The aim of this study was to examine the roles of care helpers through job analysis. To do this, this study used the Developing A Curriculum Method (DACUM) to classify job content and a multi-dimensional study design was applied to identify roles and create a job description by looking into the appropriateness, significance, frequency, and difficulty of job content as identified through workshops and cross-sectional surveys conducted for appropriateness verification. A total of 418 care helpers working in nursing facilities and community senior service facilities across the country were surveyed. The collected data were analyzed using PASW 18.0 software. Six duties and 18 tasks were identified based on the job model. Most tasks were found to be "important task", scoring 4.0 points or above. Physical care duties, elimination care, position changing and movement assistance, feeding assistance, and safety care were identified as high frequency tasks. The most difficult tasks were emergency prevention, early detection, and speedy reporting. A summary of the job of care helpers is providing physical, emotional, housekeeping, and daily activity assistance to elderly patients with problems in independently undertaking daily activities due to physical or mental causes in long-term care facilities or at the client's home. The results of this study suggest a task-focused examination, optimizing the content of the current standard teaching materials authorized by the Ministry of Health and Welfare while supplementing some content which was identified as task elements but not included in the current teaching materials and fully reflecting the actual frequency and difficulty of tasks.
Aged ; Cross-Sectional Studies ; Curriculum ; Emergencies ; Health Personnel ; Housekeeping ; Humans ; Job Description ; Long-Term Care ; Mortuary Practice ; Teaching Materials

Penetrating injuries to the upper cervical spine resulting from gunshots are rare in South Korea due to restrictions of gun use. Moreover, gunshot wounds to the upper cervical spine without neurological deficits occur infrequently because of the anatomic location and surrounding essential structures. We present an uncommon case involving the surgical removal of a bullet located in the anterior arch of first cervical vertebra (C1) via a transoral approach without neurological complications or subsequent mechanical instability.
Republic of Korea ; Spine ; Wounds, Gunshot

OBJECTIVES: We tried to evaluate the agreement of the Charlson comorbidity index values (CCI) obtained from different sources (medical records and National Health Insurance claims data) for gastric cancer patients. We also attempted to assess the prognostic value of these data for predicting 1-year mortality and length of the hospital stay (length of stay). METHODS: Medical records of 284 gastric cancer patients were reviewed, and their National Health Insurance claims data and death certificates were also investigated. To evaluate agreement, the kappa coefficient was tested. Multiple logistic regression analysis and multiple linear regression analysis were performed to evaluate and compare the prognostic power for predicting 1 year mortality and length of stay. RESULTS: The CCI values for each comorbid condition obtained from 2 different data sources appeared to poorly agree (kappa: 0.00-0.59). It was appeared that the CCI values based on both sources were not valid prognostic indicators of 1-year mortality. Only medical record-based CCI was a valid prognostic indicator of length of stay, even after adjustment of covariables (beta = 0.112, 95% CI = [0.017-1.267]). CONCLUSIONS: There was a discrepancy between the data sources with regard to the value of CCI both for the prognostic power and its direction. Therefore, assuming that medical records are the gold standard for the source for CCI measurement, claims data is not an appropriate source for determining the CCI, at least for gastric cancer.
Aged ; Comorbidity ; Female ; Humans ; Insurance Claim Review ; *Length of Stay ; Male ; Medical Records ; Middle Aged ; Neoplasm Staging ; Prognosis ; Severity of Illness Index ; Stomach Neoplasms/diagnosis/*mortality

OBJECTIVES: The research was aimed at analyzing the contents of university intranet for systematically execution of the healthy information provision and healthy consultation services from 2000 January to 2004 December. METHODS: We have analyzed 300(28.3%) the instances of accomplished health consultation cases from the whole 1,059 instances which were the replied in a university intranet. RESULTS: According to the contents of health consultation in ICPC code, a general symptom 91 cases(30.3%) was most, muscle-skeletal system 44 cases(14.7%), and digestive system 43 cases(14.3%) in order of cases of health counselling. The symptoms and complaint with 155 cases(51.7%) were most in the distribution of the health counselling contents by 17 charter of ICPC. The most common reason of counselling by 17 charter of ICPC were as follows; questions about the symptom and diagnosis(118 cases, 39.3%), the preventive and treatment methods(91 cases, 30.0%), and medical fee(20cases, 6.7%) in order. We mainly answer on the content of health counselling were as follows; make an offer of medical information and knowledge(48.3%), recommend visit clinic or hospital(23.7%), guide to treatment(12.7%), and so on. CONCLUSIONS: This research showed that the program of health counselling may not meet completely the high quality and adequate distribution of health counselling by the intranet in a university by content analysis. The finding suggests that health counselling by intranet in a university may be used to supplement of systemic improvement on the intranet Q/A format from current lack of essential health information and security for the quality of the health counselling.
Computer Communication Networks* ; Counseling* ; Digestive System

We evaluated the role of retroperitoneal laparoscopic ureterolithotomy (RPLU) for upper ureter stones. Between February 1998 and July 2004, 12 patients (10 men and 2 women) underwent RPLU for upper ureter stones (mean size 18.1 mm, range 10-25). RPLU was carried out in 5 patients as a salvage treatment after failed shock wave lithotripsy (SWL) (3) and both of failed SWL and ureteroscopy (URS) (2), and in 7 patients as primary treatment for large impacted stones. Total 6 of 12 cases were converted to open surgery. The reason of open conversion was failure of locating ureter due to severe adhesion in 5 cases and vascular injury in 1 case. In 6 successful cases, mean operation time, mean estimated blood loss, and mean postoperative hospital stay were respectively 109 min (90-120 min), 50 mL (10-100 mL), 4.6 days (2-7 days). There was no serious postoperative complication except for one patient who showed delayed urinary leakage but was cured with conservative management. Our experience suggested that RPLU was not easy to perform simply because it was indicated mainly in ureter stones with severe adhesion or after failed SWL and/or URS. Nevertheless, it can be considered as a primary procedure before open ureterolithotomy.
Urologic Surgical Procedures/*methods ; Ureteral Calculi/*therapy ; Ureter/pathology ; Treatment Outcome ; Time Factors ; Sex Factors ; Retroperitoneal Space/pathology ; Peritoneum ; Middle Aged ; Male ; Lithotripsy/*methods ; Laparoscopy/*methods ; Humans ; Female ; Adult

Pyogenic liver abscess is a serious clinical disease with severe complication in about 10-20% of cases. Metastatic septic endophthalmitis and CNS infection are rare but their incidence is increasing in liver abscess patients, especially Klebsiella pneumoniae as etiologic bacteria. Despite appropriate treatment, the outcome is devastating. We experienced a case of septic endophthalmitis, CNS infection (meninigitis, ventriculitis) and infective spondylitis associated with K. pneumoniae liver abscess. The patient had no specific risk factor. After intensive treatement such as systemic intravenous antibiotics with percutaneous abscess drainage and intravitreal injection, liver abscess was resolved completely. But, sequelae were severe. Socket reconstruction after evisceration with debridement on both eye and ventriculo-peritoneal shunt due to hydrocephalus were done. Our experience suggests that attention should be paid to the possibility of septic metastatic lesions as soon as the treatment of K. pneumoniae liver abscess is initiated.
Abscess ; Anti-Bacterial Agents ; Bacteria ; Debridement ; Drainage ; Endophthalmitis ; Humans ; Hydrocephalus ; Incidence ; Intravitreal Injections ; Klebsiella pneumoniae* ; Klebsiella* ; Liver Abscess* ; Liver Abscess, Pyogenic ; Liver* ; Meningitis ; Pneumonia ; Risk Factors ; Spondylitis ; Ventriculoperitoneal Shunt

Pyogenic liver abscess is a serious clinical disease with severe complication in about 10-20% of cases. Metastatic septic endophthalmitis and CNS infection are rare but their incidence is increasing in liver abscess patients, especially Klebsiella pneumoniae as etiologic bacteria. Despite appropriate treatment, the outcome is devastating. We experienced a case of septic endophthalmitis, CNS infection (meninigitis, ventriculitis) and infective spondylitis associated with K. pneumoniae liver abscess. The patient had no specific risk factor. After intensive treatement such as systemic intravenous antibiotics with percutaneous abscess drainage and intravitreal injection, liver abscess was resolved completely. But, sequelae were severe. Socket reconstruction after evisceration with debridement on both eye and ventriculo-peritoneal shunt due to hydrocephalus were done. Our experience suggests that attention should be paid to the possibility of septic metastatic lesions as soon as the treatment of K. pneumoniae liver abscess is initiated.
Abscess ; Anti-Bacterial Agents ; Bacteria ; Debridement ; Drainage ; Endophthalmitis ; Humans ; Hydrocephalus ; Incidence ; Intravitreal Injections ; Klebsiella pneumoniae* ; Klebsiella* ; Liver Abscess* ; Liver Abscess, Pyogenic ; Liver* ; Meningitis ; Pneumonia ; Risk Factors ; Spondylitis ; Ventriculoperitoneal Shunt

To investigate psychopathology and executive functions of attention deficit hyperactivity disorder (ADHD) children according to intelligence level, this study included 197 ADHD children who visited the outpatient department of neuropsychiatry of YeungNam University Medical Center, from July 2000 to June 2002. The children were divided into groups based on their intelligence levels. They were compared by the Personality Inventory for Children (PIC), Conncers' Continuous Performence Test (CPT), and Wisconsin Card Sorting Test (WCST). There were significant differences in PIC, on the subscales of verbal development, socialization and autism. In the CPT, there was no significant difference. In the WCST, there were significant differences in the total number of errors, the number of perseverative errors, the number of completed categories and the number of trials needed to complete the first category. Considering these results, the intelligence level of ADHD children is related to their disabilities and behavioral symptoms. Executive functions such as abstract thinking, categorization, working memory and flexibility had significant relationship to the intelligence levels of ADHD children. Therefore, the intelligence level of children with ADHD influences the higher executive functions of regulating attention and information processing rather than attentional functions and capacity alone.
Academic Medical Centers ; Attention Deficit Disorder with Hyperactivity* ; Autistic Disorder ; Automatic Data Processing ; Behavioral Symptoms ; Child* ; Executive Function* ; Humans ; Intelligence* ; Memory, Short-Term ; Neuropsychiatry ; Outpatients ; Personality Inventory ; Pliability ; Psychopathology* ; Socialization ; Thinking ; Wisconsin

BACKGROUND: High sensitivity C-reactive protein (hsCRP) is more sensitive than standard CRP assay in evaluating a risk of coronary heart diseases and other atherosclerotic events. By this time, there are several reports that type 2 diabetic subjects have higher level of hsCRP than non-diabetic subjects. However, there are few reports about factors which have influence upon the level of serum hsCRP in type 2 diabetic subjects. We had evaluated the association of serum hsCRP level with risk factors of cardiovascular diseases, carotid intima-media thickness (IMT) and microvascular complications in type 2 diabetic subjects. METHODS: 105 patients (59 men and 46 women) with type 2 diabetes were recruited, and subjects with severe cardiovascular diseases were excluded. All subjects were undergone carotid ultrasonography for evaluation of carotid IMT. Serum hsCRP concentrations were measured. For evaluation of microvascular complications, fundus photography, nerve conduction velocity test were performed, and 24-hour urine protein/albumin excretion amounts were measured. RESULTS: Serum hsCRP level was correlated with mean left IMT (r=0.366, p=0.003), maximal left IMT (r=0.370, p=0.002), mean right IMT (r=0.281, p=0.023) and maximal right IMT (r=0.370, p=0.002). Body mass index (r=0.377, p<0.001), waist circumference (r=0.342, p<0.001), waist-hip ratio (r=0.229, p=0.020), serum total cholesterol (r=0.202, p=0.024), serum triglyceride (r=0.292, p=0.022) and serum low density lipoprotein (r=0.133, p=0.044). There was no difference of serum hsCRP level between groups with or without retinopathy (1.26+/-0.83 vs 1.13+/-1.13 mg/L, p=0.704), neuropathy (1.30+/-1.27 vs 0.88+/-0.80 mg/L, p=0.203) or nephropathy (1.10+/-0.93 vs 1.06+/-1.06 mg/L, p=0.863). CONCLUSION: We conclude that serum hsCRP level is correlated with carotid IMT and the risk factors of cardiovascular diseases, and may be useful to predict accelerated atherosclerotic process in type 2 diabetic subjects. But, diabetic microvascular complications do not effect on the level of serum hsCRP.
Body Mass Index ; C-Reactive Protein* ; Cardiovascular Diseases ; Carotid Intima-Media Thickness* ; Cholesterol ; Coronary Disease ; Diabetes Mellitus, Type 2 ; Humans ; Lipoproteins ; Male ; Neural Conduction ; Photography ; Risk Factors ; Triglycerides ; Ultrasonography ; Waist Circumference ; Waist-Hip Ratio

BACKGROUND: It is generally accepted that the most spontaneously-arising epidermal cysts might be related to follicular infundibulum and palmoplantar epidermal cyst (PPEC) has been suggested to be caused from traumatic implantation of epidermal fragments. In addition there were several recent reports of human papillomavirus (HPV) implicating in formation of PPEC and also similar reports in Korean dermatologic literature. But the latter failed to reveal the presence of HPV in PPEC or a specific type of HPV by molecular biologic methods. OBJECTIVE: We tried to identify the presence of HPV and its subtype in PPEC. METHODS: After reviewing routine histopathologic findings recalling HPV infection in 8 PPECS, we undertook immunohistochemistry using polyclonal HPV antibody and polymerase chain reactions with 3 sets of HPV primers. To confirm the actual location of HPV in cyst in situ hybridization with HPV 60 probe was also done. RESULTS: All cases showed more than one feature of HPV infection. The positive reactions were 3 out of 8 on immunohistochemistry and 5 out of 8 on polymerase chain reaction. All cases (4 of 4) were positive on in situ hybridization and they were found in the horny layer and/or wall of cysts. CONCLUSION: PPEC in Korea may show similar typical histopathologic features with those reported in Japan. The HPV were detected in almost PPEC by molecular methods and their subtype was all HPV 60.
Epidermal Cyst* ; Gammapapillomavirus* ; Humans* ; Immunohistochemistry ; In Situ Hybridization ; Japan ; Korea ; Polymerase Chain Reaction