PURPOSE: To establish signal intensity characteristics of the trachea according to the histologic layers, we performed in vivo and in vitro MR studies. MATERIALS AND METHODS: We performed MR imaging of the trachea at 1.5T unit in 11 patients mediastinal masses, vascular anomalies, tracheal stenosis or iatrogenic tracheoesophageal fistula, aryepiglottic fold thickening or mass, tracheal carcinoid, one healthy volunteer and one cadaveric trachea. By using anterior, volume neck or 3 inch dual coil with various pulse sequences, axial and coronal images of the trachea were obtained. The tracheal layers with different signal intensity on MR images were correlated with the histology. RESULTS: In vivo and in vitro MR studies revealed two layers of the trachea ;the inner layer had intermediate to high signal and the outer had low signal. The tracheal cartilage showed low signal intensity in all pulse sequences. The submucosa appeared as intermediate signal intensity on T1 weighted images but high signal intersity on other images due to its abundant mucous and mucoserous glands. However, the mucosa and perichondrium could not be defined on MR images. CONCLUSION: Characterization of the signal intensity according to the histologic layers of the trachea might be helpful for the evaluation of intrinsic lesions of the irachea or the possibility of tracheal invasion from the adjacent tumors.
Cadaver ; Carcinoid Tumor ; Cartilage ; Healthy Volunteers ; Humans ; Magnetic Resonance Imaging* ; Mucous Membrane ; Neck ; Trachea ; Tracheal Stenosis ; Tracheoesophageal Fistula

To evaluate the antihypertensive effect, side effects and metabolic changes of arotinolol, a combined alpha and beta blocker, 10-15mg of arotinolol twice a day was administered for 8 weeks in 27 hypertensives (168+/-16/106+/-10mmHg) without heart failure, bradycardia, conduction disturbance, coronary heart disease or renal impairment. Blood pressure decreased to 137+/-10/90+/-6mmHg and average reduction of systolic BP and diastolic BP were 31 mmHg(18%) and 16mmHg(15%) respectively. Pulse rate reduced significantly(p<0.01) after 2weeks' treatment of arotinolol and average reduction of pulse rate was 10 beats/min after 8weeks treatment. There were no significant changes of serum ALP, AST and ALT, BUN, and serum creatinine, Na+, K+, total cholesterol, HDL cholesterol and triglyceride. But in 8 patients(30%), insomina, sleepness, cold extrimities or numbness on extremities developed or aggravated. These results suggest that arotinolol be an useful antihypertensive agent in hypertensives without heart failure, bradyarrhythmais or peripheral vascular disease.
Blood Pressure ; Bradycardia ; Cholesterol ; Cholesterol, HDL ; Coronary Disease ; Creatinine ; Extremities ; Heart Failure ; Heart Rate ; Hypertension* ; Hypesthesia ; Peripheral Vascular Diseases ; Triglycerides

PURPOSE: The purpose of the study was to compare recipients' health behavior, attitude to using medicaid, medication compliance, and the changes in hospital cost and visit-day of in-patient and out-patient care between tele-care regions (TCR) and general care regions (GCR) in Korean medicaid. METHOD: The design of the study was ex-post facto comparing recipients in TCR and GCR. The sample included 625 persons in TCR and 410 persons in GCR. To collect materials, the case manager interviewed recipients of medicaid and filled out questionnaires which were analyzed through SAS/PC 9.1. RESULTS: In studying health behavior and medication, compliance was not significant. However, the attitude to using medicaid was significantly more positive in TCR than in GCR. In out-patients, the change of hospital visit-day was not significant between TCR and GCR, but TCR showed a reduction in hospital cost compared to GCR. For in-patient recipients, GCR showed a greater reduction in changes in hospital cost and visit-day compared to TCR. CONCLUSIONS: The results of the study show that attitudes to using medicaid via telephone are positive and results are more effective than hospital visit consultation, and the cost of out-patient care could be reduced.
Case Management ; Compliance ; Delivery of Health Care ; Health Behavior ; Hospital Costs ; Humans ; Medicaid ; Medication Adherence ; Outpatients ; Surveys and Questionnaires ; Telephone

PURPOSE: To evaluate the MR findings of knee injuries in skiing and to explain the mechanism of injury with MR findings. MATERIALS AND METHODS: We reviewed MR findings of 18 patients with history of knee injuries in skiing. The MR images were evaluated retrospectively to identify the ligament injuries, bone lesions and meniscal injuries. RESULTS: Ligament injuries were seen in 16 patients, bone contusions in 16 patients, meniscal lesions in two patients. The most common group of injury was anterior cruciate ligament (ACL) and roedial collateral ligament (MCL) injuries with bone contusion on posterior lip of the lateral tibial plateau (LTP). The second common group of injury was isolated ACL injury with bone contusions on the lateral fernoral condyle (LFC) and posterior lip of the LTP. We considered that the mechanism of injury of the former group may be correlated with the valgus torque with secondary anterior displacement of the tibia and the latter group may be correlated with the pivot shift phenomenon. CONCLUSION: MR may play an important role in the diagnosis of knee injuries in skiing and its findings may explain the mechanism of injury.
Anterior Cruciate Ligament ; Collateral Ligaments ; Contusions ; Diagnosis ; Humans ; Knee Injuries* ; Knee* ; Ligaments ; Lip ; Retrospective Studies ; Skiing* ; Tibia ; Torque

The purpose of this study was to compare dietitians' with cooks' actual sterilization performance for improving points of sanitation practices of cooking instruments and facilities in Kyonggi Province school foodservices. A total of 400 questionnaires were mailed to the dietitians and the cooks at elementary and middle schools in Kyonggi Province. Finally, 140 dietitians and 140 cooks replied by making a total of 280 replies(70%). The results of this study found that the cooks' attitudes toward the sterilization of the vegetable cutter body, multiple shelf, and distributing cart showed higher frequencies than the dietitians'. Cooks disinfected the vegetable cutter blade, multiple shelf, distributing cart, cook's aprons, and 'L' transporting cart better than dietitians' guides expected. In the sterilization method, cooks performed better than indicated when cooking with rubber gloves. The most difficult thing in dietitians' managing sterilization was the lack of cooking facilities and instruments. They strongly demanded the detailed explanatory notes according to their own Cities and Provinces and the circumstantial manual of disinfection parts in School Foodservice Sanitary Management Guide. There were possibilities of food-poisoning, infection and safety incidents due to the budgetary shortage of cooking facilities and instruments.
Cooking ; Disinfection ; Gyeonggi-do* ; Humans ; Nutritionists ; Postal Service ; Surveys and Questionnaires ; Rubber ; Sanitation* ; Sterilization ; Vegetables

PURPOSE: The purpose of this study was to investigate the actual condition of the disabled due to Occupational accidents based on the functional evaluation tool. METHOD: The data were collected from 2 Workers Accident Medical Corporation, 311 subjects between February and August, 2007. The tool comprised of six components including physical function, cognitive function, communication, emotional and disturbing behavior, nursing skills and rehabilitation needs. RESULTS: Among the disabled, the average point of physical function of 5 was found in 61.92% and to express and understand were evaluated as normal in 36.69% and 33.44%, respectively. Also, hearing and vision were evaluated as normal in 53.50% and 37.98%, respectively. 19.01% of the disabled had emotional problems and 13.78% had disturbing behavior. Most disabled were in need of nursing skills with 97.73% ROM and activities. The 78.18% and 76.90% of disabled were in need of rehabilitation because of right and left leg in full movement disorders, respectively. CONCLUSION: The evaluation score for the disabled caused by Occupational accidents was diverse showing 10 to 19 points and 140 to 150 points. The result means the care cost should be determined depending on the care needs of the disabled because there is such a diverse range of care needs for them.
Accidents, Occupational ; Hearing ; Leg ; Movement Disorders ; Vision, Ocular

Healing is an intricate, interdependent process that involves complex interactions between cells, the microcellular environment, biochemical mediators and extracellular matrix molecules. The goals of wound healing are to minimize bloods loss, to replace any defect with new tissue, and to restore an intact epithelial barrier as rapidly as possible. The rate of wound healing is limited by the available vascular supply and the rate of formation of new capillaries and matrix molecules, which are heavily influenced by locally-acting growth factors that affect proliferation, angiogenesis, chemotaxis, gene expression, proteinases, and protein production. We present a new method for wound control and treatment, the V.A.C (vacuum-assisted closure) technique. It places open-cell foam dressing into the wound cavity and applies subatmospheric pressure. The application of subatmospheric pressure accelerates the rate of wound healing by the foollowing two mechanisms: 1. Removal of excessive interstitial fluids, which decrease localized edema, reduce concentration of inhibitory factors, and increase local blood flow. 2. Transmission of mechanical forces to surrounding tissues with resultant deformation of the extracellular matrix and cells, which then increase protein and matrix synthesis as well as cell proliferation. We applied it to 17 patients: 1 Livedo vasculitis, 1 burned by flame 3 pressure sores, 1 extravasation injury, 1 wound infection, 2 wound disruption, and 8 diabetes mellitus feet. In the end, most of the remaining wounds were treated with a simple split-thickness skin graft and the results were encouraging. We concluded that the V.A.C technique may be an effective substitute to help promote wound healing. It could be especially helpful in chronic complicated wounds in aging or debilitated patients who can not tolerate aggressive surgical procedures.
Aging ; Bandages ; Burns ; Capillaries ; Cell Proliferation ; Chemotaxis ; Diabetes Mellitus ; Edema ; Extracellular Fluid ; Extracellular Matrix ; Foot ; Gene Expression ; Humans ; Intercellular Signaling Peptides and Proteins ; Peptide Hydrolases ; Pressure Ulcer ; Skin ; Transplants ; Vasculitis ; Wound Healing* ; Wound Infection ; Wounds and Injuries*

PURPOSE: This study aims to develop a tool to predict occupational health patients' nursing needs or nursing time. METHOD: A tool was composed based on the materials and opinion of experts, and to verify the reliability and validity of the tool, nursing time of total 311 inpatients in 2 occupational health hospitals were surveyed. RESULTS: The developed tool was total 151 items and composed of physical function, cognitive function, communication, emotional and disturbance behavior, nursing skill, and rehabilitation need. The reliability of the tool was high, showing Cronbach's alpha coefficient of 0.95. But several items should be deleted for low corrected item-total correlation. According to the multiple regression analysis, physical function and rehabilitation need were shown to be the most powerful predictive variables for nursing time. CONCLUSION: The developed tool was appeared to have high reliability and validity. But further refinement of the tool is needed.
Accidents, Occupational ; Humans ; Inpatients ; Occupational Health ; Reproducibility of Results

PURPOSE: This study was to ascertain whether there are differences in health care utilization and expenditure for Type I Medical Aid Beneficiaries before and after applying Copayment. METHODS: This study was one-group pretest posttest design study using secondary data analysis. Data for pretest group were collected from claims data of the Korea National Health Insurance Corporation and data for posttest group were collected through door to-door interviews using a structured questionnaire. A total of 1,364 subjects were sampled systematically from medical aid beneficiaries who had applied for copayment during the period from December 12, 2007 to September 25, 2008. RESULTS: There was no negative effect of copayment on accessibility to medical services, medication adherence (p=.94), and quality of life (p=.25). Some of the subjects' health behaviors even increased preferably after applying for copayment including flu prevention (p<.001), health care examination (p=.035), and cancer screening (p=.002). However, significant suppressive effects of copayment were found on outpatient hospital visiting days (p<.001) and outpatient medical expenditure (p<.001). CONCLUSION: Copayment does not seem to be a great influencing factor on beneficiaries'accessibility to medical services and their health behavior even though it has suppressive effects on outpatients' use of health care.
Cost Sharing ; Delivery of Health Care ; Early Detection of Cancer ; Health Behavior ; Health Care Costs ; Health Expenditures ; Humans ; Korea ; Medicaid ; Medication Adherence ; National Health Programs ; Outpatients ; Quality of Life ; Statistics as Topic ; Surveys and Questionnaires

No abstract available.
Humans*