The Purpose of this study is to explore the effects of Craniosacral therapy(CST) on the chronic headache patients, and the research was used the one-group pretest-posttest design. The subjects were 31 chronic headache patients, who received Craniosacral therapy by once per week for 6 weeks. The data were collected from July 1, 2003 to August 28, 2003. In order toevaluate the effects of craniosacral therapy, Visual Analogue Scale(VAS) for headach intensity, blood pressure, pulse rate, respiration rate, craniosacral rhythm rate, depression and stress perception were measured before and after treatment. The results are as follows : 1) The mean score of intensity of headache (VAS) significantly decreased after each session of Craniosacral therapy(F=86.14, p<.001). 2) The mean score of systolic blood pressure significantly decreased after each session of craniosacral therapy(F=6.99, p<.001), and the mean score of diastolic blood pressure significantly decreased after 3rd session of Craniosacral therapy(t=5.710, p<.001). The means of pulse(F=6.19, p<.001), respiration(F=7.93, p<.001) and craniosacral impulse rate(F=22.84, p<.001) significantly decreased after each session of Craniosacral therapy. 3) The means score of depression significantly decreased after Craniosacral therapy(t=6.627, p<.001) and stress also significantly decreased after Craniosacral therapy(t=5.987, p<.001). Therefore, these results of this study suggest that Craniosacral therapy could be an effective nursing intervention to reduce the intensity of headache.
Blood Pressure ; Depression ; Headache ; Headache Disorders* ; Heart Rate ; Humans ; Nursing ; Respiratory Rate

PURPOSE: A survey was done on knowledge and attitude toward CPR and provision of CPR education to nurses on general wards. METHOD: A survey of 280 nurses on general wards in four university hospitals with 700 beds or more in the city of Pusan was done. The data were collected from September 10, to September 22, 2007. RESULTS: The mean score for knowledge of Basic Life Support was 12.71 (mean converted to 100: 63). About 76% of the nurses believed that they had a responsibility to perform CPR, but 53.3% of the nurses were not confident to perform CPR. About 94% of the nurses had received education on CPR but 32.3% of those took it 6 to 12 years ago. About 41% of the nurses spent 3-4 hours for the education and 73.2% of those took simulation education. CONCLUSION: Although most of the nurses had received CPR education, they were not knowledgeable or confident. Therefore, better CPR education programs including up-dated knowledge are needed. More reinforced education should be offered every six months or on a yearly basis in order to enhance lasting efficiency.
Cardiopulmonary Resuscitation ; Hospitals, University ; Patients' Rooms

In the treatment of aortoiliac disease, two methods could be considered. One is percutaneous transluminal angioplasty, and the other is bypass graft. However sometimes two methods could be combined in high risk patients with a lengthy unilateral occlusion of one iliac artery and less extensive obstruction of the contralateral one, since higher risk aortofemoral bypass surgery may be obviated by femoro-femoral bypass graft after percutaneous treatment of the less diseased iliac artery. We report two cases of arortoiliac disease treated with Strecker stent followed by femoro-femoral bypass graft.
Angioplasty ; Humans ; Iliac Artery ; Stents* ; Transplants*

In the treatment of aortoiliac disease, two methods could be considered. One is percutaneous transluminal angioplasty, and the other is bypass graft. However sometimes two methods could be combined in high risk patients with a lengthy unilateral occlusion of one iliac artery and less extensive obstruction of the contralateral one, since higher risk aortofemoral bypass surgery may be obviated by femoro-femoral bypass graft after percutaneous treatment of the less diseased iliac artery. We report two cases of arortoiliac disease treated with Strecker stent followed by femoro-femoral bypass graft.
Angioplasty ; Humans ; Iliac Artery ; Stents* ; Transplants*

Non-parasitic true cyst of spleen is one of the rare disease entities. It is thought that they usually develop as a result of abnormality in the development of the spleen and spontaneous or traumatic hemorrhage of the spleen with subsequent organization and liquefaction. It is often presented with asymptomatic abdominal mass, or symptom of compressive effect on a neighboring organ. After corrective differential diagnosis using USG or CT, it can be treated with splenectomy, totally or partially, according to its size and location. We report a case of true splenic cyst in 22-year old female patient who was treated with splenectomy.
Diagnosis, Differential ; Female ; Hemorrhage ; Humans ; Rare Diseases ; Spleen ; Splenectomy ; Young Adult

PURPOSE: Ewing sarcoma (ES) occurs mainly in the pediatric and adolescent population. We evaluated the clinical characteristics and the efficacy of treatment on ES in children who were treated at Seoul National University Children's Hospital. METHODS: We undertook a retrospective analysis of 12 patients diagnosed as ES between March, 1986 and December, 2002. Systemic chemotherapyregimens were as follows: CCG 731 (Vincristine, Adriamycin, Methotrexate, Actinomycin D, Cyclophosphamide; N=6), CCG 7881B (Ifosfamide, Etoposide, Vincristine, Adriamycin, Cyclophosphamide; N=2), POG-ICE (Ifosfamide, Etoposide, Carboplatin; N=1), CCG 7881B and BCD (Bleomycin, Cyclophosphamide, Actinomycin D; N=1), CCG 7881B, POG-ICE and VEC (Vincristine, Etoposide, Carboplatin; N=1). One case received CCG 7881B and autologous peripheral blood stem cell transplantation (PBSCT). RESULTS: Among the 12 patients, 8 patients were male and the others were female. The patients median age was 7 years 10 months. The primary tumors occurred in femur (N=4), pubis (N=2), vertebra (N=2) and clavicle, humerus, rib, phalanx one each. All patients were treated with systemic chemotherapy and the duration was median 13 months. Eight patients received radical surgery and nine patients received radiotherapy. Overall 5 years survival rate was 33.3% and one patient who received systemic chemotherapy and PBSCT is alive disease-free for more than 5 years. Eight patients who had more than one poor prognostic factor died. CONCLUSION: Though recent therapeutic trials led to improvement of survival in patients with ES, the prognosis for patient with high-risk disease remain poor and the treatment related toxicities are problem to solve. For the advanced or recurrent cases more intensive therapeutic modality such as autologous bone mallow transplantation or PBSCT should be considered.
Adolescent ; Carboplatin ; Child ; Clavicle ; Combined Modality Therapy* ; Cyclophosphamide ; Dactinomycin ; Doxorubicin ; Drug Therapy ; Etoposide ; Female ; Femur ; Humans ; Humerus ; Male ; Methotrexate ; Peripheral Blood Stem Cell Transplantation ; Prognosis ; Radiotherapy ; Retrospective Studies ; Ribs ; Sarcoma, Ewing* ; Seoul ; Spine ; Survival Rate ; Vincristine

Allopurinol is frequently used for the treatment of hyperuricemia and gout. Sometimes, a life-threatening reaction develops, as is illustrated by the following case report. We describe a 60-year-old male patient who was treated with allopurinol because of asymptomatic hyperuricemia, and he was presented with fever, skin rash, eosinophilia, worsening renal function and vanishing bile duct syndrome. In this report, we discussed vanishing bile duct syndrome as a serious side effect of allopurinol, and we briefly reviewed the etiology, prevention, and treatment modalities for vanishing bile duct syndrome.
Allopurinol/*adverse effects ; Bile Duct Diseases/*etiology/pathology ; Drug Hypersensitivity/*complications ; English Abstract ; Gout Suppressants/*adverse effects ; Humans ; Male ; Middle Aged

PURPOSE: Antiretroviral toxicity is an increasingly important issue in the management of HIV-infected individuals. However, adverse effects and long term safety in Koreans are hardly known. We evaluated the incidence of adverse effects of various antiretroviral drugs in Koreans, and difference among races was also studied. METHODS: One hundred and twenty six Koreans with HIV infection and AIDS treated with antiretroviral drugs at Yonsei University College of Medicine from 1992 to 2002 were investigated. We analyzed the prevalence of adverse effects of various drugs. RESULTS: The mean age of subjects at initial treatment was 34.4 8.3 years. One hundred and twelve subjects were male, and 14 subjects were female. Adverse effects were found in 40 subjects (33.3%) out of 120 subjects who received zidovudine. The prevalence of adverse effects of didanosine and indinavir were 48.3% (14 out of 29 subjects) and 57.9% (66 of 114 subjects), respectively. Frequent toxicities of the subjects who received zidovudine were bone marrow suppression (13.3%), followed by gastrointestinal intolerance (11.7%), headache (4.2%), and hepatic dysfunction (2.5%). Frequent toxicities of the subjects who received didanosine were gastrointestinal intolerance (24.1%), followed by diarrhea (13.8%), rash (3.4%), peripheral neuropathy (3.4%), and pancreatitis (3.4%). Adverse effects of indinavir were as follows: hyperbilirubinemia (37.7%), flank pain (21.1%), gastrointestinal intolerance (6.1%), and lipodystrophy (5.3%). The main adverse effect of efavirenz was impaired concentration (27.3%). The overall incidence of adverse effects from antiretroviral drugs was 64.3% (81 out of 126 subjects) in HIV-infected Koreans. Change of antiretroviral regimens was inevitable in 36 subjects (28.6%). In most cases, the subjects recovered from adverse effects by conservative management. CONCLUSION: Clinicians should be aware of toxicity profiles in various races in the management of long term treatment with antiretroviral drugs, since the toxicity hazards of these drugs may easily outshadow the success of antiretroviral therapy.
Bone Marrow ; Continental Population Groups ; Diarrhea ; Didanosine ; Exanthema ; Female ; Flank Pain ; Headache ; HIV ; HIV Infections ; Humans ; Hyperbilirubinemia ; Incidence ; Indinavir ; Lipodystrophy ; Male ; Pancreatitis ; Peripheral Nervous System Diseases ; Prevalence ; Zidovudine

PURPOSE: Antiretroviral toxicity is an increasingly important issue in the management of HIV-infected individuals. However, adverse effects and long term safety in Koreans are hardly known. We evaluated the incidence of adverse effects of various antiretroviral drugs in Koreans, and difference among races was also studied. METHODS: One hundred and twenty six Koreans with HIV infection and AIDS treated with antiretroviral drugs at Yonsei University College of Medicine from 1992 to 2002 were investigated. We analyzed the prevalence of adverse effects of various drugs. RESULTS: The mean age of subjects at initial treatment was 34.4 8.3 years. One hundred and twelve subjects were male, and 14 subjects were female. Adverse effects were found in 40 subjects (33.3%) out of 120 subjects who received zidovudine. The prevalence of adverse effects of didanosine and indinavir were 48.3% (14 out of 29 subjects) and 57.9% (66 of 114 subjects), respectively. Frequent toxicities of the subjects who received zidovudine were bone marrow suppression (13.3%), followed by gastrointestinal intolerance (11.7%), headache (4.2%), and hepatic dysfunction (2.5%). Frequent toxicities of the subjects who received didanosine were gastrointestinal intolerance (24.1%), followed by diarrhea (13.8%), rash (3.4%), peripheral neuropathy (3.4%), and pancreatitis (3.4%). Adverse effects of indinavir were as follows: hyperbilirubinemia (37.7%), flank pain (21.1%), gastrointestinal intolerance (6.1%), and lipodystrophy (5.3%). The main adverse effect of efavirenz was impaired concentration (27.3%). The overall incidence of adverse effects from antiretroviral drugs was 64.3% (81 out of 126 subjects) in HIV-infected Koreans. Change of antiretroviral regimens was inevitable in 36 subjects (28.6%). In most cases, the subjects recovered from adverse effects by conservative management. CONCLUSION: Clinicians should be aware of toxicity profiles in various races in the management of long term treatment with antiretroviral drugs, since the toxicity hazards of these drugs may easily outshadow the success of antiretroviral therapy.
Bone Marrow ; Continental Population Groups ; Diarrhea ; Didanosine ; Exanthema ; Female ; Flank Pain ; Headache ; HIV ; HIV Infections ; Humans ; Hyperbilirubinemia ; Incidence ; Indinavir ; Lipodystrophy ; Male ; Pancreatitis ; Peripheral Nervous System Diseases ; Prevalence ; Zidovudine

Purpose: The purpose of this study is to determine the risk adjusted nosocomial infection (NI) rate and distribution of Nls and their causative pathogens in adult lCU. Methods: Prospective surveillance was performed at 12 lCU's of 5 acute care hospitals in Seoul and Kyonggi Do during a 3-months period from May to July 2002. The case finding was done by direct reviews of medical charts regularly for all patients by ICPs using CDC definitions. Results: Total NI rate was 10.18/1,000 patient-days in Medical-surgical ICU (MSICU) and 12.35/1,000 patient-days in Neurosurgucal ICU(NCI). Risk adjusted infection rate was 3.44 in indwelling catheter associated UTI 2.12 in central line associated BSI. 3.51/1,000 device-days in ventilator associated pneumonia in MSICU. There were 3.72, 2.26, 6.06/1,000 device-days in NCU. The infection rate by leu type showed no significant difference. The distribution of Nls were PNEU (28.99%). UTI (28.99%), BSI (18,84%), SSI(4.35%) in MSICU, and UTI(48.0%), PNEU(24.0%), BSI (14.0%), SSI(6.I) in NCU. The most commonly isolated organisms were Candida spp (38.6%), Enterococcus spp. (13.4%) in UTI, Staphylococcus aureus(36.2%), p. aeruginosa(18.8%) in PNEU and Coagulase negative staphylococcus(44.1%). S. aureus (14.7%) in BSL, S. aureus (19.8%) was the most common organism from overall nosocomial infections in the ICU, and 96.3% of S. aureus were MRSA. Conclusion: Distribution of site-specific nosocomial infection and isolated organisms were similar to the results of KOSNIC (Korea society for nosocomial infection control) surveillance in 1996. However, the total infection rate and a risk adjusted infection rate at MSJCU is lower than 1996's. This decrease is considered to be a result of efforts to prevention and control nosocomial infections.
Adult ; Candida ; Catheters, Indwelling ; Centers for Disease Control and Prevention (U.S.) ; Coagulase ; Cross Infection* ; Enterococcus ; Gyeonggi-do ; Humans ; Korea* ; Methicillin-Resistant Staphylococcus aureus ; Pneumonia, Ventilator-Associated ; Prospective Studies ; Seoul ; Staphylococcus