BACKGROUND: It is known that QT dispersion represents asynchronous repolarization of ventricle which is related to ventricular fibrillation. The incidence of ventricular arrhythmia is increased after acute myocardial infarction. So this study compared QT dispersion and other repolarization indexes for detection of asynchronous repolarization in acute myocardial infarction. We also investigated which portion of repolarization is the key portion of the asynchrony. METHODS: In 37 acute myocardial infarction patients and 38 angina patients dispersion of QT, JT, JTpeak and QTpeak were measured. We also measured maximum adjacent dispersion of same parameters in precordial leads. In 20 survived patients and 17 dead patients after acute myocardial infarction were also compared. We also investigated correlation of PVC's on Holter monitoring with these repolarization parameters. RESULTS: 1) All ventricular repolarization indexes(QT, QTc, JT, JTpeak, QT peak and TpeakTend dispersion) were significantly increased in acute myocardial infarction group than compared with those of angina group(p<0.05). 2) Maximal precordial dispersion(QT, QTc, JT, JTpeak and QTpeak) were also significantly increased in acute myocardial infarction group than angina group(p<0.05). 3) Dead patient group after myocardial infarction showed significantly increased QTc and TpeskTend dispersion compared with those of survived patient group(p<0.05). 4) Multivariate linear correlation showed that TpeakTend dispersion and JT dispersion was correlated with QT dispersion. CONCLUSIONS: There were asynchronous myocardial repolarization changes in acute myocardial infarction. Our study demonstrated that T wave change was major determinant of dispersion of myocardial repolarization.
Arrhythmias, Cardiac ; Electrocardiography, Ambulatory ; Humans ; Incidence ; Myocardial Infarction* ; Ventricular Fibrillation

PURPOSE: The purpose of this study was to colorimetrically evaluate the masking effect of different opacity of ingots on the final shade of IPS Empress Esthetic(R) laminate veneer restorations using the CIE L*a*b* system. MATERIALS AND METHODS: Six porcelain disks of IPS Empress Esthetic(R) system (translucency: E 01, E 03, E 0C-1, E TC-1, E TC-2, E TC-3) were fabricated with 7 mm in diameter and 0.6 mm in thickness. Six extracted human incisors (shade: A1, A3, A4, B2, B3, C3) were used as the abutment specimens. The incisors were prepared using a diamond wheel and made with a flat labial surface on the middle 1/3. For each combination of different shades of abutments and copings, the change in color was measured with a colorimeter. CIE L*a*b* coordinates were recorded for each specimen. Color differences (DeltaE) were calculated. Descriptive statistical analysis was done. RESULTS: DeltaE values were significantly affected by coping translucency and abutment shade (P<.05). The color differences (DeltaE) of laminate veneers among abutments with A3, B3, C3, and A4 shade were mostly below 2.7 which was within the clinically acceptable range, while color differences between A4 and B2, A3 and B2, and A1 and A4 showed more than 2.7. CONCLUSION: The final color of IPS Empress Esthetic(R) laminate veneers were significantly influenced by translucency of the coping and shade of abutment teeth. The large value difference of abutment teeth limited the masking ability by laminate veneers.
Dental Porcelain ; Diamond ; Humans ; Incisor ; Masks ; Tooth

BACKGROUND: The aim of this study was to investigate the health problems which women feel important and what they want to know from their doctors in the family practice clinics. METHODS: The subjects were all female patients who visited the family practice clinics at the four hospitals in which some members of the Study Group for Women's Health in Korean Academy of Family Medicine worked from December 10 to 15, 2001. We surveyed by self-administered questionnaire on important health topic, health care services they woud like to receive, what they expected from their doctors, what topics they have difficulty in discussing with, the doctors preference of physician's gender. We analyzed the results by age groups; 19~44, 45~64, and 65 years old and over. RESULTS: A total of 437 women answered the questionnaires, whose mean age was 49.4 year. Health topics that women felt important were osteoporosis, stress, cervical cancer, arthritis, and stroke, which varied with the age groups and recent health perception. The provision of health care services which they desired were in the order of treatment, prevention and health promotion, and diagnosis, which varied with the age groups and recent health perception. What they expected from their doctors were in the order of giving accurate diagnosis, explaining the treatment plan, and answering their questions. They had difficulty undergoing physical exam undressed, gynecological exam, and discussing on their sexual problems. CONCLUSION: Women who visited the family practice clinics felt differently on important health problems according to the age groups. Overall, they wanted to receive health services on the treatment, prevention and health promotion of osteoporosis, stress, cervical cancer, and arthritis.
Aged ; Arthritis ; Attitude to Health ; Delivery of Health Care ; Diagnosis ; Family Practice ; Female ; Gynecological Examination ; Health Promotion ; Health Services ; Humans ; Osteoporosis ; Patient Education as Topic ; Stroke ; Uterine Cervical Neoplasms ; Women's Health ; Surveys and Questionnaires

Paraneoplastic encephalitis associated with an ovarian teratoma has been related to the development of antibodies to specific heteromers of the N-methyl-D-aspartate receptor (NMDAR). The disorder, known as anti-NMDAR encephalitis, is characterized by psychiatric symptoms, seizures, mood and behavioral changes as well as involuntary movement. Since the NMDAR is the target of many anesthetic drugs, the presence of anti-NMDAR antibodies might influence the requirements of anesthetics or their effects. We report the presentation and anesthetic experience of a young patient with anti-NMDAR encephalitis undergoing surgical excision of two ovarian teratomas, and we also review the relevant literature.
Anesthesia, General ; Anesthetics ; Anti-N-Methyl-D-Aspartate Receptor Encephalitis ; Antibodies ; Dyskinesias ; Encephalitis ; Humans ; N-Methylaspartate ; Paraneoplastic Syndromes ; Seizures ; Teratoma

Purpose: The purpose of this study was to identify related factors in the organizational socialization of new nurses, focusing on the reality shock of new nurses and social support by education specialist nurses. Methods: Participants were 122 new nurses with clinical experience of 1 year or less as nurses working in a general hospital that is carrying out a pilot project for a new nurse training system. Data were collected using self-report questionnaires which included identification of participants' characteristics, social support of education specialist nurse, reality shock and organizational socialization. Results: The organizational socialization score was 3.07±0.45 points. The results of the stepwise multiple regression showed that factors affecting organizational socialization of new nurses were social support by gender, education specialist nurse and reality shock. These three variables accounted for 72.0% of organizational socialization. Conclusion These findings suggest that the social support of education specialist nurses be enhanced to increase the organizational socialization of new nurses. There is also a need for a program to decreased the reality shock of new nurses.

PURPOSE: This study aimed to analyze stress distribution and maximum von Mises stress generated in intracoronal restorations and in tooth structures of mandibular molars with various types of cavity designs and materials. MATERIALS AND METHODS: Threedimensional solid models of mandible molar such as O inlay cavity with composite and gold (OR-C, OG-C), MO inlay cavity with composite and gold (MR-C, MG-C), and minimal invasive cavity on occlusal and proximal surfaces (OR-M, MR-M) were designed. To simulate masticatory force, static axial load with total force of 200 N was applied on the tooth at 10 occlusal contact points. A finite element analysis was performed to predict stress distribution generated by occlusal loading. RESULTS: Restorations with minimal cavity design generated significantly lower values of von Mises stress (OR-M model: 26.8 MPa; MR-M model: 72.7 MPa) compared to those with conventional cavity design (341.9 MPa to 397.2 MPa). In tooth structure, magnitudes of maximum von Mises stresses were similar among models with conventional design (372.8 – 412.9 MPa) and models with minimal cavity design (361.1 – 384.4 MPa). CONCLUSION: Minimal invasive models generated smaller maximum von Mises stresses within restorations. Within the enamel, similar maximum von Mises stresses were observed for models with minimal cavity design and those with conventional design.
Bite Force ; Dental Enamel ; Finite Element Analysis ; Inlays ; Mandible ; Molar ; Tooth

Grip strength is used in the various field to assess the disorder of upper limb. Normative data on the grip strength of population is needed to assess decreased grip strength. In this study, we tried to make a estimating model considering age and anthropometry investigation data, by analyzing 2014-2015 Korean National Health and Nutrition Examination Survey data. The subjects of this study were 10,430 participants who measured grip strength of both hands, have no missing data on anthropometry data and survey. Analysis showed that the grip strength had a curve-shaped correlation which could best be explained by the cubic expression of age, and linear correlation between height, weight and waist circumference. After the stratification of the gender, a prediction formula with age, height, and body weight as independent variables for dominant hand and non-dominant hand grip strength was presented. In addition, the distribution of estimated value to measured value ratio among subjects was suggested, which can be used to assess the abnormal value of grip strength. The distribution of non-dominant hand grip strength to dominant hand grip strength was also suggested, which can be used to determine decreased unilateral grip strength. Several studies have suggested normative value for grip strength by gender and age of Koreans, but there are no consideration for adjusting heightand weight. In this study, the model was developed to calculate the predicted grip force considering age, height, and weight. With the distribution data of measured value to predicted value ratio and non-dominant hand grip strength to dominant hand grip strength ratio, the model can be helpful to assess a reduction in grip strength.
Anthropometry ; Body Weight ; Hand ; Hand Strength* ; Korea* ; Nutrition Surveys* ; Regression Analysis ; Upper Extremity ; Waist Circumference

PURPOSE: To present a case of ocular sparoganosis presenting as itching sensation. METHODS: A 60-year-old woman presented for removal of an itchy subconjunctival mass in her left eye. Her ocular findings were normal, except for a subconjunctival mass (1.5 x 1.5 mm). RESULTS: A parasite excised from the subconjunctival mass was identified as a sparganum, by microscopic examination after hematoxylin-eosin staining. The mummified parasite was identified as the plerocercoid phase of the sparganum, by microscopy. CONCLUSIONS: Although rare, parasitic disease should be suspected in a palpable subconjunctival mass unresponsive to the medical treatment.
Sparganosis/*complications/pathology/surgery ; Pruritus/*etiology ; Ophthalmologic Surgical Procedures ; Middle Aged ; Korea ; Humans ; Female ; Eye/*parasitology

To explore the effect of follow-up management after health examination for the cerebro-cardiovascular disease risk, a survey applied with the KOSHA cerebro-cardiovascular disease risk assessment tool was conducted with 500 workers in small scale enterprise less than 50 employees. They were provided two types of health services; post-examination management and health consultation, and finally compared the cerebro-cardiovascular disease risk changes between 2014 and 2015. In normal group in 2014, only 18.7% of workers who received the follow-up management had elevated risks, while 23.8% of workers who received the health consultation had elevated risks in 2015. In risk group in 2014, only 2.8% of workers who got follow-up management had elevated risks, while 7.7% of workers who got only health consultation had elevated risks in 2015. After adjustment for gender, age, exercise, body mass index, nationality and type of industry, negative correlation was found in association to the follow-up management (odds ratio = 0.87). This study shows that workers with cerebro-cardiovascular disease or who are at high cerebro-cardiovascular risk in small scale enterprise should receive early detection and management using counselling and regular follow-up after periodic health examination. Also the health counselling including preventive education for cerebro-cardiovascular disease is needed for all workers to improve their self-management for health.
Body Mass Index ; Education ; Ethnic Groups ; Follow-Up Studies* ; Health Services ; Humans ; Risk Assessment ; Self Care

Generalized syringoma is a rare variant of syringoma, whose incidence peaks during childhood and adolescence, with no difference seen in either sex. It frequently affects the chest, neck, abdomen and axilla, and occasionally shows spontaneous regression. A 34-year-old woman presented with pruritic, multiple, 1~3 mm sized, lightbrownish papules on the chest, abdomen, and back. One year before, she had been diagnosed as having verruca plana at a private dermatologic clinic and had received immunotherapy, but experienced disappointing results. Histologically, the disorder showed numerous dilated eccrine ducts lined by two rows of epithelial cells. We herein report a case of generalized syringoma misdiagnosed as verruca plana, plus a review of the literature.
Abdomen ; Adolescent ; Adult ; Axilla ; Diagnostic Errors ; Epithelial Cells ; Female ; Humans ; Immunotherapy ; Incidence ; Neck ; Syringoma* ; Thorax ; Warts*