No abstract available.
Ethical Review*

No abstract available.
Coronary Artery Disease* ; Coronary Vessels* ; Dobutamine* ; Echocardiography, Stress* ; Humans ; Myocardium* ; Tomography, Emission-Computed, Single-Photon*

Physicians in Korea are nowadays confronted with unprecedented difficulties in practicing medicine-at every point of patient care, they should be prepared against any possibilities of medical disputes, among which ones related to medical certificates are not infrequent. Physicians issue medical certificates based on comprehensive findings from physical examinations and laboratory tests to prove the health status of the patients. Although physicians prepare medical certificates as private documents, they take effect as official documents. Hence medical certificates should be prepared with understanding of relevant health care-related laws to avoid unnecessary and avoidable medical disputes.
Dissent and Disputes ; Humans ; Jurisprudence ; Korea ; Patient Care ; Physical Examination

This survey was conducted from January 1991 to May 1991. Two hundred and eight residents in 4 government supported homes for the aged and hundred and eleven living in the community in Taegu, Korea, were examined to evaluate the depression and the anxiety of the aged with combined anxiety and depression scale (CADS) and somatization symptom check list (SCL). There are no significant differences between residents in the home for the aged and those living in the community on the total scores of CADS and SCL. However, in the case of the total score of CADS of the female subjects in the home for the aged were significantly higher than those of the community residents. The elderly in the home for the aged tended to have pure depression, while community residents were likely to have anxiety and depression. Fifty-two subjects of home for the aged and sixty-nine of the community scored over 50 points of CADS, which indicates considerable depression or anxiety. In psychosocial factors, the subjects who in the following situations had statistically significant higher scores than others. The results were as follow. Poor health, unhappiness, unsatisfaction to the past occupation, pessimistic thought in future view for both group and unsatisfaction of the relationship with familiar people for the elderly in the community. The SCL scores of two groups subgrouped by under 49 and 50 on CADS showed significant differences between each subgroup on all of the SCL items. It could be suggested that somatic symptoms for the aged is a sign of depression.
Aged* ; Anxiety* ; Daegu ; Depression* ; Female ; Homes for the Aged ; Humans ; Korea ; Occupations ; Psychology

No abstract available.

BACKGROUND: To compare the diagnostic usefulness of dobutamine stress echocardiography(DSE) and 99mTc-methoxyisobutyl isonitrile SPECT (MIBI SPECT), two studies were performed simultaneously. METHOD: Fifty-six consecutive patients undergoing coronary angiogram and MIBI SPECT for clinical indications without clincal evidence of myocardial infarction were studied prospectively. During the DSE, MIBI was injected at peak stress, and post-stress images of MIBI SPECT were required on hour later. Both echocardiographic and MIBI SPECT images were visually analysed in a blind fashion. RESULTS: On the basis of coronary angiographic findings, the sensitivites of the DSE and MIBI SPECT (n=36) were 89% and 86%, respectively. The specificities of those (n=20) were 90% and 85%, respectively. Among 33 patients without resting perfusion defect on MIBI SPECT, resting regional wall motion abnormalities on DSE were found in only one patient, whereas, resting perfusion defect on MIBI SPECT were found in 9 patients among 41 patients without resting regional wall motion abnormalities on DSE. Among 17 patients who had resting perfusion defects with partial reversibility on MIBI SPECT, resting wall motion abnormalities were present in 11 patients and five of them showed improvement in the regional wall motion during low dose dobutamine infusion. CONCLUSION: Both dobutamine stress echocardiography and MIBI SPECT are useful methods in the detection of the coronary artery disease, however, MIBI SPECT seems to overestimate the regional ischemic myocardium with contractile reserve that can hardly be evaluated with MIBI SPECT.
Coronary Artery Disease* ; Coronary Vessels* ; Dobutamine* ; Echocardiography ; Echocardiography, Stress* ; Humans ; Myocardial Infarction ; Myocardium* ; Perfusion ; Prospective Studies ; Tomography, Emission-Computed, Single-Photon*

BACKGROUND/AIMS: Imrnortalized human fetal liver cell lines established by transfecting simian virus 40 T gene wae found to lose differentiated liver cell functions in successive long-term culture. Butyrate, known as a differentiation-promoting agent for a variety of cancer cell lines, is produced in the colon by bacterial flora and selectively transported into the liver though the portal blood flow. Therefe, butyrate might play a role in the maintenance of differentiation in hepatocytes in vivo. In thepresent study, the effects of butyrate on cell growth and differentiation in human fetal liver cell lines was investigated. METHODS: Human fetal liver cell lines imrnortalized by SV 40 T antigen were treated with sodium butyrate (1mM), and cell growth rate after butyrate treatment were nmsured by the number of viable cells, determined by trypan blue dye exclusice method. The effects of sodium butyrate on the hepatocyte-specific differentiatian were assessed by albumin and alfa-fetoprotein (AFP) mRNA expression, analyzed using reverse-transcription polymerase chain reaction, and were also by the increment of albumin secretion into culture media, determined by a competitive inhibition ELISA. RESULTS: Treatment with sodium butyrate resulted in a cessation of cellular proliferation and alterations in cellular morphology (increased cell size and polygonal change in shape). The level of albumin mRNA after sodium butyrate treatment was elevated by about two times as compared to that of control. In contrast, AFP mRNA expression were dennstrated neither before nor after sodium butyrate treatment. The average amount of albumin released in the medium was less than 6pghnl/10'cells/2days in the absence of sodium butyrate, and increased to 17 p g/ml/10'cells/2days at day 2, 21ugfml 10'cells/2days at day 4 in the presence of sodium butyrate, and these levels thereafter were over 10 times higher than that in the absence of sodium butyrate until day 10. CONCLUSION: These mults indicate that treatment of immcetalized fetal liver cell lines with butyrate leads to inhibition of cellular proliferation and promotion of adult hepatocyte-specific differentiation.
Adult ; Antigens, Viral, Tumor ; Butyrates ; Butyric Acid* ; Cell Line* ; Cell Proliferation ; Cell Size ; Colon ; Culture Media ; Enzyme-Linked Immunosorbent Assay ; Hepatocytes ; Humans* ; Liver* ; Polymerase Chain Reaction ; RNA, Messenger ; Simian virus 40 ; Sodium* ; Trypan Blue

BACKGROUND: Tetracaine has been the most commonly used long-acting spinal anesthetic agent. Recently, hyperbaric bupivacaine was introduced to be useful agent, and has been reported to produce the better quality of anesthesia. The aim of the present investigation was to compare the anesthetic effects of 0.5% hyperbaric bupivacaine and 0.5% hyperbaric tetracaine spinal anesthesia. METHODS: 40 ASA Class I patients undergoing lower extremity operation were randomly distributed to two groups. Group A (n=20) received 15mg, 0.5% bupivacaine in 8% glucose, while Group B (n=20) received 15mg, 0.5% tetracaine in 10% glucose in the lateral decubitus position (L3,4 interspace). We evaluated the sensory and motor blockade, cardiovascular effects and the incidence of tourniquet pain. RESULTS: The mean maximum cephalad spread of analgesia was higher in bupivacaine group (T5) than in tetracaine group (T6) and the spread time was more rapid in bupivacaine group (13.1 +/- 3.3min.) than in tetracaine group (15.8 +/- 4.3min.), but there were no statistical significances. Tetracaine group was earlier onset of motor block and the duration of complete motor block in tetracaine group was significantly longer than in bupivacaine group. The mean decrease in systolic and diastolic blood pressure was 10% to 25% in both groups and more marked in tetracaine group. The incidence of tourniquet pain was greater in tetracaine group than in bupivacaine group. CONCLUSIONS: The quality of anesthesia obtained with bupivacaine may be superior to that produced by tetracaine. We concluded that 0.5% hyperbaric bupivacaine was suitable for short orthopedic or lower abdominal surgery because of less incidence of hypotension, shorter duration of motor block and lower incidence of tourniquet pain.
Analgesia ; Anesthesia ; Anesthesia, Spinal* ; Anesthetics ; Blood Pressure ; Bupivacaine ; Glucose ; Humans ; Hypotension ; Incidence ; Lower Extremity ; Orthopedics ; Tetracaine* ; Tourniquets

PURPOSE: This study was done to determine the diagnostic efficacy of clinical examination, fine needle aspiration (FNA) cytology, mammography, and ultrasonography in palpable breast mass. METHODS: We performed 248 FNA cytologies for a palpable breast mass, among which 106 cases were histologically examined during the period from Jan. 1994 to Dec. 1997 at the Department of Surgery, Chonbuk National University Hospital. Among the 106 patients, mammography was done for 96 patients, and ultrasono graphy for 73 patients. RESULTS: The main clinical symptom was a palpable mass in the breast at the time of visitation. Clinical diagnosis based on symptoms and physical examination had a sensitivity of 96.9% and a specificity of 57.5%. Based on a definite histologic diagnosis, the sensitivity of FNA cytology was 96.9%, its specificity was 91.7%, and its diagnostic accuracy 93.5%. 86.1% of the cytologically malignant cases proved to be malignant histologically, and 100% of the cytologically benign cases turned out histologically benign. Mammography had a sensitivity of 89.3%, a specificity of 84%, and a diagnostic accuracy of 86.8%. Ultrasonography showed a 93.5% sensitivity, a 51.4% specificity, and a 74.6% diagnostic accuracy. CONCLUSION: FNA cytology was a reliable and safe diagnostic method compared to physical examination, mammography, and ultrasonography. FNA cytology of a palpable breast mass should be the diagnostic procedure of choice for those patients classified clinically as probably benign or malignant.
Biopsy, Fine-Needle* ; Breast* ; Diagnosis ; Humans ; Jeollabuk-do ; Mammography* ; Physical Examination ; Sensitivity and Specificity ; Ultrasonography*

No abstract available.
Esophageal Atresia* ; Tracheoesophageal Fistula*