OBJECTIVES: Health care workers(HCWs) are more likely to become infected with tuberculosis from patients in the hospital. When HCWs have an active tuberculosis infection, it is possible that they also become a source of infections to other HCWs and patients. METHODS: Tuberculin tests were performed with mantoux method using 5 units of tuberculin by infection control practitioners on Feb. 21, and Mar. 7, 1997. A total of 138 newly employed HCWs including 44interns and 94 nurses were tested. Results of skin test were interpreted by themselves according to the instructions. RESULTS: Among 138 personels, skin tests were negative in 27 personels (19.6%); 4 interns (9.1%) and 23 nurses (24.5%). There were 3 persons (2.2%) who had a history of tuberculosis which had been treated. CONCLUSION: The study showed that approximately 20% of newly employed HCWs had negative tuberculin skin test. Given the possibility of being infected with tuberculosis in the hospital, regular follow up of tuberculin skin test is warranted to protect HCWs,
Delivery of Health Care* ; Humans ; Infection Control Practitioners ; Skin Tests* ; Skin* ; Tuberculin Test ; Tuberculin* ; Tuberculosis

No Abstract available.
Infection Control*

The purpose of this study w-s to predict the respose to the chincap therapy from the initial cephalometric measurements and to obtain the indication of chincap therapy. 40 patients selected for this study were classified into two groups by the occlusal stability after completion of permanent dentition and the iiu4n ovement of facial profile, after chincap therapy. One was g response group which consisted of 25 children and the other was poor response group with 15 patients. Various measurements of the craniofacial structure in the initial lateral cephalogram were calculated and analyzed by t-test and discriminant analysis. The results were, as follows 1. Good response group had more horizontal growth pattern in initial stage of treatment, and the contributing measurements were Bjork sum, anterior-posterior facial height ratio, gonial angle, lower gonial angle and occlusal plane to AB plane angle. 2. The critical points and predictive values of the influential skeletal measurements were calculated. 3. The discriminant function was obtained from three. major influential measurements; Bjork sum, gonial angle and occliml plane to AB plane angle, and this function could discreminate correctly in 85% of this samples.
Child ; Dental Occlusion ; Dentition, Permanent ; Humans

Background : It has been suggested that thrombospondin (TSP) is a p53-dependent negative regulator of tumor angiogenesis. TSP expression and localization in hepatocellular carcinomas (HCCs) and its association with overexpression of p53 protein were investigated. Methods : TSP-1 and -2 expressions were examined in 40 HCC specimens by immunohistochemical staining and in 4 HCC cell lines by Western blotting. In addition, p53 protein expression and microvessel density (MVD) were correlated with the TSP expression. Results : Strong immu- nopositivity for TSP-1 was observed in fibroblasts, vascular endothelial cells, and some vas- cular smooth muscle cells of the stroma in 18 cases (45%), and in tumor cells in 3 cases (7.5%) of 40 cases of HCC. Immunoreactivity for TSP-2 was observed in only the sinusoidal lining cells of the tumor in 15 cases (46%), and in tumor cells in 2 cases (6%) of 32 cases of HCC. TSP-1 expression was inversely correlated with MVD (p=0.028), but TSP-2 expression did not show any correlation with MVD. Although p53 was overexpressed in 17 cases, there was no significant correlation between TSP and p53 expressions. None of the HCC cell lines expressed TSP-1 or -2. Conclusions : These findings indicate that TSP-1 is mainly derived from nonparenchymal cells, and may decrease tumor angiogenesis in HCC.
Angiogenesis Inhibitors ; Blotting, Western ; Carcinoma, Hepatocellular* ; Cell Line ; Endothelial Cells ; Fibroblasts ; Microvessels ; Myocytes, Smooth Muscle ; Thrombospondin 1 ; Thrombospondins

Many kinds of different treatment options for fecal incontinence such as biofeedback therapy, anterior or posterior sphincteroplasty, pelvic floor repair, gracilis or gluteus muscle transposition have been introduced. However, appropriate indications for these treatment options have not yet been delineated up to now. PURPOSE: The aim of this study was to access the preoperative severity of fecal incontinence by physiologic tests to give an idea that indications of appropriate selection criteria and parameters for assess the outcome could be simultaneously considered by preoperatively objective physiologic data. MATERIALS AND METHODS: From January 3, 1997 to, August 1, 1997 all patients with fecal incontinence who visited colorectal clinic in the Department of Surgery, Korea Veterans Hospital, were classified into two groups according to the severity of fecal incontinence (0~20): Group I (1~9), Group II (10~20) and compared them with the results of physiologic tests: anorectal manometry, endorectal ultrasound (ERU), cinedefecography, and pudendal nerve terminal motor latency (PNTML). Statistical analysis was performed by Student's-t test, and Chi-square test and p<0.05 was considered significant. RESULTS: The number of GI was 25, and GII was 22. There were no differences between the two groups in terms of age (GI: 57.7+/-14.5, GII: 61.4+/-14.0years), gender (male: female, 19:6, 16:6), cause (neurogenic; 11/25 (GI),7/22(GII), postanal surgery; 6/25,6/22) obstetric trauma (2/25, 2/22), anal trauma (1/25, 1/22) diabetes melitus (1/25, 2/22), rectal prolapse (2/25, 1/22), and others (2/25, 3/22), duration of fecal incontinence (64.4+/-82.2, 48.7+/-65.3 months), high pressure zone (3.3+/-1.7, 3.5+/-1.4 cm), mean resting pressure (50.5+/-27.0, 51.9+/-18.7 cm H2O), maximal resting pressure (88.4+/-50.6, 89.4+/-41.8 cm), maximal squeezing pressure (150.6+/-71.0, 129.7+/-59.5 cm H2O), rectoanal inhibitatory reflex (13/21, 8/21 positive), sensitivity (37.5+/-15.2, 41.8+/-29.0 cc), compliance (19.0+/-14.5, 21.4+/-39.4 cc/cm H2O) in anorectal manometric findings, anal sphincter defect (13/21, 15/22 positive), size of defect (60+/-26.30degrees, 71 +/-30.8degrees/360degrees), thickness of the external anal sphincter (3.46+/-0.78, 3.84 +/-1.02 cm), thickness of internal anal sphincter (1.58+/-0.79, 1.74+/-0.81 cm) in ERU, anorectal angle in rest (85.2+/-28.0degrees, 97+/-22.9degrees), squeeze (72+/-27.1degrees, 82 +/-19.7degrees), push (100+/-43.9degrees, 117.9+/-34.5degrees), length of perineal descent in rest (3.7+/-1.2, 3.6+/-1.7 cm), squeeze (2.9+/-1.5, 2.7+/-1.5 cm), push (7.9+/-3.5, 6.6+/-2.6 cm) in cinedefecography. However, rectal capacity in manometry (212.5+/-99.9, 155+/-51.5 cc, p<0.05), right PNTML (1.73+/-0.39, 2.71+/-0.83 ms, p<0.001), and left PNTML (1.83+/-0.43, 2.94+/-0.80 ms, p<0.001) were significantly increased in GII compare to those of GI. CONCLUSION: As the severity of fecal incontinence was increased, rectal capacity, right and, left PNTML were increased.
Anal Canal ; Biofeedback, Psychology ; Compliance ; Fecal Incontinence* ; Female ; Hospitals, Veterans ; Humans ; Korea ; Manometry ; Patient Selection ; Pelvic Floor ; Pudendal Nerve ; Rectal Prolapse ; Reflex ; Ultrasonography

A 52-year-old man was taken to the emergency room following a motor vehicle accident. An echocardiogram showed moderate to severe tricuspid regurgitation due to rupture of the anterior chordae. An operation to repair the traumatic tricuspid regurgitation was recommended; however, the patient refused because he was asymptomatic. Two years later, he developed mild generalized edema and dyspnea. The echocardiogram revealed progressive severe tricuspid regurgitation and annular dilatation. We treated the posttraumatic tricuspid regurgitation successfully using artificial chordae and ring annuloplasty.
Dilatation ; Dyspnea ; Edema ; Emergencies ; Humans ; Middle Aged ; Motor Vehicles ; Rupture ; Tricuspid Valve ; Tricuspid Valve Insufficiency

Multidrug resistance(MDR) phenotype is frequently observed in animal and human cancer cell lines selected for in vitro resistance to a single chemotherapeutic agent. It is characterized by the diminished j drug accumulation and is related to the drug efflux mechanism in resistant cells. In the present study, adriamycin resistant cells(L1210-AdR6 : 10-6M adriamycin, -AdR5: 10-5M) and vincristine resistant cells (L1210-VcR7: 10-7M vincristine, -VcR6: 10-6M) were produced from mouse lymphoblastic leukemia cell line L1210. Growth profiles of survived cells were observed for 5 days with MTT(thiazolyl blue) assay and resistance was compared with IWdrug concentration of 50% survival reduction in absorbance). Resisrant cells proliferated more slowly than sensitive cell. Doubling times were 29.7hr in L1210, 68.7hr in L1210-AdR5 and 58.2hr in -VcR6. MDRs expressed as resistance factor were as follows, L1210-AdR5 was 76.4 times for vincristine, L1210-VcR6 was 96.4 times for adriamycin. The cell membrane proteins with three different M.W. were recognized to be related resistance, 220, 158, and 88 kd in L1210-AdR5, 158, 140 and 88 kd in L1210-VcR6 by SDS-PAG electrophoresis. Cell surface membrane proteins were identified by radio-iodination and autoradiogram. their molecular! weights were 158, 72.8. and 42.4 Kd in L1210-VcR6.
Animals ; Cell Line ; Doxorubicin ; Drug Resistance* ; Electrophoresis ; Humans ; Membrane Proteins* ; Membranes* ; Mice* ; Phenotype ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Vincristine ; Weights and Measures

Primary tumors of the heart are uncommon in the fetus and neonate and are most often histologically benign. Rhabdomyoma is the most common cardiac tumor in the fetus and pediatric population which is followed in frequency by fibroma and teratoma. Rhabdomyomas are usually multiple, solid, and lobulated and an estimated 50-86% of rhabdomyoma cases are associated with tuberous sclerosis. Since spontaneous regression of rhabdomyoma is well documented, surgical intervention is recommended only for those patients with severe hemodynamic compromise or for those with persistent arrhythmias. A case of rhabdomyoma detected by fetal echocardiography, which was proved by autopsy, is reported.
Arrhythmias, Cardiac ; Autopsy ; Echocardiography* ; Fetus ; Fibroma ; Heart ; Heart Neoplasms ; Hemodynamics ; Humans ; Infant, Newborn ; Rhabdomyoma ; Teratoma ; Tuberous Sclerosis

Primary tumors of the heart are uncommon in the fetus and neonate and are most often histologically benign. Rhabdomyoma is the most common cardiac tumor in the fetus and pediatric population which is followed in frequency by fibroma and teratoma. Rhabdomyomas are usually multiple, solid, and lobulated and an estimated 50-86% of rhabdomyoma cases are associated with tuberous sclerosis. Since spontaneous regression of rhabdomyoma is well documented, surgical intervention is recommended only for those patients with severe hemodynamic compromise or for those with persistent arrhythmias. A case of rhabdomyoma detected by fetal echocardiography, which was proved by autopsy, is reported.
Arrhythmias, Cardiac ; Autopsy ; Echocardiography* ; Fetus ; Fibroma ; Heart ; Heart Neoplasms ; Hemodynamics ; Humans ; Infant, Newborn ; Rhabdomyoma ; Teratoma ; Tuberous Sclerosis

PURPOSE: A febrile convulsion is a common event during childhood, its pathogenesis is not clear. But there are some hypotheses including electrolyte imbalance, neurotransmitter and metabolic change. Hyponatremia has been thought to decrease the threshold for febrile convulsion and low cerebrospinal zinc level induced by fever or infections causes low cerebrospinal gamma-aminobutyric acid(GABA) which is a major inhibitory neurotransmitter. We therefore carried out a prospective study to investigate whether there is an association with serum sodium levels, CSF zinc concentration and febrile convulsions. METHODS: Blood and CSF samples for sodium and zinc were taken from 37 children at Pusan Saint Benedict Hospital due to febrile illness from March 1998 to December 1998. They were divided into three groups: 11 with fever but without convulsions(Group I), 15 with aseptic(viral) meningitis(Group II), and 11 with febrile convulsions(Group III). The results were analyzed by Wilcoxon 2 Sample Test. RESULTS: The means of serum sodium, Zn level and CSF Na, Zn level in the febrile convulsion group were not significantly lower than in other groups(for serum Na : group I 143.09+/-2.84mmol/L, group II 141.60+/-2.49mmol/L, group III 142.54+/-1.80mmol/L; for CSF Na : group I 138.72+/-5.53mmol/L, group II 139.64+/-4.64mmol/L, group III 138.82+/-2.25mmol/L; for serum Zn : group I 90.38+/-9.09micro gram/L, group II 90.28+/-13.64micro gram/L, group III 97.16+/-14.54micro gram/L; for CSF Zn : group I 41.61+/-13.30micro gram/L, group II 45.80+/-12.66micro gram/L, group III 41.04+/-11.17micro gram/L). There was no statistically significant difference in serum sodium and CSF zinc between the three groups of children. CONCLUSION: There is no evidence in this study, that hyponatremia may increase the susceptability to febrile convulsion or that zinc deprivation may play a role in the pathogenesis of febrile convulsion in previous study. So, more study of pathophysiology of febrile convulsion is needed.
Busan ; Child ; Fever ; Humans ; Hyponatremia ; Neurotransmitter Agents ; Prospective Studies ; Saints ; Seizures, Febrile* ; Sodium* ; Zinc*