BACKGROUND: Immunostaining to identify nuclear antigen provides a convenient way of assessing proliferative kinetics in hyperplastic/tumor tissue. OBJECTIVE: The object of this study is to find out whether there are any differences in the expression of proliferation related protein among psoriasis, basal cell carcinoma and squamous cell carcinoma by immunohistochemical evaluation on the PCNA (proliferative cell nuclear antigen) and Ki-67. METHODS: The detection of PCNA and Ki-67 were done by,immunohistochemical methods (avidin-biotin immunoperoxidase methods) using respective monoclonal antibodies in the paraffin embeded tissues from psoriasis (17 cases), basal cell carcinomas (15 cases) and squamous cell carcinomas (10 cases). RESULTS: The labelling indices of PCNA were 14.2±4.0% in psoriasis, 10.9±5.5% in basal cell cardinoma and 28.0±7.8% in squamous cell carcinoma, while the labelling indices of Ki-67 were 15.7±3.8% in psoriasis, 11.26.1% in basal cell carcinoma and 30.3±9.4% in squamous cell carcinoma. CONCLUSION: 1. Interpretation of Ki-67 staining was easier than that for PCNA, mainly because cell morphology was better preserved and the distinction between hyperplastic/tumor and nontumor cell was clear. 2. PCNA and Ki-67 counts had strong correlation to each other (r=0.979). 3. Our immunohistochemical results of PCNA and Ki-67 suggested that proliferative activity was more marked in psoriasis than basal cell carcinoma.
Antibodies, Monoclonal ; Carcinoma, Basal Cell* ; Carcinoma, Squamous Cell ; Kinetics ; Paraffin ; Proliferating Cell Nuclear Antigen* ; Psoriasis*

While Joint Commission on Accreditation of Healthcare Organizations(JCAHO) and American College of Surgeon(ACS) have identified certain audit filters in trauma care, there are few studies to substantiate the value of these audit filters. Some researchers found that audit filters qualifiers were significantly associated with adverse outcomes, however, others were unable to reproduce such association. It is also necessary to test their validity and applicability in Korea. The purpose of this present study was to validate two trauma audit filters proposed by the JCAHO and the ACS, through the analysis of the relationship between timeliness of operation and risk-adjusted mortality. Among trauma audit filters, timeliness of operation in epidural or subdural hematoma(EDH/SDH) and intraabdominal injury were selected. By stratified random cluster sampling, 19 emergency medical centers (EMCs) were selected from 30 EMCs and all patients who received craniotomy or laparotomy in 1996 were evaluated in each hospital. Six medical records administrators reviewed medical records of 463 patients with EDH/SDH and of 508 patients with intraabdominal injury retrospectively. In other to adjust risk of mortality, timeliness of operation, age, Revised Trauma Score(RTS), ICD-9CM based ICISS, and experiences of transfer were included in logistic regression model. In the logistic regression models of all EDH/SDH or intraabdominal injury patients, timeliness of operation was not significant predictor of mortality. However, if patients who have been operated later than 12 hours were excluded from the statistical model, timeliness of operation showed significant or marginally significant relationship with mortality in the following situations; craniotomy > 4 hours in EDH(OR=30.46, p=0.032), craniotomy > 8 hours in SDH(OR=6.50, p=0.020), laparotomy > 2 hours in shock patients(OR=9.26, p=0.055). In addition to timeliness of operation, RTS and ICISS were significant variables in every logistic regression model, and experience of transfer and types of EMC were significant or marginally significant only in EDH. Timeliness of operation as audit filters for trauma care could not be applied to all cases. Early operations seem to improve clinical outcome only in the patients for whom emergent craniotomy or laparotomy were indicated. It could be interpreted as a phenomenon of 'confounding by indication'. Additional studies to establish more objective eligibility criteria for these audit filiters are needed.
Accreditation ; Administrative Personnel ; Craniotomy ; Delivery of Health Care ; Emergencies ; Humans ; Joint Commission on Accreditation of Healthcare Organizations ; Joints ; Korea ; Laparotomy ; Logistic Models ; Medical Records ; Models, Statistical ; Mortality ; Retrospective Studies ; Shock

This study was attempted to identify the knowledge to breast-feeding and the performance of nursing activities for breast-feeding and to test "how does the degree of knowledge to breast-feeding influence the nursing activities for breast-feeding?" The subjects were 180 nurses working in delivery rooms, nursery, obstetrics & pediatrics wards or OPD of obstetrics & gynecology of 8 general hospitals in Pusan as of August 3 through 13, 1996. The results are abstracted as follows : 1) Subject nurses' age : 25-29 was 45.6%(the major), education levels ; graduates from junior college were 95.0%, unmarried status was 62.2%, 76.5% of married nurses had children, 39.7% in-service education for Breast-Feeding, 337% did nursing activities for breast-feeding actively, the reason for inadequate activities for breast-feeding was "too much other tasks." 2) The degree of knowledge to breast-feeding ; mean score was 13.54, the degree of performance of nursing activities for breast-feeding ; 92.38+/-20.93 points out of possible 145 points(3.19+/-.74 out of possible 5 points) meaned that it was a low level. 3) The hypothesis "the nurses who have higher degrees of knowledge to breast-feeding will show higher degrees of performance of nursing activities for breast-feeding than the nurses who have lowe degrees of knowledge to breast-feeding" was tested by t-test(t=-.01, P=.9888), but rejected because it turned out statistically not significant at the level of P<.05) Above results suggested the degrees of knowledge to breast-feeding and the degrees of performance of nursing activities for breast-feeding were generally low and the degree of knowledge didn't influence the nursing activities. Researchers believe that the education for breast-feeding by the nurses need to be performed systemically & practically and new-method of breast-feeding education program need to include hospital managers as well as nurses related mothers and their family. In addition, researchers propose the introduction of "lactation specialist system", for the specialist can change the attitude of feeding-mothers positively with their specialty and authority.
Busan ; Child ; Delivery Rooms ; Education ; Gynecology ; Hospitals, General ; Humans ; Mothers ; Nurseries ; Nursing* ; Obstetrics ; Pediatrics ; Single Person ; Specialization ; Child Health

No abstract available.
Animals ; Brain* ; Glutamic Acid* ; Glycine* ; Rats*

BACKGROUND: Emergency Medical Technicians can do emergency care only under the control of the physicians. Emergency medical services system(EMSS) in Korea is now extended from the level of basic life support(BLS) to advanced life support(ALS). Unfortunately we don't have any official medical control system yet. We and regional EMSS, 119 rescue team(BLS), have had monthly joint meeting to validate and improve the prehospital care since August, 1998. METHODS: From August, 1998 to February, 1999, 1,708 patients were transported to Ewha Mokdong Hospital by regional 119 rescue team. Eight hundred and six(47.2%) run record were collected and analyzed. The appropriateness of the prehospital care were evaluated based on the comparison of assessment data and treatment data in each run record. The run record were divided into 5 groups; 1) necessary-adequate, 2) necessary-inadequate, 3) necessary-undo, 4) unnecessary-done, and 5) unnecessary-undo. 1) and 5) were judged as acceptable, and 2), 3), and 4) as unacceptable. RESULTS: Among 806 transported patients, 60.8% required one or more emergency care. 21.0% of required care were not provided, and 20.7% of provided care were not adequate. 78.8% of unprovided and 75.9% of inadequate care were 'airway and oxygen supply'. Overall unacceptable rate was decreased from 31.7% to 17.0% during first 5 months, but it rose up again to 24.7% after 2 months. Cardiopulmonary resuscitation(CPR) was performed in 29 prehospital cardiac arrest victims and admitted to ICU in 5 cases. CPR was not provided in 8 necessary situations, and unnecessary CPR was done in 3 cases. CONCLUSION: EMSS in Korea also need a kind of medical control system, even for BLS level. Major portion of the quality assurance program could be 'airway and oxygen supply', but attention should be focused in cardiac arrest victims and CPR. Record keeping and reliance of run record data are now pending problems. Fire department should develop a formal medical control system and the referring hospital should have an organization for maintaining the quality of prehospital care.
Cardiopulmonary Resuscitation ; Emergency Medical Services* ; Emergency Medical Technicians ; Fires ; Heart Arrest ; Humans ; Joints ; Korea ; Oxygen ; Retrospective Studies*

PURPOSE: To correlate the CT findings of renal cell carcinomas with nuclear grading in histopathology. MATERIALS AND METHODS: Preoperative CT scans and pathologic nuclear grading of 60 surgically resected renal cell carcinomas in 55 patients were retrospectively and independently reviewed. RESULTS: As nuclear grade increased, renal cell carcinomas were more likely to be of higher stage(92% of nuclear grade III renal cell carcinomas was of stage Ill, all Grade IV tumors were of stage IIIb or higher) and greater size(84% of grade III tumors and 100% of grade IV tumors>5cm in size) at presentation, and appeared more heterogeneous(84% of grade III tumors and 88% of grade IV tumors showed moderate or severe heterogeneity) and less well marginated(84% of grade Ill tumors and 100% of grade IV tumors had irregular or imperceptible margins). CONCLUSION: Small well-marginated homogeneous renal cell carcinomas were either nuclear grade I or II, and were distinguishable from the more aggressive nuclear grade III or IV lesions, which generally displayed irregular margins and greater inhomogeneity.
Carcinoma, Renal Cell* ; Humans ; Retrospective Studies ; Tomography, X-Ray Computed

In order to study species of the Fascioloidae in Korea, a series of morphological and taxonomical studies were carried out and the following results were obtained. Among the species of the Fascioloidae in Pusan area, intermediate form (F. indica?) were 70 percent, F. gigantica 25 percent and F. hepatica, 5 percent. None experimental, natural infective rate of the Fasciolosis was 3.3-3.4 percent among the cattles (Bos taurus var. domesticus) in Pusan area.
parasitology-helminth-trematoda ; Fascioloidae ; F. gigantica ; F. hepatica ; taxonomy

One fetal demise of twin pregnancy in the second or third trimester is an unusual and difficult problem in the managemcnt of pregnancy. It can be associated with an increased risk for mortality and morbidity in the remaining fetus and with maternal DIC. 255 twin gestations were delivered at our hospital between December 1984 and August 1998. 8 cases of twin pregnancies with one fetal demise were observed. We reviewed 8 cases of twin pregnancies with one fetal demise that had been managed conservatively. The incidence of twin pregnancies with one fetal demise was 3.14% in the study population. The incidence of preterm delivery was 87.5%. The perinatal mortality rate of surviving twins was 25%. There were no cases of maternal disseminated intravascular coagulation or infection. There were no cases of neurologic damages in the surviving twins. The main cause of neonatal death was prematurity. An expectant approach to the twin pregnancies with one fetal demise seems reasonable.
Dacarbazine ; Disseminated Intravascular Coagulation ; Female ; Fetus ; Humans ; Incidence ; Mortality ; Perinatal Mortality ; Pregnancy ; Pregnancy Trimester, Third ; Pregnancy, Twin*

The term "fixed drug eruption" was coined by Louis Brocq in 1894 to describe a special type of reaction to antipyrine. It is now known that many drugs can cause a fixed drug eruption. Notorious offenders have included phenolphthalein, quinine and barbiturates. We present a case of multiple fixed drug eruption appearing in a 20 year-old male patient who has generalized slate-blue colored pigmentation on neck, trunk and extremities. The area of total pigmented skin lesions are over 50% of body surface. We could confirm the fixed drug eruption by positive phenobarbital provocation test.
Antipyrine ; Barbiturates ; Criminals ; Drug Eruptions* ; Extremities ; Humans ; Male ; Neck ; Numismatics ; Phenobarbital ; Phenolphthalein ; Pigmentation ; Quinine ; Skin ; Young Adult

OBJETIVE: The aim of this study was to evaluate the outcome the GnRH antagonist (Cetrotide) short protocol in controlled ovarian hyperstimulation comparing with GnRH agonist long protocol. MATERIALS AND METHOD: From July 2000 to November 2001, 26 patients, 28 cycles were performed in controlled ovarian hyperstimulation by GnRH antagonist and GnRH agonist. GnRH antagonist (Cetrotide) was administered in 12 patients (14 cycles, Group 1) and GnRH agonist (Lucrin, Sub Q, Group 2) in 14 patients (14 cycles). Ovulation induction was performed by hMG (Pergonal) in group 1, and by Combo (Metrodine HP + Pergonal) in group 2. We compared the fertilization rate, good quality embryo, and clinical pregnancy rate between the two groups. Student-t test and Chi-square were used to determine statistical significance. Statistical significance was defined as p<0.05. RESULTS: Ovarian hyperstimulation syndrome did not occurred in which estradiol (E2) level was 3874+/-809 pg/ml and the number of retrieved oocytes was 18.4+/-2.4. The number of used gonadotropin ampules was significantly decreased in Group 1 (26.0 vs. 33.1, p<0.04). There were no significant difference in the number of preovulatory oocyte (10.6+/-6.9 vs. 10.0+/-6.1), fertilization rate (74.8+/-23.4 vs. 72.2+/-21.8), good quality embryo (58.7+/-23.6 vs. 38.7+/-36.6), and embryo transfer (4.3+/-1.6 vs. 4.4+/-1.6). Although the age of the group 1 was older than the group 2 (34.4 vs. 30.8), there was no significant difference in clinical pregnancy rate (50.0% vs. 57.1%). CONCLUSIONS: We suggest that GnRH antagonist was a safe, effective, and alternative method in the controlled ovarian hyperstimulation, especially in PCOD patients who will be develop the ovarian hyperstimulation syndrome.
Embryo Transfer ; Embryonic Structures ; Estradiol ; Female ; Fertilization ; Gonadotropin-Releasing Hormone* ; Gonadotropins ; Humans ; Oocytes ; Ovarian Hyperstimulation Syndrome ; Ovulation Induction ; Pregnancy Rate