OBJECTIVES: This study attempted to identify the factors that contribute to successful telemedicine service. This was done by analyzing the operational state of successful telemedicine services offered in Gangwon Province of Korea and their outcome for the last fifteen years. METHODS: A comparative analysis was made based on reports and a thesis on the satisfaction rate of patients and providers, patient compliance to treatment, and economic assessment of Gangwon telemedicine service, which were carried out in three periods: the years 2006, 2010, and 2012. RESULTS: The satisfaction surveys in all three periods showed similar results for patients (4.46+/-0.70 point) and healthcare practitioners, including nurses (3.82+/-0.62 point) and physicians (3.60+/-0.56 point), in decreasing order from the year 2012. Through the survey of patients' compliance with treatment, it was confirmed that telemedicine services increased patients' compliance with drug administration, facilitated improvement of lifestyle habits, improved glycated hemoglobin for patients with diabetes mellitus, and enhanced the rate of blood pressure control. In the survey conducted on patients' willingness to pay for telemedicine services in 2007, it was found that those patients were willing to pay about $3.5 for services. CONCLUSIONS: The telemedicine services of Gangwon Province increased patients' compliance with drug administration, improved blood glucose control, enhanced blood pressure control for patients with hypertension, and provided economic advantage.
Blood Glucose ; Blood Pressure ; Compliance ; Cost-Benefit Analysis ; Delivery of Health Care ; Diabetes Mellitus ; Gangwon-do* ; Hemoglobin A, Glycosylated ; Humans ; Hypertension ; Korea* ; Life Style ; Patient Compliance ; Patient Satisfaction ; Rural Health Services ; Telemedicine*

BACKGROUND: During nasotracheal intubation it is important to have proper pretreatment for nasal mucosa constriction and nasal cavity expanding. Nasal packing of epinephrine gauze is widely used as well as xylometazoline. The aim of this study was to compare and evaluate the efficacy of prophylactic intranasal spray of xylometazoline against epinephrine gauze packing in expanding the nasal cavity. METHODS: Volunteers (n = 32) in their twenties without nasal disease such as septal deviation or rhinitis were enrolled in the study. The more patent nostril in each subject was measured by acoustic rhinometry as the base value. After intranasal spray of xylometazoline, the same nostril was remeasured by same method. Twenty four hours later, intranasal packing of epinephrine gauze was done and the same treatment was done. Subject preferences about the procedures were asked. RESULTS: There were significant difference among treatments (base value: 0.582 +/- 0.164 cm2, xylometazoline spray: 0.793 +/- 0.165 cm2, epinephrine gauze packing: 0.990 +/- 0.290 cm2) in acoustic rhinometry. While the epinephrine gauze packing showed more efficient mucosa constriction, subjects preferred xylometazoline spray. CONCLUSIONS: Even though xylometazoline spray was less effective than epinephrine gauze packing, the simplicity and convenience compensated. In patients undergoing nasotracheal intubation, xylometazoline spray can be an alternative to epinephrine gauze packing.
Constriction ; Epinephrine ; Humans ; Imidazoles ; Intubation ; Mucous Membrane ; Nasal Cavity ; Nasal Mucosa ; Nose Diseases ; Rhinitis ; Rhinometry, Acoustic

Ewing sarcoma/peripheral primitive neuroectodermal tumor (ES/PPNET) arises from bone or soft tissue of many sites of body, but ES/PPNET, as primary lesion, in the soft tissue of neck is very uncommon. The authors experienced a case of ES/PPNET in a 17-year-old girl, which was manifested as isolated cervical mass in the soft tissue without any other suspected primary lesion or metastasis. We report the case with a brief review of the literature.
Adolescent ; Humans ; Neck ; Neoplasm Metastasis ; Neuroectodermal Tumors, Primitive ; Neuroectodermal Tumors, Primitive, Peripheral ; Sarcoma, Ewing

OBJECTIVES: This cross-sectional study was performed to examine if the serum gamma-glutamyltransferase (GGT) level that is within its normal range is associated with the risk of type 2 diabetes and if the association between the waist hip ratio (WHR) and type 2 diabetes is different depending on the serum GGT levels. METHODS: The study subjects were 23,436 persons aged 40 years or older and who participated in regular health check-ups at 11 hospitals (males: 5,821, females: 17,615). The gender-specific quintiles of the serum GGT and WHR were used to examine the associations with type 2 diabetes. RESULTS: The serum GGT levels within their normal range were positively associated with type 2 diabetes only in women. The adjusted odds ratios (ORs) were 1.0, 1.0, 1.4, 2.1, and 2.5 according to the quintiles of the serum GGT (p(trend)<0.01). The WHR was more strongly associated with the prevalence of diabetes among the women with a high-normal serum GGT level as compared with those with a low-normal serum GGT level (p for interaction=0.02). For example, the adjusted ORs for women with a low normal serum GGT level were 1.0, 1.2, 1.5, 2.2, and 2.4 according to the quintiles of the WHR, while those figures were 1.0, 2.4, 3.6, 5.0, and 8.3 among the women with a high normal serum GGT level. However, in men, the serum GGT was very weakly associated with type 2 diabetes and the association between the WHR and type 2 diabetes was not different depending on the serum GGT level. CONCLUSIONS: Serum GGT within its normal range was positively associated with type 2 diabetes, and central obesity was more strongly associated with the prevalence of type 2 diabetes when the serum GGT level was high-normal. However, these associations were observed only in women, which is different from the previous findings. The stronger relation between central obesity and type 2 diabetes among women with a high-normal serum GGT level can be useful for selecting a group that is at high risk for type 2 diabetes irregardless of whatever the underlying mechanism is.
Blood Glucose ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2/blood/enzymology/*epidemiology ; Epidemiologic Studies ; Female ; Humans ; Male ; Middle Aged ; Obesity, Abdominal/*epidemiology ; Odds Ratio ; Prevalence ; Republic of Korea/epidemiology ; *Waist-Hip Ratio ; gamma-Glutamyltransferase/*blood

BACKGROUND AND OBJECTIVES: Recent works have demonstrated the existence of ocular vestibular evoked myogenic potentials (OVEMPs), which reflects otolith-ocular reflex. The purpose of this study was to identify an appropriate gaze position to detect OVEMPs produced by air-conducted sound stimulation in healthy subjects. SUBJECTS AND METHOD: Twenty four healthy subjects (35 ears) were included in this study. Surface electromyographic activity was recorded from active electrodes placed inferior to each eye. Stimulation with 500 Hz short tone bursts was used to activate the vestibular end-organs. RESULTS: Sound stimulation evoked negative-positive biphasic responses on both ipsilateral and contralateral eyes, while responses were contralateral eye-dominant. Contralateral eye responses had higher response incidence and larger amplitudes. Altering the direction of gaze generally changed the incidence and size of the inter-peak amplitudes. The higher incidence and larger amplitudes were recorded when the eyes are directed to the superior and ipsilateral side to the sound stimulation. In that gaze position, the amplitude was 5.3 micronV, the first negative peak latency was 10.5 ms and the following positive peak latency was 15.4 ms on the average. CONCLUSION: OVEMPs can be evoked using an air-conducted 500 Hz tone burst and are best recorded contralaterally with a upward gaze towards the source of sound stimulation. Further changes of the test parameters are needed for higher and consistent responses.
Electrodes ; Evoked Potentials ; Eye ; Incidence ; Reflex ; Reflex, Vestibulo-Ocular ; Saccule and Utricle ; Vestibular Evoked Myogenic Potentials

BACKGROUND AND OBJECTIVES: The ocular vestibular evoked myogenic potential (OVEMP) is a recently discovered test of labyrinthine function, analogous to the cervical VEMP. Recent works have demonstrated the existence of OVEMPs, which likely reflect otolith-ocular reflex. The purpose of this study was to identify the optimal plateau and rise/fall times of short tone bursts to detect OVEMPs in healthy subjects. MATERIALS AND METHODS: Thirteen healthy subjects (26 ears) were included in this study. Surface electromyographic activity was recorded from active electrodes placed inferior to each eye. Stimulation with 500 Hz short tone bursts was used. We used a variety of plateau and rise/fall times. Three different plateau times (1, 2, and 3 ms) and rise/fall times (0.5, 1, and 2 ms) were used. The incidence, amplitudes and latencies were compared. RESULTS: VEMP responses were clearly observed in all 26 ears at the plateau time of 2 ms and two rise/fall times (0.5 and 1 ms). The amplitudes in the individual ears tested were lower at the rise/fall time of 2 ms than at the other conditions. The amplitudes were lower at the plateau time of 3 ms compared to the other conditions. When the rise/fall time was prolonged from 0.5 to 2 ms, the n1 and p1 latencies were prolonged in parallel. However, there was no such change in latencies according to the plateau times. CONCLUSIONS: Our findings show that the ideal stimulation pattern for evoking OVEMP is at the rise/fall times of 0.5 or 1 ms and the plateau time of 2 ms. The waveform morphology of the VEMP responses observed with this stimulation pattern was simultaneously the most constant and marked.
Ear ; Electrodes ; Evoked Potentials ; Eye ; Incidence ; Otolithic Membrane ; Reflex ; Reflex, Vestibulo-Ocular ; Vestibular Evoked Myogenic Potentials

PURPOSE: The purpose of this research was to determine the effect of an exercise program on the health status and depression in the elderly. METHOD: The research design was a nonequivalent control group pre-post test design. The exercise program (experimental group) consisted of 22 elderly over a period exercising for 12weeks, 3 days/week. The phone counselling about exercise and health(control group) was applied for 12 weeks for 10-15minutes/day/week. To identify the health status SF-36 was utilized and the GDS was used for depressionanalysis. The data was collected from May 2001 to July 2001. RESULT: The effect of the exercise appeared significant in the subarea of health status (physical function, physical role, mental health, general health) and depression. The effect of the phone counselling was appeared significant in subarea of health status - bodily pain. The effect of the exercise and the phone counselling did not appear significant. CONCLUSION: The exercise designed for the elderly promotes health in the elderly and further evaluation about the effect on exercise and phone counselling is needed.

PURPOSE: The Purpose of this research was to develop the integrative exercise program for the elderly. METHOD: The first step was to survey the elder's health status and general health problems. The second step was to design the exercise type, intensity, time and frequency. RESULT: 1. Elders who implement the integrative exercise program had weaker health status, lower physical performance and more depression than any other places. 2. The integrative exercise program developed the preparation stage composed of stretching and Yudongkong-Ki exercise, the central stage was composed of range of motion exercise, muscle strength exercise and aerobic exercise with favorite and popular Korean music. The finishing stage was composed of joint rounding and Yudongkong-Ki exercise. The exercise intensity was RPE(rating perceived exertion) 10-11, maximal pulse rate 40-60%, duration started from 20min to 50min and frequency is 2-3times/wk. CONCLUSION: The integrative exercise program developed by the researcher is tailored exercise that is more applicable to individual cases in community settings. Eventually, the program is safely applicable to the elders, and is expected to improve the elders' physical function and quality of life.
Aged* ; Depression ; Exercise ; Heart Rate ; Humans ; Joints ; Muscle Strength ; Music ; Quality of Life ; Range of Motion, Articular

PURPOSE: The purpose of this research is to identify factors influencing anticipatory nausea and vomiting in cancer patients. METHODS: The conceptual framework was derived from Roy's Adaptation Model. The subjects for this study were 66 adult patients with various types of cancers, who were scheduled for a third cycle of chemotherapy or above. RESULTS: 47% of the patients experienced anticipatory nausea and vomiting. CONCLUSION: The study identified two factors, psychological symptoms (p=.002) and severity of post-chemotherapy nausea and vomiting(p=.004), which are directly related to anticipatory nausea and vomiting. These two factors accounted for 39.5% of the anticipatory nausea and vomiting. Identified environmental cues were awareness of hospital setting, sensory stimuli, and experience of chemotherapy which induced nausea and vomiting. Strategies for relieving anticipatory nausea and vomiting taken by cancer patients were religion, reminiscence, distracting imagery, positive thinking, relaxation and physical exercise.
Adult ; Cues ; Drug Therapy ; Exercise ; Humans ; Nausea* ; Psychology ; Relaxation ; Thinking ; Vomiting*

OBJECTIVE: Cytomegalovirus(CMV) is the most common cause of congenital infection with diverse clinical features according to the age of hosts. This study was done to evaluate clinical manifestations and complications in congenital CMV infection. METHODS: Between October 2000 and September 2001, 10 cases of congenital CMV infection were diagnosed by urine culture within 2 weeks after birth. Demographic data, clinical and laboratory findings were collected from maternal and newborn hospital records. RESULTS: There were 7 males and 3 females. Average gestational age was 38+0 weeks(34+2-41+1), average birth weight was 2462+/-598.2g(1670-3360) and 5 cases were small for gestational age. Average head circumference was 31.9+/-1.8cm(29-34.3). There were 4 cases of microcephaly, 6 cases of petechiae, 3 cases of leukocytopenia, 6 cases of thrombocytopenia. There was no case showing hepatomegaly, hepatic dysfunction, or pathologic jaundice. 4 cases showed physiologic jaundice. IgM level was elevated in 5 out of 9 cases. Polymerase chain reaction(PCR) was positive in 7 cases. All cases showed germinal matrix hemorrhage and septated cysts on cranial ultrasonography. 1 case showed cerebral calcification. 1 case showed bilateral sensorineural hearing loss on brainstem auditory evoked potentials(BAEP). There was no case showing chorioretinitis on fundoscopy. CONCLUSION: There were diverse clinical manifestations in CMV infection in neonates. All cases showed germinal matrix hemorrhage and septated cysts. When we find these findings, we should consider the possibility of CMV infection. One patient developed bilateral sensorineural hearing loss, so its early detection and follow-up might be necessary.
Birth Weight ; Brain Stem ; Chorioretinitis ; Cytomegalovirus Infections* ; Cytomegalovirus* ; Female ; Gestational Age ; Head ; Hearing Loss, Sensorineural ; Hemorrhage ; Hepatomegaly ; Hospital Records ; Humans ; Immunoglobulin M ; Infant, Newborn* ; Jaundice ; Leukopenia ; Male ; Microcephaly ; Parturition ; Purpura ; Thrombocytopenia ; Ultrasonography