No abstract available.
Neuroma*

PURPOSE: There is increasing awareness of the clinical importance of early detection and treatment of posterior cruciate ligament(PCL) injury. We evaluate the usefulness of Magnetic resonance(MR) imaging in the diagnosis of PCL injury. MATERIALS AND METHODS: We retrospectively analysed the MR images of 140 cases with clinically suspected knee injury. Arthroscopic or surgical correlation was available in 63 cases. We observed the finding and extent of PCL injury and other associated abnormalities. The frequency of anterior and posterior meniscofemoral ligament was evaluated. RESULTS: Eleven PCL injuries were observed, six midsubstance tears, two tibial attachment tears, two fernoral attachment tear, one laxity. The sensitivity, specificity and accuracy of MR imaging diagnosis are 100%, 98.1%, 98.4%. MR findings of PCL injury are discontinuity and focal mass formation, irregular increased signal intensity, detachment or redundancy of the ligament with avulsed bony fragment. In all cases of injured PCL, other associated abnormalities of adjacent structures were observed. Accessory anterior and posterior meniscofemoral ligaments were observed in 67.4%(87/129). CONCLUSION: MR imaging is useful in evaluation of presence or absence of PCL injury, accurate extent of PCL injury and other important associated abnormalities of adjacent structures.
Diagnosis ; Knee Injuries ; Ligaments ; Magnetic Resonance Imaging* ; Posterior Cruciate Ligament* ; Retrospective Studies ; Sensitivity and Specificity

OBJECTIVE: Peripartum emergency cesarean hysterectomy of 28 cases at our hospital for 10years were reviewed that the clinical indication, history, and annual incidence change. METHODS: A retrospective descriptive analysis from January, 1988 to December, 1997 was carried out. RESULTS: There were 28 cases of emergency cesarean hysterectomy identified during this period among total 24, 689 deliveries. The annual incidence of emergency cesarean hysterectomy was significantly declined statistically(p<0.005). Cesarean hysterectomy was performed in 20 of 6, 671 cesarean section(0.30%) and in 8 of 18, 018 vaginal deliveries(0.04%), so more frequently after cesarean section than vaginal delivery. The cesarean hysterectomy rate was more frequent in multiparous women(0, 22%) than in nulliparous women(0, 02%). The most common indication of cesarean hysterectomy was 13 cases of uterine atony(46%), followed by 5 cases uterine rupture(18%), 5 cases of placenta previa with placenta accreta(18%), 3 cases of placenta previa(11%), 2 cases of uterine myoma(7%). No significant difference in length of operating time, amount of blood loss and operative complications were found between total abdominal hysterectomy and subtotal hysterectomy. The all patient who had cesarean hysterectomy recieved from 1200ml to 15840ml of blood transfusion with a mean of 3673ml. In aspect of fetal outcome, 3 cases of FDIU(Fetal death in utero) in uterine rupture and 1 case of stillbirth in preterm were found. The maternal complications were wound disruption, DIC, wound hematoma, ureter injury, vaginal stump bleeding, UTI(Urinary tract infection) and retroperitoneal bleeding, CONCLUSION: We conclude that the incidence of emergency cesarean hysterectomy declined with prediction of antenatal risk factor, preparing of sufficient fresh blood, prophylactic antibiotics, vigorous uterotonics and close observation after delivery.
Anti-Bacterial Agents ; Blood Transfusion ; Cesarean Section ; Dacarbazine ; Emergencies* ; Female ; Hematoma ; Hemorrhage ; Humans ; Hysterectomy* ; Incidence ; Peripartum Period* ; Placenta ; Placenta Previa ; Pregnancy ; Retrospective Studies ; Risk Factors ; Stillbirth ; Ureter ; Uterine Rupture ; Wounds and Injuries

Recently the alanine/valine (A/V) polymorphism of the 5,10-methylenetetrahydrofolate reductase (MTHFR) gene, one of the key enzymes catalyzing remethylation of homocysteine, has been reported to its association with coronary artery disease. lhe homozygous of C677T mutation (VV genotype) correlates with increased plasma homocysteine levels as a result of the reduced activity and increased thermolability of MTHFR. We investigated whether this rnutation and homocysteine influence risk for coronary artery disease (CAD) in normal control subjects and CAD patients and two risk groups, A (>2 risk factors) and B (<1 risk factor). The MTHFR genotype and plasma homocysteine were determined by PCR followed by HinA digestion and high performance liquid chromatography (HPLC) system, respectively. From this study, statistical significance of V mutation of MTHFR between four groups was not found. Homocysteine level was the highest in CAD patients and the lowest in risk group B. Plasma homocysteine level in VV genotype of CAD patients was significantly higher than in other two genotypes and normal control subjects. We concluded that homozygisty for the C677T mutation of MTHFR was not an independent risk factor of CAD but associated with a prediposition to increased plasma homocysteine levels in CAD patients.
Chromatography, Liquid ; Coronary Artery Disease* ; Coronary Vessels* ; Digestion ; Genotype ; Homocysteine* ; Humans ; Oxidoreductases ; Plasma ; Polymerase Chain Reaction ; Risk Factors ; Statistics as Topic

No abstract available.
Twins, Conjoined*

OBJECTIVE: The purposes of this study were to understand nurses' experience after the computerization of nursing care as a part of hospital information systems and to explore the change in nursing care time. METHODS: This study used a qualitative approach. The subjects were ten nurses by purposeful snowball sampling. In-depth interview was performed. All interviews were tape-recorded and transcribed verbatim. The data were analyzed using qualitative theme analysis. RESULTS: Nurses took into account the computerization as a 'benefit'. Their experiences after computerization were categorized into process and outcome impact. The emerged themes in nursing care process were 'accuracy', 'rapidness', and 'time saving in indirect nursing care'. Those in nursing care outcome included 'leisure', 'satisfaction', 'burden', and 'threatening privacy'. In addition, nurses' personal characteristics was the most important factor affecting the efficient use of saved time due to decrease of indirect nursing time to increase direct nursing care. CONCLUSION: Maximizing the positive impact of computerization requires redesign of nursing job description and work pattern, and education of efficient time management for individual nurse.
Education ; Hospital Information Systems* ; Humans ; Job Description ; Nursing Care* ; Nursing Staff ; Nursing* ; Time Management

The purpose of this study was to examine the frequency of eutaneous disorders in patients with chronie renal failure presently on hemodialysis(HD). The results were as follows. 1. Cutaneous lesions were present in all 78(100% ) patients with chronic renal failure. 2. The frequency of msjor cutaneous problems associated with chronic renal failure was as follows: xerosis(82.1%), pruritus(74.4%), nail changes(74.4%), hyperpigmentation(70.5 % ), xerostomia(42.3'Yo), poor wound healing(37.2%), easy bruisability(30,8%), hypotrichosis(21.896), and purpura(14.1 % ). 3. Cutaneous problems which appeared after the initiation of HD were. appearance of new pigmented nevi or lentigines(9 patients), appearance or aggravation of acne(6), contact dermatitis at AV fistula site(2), gynecomastia(1), extensive flat warts(1), extensive tinea versicolor(1), and extensive vitiligo(1). 4. Among 55 patients with hyperpigmentation, 11 patients reported decreased pigmentation following HD. In 15 patients, hyperpigmentation worsened following HD, and in 9 patients hyperpigmentation first appeared after HD was initiated. 5. Cutaneous disorders favorably affected by HD were as follows: easy bruisability(3/ 24), xerostomia(3/33), gingival friability(2/7), and hypotrichosis(5/17). 6. Poor wound healing and xerosis were not improved by HD. 7. Among 58 pruritic patients, 7 patients were improved after HD, 7 patients became worse during each HD, and 3 patients were not pruritic only for 2 to 3 days after each HD. Four patients experinced pruritus only during each HD. 8. There was no significant statistical difference between the frequency of pruritus and xerosis and the levels of blood urea nitrogen, calcium, phosphorus, and parathyroid hormone.
Blood Urea Nitrogen ; Calcium ; Dermatitis, Contact ; Fistula ; Humans ; Hyperpigmentation ; Kidney Failure, Chronic* ; Nevus, Pigmented ; Parathyroid Hormone ; Phosphorus ; Pigmentation ; Pruritus ; Renal Dialysis* ; Renal Insufficiency ; Tinea ; Wound Healing ; Wounds and Injuries

Pleomorphic adenoma presenting as primary lesion of the bronchus is very rarely encountered, and in our knowledge only 6 cases have been reported in the literature of the western world, and no case report has been published in Korea. Currently, we experienced a case of bronchial pleomorphic adenoma occuring in a 38 years old woman. On X-ray examination, hazy density in the right upper lobe and emphysematous change in the right lower lobe were noted. A right pneumonectomy was done under bronchoscopic diagnosis of bronchial adeoma. The pathologic examination of the present case showed a polypoid endobronchial tumor, 1.4 x 1.1 cm (with extraluminal portion, 2.2 x 1.7 cm) in the right upper bronchus. The microscopic examination revealed a pleomorphic adenoma showing same morphology as those found in the salivary gland. This case, therefore, was believed to be a genuine example of bronchial pleomorphic adenoma of salivary gland type. We compared this case with 6 cases in the literature.
Female ; Humans ; Adenoma

Objectives: This study was aimed to assess the usefulness of the quantitative assessment of clock drawing test (CDT) combined with the Mini-Mental State Examination (MMSE) compared to that of the Montreal Cognitive Assessment (MoCA) or the MMSE alone for screening of dementia in Parkinson disease (PD) in patients with a low educational level. Methods: A representative sample of 91 PD patients was administered MMSE, MoCA and CDT. The discriminative validity of the MMSE, MoCA, and a MMSE+CDT combination for dementia screening was determined by estimating the sensitivity and specificity of each test and by testing integrated discrimination improvement (IDI). Results: The mean age and educational years were 69.0 (years) and 7.3 in the study population. The best screening cut-off points for the MMSE, MoCA, and MMSE+CDT were 25/26, 21/22 and 41/42. In a group of patients with educational years ≤6,
Dementia

Purpose: Evidence-based practice (EBP) is a key competency that undergraduate nursing students need to learn, as EBP competence is essential for the effective implementation of EBP. However, few studies have comprehensively assessed the aspects of EBP competence using a reliable and valid measure specific to Korean nursing students. This study aimed to translate the Student Evidence-Based Practice Questionnaire (S-EBPQ) into Korean and evaluate its psychometric properties. Methods: The original S-EBPQ was translated into Korean. After a pilot test, a convenience sample of 249 college students with more than four weeks of clinical training experience was selected from three universities in September 2017. Reliability and construct validity were evaluated using exploratory and confirmatory factor analyses. Concurrent validity was evaluated by correlating the measure with informatics competency. Results: The exploratory factor analysis revealed four factors that explained 66.3 of the variance. The confirmatory factor analysis yielded a 4-factor structure (χ2/df = 1.52, p < .001, standardized root-mean-square residual = .07, root-mean-square error of approximation = .07, goodness of fit index = .84, comparative fit index = .91). The Cronbach’s α was .81 for the total scale. The scale’s correlation with informatics competency was r = .55. Conclusions The Korean S-EBPQ is a reliable and valid tool that has utility for assessing EBP competence in Korean nursing students and for making comparisons of the EBP competence of nursing students from other countries.