OBJECTIVE: To assess the potential clinical utility of in-vivo 31P magnetic resonance spectroscopy (MRS) in patients with various malignant and benign breast lesions. MATERIALS AND METHODS: Seventeen patients with untreated primary malignant breast lesions (group I), eight patients with untreated benign breast lesions (group II) and seven normal breasts (group III) were included in this study. In-vivo 31P MRS was performed using a 1.5 Tesla MR scanner. Because of the characteristics of the coil, the volume of the tumor had to exceed 12 cc (3 x 2 x 2 cm), with a superoinferior diameter at least 3 cm. Mean and standard deviations of each metabolite were calculated and metabolite ratios, such as PME/PCr, PDE/PCr, T-ATP/PCr and PCr/T-ATP were calculated and statistically analyzed. RESULTS: Significant differences in PME were noted between groups I and III (p=0.0213), and between groups II and III (p=0.0213). The metabolite ratios which showed significant differences were PME/PCr (between groups II and III) (p=0.0201), PDE/PCr (between groups I and III, and between groups II and III) (p=0.0172), T-ATP/PCr (between groups II and III) (p=0.0287), and PCr/T-ATP (between groups II and III) (p=0.0287). There were no significant parameters between groups I and II. CONCLUSION: In-vivo 31P MRS is not helpful for establishing a differential diagnosis between benign and malignant breast lesions, at least with relatively large lesions greater than 3 cm in one or more dimensions.
Adult ; Breast Neoplasms/*diagnosis/*metabolism ; Diagnosis, Differential ; Female ; Human ; Magnetic Resonance Spectroscopy/*methods ; Middle Age ; Phosphates/metabolism ; Tumor Markers, Biological/metabolism

BACKGROUND: CO laser emiis energy in the mid portion of the infrared spectrum at a wavelengt,h of 10,600nm. The CO laser is the workhorse laser in the treatment of cuianeous disease. With water as the chromophore(light-absorbing compound), CO laser light is highy absorbed in biologic tissue. Human body tissue comprises between 75% to 90% of water. The CO laser is superficially absorbed by tissue water, with little scatter, limiting penetration into the skin to less than 0.1 mm. The beam can be delivered with a large spot size and low power density(defocus mode) or focused tightly with great power density(focused mode). AS A RESULT: the CO laser may be used both to vaporize and to cut tissue while coagulating blood vessels, providing a relatively bloodless su gical field. OBJECTIVE: The purpose of this study was to evaluate the therapeutie effect of the CO laser on benign cutaneous tumors. MEHTODS: 114 cases of benign cutaneous tumors treated with the CO laser between October 1987 and September 1992 were subjected to detailed analysis, The CO later is Pizer Laser system(U.S.A., Ca) Model 20-C CO. The laser produces power output that ranges from 0 to 25 W of continuous wave. Spot size is variable, between 0.3mm and 2mm. RESULTS: 1. Angiofibromas and seborcheic keratoses showed very good response(95.3%, 92.8% ). 2. Syringomas showed a good esponse(82.8%). 3. Epidermal nevus and trichovpitheliomas showed a fair response(58.5%, 60%). 4. There were hypertrophic scars(10.5%) and transient hypopigmentation. CONCLUSION: The Co laser was a very effective modality for the treatment of benign cutaneous tumors such as angiofibromas, seborrheic keratosis and syringomas.
Angiofibroma ; Blood Vessels ; Carbon Dioxide* ; Carbon* ; Human Body ; Hypopigmentation ; Keratosis ; Keratosis, Seborrheic ; Lasers, Gas* ; Nevus ; Skin ; Syringoma ; Water

No abstract available.
Evoked Potentials, Visual* ; Humans ; Infant, Newborn*

No abstract available.
Gallstones* ; Tomography, X-Ray Computed*

BACKGROUND: Direct observation of healthcare workers is commonly used in hospitals to investigate hand hygiene compliance. However, the hand hygiene compliance rate may increase due to the Hawthorne effect, which is the modification of behavior simply because subjects become aware that they are being observed. The objective of this study was to investigate the occurrence of the Hawthorne effect when directly observing hand hygiene compliance in intensive care unit (ICU) healthcare personnel. METHODS: A total of 87 staff members from the coronary care unit and cardiac surgery ICU of a general hospital in Seoul were included in this study: 24 residents and interns, 55 nurses, and 8 nursing assistants. Both covert and overt observations, where subjects were either unaware or aware of any direct observation, were performed on separate occasions. RESULTS: A total of 1,052 covert and 1,336 overt observations were documented over 30 and 34 occasions, respectively. Overall hand hygiene compliance was significantly higher with overt observation than with covert observation (1,041/1,336, 77.9% vs. 659/1,052, 62.6%, P<0.001). The Hawthorne effect was present in all professions and behaviors, with the exception of nursing assistants, and prior to touching a patient. CONCLUSION: Direct observation of hand hygiene compliance was associated with the Hawthorne effect when observations were made overtly and this was likely to contribute to an overestimation of compliance rate.
Compliance ; Coronary Care Units* ; Delivery of Health Care* ; Effect Modifier, Epidemiologic* ; Hand Hygiene* ; Health Personnel ; Hospitals, General ; Humans ; Intensive Care Units* ; Nursing ; Seoul ; Thoracic Surgery*

This study examined burdens of primary family carcgivcrs of paticnto with cerebrovascular accidents (CVA) along with related factors. In addition, their needs for support group intervention were assessed to develop a support group to reduce the burdens of caregiving. Eighty-one primary family caregivers of patients with CVAs at a general hospital in Seoul participated in this study . The patients with CVAs aged from 26 to 83 years with mean age of 63 years. About 90% of the patients had some paralysis and 56.6% suffered speech problems. Fifty-eight percent of the primary family caregivers were spouses of the patients and 80.2% were women. Primary family caregivers' burdens were assessed by the Burden Scale originally devel oped by Zarit (1980) and Novak & Geust(1989) and modified by Jang (1995) for use in Korea. The instrument consists of six subscales time-dependent burden, developmental burden, physical burden, emotional burden, social burden, and financiaI burden. The results were as follows : 1. The average of burden score was 91.7, indicating moderate to severe level of burden. The time-dependent burden was scored highest followed by physical, developmental, social, financial, and emotional burdens. 2. of the characteristics of patients, age, gender, and severity of the disease were found to be associated with the level of burden. Of the characteristics of primary family caregivers, age and educational level were significantly related to the level of burden. Time of care since the CVA and the quality of relationship between a patient and a caregiver prior to the stroke were significant situational factors affecting the level of burden. 3. The need for support group intervention for the caregivero was very high (95.1%). The earcgivcrs of patients who had a CVA for the first time showed higher levels of need compared to those of patients who had a CVA more than once. The caregivers indicated a support group held once a month near home or hospital would be welcomed. In addition, they replied that a group composed of 9 to 10 caregivers and guided by health care professionals (e.g., physicians and nurses) would be most desirable. More than 85% of the earegivers identified the areas that they wanted intervention in as follows : knowledge, skills, and resources to care for a patient with a CVA. the counsel of health care professionals, share of their experiences with those who have similar situations, stress management skills, and methods to overcome emotional isolation due to the great responsibility for a patient. Given the results, support group is expected to be an effective way to reduce the burdens of primary family caregivers of patients with CVAs. As a follow up It is necessary to examine the effect of support group intervention on the patient's recovery and rehabilitation.
Caregivers* ; Delivery of Health Care ; Female ; Hospitals, General ; Humans ; Korea ; Paralysis ; Rehabilitation ; Self-Help Groups* ; Seoul ; Spouses ; Stroke*

BACKGROUND: The quality of specimen for Papanicolaou smear depends on the sampling methods of uterine cervix. This study was designed to test specimen adequacy and the detection of disease using t,wo cervical cytological sampling methods. pastic spatula plus Cytobrish and Cervex-Brush. METHODS: Research subjects were t.he exarninee for screening for cevical cancer in Farnily Practice Center and Health Promotion Center of University Hospital. Research sub jects were classified to two groups randomly. 5 physicians used each device at random. A group 80 test smples(plast,ic spatula plus Cytobrush) were compared with B group test samples(Cervex Brush) for the presence rate of endocervial cells and specimen adequacy. The laborat.ory was blind to the sampling met,hods. RESULTS: The plastic spatula plus Cytobrush and Cervex-Brush were comparable in cap- turing in endocervical cells. But the capturing rates of both methods were high(over 70%). Both the pastic spatula plus Cytobrush and Cervex-Brush produced adequate samples, and the adequacy scores between two methods were not different. significantly. CONCLUSIONS: Use of the plastic spatula puls Cytobrush and Cervex-Brush produced adequate smear for interpretation.
Cervix Uteri ; Female ; Health Promotion ; Humans ; Mass Screening ; Papanicolaou Test ; Plastics ; Research Subjects

Unstable microsatellite repeat sequences or DNA replication errors(RER) due to defective mismatch repair genes have been reported in a subset of sporadic colorectal tumors and in most tumors of patients of hereditary nonpolyposis colorectal carcinoma(HNPCC). To elucidate the clinicopathological correlation of these RER-positive cancers, we examined 16 cases of colorectal carcinoma of different histologic subtypes(6 cases of carcinoma with no gland formation, 5 cases of mucinous carcinoma and 5 cases of gland forming carcinoma). We detected RER in five cases. The patients with RER-positive cancers had a marked preponderance of carcinoma with no gland formations out of 6 carcinomas with no gland formation were RER-positive cancers) and of cancers proximal to splenic flexure(all of the RER-positive cases were proximal colon carcinomas). We conclude that RER-positive cancers have wiique pathologic features that may be useful for the screening and counselling of patients with hereditary colon cancers.

PURPOSE: This research was carried out to examine if music therapy is effective in decreasing elderly people's depression level and in increasing their life satisfaction level. METHODS: This study used the quasi-experimental design with nonequivalent control group and the pre-test and post-test design, and was conducted from the 26th of July to the 26th of September in 2004. Data were collected using a questionnaire developed by Y.esavage et al. (1983) to measure depression level and one developed by Yoon (1982) to measure life satisfaction level. The subjects were 80 elderly people who were the members of an elderly welfare center in G city. The subjects were divided into an experimental group (n=40) and a control group (n=40). RESULTS: The first hypothesis' The depression level will be lowered in the experimental group who received music therapy' was supported (t=3.856, p=.000). The second hypothesis' The life satisfaction level will be raised in the experimental group who received music therapy' was supported (t=2.040, p=.045). The results above suggest that music therapy can be an effective nursing intervention for reducing the depression level and increasing the life satisfaction level of elderly people.
Aged* ; Depression* ; Humans ; Music ; Music Therapy* ; Nursing ; Surveys and Questionnaires

Allergic contact dermatitis to topical agents mostly results from vehicles and preservatives and rarely from the active ingredients. Ribavirin, an active ingredient of Viramid® cream, is a synthetic nucleoside derivative with broad spectrum activity against a wide variety of DNA and RNA viruses. We report an 18-year-old woman, who had a perioral edematous patch with exudative crusts after topical application of Viramid® cream (nsung pharmaceutical Co., Korea) for the treatment of herpes labiahs. A patch test showed that the sensitizer was ribavirin, the active ingredient of the antiviral agent, Viramid® cream.
Adolescent ; Dermatitis, Allergic Contact* ; DNA ; Female ; Humans ; Patch Tests ; Ribavirin* ; RNA Viruses