No abstract available.
Fetus* ; Humans ; Pregnancy, Twin*

The objective of this study was to explore the psychosocial factors such as life events, coping styles and family relationships in middle-aged depressed women. This study was designed to compare how different variables relate to depression in two different test groups: a depressed patient group and a normal group. The Beck Depression Inventory(BDI), The Ways of Coping Checklist, Interpersonal Support Evaluation List(ISEL), Family Environment Scale were administered to 116 depressed patients and 113 normal persons between the ages of 35 and 64. The results were as follows 1) The highest stress was marital stress(n=42, 36.2%) in patient group and family stress(n=44, 38.9%) in normal group, respectively. 2) There were significant differences between patient group and normal group in BDI scores (t=15.94, p<.0001), lift events(t=4.73, p<.0001), active coping(t=6.29, p<.0001), social support(t=7.20, p<.0001), and family relationship(t=5.75, p<.0001) except for passive coping(t=0.93, p=.35). 3) In depressed patient group, BDI scores had a significantly positive correlation with the scores of the life event(r=.24, p<.01) and negative correlation with active coping(r= -.22, p<01), social support(r=-.35, p<.001) and family relationships(r=-.30, p<.001). 4) In depressed patient group, multiple regression analysis showed that social support(12.3%, beta=-.281, T=-3.162, P=.002), lift events(5.1%, beta=.279, T=3.195, F=.002), and active coping(3.5%, beta=-.204, T=-2.225, F=.028) had predictability on the BDI scores and the total predictability was 20.9%. 5) Stress experienced in family relationships were highest in life events and there was a lack of consistency(in the BDI scores ol the coping styles). Social support was the most important factor and there were no significant differences between the two groups in family relationships.
Checklist ; Depression ; Family Relations* ; Female ; Humans ; Psychology

PURPOSE: The purpose of the experiment with the rabbit was to evaluate the effect of human amniotic membrane transplantation in the extraocular muscle surgery area after the operation. METHODS: Five millimeters resection of both superior rectus muscles was performed in eight rabbits. The left eye was served as a control, and the right eye was covered with human amniotic membrane at the site where the operation was performed. Each rabbit was graded according to the degree of adhesion. A histological comparison was done after enucleation. RESULTS: At one week after the operation, it was discovered that the inflammation of the human amniotic membrane transplantation site was suppressed, but at two weeks the human amniotic membrane transplantation site was significantly inflamed. However, the inflammation decreased at six weeks. CONCLUSIONS: This study shows that strabismus surgery with transplantation of human amniotic membrane may reduce postoperative inflammation and adhesion in strabismus surgery after one week. However, after two weeks the inflammation will increase and produce more postoperative adhesion. After six weeks there was no significant inflammation in comparison to the control group.
Amnion* ; Humans ; Inflammation ; Muscles ; Rabbits* ; Strabismus* ; Tissue Adhesions*

Objectives: . The bilateral axillo-breast approach (BABA) to robotic thyroidectomy has been extended to modified radical neck dissection (MRND). This study assessed outcomes in patients who underwent robotic MRND through BABA using the da Vinci Xi system. Methods: . The medical records of 40 patients who underwent total thyroidectomy, bilateral central neck dissection, and MRND from September 2018 to March 2020 were reviewed retrospectively, including 12 who underwent robotic surgery and 28 who underwent open surgery. All operations were performed by a single endocrine surgeon. Results: . The operation time was significantly longer in the robotic group than in the open group (277.08±32.64 vs. 191.43± 60.43 minutes, respectively, P<0.01), but the number of retrieved lymph nodes did not differ significantly (32.58± 9.31 vs. 34.54±10.90, respectively, P=0.569). The incidence of transient hypoparathyroidism was significantly lower in the robotic group (16.7% [2/12] vs. 53.6% [15/28], P=0.041). The mean hospital stay was shorter (3.92±0.90 vs. 4.71±1.63 days) and the pain score on the first postoperative day was lower (2.92±0.29 vs. 3.18±0.67) in the robotic group. Six of the 12 patients (50%) in the robotic group had stimulated thyroglobulin levels <1.0 ng/mL. Conclusion . Robotic MRND through BABA has several advantages, including excellent cosmetic outcomes and a lower incidence of transient hypoparathyroidism than is the case for open MRND. Robotic MRND through BABA may be a promising surgical approach compared with conventional open MRND.

BACKGROUND: This study evaluated the effects of family type and sociodemographic factors on medical treatment, health behavior, and subjective health status in Koreans 60 years and older. METHODS: This study was based on data from the 5th Korea National Health and Nutrition Examination Survey (KNHANES), a nationwide health interview survey using a rolling sampling design involving complex, stratified, multistage, probability cluster. Our subjects included those > or =60 years of age (n=1,946) participating in the KNHANES 2010. Family type was categorized into 7 groups according to cohabitation: alone, couple cohabitation (living with a spouse), parent(s) cohabitation (couple living with parent(s)), offspring cohabitation (no spouse, living with offspring), couple offspring cohabitation (couple living with offspring), couple offspring parents cohabitation (couple living with parent(s) and offspring), and others. Logistic regression analyses were used to examine the association of family type and sociodemographic factors with health care. RESULTS: The most common family type was couple cohabitation (38.26+/-1.8%). In this group, the percentage of non-receipt of needed medical care (odds ratio [OR], 0.60; 95% confidence interval [CI], 0.42 to 0.87) and current smoking rate (OR, 0.32; 95% CI, 0.20 to 0.50) were significantly lower than those living alone. Among the sociodemographic charicteristics, male gender, apartment dwelling, high middle household income, 2 member family, education higher than middle school, and possessing own house were associated with good health care behavior. CONCLUSION: This study shows that couples have better health care behavior than other family types, in particular, limited smoking, appropriate medical treatment, and positive subjective health status. Those living alone visit medical clinics less often and have a negative subjective health status.
Delivery of Health Care ; Family Characteristics ; Health Behavior ; Humans ; Korea ; Logistic Models ; Male ; Nutrition Surveys ; Parents ; Smoke ; Smoking ; Spouses

Purpose: Postoperative adhesions after thyroidectomy adversely affect patients’ quality of life. This study assessed the anti-adhesive effect and safety of thermosensitive sol-gel agents for patients undergoing thyroidectomy. Methods: A double-blind parallel-group randomized clinical trial involving patients aged 20–70 years undergoing thyroidectomy for thyroid nodules was conducted. From August 2017 to April 2020, 90 patients were randomly assigned to the experimental (n = 45, thermosensitive sol-gel agent applied to the surgical site) and control (n = 45, no treatment) groups in a 1:1 ratio. All patients were assessed using a questionnaire for swallowing difficulty, wrinkle problems, and inflammation at 2 weeks, 3 months, and 6 months after thyroid surgery. For reoperated patients, the degree of adhesion was evaluated according to the adhesion-evaluation score system (range, 0–4). Results: During the follow-up period of 6.50 ± 1.38 months, the swallowing difficulty, wrinkle problem, and inflammation were improved in both groups. However, there was no statistically significant difference between the control and experimental groups related to swallowing difficulty, wrinkle problems, and inflammation. Two patients in the control group and 1 in the experimental group who underwent reoperation had an adhesion-evaluation score of 3 points. There were no adverse effects or allergic reactions. Conclusion A thermosensitive sol-gel agent can be safely used as an anti-adhesive barrier. However, this study did not reveal its efficacy for postoperative adhesions. A more objective and systematic study is required in the future.

Apoptosis, including the programmed cell death, is important event in normal cell turnover and maintenance of adult tissues. Apoptosis exerts a homeostatic function in relation to tissues dynamics, as the steady state of continuously renewing tissues achieved by a balance between cell replication and cell death. This study was undertaken to investigate the association between apoptosis and development of the cervical neoplasia. Archival cervical samples from normal epithelium (n 10), low-grade squamous intraepithelial lesions (LSIL, n = 10), high-grade squamous intraepithelial lesions (HSIL, n 10), microinvasive squamous cell carcinomas (n 10), and invasive squamous cell carcinomas (n = 10) were evaluated for apoptosis. We used in situ end-labeling of DNA strand breaks by terminal deoxynucleotidyltransferase incorporation of biotinylated deoxyuridine to 3-OH ends of DNA, identified by nickel-avidine-peroxidase. The apoptotic index (sum of apoptotic bodies divided by the total nuclei times 100) significantly decreased (P<0.05) as the degree of neoplasia increased: 3.1 + 0.9 % in normal epithelium, 5.5 +/- 1.4 % in LSIL, 1.6 +/- 0.4 % in HSIL, 1.9 +/- 0.5 % in microinvasive carcinomas, and 0.6 +/- 0.3 % in invasive carcinomas. Compared to normal epithelium, the total cell number per 200x field increased significantly (P<0,05): 379 +/- 47 in normal epithelium, 462 +/- 228 in LSIL, 670+/-293 in HSIL, 1035 +/- 254 in microinvasive carcinomas, and 1389 +/- 247 in invasive carcinomas. Consequently, these results suggest that progession of cervical carcinogenesis is associated with a decrease in apoptotic index and an increase in the number of the total cell.
Adult ; Apoptosis* ; Carcinogenesis ; Carcinoma, Squamous Cell ; Cell Count ; Cell Death ; Deoxyuridine ; DNA ; DNA Nucleotidylexotransferase ; Epithelium ; Humans

Although liver transplantation (LT) is the only effective treatment option for hepatopulmonary syndrome (HPS), the post-LT morbidity and mortality have been high for patients with severe HPS. We performed post-LT embolotherapy in a 10-year-old boy who had severe type I HPS preoperatively, but he failed to recover early from his hypoxemic symptoms after an LT. Multiple embolizations were then successfully performed on the major branches that formed the abnormal vascular structures. After the embolotherapy, the patient had symptomatic improvement and he was discharged without complications.
Child ; Combined Modality Therapy ; Echocardiography ; Embolization, Therapeutic/*methods ; Hepatopulmonary Syndrome/diagnosis/*therapy ; Humans ; *Liver Transplantation ; Male ; Oximetry ; Positron-Emission Tomography ; *Pulmonary Artery ; Tomography, X-Ray Computed

Recently, it becomes conspicuous that the network should have enough communication bandwidth and be organized with steadiness to operate and support hospital information system successfully. Seoul National University Hospital completed to reconstruct legacy network which had been used since 1995. We had a consultation to diagnose the current problems and reconstructed the network according to the consultation. The design of network architecture was mainly focused on the circuit route in case of error condition and the suitable bandwidth for the easy communication. We also regulated the use of unsuitable protocols which might broadcast inappropriate data packets over the whole network. After 6 months of operation we evaluated the performance of newly constructed network. The average traffic rate from the input port of main servers was 0.5% and that from the output port was 6% separately. The average traffic rate on the overall ATM backbone showed around 1 %.From the result, we concluded that the newly constructed network had such an enough capability supporting hospital information system without any interruption. Furthermore, we expect that it will be sufficient to support the additional traffic increment by PACS and group ware applications.
Hospital Information Systems ; Hospitals, General* ; Information Services* ; Information Systems* ; Seoul*

PURPOSE: Recurrent bile duct stones, following biliary surgery, cause many difficult problems and reoperation on the biliary tract has limitation due to high mortality and morbidity. In recent years, various non-operative modalities for the management of recurrent stone have been developed and reoperation on biliary. This study was designed to determine the factors contributing to the success rate, and to investigate the optimal treatment method, of reccurrent biliary stones. METHODS: Thirty-nine patients, treated by percutaneous transhepatic stone removal (PTBD group), and 42 treated by a common bile duct exploration (operation group), at Chung- Ang University Hospital, between January 1999 and August 2002, were retrospectively analyzed. RESULTS: Complete removal (Success) was achieved in 82.1 and 86.1% of the cases of the PTBD and operation groups, respectively. There were no significant differences observed relating to the sex, age, duration of hospital stay, cost, success rate. However, the complication rate was significantly decreased in the PTBD group (8 cases (20.5%) vs. 22 cases (51.2%) P=0.0057). CONCLUSION: Form the comparison of the operation and PTBD groups, similar success rates were observed. Percutaneous transhepatic stone removal is also an effective method for the management of recurrent bile duct stones. After studying more cases, re-evaluation must be performed concerning the potential advantages of percutaneous transhepatic stone removal.
Bile Ducts ; Biliary Tract ; Common Bile Duct ; Humans ; Length of Stay ; Mortality ; Reoperation ; Retrospective Studies