No abstract available.

No abstract available.

No abstract available.
Aorta, Thoracic* ; Rupture*

No abstract available.
Heart* ; Thoracic Surgery*

An Internet portal site Nurscape(R) for professional nurses was developed and evaluated. CyberNurse an interdisciplinary team of nursing academic faculty, physician and vendor personnel played an important role as an advisory committee for system design and content provision. The Nurscape(R) site was developed through the systematic approach of interaction among the CyberNurse, contents team, and technical team. Three approaches were used for a formative evaluation; 1) system evaluation including user testing and technical testing, 2) focus group survey for contents evaluation, and 3) analysis of the users' characteristics using the user registration information. Based on the data collected from the three different Internet environments (LAN, ADSL, Modem), it was found that the average access time and network status showed the corresponding differences in the latency of the network tested, but have been steady and consistent to use. And from the group survey some operational issues were found. In the user analysis the 20-30 generation nurses covered 94% of user, and clinical nurse working in the hospital and student nurse were active information seeking groups in Internet. However special nurse such as public health and home health nurse was the main group in community health area.
Advisory Committees ; Commerce ; Focus Groups ; Humans ; Information Services* ; Internet ; Nurses, Community Health ; Nursing* ; Public Health

We report an unusual case of primary extranodal non-Hodgkin's lymphoma combined with sinusitis in an AIDS patient. A 39-year-old male presented with sinusitis as initial manifestation. A nasal endoscopy revealed nasal polyposis with mucopurulent discharge in both middle meatus and paranasal sinus (PNS) CT scans demonstrated pansinusitis without lamina papyracea or skull base defect. He received antiretroviral and antibiotics therapy due to low CD4 count representing immunocompromised state. The patient was not followed up for observation and he returned with reduced right visual acuity and diplopia, and proptosis after 6 months. A PNS CT scan showed bilateral sinonasal polyposis with pansinusitis and soft tissue density in the right orbit and frontal lobe through bone defect of lamina papyracea and skull base. Endoscopic sinus surgery for orbital decompression and biopsy of intraorbital mass was performed under general anesthesia. The mass was infiltrated into orbital contents and was confirmed as an diffused large B-cell lymphoma with anaplastic variant. The patient received radiotherapy because his general condition was poor. Proptosis and ocular pain were decreased; however, he complained of a persistent headache. Brain CT and MRI showed diffused parenchymal edema around brain abscess in the right frontal lobe. Stereotactic evacuation of the right brain abscess was performed. He has no specific complaints for the last 14 months and antiretroviral therapy is concluded at the present.
Acquired Immunodeficiency Syndrome ; Adult ; Anesthesia, General ; Anti-Bacterial Agents ; B-Lymphocytes* ; Biopsy ; Brain ; Brain Abscess ; CD4 Lymphocyte Count ; Decompression ; Diplopia ; Edema ; Endoscopy ; Exophthalmos ; Frontal Lobe ; Headache ; Humans ; Lymphoma, B-Cell* ; Lymphoma, Large B-Cell, Diffuse ; Lymphoma, Non-Hodgkin ; Magnetic Resonance Imaging ; Male ; Orbit ; Radiotherapy ; Sinusitis* ; Skull Base ; Tomography, X-Ray Computed ; Visual Acuity

No abstract available.
Angioplasty, Balloon, Coronary* ; Emergencies*

This study was aimed to assess the free calcium status with or without its direct measurement in patients on hemodialysis(HD: n=27) and malnourished ones from extrarenal diseases(MN: n=14). It was performed by the comparison of measured free calcium (Ca++m) levels by gas analyzer and calculated free calcium(Ca++c) levels based on those of total calcium (TCa), albumin, and pH with the modified algorithm invented by Moore(J Clin Invest. 49:318, 1970). Of 27 HD pts, 14(5296) had low[Ca++m] below 1.05mmol/L despite only 2(796) with low [TCa] below 2.05mmoV L, whereas 14 MN pts had similar numbers between low[Ca++m] and low[TCa]. Compared to MN pts, HD pts showed significantly lower mean levels(SE) of pH(7.37 0.01 vs. 7A4 0.01, p<0.01), higher[TCa](2.33 0.04 vs. 1.83 0.08mmol/L, p<0.01), and higher albumin (4.33 0.06 vs. 2.59 0.17mg/dL, p<0.01).However, [Ca++m] between 2 groups did not reveal any significant difference. Furtherrnore, in total 41 pts of 2 groups, no similarity was observed between the values of [Ca++ml and [Ca++c] but with their significant difference(p<0.05). Only[TCa] was significantly corre- lated with albumin level(r=0.73, p<0.01). Furthermore, multiple regression analysis between [Ca++m] and other factors including pH and albumin didn't show any correlation. In conclusion, this data suggests that relatively high prevalence of low values of physiologically important free ionized calcium in chronically ill pts, especially on maintenance HD, could be missed when predicted on total calcium level, and pH without its direct measurement.
Calcium* ; Chronic Disease* ; Humans ; Hydrogen-Ion Concentration* ; Prevalence

BACKGROUND AND OBJECTIVES: The bacteriology of chronic sinusitis helps us to understand sinusitis and plays an important role in selecting appropriate antibiotics. In recent studies, a good correlation was found between middle meatus and maxillary sinus cultures. We correlate middle meatus, ethmoid sinus and maxillary sinus microbiology in patients with chronic sinusitis and try to determine whether middle meatus cultures can replace maxillary sinus and ethmoid sinus cultures as noninvasive alternative methods. STUDY DESIGN: Prospective study. PATIENTS AND METHODS: 32 patients with chronic sinusitis who didn't respond to medical therapy and received endoscopic sinus surgery were selected. Intraoperative middle meatus, anterior ethmoid and maxillary sinus samples from 32 patients under endoscopic visualization using sterile cotton swabs (BBL Culture Swab(R), BBL, USA) were collected. RESULTS: The overall correlation rate of middle meatus and ethmoid sinus cultures was estimated to be 84.4%. The overall correlation rate of middle meatus and maxillary sinus cultures was estimated to be 84.4%. The most frequently isolated bacteria were coagulase negative Staphylococci in middle meatus and Staphylococcus aureus in ant. Ethmoid and maxillary sinus. CONCLUSION: This study demonstrates that middle meatus cultures correlate well with anterior ethmoid and maxillary sinus cultures and can be used to guide antibiotics selection in chronic sinusitis.
Anti-Bacterial Agents ; Ants ; Bacteria ; Bacteriology ; Coagulase ; Ethmoid Sinus* ; Humans ; Maxillary Sinus* ; Prospective Studies ; Sinusitis* ; Staphylococcus aureus

OBJECTIVE: The purpose of this study is to reevaluate the prognostic factors by investigating the clinical and biological parameters concerned malignant gestational trophoblastic tumor in patients with hydatidiform mole. METHODS: From March 1995 to February 2000, 41 patients admitted to department of the Obstetrics and Gynecology, Yonsei University College of Medicine who were diagnosed with pathologically-proven gestational trophoblastic disease were selected. Parameters such as age, gravida, parity, presence of theca lutein cyst, ratio of uterine size to gestational age, hCG level, DNA ploidy, S-phase fraction were compared between malignant gestational trophoblastic tumor group and spontaneous remission group. RESULTS: Considering the clinical prognostic factors, the patients were divided into two age groups; the first group consisted of those older than 40 years of age and the second control group consisted of those under 40. The number of patients older than 40 in the spontaneous remission group and malignant gestational trophoblastic tumor group were 4(15.4%) and 7(46.7%), respectively, showing a significantly higher number in the group over 40years. Other parameters such as gravida, parity, presence of theca lutein cyst, ratio of uterine size to gestational age, hCG level, DNA ploidy, S-phase fraction showed no statistically significant difference between the two groups. CONCLUSION: The progression rate from hydatidiform mole to malignant gestational trophoblastic tumor was significantly higher in patients over 40 years of age. Therefore, more aggressive therapeutic approach should be considered in such patients.
DNA ; Female ; Gestational Age ; Gestational Trophoblastic Disease ; Gynecology ; Humans ; Hydatidiform Mole* ; Lutein ; Obstetrics ; Parity ; Ploidies ; Pregnancy ; Remission, Spontaneous ; Trophoblastic Neoplasms* ; Trophoblasts*