PURPOSE: The purpose of this study was to compare the two-dimensional with three-dimensional radiographic measurements of polyethylene liner wear in the Harris-Galante II acetabular cup. MATERIALS AND METHODS: We measured the polyethylene liner wear amount and the wear rate of 64 hips with Harris-Galante II acetabular cup by two methods: Livermore's method and modified Devane's method. We evaluated the relationships between the two methods. RESULTS: The average total amount of wear and the average wear rate are 0.86+/-1.01 mm and 0.18+/-0.20 mm/year using the two-dimensional method and 0.99+/-1.01 mm and 0.21+/-0.2 mm/year using three-dimensional method respectively. The amount of wear and the wear rate by the three-dimensional method was larger than those by the two dimensional method. CONCLUSION: The amount of polyethylene liner wear can be measured by the two-dimensional method because it is highly correlated with the amount that is measured by the three-dimensional method, since there was no differences between the two methods.
Acetabulum* ; Hip ; Polyethylene*

PURPOSE: This study was conducted to evaluate nutritional status, and the effects of lifestyles and depression on nutritional status of elderly people (NSE). METHOD: The participants were 280 elders who visited the Y city Senior Welfare Center between August 2006 and October 2006. Data were collected using a structured questionnaire that included general characteristics, lifestyle checklist, depression scale, and nutritional risk index. Also, Body Mass Index (BMI) was calculated from height and weight. T-test, ANOVA, Duncan test, Pearson coefficients correlation and stepwise multiple regression were used to analyze the data using the SPSS Win 12.0 program. RESULTS: The NSE mean score was mid level at 5.03. BMI was 23.42 which indicates overweight. Depression was the factor that influenced the nutritional risk index most strongly, accounting for 17.3% of the total variance in the NSE. A combination of significance of health, concerns about health, housing, condition of teeth, activity, and smoking pattern accounted for 29.8% of the variance in the NSE. Condition of teeth accounted for only 3.8% of the variance in BMI. CONCLUSION: It is necessary to be aware that variance in the NSE can be affected by several factors including depression and lifestyle and that depression is strongly related to poorer NSE.
Aged* ; Body Mass Index ; Checklist ; Depression* ; Housing ; Humans ; Life Style* ; Nutritional Status* ; Overweight ; Questionnaires ; Smoke ; Smoking ; Tooth

PURPOSE: Critical pathways (CP), also known as clinical pathways, are management plans that display goals for patients and have led to improved outcomes for many disease entities. This study was aimed at developing a critical pathway for the surgical treatment of gastric cancer patients and evaluating its usefulness. MATERIALS AND METHODS: A CP was developed and implemented by a team of surgeons, nurses, nutritionists, and administrative officials. Among the 117 patients who received curative gastrectomies for gastric cancer at Kangnam St. Mary's Hospital, The Catholic University of Korea, between October 2003 and August 2004, 26 patients were treated according to the CP. We evaluated its usefulness by comparing the clinical characterisctics, postoperative progress, hospital stays, and costs between the CP and the non-CP groups. Patient satisfaction was also surveyed with questionnaires. RESULTS: Of the initial 26 patients in the CP group, two were excluded from the final evaluation; one patient had a duodenal stump leakage, and the other had a gastric stasis postoperatively. In 8 patients, protocol violation occurred; six patients refused to be discharged on the 7th postoperative day, one patient who had an gastric staisis postoperatively stayed for 2 additional days, and one patient who needed ICU care stayed for 4 additional days. The drop-out rate was 7.7% (2/26), and the variance rate was 30.8% (8/26). The mean hospital stay was 11.3 days (10~15 days) for the CP group compared with 17.5 days (9~68 days) for the non-CP group, resulting in a difference of about 6 days (P<0.05). The mean hospital stays after surgery were 10.3 days (7~68 days) and 8.3 days (7~12 days) for the non-CP and the CP groups, respectively, but the difference was statistically not significant (P>0.05). The mean charge during the hospital stay was higher in the non-CP group (W6,292,200) than in the CP group (W4,863,685). The charge per hospital day was higher in the CP group (W430,414) than in the non-CP group (W359,554). Patient satisfaction was higher in the CP group than in the non-CP group. CONCLUSION: By developing and applying a critical pathway in the surgical treatment of stomach cancer patients, we could reduce the length of hospital stay as well as the cost. A multi-centered prospective study to establish a standard treatment pathway and to demonstrate its effectiveness is needed in the future.
Critical Pathways* ; Gastrectomy ; Gastroparesis ; Humans ; Korea ; Length of Stay ; Nutritionists ; Patient Satisfaction ; Surveys and Questionnaires ; Stomach Neoplasms*

PURPOSE: Critical pathways (CP), also known as clinical pathways, are management plans that display goals for patients and have led to improved outcomes for many disease entities. This study was aimed at developing a critical pathway for the surgical treatment of gastric cancer patients and evaluating its usefulness. MATERIALS AND METHODS: A CP was developed and implemented by a team of surgeons, nurses, nutritionists, and administrative officials. Among the 117 patients who received curative gastrectomies for gastric cancer at Kangnam St. Mary's Hospital, The Catholic University of Korea, between October 2003 and August 2004, 26 patients were treated according to the CP. We evaluated its usefulness by comparing the clinical characterisctics, postoperative progress, hospital stays, and costs between the CP and the non-CP groups. Patient satisfaction was also surveyed with questionnaires. RESULTS: Of the initial 26 patients in the CP group, two were excluded from the final evaluation; one patient had a duodenal stump leakage, and the other had a gastric stasis postoperatively. In 8 patients, protocol violation occurred; six patients refused to be discharged on the 7th postoperative day, one patient who had an gastric staisis postoperatively stayed for 2 additional days, and one patient who needed ICU care stayed for 4 additional days. The drop-out rate was 7.7% (2/26), and the variance rate was 30.8% (8/26). The mean hospital stay was 11.3 days (10~15 days) for the CP group compared with 17.5 days (9~68 days) for the non-CP group, resulting in a difference of about 6 days (P<0.05). The mean hospital stays after surgery were 10.3 days (7~68 days) and 8.3 days (7~12 days) for the non-CP and the CP groups, respectively, but the difference was statistically not significant (P>0.05). The mean charge during the hospital stay was higher in the non-CP group (W6,292,200) than in the CP group (W4,863,685). The charge per hospital day was higher in the CP group (W430,414) than in the non-CP group (W359,554). Patient satisfaction was higher in the CP group than in the non-CP group. CONCLUSION: By developing and applying a critical pathway in the surgical treatment of stomach cancer patients, we could reduce the length of hospital stay as well as the cost. A multi-centered prospective study to establish a standard treatment pathway and to demonstrate its effectiveness is needed in the future.
Critical Pathways* ; Gastrectomy ; Gastroparesis ; Humans ; Korea ; Length of Stay ; Nutritionists ; Patient Satisfaction ; Surveys and Questionnaires ; Stomach Neoplasms*

PURPOSE: To develop a model based on non-invasive clinical and ultrasonographic parameters for predicting the likelihood of subsequent histologic chorioamnionitis in women with preterm premature rupture of membranes (PPROM) and to determine whether the inclusion of invasive test results improves the predictive value of the model. MATERIALS AND METHODS: This retrospective cohort study included 146 consecutive women presenting with PPROM (20-33 weeks). Transvaginal ultrasonographic assessment of cervical length was performed. Maternal serum C-reactive protein (CRP) levels and white blood cell (WBC) counts were measured after amniocentesis. Amniotic fluid (AF) obtained by amniocentesis was cultured, and interleukin-6 (IL-6) levels and WBC counts were determined. The primary outcome measure was histologic chorioamnionitis. RESULTS: Risk scores based on serum CRP concentrations and gestational age (model 1) were calculated for each patient. The model was shown to have adequate goodness of fit and an area under the receiver operating characteristic curve (AUC) of 0.742. When including AF test results (e.g., AF IL-6 levels) in model 1, serum CRP concentrations were found to be insignificant, and thus, were excluded from model 2, comprising AF IL-6 levels and gestational age. No significant difference in AUC was found between models 1 and 2. CONCLUSION: For women with PPROM, the newly developed model incorporating non-invasive parameters (serum CRP and gestational age) was moderately predictive of histologic chorioamnionitis. The inclusion of invasive test results added no predictive information to the model in this setting.
Adult ; *Amniocentesis ; Amniotic Fluid/*cytology/microbiology ; C-Reactive Protein/*metabolism ; Chorioamnionitis/blood/*diagnosis/metabolism ; Cohort Studies ; Female ; Fetal Membranes, Premature Rupture/*blood ; *Gestational Age ; Humans ; Infant, Newborn ; Interleukin-6/blood ; Leukocyte Count ; Predictive Value of Tests ; Pregnancy ; ROC Curve ; Retrospective Studies ; Sensitivity and Specificity

A hepatodiaphragmatic interposition of the small or large intestine, which is known as Chilaiditi's syndrome, is generally asymptomatic and rarely requires surgical intervention. However, it can be associated with symptoms ranging from mild abdominal pain to a severe complicated intestinal obstruction. We report a case of Chilaiditi's syndrome associated with an ileal obstruction. A 69 year-old female patient presented with abdominal pain, vomiting and an abdominal distension. The abdominal CT and upper endoscopy findings showed an intestinal obstruction and gastric cancer, requiring surgery.
Abdominal Pain ; Aged ; Chilaiditi Syndrome* ; Endoscopy ; Female ; Humans ; Ileum* ; Intestinal Obstruction* ; Intestine, Large ; Stomach Neoplasms ; Tomography, X-Ray Computed ; Vomiting

Merkel cell carcinoma (MCC) is an uncommon but potentially aggressive neuroendocrine carcinoma of the skin. It typically develops on sun-exposed areas of the head and neck, particularly the eyelid, periorbital region, and extremities. We report a case of unusually located MCC, presenting as a conjunctival mass, which has only been reported once in the English literature. An 83-year-old male presented with a 0.8 x 0.7 cm sized mass protruding from the lower fornix of the right conjunctiva. The mass was excised. The tumor was located in the submucosa without connection to the overlying mucosa. Light microscopic findings showed a carcinoma with undifferentiated small round cells and the presence of cytokeratin (CK AE1/3, CK7) and neuroendocrine markers. We established a diagnosis of MCC. As reported in the literature, the majority of MCCs are positive for CK20 but negative for CK7. But, this case showed an uncommon cytokeratin immunohistochemical profile of positive for CK7 and negative for CK20, suggesting a new immunophenotypic MCC variant.
Aged, 80 and over ; Carcinoma, Merkel Cell ; Carcinoma, Neuroendocrine ; Conjunctiva ; Extremities ; Eyelids ; Head ; Humans ; Keratins ; Light ; Male ; Mucous Membrane ; Neck ; Neuroendocrine Tumors ; Skin

PURPOSE: To describe the status of the laboratory facilities, equipment and expenses for practice in a four-year nursing schools and to analyze mandatory requirements for laboratory facilities and equipment. METHOD: A descriptive survey research design was used. The participants were 49 of the 4-year nursing schools across the nation. The data were collected by e-mail. The return rate for questionnaires was 63.3% (n=31). RESULT: In 2001 the total expenses for laboratory practice were 21,865,230 won and the average per student was 102,418 won. Types of laboratories included single and complex. The mean size for laboratories was 318.7 m2 and mean size for laboratories for fundamental nursing was 161.1 m2. The range for number of students in a laboratory class was 20-30 for eight universities (30.8%). Among required laboratory equipment, items that were deficient in 50% in the universities were mercury and aneroid sphygmomanometers for children, electronic sphygmomanometers, Bell type fetal stetho- scopes, sheepskin, beds for children, for gynecology, and electronic hilo beds. Among the elective equipment, items that were deficient in 50% of the universities were O2 tents, Blackmore tubes, retractors, hot-water supply, and incentive spirometers. The number of items that needed to add to the equipment were 10 for required equipment and 22 for elective equipment. CONCLUSION: A standardized mandatory list of equipment for laboratory facilities and expenses for practice in 4-year nursing schools needs to be developed.
Child ; Electronic Mail ; Gynecology ; Humans ; Motivation ; Nursing* ; Research Design ; Schools, Nursing* ; Sphygmomanometers ; Surveys and Questionnaires

Surgical treatment for afferent loop syndrome (ALS) in patients with recurrent gastric cancer is usually not feasible because of the recurrent tumor mass at the anastomosis site and/or extensive carcinomatosis resulting in bowel loop fixation. Furthermore, ALS usually makes oral intake impossible, resulting in a rapid deterioration in general condition. In this situation, gastroscopic stenting at the anastomotic site and/or percutaneous external drainage may be a more feasible alternative for palliation. We herein report a recurrent gastric cancer whose ALS was successfully treated with internal and external drainage procedures.
Afferent Loop Syndrome* ; Carcinoma ; Drainage* ; Humans ; Stents* ; Stomach Neoplasms*

Asthma is a common medical syndrome which significantly increases the morbidity and mortality of surgical and anesthetic procedures. The anesthesiologist should be closely involved in the preoperative assessment and Prep-aration of these patients for, surgery and anesthesia and should be continually aware of the possibility of bronchospasm. The safe clinical management of this challenging population group demands not only expertise in carefully planning an anesthetic technique best suited to an individual patient and his specific disease process. We reported a case of bronchospasm after injection of neostigmine intravenously in 34-rear old female patient during endotracheal general inhalation anesthesia, together with brief of review of literature.
Anesthesia ; Anesthesia, Inhalation ; Asthma ; Bronchial Spasm* ; Female ; Humans ; Mortality ; Neostigmine* ; Population Groups