Endoscopy is often requested for patients who have had previous stomach aperation. In my practice these cases accounted for 2.2% of the total 5,000 cases of Gastric Fiberscopy. Endoscopist should be aware of the variois anatomic features which developed as a consequence of the surgical procedures to easy interpret and easy fiberscopic teahnique. A series of 111 cases of postperative stomach between 1982 to 1996 is described and analysied.
Endoscopy ; Humans ; Stomach*

The occurrence of malignancies during pregnancy has increased over the last decades. Risks of cancer surgery during pregnancy include spontaneous abortion and preterm labor. Radiation therapy especially during the first trimester generally is not offered because it poses high risks : teratogenecity, induction of childhood malignancies and hematologocal disorders. All chemotherapeutic agents used in the treatment of breast cancer are pregnancy category D, meaning that teratogenic effects have occurred in humans. We report a baby of a 33-year-old pregnant woman with breast cancer. She was treated with modified radical mastectomy one month before the pregnancy and full-dose adriamycin, cyclophosphamide and taxol since the first trimester, and 5,400 cGy of radiation therapy in the second trimester. The infant was delivered at 33+6 weeks of gestation and showed no evidence of malformation or abnormalities and developed normally until 8 months of corrected age.
Abortion, Spontaneous ; Adult ; Breast Neoplasms* ; Breast* ; Cyclophosphamide ; Doxorubicin ; Drug Therapy* ; Female ; Humans ; Infant ; Mastectomy, Modified Radical ; Obstetric Labor, Premature ; Paclitaxel ; Pregnancy ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Pregnant Women*

In vitro fertilization (IVF) is a main option for the infertility treatment and its major concerns are the risk of multiple pregnancy, preterm delivery, intrauterine growth retardation (IUGR), and congenital malformation. Russell-Silver syndrome (RS) is a congenital disorder characterized by intrauterine and postnatal growth retardation associated with inverted triangular face, clinodactyly, and asymmetry of the body. The possibility of genomic imprinting defect has been suggested because the risk of RS syndrome is increased after IVF like other imprinting defect disorders such as Angelman or Beckwith-Wiedemann syndrome, and the major epigenetic disturbance of RS syndrome is the hypomethylation of the imprinting in 11p15. We report three cases of RS syndrome in one of IVF twins with a review of the literature.
Beckwith-Wiedemann Syndrome ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Epigenomics ; Female ; Fertilization in Vitro ; Fetal Growth Retardation ; Genomic Imprinting ; Humans ; Infertility ; Pregnancy ; Pregnancy, Multiple ; Silver-Russell Syndrome ; Twins

PURPOSE: The evaluation of tumor recurrence or metastasis in postgastrectomy cancer patients usually depends on a serum tumor marker test or radiologic study, but in both cases, accuracy is difficult to determine. The purpose of this study was to evaluate the relationship between abdominal CT and serum tumor markers. MATERIALS AND METHODS: In 337 cases involving 226 patients who had undergone curative surgery for gastric cancer, we compared serum tumor markers and CT for the evaluation of metastasis. Among these 337 cases, CEA level was measured in 317, CA 19-9 level in 166, and both of these in 146. The cutoff level for serum carcinoembryonic antigen (CEA) and CA19-9 were 10 ng/ml and 33 U/ml, respectively. RESULTS: CEA level was elevated in 59 of 317 cases (18.6 %) and that of CA 19-9 in 58 of 166 (34.9 %). Slightly higher overall senstivity and specificity was observed for CEA than for CA 19-9 (72.9 % vs 67.2 %, 83.3 % vs 70.4 %, respectively). Among the total of 337 cases, liver or lymph node metastases were detected in 91 cases (27.0 %) on CT. Negative predictive value was significantly higher in CEA than in CA 19-9 (93.1 % vs 80 %, respectively) (p < 0.01), but positive predictive value was lower (50 % vs 54.9 %, respectively). On CT scan, there was a significant relationship between serum tumor marker level and hepatic and nodal metastasis ; specificity and positivity of serum tumor markers were both higher than sensitivity and negativity. CONCLUSION: Follow-up CT less useful when tumor markers levels are not elevated, but when these are elevated in postgastrectomy cancer patients, meticulous radiologic evaluation is necessary for the early detection of residual or recurrent tumors.
Carcinoembryonic Antigen ; Follow-Up Studies ; Humans ; Liver ; Lymph Nodes ; Neoplasm Metastasis* ; Recurrence ; Sensitivity and Specificity ; Stomach Neoplasms* ; Tomography, X-Ray Computed ; Biomarkers, Tumor*

BACKGROUND: This study aimed to investigate the goal attainment rates for hemoglobin A1c (HbA1c), blood pressure (BP), and low-density lipoprotein cholesterol (LDL-C) in elderly patients with type 2 diabetes. METHODS: The subjects were 762 over 65 years old patients with type 2 diabetes taking a hypoglycemic agent. Data were collected by reviewing medical records and included general characteristics, biochemical tests, prescribed pharmacologic agents, and complications. RESULTS: The goal attainment rates (mean value) for HbA1c, BP, and LDL-C were 50.4% (7.3% ± 1.2%), 78.9% (126.0 ± 15.1/72.1 ± 10.0 mm Hg), and 60.6% (88.6 ± 29.9 mg/dL). Diabetes-related complications for retinopathy, nephropathy, neuropathy, and cardio-cerebral vascular disease were 36.3%, 37.2%, 23.6%, and 31.9%, respectively. Life habit-related variables positively associated with goal attainment were not drinking alcohol and exercise for HbA1c, not smoking for BP and not drinking alcohol for LDL-C. Metabolic adjustment indicator-related significant variables for complications were HbA1c in retinopathy, BP in nephropathy, and LDL-C in cardio-cerebral disease. CONCLUSION: We found that goal attainment rates for parameters of metabolic adjustment were not high in elderly patients with type 2 diabetes. Thus, diabetes educators should be concerned about metabolic adjustment indicators. Also, case management guidelines according to elderly patient health and functional status should be developed to help manage metabolic adjustment.
Aged* ; Blood Pressure ; Case Management ; Cholesterol ; Cholesterol, LDL ; Diabetes Complications ; Diabetes Mellitus ; Drinking ; Hemoglobin A, Glycosylated ; Humans ; Lipoproteins ; Medical Records ; Smoke ; Smoking ; Vascular Diseases

PURPOSE: The purpose of this study was to analyze research in the Korean Journal of Rehabilitation Nursing and to suggest further perspective for rehabilitation nursing research. METHOD: In this study we reviewed the contents of 134 articles published in this journal from its beginning year 1998 to 2004. RESULTS: The majority of subjects were adult patients. The type of disease were Cerebrovascular Accident, Neuromuscular disease, Cancer patients, Urogenital disease such as Chronic Renal Failure, Spinal cord injury. Domain of research almost was client, type of research were survey (34.3%), quasi experimental study (20.9%), correlation study (19.4%). Nursing intervention of experimental study was exercise (39.0%), education (17.1%). Place of data collection was hospital (58.2%), position of researcher was professor (67.2%), method of data collection was questionnaire (50.7%). CONCLUSION: There has been a lack of written consent, child rehabilitation, measurement tool development, qualitative research. More studies about rehabilitation nursing are needed to extend the role and fields for professional nursing.
Adult ; Child ; Data Collection ; Education ; Humans ; Kidney Failure, Chronic ; Neuromuscular Diseases ; Nursing ; Qualitative Research ; Surveys and Questionnaires ; Rehabilitation Nursing* ; Rehabilitation* ; Spinal Cord Injuries ; Statistics as Topic ; Stroke

The purpose of this study is to develop the standards of care in rehabilitation nurse specialist. This study was a descriptive survey. The data were collected 143 nurses who were worked in rehabilitation unit at 4 university hospital and 3 rehabilitation center in Korea from Aug. to Nov. 2000. The questionnaire was consisted of 78 items developed by the standards of care in rehabilitation nurse specialist in A.R.N. and the practice contents of care at rehabilitation unit in Korea. Collected data were analyzed by frequency, percentage, mean, S.D. ANOVA The results are as follows 1. For the adequency of the practice contents of rehabilitation nursing, area of skin care is the highest score, and safety, elimination, emotion, respiration, was ordered. 2. The adequency of the practice contents of rehabilitation nursing according to age, educational level. position. clinical experience, clinical experience in rehabilitation unit were significant difference.
Korea ; Surveys and Questionnaires ; Rehabilitation Centers ; Rehabilitation Nursing ; Rehabilitation* ; Respiration ; Skin Care ; Specialization* ; Standard of Care*

Kabuki syndrome is characterized by peculiar facial features, developmental delay, and mental retardation. Congenital hepatic abnormalities in Kabuki syndrome patients have been sporadically reported in the literature and consist of extrahepatic biliary atresia, neonatal sclerosing cholangitis, and transient neonatal cholestasis. We report here a case of congenital hepatic fibrosis in a patient with Kabuki syndrome. To our knowledge, only one case of congenital hepatic fibrosis has been reported in the setting of Kabuki syndrome.
Abnormalities, Multiple ; Biliary Atresia ; Cholangitis, Sclerosing ; Cholestasis ; Face ; Fibrosis ; Hematologic Diseases ; Humans ; Intellectual Disability ; Vestibular Diseases

In this study, we investigated the antioxidative and antimicrobial activities of red algae Gloiopeltis tenax (GT). GT was extracted with methanol and then further fractionated it into four different types: methanol (GTMM), hexane (GTMH), butanol (GTMB) and aqueous (GTMA) soluble fractions. The antioxidant activity of the fractions from GT was investigated by measuring the scavenging activities of GT against reactive oxygen species (ROS) and reactive nitrogen species (RNS). Among the four fractions of GT, GTMM and GTMB showed a marked scavenging effect against ROS, but they displayed very low levels of the scavenging effect against RNS. The antimicrobial activity was increased in proportion to its concentration by the paper disc method. Among the various solvent layers, the GTMM and GTMB showed strong antimicrobial activities.
Methanol ; Reactive Nitrogen Species ; Reactive Oxygen Species ; Rhodophyta

The purpose of this study is to develop a systematic and efficient curriculum for the rehabilitation nurse specialist program. This research was carried out as a group work of 15 experts in order to share vanous opinions about the curriculum. and also through literature review. Articles. curriculums of other Clinical Nurse Specialist Programs. medical laws guidelines. as well as Clinical Nurse Specialist Program from the Korean Nurses Association were reviewed, and the issue was discussed throughly via group meetings. The developed cunicul urn is as follows: 1. Educational philosophy lies in the fact that the rehabilitation nurses support the patients to maximize their potential and functional level. so that they could maintain healthy state and re-adapt to changed environment. Furthermore the rehabilitation nurses are disposed of arbitrary decision power under their own responsibility. thus they take charge of we]fare and healthy environment of the local society through the patients (subjects) and local resources. 2. Educational goals are to train rehabilitation nurse specialist. who correspond to the social needs. so to say. those who have the know]edge and skills for nursing practice, education and research. 3. The curriculum consists of 37 credits, of which 24 credits are based on lectures and 13 credits based on clinical practice. General courses are 3 subjects (5 credits): nursing theory, nursing research. and laws/ethics, Mandatory courses are 8 subjects with 19 credits: advanced physical assessment, pharmacology, pathophysiology, issues in rehabilitation nursing, advanced rehabilitation nursing intervention I. advanced rehabilitation nursing intervention II. sports physiology. special rehabilitation nursing intervention. As for the clinical practice courses, assesment and evaluation for rehabilitation (64 hours), community and home based rehabilitation nursing(128 hours), hospital based rehabilitation nursing(l28 hours), institution based rehabilitation nursing(96 hours) would be treated. 4. Contents of the courses were developed to correspond with the courses' objectives and specific items. 5. Evaluation would be carried out both in the lecure and in the clinical practice. The knowledge and skills of the students would be measured to ensure full validity and credibility. However this developed curriculum should be continuously modified and updated in more desirable direction.
Curriculum* ; Education ; Equidae ; Group Processes ; Humans ; Jurisprudence ; Lectures ; Nurse Clinicians ; Nursing ; Nursing Research ; Nursing Theory ; Pharmacology ; Philosophy ; Physiology ; Rehabilitation Nursing ; Rehabilitation* ; Specialization* ; Sports