BACKGROUND: Compared with conventional routes of delivering potent analgesics to postoperative patients, transdermal administration of fentanyl offers the advantages of simplicity and noninvasiveness. The analgesic efficacy and safty of transdermal fentanyl patch (TDFP) were evaluated postoperatively. METHOD: TDFP releasing 25 mcg/hr (Group 1) or placebo (Group 2) were applied to 40 women 6 hours before total abdominal hysterectomy under the general anesthesia. Postoperatively, self-administered intravenous fentanyl was maintained with a 20-mcg incremental dose and a 10-min. locking interval. Each group was assessed following 48 hours with respects to vital signs, VAS pain scores, hourly-used fentanyl doses, satisfaction scores and side effects. RESULT: VAS observed 24 hours, 36 hours after operation were significantly lower in group 1 than group 2. Hourly-used fentanyl doses were significantly lower in group 1 than group 2 at 2 hours, 6 hours, 12 hours and 24 hours after operation. The incidence of side effects were similar between group 1 and group 2. CONCLUSION: TDFP-25 mcg applied 6 hours before operation provides supplementary analges-ia after the postoperative period without significant side effects such as respiratory depression.
Administration, Cutaneous ; Analgesics ; Anesthesia, General ; Female ; Fentanyl* ; Humans ; Hysterectomy* ; Incidence ; Postoperative Period ; Respiratory Insufficiency ; Vital Signs

OBJECTIVE: To investigate the association between endometriosis and polymorphisms of N-acetyl transferase 2 (NAT2), glutathione S-transferase M1 (GSTM1), and cytochrome P450 (CYP) 1A1 genes in Korean infertile patients. MATERIALS AND METHODS: A total of 303 infertile patients who had undertaken diagnostic laparoscopy during January, 2001 through December, 2003 at Samsung Cheil Hospital enrolled in this study. The patients were grouped according to laparoscopic findings: minimal to mild endometriosis (group I: n=147), moderate to severe endometriosis (group II: n=57), normal pelvic cavity (n=99). Peripheral blood was obtained and genomic DNA was extracted. The genotypes of each genes were analyzed using polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). For NAT2, RFLP was used to detect the wild type (wt) and mutant (mt) alleles, enabling classification into slow (mt/mt) or fast (wt/wt or wt/mt) acetylation genotypes. For GSTM1, PCR was used to distinguish active (+/- or +/+) from null (-/-) genotypes. For CYP1A1, MspI digestion was used to detect the wild type (A1A1), heterozygote (A1A2) or mutant (A2A2) genotypes. RESULTS: The genotype frequencies of NAT2 slow acetylator was 12.8%, 10.9%, 12.8% in group I, group II and control, respectively. The genotype frequencies of GSTM1 null mutation was 55.3%, 41.8%, 53.2% in group I, group II and control, respectively. The genotype frequencies of CYP1A1 MspI polymorphism was 16.3%, 9.1%, 18.1% in group I, group II and control, respectively. No significant difference was observed between endometriosis and normal controls in the genotype frequencies of the NAT2, GSTM1, CYP1A1 MspI polymorphism. CONCLUSION: The NAT2, GSTM1, CYP1A1 gene polymorphism may not be associated with the susceptibility of endometriosis in Korean women.
Acetylation ; Alleles ; Classification ; Cytochrome P-450 CYP1A1 ; Cytochrome P-450 Enzyme System* ; Cytochromes* ; Digestion ; DNA ; Endometriosis* ; Female ; Genotype ; Glutathione Transferase* ; Glutathione* ; Heterozygote ; Humans ; Laparoscopy ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Transferases*

The purposes of this study are to define the scope of occupational health management and to classify occupational management by review of related journals from 1945 to 1994 in Korea. The steps of this study were as follows: (l)Search of secondary reference; (2) Collection and review of primary reference; (3) Survey; and (4) Analysis and discussion. The results were as follows; 1. Most of the respondents majored in occupational health(71.6%), and were working in university (68.3%), males and over the age 40. Seventy percent of the respondents agreed with the idea that classification of occupational health management is necessary, and 10% disagreed. 2. After integration of the idea of respondents, we reclassified the scope of occupational health management. It was defined 3parts, that is, occupational health system, occupational health service and others (such as assessment, epidemiology, cost-effectiveness analysis and so on). 3. The number of journals on occupational health management was 510. It was slightly increased from 1986 and abruptly increased after 1991. The kinds of journals related to occupational health management were The Korean Journal of occupational Medicine(18.2%), several kinds of Medical College Journal(17.0%), The Korean Journal occupational Health(15.l%), The Korean Journal of preventive Medicine(15.l%) and others(34.6%). As for the contents, the number of journals on occupational health management systems was 33(6.5%) and occupational health services 477(93.5%). Of the journals on occupational health management systems, the number of journals on the occupational health resource system was 15(45.5%), occupational finance system 8(24.2%), occupational health management system 6(l8.2%), occupational organization 3(9.1%) and occupational health delivery system l(3.0%). of the journals on occupational health services, the number of journals on disease management was 269(57.2%), health management 116(24.7%), working environmental management 85(18.1%). As for the subjects, the number of journals on general workers was l85(71.l%), followed by women worker, white color workers and so on. 4. Respondents made occupational health service(such as health management, working environmental management and health education) the first priority of occupational health management. Tied for the second are quality analysis(such as education, training and job contents of occupational health manager) and occupational health systems(such as the recommendation of systems of occupational and general disease and occupational health organization). 5. Thirty seven respondents suggested 48 ideas about the future research of occupational health management. The results were as follows: (l) study of occupational health service 40.5%; (2) Study of organization system 27.1%; (3) Study of occupational health system (e.g. information network) 8.3%; (4) Study of working condition 6.2%; and (5) Study of occupational health service analysis 4.2%.
Classification* ; Surveys and Questionnaires ; Disease Management ; Education ; Epidemiology ; Female ; Humans ; Korea* ; Male ; Occupational Health Services ; Occupational Health*

We report a case of epidermolysis bullosa simplex occurred in a 12-year-old girl, who presented with intractable bullous lesions of the hands and feet after minor traumas ever since her early neonatal period. The bullous lesions were noted on the 2nd and 4th webs of the fingers and dorsum of the hands as well as on the skin of the ankle. The lesions were healed without scar formation. Family history was not contributary and seasonal pattern was not noted. Histologic sections revealed intraepidermal bullae just above the well preserved basement membrane. Electron microscopic findings revealed cytolysis of basal cells with preservation of the basement membrane, indicating the epidermal type of epidermolysis bullosa simplex.
Infant, Newborn ; Humans

PURPOSE: To document and compare the clinical results of symmetrical rectus muscle recession and asymmetrical rectus muscle recession in intermittent exotropia. METHODS: The medical records of 27 patients who had symmetric bilateral rectus recession and 24 patients who had asymmetric bilateral rectus recession for intermittent exotropia with at least six months of postoperative follow-up from March 2004 to March 2007 were reviewed retrospectively. The authors performed a recession of 2 mm or greater in the deviating eye than in the fixing eye. RESULTS: The mean age was 7.14+/-4.23 (range 3 to 15) years for symmetric bilateral rectus recession and 7.33+/-4.01 (range 3 to 14) years for asymmetric bilateral rectus recession. The mean follow-up was 11.83+/-5.74 (range 6 to 26) months in the symmetric bilateral rectus recession group and 11.14+/-5.05 (range 6 to 30) months in the asymmetric bilateral rectus recession group. The mean preoperative angle deviations were 27.5+/-4.8 prism diopter (PD) (range 30 to 40PD) and 27.3+/-4.6PD (range 20 to 40PD) in each group. The outcome of final follow-up (postoperative 24 months) was favorable in both groups, and slightly more successful in the asymmetric bilateral recession group but not a statistically significant amount (75.5% in the symmetric bilateral recession group and 81.2% in the asymmetric bilateral recession group). CONCLUSIONS: The present study suggests that there are no significant differences at postoperative 24 months between symmetric bilateral recession and asymmetric bilateral recession in intermittent exotropia having a fixing and a deviating eye.
Exotropia ; Eye ; Follow-Up Studies ; Humans ; Medical Records ; Muscles ; Retrospective Studies

Prior to 1988, endometrial cancer was clinically staged but there was the considerable discrepancy between clinical and aetual stage. FIGO surgical staging classification of endometrial cancer(I988) provides the advanatage of recognizing the true disease distribution and extension, and more rational treatraent can be accomplished. This retrospective study was based on a clinical review of 73 patients with endometrial carcinoma from l982 through 1991 who underwent primary surgical evaluation. A11 cases were restaged ueing the newly adopted FIGO surgical staging. The distribution of FIGO clinical staging was as follows:85 patients(89.1%) were with stage I, 5(6.9%) with stage II, 2(2.7%) with stage III and 1(l.3%) with stage IV. Surgical restaging according new FlG0 classification reveald 56(76.7%) patients with stage I, 1(1.4%) with stage II, 14(19.2%) with stage III and 2(2.7%) with stage IV. Surgery upstaged 12.3% of clinical stage I patients, In clinical stage II patients, 80.0% was doenstaged. There wes no stage changing in cliaical stage III and IV patients. The acturial survival rates for surgical stages I a, I b, I c, and III were 80.0%, 77.2%, 68.4A%, and 35.0% respectively. By using FIGO surgical staging, the initial extent of endometrial cancer can be more accurately evaluated and we may predict prognosis and survival relatively well.
Classification ; Endometrial Neoplasms* ; Female ; Humans ; Prognosis ; Retrospective Studies ; Survival Rate

No abstract available.
Chronic Disease ; Glycemic Index

OBJECTIVES: The Korean version of Bowel disease questionnaire (BDQ-K) was developed to evaluate the symptom items required to meet the definition of functional gastrointestinal disorders (FGIDs). We evaluated the test-retest reliability and validity of the self-reported BDQ-K and prevalence of functional dyspepsia (FD) and irritable bowel syndrome (IBS) according to the Rome-III criteria. METHODS: Sixty-nine patients participated in the test-retest reliability study, with a two week interval, and another 74 patients were enrolled to assess the self-reported questionnaire versus a doctor's interview (concurrent validity). A total of 3,325 subjects (mean age, 44+/-9 yrs; 58.3% male) presenting for an upper endoscopy responded to the BDQ-K at a health promotion center, but 797 subjects with organic diseases were excluded. RESULTS: In the validity study of the BDQ-K, the median kappa value was 0.74 (0.36~1.0). The median kappa value for the test-retest was 0.56 (range 0.22~1.0), including abdominal pain (kappa=0.51, P<0.001), pain onset before 6 months (kappa=0.51, P<0.001), epigastric pain (kappa=0.69, P<0.001), early satiety (kappa=0.40, P<0.001), and postprandial fullness (kappa=0.34, P<0.001). The prevalence of FD was 8.3% (209/2,528); epigastric pain more than once a week 4.4%, early satiety 2.5%, and postprandial fullness 6.1%. FD was more prevalent in women (P=0.001). The prevalence of IBS was 6.1% and IBS also predominated in women (7.1% vs 5.1% in men, P=0.032). CONCLUSION: The BDQ-K is a reliable and valid instrument for identifying FGIDs. The prevalence of FD according to the Rome III criteria was 8.3% and that of IBS was 6.1%.
Abdominal Pain ; Dyspepsia ; Endoscopy ; Female ; Gastrointestinal Diseases ; Health Promotion ; Humans ; Irritable Bowel Syndrome ; Male ; Prevalence ; Reproducibility of Results ; Rome ; Surveys and Questionnaires

Purpose: This study aimed to investigate the levels of adolescence parentification and identify its influence on adulthood depression in children of women with breast cancer. Methods: This study used a cross-sectional online survey. Data were collected from an online community comprising Korean women with breast cancer and their families. A total of 217 adult children of women with breast cancer completed the online questionnaire. Measurements included the Korean version of the Filial Responsibility ScaleAdult (FRS-A), Korean version of Rosenberg’s Self-Esteem Inventory, Korean version of the Resilience Scale (RS14), and the Korean version of Center for Epidemiologic Studies-Depression Scale. Results: The mean score for FRS-A was 2.27 out of 4 points. Adolescence parentification was significantly negatively correlated with adulthood self-esteem (r=-.74, p<.001) and resilience (r=-.72, p<.001), and significantly positively correlated with adulthood depression (r=.76, p<.001). Multiple regression analysis revealed that adolescence parentification was a significant factor associated with adulthood depression after adjusting for general characteristics, self-esteem, and resilience. Conclusion Our finding suggests that parentification can be stressful for adolescents living with a parent with cancer. Hence, a greater awareness regarding parentification is needed to prevent adolescents from developing depression in their adulthood.

Purpose: This systematic review aimed to investigate the effects of aromatherapy interventions on depression and anxiety in menopausal women. Methods: This study adhered to PRISMA (preferred reporting items of systemic reviews and meta-analysis) guidelines. Relevant studies published between 1994 and 2002 were searched in PubMed, Embase, Cochrane Library, CINAHL, Google Scholar, DBPIA, KISS, and RISS databases. Search criteria included the mesh terms 'aromatherapy menopause women depression anxiety.' The review included randomized and nonrandomized studies of women who were menopausal or postmenopausal and received aromatherapy intervention for depression and anxiety associated with symptoms of menopause. The extracted literature was evaluated via quality appraisal checklists of ROB 2 (Risk of Bias 2.0) and ROBINS-1 (Risk Of Bias In Non-Randomized Studies - of Interventions) and visualized using a risk-of-bias visualization tool. Results: The review included 6 randomized controlled studies and 2 quasi-experimental studies. The results showed that aromatherapy massage and inhalation therapy were effective in reducing depression and had beneficial effects in reducing anxiety, improving quality of sleep, and menopausal symptoms in menopausal women. Conclusion Interventions using aromatic essential oils to massage the hands, arms, back, and scalp or inhalation of aromatic oils from clothing, necklaces, and bedding might be beneficial for the emotional health of menopausal women. Women health professionals should consider applying aromatherapy to menopausal women to improve emotional health, sleep, and menopausal symptoms.