No abstract available.
Catheters* ; Humans

PURPOSE: The purpose of this study was to test the validity of a modified clinical performance examination (CPX) for preclinical students in nursing. METHOD: 70 nursing students in their second semester of the junior year at C University participated in CPX. Scenarios and checklists were developed by our research team from September to October 2005. Six stations were organized. Evaluation included physical examination of a patient with lung cancer, education on usage of a metered dosage inhaler, and lobectomy postoperative care. Students were randomly assigned to a station. RESULT: There was a difference in the CPX scores according to stations. The agreement of scoring between trained faculty members and SPs was more than moderate (r=.647). The correlation between the CPX score and the average grade in the previous semester and between the CPX score and the average grade of a paper and pen test of the pulmonary system of adults was low (r=.276; r=.048). CONCLUSION: Traditional CPX is generally recommended, however, modified CPX is appropriate for preclinical students in the current Korean Nursing school setting if there are additional scoring systems to balance the testing level at each station.
Administration, Inhalation ; Adult ; Education, Nursing, Baccalaureate/*standards ; Educational Measurement ; Female ; Humans ; Lung Neoplasms/nursing ; Male ; Medical History Taking ; Physical Examination ; Postoperative Care ; Reproducibility of Results ; Task Performance and Analysis

No abstract available.
Humans ; Microcomputers*

Augmentation rhinoplasty is one of the most popular aesthetic procedures in Asians. Numerous alloplastic implants have been used, however alloplastic implants may cause many problems in nasal and perinasal areas because of thin soft tissue cover. For these reasons, an ideal implant should be nonpalpable, readily exchangeable and biocompatible. Among these alloplastic implants, Gore-Tex(R) is a polymer of carbon bound to fluorine composed of solid nodes connected by very fine fibers. It has been reported that this material become permeated and surrounded by mature connective tissue, forming a strong supporting envelop for the material, yet the implant is easily removed because of limited tissue ingrowth. Since it's development, Gore-Tex(R) has found many applications in the field of facial plastic and reconstructive surgery. From November, 2001 to December, 2002, Gore-Tex(R) implants were removed from 17 patients due to several problems such as; decreased dorsal height, tip deformity, chronic inflammation. The implants were very hard to remove and coinciding injury of the surrounding tissue were inevitable. An analysis of the length and thickness changes in these removed implants was made. The results showed, decrease in length and thickness with a volume loss averaging, 46.3% in 45x4.0mm implants, 49.3% in 50x5.0mm implants. In view of the experiences of 17 cases of Gore-Tex(R) implants in rhinoplasty, we have concluded that Gore-Tex(R) implants were structurally unstable, fibrovascular tissue ingrowth into pores were minimal, the implants were very hard to remove and the implants caused a postoperative volume reduction. Therefore, Gore-Tex(R) use in augmentation rhinoplasty should be approached with caution.
Asian Continental Ancestry Group ; Carbon ; Congenital Abnormalities ; Connective Tissue ; Fluorine ; Humans ; Inflammation ; Plastics ; Polymers ; Polytetrafluoroethylene* ; Rhinoplasty*

Various methods of taking of optic foramen view and avalubilities have been studied by many foreigninvistigators, but those in Korea have not been reported yet. The authors have measured and examined the size andshapes of optic foramina of optic foramen views in 111 Korean checked at Inje Medical College Hospital duringabout 3 years form June 1979 to March 1982. The cases were divided into gwo groups, A and B, for the convenienceof study. Group A consisted of 50 normal Korean 5 to 55 years of age with no visual symptoms and signs. Group Bincluded 69 patients 3 to 75 yrs of age with visual symptoms and signs. The results were as follows; 1. Mean valueof actual diameter of optic foramen meassured by Goalwin's method in Group A; Right; A diameter; 4.21mm, Bdiameter; 4.32mm, Left; A diameter; 4.29mm, B diameter; 4.30mm. 2. Absolute symmetry of the greatest diameters ofboth optic foramina in Group A; 36%, difference of 0.5 or lessl 28%, from 0.5 to 1.0mm; 18%, from 1.0 to 1.5mm;8%, uncomparable cases; 10%. The greatest difference was 1.4mm. 3. The shapes of optic foramen in Group A; ovalshape; 65%, circular ; 29%, keyhole or double foramen; 6%. 4. In Goup B, the peak age group was second decade(31%), the most comon clinical cause of examiniation of optic foramen view was optic nerve atrophy(30%), and thepathologic findings were only 4 cases(7%). 5. The technique of optic foramen view by modified Pfeiffer's methoddelineated the outline of optic foramen more clearly than ordinary Rhese's method in our experience.
Humans ; Korea ; Methods ; Optic Nerve

PURPOSE: We measured pulmonary epithelial permeability by Tc-DTPA radioaerosol clearance in patients with diabetes and correlated with the presence of microangiopathy to understand the pathophysiology of pulmonary microangiopathy and evaluate Tc-DTPA radioaerosol clearance as a diagnostic test to assess pulmonary microangiopathy. MATERIALS AND METHODS: We performed ' Tc-DTPA radioaerosol scan in 10 normal subjects, 10 asym-ptomatic smokers, 20 diabetic patients without history of smoking (10 with microangiopathy, 10 without microangiopathy). Tc-DTPA clearance half-time (T1/2) was calculated, then compared with the result of chest radiography and pulmonary function test. RESULTS: Chest radiography and pulmonary function test were normal in all subjects. There were no significant difference of clinical or laboratory characteristics between these groups except age. The diabetic patients with micraangiopathy were significantly older (p<0.05). The T1/2of normal subjects and asyrnptomatic smokers were significantly different (65.2+23.7min vs 39.6+9.8min, p<0.05). For diabetic patients with microangiopathy, the T, was 90 5+46.5min and significantly delayed when compared with those of normals and asymptomatic smokers (p<0.05). However, the T1/2of diabetic patients without microangiopathy, 70.0+12.7 min, was not significantly different from those of normals or asyrnptomatic smokers (p>0.05). No significant correlation was found between the T1/2and spirometric parameters including DLcc>, FVC, FEV>, FEV(/FVC (%) and FEF)5-75g in all subjects, and between the T1/2 and duration of diabetes in diabetic patients. CONCLUSION: Eventhough the influence of age cant be excluded, delayed Tc-DTPA clearance half-time (T1/2)in diabetic patients with microangiopathy indicates decreased pulmonary cspillary permeability as one of the pathophysiologic results of pulmonary microangiopaththy. Further studies are needed in larger number of age matched control and diabetic patients to evaluate the diagnostic efficacy.
Diabetes Mellitus ; Diagnostic Tests, Routine ; Humans ; Permeability ; Radiography ; Respiratory Function Tests ; Smoke ; Smoking ; Technetium Tc 99m Pentetate ; Thorax

Eight patients in the state of ASA classification l, ll were investigate. Blood samples were collected before, just after, 30 minutes after and 60 minutes after induction of anesthesia. Glucose and electrolyte changes in relation to maintenance fluids in balanced and halothane anesthesia were as follows. 1) In both anesthetic techniques blood sugar level showed increasing tendency according to duration of anesthesia. 2) There were no specific changes in serum electrolytes related to type of anesthesia. 3) The administration of D/S and H/D showed a little increase in Na+ and Cl- level compared to the administration of just DsW. 4) The administration of H/d showed less increase in K+ level than the administration of DsW or D/S. 5) Just after induction of anesthesia the K+ level increased a little and decreased gradually thereafter.
Anesthesia ; Anesthesia, General* ; Blood Glucose* ; Classification ; Electrolytes* ; Glucose ; Halothane ; Humans

PURPOSE: 4DCT scans performed for radiotherapy were retrospectively analyzed to assess the possible benefits of respiratory gating in non-small cell lung cancer (NSCLC) and established the predictive factors for identifying patients who could benefit from this approach. MATERIALS AND METHODS: Three treatment planning was performed for 15 patients with stage I~III NSCLC using different planning target volumes (PTVs) as follows: 1) PTVroutine, derived from the addition of conventional uniform margins to gross tumor volume (GTV) of a single bin, 2) PTVall phases (patient-specific PTV), derived from the composite GTV of all 6 bins of the 4DCT, and 3) PTVgating, derived from the composite GTV of 3 consecutive bins at end-exhalation. RESULTS: The reductions in PTV were 43.2% and 9.5%, respectively, for the PTVall phases vs. PTVroutine and PTVgating vs. PTVall phases. Compared to PTVroutine, the use of PTVall phases and PTVgating reduced the mean lung dose (MLD) by 18.1% and 21.6%, and V20 by 18.2% and 22.0%, respectively. Significant correlations were seen between certain predictive factors selected from the tumor mobility and volume analysis, such as the 3D mobility vector, the reduction in 3D mobility and PTV with gating, and the ratio of GTV overlap between 2 extreme bins and additional reductions in both MLD and V20 with gating. CONCLUSION: The additional benefits with gating compared to the use of patient-specific PTV were modest; however, there were distinct correlations and differences according to the predictive factors. Therefore, these predictive factors might be useful for identifying patients who could benefit from respiratory-gated radiotherapy.
Carcinoma, Non-Small-Cell Lung ; Humans ; Lung ; Retrospective Studies ; Tumor Burden

PURPOSE: The modification of radiation-induced apoptosis by EGCG, known as antioxidants or oxidants, was studied in mice spleens irradiated with a lethal dose. MATERIALS AND METHODS: Male C57BL/6 mice were divided into control, irradiation-only, and EGCG (100 mg/kg i.p. 1 h before irradiation) pretreatment groups. The mice were irradiated with a single whole-body dose of 7 Gy. The apoptosis in the spleens after irradiation of the lethal dose were analyzed by TUNEL assay. In addition, the expression levels of the Bax and Bcl-2 proteins were quantified using a Western blotting method. RESULTS: The induction of apoptosis was detected in the splenic white pulp. The highest level of apoptosis was detected at 8 hours after irradiation. No significant difference was identified by the apoptotic index (53.9% vs. 52.1%, p=0.328) and relative Bax protein expression (0.86 vs. 0.81, p=0.335), between the irradiation-only and EGCG pretreatment group, respectively. However, a lower Bax/Bcl-2 ratio (1.64 vs. 0.97, p=0.037) and higher relative expression level of Bcl-2 protein (0.57 vs. 0.82, p=0.037) was measured in the EGCG pretreatment group. CONCLUSION: The EGCG pretreatment neither decreased the radiation-induced apoptosis in mice splenocytes, nor induced additional apoptosis.
Male ; Humans ; Oxidants

PURPOSE: The changed expressions of TGF-beta1, as a key cytokine in the fibrotic process, due to melatonin with potent antioxidative effects, were investigated in the irradiated lung using fibrosis-sensitive C57BL/6 mice. MATERIALS AND METHODS: Female C57BL/6 mice were divided into control irradiation-only, and melatonin (300 mg/kg i.p. 1 hr before irradiation) pretreatment groups. The thoraces of the mice were irradiated with a single dose of 12 Gy. The mRNA expressions of TGF-beta1 in the lung tissue 2 and 4 weeks after irradiation were quantified using semiquantitive RT-PCR, and the cellular origin and expression levels of TGF-beta1 protein were identified using immunohistochemical staining. RESULTS: The relative mRNA expression levels in the irradiation-only and melatonin pretreatment groups 2 and 4 weeks after irradiation were 1.92- and 1.80-fold (p=0.064) and 2.38- and 1.94-fold (p=0.004) increased, respectively compared to those in the control group. Increased expressions of TGF-beta1 protein were prominently detected in regions of histopathological radiation injury, with alveolar macrophages and septal epithelial cells serving as important sources of TGF-beta1 expression. At 2 and 4 weeks after irradiation, the expression levels of protein were 15.8% vs. 16.9% (p=0.565) and 36.1% vs. 25.7% (p=0.009), respectively. CONCLUSION: The mRNA and protein expressions of TGF-beta1 in the lung tissue following thoracic irradiation with 12 Gy were significantly decreased by melatonin pretreatment at 4 weeks. These results indicate that melatonin may have a possible application as an antifibrotic agent in radiation-induced lung injury.
Animals ; Epithelial Cells ; Female ; Fibrosis ; Humans ; Lung Injury ; Lung* ; Macrophages, Alveolar ; Melatonin* ; Mice ; Radiation Injuries ; RNA, Messenger ; Thorax ; Transforming Growth Factor beta1* ; Transforming Growth Factors*