No abstract available.
Intussusception*

Reconstruction of cruciate ligament has been controversial. Autogenous grafts has been used with inconsistent success rates due to their variable strength and limited length. If any autograft could cover such drawbacks it could surpass the advantage of artificial ligaments also. Recently, we used partial Achilles tendon autograft in reconstructive operation of anterior cruciate ligament with promising result. The main advantages of this Achilles tendon autograft are its sufficient length and strength. Preliminary study was done in 11 patients who received reconstruction of the anterior cruciate ligament using partial Achilles tendon autograft. The results were as followings :l. Anterior cruciate ligament reconstructions were done in 11 patients, with follow-ups ranging from 5 to 12 months, average being 8 months. 2. Average preoperative knee score was 49.1, and it was improved up to 87.4 after operation. 3. Among the 11 patients, 6 belonged to the Excellent, 4 to good, and 1 to fair. 4. Achilles tendon autograft turned out to be a good autograft substitute for the anterior crucate deficient knee. The results were promising. Long-term follow-up is needed to confirm the final status of the operated knee.
Achilles Tendon ; Anterior Cruciate Ligament ; Autografts ; Follow-Up Studies ; Humans ; Knee ; Ligaments ; Transplants

PURPOSE: To evaluate the effectiveness and the most accurate element of the diagnostic criteria of the Japan Society of Uitrasonics in medicine(JSUM, Nov. 1989) for distinguishing between benign and malignant solid breast masses on the US. METHODS AND MATERIALS: We analyzed the ultrasonic findings of histopathologically proved 51 fibroadenomas, 12 fibrocystic disease, and 39 breast cancers in relation to the diagnostic criteria of the JSUM (shape, border, boundary echo, internal echo, posterior echo, lateral echo, and depth/width ratio). RESULTS: The number of cases of fibroadenoma, fibrocystic disease, and breast cancer corresponding to the diagnostic criteria was in the shape(26/51, 5/12, 33/39), border(41/51, 9/12, 29/39), boundary echo(48/51, 12/12, 27/39), internal echo(43/51, 9/12, 24/39), posterior echo(32/51, 3/12, 21/39), and lateral shadowing(15/51, 1/12, 35/39). All diagnostic criterias showed statistical significance for differentiation of benign/malignant breast mass on the US(Chi-square test: p<0.05). The order of accuracy was boundary echo, internal echo, and border. The mean of depth/width ratio was 0.54 +/- 0.15, 0.52 +/- 0.12, and 0.69 +/- 0.21 in fibroadenoma, fibrocystic disease, and breast cancer respectively and it had statistical significance for differentiation of benign/malignant breast mass on the US(ANOVA test: p=0.0002). CONCLUSION: The diagnostic criteria of JSUM is effective for differentiation of benign/malignant breast solid masses on the US and has accuracy in the order of boundary echo, internal echo, and border. Depth/width ratio also has statistical significance.
Breast Neoplasms ; Breast* ; Fibroadenoma ; Japan* ; Ultrasonics*

Splenic artery pseudoaneurysm is a relatively rare and potentially life-threatening complication of chronic pancreatitis. The authors present a case of splenic artery pseudoaneurysm complicating ,chronic pancreatitis. It was converting into a pseudoaneurysm by vessel rupturs. In this case report, color doppler US, CT, and MRI made the definite diagnosis.
Aneurysm, False* ; Diagnosis ; Magnetic Resonance Imaging ; Pancreatitis, Chronic* ; Splenic Artery*

No abstract available.
Humans ; Nursing* ; Students, Nursing*

No abstract available.
Bacillus* ; Humans ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Idiopathic small bowel ulceration occurring beyond the duodenum is rare, and less than 5% of all the reported cases have occurred in children. In most of the cases, single ulcer of unknown cause is observed in jejunum or ileum. The diagnosis is difficult and usually made at the time of surgical exploration for the complications, such as perforation, hemorrhage or obstruction. We experienced a case of perforation of idiopathic ileal ulceration due to blunt abdominal trauma in a 11-year-old boy. The ileal segment including the lesion was resected and the pathologic findings were compatible with idiopathic small bowel ulceration. The clinical and pathological aspects are discussed, and the literatures were reviewed.
Child* ; Diagnosis ; Duodenum ; Hemorrhage ; Humans ; Ileum ; Jejunum ; Male ; Ulcer*

BACKGROUND: This study evaluated the frequency and types of hand hygiene practices among healthcare workers directed by the WHO multimodal hand hygiene improvement strategy, and investigated the effect of hand hygiene practice on methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) isolation and MRSA acquisition rate and colonization pressure. METHODS: A quasi-experimental study was performed at a tertiary care university hospital with 850 beds from January to September 2012. We assessed the hospital hand hygiene program using the WHO hand hygiene self-assessment framework. The WHO multimodal strategy was used for healthcare workers with low indexes, and the subjects were reassessed. RESULTS: Hand hygiene compliance increased significantly from a pre-intervention rate of 58.7% to 72.6% post-intervention. MRSA and VRE isolation rates decreased from 1.69 per 1000 patient days to 1.41 and from 0.17 to 0.11, respectively. In intensive care units (ICUs), hand hygiene compliance rate rose to 77.9%, with a total score of 4.16 points out of 5 being awarded for the hand hygiene method, which was higher than that for the other care units. The pre-intervention MRSA acquisition rate in the ICU decreased from 7.47% to 4.30% post-intervention. This was associated with a decrease in the MRSA colonization pressure over the intervention period (26.2% to 16.9%). CONCLUSION: The utilization of the WHO multimodal strategy for improvement of hand hygiene increased the hand hygiene compliance rate and was effective in predicting a decreased rate of cross-infection, MRSA acquisition, and colonization pressure. We conclude that the implementation of such improvement strategies is crucial to maintaining hygiene standards and reducing infection within healthcare facilities.
Awards and Prizes ; Colon ; Compliance ; Delivery of Health Care ; Hand Hygiene* ; Humans ; Hygiene ; Intensive Care Units ; Methicillin-Resistant Staphylococcus aureus ; Self-Assessment ; Tertiary Healthcare

PURPOSE: We evaluated the effects of amitriptyline in patients with urinary frequency or pelvic pain syndrome and compared with propiverine hydrochloride (BUP-4(R)) and diazepam (Valium(R)). MATERIALS AND METHODS: One-hundred and sixty-eight patients with urinary frequency or pain were included and 38 out of 168 patients were lost to follow up. The patients with interstitial cystitis, UTI and neurogenic bladder were excluded. Amitriptyline group were instructed to take 25mg to 75mg of amitriptyline before bed. Propiverine hy drochloride and diazepam group were instructed to take 20mg, 4-6mg before bed, respectively. The clinical effects and side effects were evaluated after 4 weeks of medication. RESULTS: In the amitriptyline group, 73.1% in 78 patients with frequency, 68.3% in 60 pain, 65.6% in 32 nocturia, 53.8% in 26 weak urinary stream, 53.8% in 13 dysuria, 72.7% in 11 urgency showed symptom improvement. Urinary frequency and pain score were significantly decreased in the amitriptyline group. In the propiverine hydrochloride group, 66.7% in 21 patients with frequency, 38.8% in 18 pain showed symptom improvement. In the diazepam group, 37.5% in 24 patients with frequency, 31.3% in 16 pain showed symptom improvement. Side effects of amitriptyline had appeared in 24 (27.6%) out of 87 patients; 17 cases of dry mouth, 10 drowsiness, 2 agitation, 2 nausea, 1 constipation and 1 skin rash. CONCLUSIONS: Amitriptyline is useful in vague voiding symptoms especially in urinary frequency and chronic pelvic pain syndrome. It is equally effective in both men and women. Side effects are minimal and tolerable. A double-blind placebo-controlled trial is necessary for general acceptance in the future.
Amitriptyline* ; Constipation ; Cystitis, Interstitial ; Diazepam ; Dihydroergotamine ; Dysuria ; Exanthema ; Female ; Humans ; Lost to Follow-Up ; Male ; Mouth ; Nausea ; Nocturia ; Pelvic Pain* ; Rivers ; Sleep Stages ; Urinary Bladder, Neurogenic

PURPOSE: The purpose of this study was to identify the relationship of job stress, state of sleep, and depression and to identify factors influencing depression of emergency medical technicians. METHODS: The research was a cross-sectional, descriptive study. Data collection were done using self-report questionnaires with 162 emergency medical technicians working in hospitals who agreed to participate in the study. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients and multiple regression with the SPSS/WIN 18.0 Program. RESULTS: Depression had significant negative correlations with state of sleep, (r=-482, p<.001) and positive correlations with job stress (r=.196,p=.013). State of sleep had significant negative correlations with job stress (r=-.168, p=.033). The variance for life satisfaction was 23.7% (F=25.964, p<.001). Variable of state of sleep significantly predicted depression of emergency medical technicians. CONCLUSION: Considering these results, for emergency medical technicians' job stress, state of sleep, and depression, further studies are needed. Furthermore, there is a need to develop and implement new strategies to improve depression among emergency medical technicians.
Data Collection ; Depression ; Emergencies ; Emergency Medical Technicians ; Humans ; Surveys and Questionnaires