The beneficial effects of sunlight and ultraviolet light for the treatment, of psoriasis vulgaris has long been recognized. Parrish et al were the first to introduce a controlled light source, which allowed the delivery of a known quantity of light energy to the patients skin after the patient had ingested a photosensitizer, 8-methoxypsoralen (methoxsalen) two hours previous to UVA exposure. This successful treatment has become known as PUVA (psoralen and UVA). PUVA photochernotherapy denotes a systemic approach that is based on the interaction of light and a photoactive drug. Parrish et al have described successful treatment of psoriasis with PUVA and other investigators alI over the world have confirmed their beneficial results. The rationale of photochemotherapy in psoriasis is the inhibition of the increased DNA synthesis within the psoriatic lesions by the interaction of psoralen molecule and light energy in the UVA range(320-400nm). The present study was undertaken to evaluate the therapeutic effectiveness of PUVA photochernotherapy combining orally administered methoxsalen and UAA exposure using Dermatron UVA phototherapy system in patients with wi5espread psoriasis. A total of 15 patients with psoriasis over more than 30% of their bodies were selected at the department of dermatology, National Medical Center through March 1978 to September 1978. Oral administration of methoxsalen, 20 to 50 mg doses according to body weight, was followed by exposure to a high-intensity longwave ultraviolet light emitting a continuous spectrum between 320 and 400nm (peak emission, 350 - 365nm). Initial UVA exposure times were based on each patients minimal phototoxicity dose (MPD) and exposure times were increased at each treatment by 1 - 2 minutes to maintain minimal erythema. Frequency of treatment was two to three times weekly. Once the psoriatic lesions had, cleared completely the patient was placed on a maintenance schedule. If psoriasis recurred the frequency of treatment was increased. The results were as follows: l. 5 patients were dropped out due to unknown reasons. 2. 7 cases showed clearing of over 95, of the lesions (Response 5'). Mean number of PU VA therapy was 16. 7. During 1 4 months follow-up period, 4 cases remained free of psoriasis but 3 cases couldn't be followed. 3. Immediate side effects of PUVA were temporary and generally mild. No significant changes in laboratory screenings were noted. Side effects of therapy included transient nausea(33.3%), dizziness(26.7%), erythema.(66.7%), pruritus (60%), increased pigrnentation(100 %). 4. Comparison of pre-and post-PUVA therapy in biopsy specimens by light microscopy revealed histologic improvement evidenced by diminished acanthosis and parakeratosis, and regeneration of granular layers in all of 8 cases. Glycogen accumulation in the affected epiderrnis was significantly decreased or absent after PUVA therapy in all cases.
Administration, Oral ; Appointments and Schedules ; Biopsy ; Body Weight ; Dermatitis, Phototoxic ; Dermatology ; DNA ; Erythema ; Ficusin ; Follow-Up Studies ; Glycogen ; Humans ; Mass Screening ; Methoxsalen ; Microscopy ; Parakeratosis ; Photochemotherapy* ; Phototherapy ; Pruritus ; Psoriasis* ; PUVA Therapy ; Regeneration ; Research Personnel ; Skin ; Sunlight ; Ultraviolet Rays

PURPOSE: This study was designed to identify whether alcohol use predicts marital stability and to investigate the mediating effects of marital communication and social support in international married Korean men who lived in a rural area. METHODS: The participants were 200 of the international married men. The data were collected during June, 2010. The instruments were Alcohol Use Disorders Identification Test (AUDIT), Marital Instability (MI), Marital Communication (MC), Social Support (SS). Data were analyzed using descriptive statistics, Pearson correlation coefficients, and stepwise multiple regression. RESULTS: The mean score for AUDIT was 9.6, and alcohol use was negatively correlated with marital stability, marital communication and social support. We also found that marital communication fully mediated the association between alcohol use and marital stability, while social support did not mediate this association. CONCLUSION: The outcomes of this study indicates a need to develop intervention strategies and education programs that include emphasis on moderate drinking and communication skills for couples in international marriages.
Drinking ; Education ; Family Characteristics ; Humans ; Male ; Marriage ; Negotiating*

PURPOSE: This study was conducted to identify the effects of a self-monitoring rehabilitation program based on the Bandura's self-efficacy theory on the activities of daily living (ADL), 6-minute walking distances, self-efficacy and quality of life (QoL) among stroke patients after three to six months. METHODS: The participants consisted of 29 patients in the experiment group and 28 patients in the control group who admitted at rehabilitation specific hospital. Self-monitoring program developed by the researcher lasted twice a week for 8 weeks from August to September, 2013. RESULTS: ANCOVA showed that all of dependent variables of this study, ADL and 6-minute walking distances as a physical function, self-efficacy and QoL for intervention group were higher than those for control group(p<.001). CONCLUSION: The self-monitoring rehabilitation program based on the self-efficacy theory was found to be effective in improving physical function, self-efficacy and QoL for early post-stroke patients. Early rehabilitation program for stroke patients was recommended to consider the self-monitoring of current physical and psychosocial status as a strategy of self-management.
Activities of Daily Living ; Humans ; Quality of Life* ; Rehabilitation* ; Self Care ; Self Efficacy ; Stroke* ; Walking

PURPOSE: The aims of this study were to identify the incidence of pressure ulcers and to compare the predictive validities of pressure ulcer risk assessment scales among trauma patients.METHODS: This was a prospective observational study. A total of 155 patients admitted to a trauma intensive care unit in a university hospital were enrolled. The predictive validity of the Braden, Cubbin & Jackson, and Waterlow scales were assessed based on the sensitivity, specificity, positive and negative predictive values, and area under the receiver operating characteristic curve (AUC).RESULTS: Of the patients, 14 (9.0%) subsequently developed pressure ulcers. The sensitivity, specificity, positive predictive values, and negative predictive values were 78.6%, 75.9%, 24.4%, and 97.3%, respectively, for the Braden scale (cut-off point of 12); 85.7%, 68.8%, 21.4%, and 98.0%, respectively, for the Cubbin & Jackson scale (cut-off point of 26); and 71.4%, 87.2%, 35.7%, and 96.9%, respectively, for the Waterlow scale (cut-off point of 18). The AUCs were 0.88 (Waterlow), 0.86 (Braden), and 0.85 (Cubbin & Jackson).CONCLUSION: The findings indicate that the predictive validity values of the Waterlow, Braden, and Cubbin & Jackson scales were similarly high. However, further studies need to also consider clinical usefulness of the scales.
Area Under Curve ; Critical Care ; Humans ; Incidence ; Intensive Care Units ; Observational Study ; Pressure Ulcer ; Prospective Studies ; Risk Assessment ; ROC Curve ; Sensitivity and Specificity ; Weights and Measures

No Abstract available.
Academic Medical Centers* ; Infection Control* ; Korea*

A total of 47 preoperative CT scans in patients with renal cell carcinoma were retrospectively reviewed and compared with surgical findings to assess the accuracy of CT for determining the perinephric tumor extension. CT criteria for perinephric extension were hazy ill-defined tumor margin, perirenal nodule and fascial thickening. Regardless of the tumor stage, the accuracy of CT in detecting perinephric extension was 76.6%(36/47), with a sensitivity of 88.9% (16/18) and specificity of 68.9% (20/29). The cause of understaging (n=2) was microscopic infiltration of the perinephric space. The causes of overstaging were tumor infiltration to the renal capsule (n=5), partial adhesion with the perinephric fat (n=3) and renal vein thrombosis (n=1). A smooth clear tumor margin is highly reliable sign for stage I but infiltrative findings onto renal capsule and perirenal fat could be considered stage I.
Carcinoma, Renal Cell ; Humans ; Renal Veins ; Retrospective Studies ; Sensitivity and Specificity ; Thrombosis ; Tomography, X-Ray Computed

A total of 47 preoperative CT scans in patients with renal cell carcinoma were retrospectively reviewed and compared with surgical findings to assess the accuracy of CT for determining the perinephric tumor extension. CT criteria for perinephric extension were hazy ill-defined tumor margin, perirenal nodule and fascial thickening. Regardless of the tumor stage, the accuracy of CT in detecting perinephric extension was 76.6%(36/47), with a sensitivity of 88.9% (16/18) and specificity of 68.9% (20/29). The cause of understaging (n=2) was microscopic infiltration of the perinephric space. The causes of overstaging were tumor infiltration to the renal capsule (n=5), partial adhesion with the perinephric fat (n=3) and renal vein thrombosis (n=1). A smooth clear tumor margin is highly reliable sign for stage I but infiltrative findings onto renal capsule and perirenal fat could be considered stage I.
Carcinoma, Renal Cell ; Humans ; Renal Veins ; Retrospective Studies ; Sensitivity and Specificity ; Thrombosis ; Tomography, X-Ray Computed

PURPOSE: Phospholipase D (PLD) catalyzes the hydrolysis of phosphatidyl choline to phosphatidic acid (PA) and choline. Recently, PLD has been drawing much attentions and considered to be associated with cancer process since it is involved in cellular signal transduction. In this experiment, oleate-PLD activities were measured in various tissues of the living rats after whole body irradiation. MATERIAL AND METHODS: The reaction mixture for the PLD assay contained 0.1microCi 1,2-di[1-14C]palmitoyl phosphatidylcholine, 0.5mM phosphatidylcholine, 5mM sodium oleate, 0.2% taurodeoxycholate, 50mM HEPES buffer (pH 6.5), 10mM CaCl2, and 25mM KF. phosphatidic acid, the reaction product, was separated by TLC and its radioactivity was measured with a scintillation counter. The whole body irradiation was given to the female Wistar rats via Cobalt 60 Teletherapy with field size of 10cm x 10cm and an exposure of 2.7Gy per minute to the total doses of 10Gy and 25Gy. RESULTS: Among the tissues examined, PLD activity in lung was the highest one and was followed by kidney, skeletal muscle, brain, spleen, bone marrow, thymus, and liver. Upon irradiation, alteration of PLD activity was observed in thymus, spleen, lung, and bone marrow. Especially PLD activities of the spleen and thymus revealed the highest sensitivity toward gamma-ray with more than two times amplification in their activities. In contrast, the PLD activity of bone marrow appears to be reduced to nearly 30%. Irradiation effect was hardly detected in liver which showed the lowest PLD activity. CONCLUSION: The PLD activities affected most sensitively by the whole-body irradiation seem to be associated with organs involved in immunity and hematopoiesis. This observation strongly indicates that the PLD is closely related to the physiological function of these organs. Furthermore, radiation stress could offer an important means to explore the phenomena covering from cell proliferation to cell death on these organs.
Animals ; Attention ; Bone Marrow ; Brain ; Cell Death ; Cell Proliferation ; Choline ; Cobalt ; Female ; Hematopoiesis ; HEPES ; Humans ; Hydrolysis ; Kidney ; Liver ; Lung ; Muscle, Skeletal ; Oleic Acid ; Phosphatidic Acids ; Phosphatidylcholines ; Phospholipase D* ; Phospholipases* ; Radiation Effects ; Radioactivity ; Rats* ; Rats, Wistar ; Scintillation Counting ; Signal Transduction ; Sodium ; Spleen ; Taurodeoxycholic Acid ; Thymus Gland ; Whole-Body Irradiation

Adult respiratory distress syndrome(ARDS) is described under various names in the medical literature: post-traumatic pulmonary insufficiency, wet lung. DaNang lung and shock lung etc., and the syndrome has been used to describe a serious and often fatal conditions which may develop in any patient subjected to severe trauma, major surgery or critical illness. ARDS is characterized by increasing intrapulmonary shunting, increasing work of breathing and decreasing lung compliance. There is still desagreement about exact nature of ARDS as well as its care and revention. In ARDS, the use of positive end-expiratory pressure(PEEP) has been widely debated since its introduction by Ashbaugh and Petty in 1969. Its purpose is to increase the lung volume, especially functional residual capacity at end expiration in order to obtain better alveolar expansion and improved pulmonary gas exchange. This report described two cases of ARDS following trauma, and respiratory care problems were reviewed and discussed.
Adult ; Male ; Female ; Humans

The amount and type of dietary protein that effects affect bone mineral loss after menopause and different dietary patterns may influence anthropometric measurements, biochemical values, and bone metabolism. Objective : Our objective was to investigate bone metabolism and chronic disease factors in two different dietary patterns. Design: The sample consisted of 40 lacto-ove-vegetarians(LOV) and 49 omnivores aged from 47 to 85 years in good condition without any medical problems. Results : The average energy intake of LOV was 1414.0 kcal and omnivores, 1403.2 kcal. The difference between means was not statistically significant. The differences of means of body weight and BMI between the two groups were not significant but the systolic blood pressure of LOV group was significantly lower than omniovores(p<0.05). The values of serum cholesterol(p<0.05) and glucose(p<0.05) of LOV were signifcantly lower than that of omnivores. The serum albumin level(p<0.01) of LOV was lower than it's counterpart but in a normal range. The intake of crude fiber(p<0.05) of LOV group was significantly higher. The urinary pH of LOV was 7.4 and that of omnivores was 6.3(p<0.001). Plant calcium(p>0.05) and plant iron(p<0.001) had positive correlations with the uninary pH but animal protein(p>0.05) and animal iron(p>0.05) had negative correlations with the urinary pH. The level of urinary biochemical marker of bone resorption, deoxpyidinoline(DPD) of LOV was significantly lower than the other group(p>0.05). The T-scores of bone mineral density for the two sites in the two groups were not significantly different. Conclusions : The DPD level and urinary pH value of LOV were more desirable for the bone metabolism that the omnivores. The diet of LOV had lower risk factors of chronic diseases than the other group.
Animals ; Biomarkers ; Blood Pressure ; Body Weight ; Bone Density ; Bone Resorption ; Chronic Disease* ; Diet ; Dietary Proteins ; Energy Intake ; Female ; Gyeonggi-do* ; Hydrogen-Ion Concentration ; Menopause ; Metabolism* ; Plants ; Reference Values ; Risk Factors* ; Serum Albumin