No abstract available.
Breast Neoplasms* ; Breast* ; Cyclin D1* ; Cyclins* ; Survival Rate*

No abstract available.
Animals ; Dinoprostone* ; Female ; Humans* ; Menstrual Cycle* ; Oviducts*

PURPOSE: 2003, Advances in medical-surgical technologies, histo-compatibility and immunosuppressive drugs, such as FK-506, MMF, have caused a dramatic increase in the rates of successful organ transplantation (TP). As the waiting list of patients requiring TP grows, there is a subtle donation. What is worse, its increased issues of ethics, for instance, definition of brain death, consent of living donation, paid organ donation, decreased altruism, living will, justice of sharing organ. Therefore, This study was done to develop on legal, ethical and philosophical for whole procedure of organ transplantation which is a life-saving treatment improvement the quality of life. METHODS: A survey questionnaire was used and received responses from TP doctors(59) and nursing coordinators(46) at 53 hospitals where TP were being done for this study. The basic data in TP were collected, 1) to identity the staffs in charge of TP and their jobs in the hospital, 2) committee of hospital ethics (CHE), 3) committee of brain death confirmation definition (CBDCD), 4) to research what consideration are appropriate donors and recipients, 5) the facility of hospital for TP, 6) to analyzed awaiting solution the problems for TP. The data were analyzed using SAS-program by descriptive statistics, t-test, ANOVA and Pearson correlation coefficient. RESULTS: The jobs of TP nursing coordinators were not only to give nursing information but also to take care of donors and recipients (62.8~84.4%). The job of TP has not been identified between CHE and CBDCD (62.8%). The mean score of CHE's members was 6.33 persons. The mean scores of the problems regarding the law of TP was 2.88 (full score:4). The high items of the problems regarding the law of TP were "the decreased TP, donation and brain death because of KONOS (Korea Network for Orgen Sharing) which operated TP". The mean score of the improvements regarding the law of TP was 2.97 (full score:4). The highest item of the improvements regarding the law of TP was "Compensation of loss should be paid by the KONOS. The procedure of confirm is a loose legal. Therefore that is concern about commercialization of human organ. Definition of brain death is rigid regulation. Sharing organs are a fair dealing. The problems were significantly correlated with the improvements (P<0.0001). CONCLUSION: The finding of the study suggested that a TP should manage donors and recipients in line with legal, ethical, philosophical, humanistic aspects. Various viewpoints, the CHE should be enacted from the principle of human dignity, conducted by CBDCD of professional members and the nursing coordinators played an important role. It is suggested that TP might meet the request of the time so that KONOS should be changed with the other organization of newly methods and responsibility.
Altruism ; Brain Death ; Ethics ; Ethics, Institutional ; Humans ; Jurisprudence* ; Living Wills ; Nursing ; Organ Transplantation* ; Personhood ; Quality of Life ; Surveys and Questionnaires ; Social Justice ; Tacrolimus ; Tissue and Organ Procurement ; Tissue Donors ; Transplants* ; Waiting Lists

Inflammatory myofibroblastic tumor (IMT) is a space occupying lesion which is composed of myofibroblasts, plasma cells, and lymphocytes. IMT of the maxillary sinus is rare and its etiology is unknown. We present a case of inflammatory myofibroblastic tumor occurring in the right maxillary sinus of a 57-year-old woman. Radiologically, this tumor was interpreted as malignant neoplasm. On histologic examination, bundles of spindle cells were admixed with inflammatory cells including mature plasma cells and lymphocytes. On the basis of the immunohistochemical findings and ultrastructural features, we recognized that the intervening spindle cells were myofibroblasts. We discussed etiology and prognostic factors of this tumor.
Female ; Humans ; Lymphocytes ; Maxillary Sinus* ; Middle Aged ; Myofibroblasts* ; Plasma Cells

A case of generalized pustular psoriasis in a 12 year-old girl is described. She had generalized pustular eruptions on erythematous base, presenting lake of pus, yellowish brown crusts and denudation associated with high fever and chills. With the administration of oral etretinate at a dose of 0.8mg/kg/day for 1 week, rapid and dramatic remission was achieved. About 3 months after her discharge, there developed another wave of new pustules with fever. She was again placed on etretinate therapy. However, there was no expected response as before with developing new pustules continuously. At that time, we tried combination therapy with etretinate and methotrexate. the pustules and erythema began to remit, with eventual clearing of the skin in 6 weeks.
Acitretin* ; Child ; Chills ; Erythema ; Etretinate* ; Female ; Fever ; Humans ; Lakes ; Methotrexate* ; Psoriasis ; Skin ; Suppuration

BACKGROUND: As information technology evolves rapidly computer-based surveillance systems for nosocomial infection have been developed. Well designed computerized system could provide an opportunity for improving, enlarging, and conducting hospital-wide surveillance more efficiently in the situation with limited resources. Recently, we launched a new computerized monitoring system in a hospital where digital medical information system has been operated without paper chart. METHODS: We developed a new surveillance program based on the total Electronic Medical Record (EMR) system. Numerous critical medical information can be easily accessible through this system without further work. This includes major demographic data, essential information from the inpatient medical record, the laboratory information system, and the pharmacy information, Comprehensive Clinical Data Repository (CDR) system was also developed. CDR is potentially very useful to conduct a hospital-wide surveillance by integrating all the available information. RESULTS: This system consists of several programs in the EMR and the CDR environment. In the EMR system, inquiry for patients with fever, case ascertainment and registration of nosocomial infections, inquiry for patients with indwelling devices, microbiological reports, and data on antibiotic prescriptions were included. The CDR has integrated comprehensive inquiries for frequency of major pathogens in clinical isolates and their trends of antibiotic resistance, nosocomial infection rates based on the duration of the devices or hospitalization, and the history of antimicrobial usage based on defined daily dosage. Data obtained from the EMR and the CDR systems could be easily accessed by infectious diseases specialists and healthcare workers of infection control services at any place within the hospital. A new reporting system has been built up to facilitate identification of notifiable diseases among the list of diagnoses on the EMR. In addition, the "Alert" notice was designed to highlight isolation precautions for indicated cases. CONCLUSION: This new computerized surveillance program might be a valuable model to which other hospitals can refer to develop newer version of programs in the future.
Clinical Laboratory Information Systems ; Communicable Diseases ; Cross Infection ; Delivery of Health Care ; Diagnosis ; Drug Resistance, Microbial ; Electronic Health Records* ; Fever ; Hospitalization ; Humans ; Infection Control ; Information Systems ; Inpatients ; Medical Records ; Pharmacy ; Prescriptions ; Specialization

Obtaining an available information on health concerns of parents of school-age children and furthermore developing the sound policy for the public on health education, this study was conducted during Nov.-Dec. 1985 in the four selected areas; Seoul, large, middle and small city, and farming and fishery villages for 3,337 parents of schoolchildren in Korea. In this study, parents complected a questionnaire containing 34 items related to health concerns(e.g. drinking alcohol, air pollution, cancer, etc. see Table 4 and Fig. 2). For each health items, respondents were asked to indicate a choice between three levels of concern; "Very high concern", "Moderate concern", "Little concern", and "No opinion". An analysis of responses indicated that most of the top ten health concerns identified by parents as cancer, abortions among high school students, medical malpractice, water pollution, traffic accidents, air pollution, suicide of parents and homicide of offspring, heart disease, venereal diseases, and high blood pressure in that order. Those health problems about which respondents were least concerned were more closely related to the individual, such as drinking alcohol, smoking, tooth decay, gum disease, underweight, overweight. Of greater concern were more such as water pollution, abortions among high school students, air pollution, accidents, medical malpractice. For cancer, heart disease, high blood pressure, various accidents, environmental pollution, parents showed high concern, however, for health issues which contributed as causative influences such as lung cancer from smoking and liver cirrhosis and traffic accidents from drinking alcohol showed less concern. Relationship between parent's residential areas, educational level and sex distribution and health concern showed little difference, however, for these issues parents identified as relatively high concern. Most parents showed more concern in sex-related of family-related health issues such as abortions among high school students, suicide of parents and homicide of offspring.
Accidents, Traffic ; Air Pollution ; Child* ; Surveys and Questionnaires ; Drinking ; Environmental Pollution ; Fisheries ; Gingiva ; Health Education ; Heart Diseases ; Heart Neoplasms ; Homicide ; Humans ; Hypertension ; Korea ; Liver Cirrhosis ; Lung Neoplasms ; Malpractice ; Overweight ; Parents* ; Surveys and Questionnaires ; Seoul ; Sex Distribution ; Sexually Transmitted Diseases ; Smoke ; Smoking ; Students, Medical ; Suicide ; Thinness ; Tooth ; Water Pollution

This project was a service-cum-research effort with a quasi-experimental study design to examine the health benefits of an integrated Family Planning (FP)/Maternal & Child health (MCH) Service approach that provides crucial factors missing in the present on-going programs. THE SPECIFIC OBJECTIVES WERE: 1) To test the effectiveness of trained nurse/midwives (MW) assigned as change agents in the Health Sub-Center (HSC) to bring about the changes in the eight FP/MCH indicators, namely; (i) FP/MCH contacts between field workers and their clients (ii) the use of effective FP methods, (iii) the medically supervised deliveries, (iv) prenatal care by medically qualified personnel, (v) medically supervised deliveries, (vi) the rate of induced abortion, (vii) maternal and infant morbidity, and (viii) preinatal & infant mortality. 2) To measure the integrative linkage (contacts) between MW & HSC workers and between HSC and clients. 3) To examine the organizational or administrative factors influencing integrative linkage between health workers. STUDY DESIGN: The above objectives called for quasi-experimental design setting up a study and control area with and without a midwife. An active intervention program (FP/MCH minimum "package" program) was conducted for a 2 year period from June 1982-July 1984 in Seosan County and "before and after" surveys were conducted to measure the change. SERVICE INPUT: This study was undertaken by the Soonchunhyang University in collaboration with WHO. After a baseline survery in 1981, trained nurses/midwives were introduced into two health sub-centers in a rural setting (Seosan county) for a 2 year period from 1982 to 1984. A major service input was the establishment of midwifery services in the existing health delivery system with emphasis on nurse/midwife's role as the link between health workers (nurse aids) and village health workers, and the referral of risk patients to the private physician (OBGY specialist). An evaluation survey was made in August 1984 to assess the effectiveness of this alternative integrated approach in the study areas in comparison with the control area which had normal government services. METHOD OF EVALUATION: a. In this study, the primary objective was first to examine to what extent the FP/MCH package program brought about changes in the pre-determined eight indicators (outcome and impact measures) and the following relationship was first analyzed. b. Neverthless, this project did not automatically accept the assumption that if two or more activities were integrated, the results would automatically be better than a non-integrated or categorical program. There is a need to assess the "intergration process" itself within the package program. The process of integration was measured in terms of interactive linkages, or the quantity & quality of contacts between workers & clients and among workers. Intergrative linkages were hypothesized to be influenced by organizational factors at the HSC clinic level including HSC goals, sltructure, authority, leadership style, resources, and personal characteristics of HSC staff. The extent or degree of integration, as measured by the intensity of integrative linkages, was in turn presumed to influence programme performance. Thus as indicated diagrammatically below, organizational factors constituted the independent variables, integration as the intervening variable and programme performance with respect to family planning and health services as the dependent variable. Concerning organizational factors, however, due to the limited number of HSCs (2 in the study area and 3 in the control area), they were studied by participatory observation of an anthropologist who was independent of the project. In this observation, we examined whether the assumed integration process actually occurred or not. If not, what were the constraints in producing an effective integration process. SUMMARY OF FINDINGS: A) PROGRAM EFFECTS AND IMPACT. 1. Effects on FP use: During this 2 year action period, FP acceptance increased from 58% in 1981 to 78% in 1984 in both the study and control areas. This increase in both areas was mainly due to the new family planning campaign driven by the Government for the same study period. Therefore, there was no increment of FP acceptance rate due to additional input of MW to the on-going FP program. But in the study area, quality aspects of FP were somewhat improved, having a better continuation rate of IUDs & pills and more use of effective Contraceptive methods in comparison with the control area. 2. Effects of use of MCH services: Between the study and control areas, however, there was a significant difference in maternal and child health care. For example, the coverage of prenatal care was increased from 53% for 1981 birth cohort to 78% for 1984 birth cohort in the study area. In the control area, the same increased from 41% (1981) to 65% (1984). It is noteworthy that almost two thirds of the recent birth cohort received prenatal care even in the control area, indicating that there is a growing demand of MCH care as the size of family norm becomes smaller. 3. There has been a substantive increase in delivery care by medical professions in the study area, with an annual increase rate of 10% due to midwives input in the study areas. The project had about two times greater effect on postnatal care (68% vs. 33%) & delivery care (45.2% vs. 26.1%). 4. The study area had better reproductive efficiency (wanted pregnancies with FP practice & healthy live births survived by one year old) than the control area, especially among women under 30 (14.1% vs. 9.6%). The proportion of women who preferred the 1st trimester for their first prenatal care rose significantly in the study area as compared to the control area (24% vs 13%). B) EFFECTS ON INTERACTIVE LINKAGE. 1. This project made a contribution in making several useful steps in the direction of service integration, namely; i) The health workers have become familiar with procedures on how to work together with each other (especially with a midwife) in carrying out their work in FP/MCH and, ii) The health workers have gotten a feeling of the usefulness of family health records (statistical integration) in identifying targets in their own work and their usefulness in carrying for family health. 2. On the other hand, because of a lack of required organizational factors, complete linkage was not obtained as the project intended. i) In regards to the government health worker's activities in terms of home visiting there was not much difference between the study & control areas though the MW did more home visiting than Government health workers. ii) In assessing the service performance of MW & health workers, the midwives balanced their workload between 40% FP, 40% MCH & 20% other activities (mainly immunization). However, 85-90% of the services provided by the health workers were other than FP/MCH, mainly for immunization such as the encephalitis campaign. In the control area, a similar pattern was observed. Over 75% of their service was other than FP/MCH. Therefore, the pattern shows the health workers are a long way from becoming multipurpose workers even though the government is pushing in this direction. 3. Villagers were much more likely to visit the health sub-center clinic in the study area than in the control area (58% vs. 31%) and for more combined care (45% vs. 23%). C) ORGANIZATION FACTORS (ADMINISTRATIVE INTEGRATIVE ISSUES). 1. When MW (new workers with higher qualification) were introduced to HSC, it was noted that there were conflicts between the existing HSC workers (Nurse aids with less qualification than MW) and the MW for the beginning period of the project. The cause of the conflict was studied by an anthropologist and it was pointed out that these functional integration problems stemmed from the structural inadequacies of the health subcenter organization as indicated below; i) There is still no general consensus about the objectives and goals of the project between the project staff and the existing health workers. ii) There is no formal linkage between the responsibility of each member's job in the health sub-center. iii) There is still little chance for midwives to play a catalytic role or to establish communicative networks between workers in order to link various knowledge and skills to provide better FP/MCH services in the health sub-center. 2. Based on the above findings the project recommended to the County Chief (who has power to control the administrative staff and the technical staff in his county) the following; i) In order to solve the conflicts between the individual roles and functions in performing health care activities, there must be goals agreed upon by both. ii) The health sub-center must function as an autonomous organization to undertake the integration health project. In order to do that, it is necessary to support administrative considerations, and to establish a communication system for supervision and to control of the health sub-centers. iii) The administrative organization, tentatively, must be organized to bind the health worker's midwives's and director's jobs by an organic relationship in order to achieve the integrative system under the leadership of health sub-center director. After submitting this observation report, there has been better understanding from frequent meetings & communication between HW/MW in FP/MCH work as the program developed. Lessons learned from the Seosan Project (on issues of FP/MCH integration in Korea). 1) A majority or about 80% of the couples are now practicing FP. As indicated by the study, there is a growing demand from clients for the health system to provide more MCH services than FP in order to maintain the achieved small size of family through FP practice. It is fortunate to see that the government is now formulating a MCH policy for the year 2,000 and revising MCH laws and regulations to emphasize more MCH care for achieving a small size family through planning practice. 2) Goal consensus in FP/MCH should be made among the health workers & administrators, especially to emphasize the need of care of "wanted" child. But there is a long way to go to realize the "real" integration of FP into MCH in Korea, unless there is a structural integration FP/MCH because a categorical FP is still first priority to reduce the rate of population growth for economic reasons but not yet for health/welfare reasons in practice. 3) There should be more financial allocation: (i) a midwife should be made available to help to promote the MCH program and coordinate services, (ii) there should be a health sub-center director who can provide leadership training for managing the integrated program. There is a need for "organizational support", if the decision of integration is made to obtain benefit from both FP & MCH. In other words, costs should be paid equally to both FP/MCH. The integration slogan itself, without the commitment of paying such costs, is powerless to advocate it. 4) Need of management training for middle level health personnel is more acute as the Government has already constructed 90 MCH centers attached to the County Health Center but without adequate manpower, facilities, and guidelines for integrating the work of both FP and MCH. 5) The local government still considers these MCH centers only as delivery centers to take care only of those visiting maternity cases. The MCH center should be a center for the management of all pregnancies occurring in the community and the promotion of FP with a systematic and effective linkage of resources available in the county such as i.e. Village Health Workers, Community Health Practitioner, Health Sub-center Physicians & Health workers, Doctors and Midwives in MCH center, OBGY Specialists in clinics & hospitals as practiced by the Seosan project at primary health care level.
Abortion, Induced ; Administrative Personnel ; Child ; Child Health ; Chungcheongnam-do ; Cohort Studies ; Community Health Workers ; Consensus ; Contraception ; Cooperative Behavior ; Delivery of Health Care ; Encephalitis ; Family Characteristics ; Family Health ; Family Planning Services* ; Female ; Hand ; Health Personnel ; Health Services ; House Calls ; Humans ; Immunization ; Infant ; Infant Mortality ; Insurance Benefits ; Clinical Trial* ; Jurisprudence ; Korea* ; Leadership ; Live Birth ; Local Government ; Midwifery ; Organization and Administration ; Parturition ; Population Growth ; Postnatal Care ; Pregnancy ; Prenatal Care ; Primary Health Care ; Referral and Consultation ; Social Control, Formal ; Specialization

In our preliminary study to find antiviral or antitumor agents from Korean natural products, we found that the Shope fibroma virus (SFV) induced fibromas reaching maximum size at 5~6 days with spontaneous disappearance at 15~20 days after SFV intracutaneous inoculation into Korean domestic rabbits. However, the sizes of fibromas of rabbits at day 5 after virus inoculation were significantly different individually. Assuming that the variation of tumor size was due to either susceptibility or the preexisting antibodies against SFV in the Korean domestic rabbits, the rabbits were checked for the antibodies against SFV by IFAT using SFV infected RKl3 cells. The antibody positive rate of normal Korean domestic rabbits was 32.8% and the sizes of the fibromas of the positive rabbits were significantly smaller than those of negative rabbits (p<0.0001). The fibroma sizes were dependent on the antibody titers of rabbits to SFV. The sizes of fibromas after inoculation of SFV into immunized rabbits were about one tenth of those by the first inoculation into normal rabbits. This is the first report on the antibody prevalence against SFV among normal Korean domestic rabbits and it suggest the existence of a wild fibroma virus or related virus in Korea.
Antibodies* ; Antineoplastic Agents ; Biological Products ; Fibroma Virus, Rabbit* ; Fibroma* ; Korea ; Prevalence ; Rabbits* ; Tumor Virus Infections*

Klippel-Feil syndrome(KFS) consists of short neck, low posterior hairline and restriction of motion of the neck due to fusion of cervical vertebrae. The typical disorder results from a failure of the normal segmentation of mesodermal somites during 3-8 weeks of gestation. In 1912, the first complete clinical description of this syndrome was given by Klippel and Feil. Feil reported additional cases in 1919 and distinguished between three morphologic groups. The incidence of KFS has been estimated to be approximately 1 : 40,000-42,000 births. A slight female predilection has been noted. Although the disorder is sporadic, there are examples of familial occurrence; how ever, no clear mechanism of inheritance has been accepted. Since the disturbance producing a short neck occurs early in embryogenesis, defects in other organ systems may occur at the same time. Common musculoskeletal anomalies that accompany KFS include scoliosis, as well as Sprengel's deformity in as many as one-third of cases. Neurologic, cardiovascular, and urinary tract anomalies are associated with KPS. We report a case of Klippel-Feil syndrome with associates anomalies include Sprengel's deformity.
Cervical Vertebrae ; Congenital Abnormalities ; Embryonic Development ; Female ; Humans ; Incidence ; Klippel-Feil Syndrome* ; Mesoderm ; Neck ; Parturition ; Pregnancy ; Scoliosis ; Somites ; Urinary Tract ; Wills