PURPOSE: The purpose of this study was to perform a medical audit of the screening of mammographic results according to ACR BI-RADS Follow-Up and Outcome Monitoring and to evaluate the efficacy of screening mammography in the early detection of breast cancer. MATERIALS AND METHODS: We reviewed the results of 15,300 mammographic examinations of 13, 889 women aged 30 -75 years who underwent mammography at least once at the Severance Health Promotion Center between 1994 and 1998. Women with abnormal mammographic findings were recalled for additional study and those with dense breast composition (3, 4) underwent additional ultrasound. All results were categorized on the basis of the ACR BI-RADS final assessment scale, 1 -5. We reviewed the pathologic or follow-up results of all women in categories 4 and 5, and/or those in any category who took the films out of the health center. RESULTS: The recall rate was 13%. Biopsy or surgical Consultation was recommended for 92 women and biopsy was performed in 52. Pathology revealed 17 cancers and 35 benign lesions. Positive predictive value 2 was found in 18.5% of cases, and positive predictive value 3 in 33%. The cancer detection rate was 1.2/1,000, and sensitivity was 89.5%. Invasive cancers smaller than 1cm or in situ ductal cancers were found in eight of 17 cases (47%), while node-positive invasive cancers were found in nine of 14 cases (64%). Four of 17 mammo-graphically detected cancers were palpated by a surgeon. CONCLUSION: In asymptomatic women, screening mammography is an effective method for the detection of early breast cancer.
Biopsy ; Breast ; Breast Neoplasms ; Early Detection of Cancer ; Female ; Follow-Up Studies ; Health Promotion* ; Humans ; Mammography* ; Mass Screening* ; Medical Audit* ; Pathology ; Ultrasonography

Cytologic features of inflammatory pseudotumor of the lung have not been described frequently. We report fine needle aspiration cytologic(FNAC) finding of a case of inflammatory pseudotumor misdiagnosed as adenocarcinoma in a 63-year- old man. The FNAC displayed a mixture of histiocytes, myofibroblasts, pneumocytes, and plasma cells. Some histiocytes and myofibroblasts had large nuclei with irregular nuclear membrane and prominent nucleoli, which mislead the diagnosis of adeno- carcinoma on FNAC. The heterogeneous cell population is the unique cytologic features of inflammatory pseudotumor, which are helpful to distinguish it from other circumscribed benign and malignant lesions. Familiarity with these features is essential to avoid misdiagnosis and possible overtreatment.
Adenocarcinoma ; Carcinoma, Hepatocellular ; Neoplasm Metastasis

No abstract available.
Humans ; Infant, Newborn* ; Mothers* ; Thrombocytopenia

Blunt tracheobronchial injuries are rare, and usually lethal without aggressive and appropriate management. Recently, the incidence of tracheobronchial injuries has been increased with the increase of traffic accident and mechanization. We report a case of complete tracheal transection combined with a longitudinal rupture of the membranous portion of the trachea extending to the right main bronchus following blunt chest trauma, and review the anesthetic management.
Accidents, Traffic ; Bronchi ; Incidence ; Rupture ; Thorax ; Trachea

Gram-negative toeweb infections have clinical manifest,ations of variable severity. In its mildest form, the affected tissue is damp, softened, boggy and white. But. more severe form may progress to marked denudation of second, third and fourth toewebs with a profuse serous or purulent discharge, and its treatment is difficult. We described a 39-year-old man who had ulcerated arid oozing patches on several toewebs. Pseudomonas aeruginosa was detected in bacterial cultures. We successfullg treated with split-thickness skin graft, and enoxacin on first, visit and enoxacin with gentamicin ointment, for 2 weeks on second visit.
Adult ; Enoxacin ; Gentamicins ; Humans ; Pseudomonas aeruginosa ; Skin ; Transplants ; Ulcer

OBJECTIVE: To identify the factors which can delay home discharges or transfers to other hospitals of rehabilitation inpatients in a tertiary hospital and the change of discharge destination during past 6 years. METHOD: This was a retrospective study of patients with a diagnosis of stroke, traumatic brain injury or spinal cord injury who were admitted to our hospital in 1996, 1999, 2001 and 2003. Demographic data, length of stay, discharge destination and functional status by the FIM(TM) instrument were studied by a medical record review. RESULT: Patients who were transferred to other hospitals or discharged with delay showed significantly lower admission and discharge FIM scores, lower FIM efficiencies, longer length of stays and longer intervals between the onset and admission to a rehabilitation ward. CONCLUSION: Lower functional outcome was associated with a longer length of stay and discharge to another hospital. It would be necessary to establish the long term rehabilitation care facilities with extended rehabilitation program for the patients with lower functional gains in a rehabilitation unit of the tertiary hospitals.
Brain Injuries ; Diagnosis ; Humans ; Inpatients* ; Length of Stay ; Medical Records ; Rehabilitation* ; Retrospective Studies ; Spinal Cord Injuries ; Stroke ; Tertiary Care Centers*

OBJECTIVE: To determine whether there is a difference in nerve conduction studies depend on the body mass index (BMI) of subjects METHOD: Twenty normal healthy volunteers were enrolled for the study. A routine usual sensory and motor nerve conduction study and a sensory nerve conduction study using the near nerve needle technique were performed. BMI was calculated as weight (kg) divided by height (m) squared. In order to evaluate the effect of BMI on the various measure ments of the nerve conduction study, one-way analysis of variance (ANOVA) was used. RESULTS: The sensory nerve amplitudes of median, ulnar and sural nerves correlated significantly (p<0.05) with BMI. However, no correlation was noted between BMI and sensory nerve amplitude by near nerve needle technique. There was no statistical differences noted in the measurements of latency of examined motor and sensory nerves neither the velocity of examined motor nerves. CONCLUSION: In clinical practice, the effect of BMI should be taken into account when the interpretation of abnormal sensory nerve study has to be soli.
Body Mass Index* ; Healthy Volunteers ; Needles ; Neural Conduction* ; Obesity ; Sural Nerve ; Weights and Measures

Acute appendicitis is one of the most common diseases of young people that requires emergency operation. This is especially true for those age 10 years old and older. However, the numbers of cases of appendicitis are increasing in both the young and the elderly. The main purpose of this study is to understand the clinical features of acute appendicitis in children and elderly patients. We retrospectively compared clinical characteristics in 4 groups of patients who underwent appendectomy in our hospital. There were 16 patients in the pre-school age group, 9 were males and 7 females. The total number of patients in the juvenile group were 287, 156 were males and 131 females. The total numbers of patients in the adult group were 794, 436 were males and 358 females. The numbers of elderly patients were 189, 91 were males and 98 females. Complicated appendicitis was found in 15 patients (93.7 %) in the pre-school age group, 79 patients (27.5 %) in the juvenile group, 332 patients (41.8 %) in the adult group, and 96 patients (50.7 %) in the elderly group. Four patients (40 %) had generalized panperitonitis in the pre-school group. The occurrence of perforated appendicitis was the highest in the pre-school age group and the lowest in the juvenile group. Since generalized panperitonitis has a higher incidence in the pre-school age group, prudent and careful diagnosis and treatment are required for the pre-school age group.
Adult ; Aged ; Appendectomy ; Appendicitis ; Child ; Emergencies ; Female ; Humans ; Incidence ; Male ; Retrospective Studies

Fifty nine patients of tuverculous menigiis who were admitted to the Pediatric department of Seoul Red Cross Hospital during the period from March, 1976 to December 1977 were treated with rifampin in addition to isoniazid and streptomycin injection, and Compaired with 135 cases of tuberculous meningitis who were admitted during the period from January, 1971 to December, 1975. The contrast group was composed of 21 cases who obtained as folows. 1) Out of 59 patients givern rifampin, only 5 patients died resulting in lower motality rate (8.5%) whereas 20 patients died out of 135 cases given PAS regimen showing 14.8% of motality rate. 2) Seven cases on each stage of PAS regimen group and 10 cases of stage I, 9 cases of stage II and III of rifampin group were reviewed for the respects of defeveration, durratio of disappearance of meningeal irritation signs, improvements of conciousness and neurological defects and self feeding ability. It was very hard to conclude the superiority on one group because of the similarity of days needed for the improvement. However, superior results with rifampin regimen could be mentioned among the patients with second and third stage of tuberculous meningitis for the clinical improvements. 3) Serial examination of cerebrospinal fluids of the cases in 3 stage revealed no direct relationship either for the clinical improvements or the for ultimate outcome of the patients themselves. C. S. F. improvements were observed in average within one to three weeks. 4) Side effects of fifampin ; the level of SGOT, SGPT and bilirubin at the time of of admission wrer all normal. Twenty-one cases out of 41 patients showed the impairment of liver function after the first to second week of treatment with the dosage of 15-20mg/kg/day. In 3 out of 21 cases, the drug had to be discontinued, owing to the futher elevation of SGOT and SGPT but in 18 out of 21 cases, liver function was gradually normalized within one to two weeks after the dosage of rifampin had been reduced down to 10mg/kg/day. There was no evidence of impairment of liver function on the follow-up evaluation from 4 to 10 months later. And there were no significant changes in Hb, Hct, platelet counts during the course of the therapy. The hepatitis, the well known side effects such as hemolytic anemia, skin rashes and G-I tract disturbance were not observed during the course of treatment. Bases on the above observations that rifampin reduced the motality and shortened the duration of clinical manifestation without the serious side effects except for transient hepatitis, rifampin plus isoniazid would seem to be preferred for the patients who are seen at the late stage of the disease. We know that the number of cases of this study is not enough to draw the definite conclusion of the superiority of rifampin, however, the of these prelininary observations seemed to cast a bright light for the futher trial and follow up observations.
Alanine Transaminase ; Anemia, Hemolytic ; Aspartate Aminotransferases ; Bilirubin ; Cerebrospinal Fluid ; Child* ; Exanthema ; Follow-Up Studies ; Hepatitis ; Humans ; Isoniazid ; Liver ; Platelet Count ; Red Cross ; Rifampin* ; Seoul ; Streptomycin ; Tuberculosis, Meningeal*

PURPOSE: The study purposes were to describe the process of developing the Korean versions of the Six Dimension Scale of Nursing Performance (Six-D) and Student Nurse Stress Index (SNSI) and psychometric evaluation of the two measurements. METHODS: This was a methodology study using a descriptive cross-sectional design with 51 nursing students in 4th year of university. Internal consistency reliability was assessed using Cronbach alphas. Construct validity was determined by exploring correlations among Six-D, SNSI, objective structured clinical examination (OSCE), self-efficacy and grade point average (GPA). RESULTS: Internal consistency reliability of Six-D and SNSI was acceptable with Cronbach's alpha of .95 and .82. Correlation analysis to determine construct validity revealed that Six-D presented positive correlations with OSCE (r=.109~.272) and self-efficacy (r=.005~.161) and negative correlation with GPA (r=-.246~-.394), although all were not statistically significant. SNSI presented all negative correlations with OSCE (r= -.007~-.238), self-efficacy (r=-.246~-.394), and GPA (r=-.092~-.426) and were mostly statistically significant except OSCE. CONCLUSION: Six-D needs more evidence to confirm validity to predict observed clinical competency and theoretical relationships with self-efficacy and GPA. However, SNSI presented trends of expected relationships with relevant variables. Therefore, further research is recommended in testing validity of Six-D with other student populations.
Asthma ; Humans ; Psychometrics ; Students, Nursing