Nuclear DNA content was measured using a flow cytometric method to analyze 36 paraffin- embedded and 7 fresh tissues of 43 papillary carcinomas of thyroid gland. DNA aneuploidy was found in 3 cases(6.9%) and diploidy in 40 cases(93.1%). But there were no suggestive findings in clinical history, and cytological and morphological features for aneuploidy. In 40 diploid cases, S-phase fraction(SPF) were analyzed with regard to sex, age, tumor size, presence or absence of capsular invasion, lymph node involvement and ground glass nuclei. Among the multiple factors, only the tumor size, especially the larger sized-group(above 2cm in tumor diameter) was found to have a statistically significant higher SPF than the smaller sized-group (p<0.05). And high SPF groups relatively well corresponded to the high risk group. Thirty nine cases of papillary carcinoma have also been evaluated for proliferative activity with Ki-67 monoclonal antibody. The average Ki-67 labeling index was 0.36% in total cases, and that of the aneuploid cases was 0.73%, which was higher than that of the diploid cases(0.33%). So. We think that the low aneuploid rate and low Ki-67 labeling index relatively well represent the usual good clinical course of this tumor and the high SPF is a suggestive finding for a high risk group.

OBJECTIVE: Some vaginal procedures may be safer, easier and more successful if they could be done under direct sonographic vision of the object. METHODS: All the procedures were done under the guidance of transrectal sonography. Suction curettage, after using curved plastic Karman's cannula, additional curettage was done only when there was probable remaining conceptal tissue seen on sonography. If additional curettage was needed curved metal cannula made in the same form as plastic Karman's cannula is used first and then usual metal curette if the former did not work. A high frequency cautery unit was used for myolysis. Insertion of the flexible curved cautery tip into the myoma mass was done through the uterine cavity and coagulation of the myoma tissue was performed. Myoma biopsies were done with thin loop high frequency cautery tip through laparoscopy and the vagina. RESULTS: Suction curettage in 156 cases of early pregnancy and 2 cases of previous cesarean incision site pregnancy, D&C in 11 cases, chorionic villus sampling in 13 cases, polypectomy in 1 case, myolysis in 1 case and myoma biopsy in 2 cases were done. CONCLUSION: Performing some vaginal procedures under the guidance of transrectal sonography may be better.
Biopsy ; Catheters ; Cautery ; Chorionic Villi Sampling ; Curettage ; Dilatation and Curettage ; Female ; Laparoscopy ; Myoma ; Plastics ; Pregnancy ; Ultrasonography* ; Vacuum Curettage ; Vagina

No abstract available.
Esophageal and Gastric Varices* ; Meta-Analysis as Topic

Emergency nursing intervention should be provided to patients under fatal status with much quickness and accuracy. To improve the quality of emergency medical service, triage nurse systems, being implemented in advanced hospitals which successfully provide effective emergency services, are considered in this thesis. A triage nurse is defined as a nurse who first and immediately meets the patient at the very entrance of emergency department, and performs proper intervention according to the extent of injury. Triage functions include interviewing patients, physical evaluation, classifying patients, assigning nurses/doctors, and beds, performing preliminarily required tests and remedies, re-evaluation of waiting patients, emotional supports, arranging future medical services, and education. In Korea, triage nurse systems have not yet been introduced, however, some prleminary types of triage systems are being practised. The purpose of this thesis was to review the triage functions implemented in Korean emergency department and then to suggest a model of triage nurse system for Korean emergency departments. For field study, 10 emergency departments in Seoul, which have more than 13 nurses, are selected, and a nurse who have more than 1 year experience in emergency department was interviewed from each workshift, i.e. day, evening, and night. Data collection taken 17 days from Apr. 8 to Apr. 30, 1996. In the field study, we reviewed the triage functions performed in Korean emergency departments. 40.9% of interviewed nurses show that the triage functions are performed by general nurses, 18.42% and 10.15% indicate that the functions were performed by charge nurses and assigned nurses, respectively. Thus, triage nurse systems where pre-assigned nurses consistently perform triage functions were not yet introduced in Korean emergency departments. However, 96.7% of the nurses answered that triage systems are needed in their emergency departments and 82.77% showed that triage functions would be performed at the entrance of emergency department. A triage nurse systems will unload stresses which both patients and supporters cope with, provide secure and comfortable medical environments, and reduce the waiting time. Finally, it may be improve the patients' and supporters' satisfaction. Therefore, this study provides basic data to enhance emergency medical services and leads to a future study to implement and extend specialized nursing systems in emergency departments.
Data Collection ; Education ; Emergencies* ; Emergency Medical Services ; Emergency Nursing ; Emergency Service, Hospital* ; Humans ; Korea ; Nursing ; Nursing, Supervisory ; Seoul ; Triage*

Estrogen and progesterone receptors exist in the epithelial and stromal cells of the endometrium. Proliferative disorders of the endometrium may be associated with autocrine and paracrine actions of estrogen and progesterone in epithelial and stromal cells. This study was performed to evaluate the differences estrogen and progesterone receptor(ER/PR) expression in the epithelial and stromal cells of endometrial hyperplasias and adenocarcinomas using immunohistochemical methods. Immunohistochemical analysis of proliferating cell nuclear antigen(PCNA) was done to evaluate a possible correlation between PCNA and hormone receptor expression. Evaluation was based on samples from 31 simple hyperplasias, 30 complex hyperplasias, and 32 adenocarcinomas. The immunohistochemical expression of ER, PR and PCNA in epithelial and stromal cells were examined according to a scoring system based on the percentage of positive cells and the staining intensity. The results were as follows; 1) The expression of ER and PR in epithelial cells showed a graded, significant decreases in simple hyperplasia, complex hyperplasia and endometrial carcinoma, in that order(ER: P=0.008, PR: P= 0.026). 2) PR expression in the stromal cells showed a significant decrease between hyperplasia and adenocarcinoma(P=0.003). The difference in ER expression was not significant. 3) In stromal cells, the decrease in PR expression was more prominent than the decrease in ER expression when complex hyperplasia was compared to simple hyperplasia. 4) The PCNA expression in simple and complex hyperplasia and adenocarcinoma was not higher than the expression of PCNA in nomal proliferative endometrium. There was no significant difference in PCNA expression between simple and complex hyperplasia and adenocarcinoma(P=0.073). 5) A negative correlation between PCNA and ER/PR expression was not demonstrated in simple and complex hyperplasia, or in adenocarcinoma. Endometrial hyperplasia and adenocarcinoma are probably related to a paracrine action of estrogen and progesterone in epithelial and stromal cells. A progressive loss of PR expression in stromal cells may induce abnormal proliferation of endometrium due to a disrupted hormonal balance.
Adenocarcinoma

We have studied the genetic differences among four isolates of Trichinella including a new strain of Trichinella spiralis (ISS 623) recently found from a human case who took a badger in Korea. Because they have a different host origin and came from geographically separated regions, we supposed the genetic pattern of the isolates might be different as had been previously reported. It was analysed by PCR-RFLP analysis of the rDNA repeat that can readily distinguish a species or strain from others. Isolated genomic DNA of each isolate of Trichinella larvae was amplified with ITS1 specific primers and digested with restriction endonucleases. The PCR product of ITS1 was confirmed using Southern blot analysis to be a 910 bp fragment. The restriction fragments of each isolate had variable patterns when it was digested with Rsa 1 only. According to the RFLP patterns, the estimated genetic divergence between each isolate was different. In conclusion, four isolates of Trichinella including a new strain of T. spiralis obtained from a Korean patient may have genetic differences in the ITS1 region and the Shanghai isolate was genetically more similar to the Japanese unknown isolate than others in the ITS1 region.
Animals ; *DNA, Helminth ; *DNA, Ribosomal ; Human ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Repetitive Sequences, Nucleic Acid ; Trichinella spiralis/*genetics/isolation & purification

No abstract available.
Hepatitis B* ; Hepatitis* ; Humans ; Infant, Newborn* ; Vaccination*

BACKGROUND: Family physicians help the patients to be adapted to a new life cycle with anticipatory guidance. But the later life of empty nest stage seems to be the most stressful since during this time is made preparation of his/her own death. Anticipatory guidance in later life for death is not encouraged because after death, the patient no longer exists. METHODS: From August 1, 1995 to August 31,1995, we gathered the data by the means of questionnaire to persons aged over 60 who visited the department of family medicine and geriatric center in Yong-dong Severance Hospital. The questionnaire was consisted of demographic factors, attitude toward death, fear of death, preparation of death in aspect of his/her own and also in his/her family. RESULTS: The total 104 subjects responded to the questionnaire, consisting of 58 males and 46 females. To the question asking the attitude tpward death, 71(67.6%)answered death as a spiritually new life, 39(37.1%)as an end of life and 11(10.5%)as just and event in life. 75(72.1%)persons insisted the need of preparation of death, and the content of the preparation were consideration of the family 35(33.3%), preparation of mind 34(32.4%), devotion to religion 33(31.4%), arrangement of fortune 19(18.1%). The answer about the fear of death was 42(40.0%)and the reasons for fear were pain of death 26(24.8%), separation from the family 19(18.1%), uncertainty of the nature after death 17(16.2%), suffering of the family 10(9.5% ) in rank order. The contents of preparation of death as family were being together with dying person 57(45.7%), evangelizm 32(30.5%), helping arrangement of life 30(28.6%), and the answer about fear of death of family were pain of death 40(37.1%), regret 31(26.5%), lack of preparation of after death 22(21.1%), loneliness after separation 14(13.3%). CONCLUSIONS: Family physicians should recognize death as one of the life cycles because the most persons insist of the need of preparation of death. So family physician can help the the patient prone to death by anticipatory guidance with stimulation of performance of developmental tasks.
Demography ; Female ; Humans ; Life Cycle Stages* ; Loneliness ; Male ; Physicians, Family ; Uncertainty ; Surveys and Questionnaires

Correct discrimination of the first and the second twin is important. Case: (1) The first fetus, whose amnionic cavity was closest to the cervix at 19 weeks, even though its body was higher than the second fetus, was found to be closer to the cervix by 23 gestational weeks than its twin. (2) The result of the chromosomal study of dichorionic twins at 17 gestational weeks was male with 9 inversion of the presumed first, and female with trisomy 21 of the presumed second. AT 19 gestational weeks, the sex and order of the two were found to be reversed at sonography for selective termination. In diamnionic twins, the fetus in the amnionic sac closest to the cervix is nominated as the first.
Amnion ; Cervix Uteri ; Diagnosis* ; Discrimination (Psychology) ; Down Syndrome ; Female ; Fetus* ; Humans ; Male ; Pregnancy, Twin* ; Twins*

Potter's syndrome was originally described as combination of bilateral renal agenesis and unique progeric facial characteristics in 1946 by Potter. In cases of severe renal maldevelopment such as bilateral polycystic kidney or marked hypoplasia, similar facial features has been also associated. At 1963, Potter and Osathanondth reported classification of polycystic kidney as Type I-IV by microdissection study. Recently authors experienced an autopsy case of polycystic kidney with characteristic potter face, and other combined malformations such as; absence of both ureters and urinary bladder, pulmonary hypoplasia, undescended testes and oligohydramnios, fetal growth retardation and breech presentation. According to the classification of polycystic kidney of Potter and Osathanondth, this presenting case is compatible with type IIB.