The purpose of the study was to investigate two areas as a basis for providing an educational program for pulmonary rehabilitation. A) the learning needs about chronic obstructive pulmonary disease in patients with chronic obstructive pulmonary disease and B) the perception of nurses of the same learning needs. The subjects consisted of 57 patients, with chronic obstructive pulmonary disease, at the general hospital in Seoul and 71 nurses, who were working in the medical ward. Data was obtained from a "learning need" questionnaire between October 29 and November 19, '99. Data was analyzed using SAS program for t-test, ANOVA, Scheff test. The result were as follows: 1. The learning needs of the nurses(mean 4.36 +/- .38) were higher than those of the patients (mean 3.56 +/- .83). (t=6.78, P=.001) 2. The highest ranked patient education needs were as follows ; a)"how to control dyspnea", b)"cause for activating dyspnea", and c)"how to minimize the necessity of oxygen in daily living": and nurses' learning needs were ; a)"how to cope with the risk situation", b)"management after discharge", and c)"how to control dyspnea". 3. In the patient group, those who had a college degree or higher education and paid their own hospital expenses were higher in the learning needs. According to the above results, we should consider an educational program which is realistic and effective for patients by evaluating the items the patients really want to learn about and how much they know about the evaluated items.
Education ; Hospitals, General ; Humans ; Learning* ; Oxygen ; Patient Education as Topic ; Pulmonary Disease, Chronic Obstructive* ; Rehabilitation ; Seoul ; Surveys and Questionnaires

No abstract available.
Humans ; Liver Neoplasms* ; Liver* ; Tissue Donors*

No abstract available.
Erythrocytes*

No abstract available.
Erythrocytes*

After the introduction of the central parenchymal pedicle by Hester(1985) and the round-block technique by Benelli (1988), several variations of periareolar reduction mammoplasty have been used by many authors. Periareolar reduction mammoplasty is a less aggressive procedure than traditional techniques and it produces less conspicuous periareolar scars while maintaining an acceptable overall result. We experienced 120 cases (60 patients) of periareolar reduction mammoplasty during the period from May 1994 to February 1998. We present the analysis of 60 cases of periareolar reduction mammoplasty. Periareolar reduction mammoplasty utilizing central parenchymal pedicle was performed in the first 40 patients, while a procedure utilizing the inferior dermal pedicle was done in the next 20 cases consecutively. The range of follow-up was from 1 to 5 years. Complications such as nipple areolar complex necrosis and sensory changes were reduced when the inferior dermal pedicle used. There were 5 cases of nipple areolar complex necrosis and sensory changes were reduced when the inferior dermal pedicle used. There were 5 cases of nipple areolar complex necrosis (6.2%), including 1 case of near total necrosis in cases utilizing the central parenchymal pedicle. But in the technique using inferior dermal pedicle, there was no skin flap necrosis. The central parenchymal pedicle technique has several advantages such as a wide operation field permitting complete breast contouring and better mobility of the remaining breast tissue. However, inferior dermal pedicle technique has relative superiority over central parenchymal pedicle technique in terms of anatomical rationale, as well as in the rate of complications without causing limitations in breast mobility for contouring. Such complications as nipple areolar complex necrosis, skin flap necrosis and sensory change of nipple were reduced when the inferior dermal pedicle technique was used. It is much easier to preserve the 4th intercostal nerve to the nipple anatomically. Periareolar reduction mammoplasty utilizing the inferior dermal pedicle is thought to be a reliable, reproducible method.
Breast ; Cicatrix ; Female ; Follow-Up Studies ; Humans ; Intercostal Nerves ; Mammaplasty* ; Necrosis ; Nipples ; Skin

Femoral head and neck fractures during the course of avascular necrosis are rare with only few reports in the English literature. Moreover, there are very few reports on an analysis of the patterns of these fractures. Four cases of femoral head fracture caused by minor trauma, which were quite different from the crescent fractures during the course of avascular necrosis were analyzed in regard to the underlying disease, causes, sites, types, directions, pattern of fractures and the injury mechanism of the fractures. The results are reported with special regard to the pattern of the stress fracture of the femoral head and neck during the course of avascular necrosis.
Fractures, Stress ; Head* ; Neck* ; Necrosis*

Many investigators have reported that collagen gel contraction reflects the mechanism of wound contraction. In 1995, Tsai et al. reported that hypertrophic scar-derived fibroblasts in a connective tissue model possessed the greatest contraction potency when compared with those of normal skin and normal oral mucosa-derived CTMs. In this study, we studied the effect of collagen gel contraction by growth factors such as epidermal growth factor, platelet-derived growth factor, transforming growth factor-bata1, and transforming growth factor-bata3, Skin fibroblasts used in this study were obtained from the explant of rat skin culture. Fibroblasts were cultured in Dulbecco's modified Eagle's medium containing 10% fetal bovine serum. Growth factors were added per FPCL in the desired concentrations and we measured the collagen gel diameters in growth factor-treated FPCL on day 1,2,3, and 4 respectively after starting incubation. We examined the effects of EGF, PDGF, TGF-bata1, TGF-bata3 and the effects of combinations of TGF-bata1 + EGF, TGF-bata1 + PDGF, and TGF-bata1 + TGF-bata3 to contract a collagen gel. EGF has little influence on collagen gel contraction. TGF-bata1 and TGF-bata3 increase the collagen contraction. TGF-bata1 enhanced the contractility of collagen gel according to the concentrations. While TGF-bata3 alone had stimulatory contraction effects at low dose, high doses of TGF-bata3 decreased the potency of collagen gel contraction. A combination of TGF-bata1 and EGF minimally decrease TGF-bata1 activity. A combination of TGF-bata1and PDGF had an effect similar to TGF-bata1 activity. A combination of TGF-bata1 and TGF-bata3 decreased TGF-bata1 activity. According to reports that FPCL contraction is equivalent to the process of wound contraction, growth factors which enhance gel contraction may be related to wound contraction and wound healing. TGF-bata1 is reported to enhance scar formation in fetal wound. EGF accelerates wound healing and inhibits the promotion of hypertrophic scar formation. Compared to the effect of collagen gel contraction in this study, the combination of TGF-bata1 and TGF-bata3 that inhibited the promotion of collagen gel contraction are thought to diminish the formation of scar tissue. As well, EGF that has not enhanced collagen gel contraction is thought to diminish the production of scar tissue. We will study the interactive effects of TGF-bata3, EGF and TGF-bata1 on the contraction of collagen gels in the future.
Animals ; Cicatrix ; Cicatrix, Hypertrophic ; Collagen* ; Connective Tissue ; Epidermal Growth Factor ; Fibroblasts ; Gels ; Humans ; Intercellular Signaling Peptides and Proteins* ; Platelet-Derived Growth Factor ; Rats ; Research Personnel ; Skin ; Wound Healing ; Wounds and Injuries*

According to the Mainz classification, renal cell carcinoma (RCC) consists of three subtypes: each has characteristic genetic alterations within the chromosomal or mitochondrial DNA. The three subtypes are: clear cell type, chromophil type, and chromophobe type. E-cadherin is a Ca++-dependent adhesion molecule which plays a major role in the maintenance of intercellular adhesion in epithelial tissues. In a normal kidney, E-cadherin is expressed in the distal tubule and the collecting duct, but not in the proximal tubule. We reclassified 110 cases of RCC according to mainz classification. Immunohistochemical staining for E-cadherin was done on twenty eight cases of RCC, including 18 cases of clear cell type, four cases of chromophil type, and six cases of chromophobe type. The results were as follows: 1) of the 110 cases of RCC, 96 cases (87.3%) were of clear cell type, four cases (3.6%) of chromophil type, and ten cases (9.1%) of chromophobe type, 2) there was no significant correlation between the nuclear grade and clinical stage according to each subtype, 3) E-cadherin expression showed a strong positive reaction along the cell membranes in all six cases of chromophobe type. The differential expression of E-cadherin in RCC may suggest that the chromophobe type may have different biologic characteristics from other types of RCC.
Cadherins* ; Carcinoma, Renal Cell* ; Cell Membrane ; Classification* ; DNA, Mitochondrial ; Immunohistochemistry ; Kidney ; Population Characteristics

This review-article is aimed at shedding a light upon the nature of age-associated changes in the human skeletal system. When the anatomical, physiological and biochemical consequences of bone aging are considered together with the hardening, drying and the diminished repair capabilities of the elderly, it can be seen that fractures assume greater importance as a clinical problem in the geriatric population. Older people start out with a deficit of cortical bone, making them more fracture prone and once fractures occur, the necessary treatments (immobilization, use of casts, etc.) accelerate the rate of bone loss. In addition, aged individuals stand a higher risk for complications of the hospital and enforced bed rest that may ensue. The problems resulting from bone loss in the elderly may be partially alleviated by providing adequate health service support which should include consideration of the following points : 1. Age, sex and general health status ; 2. Habits and inclinations towards physical activities ; 3. Nutritional and endocrine background ; 4. Presence of any specific bone diseases, including osteoporosis, osteoarthritis, osteomalacia and ankylosis ; 5. Psychosocial adaptability and other behavioral elements.
Aged ; Aging ; Ankylosis ; Bed Rest ; Biology* ; Bone Diseases ; Health Services ; Humans* ; Motor Activity ; Osteoarthritis ; Osteomalacia ; Osteoporosis

Symmetrical bilateral thalamic infarction is a rare cerebrovascular disease, caused by occlusion of the paramedian thalamic arteries. The clinical manifestations of this disease are much different from classical thalamic syndrome, with disturbance of consciousness, memory, eye movement and behavior. Observing two cases of bilateral symmetrical thalamic infarction on CT scan with characteristic clinical findings in Medical Center, pertinent literature were reviewed.
Arteries ; Consciousness ; Eye Movements ; Infarction* ; Memory ; Thalamic Diseases ; Tomography, X-Ray Computed