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*

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

In patients with end-stage renal disease, cannulation of the central venous system with large-bore dual-lumen catheters is often necessary until a functioning vascular access can be created. However, the technique of placing a dual-lumen catheter can make complication. The right internal jugular vein is the preferred site of hemodialysis catheter placement because its complication rate was lower compared with the subclavian and left internal jugular veins. Common complications include severe bleeding, hematoma formation, pneumothorax and hemothorax, atrial or ventricular arrhythmias, malposition of the catheter, air embolism, secondary infections, and intraarterial placement of the catheter. We report an unusual case of pseudoaneurysm of the superior thyroidal artery complicating an attempt of internal jugular-vein catheterization which was successfully treated by endovascular coil embolization.
Aneurysm, False ; Arrhythmias, Cardiac ; Arteries ; Catheterization ; Catheters ; Coinfection ; Embolism, Air ; Hematoma ; Hemorrhage ; Hemothorax ; Humans ; Jugular Veins ; Kidney Failure, Chronic ; Pneumothorax ; Renal Dialysis ; Thyroid Gland

OBJECTIVE: To evaluate intra-tester reliability of P300 more precisely, this study was designed. Event-related potential (ERP) is the result of endogenous brain response following cognitive stimulus. The P300 component of the human ERP is a positive wave with a latency of 300 ms or greater. Our purpose of this study was to estimate reliability of P300 latency and amplitude with 30 normal persons without head injury, as well as to set up them as the reference values in the event that they would be found to be highly reliable. METHODS: ERP was performed at three separate times on 30 normal adults in their 20s and 30s. We measured P300 latency and amplitude among ERP. RESULTS: P300 latency show excellent reliability with intraclass correlation coefficient (ICC) of 0.81. As to P300 amplitude, reliability was good to fair with ICC of 0.53. Average value of P300 latency was 311.3+/-37.0 ms, shorter than reference value of previous study in Korea. CONCLUSION: P300 latency revealed higher reliability than P300 amplitude, although reliability of P300 was confirmed in both component. After further study including precise mechanism, influence factor on measurement and method standardization, it is expected to be an objective indicator to assess the cognitive state and predict prognosis.
Adult ; Brain ; Craniocerebral Trauma ; Event-Related Potentials, P300 ; Evoked Potentials ; Humans ; Prognosis ; Reference Values

PURPOSE: The aims of this study were to examine the methylation status of the p16 and MGMT promoters in hepatocellular carcinoma (HCC), and to evaluate the relationship between the loss of gene expression, the promoter methylation status and hepatocarcinogenesis. METHODS: We included 24 HCC tissues and their adjacent non-tumorous tissues and 5 normal liver tissues in our study, and all the specimens were obtained by hepatectomy. The methylation status of the p16 and MGMT promoter regions were evaluated by methylation-specific polymerase chain reaction (MSP) and quantitative analysis by using a Gel-pro analyzer (Media Cybernetics, CA, USA). We also analyzed the p16 and MGMT gene expressions by performing immunohistochemical staining of the HCC tissues. RESULTS: Methylation of the p16 promoter was detected in HCC (100%, 24/24) and the adjacent non-tumorous tissues (79.2%, 19/24), but not in the normal liver tissues. Methylation of the MGMT promoter was detected in the HCC (8.3%, 2/24) and the adjacent non-tumorous tissues (4.2%, 1/24), but not in the normal liver tissues. Methylation positive HCC samples showed the loss of p16 expression in 58.3% (14/24). The loss of the p16 expression in the HCC tissues was well correlated with the increased rate of p16 promoter methylation (p=0.009). When the p16 promoter methylation status of the HCC tissues was higher than that of the adjacent non-tumorous tissues, 77.8% of the cases showed the loss of the p16 expression (p=0.002). No correlation was observed between MGMT promoter methylation and the loss of the gene expression in the HCC tissues. CONCLUSION: These results suggest that methylation of the p16 promoter and the resulting loss of p16 protein expression are significant events in hepatocarcinogenesis, and further studies are needed to evaluate the relationship between the methylation of the MGMT promoter and HCC carcinogenesis.
Carcinogenesis ; Carcinoma, Hepatocellular* ; Cybernetics ; Gene Expression ; Hepatectomy ; Liver ; Methylation* ; Polymerase Chain Reaction ; Promoter Regions, Genetic

PURPOSE: Thrombocytosis is commonly associated with various tumors, including stomach, ovarian, lung, liver and pancreas cancers. Some clinical reports have shown thrombocytosis to be associated with the disease stage and prognosis. This study investigated the prevalence of the thromobocytosis in patients with colorectal cancer, and its association with the prognosis. METHODS: Two hundreds ninety-six patients with colorectal cancer who had been surgically treated at our hospital between 1997 and 2004 were enrolled in this study. The incidence, relationship with other clinicopathological factors, and the prognostic value of thrombocytosis were evaluated retrospectively. RESULTS: Thirty-seven of the 290 (12.8%) patients had thrombocytosis. The incidence of thrombocytosis was examined with regard to gender (P=0.018), tumor location (P=0.021), and T stage of tumor (P<0.000). Univariate analysis demonstrated thromobocytosis, T stage, N stage, M stage, venous invasion, lymphatic invasion, and elevated carcinoembryogenic antigen (> or =5 ng/ml) to be associated with both the disease-free survival (DFS) and overall survival (OS). Multivariate analysis revealed thrombocytosis to be significantly associated with the disease-free survival (P=0.026). CONCLUSION: Preoperative thrombocytosis appears to be an independent prognostic indicator of the DFS in patients with colorectal cancer.
Colorectal Neoplasms* ; Disease-Free Survival ; Humans ; Incidence ; Liver ; Lung ; Multivariate Analysis ; Pancreatic Neoplasms ; Prevalence ; Prognosis ; Retrospective Studies ; Stomach ; Thrombocytosis*

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