BACKGROUND: This study aimed to identify the association of compliance with sick role behavior with satisfaction of basic psychological needs, and to assess the influence of compliance with sick role behavior among hemodialysis patients. METHODS: Participants included 109 patients from outpatient dialysis clinics at 6 major general hospitals located in urban areas in Korea. Data for compliance with sick role behavior and basic psychological needs were collected through a self-reported questionnaire and was analyzed with independent t-test, one-way analysis of variance, Pearson' correlation analysis, and multiple stepwise linear regression analysis. RESULTS: This study showed positive correlations between compliance with sick role behavior and satisfaction of basic psychological needs (r=0.59, P<0.001). The variables predicting compliance with sick role behavior were relatedness (beta=0.28), autonomy (beta=0.29), competency (beta=0.30), and age (beta=0.24). These variables accounted for 38.2% of the variance of compliance with sick role behavior in hemodialysis patients. CONCLUSIONS: Our results indicated that it is necessary to improve compliance with sick role behaviorin order to increase satisfaction of basic psychological needs in hemodialysis patients.
Analysis of Variance ; Compliance ; Dialysis ; Hospitals, General ; Humans ; Korea ; Linear Models ; Outpatients ; Patient Compliance ; Personal Autonomy ; Renal Dialysis ; Sick Role

Repeat cesarean section is one of the leading causes to make increasing a rate of cesarean section. Trial of labor TOL after cesarean section is attempt to reduce the rate of repeat cesarean section. Trial of labor has been well established as a safe alternative in carefully selected women with transverse scars in the lower uterine segment. This study was based on 104 cases of delivery with prior cesarean birth at the Chonbuk National University Hospital from January, 1991 to June, 1997. The results were as follows: 1) Among 1400 cases with previous cesarean delivery, trial of labor was done in 104 cases (7.4%). Among 104 cases, vaginal birth was successfully completed in 96 cases (92.3%). 2) Among 28 cases with PGE2, vaginal tablet, vaginal delivery was done in 23 cases (82.1%). 3) Among 22 cases with more than 4 of Bishop score, vaginal delivery was done in 21 cases (95.5%), and among 6 cases with less than 3 of Bishop score, vaginal delivery was done only 2 cases (33.3%). 4) There was no matemal death or uterine rupture in the cases of trial of labor, But in 2 cases, uterine dehiscence was observed in 4 cases and postpartal bleeding (more than 400ml) was developed. 5) In the cases of cesarean section, mean of hospital day was 7 days and medical fee was about 400,000 won. In the cases of vaginal birth after cesarean section, mean of hospital day was 2.6 days and medical fee was about 100,000 won. In condusion, vaginal birth after cesarean section is safe and effective alternative to elective repeat cesarean section and also the use of PGE, vaginal tablet is so effective to increase success rate of vaginal delivery. After all, positive these trials might decrease cesarean rate and increase maternal health and quality of medical care.
Cesarean Section ; Cesarean Section, Repeat ; Cicatrix ; Dinoprostone ; Fees, Medical ; Female ; Hemorrhage ; Humans ; Jeollabuk-do ; Maternal Health ; Parturition ; Pregnancy ; Prostaglandins E ; Trial of Labor ; Uterine Rupture ; Vaginal Birth after Cesarean* ; Vaginal Creams, Foams, and Jellies

The tibial condylar fractures involving the articular surface can produce some disability of the knee joint because it is frequently accompanied by soft tissue injury to the ligaments and menisci. Accurate anatomical reduction and rigid internal fixation with early motion is known to decrease the complications. During a period of 10 years, from January 1978 to December 1987, we treated 105 tibial condylar fractures at Severance Hospital. Of the above, 77 cases have been analyzed according to the classification, cause of injury, method of treatment, final result and complication. The 77 cases were classified as follows ; total condylar depression 17(22%), undisplaced 16 (21 %), split compression 16(21 %), comminuted 14 (18%), local compression 5 (7%), split 1 (1%) and others 8(10%). Among these, 59 cases revealed the result of “ACCEPTABLE” according to Porter's criteria. Of the conservative group, 86% obtained the rating of “ACCEPTABLE” and 67% of the operative group did as well. Possible complications include traumatic arthritis (9), limited motion (9), wound infection (6), instability (3), angular deformity (2), intraarticular loose body (2), nonunion (1) and myositis ossificans.
Arthritis ; Classification ; Clinical Study ; Congenital Abnormalities ; Depression ; Knee Joint ; Ligaments ; Methods ; Myositis Ossificans ; Soft Tissue Injuries ; Wound Infection

No abstract available.
Necrosis* ; Typhoid Fever*

PURPOSE: Galectin-3 is a member of a large family of beta-galactoside- binding animal lectins. It is thought that galectin-3 can be a suppressor of apoptosis because of its significant sequence similarity with Bcl-2. We examined the role of galectin-3 for the paclitaxel-induced apoptosis after transfection of the galectin-3 gene in LNCaP cells. MATERIALS AND METHODS: Galectin-3 cDNA was cloned into PcDNA 3.1(-) and transfected into LNCaP cells. Stable transfection of galectin-3 into the LNCaP cells was achieved. Growth of the transfectants was observed with performing MTT assay. Apoptosis was induced by 100nM paclitaxel and 2microM staurosporine, and this was observed by DNA fragmentation assay. The viable cell numbers(% of control) after induction of apoptosis were determined with performing MTT assay. RESULTS: The LNCaP subclone that expressed galectin-3(LNCaP-G3-PcDNA) grew faster than the control transfectant(LNCaP-PcDNA)(p<0.05). The DNA fragmentation bands were decreased in the LNCaP subclone expressing galectin-3(LNCaP-G3-PcDNA) as compared to the control transfectant(LNCaP-PcDNA) after induction of apoptosis by 100nM paclitaxel or 2iM staurosporine; this means that galectin-3 inhibits apoptosis. The viable cells (% of control) with LNCaP-G3-PcDNA after the induction of apoptosis by 100nM paclitaxel was 92+/-2% in 8 hours, 77.5+/-1.9% in 24 hours and 40.4+/-2.9% in 48 hours on average, respectively. In contrast, the viable cells(% of control) of the control transfectant were 84.5+/-2%, 46+/-2.5% and 19+/-2.6% on average, respectively. The viable cells(% of control) with the LNCaP-G3-PcDNA after the induction of apoptosis by 100nM paclitaxel was higher than that of the control transfectant(LNCaP- PcDNA cells)(p<0.05). CONCLUSIONS: Galectin-3 gene transfer stimulates the growth of LNCaP cells. The galectin-3 protects LNCaP cells from paclitaxel-induced apoptosis.
Apoptosis* ; Cell Line* ; Clone Cells ; DNA Fragmentation ; DNA, Complementary ; Galectin 3* ; Humans ; Lectins ; Paclitaxel ; Prostate* ; Prostatic Neoplasms* ; Staurosporine ; Transfection

BACKGROUND: The serum should be tested with a platelet panel for identification of platelet specific alloantibodies. Such platelet panels are not available from commercial sources and can usually be made using platelets from local donor population. We prepared the platelet panel by DNA genotyping for 5 major platelet specific antigens and evaluated the detection ability of panel with clinical samples from patients showing the refractoriness to platelet transfusion. METHODS: DNA genotyping of five major platelet specific alloantigens (PlA, Ko, Bak, Pen, Br) was performed for ninety three donors by reverse dot blot hybridization technique. For the evaluation of the panel we prepared, we used the antiplatelet antibody positive sera detected by modified antigen capture ELISA. RESULTS: The most frequently encountered genotypes of platelets are PlA1/PlA1, Kob/Kob, Baka/Bakb, Pena/Pena, Brb/Brb (36% of ninety three donor platelets tested). PlA2 and Penb alleles were not identified in this study. Two cases of anti-Koa were identified using panel we prepared. CONCLUSION: The genotyping of platelet alloantigens circumvented the limitation of immunophenotyping by the general lack of quality typing antisera. It is impossible to make a good panel which was composed entirely of five major platelet specific alloantigen systems because the PlA2, Penb, and Bra are very rare alleles in Koreans. But our panel can be used for the identification of antibodies against Ko and/or Bak platelet antigen in patients with platelet alloimmunization.
Alleles ; Antibodies ; Antigens, Human Platelet ; Blood Platelets* ; DNA* ; Enzyme-Linked Immunosorbent Assay ; Genotype ; Humans ; Immune Sera ; Immunophenotyping ; Isoantibodies ; Isoantigens ; Platelet Transfusion ; Tissue Donors

BACKGROUND: Aprotinin is a potent, nonspecific broad serine protease inhibitor. It's inhibitory effects on intrinsic pathway of coagulation cascade can augment anticoagulation by heparin. This study designed to demonstrate augmented anticoagulation of aprotinin to heparin contaminated blood on thromboelastography(TEG). METHODS: This study designed into two phases for 21 healthy volunteers undergoing elective opeation. The first phase study, it was for looking at TEG differences between blood treated with aprotinin 200 KIU and blood treated with heparin 0.05 unit and 0.1 unit per blood 1 ml. The second phase study was for looking at anticoagulation of aprotinin added by heparin 0.05 unit and 0.1 unit per blood 1 ml and their reversal added by optimal dose of protamine sulfate. RESULTS: The aprotinin treated blood showed only a prolonged reaction time. Blood treated with incremental dose of heparin showed longer reaction time and smaller alpha angle than TEGs of native blood. Aprotinin added to the heparin contaminated blood showed much longer reaction time and much less alpha angle when compared with TEGs of aprotinin or heparin treated blood. Depressed TEG pattern by the heparin and aprotinin mixture reversed back to the TEGs of blood treated with aprotinin when optimal dose of protamine added. CONCLUSIONS: Those results suggest that aprotinin administered in open cardiac surgery can augment the remained anticoagulation effect due to heparin even after first dose fo protamine after weaning of cardiopulmonary bypass. This is of clinically improtance to distinguish heparin related coagulopathy from heparin non related coagulopathy by thromboelastography.
Aprotinin* ; Cardiopulmonary Bypass ; Healthy Volunteers ; Heparin* ; Protamines ; Reaction Time ; Serine Proteases ; Thoracic Surgery ; Thrombelastography* ; Weaning

PURPOSE: To evaluate the imaging findings of endometrial stromal sarcoma (ESS) according to histopathologic grade. MATERIALS AND METHODS: Six patients with pathologically proven ESS were included in this study. The histopathologic diagnosis was low-grade ESS for three patients and high-grade ESS for the three others. Preoperative CT or MR images were evaluated in terms of tumor size, location, growth pattern, the presence of hemorrhage or necrosis, status of the endometrial cavity, and invasion of surrounding structures. The imaging features of ESSs, which varied according to their histopathologic grade, were compared. RESULTS: The mean maximal diameter of low-and high-grade ESSs was 6 cm and 11.2 cm, respectively. All three low-grade ESSs were located mainly in the myometrium, but two high-grade ESSs were situated in the endometrial cavity and associated with focal tumor extension into the myometrium. One high-grade ESS had completely replaced the uterus. Low-grade ESSs were relatively well-defined, but high-grade ESSs had an irregular and lobulated margin. Intratumoral hemorrhage and necrosis were, respectively, found in two and three high-grade ESSs. Widening of the endometrial cavity was noted in all three high-grade ESSs, and lymph node metastasis had occurred in one. CONCLUSION: The imaging findings of ESS vary from a well-defined intramural mass to a bulky infiltrating mass, and depend on their histopathologic grade.
Animals ; Diagnosis ; Female ; Hemorrhage ; Humans ; Lymph Nodes ; Magnetic Resonance Imaging* ; Mice ; Myometrium ; Necrosis ; Neoplasm Metastasis ; Sarcoma ; Sarcoma, Endometrial Stromal* ; Uterine Neoplasms ; Uterus

Since laparoscopic cholecystectomy(LC) was first introduced in early 1990 in Korea, LC is now widely used with an acknowledgement of the benefits of LC.The author retrospectively analyzed 120 patients who were treated by LC and 40 patients who were treated by open cholecystectomy(OC), at the Department of Surgery, Kwang Hye Hospital from Jan. 1992 to July 1995. For the statistical analysis of the variables, student's t-test and ANOVA F-test were used to assess the differences between two groups(p value = 0.05). The obtained results were as follows. 1. The mean age and sex ratio(M:F) between LC and OC group were 48.3-years-old and 1:1.45, 57.6-years-old and 1:3.4, respectively. 2. Associated diseases were observed in 62 patients (51.7%) of the LC group and 23 patients (57.5%) of the OC group. Peptic ulcer and DM were most frequent, respectively. 3. 20 patients (16.7%) had a previous abdominal operation, with appendectomy, the most frequent among them. 4. The operation times(p=0.05), hospitalization stay(p=0.0001), and postoperative hospitalization stay(p=0.0001) were significantly shorter in the LC group than in the OC group. 5. In the preoperative, intraoperative, and postoperative ABGA of the LC group, especially, intraoperative PCO2 was increased due to CO2 retension and metabolic acidosis was developed, intraoperatively. PaO2 was excessively increased due to hyperventilation to correct the metabolic acidosis, intraoperatively. Satistically, intraoperative pH (p=0.0001), PaO2 (p=0.0001), PCO2 (p=0.0001) except bicarbonate (p=0.1987) were significantly changed, compared with preoperative pH or postoperative pH. 6. Operative cholangiography(OPC) was proceeded in 17 patients(14.2%) and concurrent laparoscopic appendectomy was done in 7 patients (5.8%) of the LC group. 7. Postoperative complications were occurred in 19 patients (15.8%) of the LC group. 3 patients (2.5%) were explorated, the remainders were recovered by conservative treatment. 8. On pathologic findings, cholelithiasis and chronic cholecystitis with 105 patients (87.5%) were most frequent in the LC group. In the OC group, cholelithiasis and chronic cholelithiasis with 25 patients (62.5%) were also most frequent, GB empyema with 8 patients (20%), acute cholecystitis with 7 patients (17.5%). Conclusively, laparoscopic cholecystectomy can be safely applied with lower morbidity, shorter operation times, and shorter hospital stay in selected patients.
Acidosis ; Appendectomy ; Cholecystectomy, Laparoscopic* ; Cholecystitis ; Cholecystitis, Acute ; Cholelithiasis ; Empyema ; Hospitalization ; Humans ; Hydrogen-Ion Concentration ; Hyperventilation ; Korea ; Length of Stay ; Peptic Ulcer ; Postoperative Complications ; Retrospective Studies

BACKGROUND: Activation of ATP-sensitive K+ channels (KATP channels) in the cardiac muscle produces cardioprotective effects during myocardial ischemia. Previous experimental evidence indicates that volatile anesthetics exert beneficial actions in ischemic myocardium and enhance functional recovery of stunned myocardium. More recently, volatile anesthetics have been demonstrated to produce cardioprotective effects in stunned myocardium in vivo, and these effects are blocked by a KATP channel antagonist. This finding suggests that KATP channel activation by isoflurane may mediate antiischemic effects. However, it was demonstrated that isoflurane inhibited KATP channel activity in rabbit ventricular myocytes. To explain the discrepancy, the present investigation tested the hypothesis that isoflurane and its metabolite, trifluoroacetic acid, contributes to the activation of KATP channels in rabbit ventricular myocytes. METHODS: Single ventricular myocytes were isolated from rabbit hearts by an enzymatic dissociation procedure. Single-channel currents were measured in inside-out patch configurations of the patch-clamp technique. The perfusing liquid was equilibrated with isoflurane by passing 100% O2 through a vaporizer. RESULTS: Isoflurane inhibited KATP channel activity without a change in the single-channel conductivity. Isoflurane decreased the burst duration and increased the interburst duration. In addition, isoflurane diminished the ATP sensitivity of KATP channels. Trifluoroacetic acid, a metabolite of isoflurane, enhanced the channel activity in a dose-dependent fashion. Trifluoroacetic acid increased the burst duration and decreased the interburst duration without a change in the single-channel conductivity. Isoflurane and trifluoroacetic acid diminished the ATP sensitivity of KATP channels. CONCLUSIONS: These results imply that isoflurane and its metabolite could mediate cardioprotective effects via KATP channel activation during myocardial ischemia.
Adenosine Triphosphate ; Anesthetics ; Heart ; Isoflurane* ; KATP Channels ; Muscle Cells* ; Myocardial Ischemia ; Myocardial Stunning ; Myocardium ; Nebulizers and Vaporizers ; Patch-Clamp Techniques ; Potassium Channels* ; Potassium* ; Trifluoroacetic Acid*