The survival between Western and Eastern studies differs markedly except the early stage. Whereas the 5-year survival rates for patients with stage II and III a gastric carcinoma in the United States are around 30% and 15%, respectively, the rates are 45% and 30% in Germany and 75% and 60% in Japan and Korea. Loco-regional failures are common even after radical resection. Gastric carcinoma is as sensitive as other types of adenocarcinoma to radiation. Preoperative radiation was proven to be effective in reducing the tumor bulk and lymph node metastasis. There are substantial data to show that adequate radiation dose with combined chemotherapy is effective in management of local failure and improvement of survival. But there is no well designed randomized study to evaluate the adjuvant treatment for patients after optimal radical operation. In summary, 1) radical operation has improved the cure rate of stomach cancer, 2) local failure is still one of the common failure patterns, 3) abdominal radiation can be delivered safely in the modern era, and 4) study of pattern of failure on patients after radical surgery is necessary before designing clinical trial to evaluate the efficacy of adjuvant radiation/chemotherapy.
Adenocarcinoma ; Drug Therapy ; Germany ; Humans ; Japan ; Korea ; Lymph Nodes ; Neoplasm Metastasis ; Stomach Neoplasms* ; Survival Rate ; United States

PURPOSE: The purpose of this study is to find taxi drivers' smoking behavior, self-efficacy and expectation level of success in smoking cessation. It will provide useful information for developing nursing interventions in health promotion programs. METHOD: The subjects of this study were 271 taxi drivers in Seoul and its metropolitan area. Data were collected using a self-reported questionnaire asking smoking history, smoking behaviors, health problem, stages of change for smoking cessation, self-efficacy and the expectation level of success in smoking cessation. Data were analyzed through descriptive statistics. Pearson's correlation, Mann-Whitney U test, Kruskal-Wallis test and Cronbach's a. RESULTS: Of the taxi drivers, 83.8% were current smokers. Stages of change were as follows: 45.8% were in the precontemplation stage, 26.2% in the contemplation stage, 13.7% in the maintenance stage, 12.2% in the preparation stage and 1.5% in the action stage. In addition. 20.3% of the subjects reported health problems such as hypertension, heart disease, diabetes mellitus and respiratory disease. The expectation level of success in smoking cessation was positively related with self-efficacy. There were statistically significant differences in the expectation level of success in smoking cessation according to the number of cigarettes per day and nicotine dependency. In addition. there were statistically significant differences in self-efficacy according to the number of cigarettes per day, duration of smoking (years) and nicotine dependency. CONCLUSION: The results of this study suggest that taxi drivers' health problems and smoking rate were serious. Therefore more systematic health promotion programs for smoking cessation should be developed and executed by health care specialists at individual taxi companies.
Delivery of Health Care ; Diabetes Mellitus ; Health Behavior ; Health Promotion ; Heart Diseases ; Hypertension ; Nicotine ; Nursing ; Seoul ; Smoke* ; Smoking Cessation* ; Smoking* ; Specialization ; Tobacco Products ; Surveys and Questionnaires

After application of silver nitrate on every newborn, the incidence of gonococcal conjunctivitis was markedly decreased. But recently neonatal conjunctivitis due to chlamydial infection is increasing, so clinical observation was made on 26 newborn infants who showed eye discharge from June 1st to August 31st 1989. The results were as follows. 1. The incidence of chlamydial infection among neonatal conjunctivitis was 34.6%. 2. The most common age at diagnosis was 6-15days of life and there was no secual preponderance. 3. There was no significant difference on clinical symptoms between chlamydial conjunctivitis and other conjunctivitis. 4. Of 26 infants examined, 16 cases revealed no growth on routine bacterial culture. Of the organism cultured, P. aeruginosa was the most common agent (19.2%) and followed by S. aureus (11.5%) and S. epidermidis (7.6%). In one case of chlamydial conjunctivitis, there was concurrent S. aureus infections. 5. On this study, Giemsa stain did not give significant diagnostic aid of chlamydial conjunctivitis.
Azure Stains ; Conjunctivitis* ; Diagnosis ; Humans ; Incidence* ; Infant ; Infant, Newborn* ; Silver Nitrate

Chronic liver disease was characterized difficult to cure, long-standing disease. Patients with chronic liver disease were searching for complementary treatments to recover form illness, while they have been treated by the doctor. This study was carried out to explore application of alternative therapies in patients with chronic liver disease. For this survey, the questionnaire were developed by researchers and the data were collected for two months. Among the 192 subjects, 155 were hospitalized and 37 were out patient department and the majority of diagnoses were chronic hepatitis (42.2%), liver cirrhosis (31.3%), primary liver carcinoma (14.6%). The results were as follows. 1. Patients who have had experiences with alternative therapies were 128, not undergone were 64. Varried alternative therapies were used and 46.9% of 128 subjects used both hospitals and alternative therapies simultaneously. 2. Patients have looked for alternative therapies in the early stage of disease (71.1%), and motivated to decide a matter of having use complementary therapies as alternatives for treatments (64.8%), and obtained information from their families and friends (48.2%), mass media (14.8%). The majority of patients were acknowledged that laternative treatments have no effectiveness really but it gives them psychological comfort. And the patients have payed a lot of money in cost of alternative therapies fee ; 1.4 times higher than hospitals. 3. Among the 128 subjects, 43.8% patients were communicated with their physicians about complementary therapies, 56.2% were not. 82.1% patients who asked their physicians were experienced negative responses of their doctors. 4. patients were expected the higher effect of alternative therapies when they have been delivered treatment by hospitals with complementary therapies (chi2=57.84, P<0.05), and then they evaluated the treatment effect better in this treatment pattern (chi2=25.26, P<0.05). And in terms of general characteristics of the patients, the only duration of illness was showed the significant relationship with the utilization of alternative therapies (chi2=8.44, P<0.05). 5. In no used alternative therapies group, the reason that they have not taken alternative therapies were ; to keep their physician's prescription, to refuse alternative therapies by their physicians, and to have no trust themselves on alternative therapies. In conclusion, the further study will be required the patients' experience using alternative therapies as the progress of disease in terms of holistic view of patients.
Complementary Therapies* ; Diagnosis ; Fees and Charges ; Friends ; Hepatitis, Chronic ; Humans ; Liver Cirrhosis ; Liver Diseases* ; Liver* ; Mass Media ; Prescriptions ; Surveys and Questionnaires

The purpose of this study was to investigate the relation between hypertension and risk factors. A positive association between obesity, age, serum lipid and such life style factors as smoking, exercise, alcoholic beverage use with blood pressure problems and the prevalence of hypertension has been described in many studies. Therefore to identify and evaluate the effects of variables, which were known to be related to hypertension, multiple regression analysis was performed. We studied 110 subjects. The participants were 45 men and 65 women who visited one university hospital located in Seoul from January to December 1998. All 110 persons were identified as having primary hypertension by their physicians. The significant risk factors identified for hypertension were Obesity, BMI, length of time with hypertension. The results were as follows; 1. The systolic blood pressure average in 110 subjects was 156.65mmHg +/- 14.08mmHg, the diastolic blood pressure average was 100.73mmHg +/- 5.64mmHg. 18.2% of the subjects were smokers, 26.4% of the subjects were drinkers, and 33.6% of the subjects exercised regularly. 13.6% had a family history of hypertension. The average mean pressure was 119.37 +/- 7.40mmHg. The average history of hypertension was 28.36 +/- 34.56months. The average body weight of subjective was 65.25kg, and their average BMI was 24.54kg/m2. The average serum cholesterol of the subjects was 204.54mg/dl, HDL was 50.93mg/dl. 2. The result of this study were that variables which showed significance rationale for high systolic blood pressure in hypertension were mean arterial pressure(R2=0.808), and age(R2=0.032). And the variables which showed significance rationale for diastolic blood pressure in hypertension were mean arterial pressure(R2=0.697), age(R2=0.051), sex(R2=0.014), and somking(R2=0.010). And the best variable for prediction of mean blood pressure was the length of history of the disease. 3. According to multiple regression analysis by demographic variables, age and the length of history of hypertension were predictable variables for hypertension. And mean the blood pressure was identified best explaining variable of hypertension by biophysical variables. Therefore, life style modification for hypertension patients as a primary regimen is less important than for normal blood pressure patients. Life style modification is important intervention for normal blood pressure subjects, on the other hand drug therapy and its compliance is the most important intervention for hypertensive subjects. So to regulate blood pressure and prevent the complication of hypertension, the first regime of all should pharmacologic therapy. There is a need to develop nursing intervention to improve pharmacologic compliance for primary hypertension patients.
Alcoholic Beverages ; Blood Pressure* ; Body Weight ; Cholesterol ; Compliance ; Drug Therapy ; Female ; Hand ; Humans ; Hypertension* ; Life Style ; Male ; Nursing ; Obesity ; Prevalence ; Risk Factors* ; Seoul ; Smoke ; Smoking

PURPOSE: This study was performed to develop a scale for evaluation of attitudes toward complementary and alternative therapies (CAT) and to investigate nurses' attitudes toward CAT. METHOD: The subjects were 263 nurses working at a university hospital in Seoul and Inchon. The personally designed questionnaire was tested for its reliability and validity. Nurses' attitudes to CAT were evaluated using the questionnaire. RESULTS: Cronbach's alpha coefficient was 0.7405. 23 items were selected by item analysis and 4 factors including application, therapeutic effect, social interest and communication about CAT were classified by factor analysis. The mean score of attitudes and its subcategories were high, especially that of communication was very high. Nurses had a positive response to CAT in several items; acceptance as nursing intervention, its therapeutic value, complement for conventional medicine, and open communication about CAT. Attitudes were different significantly according to education and number of working years. There were high relationships between attitudes and its subcategories except communication. CONCLUSION: The Scale of attitudes toward CAT was proven to be reliable and valid. Positive nurses' attitudes toward CAT will help the patients be provided with a proper and safe way to take CAT.
Animals ; Cats ; Complement System Proteins ; Complementary Therapies* ; Education ; Humans ; Incheon ; Nursing ; Reproducibility of Results ; Seoul ; Surveys and Questionnaires

PURPOSE: The O'Leary Symptom Index and Problem Index (ICSI/ICPI) have been used widespread in clinical studies and research. This research was aimed to determine the reliability and validity of the ICSI/ICPI-K that was translated into Korean. METHODS: The research design was a methodological study to test the measurements. Subjects were 301 elderly women in Seoul, Chungnam and Gyungbuk. They were recruited through a formal announcement and they responded after informed consent. Data was analyzed with SPSS 15.0. The internal consistency was assessed by Cronbach's alpha coefficient and the criterion validity was assessed by Pearson correlation with the Geriatric Depression Scale (GDS) and inter-subscales. RESULTS: The elderly women were on average 74.3 years old. As to the reliability of the scale, ICSI/ICPI-K had a Cronbach alpha of .832. In addition, the results showed that ICSI/ICPI-K was valid through the Pearson correlation. That is, the ICSI-K and ICPI-K had a significant relationship with GDS (r=.295; r=.374, respectively) and strong correlations of subscale to subscale (ICSI-K & ICPI-K: r=.676). The most common symptom of the lower urinary tract by the ICSI/ICPI-K was nocturia 249 (83.3%) followed by frequency 187 (62.8%), urgency 148 (49.8%). and pelvic pain 71 (23.9%) in the elderly women. CONCLUSION: We can conclude that the ICSI/ICPI-K is reliable and valid in Korean elderly women. It needs to be evaluated in the clinical area.
Aged ; Cystitis, Interstitial ; Depression ; Female ; Humans ; Informed Consent ; Nocturia ; Pelvic Pain ; Reproducibility of Results ; Research Design ; Urinary Tract

PURPOSES: We experienced a case of infected cephalhematoma drained spontaneously. So we wanted to review the most appropriate method for investigating cephalhematomas for possible infection and to clarify the indications for the diagnostic aspiration. METHODS: MEDLINE searches were conducted for the period from 1972 to 1997, and all reports were obtained. 15 articles reporting 18 infected cephalhematomas were identified in the literature. We analyzed the medical records in patients according to age: sex ; associated infections especially sepsis or osteomyelitis, risk factors such as scalp electrode or vacuum use, local signs such as increase in size, fluctuation, local redness: organisrns: and radiographic findings. RESULTS: Escherichia coli was isolated from over 50% of the cephalhematomas that were aspirated. Most patients presented with sepsis, meningitis, and/or osteomyelitis. Plain radiographs, bone scans, and enhanced CT scans were limited in their ability to determine if a cephalhematoma was infected unless associated osteomyelitis existed. Local signs of scalp infection, such as increase in size, fluctuation, local redness were obvious in almost all cases. CONCLUSIONS: Aspiration is the diagnostic procedure of choice for cephalhematomas suspected of being infected. The indications for aspiration were increase in size, development of erythema, development of fluctuation, relapse of systemic infection, or a delay in the resolution of clinical symptoms of infection.
Diagnosis ; Electrodes ; Erythema ; Escherichia coli ; Humans ; Infant, Newborn ; Medical Records ; Meningitis ; Osteomyelitis ; Recurrence ; Risk Factors ; Scalp ; Sepsis ; Tomography, X-Ray Computed ; Vacuum

Myxofibrosarcomas (MFSs), which consist of multiple nodules with a variable cellular population in a myxoid matrix, are primarily located in subcutaneous tissue. Pleomorphic hyalinizing angiectatic tumors (PHATs) are rare soft-tissue tumors characterized by a proliferation of highly pleomorphic spindle or polygonal cells and abundant ectatic blood vessels in cellular or myxoid stroma. We present here an unusual case of a high-grade MFS with a PHAT-like appearance. A 67-year-old man presented with an asymptomatic subcutaneous mass in the right forearm. The tumor had myxoid, hypo-, and hypercellular areas with highly pleomorphic spindle or polygonal tumor cells that showed frequent mitoses and nuclear pseudoinclusions. Foci of punctuate necrosis and inflammatory infiltration were present throughout the tumor, and abundant ectatic, thick-walled vessels containing blood clots were noted. The tumor cells were immunohistochemically positive for vimentin but negative for CD34, S-100 protein, smooth muscle actin, desmin, and bcl-2.
Actins ; Aged ; Blood Vessels ; Desmin ; Forearm ; Humans ; Hyalin ; Mitosis ; Muscle, Smooth ; Necrosis ; S100 Proteins ; Sarcoma ; Subcutaneous Tissue ; Vimentin

Magnetic resonance (MR) is rapidly emerging technique that provides high quality images and potentially provides much more diagnostic information than do conventional imaging modalities. MRI is conceptually quite different from currently used imaging methods. The complex nature of MRI allows a great deal of flexibility in image production and available information, and key points are as follows. 1. MR offers a non-invasive technique with which to generate in vivo human images without ionizing radiation and with no known adverse biological effects. 2. Imaging mechanism of MRI is quite different from conventional imaging modality and for more accurate diagnostic application, It is necessary for physician to understand imaging mechanism of MRI 3. M.R. makes available basic chemical parameters that may provide to be useful for diagnostic medical imaging and more specific pathophysiologic information which are not available by alternate techniques. 4. M.R. can be produced by number of different methods. This flexibility allows the imaging technique to be applicated for particular clinical purpose. Multiplanar and three dimensional imaging may extend the imaging process beyond the single section available with current CT. 5. Future directions include efforts to; a. Further development of hard ware b. More fastening scan time c. Respiratory and cardiac gated imaging d. Imaging of additional nuclei except hydrogen. e. Further development of contrast media f. MR in vivo spectroscopy g. Real time MR imaging
Comprehension* ; Contrast Media ; Diagnostic Imaging ; Humans ; Hydrogen ; Magnetic Resonance Imaging ; Pliability ; Radiation, Ionizing ; Spectrum Analysis