Ouarian tumors of low malignant potential(OTLMP) or borderline tumors account for approximately 10% of all ovarian neaplasms. Borderline tumors have some but not all of the histologic characteristics af ma lignancy : stratification of epitheliial cells, with some degree of nuclear atypia a,nd inereased mitotic actitity but. without stromal invasion. We reviwed 20 published Rnglish written articlea from 1978 to 1992 and Korean gynecologic cancer regestry of 1990. In this review, we tried to concentrate on several debating is sues in OTLMP: 1) What kind of surgery is needed for each stages?, 2) Is postoperative adjuvant t.herapy needed?, 3) Jf needed, which type? Following result were obtained from the besis of 1516 patients with OTLMP. Patients withh OTLMIP are younger than those with invasive ovarian cancers', mean age was in their forties. The majority of patients(74.5%) had stage I disease, and the incidence dropped ahruptly to 9.4% for stage ll, 15.7% for stage III and 0.4% for stage IV. The most cammon histologic subtype was serous(56.7%), followed by muci noua(38.1%), However, interestingly in Korea and Japan, the mucinous type was the most common one. The primary treatment for OTLMP was surgery, and the conservative surgery to preserve fertility in young women was sufficient for stage I disease with careful follow-up. The majority of patients(79.1%) with stage I disease were treated by surgery alone. Adjuvant such as chemotherapy (CT) and/or radiotherapy(RT) could prolong the recurrence of disease a little later, but failed to increase diaease-free survival significantly in stage I disease. In stageII disease, the surgery should be a total abdominal hysterectomy and bilateral salpingo-oophorectomy with multiple sampling of the peritoneal cavity. About a third of patients with stageII disease received no adjuvant therapy and the others received CT and/or RT, however, there was no difference in outcome of recurrence and survival. In advanced stage. 15% of patients received no adjuvant therapy after initial debulking surgery, and the rest of patients received CT and/or RT. No differences in recurrence and survival between each groups were noticed , too. The status of second-look laparotomy(SLL) did not depend on the stage of the disease. Positive rate of SLL for stage I diaease was not statistically different from that for the combined stages II-IV. Survival for stage I at 5 years was reported to range from 80 to 100%, and even stage III had survival ranging from 64 to 96%. Long-term survival at 15~20 years was also good. Although it is quite difficult to make conclusions because of the lack of prospective randomized studies from this review, it appears clear that surgical removal of the tumor and careful follow-up of patients are all that are necessary in stage I disease and further multi-center prospective study for the effect of adjuvant therapy in advanced disease is definitely needed.
Drug Therapy ; Female ; Fertility ; Follow-Up Studies ; Humans ; Hysterectomy ; Incidence ; Japan ; Korea ; Mucins ; Peritoneal Cavity ; Prospective Studies ; Recurrence

PURPOSE: The aim of this study was to compare the relation between differently measured sports activities (metabolic equivalent [MET] and peak strain score) and distal radius bone mineral density in college-aged women. METHODS: Lifetime sports activity was scored in two different ways: 1) a sports activity score by multiplying the intensity (METs) and duration and 2) a sports activity score by adding up physical strain scores based on the ground reaction force of each sports activities. Bone mineral density was measured using dual energy x-ray densitometry (DTX-200) in the distal radius site. RESULTS: In stepwise multiple regression analysis, body weight and sports activities during the college period were significant positive predictors for distal radius bone mineral density. The explained variance of sports activity measured with a peak strain score (8.8%) for distal radius bone mineral density was higher than one measured with the MET score (3.3%). CONCLUSION: It can be concluded that sports activity scores based on MET and peak strain scores during college are very important for determining the bone mineral density in the distal radius site in women under 30.
Absorptiometry, Photon ; Bone Density/*physiology ; Data Interpretation, Statistical ; *Exercise ; Female ; Humans ; Interviews as Topic ; *Metabolic Equivalent ; Predictive Value of Tests ; Questionnaires ; *Sports ; Young Adult

PURPOSE: The purpose of this study was to identify the attributes, antecedents, and consequences of nurse's work interruptions. METHODS: Walker and Avant's concept analysis method was used to analyze this concept. Relevant articles published before August 2018 were searched through MEDLINE, CINAHL, EMBASE, KISS, and RISS databases using “interruption,” “work or task,” and “nurse” as keywords. RESULTS: The attributes of work interruption by nurses were as follows: 1) new tasks to do; 2) cognitive transition of work priorities; 3) loss of work continuity; 4) tasks to be resumed. The antecedents of work interruption were intrusion of unplanned events, internal and external factors that result in nurses forgetting their original intentions, an unpredictable work environment, and cultural climate where interruptions are considered as a part of the work process. The consequences of work interruption were decline in job satisfaction, trigger of work errors, lengthening of work completion time, decline in work productivity, increase in work stress, and delay of transferring needed information in a timely manner. CONCLUSION: The results of this study provide basic data to reduce the negative consequences of nurses' work interruptions, and contribute to expanding the knowledge necessary for improving patients' safety and nurses' performance.
Climate ; Efficiency ; Intention ; Job Satisfaction ; Methods ; Walkers ; Work Performance

BACKGROUND: Cardiopulmonary bypass during open heart surgery causes systemic inflammatory respose. IL-10 is an anti-inflammatory cytokine that inhibits inflammatory process and protects organ function by down regulation of pro-inflammatory cytokine release and maintenance of blood level balance with pro-inflammatory cytokines. MATERIAL ateial and Method: Plasma IL-10 levels were measured and analyzed in 22 patients who underwent open heart surgery (11 cases of coronary artery bypass graft, 11 cases of valve replacement) under cardiopulmonary bypass since 1988 January to July at Department of Thoracic and Czardiovascular surgery, Yeungnam University Hospital. 1g of methylprednisolone was administrated to thirteen patients randomly. Blood samp.es were taken and collected at the time of induction of anesthesia, 10 min before cardiopulmonary bypass, 10 min after starting of CPB, 10 min aftr aortic cross clamping, 10 min after ACC release, and 10 min, 2 hours, and 5 hours after CPB respectively. The plasma levels of IL-10 were determined by enzyme-linked immunosorbent assays (ELISA). Wilcoxon-Raule Sum test was used for statistical analysis. In all 22 patients, cardiopulmonary bypass time was used for statistical analysis. In all 22 patients, cardiopulmonary bypass time was 171+/-41.4 min and aortic cross clamp time was 118+/-36.5 min. Peak IL-10 level was achieved at 10 min after ACC (361.0+/-52.81pg/ml) and was decreased sharply at 2 hours after CPB. Peak IL-10 level was correlated positively with aortic cross clamp time (p=0.011); however, it did not correlated with bypass time (p=0.181). In valve replacement group, mean IL-10 level at peak point was 567.89+/-107.69 pg/ml and was significantly higher than that of coronary artery bypass group (205.67+/-192.70 pg/ml) (p<0.001). ACC time in valve replacement group was significantly longer than that of coronary artery bypass group (p<0.01), however, bypass time was not (p=0.212). Thirteen patients with steroid pretreatment before starting of CPB showed relatively higher plasma IL-10 level than in control group, however, no statistical significance was noted (p=0.19). CONCLUSION: plasma level of IL-10 was increased in association with cardiopulmonary bypass and revealed peak at 10 min after ACC release. IL-10 level was correlated positively with ACC time. Therefore, systemic inflammatory respeonse in association with cardiopulmonary bypass could be decreased by reducing ACC time during cardiac surgery.
Anesthesia ; Cardiopulmonary Bypass* ; Constriction ; Coronary Artery Bypass ; Cytokines ; Down-Regulation ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-10* ; Methylprednisolone ; Plasma ; Thoracic Surgery ; Transplants

The long QT syndromes have been classified into acquired or inheritary forms, both of which are associated with a characteristic type of life-threatening polymorphic ventricular tachycardia called torsade de points. Beta-adrenergic blocker is the first cholic treatment, but in those whom cardiac events are not prevented by beta - blockade, left thoracic sympathetic ganglionectomy may be useful in selected cases. A 50-year-old woman had an recurrent syncopal attack in which she was unconscious for 1-2 min and 1-2 times a month for 10 years. The EKG revealed that QT & QTc intervals were 744 and 632 msec respectively. Treatment with Beta-adrenergic blocker and calcium channel blocker was ineffective in preventing recurrence of syncopal spell. Therefore, she underwent left thoracic sympathetic ganglionectomy with thoracoscope. During the 9 months after operation, she was free of syncopal episodes and is doing well.
Calcium Channels ; Electrocardiography ; Female ; Ganglionectomy* ; Humans ; Long QT Syndrome* ; Middle Aged ; Recurrence ; Syncope ; Tachycardia, Ventricular ; Thoracoscopes*

Isolated congenital aneurysm of the left atrium with intact pericardium is a rate anomaly, which usually presents with arrhythmia, cerebral embolism or abnormalities on routine chest X-ray. Surgery is indicated in most cases to eliminate a potential source of systemic emboli and arrhythmias. A 42-year-old woman having cervical cancer, she was suspected of having a left atrial aneurysm on review of chest X-ray and confirmed by echocardiography and cardiac catheterization. Surgical resection of Left atrial aneurysm was achieved without complication using median sternotomy with cardiopulmonary bypass. The postoperative course was uneventful.
Adult ; Aneurysm* ; Arrhythmias, Cardiac ; Cardiac Catheterization ; Cardiac Catheters ; Cardiopulmonary Bypass ; Echocardiography ; Female ; Heart Atria* ; Humans ; Intracranial Embolism ; Pericardium ; Sternotomy ; Thorax ; Uterine Cervical Neoplasms

No abstract available.
Azoospermia* ; Sarcoidosis*

OBJECTIVE: The changes of the production of nitric oxide in preeclampsia are still controversial. To determine the changes of nitric oxide production in preeclamptic pregnancies, NOS activity and eNOS and iNOS expression in preeclamptic placentae were compared with those in normal placentae, and to determine the changes of nitirc oxide production according to the sites of placenta, NOS activity and eNOS expression in preeclamptic placentae were also compared with those in normal placentae. METHODS: Human placentae were obtained from 15 normal and 15 preeclamptic pregnant women at the time of cesarean section. NOS activity was assessed by measuring the conversion of [3H]-arginine into [3H]-citrulline. The eNOS and iNOS expression were assessed by using western blot analysis. Data were analyzed by Student t-test and paired t-test where appropriate. RESULTS: The NOS activity(judged by measurement of [3H]-citrulline production) was significantly increased in preeclamptic placentae compared to normal(P<0.05). In normal and preeclamptic pregnant placentae, the NOS activity in main stem villi was increased compared to that in terminal villi. However, the difference of NOS activity between main stem villi and terminal villi was not significant(P>0.05). Quantification of the autoradiographic images demonstrated that the integrated optical density of the immunoreactive bands of eNOS were significantly lower in preeclamptic placentae compared to normal(p<0.05). Conversely, the integrated optical densities of the bands of iNOS were significantly higher in preeclamptic placentae compared to normal(p<0.05). CONCLUSIONS: Although the eNOS expression in preeclamptic placentae was lower than that in normal placentae, the NOS activity was significantly higher in preeclamptic placentae than that in normal in this study. These are result from increased production of iNOS in the compensatory mechanisms for the decreased nitric oxide production in pre-eclamptic placentae.
Blotting, Western ; Cesarean Section ; Female ; Humans* ; Nitric Oxide Synthase* ; Nitric Oxide* ; Placenta* ; Pre-Eclampsia ; Pregnancy* ; Pregnant Women

PURPOSE: The goal of this study was to compare the effects of treatment of newborn babies with two different surfactants, Curosurf(R) and Surfacten(R). METHODS: We retrospectively reviewed the medical records from 2007 to 2009 and divided the patients into two groups: those who received Curosurf(R) (n=20) and those who received Surfacten(R) (n=21). We compared the groups for sex, gestational age (GA), birth weight, type of delivery, apgar score, maternal history, age at treatment, bronchopulmonary dysplasia (BPD), administration indomethacin for patent ductus arteriosus(PDA), necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH), periventricular leucomalacia (PVL), retinopathy of prematurity (ROP), pulmonary hemorrhage (PH), pneumothorax (PTX), duration of ventilation, need for oxygen, and administration. RESULTS: The demographic and clinical variables were similar in both groups. The gestational age for Curosurf(R) and Surfacten(R) were 32.7+/-3.1 and, 30.5+/-4.3 weeks, respectively (P=0.08). Six newborns in the Curosurf(R) group and 8 in the Surfacten(R) group developed BPD (P=0.59). No significant differences were noted for NEC, IVH, PVL, ROP, PH, PTX between the two groups (IVH, P=0.14; PVL, P=0.94; ROP P=0.94; PTX P=0.34). The mean duration of ventilation was 16.8 days with Curosurf(R) and 23.7 days with Surfacten(R), but these differences were not statistically significant (P=0.43). The differences in duration of need for oxygen and administration were also not statistically significant (P=0.92, 0.91, respectively). CONCLUSION: This study indicated no significant differences between Curosurf(R) and Surfacten(R). However, because of its convenience and the merit of minimal touching of the babies, the use of Curosurf(R) is recommended.
Apgar Score ; Birth Weight ; Bronchopulmonary Dysplasia ; Diterpenes ; Enterocolitis, Necrotizing ; Gestational Age ; Hemorrhage ; Humans ; Hydrogen-Ion Concentration ; Indomethacin ; Infant, Newborn ; Leukomalacia, Periventricular ; Medical Records ; Oxygen ; Pneumothorax ; Retinopathy of Prematurity ; Retrospective Studies ; Surface-Active Agents ; Ventilation

PURPOSE: Recently, vancomycin-resistant enterococci (VRE) have become one of the major nosocomial pathogens in Korea. However, there have been few studies on the epidemiology of VRE colonization among neonates. In this study, we investigated the prevalence of VRE colonization, risk factors for VRE, and how to control the spread of VRE infection in the Neonatal Intensive Care Unit (NICU) of Pusan National University Hospital (PNUH). METHODS: We retrospectively reviewed medical records of 192 neonates who were admitted to the NICU of PNUH from March 2006 to March 2007. Surveillance cultures from rectal swabs for detecting VRE were obtained weekly during the study period. We analyzed the prevalence of VRE and various risk factors. RESULTS: The rate of VRE colonization among NICU patients was 25% (48/192). Thirty five of these VRE colonized patients were transferred to the NICU from other local hospitals. Compared with the non-VRE group, the risk factors associated with VRE colonization were lower birth weight, congenital heart disease, applied mechanical ventilation, use of a central venous catheter, chest tubing, a history of surgery, and use of antibiotics. CONCLUSION: VRE colonization among patients admitted to the NICU is rapidly increasing. Monitoring and managing premature neonates from the beginning of the birth process, avoiding many invasive procedures, avoiding antibiotics such as vancomycin and third generation cephalosporin are important for preventing the emergence and spread of VRE colonization in the NICU.
Anti-Bacterial Agents ; Birth Weight ; Central Venous Catheters ; Colon ; Heart Diseases ; Humans ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Korea ; Medical Records ; Parturition ; Prevalence ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Thorax ; Vancomycin ; Vancomycin Resistance