BACKGROUND: In these days of increasing need for medical treatment, and the trend of changing lifestyles for personal health care, the position of medical treatment has led to the increase of careful and various services to every member of the community. But the reality of medical treatment, including the present situation of the emergency room in general hospital is recognized as the cause of those dissatisfactions and complaints of both patients and their caregivers. So this study aims at contributing to the harmonious relation between doctor and patient. METHODS: This study has been carried out by the questionnaire method on the basis of the relatively reasonable 331 papers among 430 questionnaire papers of the patients and their caregivers hospitalized by way of the emergency room in Cheonju Yeong Dong Hospital from Sep. 1994 to Apr. 1995. RESULTS: Among 331 subjects of this questionnaire, there were 121 male patients(36.6%), 76 female patients(23.0%), 80 male caregivers(24.2%), 54 female caregivers. The subjects were compaced of 23 teenagers(7.8%), 74 in their twenties(22.4%), 135 in their thirties(40.8%), 52 in their fourties(15.7%), 29 in their fifties(8.8%), 12 in their sixties(3.6%), 6 in their seventies(1.8 %). Both patients and their caregivers seemed to have a great dissatisfactions and complaints, which can be extraneous to medical treatment. Many patients complained of the unbearable situations such as delayed pain control before after a first-aid treatment, as well as various poor condition of medical treatment in emergency room. Their caregives complained of the lack of a thought explanation of diagnosis and prognosis, as well as the tedious waiting time before taking medical teratment. There were many cases where the emergent patients took medical treatment with some dissatisfa'ctions and complaints of medical staffs or medical donditions. CONCLUSIONS: When using the emergency room in a general hospital, both patients and their caregivers experiance a great deal of dissatisfactions and complaints, which can be followed by a distrust of the hospital and an obstacle of medical treatment. The medical staff, such as the hospital authorities, doctors, and nurses should make various improvements upon the medical conditions of the emergency room in general hospital.
Caregivers ; Delivery of Health Care ; Diagnosis ; Emergencies* ; Emergency Service, Hospital* ; Female ; Hospitals, General ; Humans ; Life Style ; Male ; Medical Staff ; Prognosis ; Surveys and Questionnaires

No abstract available.
Foreign Bodies* ; Granuloma, Foreign-Body* ; Lipectomy*

PURPOSE: Many studies have shown that regular exercise produces positive effects on health. The purpose of this study was to examine the differences of health-related quality of life by stage of exercise and the interaction effect of age, sex and stage of exercise. METHOD: A total of 1266 participants were interviewed with structured questionnaire. Stage of exercise was assessed with a single item and respondents were classified with respect to exercise intention and behavior. Health-related quality of life was measured with SF-36 Health Survey Questionnaire. RESULT: Health-related QOL were found to be different by stage of exercise. The subjects who were reached maintenance stage showed significantly higher scores on physical functioning, bodily pain, general health perception, mental health, role limitation due to emotional problems, social functioning, and vitality than those in preparation, contemplation, and precontemplation stage. In addition a significant interaction effect between stage of exercise and age was found on physical functioning, bodily pain, general health perception, mental health, and vitality. CONCLUSION: Perceived health-related QOL varies with stage of exercise. This finding suggests that health is related to both intention and behavior of exercise. Therefore it is important to consider cognitive-motivational and behavioral stage of change for developing exercise programs.
Adult* ; Health Surveys ; Humans ; Intention ; Mental Health ; Quality of Life* ; Social Problems ; Surveys and Questionnaires

Eating ; Female ; Hospitals, General ; Humans ; Male ; Mandible ; Mandibular Fractures ; Respiration ; Tooth ; Violence

We present a review of 131 cases in which blood was retrieved and reinfused using Constavac Blood Conservation blood retrieval and reinfusion device postoperatively. The total number of cases in this study included 84 THA, 19 Rev. THA, 16 unilateral TKA and 12 bilateral TKA. The examinations of hemoglobin, hematocrit, antithrombin III, fibrinogen and D-dimer were initiated prospectively before surgery in each case. These parameters were also examined at postoperative day 1 and at day 7 for the evaluation of safety of Constavace Blood Conservation system. The aerobic and anaerobic bacterial culture tests of draining blood were also taken. The results were as follows: 1. The amount of total blood lost averaged 1264±466cc in THA, 2187±632cc in Rev. THA, 1651±543cc in unilateral TKA and 3445±1532cc in bilateral TKA. 2. The amount of blood retrieved and transfused averaged 499±227cc(39% of total lost blood) in THA, 578±527cc(26%) in Rev. THA. 953±451cc(58%) in unilateral TKA and 2219±1191cc(64%) in bilateral TKA. The amount of reinfusion averaged 71% of blood retrieved in THA, 62% in Rev. THA, 80% in unilateral TKA and 84% in bilateral TKA. 3. Fifty one cases out of 84 cases in THA and 14 case out of 28 cases in TKA underwent operation without homologous blood replacement. In the remaining cases, transfused banked blood averaged 364cc(29% of total lost blood) in THA, 620cc(27%) in Rev. THA, 485cc(29%) in unilateral TKA and 914cc(26%) in bilateral TKA. 4. There were no significant change in hemoglobin and hematocrit at postoperative day 7 compared with the preoperative state. 5. The antithrombin III, fibrinogen and D-dimer were converted to normal range at postoperative day 7. 6. The aerobic and anaerobic bacterial culture tests of reinfusing blood proved to be negative in all cases.
Antithrombin III ; Arthroplasty ; Blood Transfusion, Autologous ; Fibrinogen ; Hematocrit ; Joints ; Prospective Studies ; Reference Values

Of 489 asymptomatic women who were referred to our institute from other screening clinics, 46 were eventually proven to be breast cancer patients, and this number equated to 8.1% of the 565 breast cancer patients treated in our institute during the period of January 1997 to December 1998. Among the 46 cancer patients of the initial 489 asymptomatic women, twenty-five(54.35%) were detected by mammogram alone, six(13.04%) by clinical breast examination(CBE) alone, and the remaining 15(32.61%) by both mammogram and CBE. In context with age, the mammographic sensitivity for cancer detection was 100% for women aged over 60, 91% for 50s, 78.9% for 40s, and 75% for 30s, and inversely correlated with the patient's age. Among the 25 cancers detected by mammogram alone, 18(72%) belonged to DCIS or stage|. In contrast, four(66.7%) of six cancers detected by CBE alone and nine(60%) of 15 cancers by both CBE and mammography were included in stage II a or II b. However, the total incidence of early cancers(stage 0 and I) was significantly higher in the screening group than in the symptomatic group(P<0.01). These results suggest that the role of mammography is important in the detection of cancers in their earlier stage and CBE is helpful in reducing false negative results in breast cancer screening. In conclusion, film mammography is the best tool for the detection of microcalcification and is useful for the detection of earlier lesions, but is not perfect for the detection of breast cancer particularly in young women. A careful CBE is an essential part of breast screening in order to reduce false-negative results.
Breast Neoplasms ; Breast* ; Carcinoma, Intraductal, Noninfiltrating ; Female ; Humans ; Incidence ; Mammography ; Mass Screening

Nitric oxide(NO) has been known to play an important role as a signal molecule in many parts of the organism as well as a cytotoxic effector molecule of the nonspecific immune response. Excessive NO has been reported to exert cytotoxic effect by direct toxicity or by reacting to superoxide radicals during ischemia-reperfusion. Therefore is strongly needed a study directly measuring NO release designed to better clarify roles of NO in ischemia-reperfusion injury and its mechanism. Male Sprague-Dawley rats were anesthetized with urethane(1g/kg) intraperitoneally, and pedicled gastrocnemius muscle flaps were elevated. The elevated flaps were subjected to 4 hours of arterial ischemia and then reperfused for 2 hours. And then NO current was measured in the gastrocnemius muscle using NO-selective microelectrode system. NO release gradually increased and then decreased in the rat gastrocnemius muscle during both ischemic and reperfusion period. The average NO releases from baseline during ischemia and reperfusion were 10405 +/- 2663 and 2513 +/- 970 picoamperes(pA), respectively. The ischemia-reperfusion caused substantial histological damage in the skeletal muscle, in which a profusion of red blood cells was observed due to extravasation of vessels, rupturing of microcirculation, and leukocyte infiltration, compared to the damage in control and ischemic rat gastrocnemius muscles. From the above results, ischemia-reperfusion injury was developed more severely during reperfusion than ischemia, and NO increased during ischemia and reperfusion as a biphasic pattern in the rat gastrocnemius muscle.
Animals ; Erythrocytes ; Humans ; Ischemia ; Leukocytes ; Male ; Microcirculation ; Microelectrodes ; Muscle, Skeletal* ; Muscles ; Nitric Oxide* ; Rats* ; Rats, Sprague-Dawley ; Reperfusion ; Reperfusion Injury ; Superoxides

We report the sonographic features of an intracystic papillary carcinoma of the breast presenting as recurrent hemorrhagic cysts following trauma. A 56-year-old woman presented with palpable breast masses after a traumatic event; sonography showed multiple, well-defined, hemorrhagic cysts. Hemorrhagic fluid was evacuated by fine needle aspiration with no residual lesions. Cytology was negative for malignancy. Five months later, the mass reappeared; sonography demonstrated multiple cysts with solid nodules. US-guided core biopsy and surgery revealed invasive papillary carcinoma. We suggest close follow-up of cystic masses, even with negative cytology, and performance of surgical excisional biopsy in cases of rapid refilling after aspiration.
Ultrasonography, Mammary/methods ; Recurrence ; Middle Aged ; Mammography/methods ; Lymphatic Metastasis ; Humans ; Hemorrhage/*diagnosis/ultrasonography ; Female ; Diagnosis, Differential ; Cysts/*diagnosis/ultrasonography ; Carcinoma, Papillary/*diagnosis/ultrasonography ; Breast Neoplasms/*diagnosis/ultrasonography

PURPOSE: Although androgens are the main steroids controlling the growth of prostate glands, estrogens are also important in the regulation of its growth. Prostate cancer cells, like other cancer cells, maintain high levels of polyamines. In LNCaP cells, apoptosis is induced by mifepristone. During the process of cell death, the regulation of ROS production, caspase-3 activation and poly (ADP-ribose) polymerase cleavage were investigated in the presence of estrogen and polyamines to identify their possible roles. MATERIALS AND METHODS: The cell growth was assessed using the MTT assay, and the intracellular ROS production by the DCFH-DA assay. The p53 protein expression, activation of caspase-3 and PARP cleavage were checked by Western blotting, with specific antibodies to each. RESULTS: The growth and viability of the cells were significantly inhibited, in a dose- and time-dependent manners, by mifepristone (MIF) treatment. The production of ROS were dependent on the MIF dosage. The activation of caspase-3 and cleavage of PARP also increased with the duration of MIF treatment. The expression of p53 protein also increased with increases in the MIF incubation time. E2 severely inhibited the ROS production, caspase-3 activation and PARP cleavage. However, polyamines only inhibited the ROS production, without influencing the caspase-3 activation or PARP cleavage. CONCLUSION: In LNCaP cells, MIF induces apoptosis through ROS production. The expression of p53 protein, caspase-3 activation and PARP cleavage accompanied the process of apoptosis. The apoptotic processes were inhibited by E2, but polyamines only inhibited the ROS production, implying the multifunctional role of E2, in addition to its role as a free radical scavenger.
Androgens ; Antibodies ; Apoptosis* ; Blotting, Western ; Caspase 3 ; Cell Death ; Estrogens* ; Mifepristone ; Polyamines* ; Prostate* ; Prostatic Neoplasms* ; Steroids

OBJECTIVE: To compare the rate of progression of de novo lesion between the cardiac rehabilitation (CR) and control groups. METHODS: This is a retrospective observational study. Patients who received drug-eluting stent (DES) due to acute coronary syndrome were included as subjects. The CR group received eight weeks of early CR program, and sustained a self-exercise program in the homes. The control group was instructed to exercise independently. Nine months after the first insertion of DES, we implemented follow-up coronary angiography, and compared the rate of progression of de novo lesion by quantitative angiographic measurement between the two groups. RESULTS: A total of 81 patients were recruited as subjects to CR group (n=32) or control group (n=49). At nine months, late luminal loss was 0.04+/-0.23 mm in the CR group and 0.00+/-0.31 mm in the control group (p=0.54, observed power=0.10). Late loss was -0.90%+/-9.53% in the CR group and 0.80%+/-11.15% in the control group (p=0.58, observed power=0.05). No target lesion revascularization procedures were needed in the CR group, while two in the control group (p=0.25). In the CR group, mean VO2max was significantly improved from 24.36+/-5.00 to 27.68+/-5.24 mL/kg/min (p<0.001). CONCLUSION: We could not observe a statistically significant difference in the progression rate of de novo lesion between the CR and control groups. Thus the current amount of nine months exercise-based CR program does not seem to have a distinct impact on the retardation of de novo coronary lesion in patients who received percutaneous coronary intervention with DES.
Acute Coronary Syndrome ; Coronary Angiography ; Coronary Stenosis ; Drug-Eluting Stents ; Follow-Up Studies ; Humans ; Observational Study ; Percutaneous Coronary Intervention ; Phenobarbital ; Rehabilitation* ; Retrospective Studies ; Stents*