No abstract available.
Cervix Uteri* ; Female

It is well known that small dose of belladonna alkaloid(atropine, scopolarnine) has the effect of decreasing the heart rate in normal conscious subjects, but the mechanism involved in it remains still unanswered. Based on various lines of evidence, the most likely mechanism seems to be the blockade of sympathetic ganglion caused by the alkaloids and it is possible that the effect on the slower heart rate may differ in the depressed state of the sympathetic ganglion when under halothane anesthesia. The present study was undertaken, therefore, on comatose patients and halothane anesthetized patients with and without atropine premedication about 1 hour before anesthesia to observe the effect of a small dose of scopolamine(0.1 mg) which affects the heart rate more significantly than atropine in conscious subjects. The results were as follows: 1) In the comatose patients, scopolamine(0.1 mg) produced a significant decrease in heart rate. 2) During halothane anesthesia without atropine premedication, scopolamine produced a slight decrease in heart rate. 3) During halothane anesthesia with atropine premedication, scopolamine produced a significant increase in the heart rate. These results indicate that scopolamine can further affect the sympathetic ganglion already depressed by halothane, and it is suggested that scopolamine is more effective in blocking the sympathetic ganglion than halothane.
Alkaloids ; Anesthesia ; Atropa belladonna ; Atropine ; Coma ; Ganglia, Sympathetic ; Halothane* ; Heart Rate* ; Heart* ; Humans ; Premedication ; Scopolamine Hydrobromide*

PURPOSE: This study was conducted to evaluate the economic efficiency of a community-based nursing care center to help policy makers determine whether or not to invest in similar facilities. METHODS: The subjects were 101 elderly people over 65 years who participated in a health management program from February 1 to July 31, 2007. Direct cost was estimated with center operations cost, medical cost for out-patients and pharmacy cost. Indirect cost was measured by transportation cost. Direct benefit was calculated by saved medical cost for out-patients, saved pharmacy cost, saved transportation cost, and reducing hospital charges. Indirect benefit was estimated with prevention of severe complications. Economic efficiency was evaluated by cost-benefit ratio and net benefit. RESULTS: Operating a community-based nursing care center was found to be cost-effective. Specifically, the cost of operating the center evaluated here was estimated at 135 million won while the benefit was estimated at 187 million won. Benefit-cost ratio was 1.38. CONCLUSION: The Community-based nursing care center that was described here could be a useful health care delivery system for reducing medical expenditures.
Administrative Personnel ; Aged ; Community Health Nursing ; Cost-Benefit Analysis ; Delivery of Health Care ; Diabetes Mellitus ; Health Expenditures ; Hospital Charges ; Humans ; Hypertension ; Nursing Care ; Outpatients ; Pharmacy ; Transportation

No abstract available.
Clomiphene*

PURPOSE: There are few reports about the natural history of patients with pseudoprecocious puberty due to autonomous ovarian cyst. We reviewed the clinical course of 7 patients who had autonomous ovarian cysts and signs of precocious puberty. METHODS: We retrospectively evaluated 7 children, aged 2.8 to 7.9 years, who were diagnosed with pseudoprecocious puberty due to autonomous ovarian cysts from November 2005 to May 2011. The follow-up durations ranged from 0.5 to 6.3 years. RESULTS: Four out of 7 patients showed elevated serum estrogen levels and all revealed prepubertal response of gonadotropin to GnRH stimulation at diagnosis. The size of the cysts was from 1.7 to 4.6 cm on pelvic ultrasound examination. After 1 to 3 months, the ovarian cysts disappeared in all patients. Three of the girls developed relapsing signs of precocious puberty (vaginal bleeding and breast budding). Two of them showed an increase in growth velocity and bone age due to recurrent ovarian cysts, and one of them was converted to true precocious puberty. CONCLUSION: In our cases, all patients with autonomous ovarian cysts resolved spontaneously. However, some showed frequent recurrence of ovarian cysts, and needed a longer follow up because of the possibility of conversion to true precocious puberty and signs of McCune-Albright syndrome.
Aged ; Breast ; Child ; Estrogens ; Female ; Fibrous Dysplasia, Polyostotic ; Follow-Up Studies ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Hemorrhage ; Humans ; Natural History ; Ovarian Cysts ; Puberty ; Puberty, Precocious ; Recurrence ; Retrospective Studies

PURPOSE: To determine referring physicians 'general attitudes, preferred reporting types, and opinions on radiologic reports. MATERIALS AND METHODS: A survey questionnaire was distributed to the 315 staff and residents of four university hospitals with 400 to 800 beds, and a total of 228 physicians responded. The questionnaire aimed to determine of the general attitude of referring physicians to radiologic reports, the type of report they preferred, and other opinions and suggestions. The responses elicited, as well as discrepancies among residents, staff, internist, and surgeons, were analyzed. RESULTS: Most referring physicians replied that they read an entire report regardless of its length, and the second majority read the conclusion first and then the remainder of the report only if clarification was required. With regard to report length, physicians answered that reports describing the findings of conventional radiography were often too short, while those dealing with MRI were verbose. The majority experienced occasional confusion when reading a report, the major cause being grammatical errors and incomprehensible sentence structure. When confused, most physicians consulted the radiologist; staff showed a greater inclination than residents to pursue this option. Most physicians preferred brief phrases or telegraphic-style sentences to a style which stressed completeness and detail, a preference which was statistically higher among residents than staff. Whereas physicians favored a brief radiologic report in cases of normal radiologic findings, conventional radiologic studies or no clinical findings, they wished to see a more detailed report in cases of abnormal radiologic findings, specific radiologic studies (special radiographs, US, CT, or MRI), or positive clinical findings. This need for more detail was expressed more frequently by internists than by surgeons. CONCLUSION: If implemented, the results of this study can be expected to enhance the quality and comprehensibility of radiologic reports, and may also lead to more efficient communication between radiologists and physicians.
Hospitals, University ; Magnetic Resonance Imaging ; Surveys and Questionnaires ; Radiography

BACKGROUND/OBJECTIVES: This study evaluated whether a mobile health (mHealth) application can instigate healthy behavioral changes and improvements in metabolic disorders in individuals with metabolic abnormalities. SUBJECTS/METHODS: Participants were divided into an mHealth intervention group (IG), which used a mobile app for 24 weeks, and a conventional IG. All mobile apps featured activity monitors, with blood pressure and glucose monitors, and body-composition measuring devices. The two groups were compared after 24 weeks in terms of health-behavior practice rate and changes in the proportion of people with health risks, and health behaviors performed by the IG that contributed to reductions in more than one health risk factor were analyzed using multiple logistic regression. RESULTS: Preference for low-sodium diet, reading nutritional facts, having breakfast, and performing moderate physical activity significantly increased in the mHealth IG. Furthermore, the mHealth IG showed a significant increase of eight items in the mini-dietary assessment; particularly, the items “I eat at least two types of vegetables of various colors at every meal” and “I consume dairies, such as milk, yogurt, and cheese, every day.” The proportion of people with health risks, with the exception of fasting glucose, significantly decreased in the mHealth IG, while only the proportion of people with at-risk triglycerides and waist circumference of females significantly decreased in the control group. Finally, compared to those who did not show improvements of health risks, those who showed improvements of health risks in the mHealth IG had an odds ratio of 1.61 for moderate to vigorous physical activity, 1.65 for “I do not add more salt or soy sauce in my food,” and 1.77 for “I remove fat in my meat before eating.” CONCLUSIONS: The findings suggest that the additional use of a community-based mHealth service through a mobile application is effective for improving health behaviors and lowering metabolic risks in Koreans.
Blood Pressure ; Breakfast ; Cheese ; Delivery of Health Care ; Diet ; Diet, Sodium-Restricted ; Disease Management ; Fasting ; Female ; Glucose ; Health Behavior ; Humans ; Logistic Models ; Meat ; Milk ; Mobile Applications ; Motor Activity ; Odds Ratio ; Public Health ; Risk Factors ; Smartphone ; Soy Foods ; Telemedicine ; Triglycerides ; Vegetables ; Waist Circumference ; Yogurt

Recently we experienced a case of mucinous prostatic adenocarcinoma treated with radical prostatectomy. The needle biopsy of indurated both lateral lobes showed prostatic adenocarcinoma. But the radical prostatectomy specimen showing a prostatic adenocarcinoma of which 90% was mucinour component.
Adenocarcinoma ; Adenocarcinoma, Mucinous* ; Biopsy, Needle ; Mucins* ; Prostate* ; Prostatectomy

Recently we experienced a case of mucinous prostatic adenocarcinoma treated with radical prostatectomy. The needle biopsy of indurated both lateral lobes showed prostatic adenocarcinoma. But the radical prostatectomy specimen showing a prostatic adenocarcinoma of which 90% was mucinour component.
Adenocarcinoma ; Adenocarcinoma, Mucinous* ; Biopsy, Needle ; Mucins* ; Prostate* ; Prostatectomy

PURPOSE:The cone-shaped epiphyses mid-5 (CSE-5) and brachymesophalagia-5 (BMP-5) are common osseous anomalies. Those are thought to be normal variants. We evaluated the frequency of CSE-5 and BMP-5 and the influence of them on adult height in Korean children with normal short stature. METHODS:We retrospectively reviewed medical records of 322 normal short stature children. Lengths of the fourth (MP-4) and fifth middle phalanx (MP-5) and widths of MP-5 of all children were measured. Two indicies for BMP-5 were used. Index 1 was based upon the ratio of the width to the length of the MP-5. Index 2 was based upon the ratio of the lengths of MP-5 to MP-4. CSE-5 was assessed by visual inspection only. We assessed several clinical parameters as follows; advanced skeletal maturation, z-scores of height, target height (THz) and predicted adult height (PAHz) according to CSE-5 and/or BMP-5. Results:Of the 322 children, 23.6% had BMP-5 (male 19.5%, female 27.4%), 23.6% had CSE-5 (male 13.0%, female 33.3%). The children with CSE-5 and/or BMP-5 were more advanced skeletal maturation than normal fifth finger (0.07+/-1.09 yrs vs -0.23+/-1.34 yrs, P=0.049), lower PAHz (-1.13+/-1.09 vs -0.71+/-1.28, P=0.008), lower PAHz- THz (-0.53+/-1.07 vs -0.14+/-1.30, P=0.013). In male subjects, the PAHz had weak correlation with index 1 (r=-0.26, P=0.001) and index 2 (r=0.27, P=0.001). CONCLUSION:This study suggests that BMP-5 and CSE-5 in Korean children with short stature are one contributable factor for adult height.
Adult ; Body Height ; Bone Development ; Bone Morphogenetic Protein 5 ; Child ; Epiphyses ; Female ; Finger Phalanges ; Fingers ; Humans ; Male ; Medical Records ; Retrospective Studies