Recently there has been attempts to develop hospital information system including order communicating system, patient tracing system, tumor registry system, office automation system and picture archiving and communication system(PACS). The authors devloped a practical system that was operated via order communication system of Yeungnam University Hospital. The system provided us the 'speed, accuracy, reliability, retention, economy and wide applicability through practical test. So we believed that this system would be one of standard computerized programs in radiation oncology practice and providing widely usable data for clinical statistics, medical record, tumor registry system and clinical researches.
Hospital Information Systems ; Humans ; Medical Records ; Office Automation ; Radiation Oncology*

Flap survival is critical to the success in reconstructive surgery, there have been many investigations to increase the blood supply to the flaps such as surgical delay and pharmacologic delay. Prostaglandin(PG) is released from various tissues including blood vessel in response to physical stimulus. Among the Prostaglandins, PGE1 has been proven to be a vasodilatation property and many authors have demonstrated its effect to increase blood supply after random cutaneous flap surgery. Clinically, however, muscle flap or musculocutaneous flap is more significantly used in reconstructive surgery and hemodynamic effects of PGE1 of this type of flap are still not documented. The authors designed the random muscle flap to study the hemodynamic effects of PGE1 of the muscle flap. Superior based rectus muscle flap was elevated from rats and the superior epigastric artery, its major vascular pedicle, was ligated to create the random-type muscle flap. Twenty two rats were divided into two experimental groups and each group had 11 rats; Group I: No drugs Group II: PGE1 injection group for 7 postoperative days intraperitoneally The average muscle flap survival rate of group I was 46+/-3.0 precent and it had a higher survival rate than the control group(23+/-4.3%). The muscle flap survival rates showed significant differences between the two groups (p< 0.005) This study shows that the administration of the PGE1, in clinical usage of the rare random muscle flap with a pedicle injury or musculocutaneous flap with the risk of distal cutaneous flap necrosis, such as TRAM flap, which might be much safer and popular.
Alprostadil ; Animals ; Blood Vessels ; Epigastric Arteries ; Hemodynamics ; Myocutaneous Flap ; Necrosis ; Prostaglandins ; Rats* ; Rectus Abdominis* ; Survival Rate ; Vasodilation

PURPOSE: The present study was designed to understand the conceptual definition and attributes of the clinical critical thinking ability(CCTA) in nursing and to grasp the characteristics of clinical critical thinking abilities. METHODS: The data were analyzed using the Hybrid model of Schwartz-Barcott and Kim(2000). RESULTS: Having the skills and dispositions to think critically, CCTA refers to something that implies the cognizant ability to interpret contextual meanings, analyze the relationships between materials or circumstances, draw out the best conclusions, predict things using relevant information and evaluate the reliability of information and the strength of inference on the one hand and the emphatic disposition to be curious, open-minded, intellectually integral, systematic and creative and to reflect on things in contextual terms on the other. CONCLUSION: CCTA is characterized by clinical circumstances, such as guessing the reasons for facts, predicting things, connecting theory to practice and approaching individual situation in total terms as well as by the Korean circumstances, such as taking another person's perspective. Hence, this study proposes developing the tools to measure the clinical critical thinking ability and the strategies to improve the clinical critical thinking ability and seeking to verify their validity, on the basis of the findings.
Chimera ; Clinical Competence ; Concept Formation ; Hand ; Hand Strength ; Problem Solving ; Thinking

To describe and evaluate the morphologic changes and the different expression of cell-specific or correlating protein molecules during cell growth, immunocytochemistry and morphologic observations were done on retinal pigment epithelial(RPE) cells obtained from several culture conditions. These include culture time, spatial or cell density, transdifferentiation, and presence of growth factors. The human fetal and porcine RPE cells were cultured with and without individual growth factor or in combinations inchlding extracellular matrix (ECM), Insulin, basic fibroblatio growth factor (bFGF) and epidermal growth factor (EGF). Mouse monoclonal anti-human, or anti-mouse antibodieg with or without species cross reactlvity against the intermediate filament proteins (cytokeratin, vimentin, GFAP) were used. To determine RPE-specific molecules of cytokeratin, nine commercially available antibodies, representing subclones of Moll's catalog number 1, 5, 7, 8, 10, 14, 17, 18, 19 were applied. The morphological changes and the proliferation of cells started after their attachment on the culture plate as soon as they lost pigment granules. The epithelial cells like fibroblasts occurred in the area where the cellular density was low, and finally, their shape was restored to their original phenotype when the cellular connuency was achieved. The degree of proliferation and the duration of achieving confluency of cells were dependent on whether ECM and growth factors were added in media or not. Cells with the epithelial morphology were positively stained with anticytokeratine antibodies, especially with clone 19, 18, 17, 8 and 7 in human RPE cells; with 19, CAM 5.26 (8/18) in porcine cells. The fusiform or digitating cells of sparse density also expressed vimentin strongly through out all stages, whereas GFAP was not expressed at any stage in either species.
Animals ; Antibodies ; Cell Count ; Clone Cells ; Epidermal Growth Factor ; Epithelial Cells* ; Extracellular Matrix ; Fibroblasts ; Humans ; Immunohistochemistry ; Insulin ; Intercellular Signaling Peptides and Proteins ; Intermediate Filament Proteins ; Keratins* ; Mice ; Phenotype ; Retinaldehyde* ; Vimentin*

To describe and evaluate the morphologic changes and the different expression of cell-specific or correlating protein molecules during cell growth, immunocytochemistry and morphologic observations were done on retinal pigment epithelial(RPE) cells obtained from several culture conditions. These include culture time, spatial or cell density, transdifferentiation, and presence of growth factors. The human fetal and porcine RPE cells were cultured with and without individual growth factor or in combinations inchlding extracellular matrix (ECM), Insulin, basic fibroblatio growth factor (bFGF) and epidermal growth factor (EGF). Mouse monoclonal anti-human, or anti-mouse antibodieg with or without species cross reactlvity against the intermediate filament proteins (cytokeratin, vimentin, GFAP) were used. To determine RPE-specific molecules of cytokeratin, nine commercially available antibodies, representing subclones of Moll's catalog number 1, 5, 7, 8, 10, 14, 17, 18, 19 were applied. The morphological changes and the proliferation of cells started after their attachment on the culture plate as soon as they lost pigment granules. The epithelial cells like fibroblasts occurred in the area where the cellular density was low, and finally, their shape was restored to their original phenotype when the cellular connuency was achieved. The degree of proliferation and the duration of achieving confluency of cells were dependent on whether ECM and growth factors were added in media or not. Cells with the epithelial morphology were positively stained with anticytokeratine antibodies, especially with clone 19, 18, 17, 8 and 7 in human RPE cells; with 19, CAM 5.26 (8/18) in porcine cells. The fusiform or digitating cells of sparse density also expressed vimentin strongly through out all stages, whereas GFAP was not expressed at any stage in either species.
Animals ; Antibodies ; Cell Count ; Clone Cells ; Epidermal Growth Factor ; Epithelial Cells* ; Extracellular Matrix ; Fibroblasts ; Humans ; Immunohistochemistry ; Insulin ; Intercellular Signaling Peptides and Proteins ; Intermediate Filament Proteins ; Keratins* ; Mice ; Phenotype ; Retinaldehyde* ; Vimentin*

OBJECTIVES: To determine the effectiveness and clinical utility of antenatal corticosteroids in the reduction of neonatal morbidity and mortality on preterm birth Material and method: Neonatal outcomes of 312 preterm babies were evaluated retrospectively. One hundred and two preterm babies(study group) were given dexamethasone more than 1 dose antenatally and 210 preterm babies(control group) were not given dexamethasone antenatally. Antenatal steroids were administered in the form of four 5mg intramuscular doses of dexamethasone 12 hours apart. Maternal and neonatal outcomes of study group were compared with those of control group. Student t- test, x2 test, Fisher's exact test, and logistic regression analysis were used where appropriate. p-value< 0.05 was considered significant. RESULTS: Antentenatal corticosteroid significantly decreased the incidence of RDS(OR:0.47, 95% CI:0.25-0.86), IVH/PVL(OR : 0.32, 95% CI : 0.12-0.86), necrotizing enterocolitis(OR : 0.49, 95% CI : 0.25-0.98), and neonatal death(OR: 0.30, 95% CI: 0.10 - 0.89) in preterm delivery. In the presence of PROM, antenatal corticosteoid seemed to have no protective effect on the neonatal complications such as RDS, IVH/PVL, NEC, PDA, and neonatal death. CONCLUSIONS: Antenatal administration of corticosteroids was effective to decrease the incidence of neonatal morbidity and neonatal mortality in the preterm neonates with no apparent maternal complications.
Adrenal Cortex Hormones ; Dexamethasone ; Humans ; Incidence ; Infant ; Infant Mortality ; Infant, Newborn ; Logistic Models ; Mortality ; Premature Birth* ; Retrospective Studies ; Steroids

OBJECTIVE: This study is to explore the effects on specific bindings between [ 3H]RX821002, alpha-2 adrenergic receptor antagonist and alpha-2 adrenergic receptor in rat brain by G-protein modulation. METHODS: The radioligand binding receptor study was conducted with [ 3H]RX821002, a new alpha-2 adrenergic receptor antagonist, in the presence or absence of Gpp(NH)p and pertussis toxin. RESULTS: The alpha-2 adrenergic receptors were saturated with [ 3H]RX821002 in the fashion of the single binding site. The dissociation constant (Kd) was 0.70+/-0.30 nM, and maximum binding (Bmax) was 599.9+/-283.4 fmol/mg protein. The saturation study showed that the maximum binding (B max ; 668.0+/-50.1 fmol/mg protein) was increased and the dissociation constant (Kd ; 0.61+/-0.14 nM) was decreased significantly in the presence of Gpp (NH)p compared to those (B max ; 559.8+/-81.9 fmol/mg protein, Kd ; 0.87+/-0.14 nM) in the absence of Gpp (NH)p (by paired t-test ; B max, p=0.023, Kd, p=0.005). In the presence of pertussis toxin, the maximum binding (B max ; 617.0+/-58.5 fmol/mg protein) was increased significantly (by paired t-test ; B max, p=0.001) but the issociation constant (Kd ; 0.92+/-0.24 nM) was not decreased compared to those (B max ; 554.1+/-66.1 fmol/mg protein, Kd ; 0.89+/-0.24 nM) in the absence of pertussis toxin. CONCLUSION: These results confirm that the binding profiles between [ 3H]RX821002 and alpha-2 adrenergic receptors be modified by G-protein modulation. This suggests that the drug effects on receptors be influenced by various conditions such as G-protein modulation.
Animals ; Binding Sites ; Brain* ; GTP-Binding Proteins* ; Guanylyl Imidodiphosphate ; Pertussis Toxin ; Rats* ; Receptors, Adrenergic, alpha-2

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

BACKGROUND: Controversy exists as to whether or not inhalation anesthetics and intravenous anesthetics impair arterial oxygenation (PaO2) during one lung ventilation (OLV). Accordingly, we examined the effect of enflurane and propofol on PaO2 and pulmonary vascular resistance (PVR) during OLV. METHODS: Forty patients, who had prolonged periods of OLV anesthesia with minimal trauma to the nonventilated lung were studied in a cross over design. Patients were randomized to four groups; Group 1 received 1 MAC of enflurane and oxygen from induction until the first 20 min after complete lung collapse, then were switched to propofol 100 g/kg/min (P100). In group 2, the order of the anesthetics was reversed. Group 3, Group 4 received the same order of the anesthetics as Group 1, Group 2, respectively but received propofol 200 g/kg/min (P200). RESULTS: During OLV, the PaO2 values were lower than those with two lung ventilation (TLV), there were no significant differences among each groups and between propofol and enflurane in PaO2, but in the selected patients (n=10, PaO2<120 mmHg during OLV), PaO2 in propofol group was higher than that of enflurane group (p<0.05). Conversion from TLV to OLV caused a significant increase in PVR, but there were no difference in PVR between propofol and enflurane group. CONCLUSIONS: These results suggest that the usual clinical dose of propofol affords no advantage over 1 MAC of enflurane anesthesia except low PaO2 patients during OLV. Propofol might be of value in risk patients of hypoxemia during thoracic surgery when OLV is planned.
Anesthesia ; Anesthetics ; Anesthetics, Inhalation ; Anesthetics, Intravenous ; Anoxia ; Cross-Over Studies ; Enflurane* ; Humans ; Lung ; One-Lung Ventilation* ; Oxygen* ; Propofol* ; Pulmonary Atelectasis ; Thoracic Surgery ; Vascular Resistance ; Ventilation

BACKGROUND: A healthy diet is important for the prevention and management of major chronic diseases including cancer, cardiovascular disease, diabetes, and obesity. However, the effect of dietary intervention-based education and consultation has not been satisfactory. This study sought to investigate the effects of a diet intervention supplying food directly to the workplace cafeteria. METHODS: Study subjects included 36 employees (23 men) staffed at two companies located in Seoul and Gyeonggi-do. Participants were supplied with liquid meals made mainly with fruits and vegetables for breakfast and dinner. Lunch was supplied as well and comprised of a balanced diet. Consumption of other foods, except water and provided snacks, were prohibited. The program also included light exercise, yoga, and mind-body control for 20 minutes, three times a week. Changes in anthropometric and metabolic parameters were evaluated. RESULTS: None of the subjects complained of serious adverse effects or dropped out of the program. Post-intervention mean body weight and body fat mass decreased significantly (-3.3 kg and -2.0 kg respectively, p<0.001 for both comparisons). There were additional reductions in systolic blood pressure (-6.7 mmHg, p<0.001), fasting glucose (-9.0 mg/dL, p<0.001), total cholesterol (-13.9 mg/dL, P=0.005), triglyceride (-44.0 mg/dL, p<0.001), and insulin (-2.4 uIU/mL, P=0.007). The satisfaction rate of the program was 88%. CONCLUSIONS: This study showed that a diet intervention supplying food directly to the workplace cafeteria could succeed in decreasing body weight and improving metabolic parameters, most likely due to high compliance.
Adipose Tissue ; Blood Pressure ; Body Weight ; Breakfast ; Cardiovascular Diseases ; Cholesterol ; Chronic Disease ; Compliance ; Diet ; Fasting ; Fruit ; Glucose ; Insulin ; Light ; Lunch ; Meals ; Obesity ; Pilot Projects ; Snacks ; Triglycerides ; Vegetables ; Yoga