OBJECTIVES: Dysfunctional uterine bleeding(DUB) is defined as abnormal bleeding from the uterine endometrium unrelated to anatomic lesions of the uterus, and its incidence is 10-15% among gynecologic diseases. We conducted this study for understanding correlation between clinical aspecets and pathological findings of DUB. Methods: We conducted a retrospective review of 599 women with DUB who underwent endometrial biopsy with special regard to the relation between pathologic findings and presenting symtoms or complaints from Jan. 1988 to Dec. 1997. RESULTS: Age distribution of DUB was mainly 5th decade, mean age was 44.1years, among various bleeding patterns, intermenstrual bleeding was the most common pattern(31.6%) and the next was menorrhagia(25.0%). Histologic findings of endometrium were proliferative phase, 327 cases(54.6%), hyperplasia, 139 cases(23.2%), secretory phase, 74 cases(12.4%) in order of frequency, and there was no difference in distribution of histologic findings among various bleeding patterns. CONCLUSION: Compared to other previoius studies, our study showed more incidence of endometrial hyperplasia, especially at age group of 40 or more. So patients aged more than this age with abnormal uterine bleeding must undergo emdometrial biopsy for pathologic diagnosis. Patients who are diagnosed endometrial hyperplasia must be carefully followed up because there are possibilities of progression to endometrial carcinoma.
Age Distribution ; Biopsy ; Diagnosis ; Endometrial Hyperplasia ; Endometrial Neoplasms ; Endometrium ; Female ; Genital Diseases, Female ; Hemorrhage ; Humans ; Hyperplasia ; Incidence ; Metrorrhagia* ; Retrospective Studies ; Uterine Hemorrhage ; Uterus

Complications after a median sternotomy incision, which is used currently in most open heart surgery, are serious, although it is infrequent. Reconstruction of the sternal defect resulting from dehiscence of median sternotomy is still big challenge to the most plastic surgeons. Since vascularized greater omentum was transposed to eliminate mediastinal wound problems, many vascularized regional muscle flaps became mainstay in reconstruction of median sternotomy wound. We treated 13 patients with median sternotomy dehiscence between October of 1993 and March of 1998. In two patients, the wound problems were so confined to superficial tissue that debrided and closed primarily. Eleven patients with deep wound infection were managed with vigorous debridement of all necrotic tissues and resultant defects were covered with regional muscle flaps: rectus myocutaneous flap(3) and bilateral pectoralis advancement flap(8). We used the pectoralis major advancement flaps without counter incision at humeral insertion site and the dissections were limited only medial to the anterior axillary line to preserve the axillary fold. In five patients with larger defects, we elevated muscle and cutaneous flaps separately to make these flaps more mobile. Large portion of two rectus abdominis flaps could not survive, whereas pectoralis advancement flaps had mo special wound problems. Only one patient developed fistula due to remained wire, regardless to flap surgery.
Debridement ; Fistula ; Humans ; Omentum ; Rectus Abdominis ; Sternotomy* ; Thoracic Surgery ; Wound Infection ; Wounds and Injuries

PURPOSE: The purpose of this study was to investigate the effects of case-based learning (CBL) on learning motivation and learning satisfaction of nursing students in a human physiology course. METHODS: The development and application of CBL scenarios was conducted from February to June, 2013. Nursing students (n=142) who registered for a human physiology course were assigned into either a control or CLB group. The control group received traditional lectures for 14 weeks. The CBL group received the same 14-week lectures and an additional 5 CBL sessions. The learning motivation and satisfaction were measured by questionnaires at the beginning and the end of the semester. Seven students in the CBL group were randomly selected for a focus-group interview. Quantitative data were analyzed by chi2-test and t-test, and qualitative data were analyzed by content analysis. RESULTS: The learning motivation and learning satisfaction were not significantly different between the two groups. However, 59% of the CBL group answered with a positive impression on the CBL approach as it helped them to feel a sense of achievement, excitement, to form their identity as nursing students, and so on. CONCLUSION: These findings suggest that the CBL could be a challenging but useful learning method in a physiology course for nursing students. Further studies with guidance, such as instructors' questions and feedback design are needed to utilize CBL more effectively.
Humans ; Humans* ; Learning* ; Lectures ; Motivation* ; Nursing* ; Physiology* ; Students, Nursing*

Asphyxia is primarily observed in either suicide or homicide. We encountered two unusual autopsy cases, which were extremely rare and atypical, with respect to the manner or cause of death. The first victim demonstrated external findings of a transverse ligature mark around his neck and foreign material in the form of flour or kneaded flour in the whole airway, including the oral and nasal cavity. Based on the scene investigation images and autopsy findings, we identified that the victim attempted to strangle himself with a necktie first, but failed. He then inhaled flour and suffocated. The second victim, who died while sleeping, had a transverse ligature mark around her neck with marked facial congestion, multiple petechia of the conjunctiva and oral mucosa, and extensive hemorrhage of the neck muscles. Police investigation found the deceased stuck in a massage machine without the protective cover that prevents small objects being sucked into the machine. Her death was ruled to be accidental. We present two unusual cases of asphyxia, discuss the mechanism of asphyxia in each case, and review the literature.

Eosinophilic coronary periarteritis (ECPA) is a new type of coronary arteritis. In most cases, it has showed sudden cardiac death due to vasospastic angina or spontaneous coronary artery dissection. Many studies about ECPA have been conducted, but the cause of ECPA has yet to be clarified. ECPA was diagnosed at autopsy and the patients were mainly 30- to 50-year-old man. We report a case of a 50-year-old woman who died from ECPA without spontaneous coronary artery dissection. The autopsy showed a sudden cardiac death and results of microscopic examiniation related to ECPA.

PURPOSE: This study examined the factors influencing posttraumatic and conflict management styles for nursing performance in intensive care units (ICUs).METHOD: In this study, 250 nurses from eight general hospitals in three cities participated. Structured self-report questionnaires were used to collect data on posttraumatic, conflict management styles, and nursing performance. Finally, the data were analyzed by SAS 9.3 program.RESULTS: The mean of total sum scores was 31.29, and the high risk of posttraumatic symptoms was 61.2%. It was noted that nursing performance is significantly correlated with collaboration, compromise, accommodation styles, and intrusion. Collaboration styles (β=0.39, p < .001) and hyperarousal (β=−0.22, p=.050), ICU experience below 1 year (β=−0.21, p=.027) and that of 5–10 years (β=−0.19, p=.049), and compromise style (β=0.16, p=.049) were found to be the factors influencing nursing performance with 35.9% explanatory power value of regression model.CONCLUSION: The results of the study reveal that conflict management styles, hyperarousal, and ICU experience are factors predicting the successful performance of ICUs. These findings emphasize the need of developing interventions to reduce stress symptoms and conflicts in ICUs.
Cooperative Behavior ; Critical Care ; Hospitals, General ; Intensive Care Units ; Methods ; Nursing ; Work Performance

This study is to research the use and the demand of the elderly generation that pursue economic ability and active lifestyle. The composition of the meals were "homemade meals" 65.3%, "homemade & convenience meals" 26.7% overall. For the "never miss a meal" category, 70~74 years old was 48.3%, over 80 years old was 60.0%. The elderly under 70 years old showed a high frequency in the use of alternative meals (p < 0.05) and the elderly with higher education used the alternative meals more frequently (p < 0.01). The rice-cakes, bread, tuna cans, Korean side-dishes, beverages, meat, cup-noodles and seafood as alternative meals are in the order of most frequency. Also, 96.0%, 59.0% and 46.5% of the elderly had experience in using "Ready to eat (RTE)", "Ready to heat (RTH)" and "Ready to cook (RTC)". The oldest group surveyed, the elderly at the age of 80 years old and above showed lower preference for "completely cooked state" but showed highest results in the "half-cooked state". This shows the difference between people's perception and the behavior that showed high frequency of 96.0% in the experience with "RTE". This can be inferred that the elderly needs the development of convenience food that is moderately packaged according to the newer lifestyle where the elderly live independent from their children. Moreover, there is a higher demand in the healthy convenience food, which means that there is a need for development in the quality of the convenience food that will allow more faith in convenience food by the elderly.
Aged ; Beverages ; Bread ; Child ; Fast Foods ; Food Preferences ; Hot Temperature ; Humans ; Life Style ; Meals ; Meat ; Seafood ; Tuna

OBJECTIVE: To investigate the correlation of multifidus muscle atrophy on MRI findings with clinical findings in low back pain patients. METHOD: Medical records of 80 patients presenting with low back pain were retrospectively reviewed. Their MR images were visually analysed to know lumbar multifidus muscle atrophy, disc herniation, disc degeneration, spinal stenosis and nerve root compression. RESULTS: Multifidus muscle atrophy increased from the upper lumbar level to the most caudal intervertebral level. It was bilateral in the majority of the cases. Multifidus muscle atrophy was well correlated with patient's age, referred leg pain, and disc degeneration. However, duration of low back pain, disc herniation, spinal stenosis, nerve root compression, sex, weight, height and BMI had no correlation with multifidus muscle atrophy. CONCLUSION: Examination of multifidus muscle atrophy should be considered when assessing MR images of lumbar spine. It may help for further evaluation and planning the treatment modalities of low back pain.
Atrophy* ; Humans ; Intervertebral Disc Degeneration ; Leg ; Low Back Pain* ; Magnetic Resonance Imaging ; Medical Records ; Muscular Atrophy ; Paraspinal Muscles* ; Radiculopathy ; Retrospective Studies ; Spinal Stenosis ; Spine

Autopsy is recognized as the gold standard for examining the body of the deceased. However postmortem inspection, which is a method for examining the body through non-invasive modalities, is very limited. Therefore, several methods have been studied to complement postmortem examination, and endoscopy emerged as a possible method. The authors of the present study performed endoscopic examination before autopsy, and the endoscopic findings were confirmed by subsequent autopsy. The endoscope was inserted mainly through the nostril due to the rigor mortis of the jaw joint. The pharynx, larynx, trachea, and esophagus were examined. Endoscopic examination was performed on a total of 35 cases. Endoscopy revealed froth in the airway (drowning cases), as well as the presence of thermal denaturation of structures in the airway and soot attached to the froth in the airway (fire death cases). However, relevant findings were not noted during external examination. In addition, agrochemical substances were detected in the airway (agrochemical poisoning death cases) during endoscopic examination. The study found that useful information can be obtained for investigating the death and estimating postmortem interval through endoscopic examination. It is thought that minimally invasive autopsy procedures, including endoscopy, cannot replace conventional autopsies, but can be used as adjuncts instead. In particular, minimally invasive autopsy procedures are thought to be useful for postmortem inspection. To this end, continued studies, as well as the development of equipment suited for postmortem examination, are needed.
Autopsy* ; Complement System Proteins ; Endoscopes ; Endoscopy ; Esophagus ; Jaw ; Joints ; Larynx ; Methods ; Minimally Invasive Surgical Procedures ; Pharynx ; Poisoning ; Rigor Mortis ; Soot ; Trachea

OBJECTIVE: To find out wheather the substance P takes part in the pain mediating system of uterus, and to ascertain the role of substance P in the hypersensitivity of hypogastric nerve to bradykinin during the uterine inflammation. METHODS: The uterus has two sensory innervations, which are the hypogastric nerve and the pelvic nerve. Since the hypogastric nerve is known to show increased sensitivity to bradykinin, a pain mediator, when the uterus is in inflammatory state, the hypogastric nerve recording was done for electrophysiological study of uterine pain-mediating mechanism in female SD rats (200-250 g). NK1 receptor antagonist (L-703,606) was injected through uterine artery before injecting bradykinin while uterus was under inflammation. RESULTS: The NK-1 receptor antagonist (L-703,606) decreased the spontaneous nerve impulse during inflammation, and it also decreased the hypersensitivity of the hypogastric nerve to bradykinin during the uterine inflammation. CONCLUSION: Substance P mediates the pain sense of hypogastric nerve, and it also plays a role in increased sensitivity of hypogastric nerve to bradykinin while uterus is in inflammatory state.
Action Potentials ; Animals ; Bradykinin* ; Female ; Humans ; Hypersensitivity ; Inflammation ; Mustard Plant* ; Negotiating ; Rats* ; Receptors, Neurokinin-1* ; Substance P ; Uterine Artery ; Uterus*