No abstract available.
Mass Screening*

PURPOSE: The purpose of this study was to evaluate the accuracy of Tc-99m DTPA diuretic renal scans in children upper urinary tract. MATERIALS AND METHODS: We reviewed diuretic renal scans of 14 pediatric patients (age range: 3 days to 4 years) with unilateral hydronephrosis diagnosed by ultrasonography. Diuretic renal scan was done using Tc-99m DTPA and standardized protocol. In 3 neonates, diuretic renal scans were performed within 1 week and 3-7 months after birth. RESULTS: Six patients required pyeloplasty and eight were managed conservatively. All 6 patients requiring pyeloplasty were diagnosed as having ureteropelvic junction obstruction in the diuretic renal scan. In these 6 patients, post-operative renal scans at 3-12 months after surgery were converted to nonobstructive pattern in 5 and a nonobstructive patterns in 1. In 3 patients who underwent diuretic renal scan within 1 week after birth., nonobstructive patterns of initial scan were coverted to obstructive patterns in the follow-up scan. However, all patients with nonobstructive diuretic renal scans performed after the neonatal period did well on serial ultrasonography and showed favorable clinical outcome without progression to obstruction. CONCLUSION: Tc-99m DTPA diuretic renal scan with standarized protocol is useful in assessing suspected ureteropelvic junction obstruction in children as an initial diagnostic or post-operative follow-up modality. Nonobstructive or indeterminate scan RESULTS in the neonatal period requires follow-up scan to monitor development of the obstructive pattern.
Child* ; Follow-Up Studies ; Humans ; Hydronephrosis ; Infant, Newborn ; Kidney Pelvis ; Parturition ; Pentetic Acid* ; Radioisotope Renography* ; Ultrasonography ; Urinary Tract*

A 2 months old male patient with Wilson-Mikity Syndrome was presented. Characteristic clinical manifestations &typical X-ray findings were confirmative for the diagnosis of this syndrome. Pertinent liiteratures &references on Wilson-Mikity syndrome were reviewed briefly.
Diagnosis ; Humans ; Infant ; Male

No abstract available.
Dandy-Walker Syndrome*

BACKGROUND: Despite remarkable progress of understanding the pathophysiology and therapy of bronchial asthma, asthma morbidity and mortality are on the rise. Also hospitalization and attending rates of emergency department for asthma have been increasing gradually. We analyzed clinical characteristics and prognosis of patients who visited emergency room due to asthma attack in order to define clinical characteristics of these group of patients. METHOD: We reviewed 105 adult asthmatic patients who attended emergency department of Korea University Hospital between August 1995 and July 1996, retrospectively. RESULTS: 103 patients(56 female, 47 males, mean age : 48.6 years) attended-68 self referral, 18 practitioner referral and 17 OPD transfer- and 86 patients(83.5%) were admitted. Attending emergncy department was clearly more frequent in December(13.6%) and May(12.6%). Time lag between onset of asthmatic attack and arrival at the hospital was 14.2 15.5 hour and initial peak expiratory flow rate was 166.7 68.3L/min.(43.3% predicted) The commonest cause for visiting emergency room was aggravation of asthma due to upper respiratory tract infection in mild asthmatics. About half of them had history of previous ER visits. Their prognosis was not bad, but after discharge, about half of patients escaped from OPD follow-up. CONCLUSION: As a group they merit detailed attention and follow up arrangement. Clinician need to monitor and review the treatment plans, the medications, the patient's management technique, and the level of asthma control. For this group, plans for longer term treatment, including asthma education program and adjustment of overall treatment plan should be made.
Adult ; Asthma ; Education ; Emergencies* ; Emergency Service, Hospital* ; Female ; Follow-Up Studies ; Hospitalization ; Humans ; Korea ; Male ; Mortality ; Peak Expiratory Flow Rate ; Prognosis ; Referral and Consultation ; Respiratory Tract Infections ; Retrospective Studies ; United Nations

BACKGROUND AND OBJECTIVES: The Tinnitus Handicap Inventory (THI) often requires patients to devote their time to complete the questionnaire than they expect. Given that it limits the effectiveness of THI in a busy clinical practice that desires a quick and easy assessment of tinnitus handicap, this study evaluated clinical usefulness of a Simplified version of Tinnitus Handicap Inventory (THI-S) in measuring the severity of tinnitus handicap as well as predicting the psychological distress associated with tinnitus. SUBJECTS AND METHODS: A total of 129 outpatients suffering from tinnitus (61 with normal hearing and 68 with hearing loss) participated in this study. The responses of THI-S (10 items) and THI (25 items) were evaluated to quantify the subjective handicap of tinnitus. The self-perceived level of stress, anxiety, and depression of all participants was measured with a series of self-report questionnaires such as Korean version of Brief Encounter Psychosocial Instrument (BEPSI), State Trait Anxiety Inventory (STAI), and Beck Depression Inventory (BDI), respectively. All the questionnaire responses were analyzed using non-parametric analyses to examine the convergence, comparability, internal consistency reliability and validity of THI-S. RESULTS: The severity of tinnitus handicap and the relevant psychological distress greatly varied across individuals. The THI-S responses were comparable to original THI responses, regardless of hearing status of patients. The internal consistency of THI-S responses was found to be good for total score (Cronbach's alpha=0.83-0.91), with moderately high consistency for the emotional, functional, and catastrophic subscales. Significant (p<0.01) correlations of the THI-S with the THI (r(s)=0.95) as well as with the BEPSI, STAI, BDI questionnaires (r(s)=0.40-0.45) suggest that the THI-S questionnaire appeared to be useful to provide objective data of subjective tinnitus handicap as well as predict psychological distress. Three factors were extracted through factor analysis, which explained 73% of the total variance. CONCLUSIONS: Despite reducing the length of 25 items of THI to 10 items, the THI-S can be used as s a simple but reliable and valid tool for evaluating severity of tinnitus handicap as well as detecting its negative impact on psychological functioning.
Anxiety ; Depression ; Hearing ; Humans ; Outpatients ; Reproducibility of Results ; Tinnitus*

The present study was aimed at investigating the molecular regulation of the renin- angiotensin system (RAS) in two-kidney, one clip (2K1C) hypertension. The expression of renin, angiotensinogen and angiotensin II receptor genes was determined by Northern blot analysis in rats made 2K1C hypertensive for 2 or 4 weeks. The expression of renin gene was increased in the clipped kidney and decreased in the contralateral non-clipped kidney at weeks 2 and 4. The expression of angiotensinogen gene was not significantly altered at week 2, but increased at week 4 in the clipped kidney. However, it was not significantly altered in the contralateral kidney either at week 2 or 4. Nor was the expression of angiotensinogen gene significantly altered in the liver either at week 2 or 4. On the other hand, the expression of angiotensin II receptor gene was decreased at week 2, and increased at week 4 in the clipped kidney, whereas it was not significantly changed in the contralateral kidney either at week 2 or 4. In the liver, the expression of angiotensin II receptor gene was not significantly altered at week 2, but decreased at week 4. These results suggest that the components of RAS are transcriptionally regulated in 2K1C hypertension in a manner dependent on tissues and duration of hypertension.
Angiotensin II* ; Angiotensinogen* ; Angiotensins* ; Animals ; Blotting, Northern ; Hand ; Hypertension ; Kidney ; Liver ; Rats* ; Receptors, Angiotensin* ; Renin

In order to determine the relationship between acid-base balance and K+ metabolism in patients whi controlled respiration during surgery, 20 patients under general anesthesia were studied. Anesthesia was induced with 2% thiopental and was maintained with halothane. Suxamethonium was used for intubation. During surgery, the respiration of the patient was controlled by a volume controlled respirator with tidal volume of 800ml and a rate of 12/min. Blood and urine samples were collected before anesthesia, and 30 and 60 minutes thereafter. REsults were as follows: Hyperventilation induced by artificial respiration during surgical anesthesia produced a significant decrease in PaCO2 from 36.1+/-1.3mmHg to 19.9+/-1.5mmHg at 30 min, and to 20.1+/-1.7mmHg at 60 min. Hyperventilation increased arterial pH from 7.41+/-0.008 to 7.49+/-0.028 at 30 min, and 7.47+/-0.011 at 60 min. Hyperventilation produced a significant decrease in serum concentration of K+ from 4.04+/-0.12 to 3.75+/-0.08mEq/l at 30min, and 3.62+/-0.05 mEq/l at 60min. Urinary excrets of K+ was not significantly altered during the hour of the hyperventilation. These results suggest that hypokalemia followed by respiratory alkasisis mainly due to the movement of K+ from extracellular to intracellular compartments rather than a change in renal excretion of K+.
Acid-Base Equilibrium ; Anesthesia ; Anesthesia, General ; Halothane ; Humans ; Hydrogen-Ion Concentration* ; Hyperventilation* ; Hypokalemia ; Intubation ; Metabolism* ; Potassium* ; Respiration ; Respiration, Artificial ; Succinylcholine ; Thiopental ; Tidal Volume ; Ventilators, Mechanical

PURPOSE: This study was a part of a drive to develop a community health center-based hospice management model which is concerned with hospice care at a community health care setting and available resources of the local community. METHODS: Development of a community health center-based hospice management model involved evaluation of existing hospice-related research, including literature review, and research on hospice facilities at the study site, as well as evaluation of model operation. The latter involved community health center-based hospice test operation, and evaluation of test operation by a research team, including of a nursing professor majoring in hospice care and staffs from a community health center in Busan metropolitan city, regional cancer center, and regional terminal cancer patient medical institute. The study was conducted in the 2008 calendar year. RESULTS: The community health center-based hospice management model provides service linked with local community resources, focusing on the local community health center. Financial and administrative assistance is provided by the regional cancer center, with collaboration from academic health care professionals who guide the operation management. The community health center hospice nurse in consultation with a visiting nurse team registers terminally-ill cancer patients and, after assessment, the hospice team prioritize hospice care during team meeting. Care is delivered by staffs and volunteers. CONCLUSION: The developed community health center-based hospice operation management model maximally utilizes available community health resources to produce qualitative improvement of regional health and welfare policy through improving the lives of home-based cancer patients and their family who are in medical blind spot.
Community Health Centers ; Community Health Nursing ; Community Health Services ; Cooperative Behavior ; Delivery of Health Care ; Health Resources ; Hospice Care ; Hospices ; Humans ; Models, Organizational ; Optic Disk ; Organization and Administration ; Pilot Projects

Porcelain is considered to be one of the materials of choice for restoration where esthetics is of concern. But porcelain surface without final glazing treatment may induce undesirable results such as inflammatory respones on adjacent soft tissues due to plaque accumulation and increased wear of opposing teeth. Therefore, rough porcelain surface must be smoothened by final glazing treatment or chairside polishing procedure. The purpose of this study was to compare the surface roughness among self-glazed, overglazed and polished porcelain with various polishing kit, and to detect which phase of polishing is optimal in clinic. Specimens were fabricated with Vita VMK porcelain. The surface treatment of each group was performed as follows. Group 1 : overglazing treatment Group 2 : self-glazing treatment Group 3 : polishing with the Truluster Polishing System for Porcelain(Brasseler, U.S.A.) Group 4 : polishing with the Exa Cerapol Adjustment kit (Edenta dental products, Switzerland) followed by finishing with diamond-filled polishing paste Group 5 : polishing with the Shofu Porcelain Adjustment kit (Shofu inc., Japan) followed by finishing with diamond-filled polishing paste. At each polishing steps, the measurement of Ra and Rq values were performed, and the surface was examined by scanning electron microscope. The results were as follows: 1. Overglazing treatment brought smoother surface than self-glazing treatment. 2. Polishing systems without porcelain polishing paste did not make better result than self-glazing treatment. 3. Polishing system with porcelain polishing paste made similar result to overglazing treatment. 4. Applying diamond-filled polishing paste after using polishing system which has porcelain polishing paste produced surface as smooth as overglazing treatment does.
Dental Porcelain* ; Esthetics ; Tooth