The Influence of Dispositional Optimism and Food-related Lifestyle on Health Promoting Behavior in Middle-Aged Early Onset Stroke Patients / 재활간호학회지

Purpose@#This study aimed to investigate the influence of the propensity for dispositional optimism and food-related lifestyle on health promotion behaviors in middle-aged early onset stroke patients. @*Methods@#With a descriptive study design, this study covered middle-aged patients aged 40 to 65 years old who were admitted to P city general hospital after the onset of hemorrhagic or ischemic stroke. Date were collected with a questionnaire including dispositional optimism, food-related lifestyle, and health promoting behaviors. Using SPSS/MIN 23.0 program, data were analyzed with descriptive statistics, frequency, t-test, one-way ANOVA, Pearson's correlation coefficients and multiple regression. @*Results@#The dispositional optimism had a significant correlation with health promotion behavior. Positive awareness and coping with life (β=.28, p<.001) showed the greatest influence on health promotion behavior. In food-related lifestyle, health type (β=.26, p<.001), foodie type (β=.20, p=.002), and stable type (β=.14, p=.027) and occupation (β=-.14, p=.037) influenced on health promotion behavior. The explanatory power value of regression model was 46.5% and it was statistically significant (F=16.73, p<.001). @*Conclusion@#An early program may help health promotion behavior by enhancing the dispositional optimism and food-related lifestyle in middle-aged early onset stroke patients.

Heterotopic Mesenteric Ossification Following Damage Control Surgery

No abstract available.

Antibacterial effect of lidocaine in various clinical conditions

BACKGROUND: Infection, one of the complications associated with procedures, can cause fatal outcomes for patients. Although the local anesthetic agent we use is less susceptible to infection due to its antibacterial action, we performed this study to check the change in the antibacterial effect of lidocaine in various clinical conditions. METHODS: After exposing lidocaine to five contaminated environments, we checked on whether the bacteria could be cultured in blood agar plate (BAP) media. In each contaminated environment, lidocaine was exposed for 4 h (n = 9) and 8 h (n = 9), and the results were compared. Lidocaine was swabbed with chlorhexidine (group A), brought into contact with saliva (group B), skin (group C), an operating room floor and an outpatient room floor (group D), operating room air for 24 h (group A-a), and outpatient room air for 24 h (group A-b). After exposure, the culture was initiated. RESULTS: In 2 of 9 BAP media where lidocaine was exposed to saliva (group B) for 8 h, growth of a colony was observed. In gram staining, it was found to be Streptococcus viridans. No bacteria were found in any other groups. CONCLUSIONS: Though lidocaine has strong antibacterial activity, it has been found that long-term exposure to a contaminated environment reduces its antibacterial activity and that drug contamination can be heavily affected not only by environmental but also human effects. Therefore, the use of aseptic drugs is necessary, and stopping the reuse of the drug is a way to prevent complications, including infection.

Pneumatic Colorectal Injury Caused by High Pressure Compressed Air

The pneumatic colorectal injury caused by high pressure compressed air are rare and can be fatal. Herein, we present a case of 45-year-old male who developed sudden onset of severe abdominal pain after cleaning the dust on his pants with high pressure compressed air gun dust cleaner. Emergent exploratory laparotomy was done which findings are a huge rectal perforation with multiple serosal and subserosal tear in sigmoid to splenic flexure of colon. Anterior resection with left hemicolectomy, and temporary transverse colostomy was performed. Postoperative course was uneventful. Recently, prognosis is generally favorable because of prompt diagnosis and emergent surgical management.

Experience of Penetrating Gunshot Wound on Head in Korea

Craniocerebral gunshot injuries (CGIs) are extremely seldom happened in Korea because possession of individual firearm is illegal. So, CGIs are rarely encountered by Korean neurosurgeons or Korean trauma surgeons, though in other developing countries or Unites states of America their cases are indefatigably increasing. Management goal should focus on early aggressive, vigorous resuscitation. The treatments consist of immediate life salvage through correction of coagulopathy, intracranial decompression, prevention of infection and preservation of nervous tissue. There have been few studies involving penetrating CGIs in Korea. Here we present a case of penetrating gunshot wound in Korea. We present a 58-year-old man who was unintentionally shot by his colleague with a shotgun. The patients underwent computed tomography (CT) for assessment of intracranial injury. The bullet passed through the left parietal bone and right lateral ventricle and exited through the posterior auricular right temporal bone. After CT scan, he arrested and the cardiopulmonary resuscitation was conducted immediately. But we were unable to resuscitate him. This case report underscores the importance of the initial clinical exam and CT studies along with adequate resuscitation to make the appropriate management decision. Physicians should be familiar with the various injury patterns and imaging findings which are poor prognostic indicators.

Right-sided diaphragmatic rupture in a poly traumatized patient

Traumatic diaphragmatic rupture (TDR) is uncommon, and may be associated with other severe life-threatening injuries after blunt trauma. Recently, we experienced a right-sided TDR patient with other multiple life-threatening injuries. A 59-year-old female inflicted with a right-sided TDR accompanied by herniated liver was treated with thoracoscopic exploration. We successfully managed associated life-threatening injuries such as traumatic brain injury and pelvic bone fractures with bleeding, simultaneously.

Adaptation of New Oral Anticoagulants for Warfarin Anticoagulated Patient with Traumatic Ongoing Hemorrhage

The traditional drug for anticoagulation in those with a high risk of thrombosis is a vitamin K antagonist, such as warfarin. On the other hand, this drug has several limitations and hemorrhagic complications. Recently, novel or non-vitamin K-dependent antagonist oral anticoagulants (NOACs) have been developed to solve these problems. This paper presents a case of adaptation of NOAC for a warfarin anticoagulated patient with traumatic ongoing hemorrhages with a discussion of the clinical implications of NOAC.

The effect of midazolam dose and age on the paradoxical midazolam reaction in Korean pediatric patients / 대한마취과학회지

BACKGROUND: Although midazolam administration may occasionally induce a paradoxical episode, such as threatened crying and violent behavior in children, systematic studies on the causes of paradoxical reaction are limited. We investigated the effect of children's age and a dose of midazolam on the paradoxical reaction. METHODS: A total of one hundred sixty four children of 1-3 years and 3-5 years, were enrolled in this study. Each age group randomly received 0.05 mg/kg or 0.1 mg/kg of intravenous midazolam (41 patients/group). RESULTS: The incidence of paradoxical midazolam reaction in the study groups, 1-3 years with 0.1 mg/kg of intravenous midazolam, 1-3 years with 0.05 mg/kg, 3-5 years with 0.1 mg/kg, and 3-5 years with 0.05 mg/kg were as follows: 29.3%, 12.2%, 7.3% and 2.4%, respectively. The incidence among the 4 groups was significantly different (P = 0.002), highest in the 1-3 years receiving 0.1 mg/kg of midazolam (29.3%). Both age (P = 0.004, OR [95%CI] = 5.3 [1.7-16.8]) and dose of midazolam (P = 0.036, OR [95%CI] = 3.0 [1.1-8.4]) were risk factors. Perioperative clinical data including anxiety scales of children were not associated with the paradoxical midazolam reaction. CONCLUSIONS: In conclusion, we suggest that children less than 3 years old receiving higher dose of intravenous midazolam are at risk for the paradoxical midazolam reaction.

A case of anaphylactic reaction to oral cefaclor / 대한내과학회지

Antibiotics induced anaphylaxis is one of the most acute and potentially fatal drug-related adverse reactions. Cefaclor, an oral second-generation cephalosporin with a beta lactam ring, is used various infectious diseases of the respiratory tract. Few cases of cefaclor anaphylaxis have been rarely reported. Here we report a case of anaphylactic reaction to cefaclor in a 40-year-old female patient. She developed systemic reaction comprised of generalized hives with itching, vomiting, abdominal pain, and hypotension. She was treated on our ER with intravenous fluids, intravenous diphenhydramine and subcutaneous epinephrine. Since four month ago, she had developed generalized pruritic eruptions with flu-like symptoms. The rash resolved the same day after treated with intravenous diphenhydramine. On detailed history taking for medication, we had known that she received a same prescription containing a cefaclor at every episode. Subsequently we tested the patient with cefaclor and conducted an intradermal skin test and an ELISA to cefaclor-HSA conjugate. She showed a positive response. Cefaclor is widely used for common infections, physicians should anticipate the possibility of anaphylactic reaction treated with this agent, particularly in cases of multiple exposure.

A case of cobalt-induced occupational asthma / 천식및알레르기

Cobalt is known as a hard metal used in cement and various household products. Occupational exposure occurs during the production of cobalt powder, the processing of hard metals, the polishing of diamonds, and the processing of cobalt alloys. There have been cases of cobalt induced interstitial pneumonitis, occupational asthma, and allergic dermatitis. We report a 21-year-old patient with rhinitis and asthma induced by cobalt in a factory manufacturing diamond-cutter made from hard metal. The patient complained of rhinorrhea, sneezing, and dyspnea 5 months after working in the diamond-cutting industry. Skin prick test and patch test with cobalt(CoCl2) showed negative responses. Bronchoprovocation with CoCl2 showed a early asthamtic response. In conclusion, we report a case of cobalt-induced occupational rhinitis and asthma who worked in a factory manufacturing diamond-cutter. Further studies will be needed to investigate the pathogenesis of bronchoconstriction induced by cobalt.

Evaluation of multi-allergen dipstick (Allergodip(R)) as a screening test in allergy patients / 천식및알레르기

BACKGROUND AND OBJECTIVE: The Allergodip(R) multi-allergen screening test is a simple method for measuring serum-specific IgE to common inhalant allergens simultaneously. The dipstick contains nine separate allergen pads including D. pteronyssinus, Alternaria, cat epithelium, dog epithelium, English plantain, mugwort, birch, rye and six-grass mixture pollen extracts, as well as positive and negative controls. This study was performed in order to evaluate sensitivity and specificity of this test in comparison to skin prick test. MATERIALS AND METHOD: We compared the results obtained by skin prick test (PT) to those obtained by Allergodip(R) test (AT) in 30 patients with various allergic diseases. The skin reactivity was presented as allergen to histamine ratio (A/H) and results of the AT test were assessed visually and classified into Allergodip(R) class 0-4. RESULTS: Compared with PT, results of AT gave a sensitivity of 55.3% and a specificity of 93.8% when the A/H > OR = 3 was considered a positive response for PT. The agreement rate between positive PT and positive AT to each antigen was 82.6% in D. pteronyssinus, 82.9% in Alternaria, 71.1% in dog epithelium, 57.2% in mugwort pollen, 57.2% in birch pollen, 49.9% in grasses mixture pollen, 23.6% in cat epithelium and 6.7% in rye grass pollen, respectively. Significant correlations were noted between PT and AT classes in D. pteronyssinus, Alternaria, dog epithelium, mugwort pollen, birch pollen, and in grasses mixture pollen (p < 0.05, respectively), but not in cat epithelium or rye grass pollen. CONCLUSION: We concluded that Allergodip(R) test is useful in screening serum-specific IgE antibodies against multiple allergens at one time.

Factors associated with clinical severity determined by requirement for systemic corticosteroid therapy in adult asthmatic patients / 천식및알레르기

BACKGROUND: Most studies involving factor analysis on clinical severity of bronchial asthma are short-term and cross-sectional. OBJECTIVES: We evaluated the clinical severity of bronchial asthma according to requirement of systemic corticosteroid therapy, and analyzed the factors associated with long-term systemic corticosteroid therapy. METHODS: The records of 158 asthmatic patients (including 76 patients followed for one year) visiting the clinic of Allergy-Immunology of Ajou University Hospital between June, 1997 and May, 1999 were reviewed retrospectively. RESULTS: Among the 76 asthmatic patients who had been followed-up for one year, asthmatic patients (n=28) treated with systemic corticosteroid for more than 60 days had lower initial FEV1(% predicted) values (p=0.001), lower prevalence of concomitant allergic diseases (p= 0.04), and lower frequency of allergen-specific immunotherapy (p=0.006) than asthmatic patients treated with systemic corticosteroid for less than 60 days (n=48). Among the 158 asthmatic patients, 87 patients (55%) were atopic asthmatics and 71 patients (45%) were nonatopic asthmatics. Nonatopic asthmatics showed older age at initial visit (p<0.001), lower serum total IgE levels (p=0.02), lower prevalence of concomitant allergic diseases (p=0.004), and higher prevalence of aspirin-sensitivity (p<0.001) than atopic asthmatic patients. Among the 76 patients followed for one year, nonatopic asthmatic patients were treated with significantly higher cumulative-doses of systemic steroid than atopic asthmatic patients (p=0.04). CONCLUSION: Initial pulmonary function and nonatopy are significantly associated with clinical severity determined by requirement of systemic corticosteroid therapy in adult asthmatic patients.