OBJECTIVES: We compared the characteristics of the pain threshold and pain experience between demented group and non-demented group. METHODS: This study was part of Gangwon projects for early detection of dementia in 2010. We recruited 8302 local resident ages over 65 years old. Of theses, 1259 people who scored low MMSE were selected and 365 of them completed CERAD-K(Consortium to Establish a Registry for Alzheimer's disease). Finally, 90 in non-demented group and 57 in demented group(mild to moderate Alzheimer's disease) were analyzed. Pain threshold was experimentally measured by pressure algometer and we investigated the pain experience, by Brief pain inventory (BPI), a self-report test. RESULTS: In the demographic characteristics, there are more female, higher ages, lower education in the demented group. There was no significant difference between the two groups in the pain threshold. On the BPI results, 'shoulder pain', 'the number of pain' and 'interference of working' were significantly more prevalent in non-demented group. However, there are no significant differences between the groups in the 'pain severity', 'prevalence of pain' and 'pain treatment'. CONCLUSIONS: Demented group report less pain experience but, still perceived pain. It support previous studies that patient with dementia have increased pain tolerance but preserved pain threshold. Thus, active pain assessment and treatment for patients with dementia is needed.
Aged* ; Dementia* ; Education ; Female ; Gangwon-do ; Humans ; Pain Measurement ; Pain Threshold*

Tuberculosis of the thyroid gland is extremely rare with few cases reported in recent years. Tuberculosis may involve the thyroid gland in two main forms. The more common of theses is miliary spread to the thyroid as part of generalized dissemination and less commonly focal or caseous tuberculosis of the thyroid may occur, presenting as a nodule, as a thyroiditis, as a abscess, or as carcinoma like.We experienced two cases of tuberculosis of the thyroid gland presenting with palpable thyroid nodule in 26 year-old female and 65 year-old female patients. They have been clinically and biochemically euthyroid and their thyroid scans demonstrated a cold nodule at right thyroid gland. We found no evidence of tuberculosis elsewhere. The goiter was removed surgically and confirmed to be tuberculosis. They were medicated antituberculous agents after operation and followed up regulary out patient department.We report the cases of two patients with tuberculosis involving thyroid with reviews of literature.
Abscess ; Female ; Goiter ; Humans ; Thyroid Gland ; Thyroid Nodule ; Thyroiditis ; Tuberculosis

No abstract available.
Female* ; Humans ; Transplants*

Non-invasive positive pressure ventilation (NIPPV) was mainly applied to acute respiratory failure in chronic obstructive pulmonary disease (COPD) and to intrinsic lung disease such as neuromuscular disorders. It has been reported that this maneuver reduces morbidity, mortality and hospital stay in patients in the intensive care unit. We observed a 32-year-old female renal transplantation patient who developed pulmonary edema during the perioperative state. The mainteance of an endotracheal tube in intubated patients who were on immunosuppresive therapy might increase nosocomial pneumonia significantly. In this case, the mortality increase was expected, therefore we considered that early extubation and mask continuous positive airway pressure (mask CPAP) could help. By using mask CPAP, the patient showed a good response and the pulmonary edema was improved. We report a case about the benefits of NIPPV in the treatment of pulmonary edema in an immunosuppressed patient of which the result was very satisfactory.
Adult ; Continuous Positive Airway Pressure ; Female ; Humans ; Intensive Care Units ; Kidney Transplantation ; Kidney* ; Length of Stay ; Lung Diseases ; Masks ; Mortality ; Pneumonia ; Positive-Pressure Respiration* ; Pulmonary Disease, Chronic Obstructive ; Pulmonary Edema* ; Respiratory Insufficiency

The toxic effect of azalea extract, especially on cardiovascular system, in relatively unclear. The purpose of this study is to study the possible underlying mechanism and effect of toxic ingredient of azalea on cardiovascular system. The 71 healthy rabbits were divided into 10 groups: In group as preliminary study; 4 cc of normal saline was administered intravenously (N); 0.7 gm/kg and 1.0 gm/kg of azalea extract was administered respectively in the same route, volume (A1, A2); atropine was administered intravenously (A); after pretreatment with atropine (0.04 mg/kg) to block parasympathetic system, azalea extract was injected like the above groups (AA1, AA2); normal saline, 0.7 gm/kg and 1.0 gm/kg of azalea extract were administered respectively with 0.2 cc (1:1000) epinephrine (E0, E1, E2). We measured the following indices at I minute interval during first 10 minutes and then 10 minute interval during next 30 minutes: RR interval, QTc interval, maximal systolic and diastolic pressure drop with occurring time and presence of significant arrhythmia. The results were as follows: 1. The changes of RR interval, QTc interval were significantly increased in groups by Azalea extract. The blood pressure change was significantly decreased in groups by Azalea extract. There were no significant differences according to dosage of Azalea extract. 2. The changes of RR interval, blood pressure were significant differences between administration of atropine and Azalea extract after pretreatment with atropine, but not in the change of QTc interval. 3. There were no significant differences in the change of RR interval, ATc interval, blood pressure drop according to pretreatment with atropine. 4. The interaction between epinephrine and Azalea extract was not noted by the effect of epinephrine itself. 5. The ST change by 0.7 gm/kg, 1.0 gm/kg of Azalea extract was revealed in 1 case (14.0%), 7 case (100%), respectively. 6. Most of all cases with arrhythmia, ventricular tachycardia, ventricular fibrillation, were noted in the group by epinephrine, except on case by Azalea extract (1.0 gm/kg). It was idioventricular rhythm. In conclusion, azalea extract has negative inotropic and chronotropic effect with arrhythmogenic potential possibly through direct myocardial ischemia or injury but we can't be absolutely exclusive of actions of autonomic nervous system, especially parasympathetic nervous system.
Arrhythmias, Cardiac ; Atropine ; Autonomic Nervous System ; Blood Pressure ; Cardiovascular System* ; Epinephrine ; Myocardial Ischemia ; Parasympathetic Nervous System ; Rabbits ; Tachycardia, Ventricular ; Ventricular Fibrillation

PURPOSE: This study was performed to evaluate the efficacy and compliance of beta2- agonist according to the type of preparations in the children with asthma. METHODS: Randomly selected 30 patients, who visited to Soonchunhyang University Hospital with acute asthma attack from May to August, 2004 were enrolled. Patients were randomly divided into 3 groups. We evaluated asthma symptom score before and 1 week after treatment in each group. Also, we measured O2 saturation, peak expiratory flow rate (PEFR), heart rate, and evaluated adverse reactions during the treatment. Treatment compliance was evaluated by the face to face interview with the patients and their guardians after 1 week of treatment. RESULTS: The mean asthma symptom score before and after treatment in each group were 5.9 and 1.1 in transdermal group, 5.4 and 0.9 in inhalation group, and 5.5 and 1.3 in oral group, respectively. Mean improvement of PEFR was 23.7% predicted after treatment. There was no serious adverse reactionin each group except mild itching of patch site in one case of transdermal group. Compliance of each group was relatively good. CONCLUSION: For the treatment of acute asthma attack, there was no difference in efficacy and safety of beta-agonist among the type of preparations. Also, there was no difference in adverse reaction and compliance between the type of preparation. Therefore it will be useful to choose the preparation with better compliance in each patient for the effective treatment of childhood asthma.
Asthma* ; Child ; Compliance* ; Heart Rate ; Humans ; Inhalation ; Peak Expiratory Flow Rate ; Pruritus

BACKGROUND: We compared clinical outcomes after total knee arthroplasty with the Low Contact Stress (LCS) rotating platform mobile bearing knee system and the Press Fit Condylar Sigma rotating platform high flexion (PFC Sigma RP-F) mobile bearing knee system. METHODS: Fifty cases of total knee arthroplasty were performed with the PFC Sigma RP-F mobile bearing knee system and sixty-one cases were performed with the LCS mobile bearing total knee arthroplasty. The average duration of follow-up was 2.9 years. RESULTS: The mean Hospital for Special Surgery (HSS) knee score was 62.1 (range, 52 to 75) in the LCS group and 61.9 (range, 50 to 74) in the Sigma RP-F group preoperatively, and 90.1 (range, 84 to 100) in the LCS group and 89.8 (range, 83 to 100) in the Sigma RP-F group at the final follow-up. The mean preoperative flexion contracture was 6.7degrees (range, 0degrees to 10degrees) in the LCS group and 9.3degrees (range, 0degrees to 15degrees) in the Sigma RP-F group preoperatively. The mean range of motion was 124.6degrees (range, 105degrees to 150degrees) in the LCS group and 126.1degrees (range, 104degrees to 145degrees) in the Sigma RP-F group at the final follow-up. CONCLUSIONS: After a minimum duration of follow-up of two years, we found no significant differences between the two groups with regard to the range of knee motion or the clinical or radiographic results.
Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee/*methods ; Chi-Square Distribution ; Female ; Follow-Up Studies ; Humans ; Knee Joint/*physiology/radiography/surgery ; *Knee Prosthesis ; Male ; Middle Aged ; Pain Measurement ; Range of Motion, Articular/physiology ; Treatment Outcome

PURPOSE: This study was to develop and prove the effects of aself management compliance promotion program for primary hypertension patients who reside in rural communities. METHOD: The content of the self management compliance promotion program developed by this study was as follows: A leader trains patients as a group or individually, in walking, education and green tea therapy from the first to twelfth week. From the thirteenth to twenty fourth week, the patients should perform walking and green tea therapy by themselves. One hundred twenty subjects volunteered to participate in the study, who were among those registered as hypertension patients in the 14 community health clinics located in Chungcheongbuk-do. RESULT: Systolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, triglyceride, step width, and degree of obesity decreased significantly. High-density lipoprotein cholesterol, step length, knowledge of hypertension, and self management compliance significantly increased. CONCLUSION: A self management compliance promotion program for primary hypertensive patients enhances biophysical index and knowledge on hypertension, thus ultimately suggesting a nursing intervention for promoting self management compliance.
Adult ; Aged ; Aged, 80 and over ; Female ; Health Promotion ; Humans ; Hypertension/psychology/*therapy ; Life Style ; Male ; Middle Aged ; Patient Compliance ; *Patient Education as Topic ; Rural Population ; *Self Care

Probiotics that are able to provide beneficial effects on animal health have become important ingredients of dog foods. This study was conducted to characterize the probiotic potentials of two strains, Lactobacillus reuteri BCLR-42 and Lactobacillus plantarum BCLP-51, that were derived from feces of healthy dogs and evaluated based on tolerance to low pH and bile acid, antimicrobial activities, enzyme profiles, sensitivity to antibiotics, and innate immune enhancing potentials. Both strains showed survival of more than 90% at pH 3 and 0.2% bile acid and exhibited broad antimicrobial activities against indicator bacteria. Moreover, both strains showed high sensitivity to antibiotics, except vancomycin, metronidazole, and gentamicin. The alkaline phosphatase was negligible (score 0), whereas they showed strong beta galactosidase activity (score range 5 or 3, respectively). The phagocytosis and oxidative burst activities of canine granulocytes were significantly enhanced in response to both strains. These results show that both strains have the capability to act as probiotics and the potential for application as ingredients in dog foods.
Alkaline Phosphatase ; Animals ; Anti-Bacterial Agents ; Bacteria ; beta-Galactosidase ; Bile ; Dogs* ; Feces ; Gentamicins ; Granulocytes ; Hydrogen-Ion Concentration ; Lactobacillus plantarum* ; Lactobacillus reuteri* ; Lactobacillus* ; Metronidazole ; Phagocytosis ; Probiotics* ; Respiratory Burst ; Vancomycin

Emphysematous pyelonephritis (EPN) is a life-threatening infection characterized by the formation of gas. Complications of EPN include septic shock, acute renal failure, and disseminated intravascular coagulation. Spontaneous subcapsular hematoma (SCH) has also been reported as a rare complication of EPN, although there have been no reports to date of this occurring prior to the presentation of EPN. We report a case of EPN that initially presented as spontaneous SCH. The patient was admitted for left flank pain, and initial computed tomography revealed SCH without any air shadows. Laboratory findings and clinical symptoms suggested the presence of urinary tract infection and the patient was started on antibiotics. Fever developed 24 hours after admission. On follow-up computed tomography 7 days later, EPN was newly observed, and a percutaneous drain was inserted. Blood, urine, and drainage fluid cultures all revealed growth of extended-spectrum beta-lactamase-negative Escherichia coli.
Acute Kidney Injury ; Anti-Bacterial Agents ; Disseminated Intravascular Coagulation ; Drainage ; Emphysema ; Escherichia coli ; Fever ; Flank Pain ; Follow-Up Studies ; Hematoma* ; Humans ; Pyelonephritis* ; Shock, Septic ; Urinary Tract Infections