No abstract available.
Child* ; Humans ; Urodynamics*

OBJECTIVES: This study is aimed to quantify the complex dynamics of beat-to-beat fetal heart rate(FHR) fluctuations by using approximate entropy(ApEn) which is a recently developed mathematical formula quantifying regularity and also to determine the differences between normal fetuses and growth retarded fetuses. BACKGROUND: Recently, some measures of heart rate variability and nonlinear "complexity" of heart rate dynamics have been used as indicators fetal well-being. Approximate entropy is a new mathematical approach and formula to quantify regularity in data. It has been shown to provide new information in fetal heart rate analysis. Because growth retarded fetus accounts for a significant increase in perinatal morbidity and mortality, than normal fetus, we postulated that there existed important differences between normal fetuses and growth retarded fetuses. METHODS: We analyzed FHR tracings for 40 minutes, and approximately 5,000 points in normal fetuses(n=315) and growth retarded fetuses(n=76). The overall "complexity" of each FHR time series was quantified by its approximate entropy, measure of regularity derived from nonlinear dynamics, "chaos theory". RESULTS: Mean baseline FHR increased in growth retarded fetuses than normal fetuses. And the FHR ApEn significantly decreased in growth retarded fetuses(ApEn=0.623) compared to that of the normal fetuses(ApEn=0.868) throughout all gestational ages(p < 0.001). CONCLUSIONS: The ApEn of FHR decreased in growth retarded fetuses throughout all gestational ages. These findings indicated that decreased ApEn values of FHR are associated with sickness and the greater perinatal morbidity risks. Therefore ApEn quantifies subtle changes in FHR regularity and promises for new information in FHR analysis.
Entropy* ; Female ; Fetal Heart* ; Fetus* ; Gestational Age ; Heart Rate ; Heart Rate, Fetal* ; Mortality ; Nonlinear Dynamics ; Pregnancy

Forty-six patients (fifty hips) underwent revisions of a total hip arthroplasty that had failed but was not associated with infection, Three of these patients had a third revision. The mean length of follow-up was approximately two years. Thirty patients reported that their condition was improved. On final roentgenographic examination showed, two loosening of the acetabular components and five of the femoral components in which there was one sympto matic loosening (moderate severe pain and probable roentgengraphic loosening) noted. The extralong stems are not necessary in all revision cases, cortical defects at the tip of standard stem obviously should require bypass the stress riser with a longer stem. If the stability can be achieved with host bone, Revision may be carried out with a relatively short stem. Significant postoperative complications as subsidence and progressive loosening were noted in seven out of the forty-six patients. We consider that extensive porocoated cementless stem or standard flute stem seem to be a better outcome in revision arthroplasty.
Acetabulum ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Follow-Up Studies ; Humans ; Postoperative Complications

No abstract available.
Child* ; Colon* ; Constipation* ; Enema* ; Fecal Incontinence* ; Humans

No abstract available.
Seizures*

No abstract available.

No abstract available.
Suicide, Attempted*

Three freshwater snail species of the family Lymnaeidae have been reported from Korea, Radix auricularia coreana, Austropeplea ollula and Fossaria truncatula. Out of 3 lymnaeid snail species, A. ollula was naturally infected with the Echinostoma cinetorchis cercariae (infection rate = 0.7%). In the experiments with the laboratory-bred snails, F. truncatula as well as A. ollula was also susceptible to the E. cinetorchis miracidia with infection rates of 25% and 40%, respectively. All of three lymnaeid snail species exposed to the E. cinetorchis cercariae were infected with the E. cinetorchis metacercariae. It is evident that A. ollula acts as the first molluscan intermediate host of E. cinetorchis in Korea, and F. truncatula may be a possible candidate for the first intermediate host of this intestinal fluke. Also, three lymnaeid snail species targeted were experimentally infected with E. cinetorchis metacercariae.
Animals ; Echinostoma/pathogenicity/*physiology ; Echinostomiasis/parasitology ; Host-Parasite Relations ; Korea ; Lymnaea/*parasitology ; Rats ; Rats, Sprague-Dawley ; Support, Non-U.S. Gov't

PURPOSE: This study was to develop, implement, and evaluate an e-learning education program for improving practical knowledge and preventing nursing errors and adverse events of nurses working in the operating room (OR). METHOD: The e-learning program was developed and evaluated according to the following processes: 1) preparation phase 2) implementation phase 3) evaluation phase. In evaluation phase, the effectiveness was analyzed based on the Kirkpatrick's model. RESULTS: The e-learning program consisted of OR basic nursing skills and techniques and nursing activities' manual based on the categories of nursing errors: surgical operation preparation, nursing skills and techniques, environment management, patient safety and comfort, and patient monitoring. The program was provided through on-line, http:// cafe.daum.net/pnuhorn, for 4 weeks. The mean score(percent) of participants' satisfaction was 21.24+/-1.71(68.2%). Their total knowledge level was significantly improved(Z=-3.00, p=.003) and specifically in the category of environment management(Z=-3.77, p<.001) and patient monitoring(Z=-2.46, p=.014). The occurrence of nursing errors or adverse events was a little decreased, but not statistically significant(Z= -3.10, p=.756). CONCLUSION: E-learning for nurses is one way of effective and efficient teaching-learning strategies. For better e-learning, it is important to develop the vital content of the education and objective measures for detecting nursing errors and adverse events.
Education* ; Education, Nursing, Continuing ; Humans ; Medical Errors ; Monitoring, Physiologic ; Nursing* ; Operating Rooms* ; Patient Safety ; Program Development ; Program Evaluation

Background : The approximate entropy of heart rate variability has recently been used as a tool in evaluating cardiovascular health and physiology and in diagnosing pertubated physiologic status, by quantifying the irregularity and the pattern of the heart rate variability. Therefore approximate entropy of the fetal heart rate variability will be used as an important tool in studying the fetal cardiovascular health and disease, but unfortunately there have been no previous systematic studies of the approximate entropy in normal fetuses. This study's aim has been to present the normal approximate entropy values of the fetal heart rate variability according to the gestational age, to demonstrate the developmental maturation of physiology of the control systems of the heart rate, and to quantify the evolution of the pattern of fetal heart rate variability. METHODS: Three hundred and thirty seven mothers with normal singleton pregnancies, who were 20 weeks or more of gestational age, were randomly chosen. For more than 40 minutes fetal heart rates and fetal movements were recorded and were downloaded to a computer. From each heart rate data, 5000 points ('total') of heart rate during which fetal movements occured and 1200 points ('rest') during which no fetal movement occured were selected and the approximate entropy was calculated, and then 2 weeks' average of the approximated entropy of the heart rate were calculated and compared to find the maturational differences of them. RESULTS: The approximate entropy of the rest period showed a tendency to increase with advancing gestation (p=0.0001). It was significantly higher between the 41st-42nd week (0.987 +/-0.017) than the period before the 24 th week (0.864+/-0.032) and between the 25th-26th week (0.868+/-0.022). (p<0.05). The approximate entropy of the total period showed another tendency (p<0.05): from a low level before the 24 th week (0.788+/-0.067) it increased to reach its peak at the 29th-30 th week (0.963+/-0.041) then it gradually decreased again to significantly (p<0.05) lower levels at the 37th-38th week (0.776+/-0.046) and the 39th-40th week (0.786+/-0.047). CONCLUSIONS: Normal value of approximate entropy, which is bound to be used as an index in evaluating the fetal well-being, has been presented from 20th to 42th week of gestation with an interval of two weeks. The systems that control the heart rate seem to mature consistently as gestation advances, but before the 26th week it is significantly more immature than at term. Fetal heart rate variability evolves from an immature oscillating pattern into a transitional patternless pattern during the second trimester and finally consolidates into a mature accelerational pattern during the third trimester.
Entropy* ; Female ; Fetal Heart* ; Fetal Movement ; Fetus ; Gestational Age ; Heart Rate ; Heart Rate, Fetal* ; Humans ; Mothers ; Physiology ; Pregnancy ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Pregnancy* ; Reference Values