BACKGROUND: Breast cancer is the most frequent malignant neoplasm among women in the Orient. This cancer is also increasing in Korea due to westernization of the living pattern, increased recognition among the general population, and improved methods for early detection. In the surgical treatment of breast cancer, cosmetic conservation of the breast has drawn the patients' attention so that conservative surgery is increasing nowadays. The purpose of this study is to describe the current status of breast cancer management at our institution and to identify the survival and the recurrence rates according to the stage and the surgical method used. METHODS: We reviewed the medical records of 150 patients diagnosed as having breast cancer on pathologic examination at the Department of General Surgery, EulJi College of Medicine, from January 1991 to December 1996 and evaluated the clinical findings, the diagnostic method, operation, and the prognosis. RESULTS: The mean age of the patients was 49.1 years, and 34.0% of the patients was in the fifth decade. A palpable mass in the breast was the most frequent clinical symptom and sign (80.7%). The interval between symptom onset and diagnosis was about 6 months in 76.0% of patients. The size of the mass was 2~5 cm in 51.3% of the patients. A modified radical mastectomy was the most frequently employed surgical method (74.0%), but conservative surgery has increased lately. Seventy-ight patients (52.0%) were in stage II. The five-ear survival rates for stages I, II, III were 100%, 82.9%, and 55.0% (p=0.00006). The five-ear survival rates for 0, 1~3, 4~9, and more than 10 axillary-ode metastases were 85.9%, 55.3%, 53.6%, and 21.1%, respectively (p=0.0007). The five-ear survival rates for breast-conserving surgery and a modified radical mastectomy, for both stage of I and II, were 90.9% and 89.3% (p=0.8114), respectively, and the recurrence rates were 17.9% and 23.8% (p=0.88). CONCLUSIONS: The authors may conclude that breast-onserving surgery may offer an effective alternative to a modified radical mastectomy for patients with stage I & II breast cancer.
Breast Neoplasms* ; Breast* ; Diagnosis ; Female ; Humans ; Korea ; Mastectomy, Modified Radical ; Mastectomy, Segmental ; Medical Records ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Survival Rate

On a standpoint of commonly available ESWL for the treatment of urinary stone, percutaneous stone extraction had the role of cooperation to it, and sometimes it could be the first procedure of choice. We have performed percutaneous extraction of the renal and upper ureteral stones in 35 renal unite. The overall success rate was 78.4%, average operation time was 81 minutes, mean fluoroscopic exposure time was 11 minutes, average postoperative hospital stay was 7 days. Causes of failure were as followings ; five inadequate calyceal puncture, one ureteral perforation, one impacted stone, and one downward stone migration. The complications were inappropriate position of the nephrostomy tube, prolonged hematuria through nephrostomy tube, and partial ureteral avulsion. They were not serious but resolved by conservative management.
Hematuria ; Length of Stay ; Punctures ; Ureter ; Urinary Calculi

Rotor syndrome is a rare disease of hereditary hyperbilirubinemia transmitted with autosomal recessive trait. In general, Rotor syndrome shows direct hyperbilirubinemia and there has been several reports since Sons's report in 1966, in Korea. A 34-year-old female was admitted with the chief complaint of intermittent icteric sclera for 24 years. There was no family history of jaundice. Rotor syndrome was diagnosed by oral cholecystogram, BSP retention test, 99mTc-DISIDA scan, liver biopsy and electron microscopy study of liver biopsy specimen. We report this case with brief review of the literature.
Adult ; Biopsy ; Female ; Humans ; Hyperbilirubinemia ; Hyperbilirubinemia, Hereditary* ; Jaundice ; Korea ; Liver ; Microscopy, Electron ; Rare Diseases ; Sclera ; Technetium Tc 99m Disofenin

The need for a short-acting non-depolarizing neuromuscular blocking agent to replace succinylcholine chloride(succinylcholine) is recognized widely and attempts to find such a drug have been numerous. Atracurium besylate(atracurium) is one of the new series of neuromuscular blocking agents with little cardiovascular effect and is not dependent on hepatic and renal function for terminating its action because of its self-destroying mechanism. Because succinylchline may occasionally be contraindieated for intubation in parturients we studied the use of atracurium in 23 patients having cesarean section. All patients received 0. 5 mg/kg atracurium for intubation and neuromuscular relaxation. Hemodynamic changes, the time from the injection of atracurium to maximal twitch suppression, the time between atracurium administration and the return to 10% of control twitch height were recorded and observed the degree of vocal cord relaxation and conditions of intubation and evaluated the Apgar scores. 1) Mean arterial pressure and heart rate increased significantly after intubation compared with that of control and just before intubation but there were no significant changes in 5 minutes after intubation. 2) The 90% twitch suppression following atracurium administration was 75.6+/-20.9 seconds. 3) The return of 10% of control twitch height was 2449.3+/-1114.0 seconds. 4) Intubation conditions were excellent for 19 patients. 5) The Apgar scores of 20 neonates were high. These data suggest that the use of atracurium may be a useful alternative for induction for Cesarean section when succinylcholine is contraindicated.
Arterial Pressure ; Atracurium* ; Cesarean Section* ; Female ; Heart Rate ; Hemodynamics ; Humans ; Infant, Newborn ; Intubation ; Intubation, Intratracheal* ; Neuromuscular Blockade ; Neuromuscular Blocking Agents ; Pregnancy ; Relaxation ; Succinylcholine ; Vocal Cords

In order to investigate the adolescent's beverage drinking pattern and its related ecological factors, a questionnaire survey was conducted with the subjects of 920 middle and high-school students, 450 boys and 470 girls, residing in 4 cities of the Chungnam area. Of the subjects 65% liked, or liked very much, beverages and only 3.7% did not like beverages. They drank beverages 4.3 +/- 4.0 times a week on average, but 10.4% of them drank beverages more than twice a day. Male students drank more frequently than the females. The intake frequency of carbonated drinks was 1.7 +/- 2.3 a week, which was about 40% of the total beverages. However, more students drank mainly ion beverages (33.6%) than carbonated drinks (28.7%). As the students took more balanced food and ate more regularly, their beverage drinking frequency decreased and those taking carbonated drinks also tended to decrease. The more frequent the students took fast food, the more frequent they drank carbonated beverages. The drinking frequencies for beverages or carbonated beverages were also less in students eating cooked rice with sidedishes as breakfast than in students eating others. The drinking frequency for carbonated drinks showed significant correlations with the students' activities such as the time spent using computers and watching TV got longer, the drinking frequency for soft drinks was also higher. When nutritional knowledge was higher, drinking frequency for carbonated drinks got lower. In conclusion, to make the adolescents improve their attitudes toward drinking beverages and to prevent excessive drinking of carbonated drinks, they should be educated not only on the nutritional knowledge and the proper intake of beverages, but also on good dietary habits including balance, regularity, and types of meals. Proper snacking and fast food consumption also should be taught. Since ion beverages were taken more frequently than carbonated drinks among adolescents, further study is recommended on the impact of excessive intake of ion beverages.
Adolescent* ; Beverages* ; Breakfast ; Carbonated Beverages ; Chungcheongnam-do* ; Drinking ; Fast Foods ; Female ; Food Habits ; Humans ; Male ; Meals ; Snacks

PURPOSE: Hemodialysis remains the most important support for patients with end stage renal disease, and vascular access is an essential component for their life. Since 1966, internal arteriovenous fistula (AVF) has been used widely today. If vessels were not available for AVF, the alternative would be used such as prosthetic graft. But in 1997, the National Kidney Foundation-Dialysis Outcome and Quality Initiative (DOQI) recommended increased use of native arteriovenous fistula to improve overall patency and curtail angioaccess costs. This retrospective study is to review our experience and to evaluate the overall patency rate and the influencing factors on the patency of the AVF. METHOD: From March 1995 through October 2000, 111 fistulas were created of 111 patients in Eulji university hospital. Among them, 106 cases were able to follow up survey. The statistical analysis used by SPSS package. RESULT: The male versus female ratio was 1.22:1 and the age distribution was occurred on from 3rd decade to 9th decade. the common causes of renal failure was hypertension, glomerulonephritis and diabetes (62.1%). the autogenous graft fistulas were performed in 101 cases (wrist/antecubital fossa. 101/3), Goretex graft fistula were 7 cases. The early graft failures were 12 cases (11.4%) and the causes was thrombosis or stricture, and immaturation, psudoaneurysm, venous hypertension in order of frequency. At 12, 24, 36 months, the assisted patency rates of AVF were 80.4, 76.5, 71.3%, respectively. CONCLUSION: We could get higher patency rate of AVF due to liberal use of native veins and aggressive intervention of the failing AVF as recommendation of DOQI.
Age Distribution ; Arteriovenous Fistula* ; Constriction, Pathologic ; Female ; Fistula ; Follow-Up Studies ; Glomerulonephritis ; Humans ; Hypertension ; Kidney ; Kidney Failure, Chronic ; Male ; Polytetrafluoroethylene ; Renal Dialysis ; Renal Insufficiency ; Retrospective Studies ; Thrombosis ; Transplants ; Veins

PURPOSE: The purpose of this study was to develop a vital signs e-book for undergraduate student nurses and evaluate the content, system and student satisfaction. METHOD: This study was done in three stages, the development of a vital signs e-book, implementation and evaluation. The subjects were 73 undergraduate student nurses in Y university. RESULT: Thirty one learning objectives were used to create the contents. A set of 5 chapters and 18 subsections were defined after validation from nurse educators. The e-book is available at http://123.134.207.23/ebook/vitalsigns. Analysis of the questionnaires showed a mean score for content, system and students satisfaction of 3.17 +/- .73, 3.11 +/-.79, and 2.96 +/-.74 respectively out of a possible 4 points. CONCLUSION: Nurse educators should provide quality and effective web-based courses that meet undergraduate student nurses' learning needs and they should incorporate web-based learning into traditional teaching to meet the demands of nursing education.
Respiration ; Pulse ; *Physical Examination ; *Internet ; *Education, Nursing ; *Computer-Assisted Instruction

We tried percutaneous extraction of upper ureteral stones in five patients via Wolf rigid ureteroscope with grasping forceps. The procedure was performed at two session. The nephrostomy tract dilation was carried out by combination of metal dilator and Amplatz teflon renal dilator under fluoroscopy. All the five cases of PCN were successful without any complication at first trial. The advantage of this technique is low postoperative morbidity, rapid convalescence, sooner return to work and cheap price. It seems that endourological treatment of mid ureteral stone as well and upper ureteral stone can be extracted through percutaneous nephrostomy tract.
Convalescence ; Fluoroscopy ; Hand Strength ; Humans ; Nephrostomy, Percutaneous ; Polytetrafluoroethylene ; Pregnenolone Carbonitrile ; Return to Work ; Surgical Instruments ; Ureter* ; Ureteroscopes ; Wolves

Background: Topical recombinant human epidermal growth factor (rhEGF) is effective in the treatment of diabetic foot ulcers, surgical wounds, burns, and scars. Binding of EGF to EGF receptors results in cell proliferation and differentiation. Objective: This study aimed to evaluate the efficacy of topical rhEGF ointment compared with that of topical mupirocin in healing herpes zoster (HZ) lesions. Methods: Thirty patients diagnosed with typical HZ were recruited in August, 2018. The rats were randomly divided into two groups: topical mupirocin and topical rhEGF ointment. HZ lesions were evaluated using the Vancouver Scar Scale (VSS) at the initial visit, 1st, 2nd, and 4th weeks. Results: The total number of recruited patients (n=30) included males (n=16, 53.3%) and females (n=14, 46.7%) with a mean age of 58.2. The proportion of patients with a 50% reduction in the VSS score (VSS 50) at 2nd week was significantly higher in the rhEGF group (33.0% vs. 72.0%, respectively, p=0.035). The complete resolution rate (VSS=0, 1) at 4th week was also higher in the rhEGF group (17.5% vs. 50.0%, p=0.03). Conclusion Topical rhEGF showed a more rapid treatment response and anti-scarring effect than topical mupirocin in patients with HZ lesions.

An 82-year-old man diagnosed with supraglottic cancer sought a consultation for percutaneous endoscopic gastrostomy (PEG) placement. Preoperative chest radiography (posterior-anterior [PA] view) revealed no abnormalities, and PEG tube placement was performed using the “pull” method. Chest radiography (PA view) performed 3 days postoperatively showed free air that was not observed immediately after PEG tube placement; therefore, the patient was diagnosed with pneumoperitoneum. Abdominal computed tomography confirmed that the PEG tube was appropriately positioned within the stomach; however, the colon was observed between the abdominal wall and stomach, which indicated that the PEG tube had passed through the colon. Review of preoperative chest radiographs (PA views) confirmed that the colon was visualized in the area wherein usually stomach gas should have been observed. The patient was diagnosed with a gastro-colo-cutaneous fistula that occurred postoperatively, following a procedure that was performed without confirmation of anatomical variations. The PEG tube was removed surgically, and we performed percutaneous gastrostomy.