A retrospective quality assurance study of intraoperative consultation (frozen section) was carried out to assess the accuracy and to determine the reasons of discordance. Of 14,977 surgical pathology cases accessioned over a 6-month period in Asan Medical Center, frozen sections were done on 1,270 (8.5%) patients and 2,392 frozen sections (1.88 frozen sections/case) were performed. Discordance was noted in 106 cases (4.4%) and diagnosis was deferred in 26 cases (1.1%). All deferred cases were reviewed with the result of 53.8% justified and 46.2% unjustified. The discordant cases were divided into three categories as to their clinical significances: category A (no affect on patient care) 61.3%, B (minimal affect) 9.4%, and C (major affect) 29.2%. Of 31 category C cases, 7 cases were false positive and 24 cases were false negative. Misinterpretation (70.8%) was the leading cause of discordance, followed by sampling error (15.1%), failure to identify lesion (8.5%), and technical problem (5.7%). More than one-third (35.8%) of all discordances were of central nervous system cases. Total central nervous system cases were 403 (16.8%) with a significantly higher disordance rate (9.8%) and deferral rate (2.5%) in comparison to the other cases with 3.4% discordance rate and 0.8% deferral rate. There were 43 colorectal cancer cases of intraoperative consultation for adequacy of resectional margins. The surgical margins were between 0.4 cm and 28 cm (mean: 6.7 cm) away from the tumor and there was no tumor-positive case. The study indicates surgical pathology should 1) promote interpretative skills in cases involving minute fragments of neurosurgical cases, 2) defer the diagnosis and ask for more tissue on inadequate or inappropriate specimens and 3) give only gross opinions without unnecessary frozen section procedures in the event of simple, clear-cut cases.
Abscess ; Anti-Bacterial Agents ; Biopsy ; Central Nervous System ; Chungcheongnam-do ; Colitis, Ulcerative ; Colorectal Neoplasms ; Diagnosis ; Diagnosis, Differential ; Endoscopy ; Enterocolitis, Pseudomembranous* ; Frozen Sections* ; Humans ; Mucous Membrane ; Necrosis ; Pathology ; Pathology, Surgical ; Retrospective Studies ; Selection Bias

No abstract available.
Child* ; Humans

The analysis of 48 infants of congenital torticollis and the result of their conservative treatment are reported. The abnormalities of their neck were noticed by mothers within three months of infant life but mostly at three to four weeks. The ratio of male to female was 9:7 and incidence of right and left was 30 to 18. The mass located mostly(50%) at middle third of the sternocleidomastoid muscle belly. The prominence of incidence were noticed on the abnormality of fetal position in the uterus, mode of delivery and also on the baby of elderly primipara. About 67% of cases were breech(46%) and transverse(21%) position prenatally and 67% were delivered by forceps(41.7%), vacum and induction(12.5%each). The age of mother at delivery has close relationship between congenital torticollis with about two third of them are born of 29–34 year old mother and primipara infants were 61%. For the treatment, daily stretch exercises of affected sternocleidomastoid muscle was done by physical therapist for 20–30 times in two separate session. The effect can be noticed by the gradual correction of rotation deformity first and then the mass become soften and smaller. The next change is the correction of deviation deformity but the mass remain last. However, the mass remaining one fourth of original size was absorbed spontaneously without further treatment. The result of complete cure in ten weeks of treatment were 43(90%) out of 48 patients and the remianing five cases required for 15 weeks of treatment. In conclusion the congenital torticollis can be treated effectively by stretch exercises when it began within three months of age of the patient. A hundred per cent effect of cure may be obtained in ten weeks of treatment in case of initial treatment is begin within four weeks of age and required for 15 weeks of treatment on 4–12 weeks old infants.
Aged ; Congenital Abnormalities ; Exercise ; Female ; Humans ; Incidence ; Infant ; Male ; Mothers ; Neck ; Physical Therapists ; Torticollis ; Uterus

No abstract available.
Metallothionein*

PURPOSE: This study was designed to identify the factors affecting the experience of smoking in middle school girls. A comprehensive analysis of individual and family factors was used. METHOD: The students in this descriptive survey on causal relations were 433 girls enrolled in middle schools selected by convenience sampling. The data were collected in November-December 2003 and logistic regression analysis was used to build a forecast model. FINDINGS: The findings showed the following, 1) Individual factors such as grade, alcohol consumption, sexual experience and the frequency of exposure to pornographic materials, and 2) family factors such as parental living arrangement were significant factors. CONCLUSION AND RECOMMENDATION: The experience of smoking among Korean middle school girls was associated not only with individual factors, but also with family factors, which exert a strong influence on health behavior. There is therefore a need for school-based smoking prevention programs, which deal comprehensively with these factors that influence smoking. It is recommended that a program be developed that will help to control the variables identified in this study along with follow-up study to verify the model.
Alcohol Drinking ; Female* ; Health Behavior ; Humans ; Logistic Models ; Parents ; Residence Characteristics ; Smoke* ; Smoking* ; Child Health

PURPOSE: A number of studies have been published on the effect of growth hormone therapy over 1-3 years in children with growth hormone deficiency(GHD) & Familial short stature(FSS). So far final height data are seldomly available. Final heights of GH treated children with GHD & FSS were evaluated. METHODS: 10 Children with GHD and 69 children with with FSS were enrolled for the study. They were treated with GH 0.1IU/kg/daily in 10 GHD and 20 children with FSS. They were grown up and reached adult height. 49 children with FSS were not treated at all. Facors influencing final height were investigated. RESULTS: 1) All patients with GHD(Idiopathic 8 cases, Organic 2 cases) had additional gonadotropin deficiency and had multiple pituitary hormone deficiency. 2) At start of GH treatment boys of idiopathic GHD were 9.8 years old and 12.4 years old in girls and their mean height was 114.8cm(-2.8SDS), 123.0cm(-2.9 SDS)in boys and girls respectively. Boy with orgnaic GHD was 11.1 years and 6.7 years old in girl. Their height were 126.0cm(-1.5SDS) and 104cm(-1.2SDS) respectively. 3) Mean final height of idiopathic GHD was 167.6cm(-0.5SDS) in male and 161.0 cm(0.7SDS) and that of organic GHD was 173.0cm(0.5SDS) in male and 157cm (0SDS) in girl. 4) Mean Final height in untreated children with FSS was 159.8+/-.2cm(-1.6 SDS)in male and 149.6+/-.3cm(-1.4SDS) in female. Mean final height of GH treated in FSS was 162.5+/-.1cm(-1.5SDS) in male and 152.0+/-.4cm(-1.2SDS) in female But there was no statiscally difference between untreated and treated children in final height. 5) The age of onset of menarche was 12.74+/-.78 years old in GH treated group (n=12) and 12.45+/-.16 years old in untreated group(n=34). CONCLUSION: The GH administration in patients with GHD has been confirmed for growth promotion. but in case of FSS there was no significant difference between treated and untreated group. More further studies are needed for the confirmation of the efficacy of GH therapy in patients with FSS.
Adult ; Age of Onset ; Child* ; Female ; Gonadotropins ; Growth Hormone* ; Humans ; Male ; Menarche

No abstract available.

The purpose of this study was to investigate characteristics of teenagers' perceptions to bullies according to the classification types of Q-methodology. The results of the analysis were classified in 5 types. Type 1, which was the type geared foward solution, showed that they expressed a strong attitude of sympathy and protection towards the victim. However, they had harbored rage and hostile feelings against the assaulter. For example, when they witnessed the bully in action, they positively intervened in the situation. Type 2, which was the observer type, showed that they thought the victims were to blame for their misfortune. Also, when a friend who was left out in the cold by his classmates, they were just watched without showing any special interest. Type 3, which was the type of conflict, indicated that they believed that the both the victim and the assaulter should have responsibility. In contrast to the previous type, they had sympathy for the friend who was left out in the cold by his classmates, they had the dual feeling that intended to use the bully under the situation with his friend. Type 4, which was the type of assenting, indicated that they assumed an indifferent attitude to the situation, while they implied assenting to the situation of the friend who had a bad relationship with them. Type 5, which was the negative type, showed that they had the negative view to the situation of bully itself so that they did not recognize the bully as the method of revenge for whatever reason. The results of the study showed that the bully increased the factor of stress to school life of the victim or assaulter, even in the subjective position. The perception of the bully should change according to the characteristics of the types of people and it is necessary to study how to cope with the situations.
Adolescent* ; Classification ; Friends ; Humans ; Rage

By using Q-methodology, this study examines the attitudes of pregnant womens' husbands toward breastfeeding. Also, the research provides basic data necessary to develop a strategy for recommending breastfeeding. A total of 112 items for the Q-population were collected from related literature and interviews with the general public, specialists, pregnant women and the general public, specialists, pregnant women and their husbands. Finally, 38 statements were selected. Twenty one husbands of pregnant women classified these statements on each card on a 1 to 9 point scale(forced normal distribution) and wrote the reasons for both the most supported and the mos resisted statements. The materials collected were analyzed by using pc QUANL program. The analysis drew down following fact that even though the attitudes of the husbands of pregnant were very similar, they could be classified to three types according to the motivation and recognition the degree of choosing breastfeeding. Type 1 is the mother's duty supporter, who insists that breastfeeding is completely natural and the proper duty of the mother. Type 2 is the emotional value supporter, who thinks that breastfeeding emotionally affects both the baby and the mother in a positive way. Type 3 is the conditional choice supporter, who chooses the most proper suckling way of feeding according to given conditions.
Breast Feeding* ; Breast* ; Female ; Humans ; Mothers ; Motivation ; Pregnant Women ; Specialization ; Spouses*

This study was done to evaluate the quality of clinical nursing care using the variables of structure, process, and outcome and to analyze the relationship between the variables. This study also explored which variables are validating indicators to evaluate the quality of nursing care. The results analyzed by multiple regression showed that, generally structural variables did not contribute to the variance in outcome scores, but process variables of nursing care contributed significantly to the outcome variable of patient satisfaction. A combination of structure and process variables more than structural variables alone. Also, patient satisfaction and hospital preference were significantly related to each other. Therefore, if nursing quality evaluation relies solely upon on structural variables such as number of available nurses and workload, it would be inaccurate because process variables of nursing care are strongly related to outcome variables and the two categories of structure and process variables helped to strengthen the relationships. Thus, it is important to focus on variables of structure, process, and outcome together in evaluating nursing care quality.
Nursing Care* ; Nursing* ; Patient Satisfaction