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*

PURPOSE: To evaluate diagnostic usefulness of ultrasonography(US) in pediatric patient with urinary tract infection. MATERIALS AND METHODS: Fifty-five children with urinary tract infection underwent renal ultrasonography and voiding cystourethrography(VCUG). The imaging findings were analyzed retrospectively. RESULTS: Renal sonograms were normal in 34 of 55 children(62%). Five of 34 patients with normal sonogram had vesicoureteral reflux of grade I to III on VCUG. Renal sonograms were abnormal in 21 of 55 children(38%). Sonographic findings included hydronephrosis, hyperechoic kidney, nephromegaly, atrophic kidney, renal abscess, and duplex ureter. Eleven of 21 patient with abnormal SOhogram had vesicoureteral reflux of grade I to IV on VCUG. CONCLUSION: Ultrasonography is an useful and reliable initial screening examination in the investigation of children with UTI. Unfortunately US is neither sufficiently sensitive nor specific for detecting VUR. VCUG provides confirmative and valuable information about vesicoureteral reflux, and VCUG should be considered as a next modality for UTI. The combined use of sonography and VCUG provides more valuable information in urinary tract infection.
Abscess ; Child* ; Humans ; Hydronephrosis ; Kidney ; Mass Screening ; Retrospective Studies ; Ultrasonography* ; Ureter ; Urinary Tract Infections* ; Urinary Tract* ; Vesico-Ureteral Reflux

No abstract available.
Acquired Immunodeficiency Syndrome ; Cytomegalovirus ; Cytomegalovirus Infections ; Humans

OBJECTIVES: The aim of this study was to evaluate the differences in patients with positional dependent sleep apnea according to their non-supine apnea-hypopnea index (AHI, > or =5 vs. <5). METHODS: 92 patients with positional sleep apnea were evaluated. The patients were divided into two groups : group I was non-supine AHI having > or =5 ; group II was non-supine AHI having less than 5. Statistical analysis was performed to find the difference between two groups. RESULTS: In 92 patients, the number of group I patients was 11 (12%) and the number of group II patients was 81 (88%). In the severe AHI group, percentage of group I was dominated (70%) and showing a significant difference compared with the mild and moderate AHI groups (p<.05). In the severe body mass index (BMI) group, percentage of group I was dominated (54.5%) and showing a significant difference compared with of the mild and moderate BMI groups (p<.05). The percentage of group I was significantly higher than group II (p<.05) in the AHI, supine AHI, non-supine AHI and snore time. CONCLUSIONS: In patients with positional sleep apnea, severe OSA and high BMI are more common in patients with non-supine AHI> or =5 than non-supine AHI<5.
Body Mass Index ; Humans ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive

OBJECTIVE: To determine the changes of nitric oxide production in preeclampsia, the concentration of nitric oxide metabolite, nitrite, was measured in umbilical vein after perfusing plasma from normal pregnant women and preeclamptic pregnant women. MATERIAL AND METHOD: 15 normal and 15 preeclamptic umbilical cords were obtained at the time of cesarean section. Two pieces of umbilical cord in equal length(20 cm in length) were prepared from each umbilical cord. Two pieces of umbilical cord were connected in parallel in a perfusion chamber. One piece of umbilical cord was perfused sequentially for 20-minutes' interval with the perfusates in the order of cord buffer, cord buffer including 15% normal pregnant serum, 15% normal pregnant serum with histamine(10-5mol/L), 15% normal pregnant serum with calcium ionophore A23187(5 mol/L) and the other one was perfused exactly same way using 15% preeclamptic serum instead of 15% normal pregnant serum. All the perfusates used were gassed with 95% O2 and 5% CO2 and warmed to 37degree C. Perfusates were collected in eppendorf tube and freezed at -70degree C until assayed. NO was measured by means of Greiss reaction. one way ANOVA and paired t-test were used where appropriate and p-value < 0.05 was considered significant. RESULTS: NO production in normal umbilical cords was not different regardless of perfusate. Although adding histamine and calcium ionophore, the NO production was slightly increased but statistically not significant in both groups. NO production in preeclamtic umbilical cords was significantly increased with 15% preclamptic serum(15% normal serum vs. 15% preeclamptic serum; 0.060+/-0.016microgram/ml/min vs 0.075+/-0.014microgram/ml/min, p<0.05). CONCLUSION: The preeclamptic sera may not affect the production of NO in the human umbilical vein endothelial cells. The biologic significance of increased NO production in preeclamptic umbilical cord with perfusing preeclamptic serum is unknown, but it might be compensation for the vasoconstriction of preeclampsia.
Calcium ; Cesarean Section ; Compensation and Redress ; Female ; Histamine ; Human Umbilical Vein Endothelial Cells ; Humans ; Nitric Oxide* ; Perfusion ; Plasma ; Pre-Eclampsia* ; Pregnancy ; Pregnant Women ; Umbilical Cord ; Umbilical Veins ; Vasoconstriction

No abstract available.
Bowen's Disease*

Stress distribution on mandibular implants supporting overdentures were registered in vitro experimental model by means of 4 rosette gauges which were placed around the implant. The overdenture attachments used in this study were the Resilient Dolder bar, Rigid Dolder bar, Round bar, Hader bar&Dal-Ro attachment. An occlusal jig was placed on the overdenture and the loading sites were 3 points which mimicked working, balancing, and median relations. With 5 and 10kg loading, strains were measured by strain indicator(P-3500, Measurement group, Raleigh, USA), and using these data, maximum and minimum principal stresses and Von Mises stress were calculated and evaluated. The results were as follows: There was a tendency of high stress concentration in the lingual side of the implant, and in the buccal side low stress was developed regardless of the attachment systems. The resilient Dolder bar concentrated highest stress among the attachment systems, and the Round bar and the Dal-Ro attachment provided comparatively low stresses around the implant. The rigid Dolder bar concentrated high stress in the mesial side, and the Dal-Ro attachment developed tensile stress patterns in the lingual and distal sides of the implant at the balancing relation.
Denture, Overlay* ; Models, Theoretical

OBJECTIVE: The changes of the production of nitric oxide in preeclampsia are still controversial. To determine the changes of nitric oxide production in preeclamptic pregnancies, NOS activity and eNOS and iNOS expression in preeclamptic placentae were compared with those in normal placentae, and to determine the changes of nitirc oxide production according to the sites of placenta, NOS activity and eNOS expression in preeclamptic placentae were also compared with those in normal placentae. METHODS: Human placentae were obtained from 15 normal and 15 preeclamptic pregnant women at the time of cesarean section. NOS activity was assessed by measuring the conversion of [3H]-arginine into [3H]-citrulline. The eNOS and iNOS expression were assessed by using western blot analysis. Data were analyzed by Student t-test and paired t-test where appropriate. RESULTS: The NOS activity(judged by measurement of [3H]-citrulline production) was significantly increased in preeclamptic placentae compared to normal(P<0.05). In normal and preeclamptic pregnant placentae, the NOS activity in main stem villi was increased compared to that in terminal villi. However, the difference of NOS activity between main stem villi and terminal villi was not significant(P>0.05). Quantification of the autoradiographic images demonstrated that the integrated optical density of the immunoreactive bands of eNOS were significantly lower in preeclamptic placentae compared to normal(p<0.05). Conversely, the integrated optical densities of the bands of iNOS were significantly higher in preeclamptic placentae compared to normal(p<0.05). CONCLUSIONS: Although the eNOS expression in preeclamptic placentae was lower than that in normal placentae, the NOS activity was significantly higher in preeclamptic placentae than that in normal in this study. These are result from increased production of iNOS in the compensatory mechanisms for the decreased nitric oxide production in pre-eclamptic placentae.
Blotting, Western ; Cesarean Section ; Female ; Humans* ; Nitric Oxide Synthase* ; Nitric Oxide* ; Placenta* ; Pre-Eclampsia ; Pregnancy* ; Pregnant Women

PURPOSE: To identify factors that influence serum zinc concentrations in children with acute gastroenteritis. METHODS: Thirty-two children under 5 years of age (15 boys and 17 girls) were selected randomly among those who visited to an pediatric emergency room of Ehwa Womans University Mokdong Hospital with acute gastroenteritis from May to August 2005. This study estimated the association between serum zinc concentrations and clinical, biochemical variables in patients with acute gastroenteritis. RESULTS: Serum zinc concentration was lower in febrile patients than afebrile patients with acute gastroenteritis (67.0+/-25.3 vs 85.5+/-14.2, p<0.05). It also was lower in patients with positive C-reactive protein (CRP) than those with negative CRP (63.9+/-25.4 vs 86.7+/-13.8, p<0.05). Serum zinc concentration was negatively correlated (r=-0.494, p<0.05) with CRP concentration, whereas positively correlated with hematocrit (r=0.370, p<0.05), total protein (r=0.474, p<0.05), and albumin (r=0.636, p<0.05). Twelve patients (37.5%) showed very low serum zinc concentration (<70 microgram/dL) without clinical symptoms of deficiency or growth retardation. Frequency of febrile illness or positive CRP is significantly greater in group with zinc <70 microgram/dL than the group with zinc > or =70 microgram/dL (91.7% vs 55%, p<0.05; 91.7% vs 40%, p<0.05, respectively). CONCLUSION: In patients with acute gastroenteritis, serum zinc concentration was influenced by various factors such as fever, CRP, and biochemical factors. For evaluating zinc status in the body. factors.
C-Reactive Protein ; Child* ; Emergency Service, Hospital ; Female ; Fever ; Gastroenteritis ; Hematocrit ; Humans ; Zinc*