PURPOSE: Although high-dose-rate intracavitary radiotherapy (HDR ICR) has been used in the treatment of cervical cancer, the potential for increased risk of late complication, most commonly in the rectum, is a major concern. We have previously reported on 136 patients treated with HDR brachytherapy between 1995 and 1999. The purpose of this study is to upgrade the previous data and confirm the correlation between late rectal complication and rectal dose in cervix cancer patients treated with HDR ICR. MATERIALS AND METHODS: A retrospective analysis was performed for 222 patients with cervix cancer who were treated for curative intent with external beam radiotherapy (EBRT) and HDR ICR from July 1995 to December 2001. The median dose of EBRT was 50.4 (30.6~56.4) Gy with a daily fraction size 1.8 Gy. A total of six fractions of HDR ICR were given twice weekly with fraction size of 4 (3~5.5) Gy to A point by Iridium-192 source. The rectal dose was calculated at the rectal reference point using the barium contrast criteria. in vivo measurement of the rectal dose was performed with thermoluminescent dosimeter (TLD) during HDR ICR. The median follow-up period was 39 months, ranging from 6 to 90 months. RESULTS: Twenty-one patients (9.5%) experienced late rectal bleeding, from 3 to 44 months (median, 13 months) after the completion of RT. The calculated rectal doses were not different between the patients with rectal bleeding and those without, but the measured rectal doses were higher in the complicated patients. The differences of the measured ICR rectal fractional dose, ICR total rectal dose, and total rectal biologically equivalent dose (BED) were statistically significant. When the measured ICR total rectal dose was beyond 16 Gy, when the ratio of the measured rectal dose to A point dose was beyond 70%, or when the measured rectal BED was over 110 Gy3, a high possibility of late rectal complication was found. CONCLUSION: Late rectal complication was closely correlated with measured rectal dose by in vivo dosimetry using TLD during HDR ICR. If data from in vivo dosimetry shows any possibility of rectal bleeding, efforts should be made to reduce the rectal dose.
Barium ; Brachytherapy* ; Follow-Up Studies ; Hemorrhage ; Humans ; Radiotherapy ; Rectum ; Retrospective Studies ; Uterine Cervical Neoplasms*

Medullary carcinoma of the thyroid gland(MTC) constitutes approximatesly 3% to 10% of all malignant thyroid tumors. It appears in both familial and sporadic forms. Metastases are frequently present at diagnosis and are resistant to chemotherapy and radiotherapy. Surgical resection of the primary tumor and the metastases is the mainstay of treatment. Although MTC can be detected by elevated serum calcitonin, localization of residual or metastatic foci may be difficult. Many scintigraphic methods have been used for identification of the residual tumor or metastasis. However, most of them have either low sensitivity or low specificity. MTC frequently secretes somatostatin and may express somatostatin receptors. Recently, somatostatin-receptor imaging has been known to be useful for the detection of residual and recurrent medullary thyroid carcinoma. A 25 year-old woman who was dignosed as medullary carcinoma by biopsy of thyroid mass is presented. Thirteen years ago, she underwent left thyroidectomy due to thyroid cancer(MTC). Laboratory tests revealed an increase in the levels in serum CEA(CEA=557.6 ng/ml) and calcitonin(calcitonin= 720 pg/ml). The second patient, a 30 year-old female, complained of a palpable mass in the left anterior neck. Ten years ago, she underwent a right lobectomy of thyroid gland due to adenomatous goiter. Laboratory tests revealed an increase in the levels in serum CEA(CEA=617 ng/ml) and Calcitonin (Calcitonin=2,300 pg/ml). In both cases, pre- and postoperative In-111 pentetreotide scintigraphy were done and compared with "'I scintigraphy. In-111 pentetreotide scan may be useful for the localization of residual or metastatic medullary thyroid carcinoma. Further study is warranted to define the sensitivity and specificity of the technique.
Biopsy ; Calcitonin ; Carcinoma, Medullary ; Diagnosis ; Drug Therapy ; Female ; Goiter ; Humans ; Neck ; Neoplasm Metastasis ; Neoplasm, Residual ; Radionuclide Imaging ; Radiotherapy ; Receptors, Somatostatin ; Sensitivity and Specificity ; Somatostatin ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy

In Langerhans cell histiocytosis, diabetes insipidus is the most common endocrinologic complication. We experienced a case of Langerhans cell histiocytosis, involving pituitary stalk and lung. The patient was a 43 year old male with complaint of polyuria and polydipsia. The water deprivation test was carried out to confirm the diagnosis of diabetes insipidus. We found multiple small cysts and nodules in HRCT of lung, and diagnosed Langerhans cell histiocytosis by transbronchial lung biopsy, The patient was managed conservatively with DDAVP nasal spray. The polyuria,polydipsia was relieved completely. After that, we follow up and observe closely the patients lung and pituitary lesion.
Adult ; Biopsy ; Deamino Arginine Vasopressin ; Diabetes Insipidus ; Diagnosis ; Follow-Up Studies ; Histiocytosis, Langerhans-Cell ; Humans ; Lung ; Male ; Pituitary Gland ; Polydipsia ; Polyuria ; Water Deprivation

PURPOSE: This study was conducted to develop an empowering education program for Maternal-Fetal Intensive Care Unit (MFICU) nurses who provide intensive care to high-risk mother and fetus at hospitals, to test effects of the education program on nursing care confidence and nursing knowledge, and to examine program satisfaction. METHODS: This study comprised of 2 phases: program development and evaluation. First, we have followed a process of program development to develop and refine an empowering education program for MFICU nurses through collaborative works among clinical obstetrics and gynecology doctors and nurses and academic nursing professors. Second, the empowering education program was provided to 49 nurses and evaluated from July 5 to 6, 2019. Levels of MFICU nursing care confidence and knowledge were measured. RESULTS: The empowering education program included 18 hours of lectures, discussion, and Q & A, which continued for 2 days. This program significantly improved high-risk maternal-fetal nursing care confidence and knowledge of nurses. The program was well met with nurses' education need and goals, and found to be highly satisfactory. CONCLUSION: The empowering education program was observed to be effective in terms of improve nursing care confidence and knowledge of nurses in MFICU. It is proposed that this program should be open regularly for nurses to obtain and improve their clinical knowledge, confidence, and competency. Further study is needed to develop and run 2-levels of education such as basic and advanced levels based on nurses' clinical background and competency.
Critical Care ; Education ; Fetus ; Gynecology ; Humans ; Intensive Care Units ; Lectures ; Mothers ; Nursing ; Nursing Care ; Obstetrics ; Pregnancy, High-Risk ; Program Development

This study used data from the Korea National Health and Nutrition Examination Survey IV–VII from 2007 to identify the prevalence of obesity and its phenotypes (metabolically unhealthy obesity [MUO] and metabolically healthy obesity [MHO]) and their secular changes. The prevalence of obesity in Korea increased with significant secular changes observed (β=0.326, P trend <0.01) between 2007 and 2017, and especially in men (β=0.682, P trend <0.001) but not in women. The changes in the prevalence of obesity during the study period were different between men and women (P=0.001). The prevalence of MUO significantly increased only in men (β=0.565, P trend <0.01), while that of MHO increased only in women (β=0.179, P<0.05), especially in the younger age group (β=0.308, P<0.01).

PURPOSE: The purpose of this study was to identify students' experiences of performance and their satisfaction with clinical nursing practice in Women's health nursing. METHODS: Data was collected using questionnaire consisting of 104; 89,; and 82 nursing activities with 12; 10; and 7 domains for delivery floor, obstetric, and gynecologic wards retrospectively. Five hundred ninety nursing students from 10 four year and one three year colleges, were recruited and selected for data collection. RESULTS: Site specific core nursing activities among top 15 items of performed experience were: interpreting fetal monitoring; massage for pain reduction; breathing technique; perineal pad change; non stress test; manual check for uterine contraction; and position change for the delivery floor. Experiences of clinical nursing practice for the obstetric ward and the gynecologic ward were identified and ranked as well. Observation of delivery, measurement & test during labor and observation of anesthesia and operation were the highest ranked activity domains of satisfaction for delivery floor, obstetric and gynecologic wards retrospectively. CONCLUSION: Discussions are needed to standardize curriculum for clinical practice in women's health nursing initiated at the level of Korean Society of Womens' Health Nursing by reflecting this result. Strategic approaches are emphasized in order to enhance a collaboration between clinical fields and colleges.
Anesthesia ; Cooperative Behavior ; Curriculum ; Floors and Floorcoverings ; Humans ; Massage ; Surveys and Questionnaires ; Respiration ; Retrospective Studies ; Students, Nursing ; Women's Health

BACKGROUND AND OBJECTIVES: Transradial coronary angiography and intervention are getting more popularity throughout the world because of lower incidence of puncture site complications and the patients have displayed early ambulation. However, radial arterial spasms and possible endothelial injury due to the small size of radial artery are troublesome. To overcome this problem, we investigated the usefulness of performing transradial coronary angiography using a single Judkins left catheter (JL). SUBJECTS AND METHODS: A total of 268 patients who underwent right transradial coronary angiography from June 2003 to December 2003 were enrolled for this prospective study. The Judkins Left 3.5(JL3.5), the Multipurpose (MP) and Amplatz Left (AL2 for males, AL1 for females) were assigned to be used in patients with a randomized protocol. The technical/angiographic success rate, procedural/fluoroscopic time and the frequency of stiffwire usage were assessed. RESULTS: Technical success was accomplished in 87 (96.7%) of the patients with a single JL3.5, in 90 (97.8%) of the patients with the MP and in 83 (96.5%) of the patients with the AL catheter. Successful angiography success was achieved in 77 (85.6%) of the patients using the JL3.5, in 71 (77.2%) of the patients using the MP and in 66 patients (76.7%) using the AL. The technical success rate (p=0.270) and the angiographic success rate (p= 0.162) showed no significant difference among the three catheters. The procedural time was 8.1+/-4.0 min in the JL3.5 group, 8.1+/-3.7 min in the MP group and 7.3+/-3.4 min in the AL group, respectively (p=0.431). Also, the fluoroscopic time was not different among the three groups. CONCLUSION: The JL3.5 catheter is an excellent tool for both coronary imaging and it is equally successful as compared with the MP and AL catheters. Therefore, the JL3.5 may be considered as the initial catheter that can be used, including for those difficult cases having tortuous vasculature of the subclavian artery and the ascending aorta, during transradial coronary angiography.
Angiography ; Aorta ; Catheters* ; Coronary Angiography* ; Early Ambulation ; Humans ; Incidence ; Male ; Prospective Studies ; Punctures ; Radial Artery ; Spasm ; Subclavian Artery

Classical mumps patients develop bilateral or less commonly unilateral parotitis. Mumps virus belongs to the genus Rubulavirus in the family Paramyxoviridae. It contains single stranded RNA genome with negative polarity. To characterize the antigenicity of mumps virus isolated in Korea, nineteen hybridoma cell lines producing monoclonal antibodies to mumps virus were established by fusion of Sp2/0-Ag14 mouse myeloma cells with spleen cells of mice immunized with mumps virus strain 98-40. The specificity of these monoclonal antibodies was established by immunofluorescence microscopy and immunoblotting analysis. Fifteen out of nineteen hybridoma cell lines secreted IgG monoclonal antibodies (MAbs) against mumps virus, and the remaining four secreted IgM. The isotypes of thirteen clones of 19 MAbs were IgG1, two were IgG2a, and four were IgM. Eight MAbs reacted with a 68 kDa nucleocapsid protein, six MAbs reacted with a 46 kDa phosphoprotein, and five MAbs reacted with a 42 kDa matrix protein.
Animals ; Antibodies, Monoclonal* ; Cell Line ; Clone Cells ; Genome ; Humans ; Hybridomas ; Immunoblotting ; Immunoglobulin G ; Immunoglobulin M ; Korea* ; Mice ; Microscopy, Fluorescence ; Mumps virus* ; Mumps* ; Nucleocapsid Proteins ; Paramyxoviridae ; Parotitis ; RNA ; Rubulavirus ; Sensitivity and Specificity ; Spleen

BACKGROUND: The apolipoprotein B/A1 (apoB/A1) ratio is a stronger predictor of future cardiovascular disease than is the level of conventional lipids. Statin and ezetimibe combination therapy have shown additional cardioprotective effects over statin monotherapy. METHODS: This was a single-center, randomized, open-label, active-controlled study in Korea. A total of 36 patients with type 2 diabetes mellitus were randomized to either rosuvastatin monotherapy (20 mg/day, n=20) or rosuvastatin/ezetimibe (5 mg/10 mg/day, n=16) combination therapy for 6 weeks. RESULTS: After the 6-week treatment, low density lipoprotein cholesterol (LDL-C) and apoB reduction were comparable between the two groups (−94.3±15.4 and −62.0±20.9 mg/dL in the rosuvastatin group, −89.9±22.7 and −66.8±21.6 mg/dL in the rosuvastatin/ezetimibe group, P=0.54 and P=0.86, respectively). In addition, change in apoB/A1 ratio (−0.44±0.16 in the rosuvastatin group and −0.47±0.25 in the rosuvastatin/ezetimibe group, P=0.58) did not differ between the two groups. On the other hand, triglyceride and free fatty acid (FFA) reductions were greater in the rosuvastatin/ezetimibe group than in the rosuvastatin group (−10.5 mg/dL [interquartile range (IQR), −37.5 to 29.5] and 0.0 µEq/L [IQR, −136.8 to 146.0] in the rosuvastatin group, −49.5 mg/dL [IQR, −108.5 to −27.5] and −170.5 µEq/L [IQR, −353.0 to 0.8] in the rosuvastatin/ezetimibe group, P=0.010 and P=0.049, respectively). Both treatments were generally well tolerated, and there were no differences in muscle or liver enzyme elevation. CONCLUSION: A 6-week combination therapy of low-dose rosuvastatin and ezetimibe showed LDL-C, apoB, and apoB/A1 ratio reduction comparable to that of high-dose rosuvastatin monotherapy in patients with type 2 diabetes mellitus. Triglyceride and FFA reductions were greater with the combination therapy than with rosuvastatin monotherapy.
Apolipoprotein A-I ; Apolipoproteins ; Apolipoproteins B ; Cardiovascular Diseases ; Cholesterol, LDL ; Diabetes Mellitus, Type 2 ; Ezetimibe ; Fatty Acids, Nonesterified ; Hand ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Korea ; Liver ; Rosuvastatin Calcium ; Triglycerides

PURPOSE: This study was performed to establish the role and to analyze the job of MFICU (Maternal Fetal Intensive Care Unit) nurses using DACUM (Developing a curriculum). METHODS: A DACUM workshop was held to define MFICU nurses' role and identify their duties and tasks. A DACUM committee was consisted of 7 nurses, 2 nursing professors and 1 medical doctor and as a result, a survey was developed which contained duties and tasks of MFICU nurse. Pre-test was carried out for the validity, finally collected the data from 97 nurses who worked at 7 MFICU and 10 delivery room. RESULTS: A total of 60 duties, 115 tasks and 822 elements of tasks were defined on the DACUM chart and survey. The importance, frequency and difficulty of the tasks were presented the determinant coefficient (DC), the highest DC duty was ‘Manage maternal ventilator’ (15.09) and the lowest DC was ‘Provide nursing care for leisure to gestation extension mother’ (6.52). Twenty-eight tasks were differentiated between MFICU and delivery nurses significantly. And the most important, frequently, difficulty task perceived by MFICU nurse was ‘Check fetal heartbeat with electronic fetal heart monitor’. CONCLUSION: The organized educational program and policy was needed to develop for MFICU nurses.
Critical Care ; Delivery Rooms ; Education ; Fetal Heart ; Intensive Care Units ; Leisure Activities ; Nursing ; Nursing Care ; Pregnancy