Social support was found to have buffering effects on the stress response of stroke patients. Especially, the aspects of social support found to be most influential were support from a close, personal source, and overall satisfaction with support. The purpose of this study was to identify the current social network and its characteristics according to gender difference in post-hospitalized stroke patients in Korea. The sample consisted of a convenience sample of 254 patients was recruited 129 men and 125 women who were receiving follow-up care at outpatients clinics. Four aspects of social support-source, quantity, quality & type-were measured using the modified Social Support Inventory for Stroke Survivors(SSISS) which was developed by McColl & Friedland(1989). Regarding sources of social support, 61.4% reported for 'spouse' as primary caregiver and 31.9%, 'children'. But the distribution of sources of personal support were related to gender; 82.2% of male patients had support from their spouses, while only 40% of female patients reported from 'spouse' but 51.4% from 'children'. Among the children, daughters and sons were more significant support persons than daughters-in-law. The percentages for sources of these significant other support persons were 55.5% for 'children', 8.7% for 'spouse', and 8.3% for 'brothers'. The physician at the outpatient department was the main source of professional support. For the quantity and quality of social support, the primary caregiver's support was more significant than support by significant other persons. Male patients reported that primary the caregiver' support was greater than that of significant other persons, while female patients perceived significant other persons as giving greater support. Regarding the type of perceived social support, the stroke patients were highly satisfied with the primary caregiver's support in aspects of instrumental, emotional, and informational support. They also reported high satisfaction with support from significant others' support in the aspect of emotional support, while emotional and informational support from professionals was reported as satisfactory. In conclusion, gender difference in the social support network was found in that male patients perceived more support from their spouses, while female patients perceived more support from their children as compared to their spouses.
Caregivers ; Child ; Female ; Follow-Up Studies ; Humans ; Korea ; Male ; Nuclear Family ; Outpatients ; Spouses ; Stroke*

Carcinoma of Gall bladder remains a terminal illness in most patients despite improved diagnostic capabilities, better perioperative care and a more aggresive surgical approch based on improved knowledge of this tumors natural histiory. Overall 5-year survival rates remain below 5%. This failure to significantly improve patient oucome is largely due to late recognition of gall badder cancer. Authors experienced 21 cases of gall bladder cancer confirmed by operation at the Kwang Ju Christian hospital from march 1983 to March 1991, and the results obtained were summarized as follows. (continue...)
Gallbladder Neoplasms ; Gwangju ; Humans ; Perioperative Care ; Survival Rate ; Urinary Bladder*

BACKGROUND AND OBJECTIVES: Dysplasia of lateral semicircular canal (LSCC) is the most common inner ear malformation, because LSCC is the last single structure to be formed during inner ear embryogenesis. There have been several case reports about the LSCC anomaly which showed clinical spectrum ranging from no symptom to severe sensorineural hearing loss. The authors investigated the clinical characteristics of 7 patients with LSCC dysplasia. MATERIALS AND METHODS: The medical records of 7 patients who were diagnosed as LSCC dysplasia from temporal bone computed tomography were retrospectively reviewed. We analysed the findings of history taking, pure tone audiometry, speech audiometry, and caloric tests. RESULTS: The LSCC dysplasia was observed in all of 7 patients in which 5 showed unilaterally confined LSCC dysplasia, 1 showed bilaterally confined LSCC dysplasia, and 1 exhibited bilateral LSCC dysplasia combined with bilateral posterior semicircular canal dysplasia. From 7 patients, hearing loss was chief complaint only in 2 patients. Pure tone audiometry revealed sensorineural hearing loss in one patient, and conductive hearing loss in the other patient. Two patients complained of whirling type vertigo, and 3 complained of nonspecific dizziness. CONCLUSION: The patients with LSCC dysplasia may show variable symptoms such as sensorineural hearing loss, conductive hearing loss, vertigo and nonspecific dizziness.
Audiometry ; Audiometry, Speech ; Dizziness ; Ear, Inner ; Embryonic Development ; Female ; Hearing Loss ; Hearing Loss, Conductive ; Hearing Loss, Sensorineural ; Humans ; Medical Records ; Pregnancy ; Retrospective Studies ; Semicircular Canals ; Temporal Bone ; Vertigo

The related factors of the quality of life (QOL) in stroke patients was identified empirically. The subjects were 254 stroke patients who were discharged and taken follow-up care at the outpatient department. In this model, the physical, psychological, and social status were assumed to affect the QOL. And the social support was assumed to moderate these effects. NIH stroke state, ADL, and IADL were used to measure the physical status. Using CES-D, the psychological status was measured. The social status was defined as the job change after stroke attack. The satisfaction with the care by primary caregivers, significant others, and health professionals was measured as the social support. To identify the effect of the physical, psychological, and social status on the QOL, multiple regression analysis was carried out. The psychological and social status were found to be the significant predictors of the QOL(R2=0.27, p=0.00). Next, to identify the moderating effect of the social support, the subjects were divided into two groups, that is, the low social support group and the high social support group. It is found that the predicting variance is different between these two groups. In the low social support group, the psychological, social, and physical status predicted as much as 42% of the QOL. On the contrary, the psychological status predicted only 8% of the QOL in the high social support group. So it is concluded that the social support moderates the effects of the physical, psychological, and social status on QOL. Finally, to identify the social support which moderates those effects, the social support was divided into three classes. Each social support class was divided into the low and high social support group again. In the every class of social support, the difference between two groups was also identified. So the model of the QOL is recommended for the framework of the care for the stroke patients. Also these results support the claim that the long-term facilities for stroke patients are necessary.
Activities of Daily Living ; Caregivers ; Follow-Up Studies ; Health Occupations ; Humans ; Outpatients ; Quality of Life* ; Self-Help Groups ; Stroke*

OBJECTIVES: While other cytokines are known to be associated with otitis media with effusion (OME), the involvement of heat shock protein 70 (HSP70) in middle ear effusion (MEE) is unknown. This study was undertaken to investigate the possibility of there being a HSP70 expression in human MEE and to determine its potential role as a cytokine in OME. METHODS: The levels of HSP70, tumor necrosis factor-alpha and interleukin-1beta were measured by enzyme-linked immunosorbent assay in the effusion of different groups of OME patient following collection of the MEE using our new collection system. The clinical characteristics of the OME patients and the MEE status were analyzed. RESULTS: HSP70 was expressed in all the types of MEE. The mucous and seromucous effusions showed higher HSP70 levels than that of the serous effusion. The HSP70 level was correlated with the levels of tumor necrosis factor (TNF)-alpha and interleukin (IL)-1beta in the effusions. The positive correlations between HSP70, TNF-alpha and IL-1beta were statistically significant (P<0.05). CONCLUSION: The highly elevated level of HSP70 in the seromucous and mucous effusions implicates this protein in the chronicity of OME.
Cytokines ; Ear, Middle ; Enzyme-Linked Immunosorbent Assay ; Heat-Shock Proteins ; HSP70 Heat-Shock Proteins ; Humans ; Interleukin-1beta ; Interleukins ; Otitis Media with Effusion ; Tumor Necrosis Factor-alpha

Double primary cancer of the stomach and esophagus has been revealed a very low incidence in the world except Japan and reported only 6 cases in Korea. Furthermore, it is difficult to manage this type of double cancer because esophageal cancer has a biologic tendency to early metastasis. This paper is concerned with a case of double primary cancer, which we have synchroniously confi~rmed esophageal squamous cell carcinoma and gastric adenocarcinoma with gastrofiberscopic biopsy, and then treated them by radical resec tion and systemic chemotherapy.
Adenocarcinoma ; Biopsy ; Carcinoma, Squamous Cell ; Drug Therapy* ; Esophageal Neoplasms ; Esophagus ; Incidence ; Japan ; Korea ; Neoplasm Metastasis ; Stomach Neoplasms

Hypopituitarism is not a common cause of delayed puberty, however it should always be considered, especially if there are such signs as severe dwarfism, dollish face, truncal obesity, small hands and feet, and microgenitalia. Either congenital or acquired, hypopituitarism can be resulted from hypothalamic and hypophyseal lesions. The clinical feature can be diverse depending on age of the patients, rate of progression, degree of hormone deficiency and characteristics of the lesion. The recent high interest in delayed puberty and the improved detection of hypothalamic hypophyseal lesions using combined pituitary fuction stimulation test, brain CT and MRJ, has made the differential diagnosis of hypopituitarism possible as the cause of delayed puberty. MRI has shown hypophyeal hypoplasia accompanied by anterior pituitary hypoplasia and ectopic neurohypophysis in some of the patients with hypopituitasm, and although the anatomical abnormality around the hypophysis in these patients is considered the reason for hypopituitarism, the pathogensis of which has not yet to be known. We, here, report a case of delayed puberty by hypopituitarism due to hypoplasia of anterior pituitary gland, pituitary stalk agenesis and ectopic neurohypophysis with brief review of the litereature.
Brain ; Diagnosis, Differential ; Dwarfism ; Foot ; Hand ; Humans ; Hypopituitarism ; Magnetic Resonance Imaging ; Obesity ; Pituitary Gland* ; Pituitary Gland, Anterior* ; Pituitary Gland, Posterior* ; Puberty, Delayed*

BACKGROUND AND OBJECTIVES: The ocular vestibular evoked myogenic potential (OVEMP) is a recently discovered test of labyrinthine function, analogous to the cervical VEMP. Recent works have demonstrated the existence of OVEMPs, which likely reflect otolith-ocular reflex. The purpose of this study was to identify the optimal plateau and rise/fall times of short tone bursts to detect OVEMPs in healthy subjects. MATERIALS AND METHODS: Thirteen healthy subjects (26 ears) were included in this study. Surface electromyographic activity was recorded from active electrodes placed inferior to each eye. Stimulation with 500 Hz short tone bursts was used. We used a variety of plateau and rise/fall times. Three different plateau times (1, 2, and 3 ms) and rise/fall times (0.5, 1, and 2 ms) were used. The incidence, amplitudes and latencies were compared. RESULTS: VEMP responses were clearly observed in all 26 ears at the plateau time of 2 ms and two rise/fall times (0.5 and 1 ms). The amplitudes in the individual ears tested were lower at the rise/fall time of 2 ms than at the other conditions. The amplitudes were lower at the plateau time of 3 ms compared to the other conditions. When the rise/fall time was prolonged from 0.5 to 2 ms, the n1 and p1 latencies were prolonged in parallel. However, there was no such change in latencies according to the plateau times. CONCLUSIONS: Our findings show that the ideal stimulation pattern for evoking OVEMP is at the rise/fall times of 0.5 or 1 ms and the plateau time of 2 ms. The waveform morphology of the VEMP responses observed with this stimulation pattern was simultaneously the most constant and marked.
Ear ; Electrodes ; Evoked Potentials ; Eye ; Incidence ; Otolithic Membrane ; Reflex ; Reflex, Vestibulo-Ocular ; Vestibular Evoked Myogenic Potentials

BACKGROUND AND OBJECTIVES: A significant recovery of resting activity in the vestibular nuclei ipsilateral to the unilateral labyrinthectomy has been reported by the time symptoms such as spontaneous nystagmus and roll head tilt have largely disappeared. However, the dynamic vestibular response after unilateral vestibular loss to passively imposed vestibular stimuli does not recover. MATERIALS AND METHODS: We investigated changes of the caloric responses in 32 patients with vestibular neuritis during in- and out-patient visits separated by 2 months in an attempt to identify changes brought about by peripheral and/or central compensation processes. RESULTS: The slow-phase eye velocities stimulated by warm caloric stimulation at acute and follow-up stage were 6.6+/-6.6 degrees/s, 9.5+/-9.9 degrees/s in the lesioned side; 28.4+/-19.1 degrees/s, 24.5+/-11.6 degrees/s in the intact side. The slow-phase eye velocities stimulated by cold caloric stimulation at acute and follow-up stage were 5.9+/-7.7 degrees/s, 10.3+/-8.2 degrees/s in the lesioned side; 19.8+/-10.3 degrees/s, 18.8+/-9.9 degrees/s in the intact side. CONCLUSION: Our findings show that the recovery of caloric responses comes mostly from the recovery of the eye responses to the caloric stimulation in the lesioned side and the eye responses to the caloric stimulation in the intact side does not change over time after vestibular neuritis.
Caloric Tests ; Cold Temperature ; Compensation and Redress ; Eye ; Eye Movements ; Follow-Up Studies ; Head ; Humans ; Outpatients ; Reflex, Vestibulo-Ocular ; Vestibular Neuronitis ; Vestibular Nuclei

No abstract available.
Acetylcholine/physiology ; Adult ; Cold Temperature/adverse effects ; Exercise ; Hot Temperature/adverse effects ; Humans ; Male ; Urticaria/diagnosis/*etiology/physiopathology