No abstract available.
Lung*

OBJECTIVE: To investigate incidence, characteristics, and risk factors of insomnia and to compare the functional outcomes between insomnia and non-insomnia group in rehabilitation patients. METHOD: Sixty nine consecutive admissions between May and June, 1999 have been evaluated. The St. Mary's Hospital Sleep Questionnaire were employed and medical records of the patients have been reviewed. RESULTS: Incidence of insomnia was 60.9%. The most common type of insomnia was difficulty in maintaining sleep during the night (interrupted type). 66.9% of the total patients with insomnia had recognizable causal factors. The common factors influencing insomnia were somatic symptoms, environmental, and psychological factors. On discharge, lower FIM gain was noted in insomnia group even though statistical significance was not found. CONCLUSION: Since sleep disturbances have been common to the rehabilitation patients, and may influence functional outcome, early diagnosis and therapeutic intervention may be needed.
Early Diagnosis ; Humans ; Incidence ; Inpatients* ; Medical Records ; Psychology ; Surveys and Questionnaires ; Rehabilitation* ; Risk Factors ; Sleep Initiation and Maintenance Disorders*

No abstract available.
Endocardial Cushion Defects* ; Endocardial Cushions* ; Hernia, Diaphragmatic*

This study was conducted to investigate plasma levels of oral methotrexate in rabbits and children receiving maintenance chemotherapy for acute lymphocytic leukemia. Eight New Zealand white rabbits, weighing 2kg in body weight, were divided into 3 groups and 5mg of methotrexate from 3 different manufactorying company was administered to the each group rabbits via nasogastric tube. Time to peak concentration ranged from 30 minutes to 3 hours (mean 1.2+/-0.9 hour)and the peak plasma concentration ranged from 0.08 micro M to 0.21micron M(mean 0.14+/-0.05 micronM)and area under the plasma concentration-time curve ranged from 0.6micron M.hr to 1.66micron M,hr (mean 1.06+/-0.36micronM,hr). There were no statistically significant difference in AUC of methotrexate in 3 groups, but interindividual variability in plasma levels of methotrexate was noted. Twelve patients with ALL who were receiving maintenance chemotherapy at pediatric department of Yeungnam University Hospital from August, 1988 to August, 1991 were studied. Plasma levels of oral methotrexale were monitored following an oral dose of 3.3 mg~10mg/m2 which was modified from recommended dose of 10 mg/m2 due to hepatotoxicity or myelosuppression. Time to peak concentration ranged from 30 minutes to 2 hours(mean 1.2+/-0.4 hour) and the peak plasma concentration ranged from 0.34 micron M to 0.8 micron M (mean 0.58+/-0.18micron M). The area under the plasma concentration-time curve ranged from 1.25micron M,hr to 3.79 micronM,hr (mean 2.71+/-0.84microM,hr)while standard area under the plasma concentration-time curve ranged from 0.13micronM, hr/mg/m2 to 0.54micronM, hr/mg/m2 (mean0.4+/-0.15micronM hr/mg/m2).Interindividual variability in plasma levels following an oral dose of methotrexate was noted. Peak plasma concentrations of study patients were all less than 1 micronM which is necessary for antileukemic effect of methotrexate in vitro. It seems to be necessary to increase the dose of methotrexate for all study patients, however optimal dose increment of methotrexate avoiding hepatotoxicity and myelosuppression need to be investigated further and measurement of plasma level of methotrexate is recommended when dose modification of methotrexate is made.
Area Under Curve ; Body Weight ; Child* ; Humans ; Maintenance Chemotherapy* ; Methotrexate* ; Pharmacology ; Plasma* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Rabbits

For cervical cancer, the combination chemotherapy could increase the trial of radical hysterectomy due to reduction in tumor volume even in advanced stage and help to decrease corrected dose of radiotherapy. It also reduces postoperative radiotherapy to avoid the side effect and therefore make the quality of life better. Cisplatin chemotherapy alone was known to result in objective response rates of 20%. Todays animal experiment studies stated that Ifosfamide could accelerate the efficacy of Cisplatin. Thus in this study, neoadjuvant chemotherapy was applied to those cervical cancer patients in the use of the combination chemotherapy including Ifosfamide, PI(Cisplatin+ Ifosfamide) and PAIB(Cisplatin+ Ifosfamide+ Adriamycin+ Bleomycin). A total of 43 patients were entered in this trial, 23(53%) achieved at least a 50% reduction in tumor volume, 20(47%) showed no change. After completion of combination chemotherapy, 30(70%) of the 43 were done radical hysterectomy, 13(30%) given to radiotherapy. 9(30%) of the 30 patients were applied postoperative radiation therapy. Nausea and vomiting occurred in 35 of the 43 patients(81%) and alopecia 15(34%) for toxicity. Severe CNS toxicity(Grade 4) was detected in one patient. This study suggest that Ifosfamide combination chemotherapy is effective in tumor reduction and minimal toxity and can performed radical operation in cases of large tumor volume.
Alopecia ; Animal Experimentation ; Cisplatin ; Doxorubicin* ; Drug Therapy ; Drug Therapy, Combination ; Humans ; Hysterectomy ; Ifosfamide* ; Nausea ; Quality of Life ; Radiotherapy ; Tumor Burden ; Uterine Cervical Neoplasms* ; Vomiting

Neurofibromatosis, or von Recklinghausen's disease, is a hereditary, harmartomatous disorder that primarilyinvolves neuroectoderm and mesoderm. The estimated incidence is 1 in 2,500 to 3,000 births. The clinical featuresare skin manifestations such as cafe-au-lait spots, skeletal manifestations primarily in volving vertebrae,central and peripheral nervous manifestations, and other associated abnormalities with increased risk ofmalignancy. The authors analysed the radiologic findings of 18 cases of patients with neurofibromatosis whovisited Pusan Kosin Medical Center and Taegu Dongsan Medical Center during the last five years. All were proven bysurgery, biopsy and other diagnostic criteria. The results obtained were as follows: 1. The male ot female ratiowas 11:7 and the age ranged from 11 months to 51 years. 2. All the cases fulfilled the diagnotic criteria of Croweand associates. 3. Bone manifestations were present in 44% of the cases. The other radiologic findings wereintrathoracic meningocele, bilateral acoustic neurinomas, mediastinal or chest wall mass shadows, and peripheralsoft tissue masses. 4. One of the soft tissue masses was proved to be malignant.
Biopsy ; Busan ; Cafe-au-Lait Spots ; Daegu ; Female ; Humans ; Incidence ; Male ; Meningocele ; Mesoderm ; Neural Plate ; Neurofibromatoses ; Neurofibromatosis 1 ; Neurofibromatosis 2 ; Parturition ; Skin Manifestations ; Thoracic Wall

Hemorrhagic fever with renal syndrome (HFRS) in Korea is caused by 2 serotypes of hantavirus, Hantaan and Seoul. Even though the number of peripheral CD8' T-lymphocytes is markedly elevated in the acute phase of HFRS, the pathogenetic role of this phenomena is not clear. To elucidate the role of cell-mediated immune response in HFRS, we measured concentrations of cytokines, such as IL-1, IL-2, IL-4, IL-6, IL-10 and IFN-r in plasma samples obtained from 15 patients (15 men, 20-24 years old) at various phase of illness. Cytokines were measured by ELISA in plasma samples. The plasma concentration of IL-10 was elevated in 13/15 patients. The median maximum value, during days 4-8, was 23 ng/L (range, 0-70.2). The maximum values were significantly higher(p=0.005) than the baseline. IL-1 and IL-6 was detected in 6 patients. Other cytokine responses (IL-2, IL-4, IFN-r ) were negligible. There was no significant correlation between maximum levels of IL-10 and maximum serum concentration of creatinine (r=0.118, p=0.675), and lowest plate#let count (r=-0.088, p=0.765). Kinetics of IL-10 were quite similar in HFRS patients with maximum creatinine values >3 mg/dL and in those with values <3 mg/dL. In conclusion, plasma IL-10 levels, but not IL-2, IL-4 or INF-r were elevated in acute phase of HFRS, and it suggests that the systemic immunosuppressive activities of IL-10 might have some pathogenetic role in HFRS.
Creatinine ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Hantavirus ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Interleukin-1 ; Interleukin-10 ; Interleukin-2 ; Interleukin-4 ; Interleukin-6 ; Kinetics ; Korea ; Male ; Plasma* ; Seoul ; T-Lymphocytes

We performed a meta-analysis using results in the Korean literatures to determine whether laparoscopic appendectomy (LA) or open appendectomy (OA) provide the better outcome in possible acute appendicitis patients. To perform the meta-analysis, an extensive literature search was conducted, giving priority to the Journal of the Korean Surgical Society, and domestic literature in its search database, published since January 1993, to ascertain the usefulness of LA in the treatment of acute appendicitis. The criteria used for the quality evaluation were as follows: 1) study subjects must have been evaluated clinically for suspected acute appendicitis, and 2) articles were included only if sufficient data (e.g. patient number, mean and standard deviation of patient outcome variables) were available regarding patient outcomes for LA or OA treated appendicitis. Of the 136 articles retrieved, 8 studies (1, 258 patients) were selected for quantitative meta-analysis. Because insufficient data was available in some studies, operating time and hospitalization days were assessed for all 8 studies, but the time required to return to full functioning was assessed for only 3 studies. Overall effect size estimates were calculated using a random effect model for four patient outcomes (operating time, Q=38.6699, p < 0.001; length of stay, Q=19.3876, p < 0.001; postoperative hospital stay, Q=20.9164, p < 0.001; and return time to full functioning, Q=41.5061, p < 0.001). Because the overall effect size for operating time was -0.3218 (95% confidence interval [CI] -0.6108 to -0.0328), LA operating time was significantly greater than that of OA. In addition, a significant difference was found between the two modalities in terms of the length of hospital stay. Overall effect size in terms of the time required to return to full functioning was 1.9757 (95% CI 1.0066 to 2.9448), and LA reduced the time required by about 2 days versus OA. Considering the overall odds ratio (0.33) and 95% CI (0.20 to 0.55) the incidence of wound infection was significantly lower in LA than in OA. This review of the published evidence suggests that LA is more useful for treating acute appendicitis, especially when perforated appendicitis is suspected.
Acute Disease ; Appendectomy/*methods ; Appendicitis/*surgery ; Human ; Korea ; *Laparoscopy ; Support, Non-U.S. Gov't

Thirty - five cases of coarctation of aorta, diagnosed by cardiac catheterization and angiography during the period of 1980-1984, at the department of Pediatrics of Seoul National University Hospital, were studied on the clinical features and management. The followoing results were obtained : 1) The incidence of coartation of aorta was 1.2% of congenital heart disease and sex ratio of male to female was 2.2 : 1. 2) The anatomical type of coarctation was preductal in 19 cases, juxtaductal in 15 cases and postductal in 1 case. Most of preductal coarctation (89.5%) were associated with aortic arch or isthmus hypoplasia. 3) All of these patients had various type of additional cardiac anomalies and among them, PDA was the most common associated lesion and followed by VSD. 4) Significant BP gradient between upper and lower extremies and weak femoral pulsation were noticed in 15 cases(42.8%). 5) Congestive heart failure was present in all but one patient less than 1 year old, while only 3 cases(15%) had congestive heat failure in patients older than one year. 6) Overall surgical mortality was 31.8%, but significant decrease in surgical mortality was found since 1983.
Angiography ; Aorta ; Aorta, Thoracic ; Aortic Coarctation* ; Cardiac Catheterization ; Cardiac Catheters ; Estrogens, Conjugated (USP) ; Female ; Heart Defects, Congenital ; Heart Failure ; Hot Temperature ; Humans ; Incidence ; Male ; Mortality ; Pediatrics ; Seoul ; Sex Ratio

PURPOSE: The purpose of this study was to monitor the use of health-related quality of life (HRQOL) instruments in Korean studies of patients with diabetes. METHODS: Of 86 Korean studies initially identified, 17 studies met the inclusion criteria. For each study, a description of the instrument and its psychometric properties were monitored by the Instrument Review Criteria of the Scientific Advisory Committee. These criteria include conceptual definition, attributes, taxonomy, reliability, validity, responsiveness, administrative mode, and language adaptations. RESULTS: Five generic and one diabetes specific type questionnaires were identified from the 17 studies. Of those studies, conceptual definitions with the attributes of multi-dimension and subjectiveness were provided for 11 studies (71%). In the analysis of conceptual taxonomy, only 6 studies were classified as HRQOL, while other studies were done as QOL or health status. In monitoring of psychometric properties, reliability, validity, and responsiveness were reported for 88.2%, 64.7%, and 29.4%, respectively. One generic instrument was developed with a Korean population, while the other instruments were developed for Western countries. However, language adaptations were performed for only a few of the instruments. CONCLUSION: The psychometric properties including responsiveness of most instruments warrants further research, and the development of diabetes-specific HRQOL measurements should be sought to facilitate intervention outcomes across Korean studies of patients with diabetes.
Diabetes Mellitus/*psychology ; Health Status ; Humans ; Psychometrics ; *Quality of Life ; Questionnaires ; Republic of Korea