatosplenomegaly, and abnormal laboratory findings including pancytopenia, hypertriglyceridemia, hypofibrinogenemia, and high ferritin levels. Cutaneous manifestations, which occur in 6~65% of patients, can develop at any moment in the clinical course of the syndrome. Most skin eruptions in HLH patients are generalized, transient maculopapular rashes. We describe an HLH patient who first manifested cutaneous symptoms as a large purpuric patch on her thigh. A skin biopsy found high levels of hemophagocytic histiocytes.
Biopsy ; Exanthema ; Ferritins ; Fever ; Histiocytes ; Humans ; Hypertriglyceridemia ; Lymphatic Diseases ; Lymphohistiocytosis, Hemophagocytic* ; Pancytopenia ; Purpura ; Skin ; Thigh

Pheochromocytoma is a catecholamine-producing tumor characterized by hypertension, headache, tachycardia, excessive diaphoresis, and angina pectoris. The thunderclap headache is so named because the pain strikes suddenly and severely. Although the symptoms of bladder pheochromocytoma are rather evident, the diagnosis of this rare neuroendocrine tumor can be missed. This study reports the case of a woman diagnosed with bladder pheochromocytoma who experienced thunderclap headache triggered by urination and angina pectoris as an initial manifestation. This case study suggests that thunderclap headache and angina pectoris occurring concurrently with sudden blood pressure elevation during or immediately after urination are important diagnostic clues of bladder pheochromocytoma.
Angina Pectoris* ; Blood Pressure ; Diagnosis ; Female ; Headache ; Headache Disorders, Primary* ; Humans ; Hypertension ; Neuroendocrine Tumors ; Pheochromocytoma* ; Strikes, Employee ; Tachycardia ; Urinary Bladder* ; Urination*

Presently, media for sanitation education consisting of a sanitation manual and a CD-ROM intended for restaurant employers and employees was developed and evaluated. The sanitation manual consisted of five principles: prevention of foodborne illness, personal hygiene, control of food production, instrument and equipment cleaning and sanitation, and management of environmental sanitation. The CD-ROM was composed of animations detailed real-life examples of Salmonella, Staphylococcus aureus, and Norovirus foodborned illness outbreaks; slides summarizing the five principles of the manual; and a poster entitled You can prevent foodborne illness listing and describing the principles. A 15 question evaluation survey was developed to gauge the efficacy of the animations. The survey was divided into five sections on comprehension of the instructions, content organization concerning understanding, content organization concerning the information presented, content organization concerning retention of interest (concentration), and recommendations concerning concentration. Ranked on a 5-point scale the survey produced a mean value of 3.80+/-0.39 and individual scores of 3.92+/-0.45 (learning instruction), 3.86+/-0.48 (understanding), 3.82+/-0.52 (information), 3.75+/-0.49 (concentration), and 3.67+/-0.58 (concentration-recommendation). Overall, evaluation results of the animation were good and easy to understand, with only a few respondents electing to watch the animations more than once. In terms of continuous and recurring education, sanitation training programs should be easy to learn and contain sufficient and specific examples of the importance of sanitation in achieving food safety.
CD-ROM ; Comprehension ; Surveys and Questionnaires ; Humans ; Hygiene ; Norovirus ; Restaurants ; Retention (Psychology) ; Salmonella ; Sanitation ; Staphylococcus aureus

Addison's disease is a rare disorder caused by a chronic deficient production of the adrenal cortical hormone. Cutaneous features of the disease are generalized hyperpigmentation of the head, neck, hand, palmar crease, elbow, knee, groin, and genitalia. Axillary or pubic hair loss are also common findings. Other autoimmune disorders such as vitiligo, primary hypothyroidism, and Grave's disease may occur in conjunction with Addison's disease. However, to date there has been no reported case associated with idiopathic guttate hypomelanosis. We report a case of Addison's disease with idiopathic guttate hypomelanosis.
Addison Disease* ; Elbow ; Genitalia ; Groin ; Hair ; Hand ; Head ; Hyperpigmentation ; Hypopigmentation* ; Hypothyroidism ; Knee ; Neck ; Vitiligo

PURPOSE: This study aimed to identify the predictors of failure in medical students. METHODS: We conducted a 10-year follow-up survey of 231 medical students. The students' general characteristics, study-related factors, health-related behavior, and self-perceived health were examined using questionnaires that were given late in the first year of a premedical course. We evaluated the failure incidence of students using school records from the second year of a premedical course to the fourth year of medical school. The statistical analyses that were used were chi2-test, student t-test, and multiple logistic regression analysis. RESULTS: Sixty-five students experienced failure. Thirty-seven (56.9%) had 1 failure, 11 (16.9%) had 2 failures, 8 (12.3%) had 3 failures, 4 (6.2%) had 4 failures, and 5 (7.7%) had 5 failures. From the results of multiple logistic regression, the rates of failure were significantly higher for those whose grade point average (GPA) in the first year of a premedical course was below 2.5 (Relative Risk [RR]=6.52, 95% Confidence Interval [CI]: 1.42~29.8), who smoked more than 1 pack of cigarettes per day (RR=7.37, 95% CI: 1.23~44.07), who drank more (RR=1.16, 95% CI: 1.02~1.33), and exercised less (RR=0.997, 95% CI: 0.995~0.999). CONCLUSION: It was demonstrated that the incidence of failure in medical students was reflected in their academic records in the first year of a premedical course and by unhealthy lifestyles. This study suggests that students who have poor academic marks and unhealthy lifestyles in the first year of a premedical course should be properly guided to reduce the incidence of failure.
Follow-Up Studies ; Humans ; Incidence ; Life Style ; Logistic Models ; Schools, Medical ; Smoke ; Students, Medical ; Tobacco Products ; Surveys and Questionnaires

BACKGROUND: A variety of dermatological disorders develop in hospitalized patients and the need for dermatological consultations is on the rise. OBJECTIVE: We analyzed 2 years of dermatological consultation data from a tertiary medical center in Korea and compared dermatological problems among individual departments. METHODS: We reviewed 3,102 dermatological inpatient consultations by performing a retrospective chart review. RESULTS: Contact dermatitis (11.4%), drug eruption (9.6%), tinea pedis (5.5%), xerotic eczema (5.3%), and seborrheic dermatitis (5.2%) were the 5 dermatological disorders that were most commonly referred to dermatologists. Patients in the allergy and pulmonology departments had higher rates of drug eruptions. Endocrinology-admitted patients, especially diabetic patients, frequently complained of foot dermatitis. The cardiology, gastroenterology, and hemato-oncology departments referred many patients with purpuric dermatosis to dermatologists. Patients from the surgical departments consulted more frequently consulted contact dermatitis and drug eruptions. The neurology and rehabilitation medicine departments referred more seborrheic dermatitis patients than other departments. Pediatric patients commonly consulted for atopic dermatitis, viral exanthemata, and seborrheic dermatitis. Regardless of department, patients who suffered from severe illness and underwent major surgery developed herpes zoster and cutaneous fungal infections more frequently than other patients. Personal hygiene was closely related to the development of follicular disorders. CONCLUSION: Dermatologists should be familiar with the diverse dermatological complaints of patients admitted to various departments and be actively involved in the diagnosis, treatment, and education of doctors and patients to improve the quality of inpatient care.
Cardiology ; Dermatitis ; Dermatitis, Atopic ; Dermatitis, Contact ; Dermatitis, Seborrheic ; Diagnosis ; Drug Eruptions ; Eczema ; Education ; Foot ; Gastroenterology ; Herpes Zoster ; Humans ; Hygiene ; Hypersensitivity ; Inpatients* ; Korea ; Neurology ; Pulmonary Medicine ; Referral and Consultation ; Rehabilitation ; Retrospective Studies ; Skin Diseases ; Tinea Pedis

BACKGROUND: The pathogenesis of melasma has not yet been clearly identified. Recently, it was reported that dermal fibroblasts played an important role in the epidermal pigmentary disorders. OBJECTIVES: To investigate the role of fibroblast-derived cytokines, hepatocyte growth factor (HGF), stem cell factor (SCF), tumor necrosis factor (TNF)-alpha, and interleukin (IL)-1alpha in the development of melasma. METHOD: Using immunohistochemistry, we measured the levels of cytokines produced by fibroblasts derived from lesional skin, compared with perilesional normal skin in 50 melasma patients. RESULTS: The expression of HGF and SCF was found to be significantly increased in the lesional dermis compared to perilesional normal skin. However, there was no significant difference in the expression of TNF-alpha and IL-1alpha in melasma skin. CONCLUSION: These results may indicate that the dermal fibroblast-derived cytokines, HGF and SCF play an important role in the mechanism of hyperpigmentation in melasma.
Cytokines* ; Dermis ; Fibroblasts ; Hepatocyte Growth Factor ; Humans ; Hyperpigmentation ; Immunohistochemistry ; Interleukins ; Melanosis* ; Skin ; Stem Cell Factor ; Tumor Necrosis Factor-alpha