PURPOSE: This paper studies the influence of the case-management program on the change of blood sugar, lifestyle, and knowledge level of diabetes mellitus (DM) for medium-sizedenterprise employees suffering from DM. METHOD: Subjects, divided into experimental and control groups, are 59 workers with FBS higher than 126mg/dl or under DM medication treatment in the medium-sized enterprises, being managed by two distinct university hospital group occupational health management service teams. The case management program for DM patients consists of 6 different processes in which each subject is treated. RESULT: FBS decreased in the experimental group after the program, while that of the control group increased significantly. In the experimental group, the amount of smoking, the frequency of drinking and the amount of drinking per week decreased. Also, the knowledge level for DM and the change of nutrition management showed significant increase. In the control group, the amount of smoking increased and the frequency of drinking, the amount of drinking and nutrition level did not change significantly. And the knowledge level for DM decreased. CONCLUSION: We expect that taking this case management program for DM management may significantly improve diabetic patients' overall health.
Blood Glucose ; Case Management ; Diabetes Mellitus ; Drinking ; Humans ; Life Style ; Occupational Health ; Smoke ; Smoking ; Stress, Psychological

No abstract available.
Breast Neoplasms* ; Breast* ; Drug Resistance, Multiple* ; Genes, MDR*

No abstract available.
Adult* ; Epiglottitis* ; Humans

All-ceramic restorations have become an attractive alternative to porcelain-fused-to-metal crowns. In-Ceram, and more recently IPS Empress 2 were introduced as a new all-ceramic system for single crowns and 3-unit fixed partial dentures. But their strength and marginal fit are still an important issue. This study evaluated the fracture resistance and marginal fit of three systems of 3 unit all-ceramic bridge fabricated on prepared maxillary anterior resin teeth in vitro. The 3 all-ceramic bridge systems were: (1) a glass-infiltrated, sintered alumina system (In-Ceram) fabricated conventionally, (2) the same system with copy-milled alumina cores (copy-milled In-Ceram), (3) a heat pressed, lithium disilicate reinforced glass-ceramic system (IPS Empress 2). Ten bridges of each system with standardized design of framework were fabricated. All specimens of each system were compressed at 55degree at the palatal surface of pontic until catastrophic fracture occurred. Another seven bridges of each system were fabricated with standard method. All of the bridge-die complexes were embedded in epoxy resin and sectioned buccolingually and mesiodistally. The absolute marginal discrepancy was measured with stereomicroscope at x50 power. The following results were obtained: 1. There was no significant difference in the fracture strength among the 3 systems studied. 2. The Weibull modulus of copy-milled In-Ceram was higher than that of In-Ceram and IPS Empress 2 bridges. 3. Copy-milled In-Ceram (112micrometer) exhibited significantly greater marginal discrepancy than In-Ceram (97micrometer), and IPS Empress 2 (94micrometer at P=0.05. 4. The lingual surfaces of the ceramic crowns showed smaller marginal discrepancies than mesial and distal points. There was no significant difference between teeth (incisor, canine) at P=0.05. 5. All-ceramic bridges of three systems appeared to exhibit sufficient initial strength and acceptable marginal fit values to allow clinical application.
Aluminum Oxide ; Ceramics ; Crowns ; Denture, Partial, Fixed ; Hot Temperature ; Lithium ; Tooth

Purpose: We wanted to evaluate the clinical and radiologic results of acetabular revision using the acetabular reinforcement ring and also the allograft impaction in the acetabulum having deficient bone stock. Material and Methods: Nineteen hips revision arthroplasty were performed in 18 patients (9 males and 9 females) with using an acetabular reinforcement ring and allograft between July 1993 and December 2003. The patients were followed for an average of 64 months (range: 24-153). The mean age at the time of arthroplasty was 59 years old (range: 34-76). The causes of revision were aseptic loosening of the acetabular component in 16 cases, severe progressive osteolysis around the acetabular component in 2 cases and Girdlestone state after infected total hip arthroplasty in one case. The acetabular deficiency was type II in 5 hips, type III in 13 hips, and type IV in one hip according to the AAOS classification. The clinical results were evaluated using the modified Harris hip score, and the radiologic results were evaluated by assessing the preoperative and serial follow-up radiographs. Results: The mean preoperative Harris hip score of 47 was improved to 86 points at the latest follow-up. Periacetabular osteolysis was found in 2 cases, which did not progress at follow-up. The anatomic hip center was restored after revision arthroplasty (p<0.05). Complications were dislocation in 2 cases, breakage of the hook of the Ganz ring in one case, heterotopic ossification in one case and femoral artery injury in one case. All cases showed stable fixation of the acetabular component and good remodelling of the impacted allograft. There was neither recurrence of dislocation nor progression of the acetabular component loosening on the radiographs. Conclusion: Acetabular revision with acetabular reinforcement ring and allograft impaction showed satisfactory clinical and radiologic results with restoration of the hip center and consolidation of the allograft.
Acetabulum* ; Allografts* ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Classification ; Dislocations ; Femoral Artery ; Follow-Up Studies ; Hip ; Humans ; Male ; Ossification, Heterotopic ; Osteolysis ; Recurrence

PURPOSE: Intussusception is a very common pediatric problem and needs early management. This study evaluated the risk factors of intussusception in infants and children for early diagnosis and treatment. METHODS: 216 cases of pediatric intussusception occurring between 1993 and 1999 in Mokpo Catholic Hospital were investigated retrospectively. 164 patients treated with barium reduction comprised the barium reduction (BR) group and 52 patients treated with manual reduction or bowel resection was operation (OP) group. RESULTS: The age incidence under 1 year old was 108 patients (65.9%) in BR group, 45 patients (86.5%) in OP group. Male to female ratio was 1.8:1 in BR and 1.7:1 in OP, respectively. In the seasonal distribution spring was more common in both group (34.1%, 34.6%). 60.4% in BR group, 76.9% in OP group were revealed leukocytosis above 10.000/mm3 in serum. Previous combined diseases were upper respiratory infection (31.7%, 42.3%), acute gastroenteritis (1.2%, 1.9%) and multiple familial polyposis (0.5% in BR group). The frequent symptoms and signs were bloody stool (86.0%,92.3%), abdominal pain and irritability (86.6%, 82.7%), vomiting (76.9%, 67.3%), and abdominal mass (56.7%, 76.9%). Tachycardia was 12.2% in BR and 44.2% in OP. In plain abdominal radiography, intestinal obstructive pattern was present in 5.5% of BR group and 53.8% of OP group. Success rate of barium reduction within 24 hours after symptom appearance was 82.3%. Within 24-48 hours was 61.1%, above 48 hours was 25%. There was a statistically significant difference between BR group and OP group of patients under 1 year old, with tachycardia, symptoms for longer than 48 hours and obstructive pattern on plain abdominal radiography (p<0.05). Of surgical cases, 84.6% were idiopathic. The common anatomical type was ileo-colic type (53.9%). The methods of operation were manual reduction (94.2%) and bowel resection (5.8%). Postoperative complications occurred in 4 cases; 3 cases of wound infection and 1 case of pulmonary complication. Recurrence rate was 12.8% in BR group. CONCLUSION: Risk factors of high incidence such as under 1 year old, severe obstructive pattern on the plain abdominal radiograph, symptoms for longer than 48 hours, and tachycardia, were related with a low success rate of barium reduction. Therefore, a gentle barium enema is recommended in high risk patients for diagnosis and prompt surgical intervention.
Abdominal Pain ; Barium ; Child* ; Diagnosis ; Early Diagnosis ; Enema ; Female ; Gastroenteritis ; Humans ; Incidence ; Infant* ; Intussusception* ; Jeollanam-do ; Leukocytosis ; Male ; Postoperative Complications ; Radiography, Abdominal ; Recurrence ; Retrospective Studies ; Risk Factors ; Seasons ; Tachycardia ; Vomiting ; Wound Infection

The purine antimetabolite 6-Mercaptopurine (6-MP) has been in clinical use for over 30 years and is still a widely used agent in the treatment of childhood acute lymphoblastic leukemia. The bioavailibility, clinical efficacy and toxicity of 6-MP administered orally for maintenance therapy of children with acute lymphoblastic leukemia are highly variable in many studies, as well as at differnt times in same patient. there are many factors affecting the bioavailibility of 6-MP. The most notably factor being that concomitantly administered drugs and foods might contribute to a decrease in the bioavailibity of this drug. In our sociocultural environment milk is a major constituent of child's foods. Cow's milk contains a high concentration of xanthine oxidase, which could potentially transform 6-TM into 6-thioxanthine (6-TX) and 6-thiouric acid (6-TUA) which have no more therapeutic effects. In this study, we evaluated the effect of various milk products on the bioavailability of 6-MP. Incubation at 37degrees C for 30 min raw or pasteurized milk resulted in transformation of a large quantity of clinically relevant concentration of 6-MP into 6-TUA. The concomitant adminstration of folic acid and allopurinol has markedly inhibitory effect on the 6-MP destroying activity of milk at clinically relevant concentrations. These observations may help to optimize modalities of administration of 6-MP for the treartment of patients with childhood leukemia.
6-Mercaptopurine* ; Allopurinol ; Biological Availability* ; Child ; Complement Factor B ; Folic Acid ; Humans ; Leukemia ; Milk* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Xanthine Oxidase

PURPOSE: This study was to develop, implement, and evaluate an e-learning education program for improving practical knowledge and preventing nursing errors and adverse events of nurses working in the operating room (OR). METHOD: The e-learning program was developed and evaluated according to the following processes: 1) preparation phase 2) implementation phase 3) evaluation phase. In evaluation phase, the effectiveness was analyzed based on the Kirkpatrick's model. RESULTS: The e-learning program consisted of OR basic nursing skills and techniques and nursing activities' manual based on the categories of nursing errors: surgical operation preparation, nursing skills and techniques, environment management, patient safety and comfort, and patient monitoring. The program was provided through on-line, http:// cafe.daum.net/pnuhorn, for 4 weeks. The mean score(percent) of participants' satisfaction was 21.24+/-1.71(68.2%). Their total knowledge level was significantly improved(Z=-3.00, p=.003) and specifically in the category of environment management(Z=-3.77, p<.001) and patient monitoring(Z=-2.46, p=.014). The occurrence of nursing errors or adverse events was a little decreased, but not statistically significant(Z= -3.10, p=.756). CONCLUSION: E-learning for nurses is one way of effective and efficient teaching-learning strategies. For better e-learning, it is important to develop the vital content of the education and objective measures for detecting nursing errors and adverse events.
Education* ; Education, Nursing, Continuing ; Humans ; Medical Errors ; Monitoring, Physiologic ; Nursing* ; Operating Rooms* ; Patient Safety ; Program Development ; Program Evaluation

No abstract available.
Acyclovir* ; Necrosis*

A 4-year-old girl developed acute motor, sensory impairment, lower abdominal pain and urinary dysfunction after URI. In acute stage of disease, MRI showed diffuse spinal cord swelling and high signal intensity on T2WI below T2 body level. The patient did not improved and one month later, follow-up MRI showed diffuse spinal cord atrophy and syrinx formation as sequelae of ATM on T1WI below T9 level. To our knowledge, this is the first case showing the sequelae of acute transverse myelitis seen in Korea.
Abdominal Pain ; Atrophy* ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Korea ; Magnetic Resonance Imaging ; Myelitis, Transverse* ; Spinal Cord*