Cervicography is used commonly in cervical cancer screening with a Pap smear. Many reports shows that the combination of these two methods is more accurate and helpful in cervical cancer screening. OBJECTIVE: The purpose of this investigation was to evaluate the efficacy of conjoined methods in cervical cancer screening and to evaluate any difference between health care center and out-patient treatment. METHODS: Pap smear and cervicogram data were obtained for 699 patients who visited the Department of Obstetrics and Gynecology, Chungnam National University Hospital from January 1997 to December 1997. Of these patients, 551 patients visited the health care center and 148 were out-patients. We exmined all pertinent information, including biopsy results, for patients with detected abnormalities. A total of 62 patients received a biopsy. RESULTS: 1. Results for Papanicolaou smear were: sensitivity, 81.8%, specificity, 98.0%, positive predictive value, 83.7%, negative predictive value, 98.8%, false negative rate, 18.2%, and false positive rate, 2.0%. 2. Results for cervicography were: sensitivity, 86.4%, specificity, 97.8%, positive predictive value, 73.1%, negative predictive value, 99,1%, false negative rate, 13.6%, and false positive rate, 2.2%. 3. Results for the conjoined method were: sensitivity, 97.7%, specificity, 97.2%, positive predictive value, 70.5%, negative predictive value, 99.8%, false negative rate, 2,3%, and false positive rate, 2.8%. 4. When cervicography and Papanicolaou smear were used conjointly The sensitivity, specificity, negative predictive value, false negative rate, and false positive rate were statistically significant for Papanicolaou smear (P<0.05). 5. There was no statistical significance difference between cervicography and the conjoined method. 6. Compared with out-patients, Health care center patients showed increased diagnostic error and failure to follow-up. CONCLUSION: When cervicography and Papanicolaou smear were used conjointly, cervical cancer detection rates were increased.
Biopsy ; Chungcheongnam-do ; Delivery of Health Care ; Diagnostic Errors ; Follow-Up Studies ; Gynecology ; Humans ; Mass Screening* ; Obstetrics ; Outpatients ; Papanicolaou Test ; Sensitivity and Specificity ; Uterine Cervical Neoplasms*

No abstract available.
Adenocarcinoma*

PURPOSE: We reported the CT and MR findings of 2 cases with Sturge-Weber syndrome which were not accompanied by facial nevi. MATERIALS AND METHODS: They were examined with both CT and MR in one case and with MR only in the other case. RESULTS: CT was better than MR in the demonstration of the characteristic cortical calcification. MR was superior to CT in the depiction of the abnormalities of the surrounding parenchyma and the intense enhancement of pial angiomatosis with Gd-DTPA enhancement. CONCLUSION: Gd-DTPA enhanced MR imaging could be useful in the demonstration of the presence and extent of pial angiomatosis in patients with suspected Sturge-Weber syndrome.
Angiomatosis ; Gadolinium DTPA ; Humans ; Magnetic Resonance Imaging ; Nevus* ; Sturge-Weber Syndrome*

Hamartoma of the breast is a rare benign lesion presenting as palpable mass. They are, however, sometimes misdiagnosed by pathologist due to their resemblance to other benign or physiologic conditions of the breast. We report two cases of hamartomas of the breast. The clinical diagnosis was fibroadenoma in both cases. One patient was a 49-year-old woman presented with palpable mass for the duration of 5 months. Mammography showed a well demarcated round mass with homogeneous density which is slightly greater than the surrounding glandular tissue. Grossly it was a 3.5 3.0 2.0 cm sized round firm mass covered by thin fibrous tissue. Microscopically it was a well defined mass composed of variable amount of breast lobules, dilated ducts and adipose tissue surrounded by dense hyalinized connective tissue. The adipose tissue accounted for 30% of the entire lesion. Cellular atypism was not found. The other patient was a 18-year-old woman presented with palpable mass of the duration of 3 years, which was increased in size recently. Mammography demonstratesd a well delimited lobulated mass with lucent halo. Ultrasonography showed a well encapsulated low echoic mass admixed with high echoic areas. Grossly, it was a 4.0 4.0 2.0 cm sized well demarcated oval-shaped firm mass with translucent thin fibrous capsule.. Microscopic findings were similar to the former. The amount of adipose tissue was 20%.
Adipose Tissue ; Adolescent ; Breast* ; Connective Tissue ; Diagnosis ; Female ; Fibroadenoma ; Hamartoma* ; Humans ; Hyalin ; Mammography ; Middle Aged ; Ultrasonography

PURPOSE: The purpose of this study was to evaluate Cardiopulmonary Resuscitation ability and level of knowledge among certain dental hygienists in Seoul and Gyeonggi-do. METHODS: We surveyed ability and knowledge of CPR among dental hygienists working at dental offices and dental hospitals located in Soul and Gyeonggi-do from September 18, 2010 to October 16, 2010. Data acquired from dental hygienists who had completed the questionnaire that we designed were used in the analysis. Uni- and bi-variate analysis and Chi-square test were performed using SAS 9.2. RESULTS: According to our findings, among respondents, approximately 14.29% of dental hygienists had a CPR license. Their CPR licenses are affected by working period, job position, and level of education (p<.05). Factors including working period, type of CPR license, and CPR license renewal were indicators of CPR knowledge level (p<.05). Significant differences were observed among dental hygienists with regard to subjective CPR abilities, which is dependent on obtaining a CPR license, CPR knowledge level, and education channel for CPR (p<.05). CONCLUSION: CPR ability and knowledge level among dental hygienists were not sufficient to save emergency people in the dental clinic. In order to save emergency patients patients, implementation of a CPR education and renewal program for dental hygienists is recommended.
Cardiopulmonary Resuscitation ; Surveys and Questionnaires ; Dental Clinics ; Dental Hygienists ; Dental Offices ; Emergencies ; Humans ; Licensure ; Phenothiazines ; Resuscitation

BACKGROUND: It has been reported that sudden cardiac death can occur in postoperative tetralogy of Fallot (TOF) and this episode is related to the sustained ventricular tachyarrhythmia. However, the connecting mechanism of various clinical features and sudden cardiac death is not defined yet. Based on the reports that sudden cardiac death is related to the alteration of heart rate dynamics in some diseases, investigation of heart rate dynamics in postoperative TOF seems important to reveal the mechanism of sudden cardiac death. This study was done as a part of the project to investigate the alteration of heart rate variability and to identify the factors related to the sudden cardiac death in postoperative TOF. METHODS: Among the children with postoperative TOF, 13 asymptomatic children without significant hemodynamic disturbances (Doppler velocity for tricuspid regurgitation 2.5m/sec and mild pulmonary regurgitation) and ventricular arrhythmia were selected (10 boys, 3 girls; mean age, 9 year 3 months; mean duration after operation, 7 years). We evaluated the complexity and periodic dynamics of heart rate (HR) throughout 24 hours in these children and control group (mean age, 8 year 10 months). After examining each ECG data on 24-hour Holter ECG segmented into 1-hour length, we analyzed each HR time series and quantified the overall complexity of each HR time series by its correlation dimension. In addition, the power spectrum of HR and obtained low-frequency component (0.08-0.15Hz) and high-frequency component (0.15-0.4Hz) were calculated. RESULTS: This study showed that TOF group had lower correlation dimension and a nonlinear characteristics of HR time series than control group (4.055+/-0.4134 vs. 4.9310+/-0.2054, p<0.05). However, the difference was not significant in the low- (0.9864+/-0.5598 vs. 1.5560+/-0.8325, p<0.05) and high- (1.1168+/-0.1.1448 vs. 0.9271+/-0.6528, p<0.05) frequency components. CONCLUSIONS: It can be concluded that HR time series are more regular in postoperative TOF. The result was significant in correlation dimension analysis and not in the frequency domain analysis. Although the meaning of this finding in postoperative TOF is not clear at present, this may suggest the phenomenon related to the sudden cardiac death.
Arrhythmias, Cardiac ; Child* ; Death, Sudden, Cardiac ; Electrocardiography ; Female ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Tachycardia ; Tetralogy of Fallot* ; Tricuspid Valve Insufficiency

BACKGROUND: It has been reported that sudden cardiac death can occur in postoperative tetralogy of Fallot (TOF) and this episode is related to the sustained ventricular tachyarrhythmia. However, the connecting mechanism of various clinical features and sudden cardiac death is not defined yet. Based on the reports that sudden cardiac death is related to the alteration of heart rate dynamics in some diseases, investigation of heart rate dynamics in postoperative TOF seems important to reveal the mechanism of sudden cardiac death. This study was done as a part of the project to investigate the alteration of heart rate variability and to identify the factors related to the sudden cardiac death in postoperative TOF. METHODS: Among the children with postoperative TOF, 13 asymptomatic children without significant hemodynamic disturbances (Doppler velocity for tricuspid regurgitation 2.5m/sec and mild pulmonary regurgitation) and ventricular arrhythmia were selected (10 boys, 3 girls; mean age, 9 year 3 months; mean duration after operation, 7 years). We evaluated the complexity and periodic dynamics of heart rate (HR) throughout 24 hours in these children and control group (mean age, 8 year 10 months). After examining each ECG data on 24-hour Holter ECG segmented into 1-hour length, we analyzed each HR time series and quantified the overall complexity of each HR time series by its correlation dimension. In addition, the power spectrum of HR and obtained low-frequency component (0.08-0.15Hz) and high-frequency component (0.15-0.4Hz) were calculated. RESULTS: This study showed that TOF group had lower correlation dimension and a nonlinear characteristics of HR time series than control group (4.055+/-0.4134 vs. 4.9310+/-0.2054, p<0.05). However, the difference was not significant in the low- (0.9864+/-0.5598 vs. 1.5560+/-0.8325, p<0.05) and high- (1.1168+/-0.1.1448 vs. 0.9271+/-0.6528, p<0.05) frequency components. CONCLUSIONS: It can be concluded that HR time series are more regular in postoperative TOF. The result was significant in correlation dimension analysis and not in the frequency domain analysis. Although the meaning of this finding in postoperative TOF is not clear at present, this may suggest the phenomenon related to the sudden cardiac death.
Arrhythmias, Cardiac ; Child* ; Death, Sudden, Cardiac ; Electrocardiography ; Female ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Tachycardia ; Tetralogy of Fallot* ; Tricuspid Valve Insufficiency

PURPOSE: The purpose of this study was to identify factors influencing neonatal pain management by nurses in order to provide evidence-based data for the development of more efficient neonatal pain care programs. METHODS: This study used a descriptive research design to survey 204 registered nurses working in neonatal intensive care units and nurseries in Busan. Data collection was done from July to September 2010. General knowledge of pain and pain scale, pain intervention, neonatal pain management, and barriers to pain management were measured. Data were analyzed using stepwise multiple regression with SPSS 17.0. RESULTS: It was found that among the factors affecting neonatal pain management by nurses, the unit where the nurse worked was the most important influential factor, followed by knowledge of pain management, education level, and barriers from medical personnel in that order. The explanatory power of these four variables accounted for 42.0% of neonatal pain management. CONCLUSION: Study results indicate that it is necessary to develop education programs to increase knowledge of neonatal pain management for nurses caring for neonates. Also, plans for reduction of obstacle factors in medical personnel should be prepared.
Data Collection ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal ; Nurseries ; Pain Management ; Research Design ; Child Health ; Surveys and Questionnaires

No abstract available.
Breast Neoplasms* ; Breast* ; Humans ; Soil*

PURPOSE: The design of the attachment must provide an optimum stress distribution around the implant. In this study, for implant overdentures with a bar/clip attachment or a locator attachment, the stress transmitted to the implant in accordance with the change in the denture base length and the vertical pressure was measured and analyzed. MATERIALS AND METHODS: Test model was created with epoxy resin. The strain gauges made a tight contact with implant surfaces. A universal testing machine was used to exert a vertical pressure on the mandibular implant overdenture and the strain rate of the implants was measured. RESULTS: Means and standard deviations of the maximum micro-deformation rates were determined. 1) Locator attachment: The implants on the working side generally showed higher strain than those on the non-working side. Tensile force was observed on the mesial surface of the implant on the working side, and the compressive force was applied to the buccal surface and on the surfaces of the implant on the non-working side. 2) Bar/clip attachment: The implants on the both non-working and working sides showed high strain; all surfaces except the mesial surface of the implant on the non-working side showed a compressive force. CONCLUSION: To minimize the strain on implants in mandibular implant overdentures, the attachment of the implant should be carefully selected and the denture base should be extended as much as possible.
Denture Bases* ; Denture, Overlay* ; Dentures*