PURPOSE: This study was done to determine how a hospital life guidance movie enhanced the understanding of hospital life by elderly in-patients. METHOD: A non-equivalent control group post-test design was used for the study. The experimental group watched a movie on guidance for hospital life while an in-patient control group read corresponding guidance booklets. The understanding and satisfaction from the respective programs for the two groups were surveyed with a questionnaire. The data were analyzed using SPSS. RESULTS: The group which watched the movie had a better understanding of hospital life than the group which read the booklets. The patients who watched the movie also expressed more satisfaction with their guide program than the patients who only read the booklets. Understanding of hospital life had relevance to satisfaction with the given program. CONCLUSION: The results of this study suggests that a movie on hospital life provides better guidance which helps the prospective patients understand and adapt better to their hospital life. Therefore, this type of movie is considered to be an effective medium to provide guidance to elderly in-patients.
Aged ; Humans ; Pamphlets ; Patient Admission ; Patient Education as Topic ; Questionnaires

In patients disabled by severe rheumatoid and degenerative arthritis of both knees, bilateral total knee arthroplasty(TKA) afforded much functional improvement in pain relief and function. Postoperative results of bilateral TKA was described as being similiar to those observed among patients with single joint replacement. The purpose of this study is to evaluate the etiology and postoperative result of bilateral TKA performed on 32 knees in 16 patients at Department of Orthopedic Surgery, Seoul National University Hospital from Mar. 1985 to Oct. 1988. In our series, there were 15 females and only 1 male, their mean age was 53 years. Duration of follow up was ranged from 1 to 4 years and 5 months being average 1 year and 6 months. The results were as follow. 1. Cheif complaints were pain in 18 cases(100%) and difficulty in walking in 15 cases(82%). 2. Preoperative etiology was rheumatoid arthritis in 11 cases and degenerative arthritis in 7 cases. 3. Knee joint function by HSS(Hospital for Special Surgery) knee rating score was increased from 44.6 points preoperatively to 81.2 points postoperatively. 4. The tibiofemoral angle was changed from 1.4 degree varus to 4 degree valgus. 5. The prothesis type used were PFG(Press Fit Condylar) in 22 knees, Miller-Galante in 8 knees, AMK in 3 knees, PCA in 2 knees and unicompartmental type in 1 knee. 6. Complication were 1 case of knee fusion due to concomittant tuberculous arthritis and mild joint effusion in 6 knees. 7. Bilateral one-stage arthroplasty may be considered as an alternative procedure.
Arthritis ; Arthritis, Rheumatoid ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Female ; Follow-Up Studies ; Humans ; Joints ; Knee ; Knee Joint ; Male ; Orthopedics ; Osteoarthritis ; Passive Cutaneous Anaphylaxis ; Seoul ; Walking

Rheumatoid arthritis is a chronic inflammatory systemic disease of young or middle aged adults, characterized by destructive and proliferative changes in the synovial membrane, periarticular structures, skeletal muscle and perineural sheath. Eventually, the joints are destroyed, ankylosed and deformed. Therfore, the aim of treatment is to keep the inflammatory process at a minimum, thereby preserving the joint motion, maintaining the health of muscle supplying motor power about the joint and preventing secondary joint stiffness and deformity. Surgical treatment in rheumatoid arthritis has progressed and there have been advances in the relief of pain and increase in the range of motion. Among them the results of total knee arthroplasty (TKA) have improved steadily during the past decade due to refinements in design, fixation, and surgical technique. At orthopedic department of seoul national university hospital, we performed 31 total knee replacement in 18 patients who had suffered from rheumatoid arthritis during the period from Aug. 1982 to Dec. 1988. Following results were obtained. 1. Knee score increased from 37.8 to 76.9. 2. Tibio-femoral angle was corrected from 0.9° valgus to 5.3° valgus. 3. Conplications were peroneal nerve palsy in 3 knees, instability in 1 knee, tuberculous arthritis in 1 knee. 4. In 25 out of 31 knees, good functional results were obtained.
Adult ; Arthritis ; Arthritis, Rheumatoid ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Congenital Abnormalities ; Humans ; Joints ; Knee ; Middle Aged ; Muscle, Skeletal ; Orthopedics ; Paralysis ; Peroneal Nerve ; Range of Motion, Articular ; Seoul ; Synovial Membrane

The purpose of this in vitro study was to compare the effects of root canal debridement following rotary Ni-Ti instruments with positive versus negative rake angle. Seventy sound, extracted human anterior teeth & premolars were randomly divided into four groups. The used rotary instruments were Ni-Ti HERO 642(Micro-Mega in France, 20 specimen), Ni-Ti ProFile(Maillefer, Ballaigues, Switzerland, 20 specimen), stainless steel engine reamer(Mani, Matsutani Seisakusho Co.,Japan, 20 specimen) and negative control group(10 specimen) was only extirpated with barbed broach(Mani, Matsutani Seisakusho Co.,Japan) Group 1 & 2 teeth were prepared to a #40 at the apex followed by 1 mm using crown-down technique. Group 3 teeth were instrumented from a #15 to a #40 in sequential order. After preparation and final irrigation, the roots split longitudinally into a bucco-lingual direction. Root halves were cross-sectioned in apical third portion again. all root specimens were prepared for SEM investigation & photographed. Separate evaluations were undertaken for smear layer on prepared walls with a five score-index for each using reference photograph in root halves. the penetration depth of smear layer into dentinal tubules was also estimated in the other halves. the following results were obtained : 1. Smear layer was observed on all the prepared walls with three experimental groups except negative control group 2. Smear layer characteristics 1) HERO 642 groups showed snowy & dusty appearance & were observed only few some dentinal tubuli open on the prepared walls, and the penetration depth of it into dentinal tubules may be 1-2 microm thick. 2) ProFile groups showed shiny & burnished appearance & complete root canal wall covered by a homogenous smear layer with no open dentinal tubuli and penetration depth of it into dentinal tubules may be 1-2 microm thick. 3) Engine reamer groups showed obviously file's passed tracks on the prepared walls & were observed complete root canal wall covered by a homogenous smear layer with no open dentinal tubuli. The results revealed that a completely clean root canal could not be achieved regardless of positive & negative rake angle, which is in accordance with the majority of studies on root canal cleanliness. In conclusion, throughout irrigation with antibacterial solutions or chelating agents is recommended to remove the smear layer on prepared canal walls.
Bicuspid ; Chelating Agents ; Debridement ; Dental Pulp Cavity ; Dentin ; Electrons ; France ; Humans ; Nickel ; Smear Layer ; Stainless Steel ; Switzerland ; Titanium ; Tooth ; Track and Field

To develop an animal model of nephrolithiasis similar to the pattern of human renal stone disease, we adopted a protocol of administration of stone substrates along with induction of renal tubular injuries. Male Wister rats fed with 3% ammonium oxalate containing chows with or without additional 40 mg/kg/day of gentamicin for 8 days were compared with those fed with normal chows. On dissecting microscopic examination, rats receiving oxalate and gentamicin showed more crystals and plaques than rats receiving oxalate only, both in 15 days and 22 days after feeding, and most of the crystals were located at renal papilla. Average score of crystal abundance was 0.4, 1.15, respectively in rats receiving oxalate only and oxalate plus gentamicin after 15 days of feeding, and 0.9 and 1.55, respectively after 22 days. Little crystals were found in rats fed with normal chow with or without gentamicin. Urinary excretion of tubular epithelial brush border enzyme, gamma-glutamyl transpeptidase(GGT), was increased by gentamicin administration whereas creatinine clearance rate was not changed. Urinary excretion of oxalate was unchanged, but calcium and uric acid was markedly decreased in rats fed with oxalate and formed crystals, and citrate and magnesium excretion was also decreased. These results indicate that administration of oxalate along with inducing renal tubular damages by subcutaneous injection of gentamicin seems to form crystals and plaques in the kidney more rapidly and abundantly than feeding with oxalate alone.
Animals* ; Calcium ; Citric Acid ; Creatinine ; Gentamicins ; Humans ; Injections, Subcutaneous ; Kidney ; Magnesium ; Male ; Microvilli ; Models, Animal* ; Nephrolithiasis* ; Oxalic Acid ; Rats ; Uric Acid

No abstract available.
Health Status Indicators* ; Surveys and Questionnaires

PURPOSE: The purpose of this study is to illustrate MR patterns of signal intensity of proximal femur in normal subjects according to the age distribution. METHOD AND MATERIAL: Tl-weighted MR images of the proximal femur in 125 subjects, aged 13 days to 25 years, were retrospectively analyzed. Age distribution was classified to 4 groups;below 4 months, 5 months to 4 years, 5 years to 14 years, and 15 years to 25 years. RESULTS: By the age of 4 months, the non-ossified femoral epiphysis was seen as intermediate-signal-intensity cartilage. At 5 months-4 years, the ossified fernoral capital epiphysis was seen within intermediate-signal-intensity cartilage and appeared as decreased or increased signal-intensity red or yellow marrow surrounded by a rim of low-signal-intensity cortical bone. At 5-14 years, the ossified femoral capital and greater trochanteric epiphysis were seen within the intermediate-signal-intensity cartilage and appeared as decreased or increased signal-intensity red or yellow marrow. At 15-25 years, the proximal metaphyseal marrow showed increased signal intensity. Four patterns of the metaphyseal marrow were recognized by Ricci et al. The frequency of pattern la progressively decreased with age. Pattern 2 and 3 were visible in the 15-25 years age group. CONCLUSION: An understanding of the spectrum of normal age-related change of the proximal femoral cartilage and marrow patterns serves as the foundation for interpretation of proximal femur pathologies.
Age Distribution ; Bone Marrow ; Cartilage ; Epiphyses ; Femur* ; Humans ; Magnetic Resonance Imaging* ; Pathology ; Retrospective Studies

BACKGROUND: Early reperfusion therapy with thrombolytic agents or primary PTCA is most important to salvage ischemic myocardium in acute myocardial infarction(AMI). Timely reperfusion of jeopardized myocardium clearly improves hemodynamics, decreases infarct size and improves survival. The extent of protection appears to be directly related to the rapidity of reperfusion after onset of coronary occlusion. Although the intravenous thrombolysis is a feasible therapy in the patients with evolving AMI, the benifit of thrombolytic therapy decreases because of the time delay after onset of symptom. This study was perfomed to analyze the factors time delay between onset of symptom and the thrombolytic therapy with retrospective and prospective questionaire in the patients with AMI. METHOD: Eighty one patients with AMI were included in this study who came to the emergency room(ER) of Chungnam National University Hospital(CNUH) from Feburary 1995 to October 1996. Delay between door and thrombolytic therapy was defined as hospital time delay. RESULTS: Thrombolytic therapy(rt-PA or urokinase iv) was done in 60 patients(74.1%) and mean prehopital time delay was significantly decreased in the patients with thrombolytic therpapy when compared with those without thormbolytic threapy(462+/-90 vs 1375+/-473 minutes, p=0.005). There were no singificant factors for prehospital time delay such as age, sex, redsidence, ER near residence, transfer time to ER near residence, family status, family history of AMI, severity of chest pain, presence of risk factors of cardiovascular disease(CVD), previous CVD, degree of education, history of other disease and routine check, transfer methods. The only 8 patients(9.8%) knew about AMI and 7 patients among these patient came to ER earlier and received thrombolytic therapy. From 57 referred patients, 40 patients(70.2%) received reperfusion therapy and only 30 patients(52.6%) had recored EKG in the referred hospital. In the analysis of hospital delay from patient's arrival to the thrombolytic therapy, the arrival time at weekdays and weekend had no differences, but hospital delay were significantly prolonged when patients arrived at ER in the night. CONCLUSION: Since prehospital time delay is a most important factor of time delay for the effective thrombolytic therapy in AMI, the pubic education program and effective transport system are needed. And routine record of EKG in patient with chest pain in the local hospital is very helpful to start effective thromolytic therapy at ER. The well designed prospective study with more patinets in our local region is essential to get more accurate information about transport system and to improve survival rate in patients with AMI.
Chest Pain ; Chungcheongnam-do ; Coronary Occlusion ; Education ; Electrocardiography ; Emergencies ; Fibrinolytic Agents ; Hemodynamics ; Humans ; Myocardial Infarction* ; Myocardium ; Prospective Studies ; Reperfusion ; Retrospective Studies ; Risk Factors ; Survival Rate ; Thrombolytic Therapy* ; Urokinase-Type Plasminogen Activator

The Nuss procedure has good cosmetic effects, but it could be cause of bleeding and organ injury during dissection of the anterior mediastinum. We have made an effort to overcome the defects of the traditional method through the anterior mediastinum, thus we developed a transilluminated introducer that made it safer and simpler to operate within a 1 cm incision only. A total of 67 patients underwent the Nuss procedure using the transilluminated introducer. Thirty-six patients underwent the procedure with the transilluminated introducer only (age<14 years). Thirty-one patients had an additional thoracoscopy (age> or =14 years). There were no major complications, such as massive bleeding or organ injury in the thoracic cavity during or after the Nuss procedure. Our findings demonstrated that the anterior mediastium could be dissected simply and safely by the use of a transilluminated introducer during the Nuss procedure without fatal major complications, such as bleeding and organ injury.
Cosmetics ; Funnel Chest ; Hemorrhage ; Humans ; Mediastinum ; Thoracic Cavity ; Thoracic Wall ; Thoracoscopy

The authors present a very rare case of an intrasellar cavernous hemangioma that mimick a pituitary macroadenoma radiologically. A 63-year-old male patient was admitted with visual field defect and clinical manifestations of pituitary failure. MR image revealed intrasellar gadolinium-enhancing tumor with parasellar extension suggesting pituitary macroadenoma. But pathology was cavernous hemangioma. It was suggested that cavernous hemangioma should be included in the differential diagnosis of pituitary mass.
Diagnosis, Differential ; Hemangioma, Cavernous* ; Humans ; Male ; Middle Aged ; Pathology ; Pituitary Neoplasms ; Sella Turcica ; Visual Fields