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

The authors report two cases of high cervical spinal chordomas that were removed via the median labiomandibular glossotomy(MLG) approach. One patient was a 62-year-old female in whom an extradural chordoma was found at the level of C3 vertebra with huge prevertebral extension, and causing dyspnea and dysphagia; the other was a 47-year-old female, found to be suffering from a chordoma of C2 vertebral body, which was found incidentally. After removal of the tumors, ventral instrumented fusions were performed in both patients, who showed good recoveries with only minor complications. The MLG approach is radical, and rarely performed by neurosurgeons, but for treatment of an expanded high cervical lesion that needs ventral surgery and seems to be inaccessible via the conventional transoropharyngeal or anterolateral retropharyngeal route, it should be considered. The authors discuss the clinicopathological characteristics of spinal chordomas and general considerations of the MLG approach to high cervical lesions, and briefly describe the surgical techniques involved in this approach.
Chordoma* ; Deglutition Disorders ; Dyspnea ; Female ; Humans ; Middle Aged ; Spine

In order to observe the changes in left ventricular function during coronary artery occlusion and reperfusion, left anterior descending (LAD) coronary arteries in the anesthetized dogs were occluded for 1 hour and then reperfused for 4 hours. Hemodynamic indexes of global systolic and diastolic function and regional wall thickness changes as a regional contractile index were measured during occlusion and reperfusion. The results were as follows; 1) Indexes of global systolic function (left ventricular peak systolic pressure, peak positive dP/dt) and global diastolic function (peak negative dP/dt, time constant, left ventricular end-diastolic pressure) showed deterioration in early occlusion period (10-30 minutes) but gradually improved even if coronary occlusion persisted. Reperfusion did not induce significant changes except that peak positive dP/dt transiently deteriorated 30 minutes after reperfusion and left ventricular end-diastolic pressure decreased 1.5-2 hours after reperfusion. 2) Indexed of regional function (i.e, end-diastolic thickness and % systolic thickening of anterior left ventricular wall) deteriorated by 10 minutes' occlusion which persisted during the entire occlusion period. Reperfusion induced no significant improvement in regional contractile function compared with occlusion 60 minutes' data, which suggested reperfusion for 4 hours after 1 hour's LAD occlusion may be insufficient for the ischemic region to recover its contractility. 3) Reperfusion arrhythmia (ventricular tachycardia) was noted in most (6/9) of the dogs, one of which deteriorated into ventricular fibrillation and the others spontaneously converted to normal sinus rhythm.
Animals ; Arrhythmias, Cardiac ; Blood Pressure ; Coronary Occlusion ; Coronary Vessels* ; Dogs ; Hemodynamics ; Reperfusion* ; Ventricular Fibrillation ; Ventricular Function, Left*