OBJECTIVES: The treatment setting of mental hospital has a great influence on the outcome of treatment. The authors compared the characteristics of treatment setting of the open and the closed wards in a mental hospital and the attitudes of the staff and patients on each ward. METHODS: Total four wards two typical open wards and two typical closed wards were selected and each contained one male ward and one female ward. Ward Atmosphere Scale(WAS) was conducted to each and the mean scores of suscales of WAS were compared by using Student's t-test. RESULTS: 1) The closed ward was similar to the treatment setting of control-oriented program which stresses the stator control and the nile of ward and ignores the autonomy of patients and such a evaluation was perceived more by the patients than by the staff. 2) The open ward supported and encouraged the staff and patients and focused on solving the practical problems of the patients, and especially the staff perceived it as the treatment program the activated ward. 3) It was shown that the open ward was more therapeutic and while it focused on the autonomous problem solving, the closed ward pup enguasis on the protection of patients. In addition, the patients were more sensitive to the difference of setting between the two wards than the star. CONCLUSION: In conclusion, if various and realistic programs were offered to the patients in the ward, the open ward would be proposed as a desirable therapeutic form for the chronic psychiatric inpatients.
Atmosphere ; Female ; Hospitals, Psychiatric* ; Humans ; Inpatients ; Male ; Problem Solving

No abstract available.

PURPOSE: We performed a pulmonary function test with simple, computerized spirometry composed of pneumotachometry and evaluated the predicted normal values of air flow rates and lung volumes in healthy Korean children. We calculated each of the simple and complex linear and logarithmic regression equations setting the predicted values. METHODS: Four hundred and fifty-two healthy children were enrolled from December, 1994 to August, 1995. We measured air flow rates (FVC, FEV1, PEFR, FEF25-75) and lung volumes (VC, ERV, IC, VE). Data was analyzed according to sex, age, height, weight, and body surface area. RESULTS: In 452 children (male : 282, female : 170), the age distribution was from 8 through 19 years, the height from 121cm to 180cm and the weight from 21kg to 79kg. We could get determinant coefficients between parameter and air flow rates. In boys, height showed the highest determinant coefficient in examing air flow rates, followed by age, body surface area and weight in order. In girls, body surface area showed the highest determinant coefficient in examing air flow rates, followed by height, weight, and age in order. A determination coefficient to the parameter was the highest with FVC. We could get determinant coefficients between parameter and lung volumes. Boys showed high determinant coefficient with only IC, girls with VC and IC. In examing IC, height showed the highest determinant coefficient, followed by body surface area and weight in order. Predicted values of pulmonary function test were generally higher in boys than in girls. CONCLUSION: After performing the pulmonary function test in healthy Korean children, we report their normal values of air flow rates, lung volumes and regression equations for the predicted values.
Age Distribution ; Body Surface Area ; Child* ; Female ; Humans ; Lung ; Peak Expiratory Flow Rate ; Reference Values ; Respiratory Function Tests* ; Spirometry

PURPOSE: Tumors at the level of the anorectal junction had required total levator-ani muscle excision to achieve an adequate resection margin. However, in the cases of tumor invading ipsilateral levator-ani muscle and intact external sphincter, en bloc resection of rectum with levator-ani muscle including tumor would be possible. This hemilevator excision (HLE) technique enables preserving the anal sphincter function while obtaining oncologic clearance and avoiding permanent colostomy in those patients. This study aimed to evaluate the surgical outcomes and feasibility of HLE. METHODS: Data on 13 consecutive patients who underwent HLE for pathologically proven low rectal cancer were retrospectively collected. All 13 patients presented low rectal cancer at the anorectal ring level that was suspected to invade or abut to the ipsilateral side of the levator-ani muscle. RESULTS: A secure resection margin was achieved in all cases, and anastomotic leakage occurred in 2 patients. During follow-up, 3 patients experienced tumor recurrence (2 systemic and 1 local). Among 6 patients who underwent diverting ileostomy closure after the index operation, 2 complained of fecal incontinence. The other 4 patients without fecal incontinence showed <10 times of bowel movement per day. Accessing their incontinence scale, mean Wexner score was 9.4. CONCLUSION: HLE is a novel sphincter-preserving technique that can be a treatment option for low rectal cancer invading ipsilateral levator-ani muscle, which has been an indication for abdominoperineal resection (APR) or extralevator APR. However, the long-term oncologic and functional outcomes of this procedure still need to be assessed to confirm its validity.
Anal Canal* ; Anastomotic Leak ; Colostomy ; Fecal Incontinence ; Follow-Up Studies ; Humans ; Ileostomy ; Pelvic Floor* ; Rectal Neoplasms* ; Rectum ; Recurrence ; Retrospective Studies

BACKGROUND: Bisphosphonates are now well established as successful antiresorptive agents for the prevention and treatment of osteoporosis. We investigated the effect of cyclic intravenous treatment with an aminobisphosphonate, pamidronate in cases of primary osteoporosis. METHODS: Eighteen patients with primary osteoporosis (bone mineral density BMD t-score < -2.5) received four courses of pamidronate (30 mg with 500 mL normal saline over 2 hours every 3 months). The serum biochemical parameters and bone turnover markers were measured before each treatment. The bone pain score, medication score, and the side effects were also monitored. BMD and simple spine X-ray were performed before and 1 year after of treatment. RESULTS: BMD at the lumbar spine (L2-4) significantly increased from 0.798+/-0.110 g/cm2 to 0.860+/-0.107 g/cm2 after 1 year of treatment with pamidronate: by +8.3+/-9.4% of baseline. BMDs at the femoral neck, Ward s triangle and the trochanter also increased, but not significantly. Serum total alkaline phosphatase (p<0.05) and urine deoxypyridinoline/creatinine (p=0.069) decreased with treatment. Other bone turnover markers were unchanged. The bone pain score decreased significantly. None of the patients experienced a new fracture during treatment. The frequency of the side effects following the first infusion was 61.1% (a transient fever and myalgia with flu-like symptoms in 10 patients and mild phlebitis in 1 patient). However, only two patients complained of flu-like symptoms after second infusion, and no patient complained following the third infusion. CONCLUSION: Cyclic intravenous treatment of pamidronate every three months was effective in increasing BMD and in the decreasing bone turnover rate, and was relatively well tolerated in primary osteoporotic women.
Alkaline Phosphatase ; Bone Density ; Bone Density Conservation Agents ; Diphosphonates ; Female ; Femur ; Femur Neck ; Fever ; Humans ; Myalgia ; Osteoporosis ; Phlebitis ; Spine

PURPOSE: To investigate the utility of surgical treatment of clavicle shaft fracture using a percutaneous towel clip reduction and intramedullary fixation. MATERIALS AND METHODS: This study was conducted for total 16 cases of patients who had no neurovascular injury and a few comminuted bone fragment among patients with clavicle shaft fracture from January 2002 to July 2003. The method of operation was percutaneous towel clip reduction and intramedullary fixation. The clinical and radiological results were evaluated. RESULTS: Radiologically, 15 cases showed bone unions and the average time was 9.1 weeks. According to Kang's criteria clinically, there were 14 cases which were more than an excellence. One case substituted open reduction and nailing fixation due to a medial migration of K-wire and re- displacement of fracture even in 1 week. However, there wasn't any other major complication. CONCLUSION: Due to its having no additional injury to soft tissues, no scar formations, and its short operation time, percutaneous towel clip reduction and intramedullary fixation will be very useful as one of the treatments of clavicular shaft fracture if it follows correct surgical indications.
Cicatrix ; Clavicle* ; Humans

Background: This study aimed to evaluate ChatGPT’s performance accuracy in responding to questions from the national dentalhygienist examination. Moreover, through an analysis of ChatGPT’s incorrect responses, this research intended to pinpoint the predominant types of errors. Methods: To evaluate ChatGPT-3.5’s performance according to the type of national examination questions, the researchers classified 200 questions of the 49th National Dental Hygienist Examination into recall, interpretation, and solving type questions. The researchers strategically modified the questions to counteract potential misunderstandings from implied meanings or technical terminology in Korea. To assess ChatGPT-3.5’s problem-solving capabilities in applying previously acquired knowledge, the questions were first converted to subjective type. If ChatGPT-3.5 generated an incorrect response, an original multiple-choice framework was provided again. Two hundred questions were input into ChatGPT-3.5 and the generated responses were analyzed.After using ChatGPT, the accuracy of each response was evaluated by researchers according to the types of questions, and the types of incorrect responses were categorized (logical, information, and statistical errors). Finally, hallucination was evaluated when ChatGPT provided misleading information by answering something that was not true as if it were true. Results: ChatGPT’s responses to the national examination were 45.5% accurate. Accuracy by question type was 60.3% for recall and 13.0% for problem-solving type questions. The accuracy rate for the subjective solving questions was 13.0%, while the accuracy for the objective questions increased to 43.5%. The most common types of incorrect responses were logical errors 65.1% of all. Of the total 102 incorrectly answered questions, 100 were categorized as hallucinations. Conclusion ChatGPT-3.5 was found to be limited in its ability to provide evidence-based correct responses to the Korean nationaldental hygiene examination. Therefore, dental hygienists in the education or clinical fields should be careful to use artificial intelligence-generated materials with a critical view.

Adipsic hypernatremia cause chronic hyperosmolality and hypernatremia through a combination of impaired thirst and osmotically stimulated antidiuretic hormone secretion. This syndrome can be grouped together as disorders of osmoreceptor dysfunction due to the various degrees of osmoreceptor destruction related with different types of intracranial lesions around the anterior hypothalamus, consistent with the location of primary osmoreceptor cells. Adipsic hypernatremia, associated with developmental disorder of corpus callosum, is very rare. Most cases are diagnosed at infancy and early childhood; the replacement of desmopressin is necessary. Herein, we report adipsic hypernatremia associated with anomalous corpus callosum in adult with mental retardation; they were treated with only free water without desmopressin.
Adult ; Corpus Callosum ; Deamino Arginine Vasopressin ; Humans ; Hypernatremia ; Hypothalamus, Anterior ; Intellectual Disability ; Thirst ; Water

Purpose: Blood transfusion is one of the most common procedures used to treat anemia in colorectal surgery. Despite controversy regarding the adverse effects of blood products, surgeons have maintained standards for administering blood transfusions. However, this trend was restrictive during the COVID-19 pandemic because of a shortage of blood products. In this study, we conducted an analysis to investigate whether the restriction of blood transfusions affected postoperative surgical outcomes. Methods: Medical records of 318 patients who underwent surgery for colon and rectal cancer at Ewha Womans University Mokdong Hospital between June 2018 and March 2022 were reviewed retrospectively. The surgical outcomes between the liberal and restrictive transfusion strategies in pre– and post–COVID-19 groups were analyzed. Results: In univariate analysis, postoperative transfusion was associated with infectious complications (odds ratio [OR], 1.705; 95% confidence interval [CI], 1.015–2.865; P=0.044). However, postoperative transfusion was not an independent risk factor for the development of infectious complications in multivariate analysis (OR, 1.305; 95% CI, 0.749–2.274; P=0.348). In subgroup analysis, there was no significant association between infectious complications and the hemoglobin threshold level for the administration of a transfusion (OR, 1.249; 95% CI, 0.928–1.682; P=0.142). Conclusion During colorectal surgery, the decision to perform a blood transfusion is an important step in ensuring favorable surgical outcomes. According to the results of this study, restrictive transfusion is sufficient for favorable surgical outcomes compared with liberal transfusion. Therefore, modification of guidelines is suggested to minimize unnecessary transfusion-related side effects and prevent the overuse of blood products.

BACKGROUND: Discrepancies exist in the currently available data on the prevalence of diabetic neuropathy. Variations in the prevalence of diabetic neuropathy have reflected the different criteria used to form its diagnosis. The majority of diagnostic criteria are less practical in many routine clinical settings where there is a need for a simple assessment using widely available techniques to rapidly screen large numbers of patients. We already reported that the questionnaire of Feldman's two-step assessment was less useful in Koreans, because of the different expression of neuropathic symptoms. We proposed a representative questionnaire which was based on patients' own complaints, and assessed its clinical availability. METHODS: Ninety diabetic patients(45 cases with diabetic neuropathy, 45 cases without neuropathy) were included in this study. Diabetic neuropathy was diagnosed by neurologic examination and nerve conduction velocity. The questionnaire consisted of 7 questions on foot sensation (prickling, lancinating, burning, numb), which are frequent complaints of diabetic patients. All subjects were assessed with the questionnaire. RESULTS: 1. The most sensitive symptom was tingling sensation (75.6%) and the least sensitive one was numbness(28.9%). 2. The most specific symptom was numbness(82.2%) and the least specific one was tingling sensation(33.3%). 3. If we would assume that three or more of symptoms were diagnostic, the sensitivity and specificity were 66.7% and 53.3%, respectively. CONCLUSION: Our new questionnaire can be used as a screening test or a follow-up tool for the diagnosis of diabetic peripheral neuropathy in Koreans.
Burns ; Diabetic Neuropathies ; Diagnosis* ; Follow-Up Studies ; Foot ; Humans ; Mass Screening ; Neural Conduction ; Neurologic Examination ; Peripheral Nervous System Diseases* ; Prevalence ; Sensation ; Sensitivity and Specificity ; Surveys and Questionnaires