OBJECTIVES: The purpose of this study was to provide a basic data of nutrition services in home health care by analyzing hospital-based home-visit nutrition education needs of patients at discharge. METHODS: Data was collected from September 11 to October 12, 2012 by administering questionnaires to 289 chronic disease patients to be discharged from a university hospital in Pusan. The home-visit nutrition education instruments used for collecting data were developed by the researcher. RESULTS: Regarding the demands of home-visit nutrition education, 62.3% of subjects were willing to use home-visit nutrition education and 37.7% weren't. The main reason for using the home-visit nutrition education was "the effective nutrient management in consultation with an individual's doctor", 38.9% and 31.2% of patients who did not wish to use the service gave the reason for their decision as, "Just by managing the nutritional requirements of a family's diet and, the patient will be able to fully recover", respectively. As for the demand, classified with the areas of home-visit nutrition education, the demand for the area of basic nutrition (3.75/5.00) was the highest followed by, the area of educational nutrition (3.74/5.00), therapeutic nutrition (3.67/5.00), and dietary nutrition (3.55/5.00). The demand for the area of educational nutrition was high "Considering the state of dietary management, such as disease status and drugs", 73.7%. As for the relation between the characteristics of the study subjects and analysis of demand home-visit nutrition education, the characteristic of subjects, that is, "regular home-visit nutrition education", "practice of diet therapy after discharge" had a significant difference statistically (p < 0.01). As for the relation between the needs for fundamental home-visit nutrition education and the demand of home-visit nutrition education, basic nutrition, educational nutrition, therapeutic nutrition, and dietary nutrition had a significant difference statistically (p < 0.01). CONCLUSIONS: Hospital-based home-visit nutrition education need the access of home nutrition support team.
Busan ; Chronic Disease ; Delivery of Health Care ; Diet ; Diet Therapy ; Education* ; Humans ; Nutritional Requirements ; Surveys and Questionnaires

PURPOSE: To identify predictive factors for recovery time in patients with orbital fracture with diplopia through analysis of preoperative and postoperative computed tomography (CT) images and postoperative recovery time. METHODS: We retrospectively analyzed CT findings-preoperative: fracture size, type of fracture, fracture site, extraocular muscle (EOM) swelling, EOM and soft tissue injury, and the amount of soft tissue herniation; post-operative: degree of enophthalmos, and diplopia recovery period in 379 patients who underwent surgical treatment for orbital fracture between March 2006 and December 2015. RESULTS: The average postoperative follow-up period was 556.2 ± 59.5 days, and the mean duration of recovery was 23.9 ± 42.5 (range, 3–186) days. The recovery time of diplopia was significantly increased with the following preoperative CT findings: fracture size (small and medium < large) (p = 0.049), type of fracture (linear < hinge < comminuted, trap-door) (p < 0.01), fracture site (inferior < medial and both) (p < 0.01), EOM and soft tissue injury (prolapse and torsion, muscle entrapment, kinked muscle) (p < 0.01), and the amount of soft tissue herniation (small and medium < large) (p < 0.001). The mechanism of injury, sex, age, and the degree of enophthalmos were not related to the length of the diplopia recovery period. CONCLUSIONS: The length of diplopia recovery could be predicted by CT findings.
Diplopia ; Enophthalmos ; Follow-Up Studies ; Humans ; Orbit ; Orbital Fractures ; Retrospective Studies ; Soft Tissue Injuries

A case of primary malignant fibrous histiocytoma(MFH) of the lung occurring in a 62-year-old man is presented. After preoperative bronchial brushing and washing cytologic diagnosis of poorly differentiated carcinoma, surgical resection and lymph nodes dissection were performed. Subsequent histologic examination revealed a primary MFH. The diagnosis was confirmed by electron microscopic and immunohistochemical examinations. The review of the bronchial brushing and washing cytologic features disclosed many bipolar and a few unipolar spindle tumor cells with a "comet" configuration, mainly single cells, but also forming loose clusters. The nuclei were elongated and hyperchromatic and contained one or more irregular nucleoli. Scattered bizarre, multinucleated tumor giant cells were also present.
Diagnosis ; Giant Cells ; Histiocytoma, Malignant Fibrous* ; Humans ; Lung* ; Lymph Nodes ; Middle Aged

This report evaluated long-term changes in clinical severity and laboratory parameters in 3 adult patients with severe recalcitrant atopic dermatitis (AD) who were treated with intramuscular injections of 50 mg of autologous immunoglobulin G (IgG) twice a week for 4 weeks (autologous immunoglobulin therapy, AIGT) and followed up for more than 2 years after the treatment. We observed the following 4 major findings in these 3 patients during the long-term follow-up after AIGT. (1) Two of the 3 patients showed a long-term clinical improvement for more than 36 weeks after AIGT with a maximum decrease in clinical severity score greater than 80% from baseline. (2) These 2 patients also showed long-term decreases in serum total IgE concentrations and peripheral blood eosinophil count for more than 36 weeks after AIGT with a maximum decrease in the two laboratory parameters of allergic inflammatory greater than 70% from baseline. (3) No significant side effect was observed during the 2 years of follow-up period after the AIGT in all 3 patients. (4) Serum levels of IgG anti-idiotype antibodies to the F(ab')2 fragment of autologous IgG administered for the treatment were not significantly changed after AIGT in all 3 patients. These findings suggest that AIGT has long-term favorable effects on both clinical severity and laboratory parameters in selected patients with severe recalcitrant AD. Further studies are required to evaluate the clinical usefulness and therapeutic mechanism of AIGT for AD.
Adult ; Antibodies ; Antibodies, Anti-Idiotypic ; Dermatitis, Atopic* ; Eosinophils ; Follow-Up Studies ; Humans ; Immunization, Passive* ; Immunoglobulin E ; Immunoglobulin G ; Immunoglobulins* ; Immunomodulation ; Injections, Intramuscular

PURPOSE: High frequency oscillatory ventillation (HFOV) is an alternative to conventional ventilation (CV) when oxygenation deteriorates. This study evaluates the efficacy and safety of HFOV in children with respiratory failure. METHODS: Ten cases with respiratory failure (age 8.7+/-7.6 mo, body weight 6.8+/-2.6 kg) that underwent HFOV for more than 3 days because of failure of oxygenation by CV were enrolled. PaO2/FiO2, oxygenation index (OI), (A-a) DO2, mean airway pressure (MAP), blood pressure, heart rate, PEediatric Logistic Organ Dysfunction (PELOD) score and complications were evaluated before and at 6, 12, 24, 48, 72 hours of HFOV. The influencing factors were compared between an HFOV success group and a failure group, and outcomes were evaluated. RESULTS: 1) Lower FiO2 was required for proper oxygenation by HFOV, although MAP was significantly increased. (P< 0.05) 2) PaO2/FiO2 was higher (P=0.002) and (A-a) DO2 was lower than baseline (P< 0.001) during HFOV. However, no significant difference was observed for OI, PaO2, PaCO2 or pH. 3) In the HFOV success group, (A-a) DO2 was significantly lower than failure group at baseline, (P=0.045) and OI was also significantly lower than in the failure group at 6 hours of HFOV. (P=0.032) PaO2/FiO2 was significantly improved in the success group at 6 hours of HFOV. (P=0.045) 4) Complications were air leak, 20% (2/10), and hypotension, 40% (4/10), which was corrected by using inotropics. PELOD scores decreased in all patients compared to at baseline throughout HFOV. (P=0.03) 5) Sixty percent patients survived for 3 months after HFOV were 60% (6/10). The success of HFOV related to survival. (P=0.048) CONCLUSION: HFOV can be used to improve oxygenation effectively and safely in children with respiratory failure who did not improve with CV.
Blood Pressure ; Body Weight ; Child* ; Heart Rate ; High-Frequency Ventilation ; Humans ; Hydrogen-Ion Concentration ; Hypotension ; Oxygen ; Respiration, Artificial ; Respiratory Insufficiency* ; Ventilation*

BACKGROUND: Perfusion scintigraphy with dipyridamole have been reported to be useful for diagnosis of coronary artery disease and the assessment of the presence and extent of myocardium at ischemic risk, especially in patients who can not undergo dynamic exercise testing. Dipyridamole, pharmacologic coronary vasodilator, also induces fall in blood pressure and rise in heart rate. The purpose of this study was to answer the question if dipyridamole induced peripheral hemodynamic responses were related to chest pain, ST changes on EKG, scintigraphic defect or extent of coronary stenosis. METHODS: Dipyridamole 99mTc-MIBI myocardial scintigraphy and coronary angiography on 43 subjects who were suspected to have coronary artery disease. The peripheral hemodynamic response was graded as absent(group 0) if there was a < or =10mm fall in systolic blood pressure (SBP) and/or < or =10 beats/min rise in geart rate(HR) ; moderate(group 1) if there was >10 but < or =20mm fall in SBP and/or >10 but < or =20 beats/min rise in HR ; and marked (group 2) if there was >20mm fall in SBP and/or >20 beats/min rise in HR. RESULTS: The overall diagnostic sensitivity and specificity for coronary artery disease of dipyridamole perfusion scintigraphy were 68%, 83% while per vessel sensitivity and specificity for coronary artery disease were 66%, 97%. The numbers of induced chest pain and ischemic ST changes among hemodynamic subgroups, were 40%, 40% in group 0, 33%, 27% in group 1 and 50%, 40% in group 2 without significant difference in each hemodynamic subgroups. Either the numbers of diseased coronary arteries or the numbers of patients demonstrationg reversible scintigraphic defects were not statically different among each subgroups. CONCLUSION: Although the peripheral hemodynamic response dose not always correlate with its central coronary effect but dipyridamlole 99mTc-MIBI myocardial perfusion scintigraphy is an useful test for diagnosis of coronary artery disease.
Blood Pressure ; Chest Pain ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Diagnosis ; Dipyridamole* ; Electrocardiography ; Exercise Test ; Heart Rate ; Hemodynamics* ; Humans ; Myocardial Perfusion Imaging ; Myocardium ; Perfusion Imaging ; Sensitivity and Specificity

BACKGROUND: Several studies have indicated that lumbar epidural anesthesia may decrease the incidence of deep vein thrombosis and pulmonary embolism, particulary after total hip replacement. Moreover venous thromboembolism also occurs after the release of a tourniquet in orthopedic surgery. The d-dimer test has been reported to be useful for predicting lower limb DVT and PE. Of the d-dimer test methods, the latex agglutination method shows excellent sensitivity and specificity. METHODS: We compared the quantity of d-dimer for General (n = 21) and Epidural (n = 20) anesthesia after tourniquet release in patients undergoing arthroscopic knee surgery. RESULTS: D-dimer significantly increased after tourniquet release in both groups, whereas the increase of d-dimer in the Epidural group was no smaller than that in the General group. Epidural group showed a correlation between tourniquet application and d-dimer. CONCLUSIONS: The present data suggest that DVT and PE after tourniquet release could occur during arthroscopic knee surgery and that epidural anesthesia may increase the fibrinolysis of a tourniquet induced thrombus.
Agglutination ; Anesthesia ; Anesthesia, Epidural* ; Anesthesia, General* ; Arthroplasty, Replacement, Hip ; Fibrinolysis ; Humans ; Incidence ; Knee* ; Latex ; Lower Extremity ; Orthopedics ; Pulmonary Embolism ; Sensitivity and Specificity ; Thromboembolism ; Thrombosis ; Tourniquets* ; Venous Thromboembolism ; Venous Thrombosis

BACKGROUND: Propofol is a good induction agent. but it has a disadvantage of pain on intravenous injection. Pretreatment of metoclopramide or lidocaine have been reported to reduce pain on injection. thus, we have evaluated the quantity and quality of anagesic effect of metoclopramide and lidocaine. We observed differences in quality of pain according to venous cannula sizes and intravenous injection sites as well as nausea and vomiting in the postoperative state. METHODS: Eighty patients scheduled for an elective operation by general anesthesia were chosen according to ASA (I or II) and divided into four groups randomly. Each group was injected through venous cannulas with normal saline (control group), metoclopramide 5 mg (group 1), metoclopramide 10 mg (group 2), or 2% lidocaine 40 mg (group 3) respectively. Then, propofol was injected of a 2 mg/kg dose with 0.5 ml/sec to all groups and we asked questions about injection pain after 10 seconds. RESULTS: Pain relief was shown in all groups compared with the control. but metoclopramide 10 mg and lidocaine 40 mg pretreatment groups showed significant pain reief. Pain was relieved significantly when the drug was injected in the antecubital area. Postoperative nausea and vomiting were not observed. CONCLUSIONS: Metoclopramide 10 mg or lidocaine 40 mg pretreatment to induction by propofol revealed a good analgesic effect for propofol injection pain.
Anesthesia, General ; Anesthetics ; Catheters ; Humans ; Injections, Intravenous ; Lidocaine ; Metoclopramide* ; Nausea ; Postoperative Nausea and Vomiting ; Propofol* ; Vomiting

Poland syndrome is characterized by unilateral absence or hypoplasia of the pectoralis muscle and variable degree of ipsilateral hand anomalies. Mobius syndrome is a congenital neurological disorder characterized by complete or partial facial paralysis. Although the pathogeneses of these diseases are not well-characterized, diminished blood flow to the affected side is thought to play a role. A male infant weighing 2.670 g was born at 38+3 weeks of gestation with left facial paralysis, left chest wall defect with dextrocardia, and symbrachydactyly between the second and third fingers. The combination of Poland-Mobius syndrome is rare, and only 2 cases associated with dextrocardia have been reported worldwide. Here, we report the first case of Poland-Mobius syndrome associated with dextrocardia in Korea.
Dextrocardia ; Facial Paralysis ; Fingers ; Hand ; Humans ; Infant ; Korea ; Male ; Mobius Syndrome ; Nervous System Diseases ; Pectoralis Muscles ; Poland Syndrome ; Pregnancy ; Thoracic Wall