This study examined burdens of primary family carcgivcrs of paticnto with cerebrovascular accidents (CVA) along with related factors. In addition, their needs for support group intervention were assessed to develop a support group to reduce the burdens of caregiving. Eighty-one primary family caregivers of patients with CVAs at a general hospital in Seoul participated in this study . The patients with CVAs aged from 26 to 83 years with mean age of 63 years. About 90% of the patients had some paralysis and 56.6% suffered speech problems. Fifty-eight percent of the primary family caregivers were spouses of the patients and 80.2% were women. Primary family caregivers' burdens were assessed by the Burden Scale originally devel oped by Zarit (1980) and Novak & Geust(1989) and modified by Jang (1995) for use in Korea. The instrument consists of six subscales time-dependent burden, developmental burden, physical burden, emotional burden, social burden, and financiaI burden. The results were as follows : 1. The average of burden score was 91.7, indicating moderate to severe level of burden. The time-dependent burden was scored highest followed by physical, developmental, social, financial, and emotional burdens. 2. of the characteristics of patients, age, gender, and severity of the disease were found to be associated with the level of burden. Of the characteristics of primary family caregivers, age and educational level were significantly related to the level of burden. Time of care since the CVA and the quality of relationship between a patient and a caregiver prior to the stroke were significant situational factors affecting the level of burden. 3. The need for support group intervention for the caregivero was very high (95.1%). The earcgivcrs of patients who had a CVA for the first time showed higher levels of need compared to those of patients who had a CVA more than once. The caregivers indicated a support group held once a month near home or hospital would be welcomed. In addition, they replied that a group composed of 9 to 10 caregivers and guided by health care professionals (e.g., physicians and nurses) would be most desirable. More than 85% of the earegivers identified the areas that they wanted intervention in as follows : knowledge, skills, and resources to care for a patient with a CVA. the counsel of health care professionals, share of their experiences with those who have similar situations, stress management skills, and methods to overcome emotional isolation due to the great responsibility for a patient. Given the results, support group is expected to be an effective way to reduce the burdens of primary family caregivers of patients with CVAs. As a follow up It is necessary to examine the effect of support group intervention on the patient's recovery and rehabilitation.
Caregivers* ; Delivery of Health Care ; Female ; Hospitals, General ; Humans ; Korea ; Paralysis ; Rehabilitation ; Self-Help Groups* ; Seoul ; Spouses ; Stroke*

PURPOSE: The purpose of this study was to identify the main factors influencing family functioning of caregivers in families with stroke. METHOD: A Convenient sample of 173 primary family caregivers who take care of a stroke patient at an Oriental medicine hospital in Jeonbuk. Interviews were done with a standardized questionnaire including family functioning by nurses. RESULTS: In Pearson's correlation analysis, the influencing factors related to family functioning were ADL(p=.017), level of paralysis(p=.019) as stressors, Quality of relation(p=.000) as situational variables, and family caregivers' burden(p=.000). Stepwise multiple regression analysis showed 29.9% of the variance family functioning was significantly accounted for by the quality of relationship between stroke patient and caregiver(26.8%), and caregiver burden(3.1%). CONCLUSIONS: Findings indicate that families of stroke patients need family-focused nursing intervention as supported care to improve the relationship between patient and primary caregiver and relieve caregiver burden by culturally tailoring to Korean.
Caregivers* ; Humans ; Jeollabuk-do ; Medicine, East Asian Traditional ; Nursing ; Stroke* ; Surveys and Questionnaires

In vivo 31P magnetic resonance spectroscopy (MRS) was used to evaluate the effect of nimodipine on changes of [H] (pH) and the ratio of [PCr]/[Pi] in cats subjected to an incomplete global cerebral ischemia-reperfusion under the pretreated condition of hyperglycemia. Animals were subjected to a transient (18 minutes) incomplete global cerebral ischemia; the systemic arterial hypotension was induced, and immediately followed by the bilateral carotid artery ligation. Twenty cats were divided into 3 groups; for group 1 (control), 7 cats were employed for a control group; for group 2 (hyperglycemia), 7 cats were a hyperglycemia group with infusion of 50% glucose prior to ischemia; for group 3 (Nimodipine), 6 cats were infused with 50% glucose prior to ischemia, and nimodipine after ischemia. The time course of changes in pH and [PCr]/ [Pi] was monitored before, during and after ischemia. The pH decreased immediately after ischemia in all three groups. After the reperfusion was made, the values of the pH did not retum to the baseline value for the group 2 (hyperglycemia) and 3 (nimodipine), in contrary to the group 1 (control). The ratio of [PCr]/[Pi] was dropped to 20% of the baseline value after ischemia in all three groups. The value was recovered progres- sively during reperfusion period for group 1 (control), whereas for group 2 (hyperglycemia) and group 3 (Nimodipine) the values were remained depressed. The results suggest that the condition of hyperglycemia induced by the infusion of 50% glucose prior to the incomplete global cerebral ischemia-reperfusion, may deteriorate the cerebral ischemia and the infusion of nimodipine during ischemia-reperfusion has no beneficial effects to improve the cerebral acidosis and the metabolic recovery.
Acidosis ; Animals ; Brain Ischemia ; Carotid Arteries ; Cats* ; Glucose ; Hydrogen-Ion Concentration ; Hyperglycemia* ; Hypotension ; Ischemia ; Ligation ; Magnetic Resonance Spectroscopy ; Nimodipine* ; Reperfusion

In vivo 31P magnetic resonance spectroscopy (MRS) was used to evaluate the effect of nimodipine on changes of [H] (pH) and the ratio of [PCr]/[Pi] in cats subjected to an incomplete global cerebral ischemia-reperfusion under the pretreated condition of hyperglycemia. Animals were subjected to a transient (18 minutes) incomplete global cerebral ischemia; the systemic arterial hypotension was induced, and immediately followed by the bilateral carotid artery ligation. Twenty cats were divided into 3 groups; for group 1 (control), 7 cats were employed for a control group; for group 2 (hyperglycemia), 7 cats were a hyperglycemia group with infusion of 50% glucose prior to ischemia; for group 3 (Nimodipine), 6 cats were infused with 50% glucose prior to ischemia, and nimodipine after ischemia. The time course of changes in pH and [PCr]/ [Pi] was monitored before, during and after ischemia. The pH decreased immediately after ischemia in all three groups. After the reperfusion was made, the values of the pH did not retum to the baseline value for the group 2 (hyperglycemia) and 3 (nimodipine), in contrary to the group 1 (control). The ratio of [PCr]/[Pi] was dropped to 20% of the baseline value after ischemia in all three groups. The value was recovered progres- sively during reperfusion period for group 1 (control), whereas for group 2 (hyperglycemia) and group 3 (Nimodipine) the values were remained depressed. The results suggest that the condition of hyperglycemia induced by the infusion of 50% glucose prior to the incomplete global cerebral ischemia-reperfusion, may deteriorate the cerebral ischemia and the infusion of nimodipine during ischemia-reperfusion has no beneficial effects to improve the cerebral acidosis and the metabolic recovery.
Acidosis ; Animals ; Brain Ischemia ; Carotid Arteries ; Cats* ; Glucose ; Hydrogen-Ion Concentration ; Hyperglycemia* ; Hypotension ; Ischemia ; Ligation ; Magnetic Resonance Spectroscopy ; Nimodipine* ; Reperfusion

OBJECTIVE: This study aimed to propose clinical guidelines for placing miniscrew implants using the results obtained from 3-dimensional analysis of maxillary anterior interdental alveolar bone by cone-beam computed tomography (CBCT). METHODS: By using CBCT data from 52 adult patients (17 men and 35 women; mean age, 27.9 years), alveolar bone were measured in 3 regions: between the maxillary central incisors (U1-U1), between the maxillary central incisor and maxillary lateral incisor (U1-U2), and between the maxillary lateral incisor and the canine (U2-U3). Cortical bone thickness, labio-palatal thickness, and interdental root distance were measured at 4 mm, 6 mm, and 8 mm apical to the interdental cementoenamel junction (ICEJ). RESULTS: The cortical bone thickness significantly increased from the U1-U1 region to the U2-U3 region (p < 0.05). The labio-palatal thickness was significantly less in the U1-U1 region (p < 0.05), and the interdental root distance was significantly less in the U1-U2 region (p < 0.05). CONCLUSIONS: The results of this study suggest that the interdental root regions U2-U3 and U1-U1 are the best sites for placing miniscrew implants into maxillary anterior alveolar bone.
Adult ; Cone-Beam Computed Tomography ; Female ; Humans ; Incisor ; Male ; Tooth Cervix

No abstract available.
Telephone*

No abstract available.
Anencephaly* ; Humans ; Pregnancy, Twin* ; Twins*

OBJECTIVE: To investigate whether motor evoked potential (MEP) amplitude ratio measurements are sufficiently objective to assess functional activities of the extremities. We also delineated the distribution between the presence or absence of MEPs and the Medical Research Council (MRC) scale for muscle strength of the extremities. METHODS: We enrolled 183 patients with first-ever unilateral hemiplegia after stroke. The MEP parameters were amplitude ratio (amplitude of affected side/amplitude of unaffected side) recorded at the first dorsal interosseous (FDI) and tibialis anterior (TA) muscles. We performed frequency analyses using the MRC scale for muscle strength and the presence or absence of evoked MEPs. Change on the MRC scale, hand function tests (HFTs), and the Modified Barthel Index (MBI) subscore were compared between the evoked MEP and absent MEP groups using the independent t-test. Receiver operating characteristic curves were used to determine the optimal cutoff scores for the MEP amplitude ratio using the HFT results and MBI subscores. Correlations between the MEP amplitude ratio and the MRC scale, HFTs, and MBI subscore were analyzed. RESULTS: About 10% of patients with MRC scale grades 0-2 showed evoked MEPs at the FDI muscle, and 4% of patients with MRC scale grades 3-5 did not show MEPs. About 18% of patients with MRC scale grades 0-2 showed evoked MEPs at the TA muscle, and 4% of patients with MRC scale grades 3-5 did not show MEPs. MEP amplitude increased with increasing MRC scale grade. The evoked MEP group had more significant changes on the MRC scale, HFT, and the climbing stair score on the MBI than those in the group without MEPs. Larger MEP amplitude ratios were observed in patients who had more difficulty with the HFTs and ambulation. The MEP amplitude ratio was significantly correlated with the MRC scale, HFT, and MBI subscore. CONCLUSION: We conclude that the MEP amplitude ratio may be useful to predict functional status of the extremities in patients who suffered stroke.
Activities of Daily Living ; Evoked Potentials, Motor* ; Extremities* ; Hand ; Hemiplegia ; Humans ; Motor Skills ; Muscle Strength ; Muscles ; ROC Curve ; Stroke* ; Walking

Axial mesodermal dysplasia complex (AMDC) arises in variable combinations of craniocaudal anomalies such as musculoskeletal deformities, neuroschisis, or rhombencephalic developmental disorders. To the best of our knowledge, the co-existence of AMDC with associated musculoskeletal anomalies, medullary neuroschisis with mirror movements, and cranial nerve anomalies has not yet been reported. Here, we report the case of a 4-year-old boy whose clinical features were suggestive of Goldenhar syndrome and Poland syndrome with Sprengel deformity. Moreover, he showed mirror movements in his hands suspected of rhombencephalic malformation, and infranuclear-type facial nerve palsy of the left side of his face, the opposite side to the facial anomalies of Goldenhar syndrome. After conducting radiological studies, he was diagnosed with medullary neuroschisis without pontine malformations and Klippel-Feil syndrome with rib anomalies. Based on these findings, we propose that clinical AMDC can be accompanied by a wide variety of musculoskeletal defects and variable degrees of central nervous system malformations. Therefore, in addition to detailed physical and neurological examinations, imaging studies should be considered in AMDC.
Central Nervous System ; Child, Preschool ; Congenital Abnormalities ; Cranial Nerves ; Facial Nerve ; Goldenhar Syndrome ; Hand ; Humans ; Klippel-Feil Syndrome ; Male ; Medulla Oblongata ; Mesoderm* ; Neurologic Examination ; Paralysis ; Poland Syndrome ; Rhombencephalon ; Ribs

Doxazosin is an adrenergic alpha-1 receptor antagonist used to treat lower urinary tract symptoms that are common in prostatic hyperplasia. To our knowledge, few cases of gynecomastia and mastodynia, as a complication of adrenergic alpha-1 receptor antagonist, have been reported to date; no cases have been reported in Korea. We describe a case involving a 78-year-old man treated for prostatic hyperplasia with 13 months of doxazosin. He complained about unilateral gynecomstia and mastodynia. Five months after the discontinuation of doxazosin, the gynecomastia was significantly improved. This is the first reported case of gynecomastia and mastodynia associated with doxazosin use in Korea.
Aged ; Doxazosin* ; Gynecomastia* ; Humans ; Korea ; Lower Urinary Tract Symptoms ; Male ; Mastodynia ; Prostatic Hyperplasia