OBJECTIVE: To evaluate the effects of early regular exercise and to assess the electrophysiological and histopathological findings of the rat tail nerve in relation to the timing of exercise training for swimming exercise in rats with diabetic neuropathy. METHODS: We used 70 Sprague-Dawley male rats, and the experimental group comprised 60 rats, and the control group comprised 10 rats. Diabetes was induced by intraperitoneal injection of streptozotocin. Blood glucose concentrations were measured in tail vein blood samples. The experimental group was divided into 6 subgroups according to insulin treatment and swimming exercise: group 1, diabetic control; group 2, insulin treated; group 3, insulin untreated with early swimming exercise; group 4, insulin treated and early swimming exercise; group 5, insulin treated and late swimming exercise; and group 6, insulin untreated with late swimming exercise. Sensory and motor nerve conduction studies were performed weekly up to the 13th week using rat tail nerves. The effect on structural diabetic neuropathy was assessed by morphometry and ultrastructural examination of the rat tail nerve fiber at the 14th week. RESULTS: An exercise effect was observed in the insulin treated groups, but it was not observed in the insulin untreated groups. The sensory nerve conduction study in the rat tail revealed significantly prolonged latency and decreased amplitude in groups 1 and 6, and a further delay was observed in group 5 when compared to group 4. Decreased thickness of myelin was found in groups 1 and 6 through morphometry. CONCLUSION: Early regular exercise programs in addition to conventional insulin treatment may retard the progression of diabetic peripheral neuropathy.
Animals ; Blood Glucose ; Diabetic Neuropathies ; Humans ; Injections, Intraperitoneal ; Insulin ; Male ; Myelin Sheath ; Nerve Fibers ; Nerve Tissue ; Neural Conduction ; Peripheral Nervous System Diseases ; Rats* ; Rats, Sprague-Dawley ; Streptozocin ; Swimming ; Tail ; Veins

BACKGROUND: This study was designed to assess the effects of pneumoperitoneal pressure (PP) and positional changes on the respiratory mechanics during laparoscopy assisted colectomy. METHODS: Peak inspiratory pressure, plateau pressure, lung compliance, and airway resistance were recorded in PP of 10 mmHg and 15 mmHg, with the position change in 5 steps: head-down at 20degrees, head-down at 10degrees, neutral position, head-up at 10degrees and head-up at 20degrees. RESULTS: When the patient was placed head-down, the position change accentuated the effects of pneumoperitoneum on respiratory mechanics. However, when the patient was placed in a head-up position during pneumoperitoneum the results showed no pattern. In the 20degrees head-up position with the PP being 10 mmHg, the compliance increased from 30.6 to 32.6 ml/cmH2O compared with neutral position (P = 0.002). However with the PP being 15 mmHg, the compliance had not changed compared with neutral position (P = 0.989). In 20degrees head-down position with the PP of 10 mmHg, the compliance was measured as 24.2 ml/cmH2O. This was higher than that for patients in the 10degrees head-down position with a PP of 15 mmHg, which was recorded as 21.2 ml/cmH2O. Also in the airway resistance, the patient in the 20degrees head-down position with the PP of 10 mmHg showed 15.8 cmH2O/L/sec, while the patient in the 10degrees head-down position with the PP of 15 mmHg showed 16.2 cmH2O/L/sec of airway resistance. These results were not statistically significant but still suggested that the head-down position accentuated the effects of pneumoperitoneum on respiratory mechanics. CONCLUSIONS: Our results suggest that respiratory mechanics are affected by the patient position and the level of PP - the latter having greater effect.
Airway Resistance ; Colectomy ; Compliance ; Humans ; Laparoscopy ; Lung Compliance ; Pneumoperitoneum ; Respiratory Mechanics

We describe a case of cement leakage from the pedicle of vertebrae to the subcutaneous tissue after kyphoplasty.We attempted to remove all cement leakage, but residual cement remained in the paraspinal tissue without any neurological complications.This case illustrates the importance of the right timing of cement injection and when to detach the bone-filler device from the cement.
Kyphoplasty ; Spine ; Subcutaneous Tissue

The integrated cell culture-PCR (ICC-PCR) method has been suggested as an improved method for detection of viruses in water environments. We tested 57 source waters including finished water samples in Gyeonggi-do for enteric viral contamination using total culturable virus assay (TCVA) using BGMK cells and ICC-PCR. Nineteen of the 57 source water samples (33.3%) exhibited the cytopathic effect (CPE) on BGMK cells and no finished water did exhibited CPE. Nineteen samples (33.3%) of the 57 were positive for reoviruses. For the enteroviruses, only 3 samples (5.3%) of the 57 samples showed positive results. By using ICC-PCR method, 202 flasks from source water samples were positive for enteroviruses and reoviruses. Three samples from source water were positive for both viruses. However, any flasks tested was not co-infected with two types of viruses. While the enteric viral frequencies in TCVA and ICC-PCR were similar, the viral frequency for reoviruses at first passage in two type of method was higher in ICC-PCR (94.7%) than TCVA (56.9%).
Enterovirus ; Viruses ; Water

PURPOSE: This study was to examine the effects of Seogeum therapy for middle-aged abdominal obese women. METHODS: Seogeum therapy combined cupping, stepping on ion aluminum board, adhering to Seoam moxibustion and Seoam pellet. The subjects consisted of 30 middle-aged abdominal obese women between 40 and 59 years of age: fifteen were assigned to experimental group, fifteen to control group. The data collection and treatments were performed from June to October, 2007. The subjects of experimental group participated in Seogeum therapy for 5 times per week during 8 weeks. The data were analyzed with Chi-square test, Wilcoxon signed rank test and Wilcoxon rank-sum test with SPSS/Window 12.0 program. RESULTS: Seogeum therapy experimental group showed significant difference in change of general obesity indexes(body weight, body fat amount, body fat ratio, BMI) than control group supporting hypothesis 1. Experimental group showed significant difference in change of abdominal obesity indexes(abdominal fat ratio, waist circumference, hip circumference) than control group supporting hypothesis 2. CONCLUSION: Obesity management of Seogeum therapy had a positive effect for middle-aged obese women. Therefore, it is concluded that the obesity management of Seogeum therapy can be applied as a nursing intervention to decrease the obesity for middle-aged women.
Adipose Tissue ; Aluminum ; Body Weight ; Complementary Therapies ; Data Collection ; Female ; Hip ; Humans ; Middle Aged ; Moxibustion ; Obesity ; Obesity, Abdominal ; Waist Circumference

PURPOSE: Ego-integrity in older adults is the central concept related to quality of life in later life. Therefore, for effective interventions to enhance the quality of later life, a scale to measure ego-integrity in older adults is necessary. This study was carried out to develop a scale to measure ego-integrity in older adults. METHODS: This study utilized cronbach's alpha in analyzing the reliability of the collected data and expert group, and factor analysis and item analysis to analyze validity. RESULTS: Seventeen items were selected from a total of 21 items. Cronbach's alpha coefficient for internal consistency was .88 for the 17 items of ego-integrity in the older adults scale. Three factors evolved by factor analysis, which explained 50.71% of the total variance. CONCLUSIONS: The scale for measuring ego-integrity in Korean older adults in this study was evaluated as a tool with a high degree of reliability and validity.
Aged ; Aged, 80 and over ; *Ego ; Female ; Humans ; Korea ; Male ; Questionnaires ; Self Concept

Although mycobacterial culture and the subsequent drug-susceptibility test (DST) for anti-tuberculosis (TB) drugs take several months to complete using solid media, there are no reports on the turnaround times of these tests under clinical conditions. The aim of this study was to determine the interval between initiation of anti-TB treatment and receipt of DST requested at an outpatient clinic. We prospectively enrolled patients with culture-positive pulmonary TB at Seoul National University Hospital from September 2002 to December 2004. Patients were followed up monthly. Mycobacterial cultures were done using Ogawa media at Seoul National University Hospital. DST were performed at the Korean Institute of Tuberculosis. Of the 104 patients enrolled, 54 were male. The median age was 41 yr. The median interval from initiation of anti-TB treatment to receipt of mycobacterial culture results by clinicians was 37 days (range, 0-89 days). The median interval from initiation of treatment to confirmation of DST by requesting clinicians was 80.5 days (range, 28-145 days). Clinicians only received the results of DST more than two months after initiation of treatment when they followed up patients monthly and mycobacterial culture was performed using solid media.
Tuberculosis, Pulmonary/*drug therapy ; Time Factors ; Prospective Studies ; Middle Aged ; *Microbial Sensitivity Tests ; Male ; Humans ; Female ; Antitubercular Agents/pharmacology/*therapeutic use ; Aged ; Adult ; Adolescent

As the incidence of nontuberculous mycobacterial infection has been increasing recently in Korea, the importance of drug susceptibility test for clinical isolates of mycobacteria has become larger. In this study we determined the antimicrobial susceptibility patterns of clinical isolates of M. fortuitum and M. abscessus in Korea, and evaluated the efficacy of a modified broth microdilution method using 2,3-diphenyl-5-thienyl-(2)-tetrazolium chloride (STC), in terms of its ability to provide accurate and easy-to-read minimal inhibitory concentration (MIC) endpoints for the susceptibility testing of rapidly growing mycobacteria. Most isolates of M. fortuitum and M. abscessus in Korea are susceptible or intermediately susceptible to amikacin, cefoxitin, ciprofloxacin, and clarithromycin. Many isolates of M. fortuitum are susceptible to doxycycline, sulfamethoxazole, and imipenem, while many M. abscessus isolates are resistant to these drugs. In the present study, the modified broth microdilution method using STC was found to be reliable, easy to read, and inexpensive for M. fortuitum and M. abscessus susceptibility testing. The modified colorimetric MIC testing method using STC was proven to be a useful surrogate for RGM antibiotic susceptibility testing.
Anti-Bacterial Agents/pharmacology ; Cefoxitin/pharmacology ; Chemistry, Pharmaceutical/methods ; Ciprofloxacin/pharmacology ; Clarithromycin/pharmacology ; Colorimetry/methods ; Drug Resistance, Bacterial ; Korea ; *Microbial Sensitivity Tests ; Mycobacterium/*metabolism ; Mycobacterium fortuitum/*metabolism ; Tetrazolium Salts/*pharmacology

The malfunction of an expiratory unidirectional valve (EV) can cause rebreath of expired gas, barotraumas, or ventilatory failure during the general anesthesia. The following is a report on a case of ventilatoryfailure caused by an EV that failed to open during the induction of anesthesia. A 57-year-old man was scheduled for the biopsy of a vocal cord polyp. After intubation, we could not detect the evidence of ventilation through the endotracheal tube. Suspecting the esophageal intubation, we administered extubation. The patient was still having difficulty in ventilating even after a retrial of intubation. Then we discovered the EV was failing to open properly with ventilation and thus not able to function properly. The common cause of ventilatory failure immediately after intubation is malposition of an endotracheal tube, like esophageal intubation, and equipment failure also has reported. Accordingly, we should remember possible causes of ventilatory failure after intubations and routine conscientious inspection of the ventilator.
Anesthesia ; Anesthesia, General ; Barotrauma ; Biopsy ; Equipment Failure ; Humans ; Intubation ; Intubation, Intratracheal* ; Middle Aged ; Polyps ; Ventilation ; Ventilators, Mechanical ; Vocal Cords

PURPOSE: This study was conducted to examine the knowledge level and assessment experience of nurses in regards to delirium, and to utilize the study results as baseline data for planning delirium education programs for nurses. METHODS: Subjects were 465 nurses who were working in a general hospital. A 'delirium related knowledge and assessment experience' questionnaire was used to collect data. RESULTS: Knowledge levels regarding delirium averaged 70 out of 100, and at each domain, they scored 87 for etiology of delirium, 62 for symptoms, and 69 for nursing management. The knowledge level of delirium was significantly different according to educational level (F=3.851, p=.022), past education related to geriatrics(t=2.471, p=.014), and awareness of need for in-service education on geriatric nursing(F=2.663, p=.032). About 85% of nurses had past experience of dealing with delirious patients and only 7.7% of nurses used delirious state assessment tools. CONCLUSION: According to the above results, it is necessary, not only to provide delirium related educational programs for nurses, but also to emphasize the usefulness of applying the assessment tool.
Delirium* ; Education ; Hospitals, General ; Humans ; Nursing ; Surveys and Questionnaires