PURPOSE: The purpose of this study is to examine how well patients who had hip arthroplasty comply with medical regimens given to them after the operation. METHOD: The subjects of the study were patients who had arthroplasty at P Hospital between April 1. 2001 and August 30, 2002. 20 patients of the subjects experienced complications after the operation and the other 20 did not. Data from a survey using the qustionnaire were statistically analyzed in terms of real number, percentage point, mean and standard deviation by using chi2test. t-test and ANOVA. RESULT: 1) the surveyed patients were significantly different in the compliance of medical regimen among them according to their education background as one of the subjects general characteristics. 2) It was found that the group of complication was higher in the compliance of medical regimen than that of non-complication. The two groups showed statistically significant difference with each other in the degree of compliance with therapeutic instructions than the experimental group in terms of the maintenance of abduction after the operation, training instructions on step-by-step basis, urination cotrol on bed, accurate use of crutch, compliance with medication, balance among medical treatment, training, leisure, rest and nutrition. instructions by physicians, nurses and physical therapists, use of low armchairs and toilet bowels and no bending of the body forward, and use of a non-operated leg in case of go upstairs or downstairs. CONCLUSION: It seems necessary to develop systematic and sessional education programs for improving the compliance of medical regimen. ultimately reducing complications following hip arthroplasty.
Arthroplasty* ; Compliance ; Education ; Hip* ; Humans ; Leg ; Leisure Activities ; Patient Compliance* ; Physical Therapists ; Urination

PURPOSE: The purpose of this study was to perform a medical audit of the screening of mammographic results according to ACR BI-RADS Follow-Up and Outcome Monitoring and to evaluate the efficacy of screening mammography in the early detection of breast cancer. MATERIALS AND METHODS: We reviewed the results of 15,300 mammographic examinations of 13, 889 women aged 30 -75 years who underwent mammography at least once at the Severance Health Promotion Center between 1994 and 1998. Women with abnormal mammographic findings were recalled for additional study and those with dense breast composition (3, 4) underwent additional ultrasound. All results were categorized on the basis of the ACR BI-RADS final assessment scale, 1 -5. We reviewed the pathologic or follow-up results of all women in categories 4 and 5, and/or those in any category who took the films out of the health center. RESULTS: The recall rate was 13%. Biopsy or surgical Consultation was recommended for 92 women and biopsy was performed in 52. Pathology revealed 17 cancers and 35 benign lesions. Positive predictive value 2 was found in 18.5% of cases, and positive predictive value 3 in 33%. The cancer detection rate was 1.2/1,000, and sensitivity was 89.5%. Invasive cancers smaller than 1cm or in situ ductal cancers were found in eight of 17 cases (47%), while node-positive invasive cancers were found in nine of 14 cases (64%). Four of 17 mammo-graphically detected cancers were palpated by a surgeon. CONCLUSION: In asymptomatic women, screening mammography is an effective method for the detection of early breast cancer.
Biopsy ; Breast ; Breast Neoplasms ; Early Detection of Cancer ; Female ; Follow-Up Studies ; Health Promotion* ; Humans ; Mammography* ; Mass Screening* ; Medical Audit* ; Pathology ; Ultrasonography

We investigated the expression of the growth-related nuclear proto-oncogenes, c-fos and c-myc, in early preneoplastic regions and tumor nodules of 3'-MeDAB induced rat hepatocarcinoma. To amplify the levels of these transcripts, we gave cycloheximide (100 mg/kg B.W. i.p.) to each group of rats. The elevated levels of the 2.2 kb c-fos and 2.4 kb c-myc transcripts appeared as early as the 2nd week after feeding on the 3'-MeDAB diet and lasted through the 4th; 6th weeks and tumor. Southern blot analysis indicated that gross amplification or rearrangements were not observed in DNA of the preneoplastic livers and hepatoma nodules. We also measured the rate of the incorporation of [3H] thymidine into hepatic DNA in order to monitor the rate of cell proliferation occurring at the early preneoplastic periods. We have found that the rate of [3H] thymidine incorporation corresponds to the elevated levels of c-fos and c-myc transcripts in the precancerous stages. This finding suggests that the elevated expressions of c-fos and c-myc may result from the continuous cell proliferative stimuli generated in the carcinogen altered cells, which is essential to the initiation and promotion of chemical hepatocarcinogenesis.
Animal ; Blotting, Southern ; DNA/biosynthesis ; Female ; *Gene Expression ; *Genes, fos ; *Genes, myc ; Liver Neoplasms, Experimental/chemically induced/*genetics ; Methyldimethylaminoazobenzene/*toxicity ; Precancerous Conditions/chemically induced/*genetics ; Rats ; Rats, Sprague-Dawley ; Support, Non-U.S. Gov't

Fifty nine patients of tuverculous menigiis who were admitted to the Pediatric department of Seoul Red Cross Hospital during the period from March, 1976 to December 1977 were treated with rifampin in addition to isoniazid and streptomycin injection, and Compaired with 135 cases of tuberculous meningitis who were admitted during the period from January, 1971 to December, 1975. The contrast group was composed of 21 cases who obtained as folows. 1) Out of 59 patients givern rifampin, only 5 patients died resulting in lower motality rate (8.5%) whereas 20 patients died out of 135 cases given PAS regimen showing 14.8% of motality rate. 2) Seven cases on each stage of PAS regimen group and 10 cases of stage I, 9 cases of stage II and III of rifampin group were reviewed for the respects of defeveration, durratio of disappearance of meningeal irritation signs, improvements of conciousness and neurological defects and self feeding ability. It was very hard to conclude the superiority on one group because of the similarity of days needed for the improvement. However, superior results with rifampin regimen could be mentioned among the patients with second and third stage of tuberculous meningitis for the clinical improvements. 3) Serial examination of cerebrospinal fluids of the cases in 3 stage revealed no direct relationship either for the clinical improvements or the for ultimate outcome of the patients themselves. C. S. F. improvements were observed in average within one to three weeks. 4) Side effects of fifampin ; the level of SGOT, SGPT and bilirubin at the time of of admission wrer all normal. Twenty-one cases out of 41 patients showed the impairment of liver function after the first to second week of treatment with the dosage of 15-20mg/kg/day. In 3 out of 21 cases, the drug had to be discontinued, owing to the futher elevation of SGOT and SGPT but in 18 out of 21 cases, liver function was gradually normalized within one to two weeks after the dosage of rifampin had been reduced down to 10mg/kg/day. There was no evidence of impairment of liver function on the follow-up evaluation from 4 to 10 months later. And there were no significant changes in Hb, Hct, platelet counts during the course of the therapy. The hepatitis, the well known side effects such as hemolytic anemia, skin rashes and G-I tract disturbance were not observed during the course of treatment. Bases on the above observations that rifampin reduced the motality and shortened the duration of clinical manifestation without the serious side effects except for transient hepatitis, rifampin plus isoniazid would seem to be preferred for the patients who are seen at the late stage of the disease. We know that the number of cases of this study is not enough to draw the definite conclusion of the superiority of rifampin, however, the of these prelininary observations seemed to cast a bright light for the futher trial and follow up observations.
Alanine Transaminase ; Anemia, Hemolytic ; Aspartate Aminotransferases ; Bilirubin ; Cerebrospinal Fluid ; Child* ; Exanthema ; Follow-Up Studies ; Hepatitis ; Humans ; Isoniazid ; Liver ; Platelet Count ; Red Cross ; Rifampin* ; Seoul ; Streptomycin ; Tuberculosis, Meningeal*

This study was conducted to identify the attributes constituting Korean social support and to validate the results of the previous study 'Search for the meaning of social support in Korean Society.' The informants were 41 Korean middle-aged women in three cities : Seoul, Dagjun and Daeku. The data were collected through indepth interviews using the interview guide from Jun. 1994 to Jun. 1995. The interview guide was developed in the simulated situations of 'Stroke attack' which expected to be in need of social support. The women were asked to answer what they felt and the appropriated terms representing the situations. Data analysis were conducted by content analysis. consequently, the Koran social support pyramid was modified as follows ; Support is the apex of the pyramid. The four sides of the pyramid are made up of 'Jung'(Bound by ties of affection, regard or shared common experience, Connectedness), Do-oom(both emotional and material help), Mi-dum(Faith or belief in) and Sa-Rang(Love). The base of the pyramid is 'yun'(the basic network of relationships in Korean culture) that connote the meaning of Eunhae(Benevolence), Euimu(duty, responsibility) and Dori(obligation).
Female ; Humans ; Middle Aged* ; Seoul ; Statistics as Topic

An aneurysm of the innominate artery could compress the tracheal lumen, and this requires special care. Intubation without intensive monitoring and antihypertensive agents could aggravate the hypercapnia and completely rupture the aneurysm. There are few reports on the airway management of tracheal compression that's caused by an innominate artery aneurysm. We report here on a patient who had a severe hypercapnia after endotracheal intubation above the stenotic area of the tracheal compression, which was caused by an artery aneurysm. Permissive hypercapnia was inadvertently enforced without our knowledge, but the patient recovered without any neurologic problems.
Airway Management ; Aneurysm ; Antihypertensive Agents ; Arteries ; Brachiocephalic Trunk ; Humans ; Hypercapnia ; Intubation ; Intubation, Intratracheal ; Rupture

BACKGROUND: Philadelphia(Ph) chromosome is found in about 95 percent of chronic myelogenous leukemia(CML) patients. Ph chromosome results from a reciprocal translocation between the long arms of chromosomes 9 and 22, and the fusion gene, BCR-ABL contribute to oncogenesis. Three to five years after first diagnosis, CML progresses to the blast crisis, and is accompanied by secondary cytogenetic changes in about 85% of cases. In this study, we investigated the incidence of ABL deletion of derivative 9 chromosome in CML and evaluated the association between this deletion and progression to the blast crisis by interphase fluorescence in situ hybridization(FISH). METHOD: The subjects included in this study were a consecutive series of 58 patients who were diagnosed as CML at Seoul National University Hospital between January 1997 and April 2000. On 90 archival bone marrow aspirate samples from these 58 CML patients, interphase FISH was performed with a commercially available probe. RESULTS: The ABL deletion of derivative 9 chromosome was detected in 17(29.3%) of 58 patients with CML. Eighteen of 58 patients progressed to blast crisis in this period. ABL deletion was found in 7 of 18 patients with blast crisis, and not in 11 remainders. The mean duration from the diagnosis to blast crisis was 37.1 months in 7 patients with the ABL deletion, while the mean duration was 74.2 months in 11 patients without the ABL deletion. The mean duration from the diagnosis to blast crisis in patients with ABL deletion was significantly shorter than in patients without ABL deletion(P=0.043). CONCLUSIONS: We found that 29.3% of patients with CML had the ABL deletion on derivative 9 chromosome. In these patients, the time taken for evolution to blast crisis was significantly shorter than that of the patients without ABL deletion.
Arm ; Blast Crisis* ; Bone Marrow ; Carcinogenesis ; Cytogenetics ; Diagnosis ; Fluorescence* ; Humans ; Hydrogen-Ion Concentration ; In Situ Hybridization* ; Incidence* ; Interphase* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Philadelphia Chromosome ; Seoul

Nephrotic syndrome occurs infrequentiy prior to the second year of life. When nephrotic syndrome does develop during the first year, the course differs from that of older children with nephrotic sydrome, being characterized by an extremely poor prognosis and an almost complete refractoriness to therapy. Despite its low incidence congenital nephrotic syndrome is important, not only because of the severity and the disorder itself but also because the occurrence of nephrotic syndrome in this age group rasies question regarding the etiology of the disease. We experienced one case of congenital nephrotic syndrome which was confirmed by autopsy. The patient was born as a premature infant with body weight 1,400gm and 37weeks of gestational age, to a toxemic mother, gravida 3 and parity 3 in Obsteric Department of Seoul Red Cross Hospital. The patient had an uncomplicated nursery staying even though routine weekly urinalysis did show up various degree of proteinuria and microscopic hematuria without any obvious edema till the age of 50 days with body weight 2,400gm on the discharge. He was lost to be followed at Out Patient Department untill the age of 4months when he was brought to admission because of respiratory distress in generalized edematous state. He died at 7 months of age following progressive down-hill cours, despite treatment with prednisolone and cyclophosphamide for 2 months. At autopsy, almost all of the glomeruli (99%) were sclerotic with occassional creascent formation and tubules showed mircocystic dilataions. It is considered that this case was the first one which was presented on literature in Korea.
Autopsy ; Body Weight ; Child ; Cyclophosphamide ; Edema ; Female ; Gestational Age ; Hematuria ; Humans ; Incidence ; Infant, Newborn ; Infant, Premature ; Korea ; Mothers ; Nephrotic Syndrome* ; Nurseries ; Parity ; Prednisolone ; Prognosis ; Proteinuria ; Red Cross ; Seoul ; Urinalysis

Septo-optic dysplasia, as first described by de Morsier, is a rare developmental anomaly involving optic nerve hypolasia, midline anomalies of the brain and variable hypothalamic-pituitary dysfunction. We experienced a case of septo-optic dysplasia in 56-day old male infant who presented with prolonged jaundice. A magnetic resonance imaging of the brain showed absence of the septum pellucidum and the ophthalmoscopic examination disclosed left optic nerve hypoplasia. Thus, we reported it with a brief review of literatures.
Brain ; Humans ; Infant ; Jaundice ; Magnetic Resonance Imaging ; Male ; Optic Nerve ; Septo-Optic Dysplasia* ; Septum Pellucidum

This study was to verify that the combined application of NaOCl and EDTA was more effective in removal of smear layer than the application of NaOCl alone. Furthermore it was aimed to find out the optimal time for the application of EDTA. Thirty five single rooted teeth were cleaned and shaped. NaOCl solution was used as an irrigant during instrumentation. After instrumentation, root canals of the control group were irrigated with 5 ml of NaOCl for 2 minutes. 30 sec, 1 min, and 2 min group were irrigated with 5 ml of 17% EDTA for 30 sec, 1 min, and 2 min respectively. Then the roots were examined with scanning electron microscopy for evaluating removal of smear layer and erosion of dentinal tubule. The results were as follows; 1. The control group: The smear layer was not removed at all. 2. The other groups: 1) Middle(1/3): All groups showed almost no smear layer. And the erosion occurred more frequently as increasing irrigation time. 2) Apical(1/3): The cleaning effect of 2 min group was better than the others. The results suggest that 2 min application of 17% EDTA should be adequate to remove smear layer on both apical(1/3) and middle(1/3).
Dental Pulp Cavity* ; Dentin ; Edetic Acid* ; Microscopy, Electron, Scanning ; Smear Layer* ; Tooth