No abstract available.
Embryonic Structures* ; Humans*

PURPOSE: The purpose of this study was to analyze and clarify the ambiguous concept of DNR, and to distinguish between DNR and euthanasia. METHOD: This study used the process of Walker & Avant's concept analysis. RESULT: The definable attributes of DNR were care for comfort, no further treatment and no CPR. The antecedents of DNR were the autonomy of patients and families feelings about death, the uselessness of treatment and the right to die with dignity. The process of the DNR decision should be documented and the antecedents of DNR also can be a basis for objective standards of DNR decision-making. The result of DNR was the acceptance of death by patients and families. CONCLUSION: DNR is decided and documented by the antecedents of DNR, and the result is a natural acceptance of death, the last process of human life. Hospice care should be activated and nurses must be patient's advocates and families' supporters in the process.
*Attitude to Death ; Decision Making ; Family ; Hospice Care ; Humans ; *Resuscitation Orders

No abstract available.
Tretinoin*

So many modalities have been suggested for the treatment of servere pain and ankylosis of the elbow with destruction of the articular surfaces. Among them, two major methods which have been widely used are resection arthroplasty and prosthetic replacement arthroplasty. However prosthetic replacement arthroplasty has some problems. Its indications are limited in the elderly inactive subjects. And there have been many kinds of complications including loosening and infection. Also, resection arthroplasty in now rarely indicated due to severe instability. From July 1980 to July 1987, we tried distraction arthroplasty in 8 cases of elbow with severe destruction of its articular surfaces, mainly in the young active persons. The average follow-up period was 45 months. The effect of distraction arthroplasty on relief of pain was not remarkable. The average increase in ROM, including that of one reankylosed elbow, was 51 ±22 degrees in flexion-extension and 48 ±23 degrees in pronstion-supinstion. No deep wound infection and instability which was main complication of resection arthroplasty were observed with our method of distraction arthroplasty. On the basis of functional results, the the results were excellent in 4, good in 1, fair in 2 and poor in 1 cases. In conclusion, distraction arthroplasty of the elbow can be one of the of effective methods reconstruction for the young active patients with the destruction of the elbow, if they are intelligent and motivated.
Aged ; Ankylosis ; Arthroplasty ; Arthroplasty, Replacement ; Elbow ; Follow-Up Studies ; Humans ; Methods ; Wound Infection

Air bag has gained increasing acceptance as a device that reduce serious head and chest injury in vehicle accident. Although air bag reduces incidence and severity of facial and periorbital trauma, the possibility of ocular trauma by air bag inflation itself cannot be trivialized. We experienced a patient who developed hyphema, angle recession and macular hemorrhage after air bag inflation, and reviewed the available literatures regarding this type of injury.
Air Bags* ; Head ; Hemorrhage* ; Humans ; Hyphema* ; Incidence ; Inflation, Economic ; Thoracic Injuries

This Study has been carried out to make a recommendation for the next amendment of the Infectious Disease Prevention Act with a specific focus on the kind of notifiable disease. Korean, Japanese, German, U.S, English and French acts on infectious diseases prevention were reviewed, compared with and analyzed in regards of numbers and kinds of notifiable infectious diseases and their tendency of amendments. An criteria was designed to assess the level of validity of diseases to be designated in the act. Four items, the fatality (greater than 10% or not), the possibility to make a big epidemic, the availability of efficient vaccination and the usefulness of isolation, are used in the assessment. This index is applied to the diseases in Korean and other countries' Infectious Disease Prevention Acts. Results are as follows : 1. The Korean Infectious Disease Prevention Act has a unique way of classifying the notifiable infectious disease, that is, the first, the second and the third class. But the author cannot find the basis of classification. No other countries reviewed have the similar classification. 2. The ten diseases, cholera, plague, yellow fever, diphtheria, typhoid fever, poliomyelitis, rabies, tetanus, malaria, and meningococcal meningitis are designated as the notifiable diseases not only in Korea but also in Japan, Germany, United States, England and France. 3. Thirty seven diseases including small pox, Lassa fever, anthrax, influenza, German measles, Legionellosis, infection with E. coli O157:H7, Q-fever, brucellosis, Lyme disease are designated as legal disease at least one of the above mentioned countries. 4. The Korea has been coped with the change of the infectious disease occurrence for last fifty years in amendment of the Infectious Disease Prevention Act. 5. Japan has a special infectious surveillance system composed of 3,880 clinics throughout the whole country. 6. Germany has classified infectious diseases in five categories which are based on seriousness of disease. Any confirmed death, cases and suspected cases in class I should be reported within 24 hours. But only confirmed death and cases in class II, but not suspected cases, are repotable in Germany. 7. Plague, bacillary dysentery, pertussis, mumps, Japanese encephaltis and Korean hemorrhagic fevers are diseases with high credits validity index among Korean legal disease. 8. German measles, anthrax, E. coli O157:H7 infection, Lassa fever, Q-fever, brucellosis are high in validity index among those which are not designated in Korea but designated in other countries. In conclusion, the Korean Infectious Disease Prevention Act has well been coped with the changes of infectious disease occurrence for last fifty years, but the classification basis and the validity of diseases to be designated as legal diseases is worth reevaluating.
Anthrax ; Asian Continental Ancestry Group ; Brucellosis ; Cholera ; Classification ; Communicable Diseases* ; Diphtheria ; Dysentery, Bacillary ; England ; Fever ; France ; Germany ; Humans ; Influenza, Human ; Japan ; Korea ; Lassa Fever ; Legionellosis ; Lyme Disease ; Malaria ; Meningitis, Meningococcal ; Mumps ; Plague ; Poliomyelitis ; Rabies ; Rubella ; Tetanus ; Typhoid Fever ; United States ; Vaccination ; Whooping Cough ; Yellow Fever

This study evaluated the effects of combination treatment with alendronate (ALEN) and hormone therapy (HT) on bone mineral density (BMD) in postmenopausal Korean women. This multicenter, randomized, controlled clinical trial enrolled 344 postmenopausal women with low BMD. The women received HT (0.625 mg/day of conjugated equine estrogen and 2.5 mg/day of medroxyprogesterone acetate) alone or in combination with ALEN (10 mg/day) for 1 year. Changes in BMD and biochemical markers of bone turnover were evaluated. Data from 203 women (HT alone, 99; combination treatment, 104) who completed this study were analyzed. BMD at the lumbar spine and total hip increased significantly in both treatment groups after 1 year. There were no significant differences between HT alone vs. the combination of ALEN and HT in mean BMD increase at the lumbar spine (6.9% vs. 7.9%) and total hip (3.7% vs. 3.8%). Combined therapy suppressed serum osteocalcin and urinary deoxypyridinoline to a greater extent than HT alone. In conclusion, compared to HT alone, combination treatment with ALEN and HT for 1 year did not offer a benefit in BMD in postmenopausal Korean women with low BMD.
Alendronate* ; Biomarkers ; Bone Density* ; Bone Remodeling ; Estrogens ; Female ; Hip ; Humans ; Medroxyprogesterone ; Osteocalcin ; Osteoporosis ; Spine

STUDY DESIGN: Literature review. OBJECTIVES: The aim of this study was to demonstrate surgical strategies for successful minimally invasive transforaminal lumbar interbody fusion (TLIF). SUMMARY OF LITERATURE REVIEW: Although many studies have reported the benefits and disadvantages of minimally invasive TLIF, few have described surgical strategies to improve the success rate or to reduce complications. MATERIALS AND METHODS: We searched for studies reporting the clinical and radiological outcomes of minimally invasive TLIF, and analyzed the optimal indications, technical pitfalls, and tips for successful surgical outcomes. RESULTS: The ideal candidate for minimally invasive TLIF is a patient with single or 2-level low-grade adult degenerative or isthmic spondylolisthesis. Incomplete decompression, dura tearing, nerve root injury, and implant-related complications were found to be the most commonly reported adverse events, especially in the early periods of a surgeon's experience. Precise positioning for skin incision and tube insertion, complete neural decompression, proper interbody preparation for bone graft and cage insertion, and the correct placement of percutaneous pedicle screws are critical strategies for successful surgical outcomes. Fully understanding the surgical pitfalls and tips described in this review is also important to avoid potential complications. CONCLUSIONS: It is imperative not only to carry out a comprehensive preoperative evaluation and proper patient selection, but also to perform meticulous surgical procedures with thoughtful considerations of potential pitfalls, in order to improve the success rate and to reduce the complications of minimally invasive TLIF.
Adult ; Decompression ; Humans ; Patient Selection ; Pedicle Screws ; Skin ; Spondylolisthesis ; Tears ; Transplants

Lipoma of the head and neck region rarely occurs, if any, on the posterior triangle of neck. We have experienced a lipoma on Eustachian tube, which caused recurrent middle ear effusion. A 42-year-old female patient was presented with right aural fullness and hearing disturbance. She had a history of several cases of right middle ear effusion in the past and insertions of ventilation tubes to relieve each of them. A yellowish round mass was found on the pharyngeal orifice of the right Eustachian tube by fiberoptic nasopharyngoscopy. It was removed via endoscopic endonasal approach and there is no evidence of recurrence along about 3 months after the surgery. This would be a good case for the importance of nasopharyngeal examination in patient with middle ear effusion.
Adult ; Ear, Middle ; Eustachian Tube ; Female ; Head ; Hearing ; Humans ; Lipoma ; Neck ; Otitis Media with Effusion ; Recurrence ; Ventilation

OBJECTIVE: The aim of this paper was to develop efficient and practical health promotion strategies in the workplace by investigating both the present status of health promotion and the barriers to its practice. METHODS: A questionnaire was administered to 20% of industrial workers in the workplaces which receives the health care agency enterprise or are supported by a grant from the national treasury, K University Hospital in Gyeong-Gi province, and C University Hospital in Seoul. RESULTS: According to the questionnaire survey, 51.3% workers were practicing health promotion activities and smoking cessation was the most common method among them. Regarding the factors that prompt workers to commence health promotion activities, TV or the mass media had a 33.4% effect, followed by a 22.1% effect for an abnormal finding at regular health screening. The most necessary health promotion activity in the workplace was exercise (41.9%), followed by stress management. When asked about their expectations of the health promotion program, 84.8% of the respondents answered that they expected it to be significantly or somewhat effective. Factors affecting the health promotion activities of workers were worker's health status and job control. CONCLUSIONS: This study demonstrated that workers evaluate health promotion activities positively and that some workers are unable to participate in these activities despite their willingness to do so due to the barrier of circumstances. To encourage worker's participation, the government and employers should remove barriers.
Community-Institutional Relations ; Data Collection ; Delivery of Health Care ; Financing, Organized ; Health Promotion* ; Mass Media ; Mass Screening ; Occupational Health ; Questionnaires ; Seoul ; Smoking Cessation