The purpose of this study was to determine the impact of situational, clinical and psychsoical factors on treatment-seeking behavior among those with acute myocardial infarction(AMI). This study used a retrospective, descriptive design. The sample consisted of 72 patients aged over 30 and who were diagnosed with an acute myocardial infarction at two large university-affiliated medical centers from July 1, 1998 to March 30, 2000. But of 72, patients 5 who were an outlier in treatment-seeking time were deleted. Data were collected by using questionnaires, which included demographic data, situational, clinical and psychosocial data. Also patient interviews and chart review were used to obtain information related to treatment-seeking time. The results of this study were summarized as follows; 1. Mean time from the onset of AMI symptoms to arrival at the hospital was 12.09 +/- 11.44 hours; 2. Treatment-seeking time was not significantly different by age, gender, or education; 3. Most(44 or 65.78%) patients were at home when they began having AMI symptoms. The remaining patients were either in a public area, workplace or in a car. Patients at home delayed longer than those who had their first symptoms elsewhere, but not significantly different. Also, most patients were with another person when they began to experience AMI symptoms: a spouse(25 or 37.3%), other family member(31 or 46.3%); the remaining 11 were alone. There were no significant differences in treatment-seeking time based on whether alone or with others. Most patients(46 or 68.7%) used an ambulance rather than taking private transportation, and patients who used an ambulance were delayed longer than those who used private transportation, but there were no significant differences; 4. Time to treatment-seeking was not significantly different by blood pressure, heart rate on admission and the peak CK-MB, CPK and Cholesterol level, Killips class; 5. There were no significant statistical differences in treament-seeking times by anxiety level, mood status or control ability.
Ambulances ; Anxiety ; Blood Pressure ; Cholesterol ; Education ; Heart Rate ; Humans ; Myocardial Infarction* ; Psychology* ; Retrospective Studies ; Transportation ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to identify effects of a self-management program on self-efficacy and compliance in patients with CHF. Hypothesis: 1) Patients with CHF who are provided with a self-management program will show higher self-efficacy scores than a control group. 2) Patients who are provided with a self-management program will show higher compliance scores than a control group. METHOD: This study was designed as a nonequivalent non-synchronized pre-posttest control group. There were eight patients in the experimental group, and twelve in the control group. According to NYHA classification, all patients belonged under the classesl to lV. Data were collected using the instruments developed by the researchers. Data were analyzed using descriptive statistics and Mann Whitney U test. RESULT: There were significant differences in self-efficacy scores and compliance scores between the experimental and control group. CONCLUSION: By utilizing the program, patients were able to monitor their symptoms routinely, comply with therapeutic regimen, and feel better able to positively influence their disease. Therefore, better compliance means fewer readmissions of patients with CHF.
Classification ; Compliance* ; Decision Trees* ; Heart Failure* ; Heart* ; Humans ; Self Care* ; Statistics, Nonparametric ; Surveys and Questionnaires

The incidence of intertrochanteric fracture of the femur in the elederly patient was lower than young in korea because of low average span and causes of injuries. But recently, the incidence is progressively in creased due to prolongation of korean average life span and improvement of residental enviroment. The mortality and morbidity are higher in spite of various treatment methods because of associated diseases and the poor general conditions of patients. Total 102 cases of intertrochanteric fracture of the femur were treated at the Department of Orthopaedic Surgery of Soonchunhyang University Hospital during the period from January, 1978 to December, 1985. Among them, 67 cases(65.7%) were over 60 years in the age, and of which 55 cases(one case was bilateral) were followed from 8 months to 3 years and 4 months(Average 14.7 months). The results were as followes: l. Out of 54 patients, 33 patients were female and the mean age was 74 years. 2. The most common cause is the injury from slip down and the ratio between in-door injury to out-door injury was 1.7: l. 3. The 41 cases(74%) out of the 55 cases were operated within 2 weeks after the accident, 35 cases were treated by Richard compression hip screw, 11 cases were by intramedullary nailing, and 9 cases were by multiple pinning. The multiple pinning were usually tried to patients of poor general condition, which was needed to shorten the operation times. 4. The mean duration of multiple pinning operation time was 1 hour 12 minutes, intramedullary nailing operation time was 1 hour 47 minutes and Richard compression hip screw operation time was 2 hour 42 minutes. 5. Among 55 cases, 20 cases(36%) were complicated.
Aged ; Female ; Femur ; Fracture Fixation, Intramedullary ; Hip ; Humans ; Incidence ; Korea ; Mortality

Three hundred and fourty two patients with a fracture of tibial shaft were treated and managed in the Department of Orthopaedic Surgery, Soon Chun Hyang University Hospital from January 1981 to December 1985. In 147 cases, 62 cases had only tibial shaft fracture and 85 tibial and fibular shaft fracture. All of these were treated conservatively by manipulation and cast immibilization. We analyzed the initial fracture characteristics, the treatment employed, and the subsequent complications in fracture healing in a series of patients who had sustained a tibial shaft fracture with and without a fibular fracture. The results were as follows; 1. Duration of average bone healing was more slowly in the patients more than twenty years old who were treated for a tibial shaft fracture with and without a concomitant fibular fracture than in the patients less than twenty years old. 2. Duration of average bone healing was more slowly by one or two weeks in the the group of tibial shaft fracture without fibular fracture than in than in those with fibular fracture. 3. The frequency of delayed union, nonunion, varus malunion and pain in the ipsilateral ankle joint were more increased in the group of the tibial shaft fractures without fibular fracture in than those with fibular fracture. 4. The frequency of valgus malunion was more increased in the group of the tibial shaft fractures with fibular fracture than in those without fibular fracture.
Ankle Joint ; Fracture Healing ; Humans ; Tibia

No abstract available.
Animals ; Rats* ; Reperfusion*

PURPOSE: This study was done to develop and test validity and reliability of on instrument for predicting nursing intention for SARS patient care. METHOD: The psychometric properties of a SARS patient care attrition prediction tool, based on the Theory of Planned Behavior, were examined in this study. The Three-phase design involved a) salient beliefs generated from clinical nurses (n=43) b) content validation by expert panel evaluations(n=5) c) face validation by plot testing (n=10) d) and instrument validation in a cross sectional survey (n=299). Psychometric analysis of survey data provided empirical evidence of the construct validity and reliability of the instrument. RESULT: Principal component analysis verified the hypothesized 6-factor solution, explaining 68.2% of variance, and Alpha coefficients of .7538 to .9389 indicated a high internal consistency of the instrument. CONCLUSION: The instrument can be used by nurse administrators and researcher to assess clinical nurses' salient beliefs about caring for SARS patients, guide tailored intervention strategies to effective caring, and evaluate the effectiveness of interventions.
Severe Acute Respiratory Syndrome/*nursing ; Reproducibility of Results ; *Questionnaires ; Nursing Methodology Research ; Nursing Care ; Nurses/*psychology ; Humans ; Female ; Attitude of Health Personnel ; Adult

No abstract available.
Animals ; Rats*

Early and delayed 201Tl SPECT studies were performed on 20 patients with intracranial meningioma who were classified into 4 groups according to Helsinki Grading System: Grade I: benign(n=15), Grade II: atypical(n=5), Grade III: anaplastic(n=0) and Grade IV: sarcomatous(n=0). The early uptake indices(eTl, ratios of average counts/pixel in the lesion to those of contralateral area on early image) were relatively high in all types: Grade I, 3.05+/-1.44(mean+/-standard deviation): Grade II, 2.66+/-1.29. There was no statistical difference in relation to pathological grade. The delay uptake indices were 2.64+/-1.34 and 2.67+/-1.31 respectively, there was no statistical difference in relation to pathological grade. The retention indices(RI, ratios of delay to early uptake indices) were 0.92+/-0.35, 1.04+/-0.36 respectively. there was no statistical differences in relation to pathological grade. In ten cases presenting mitosis, RI was 1.11+/-0.30. But other cases not presenting mitosis RI was 0.80+/-0.34. There was significant difference between two groups p<0.05. The 99mTc-MIBI SPECT study was performed in 14 patients who classified into 4 group: Grade I(n=10) and Grade II(n=4). The uptake ratios were high in all types: Grade I, 6.70+/-3.63 and Grade II, 5.40+/-0.92. There were no statistical difference. In this study, there was no malignant case(Grade III, IV). In summary, if the further study including malignant cases, this study would aid in overcoming to overcome the limitation of CT, MRI about tumor differentiation, with regards to possible detection of presence of residual tumor and viability of tumor after treatment.
Humans ; Magnetic Resonance Imaging ; Meningioma* ; Mitosis ; Neoplasm, Residual ; Tomography, Emission-Computed, Single-Photon*

The authors reviewed 11 consecutive patients with hemorrhage in pituitary adenomas, which were treated by transsphenoidal approach from Jan. 1992 to Dec. 1997. We evaluated nine cases of female and 2 cases of male patients(mean age: 43.4 years old). The diagnosis of pituitary apoplexy was made by severe neurologic sign with sudden onset of headache and visual disturbance, in the setting of hemorrhage in the pituitary adenoma on computed tomographic or magnetic resonance imaging scans. Two cases were diagnosed as pituitary apoplexy and the remaining cases were diagnosed as intratumoral hemorrhages. In our series, the most common symptoms were headache(81.8%) and visual disturbance(81.8%). Other symptoms and signs were hormonal symptoms(63.6%) due to preexisting tumor, cranial nerve signs(18.2%) and alteration of mentality(18.2%). Radiologic findings were changes of sellar contour(double floor sign, widened sellae and obliteration of anterior or posterior clinoid processes) on plain skull X-ray, high density lesion in sellar area on computed tomographic scan. The magnetic resonance images were taken in all patients. Among 11 patients, 9 cases showed subacute hemorrhage(high signal intensity on T1 weighted image) and 2 showed that of chronic stage(iso signal intensity on T1 image and high signal intensity on T2 image). According to the hormonal type, the most common type of tumors associated with intratumoral hemorrhage was non-functioning adenoma(7 cases) compared to other types(GH secreting: 2, ACTH secreting: 1, Prolactin secreting: 1). All patients showed significant improvement of symptoms after surgery(average follow-up, 12.5 months). Rapid diagnosis with computed tomography and/or magnetic resonance imaging, hormonal replacement and transsphenoidal decompression constituted effective therapy.
Adrenocorticotropic Hormone ; Cranial Nerves ; Decompression ; Diagnosis ; Female ; Follow-Up Studies ; Headache ; Hemorrhage* ; Humans ; Magnetic Resonance Imaging ; Male ; Neurologic Manifestations ; Pituitary Apoplexy ; Pituitary Neoplasms* ; Prolactin ; Skull

The clinical, radiological and pathological features of nine cases of adult-onset neurological dysfunction secondary to tethered cord were studied. Sixty-seven percent of these patients had symptomatic onset under specific circumstances: additional tugging of the already tight conus, narrowing of the spinal canal, or direct trauma to the buttocks. Pain in the non-dermatomal leg and perineal area was the most common presenting symptom. Progressive sensory-motor deficit in the lower extremities, as well as sphincter dysfunction were also common findings. Unlike in tethered cord syndrome in children, however, foot and spinal deformities were not seen. The surgical outcome was excellent in relation to pain and sensory-motor deficit, but recovery of sphinctor dysfunction was disappointing. Successful treatment depends on early diagnosis and adequate surgical management of the tethered conus.
Buttocks ; Child ; Congenital Abnormalities ; Conus Snail ; Early Diagnosis ; Foot ; Humans ; Leg ; Lower Extremity ; Neural Tube Defects* ; Spinal Canal