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

OBJECTIVE: The accuracy of analytical results of blood and urine heavy metals came out to the main issue on occupational health from late eighties. The discrepancy of the results for same samples from different laboratories made the diagnosis for occupational diseases be unreliable. Therefore, a quality control program for analysis of samples taken from workplace had been introduced in Korea since 1992. This study aims to show the quality control program f'or analysis of blood and urine samples and its proficient rates from 1992 to 1999 and to know how they have been being used in occupational health. METHODS: The quality control program runs twice a year with mandatory items of blood lead and urine hippuvic acid and voluntary items of blood cadmium and manganese and urine mandellic acid and methyl hippuric acid. Participant laboratories are receiving three levels for each items and two out of three samples have to be qualified for being a proficient laboratory for the item. The acceptable range of blood lead and urine hippuric acid is +/-15% and that of the others is within 3 SD(standard deviation) from the reference values. RESULTS: The proficient rates of blood lead and urine hippuric acid was 89%, 90%, repectively, however those of the other voluntary items have been from 51% to 62%. The proficient rates of urine mercury and urine N-methylformamide(NMF), which are introduced since 1999, were very poor. Urine hippuric acid and blood lead were analyzed frequently for the purpose of biological monitoring conducting by special health examination organizations. Urine and blood manganese and urine metabolites of trichloroethylene, urine phenol, methylhippuric acid and cadmium were followed. CONCLUSIONS: In conclusion, the quality control program for biological monitoring has dramatically improve the ability of analysing blood and urine samples and eventually contributes to diagnose occupational diseases and to prevent occupational poisoning. However, some biological monitoring data, such as urine manganese, mercury and NMF, have been still reported from laboratories that were not accepted as a proficient laboratory.
Cadmium ; Diagnosis ; Environmental Monitoring ; Korea ; Manganese ; Metals, Heavy ; Occupational Diseases ; Occupational Health ; Phenol ; Poisoning ; Quality Control ; Reference Values ; Trichloroethylene

No abstract available.
Child* ; Humans

No abstract available.
Cerebellopontine Angle*

Dent disease is a rare inherited kidney tubulopathy caused by mutations in either the CLCN5 (Dent disease 1) or OCRL1 (Dent disease 2) genes, and which is often underdiagnosed in practice. A diagnosis is clinically suspected in patients with low-molecular-weight proteinuria, hypercalciuria, and one of the following: hematuria, nephrolithiasis, nephrocalcinosis, hypophosphatemia, or chronic kidney disease. Inheritance is X-linked recessive, meaning, these symptoms are generally only found in males; female carriers may have mild phenotypes. Genetic testing is only a method to confirm the diagnosis, approximately 25% to 35% of patients have neither the CLCN5 nor OCRL1 pathogenic variants (Dent disease 3), making diagnosis more challenging. The genotype-phenotype correlations are not evident with the limited clinical data available. As with many other genetic diseases, the management of patients with Dent disease concentrates on symptom relief rather than any causative process. The current treatments are mainly supportive to reduce hypercalciuria and prevent nephrolithiasis. Chronic kidney disease progresses to end-stage between the ages of the third to fifth decades in 30% to 80% of affected males. In this review, we aimed to summarize the literature on Dent disease and reveal the clinical characteristics and molecular basis of Korean patients with Dent disease.

No abstract available.
Coronary Artery Bypass* ; Vocal Cord Paralysis*

Ligamentum flavum (LF) is yellowish ligament tissue connecting the lamina of adjacent vertebra. Degenerative changes in the spine cause the hypertrophy of LF and facet joint and disc bulging and herniation. These changes results in a narrowing of the spinal canal. Neural decompression surgery by removing the hypertrophied lamina, LF and disc pathologies has been considered as successful treatment method in lumbar spinal stenosis. This surgery has showed relatively satisfactory clinical results and has increased life-expectancy in elderly patients. However, issues about post spinal surgery syndrome and re-stenosis after the surgery also have been reported. Because LF is one of the main mechanisms of spinal stenosis, accurate understanding about pathologic mechanism on the LF hypertrophy may suggest alternative treatment methods such as medical treatment or less invasive treatment than surgical decompression can be considered. Hypertrophy of the ligamentum flavum is generated from increase of collagen synthesis, fibroblast proliferation, and fibrosis caused by 1) the expression of growth factors (TGF-beta1 etc.) stimulated by the repeated mechanical tension, 2) inflammatory cytokines from spinal facet joint structure and LF 3) delayed cell death, and 4) inflammatory cytokine from hypertrophied and degenerated LF itself. After the middle ages, gradual and partial inhibition of LF hypertrophy can be expected by administration NSAIDs or selective cyclo-oxygenase-2 inhibitors because these drugs may cause reduction of the increased cytokines. Also, relaxin can be another new treatment material for spinal stenosis by the mechanism of melting hypertrophied LF and reducing synthesis of collagen.
Aged ; Anti-Inflammatory Agents, Non-Steroidal ; Cell Death ; Collagen ; Cytokines ; Decompression ; Decompression, Surgical ; Fibroblasts ; Fibrosis ; Freezing ; Humans ; Hypertrophy* ; Intercellular Signaling Peptides and Proteins ; Ligaments ; Ligamentum Flavum* ; Pathology ; Relaxin ; Spinal Canal ; Spinal Stenosis ; Spine ; Zygapophyseal Joint

OBJECTIVES: The addition of bevacizumab to standard chemotherapy has been improved survival outcomes in patients with metastatic colorectal cancer. However, the combination of bevacizumab with oxaliplatin-based chemotherapy as first-line treatment showed limited survival benefit. The purpose of this study was to investigate the clinical efficacy and toxicity of the combination of bevacizumab to oxaliplatin and leucovorin (FOLFOX4) in the first-line treatment of patient with metastatic colorectal cancer. METHODS: Between December 2004 and September 2009, medical records of patients who were diagnosed with metastatic colorectal cancer and received the first line chemotherapy with bevacizumab and FOLFOX4, were retrospectively reviewed. RESULTS: A total of forty patients were analyzed. The median age of the patients was 55 years (range, 33–80), and 55% was male. The patients received a total of 206 cycles of therapy (median 4 cycles per patient; range 1 – 15 cycles). Of these 40 patients, none achieved complete response (CR) and 15 achieved a partial response (PR), for the overall response rate (ORR) 37.5% (95% CI, 22.5–52.5). Median progression free survival (PFS) was 6.9 months (95% CI, 3.4–10.5) and median overall survival (OS) was 22.6 months (95% CI, 17.3–27.8The most common grade 3 or 4 hematologic toxicity and non-hematologic toxicity were neutropenia (10.0%) and diarrhea (10.0%), respectively. Two patients experienced gastrointestinal perforation. CONCLUSIONS: In this study, the combination bevacizumab with FOLFOX4 was associated with favorable OS, but did not showed favorable PFS and ORR.
Bevacizumab* ; Colorectal Neoplasms* ; Diarrhea ; Disease-Free Survival ; Drug Therapy ; Humans ; Leucovorin ; Male ; Medical Records ; Neutropenia ; Retrospective Studies* ; Treatment Outcome*

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 AND OBJECTIVES: Ventricular septal defect (VSD) is the most common congenital heart disease, and an effective cooperative practice system can change its therapeutic outcome. We tried to develop and find the effects of the application of the critical pathway (CP) in patients with VSD. MATERIALS AND METHODS: First, we reviewed the charts of patients diagnosed with VSD who had been operated on between January and December 1999, and the preliminary CP for the VSD completed. Second, the Delphi process was achieved by exchanging mail between two professional groups to establish the final CP for the VSD. This process was applied to thirteen patients having had operations at the Gil Heart Center between June and November 2000. On admission, the patients were informed of the practice, and their degree of satisfaction was anonymously surveyed prior to discharge. RESULTS: The CP for patients with VSD is composed of eight categories - monitoring, vital signs, laboratory tests, ventilator, diet (fluid-electrolyte balance), drugs, treatment, consultation and education. These were applied and evaluated daily from two days preoperatively, until the day of discharge (seven days postoperatively), to 13 of the 15 (86.7%) patients, as approved in the instruction manual. The duration of antibiotic injections significantly decreased from 5.3+/-1.3 days to 3.1+/-0.5 days (p=0.00002), as did that of thoracic tube insertion from 84+/-21 hours to 48+/-16 hours (p=0.0001). The degree of satisfaction of the parents was 4.2, the highest score possible being 5. CONCLUSION: Improvement in the quality of medicine can be achieved by developing and applying the CP to perioperative patients with VSD. Our conclusions from this study are only tentative as it was only applied to limited small number of cases.
Anonyms and Pseudonyms ; Critical Pathways* ; Diet ; Education ; Heart ; Heart Defects, Congenital ; Heart Septal Defects, Ventricular* ; Humans ; Parents ; Postal Service ; Ventilators, Mechanical ; Vital Signs