OBJECTS: Thls study was designed to assess muscle tensions while working at a YDT workstation with surface electromyography (SEMG). METHODS: Variables texted were desk height, monitor positon on the desk, distance from edge of the desk to the keyboard. Eleven female volunteers working in the tele-com munication company were seated at an ergonomically adjusted workstation. They were assigned to a task of typing for 5 minutes and were given a 10 minutes resting with hands in their lap. For the initial experiment, the desk height was fixed to standard desk height(65.0 cm) recommended by ANSI and latter adjusted to a higher desk height (72.8 cm) for this study such that the subjects experienced slight elevation of shoulders. The monitor position initially at the center on the desk and latter left site of the desk (45o from monitorneck axles). The keyboard was positioned to an optimal distance (15 cm from the desk edge) and an abnormal distance (30 cm). Five muscle groups (paraspinal muscles, upper trapezium muscle, supraspinatus muscle, infraspinatus muscle, and rhomboid muscle) were selected for the study. The data of SEMG were analyzed by 2x2x2xs mixed factorial design. RESULTS: The results were as follows: 1. SEMG activity recorded from the paraspinal muscles were significantly higher when the angle of the monitor adjusted to 45 degree from the center of the desk.. 2. SEMG activity recorded from the upper trapezius/supraspinatus/infraspinatus muscles were significantly higher when the hight of the desk was elevated from the recommended height.3. SEMG activity from the rhomboid muscle showed no significantiy difference in all test conditions. CONCLUSIONS: The results of thls study confirm that the helght of a VDT workstation and the angle of the monitor are risk factors of upper extremity cumulative trauma disorders. Also SEMG would be useful for measuring muscle activities during workstation assessment.
Cumulative Trauma Disorders ; Electromyography* ; Female ; Hand ; Humans ; Muscles ; Paraspinal Muscles ; Risk Factors ; Shoulder ; Upper Extremity ; Volunteers

PURPOSE: The study was to get basic data on the well-being of middle-aged people concerning their preparation for their upcoming old age and their quality of life. METHODS: The subjects were 440 people aged between 40 and 59 living in Seoul and Gyeonggi-do. RESULTS: First, physical preparation for old age was affected by religion, children, health, monthly income, and economical status, and these factors were shown statistically significant. Emotional preparation and spiritual preparation were also related to the above-mentioned factors. Secondly, in the subjects' mental picture, a nursing home was a place for the aged without anyone who is going to take care of them and without abilities to care of themselves. Preference for nursing home was based on two factors, i.e., nursing and treatment care, and the cost was about one million won per month. Also they wanted that the government should pay a certain amount for private users. CONCLUSION: Therefore, people should lead a life of good health-related habits along with economical preparation for their old age.
Child ; Gyeonggi-do ; Humans ; Long-Term Care* ; Nursing ; Nursing Homes ; Quality of Life ; Seoul

OBJECTIVES: Our purpose was 1) to determine whether elevated maternal serum alpha- fetoprotein(MSAFP) predict increased risk of spontaneous preterm delivery and indicated preterm delivery; 2) to determine whether elevated maternal serum human chorionic gonadotropin(MSHCG) predict increased risk of preterm delivery. Methods: Between September 1995 and April 1998, 945 of 2105 pregnant women who received midtrimester MSAFP screening were identified and evaluated. 81 women with MSAFP levels of 2.0 MoM or more were included in the study group while 864 women with levels less than 2.0 MoM served as controls. Pregnancy outcome were obtained from hospital records and statistical analysis were performed. RESULTS: Women with elevated MSAFP levels showed an increased risk for preterm delivery(p<0.05), fetal growth restriction(p<0.05) and hypertensive disorders(p<0.05), but not for preterm premature rupture of membrane, fetal death in utero. There was a strong association between unexplained elevated MSAFP levels and spontaneous preterm delivery(p<0.05) but our study does not support an association between unexplained elevated MSAFP levels and indicated preterm delivery. There was no association between elevated MSHCG levels and preterm delivery regardless of MSAFP levels. CONCLUSION: We concluded that unexplained elevated levels of midtrimester MSAFP were associated with an elevated risk of spontaneous preterm delivery but not with a risk of indicated preterm delivery. Elevated MSHCG levels were not associated with a risk of preterm delivery and spontaneous preterm birth.
alpha-Fetoproteins* ; Chorion ; Extraembryonic Membranes ; Female ; Fetal Development ; Hospital Records ; Humans ; Mass Screening ; Obstetric Labor, Premature ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, Second* ; Pregnant Women ; Premature Birth* ; Rupture

OBJECTIVES: To compare the diagnostic and prognostic performance of amniotic fluid white blood cell(AF WBC) count and amniotic fluid culture for the prenatal diagnosis of intrauterine infection and the prediction of neonatal outcomes in patients with preterm labor and intact membranes. Methods: Amniocentesis was performed in 75 patients with preterm labor and intact membranes, who delivered preterm neonates within 72 hours after amniocentesis. AF WBC was determined and amniotic fluid was cultured for aerobic and anaerobic bacteria as well as mycoplasma. The relations among placental histologic findings, perinatal outcome, AF WBC count, and AF culture were examined. Student t test, Mann Whitney U test, lamda2 test, Fisher's exact test, modified t test, and logistic regression analysis were used for statistical analysis. RESULTS: Microbial invasion of the amniotic fluid was more frequent in the patients with histologic chorioamnionitis than patients without histologic chorioamnionitis (28.9% vs 5.4%, p<0.05), and patients with histologic chorioamnionitis had significantly higher amniotic fluid white blood cell counts than those patients without such lesion (median 99, range 0-3024 cells/mm3 vs median 1, range 0-180 cells/mm3, p<0.01). Amniotic fluid white blood cell count (> or = 50cell/mm3) had a sensitivity of 55.3%(21/38) and a specificity of 94.6%(35/37) for the diagnosis of histologic chorioamnionitis and a sensitivity of 47.5%(19/40) and specificity of 90.9%(30/33) for the prediction of significant neonatal morbidity (defined as neonatal sepsis, respiratory distress syndrome, pneumonia, intraventricular hemorrhage, bronchopulmonary dysplasia, or necrotizing enterocolitis). These sensitivities were significantly higher than those of amniotic fluid culture (for histologic chorioamnionitis, 55.3% vs 28.9% ; for significant neonatal morbidity, 47.5% vs 25.0%, p<0.01 for each). CONCLUSION: Amniotic fluid WBC count is a more sensitive test for the prenatal diagnosis of intrauterine infection and for the prediction of significant neonatal morbidity than amniotic fluid culture in the patients with preterm labor and intact membranes.
Amniocentesis ; Amniotic Fluid* ; Bacteria, Anaerobic ; Bronchopulmonary Dysplasia ; Chorioamnionitis ; Diagnosis ; Female ; Hemorrhage ; Humans ; Infant, Newborn ; Leukocyte Count* ; Leukocytes* ; Logistic Models ; Membranes* ; Mycoplasma ; Obstetric Labor, Premature* ; Pneumonia ; Pregnancy ; Prenatal Diagnosis* ; Sensitivity and Specificity ; Sepsis

PURPOSE: This study was to develop the clinical competency evaluation, and to examine the effects of the developed evaluation by comparing it with existing evaluation on clinical competency, communication skill, and self-efficacy of nursing students. METHODS: Design was a randomized control group post-test design. The subjects were 102 senior nursing students(Experimental group: 48, Control group: 54) at K university in seoul, Korea. The experimental group took the clinical competency evaluation using standardized patients and the control group took the existing evaluation using a doll. The clinical competency and communication skills were measured by evaluators, and self-efficacy was self reported by the nursing students. RESULTS: The experimental group had higher scores in clinical competency, communication skills, and self-efficacy than those in the control group. CONCLUSION: Through these results, practice education of nursing education programs need to activate the clinical competency evaluation using standardized patients.
Education, Nursing ; Humans ; Korea ; Self Report ; Students, Nursing

The dispatch life support(DLS) copes with the emergent situations with the pre-arrival instructions. The instructions are made based on the logical branch which simulates and reflects the knowledge and decision processes of the emergency medical dispatcher. The present practice of the emergency fire-fighting offices in our country is such that the identification of the emergency caller and other administrative affairs are principal, and there is not any systematic standard medical instruction by use of communications system. The emergency medical system(EMS) is defined as the integrated system which can provide the emergency patients with the proper supports with a timely manner and it is essential to construct the emergency medical communication system which connects the patient with all the people involved in the situation. This study focuses on development of the basic DLS model in the emergency communication model. The model comprises of the systematic and standard instructions which can be used for the recovery of the emergency patient. 32 AMPDS, one items of the Heart! Respiratory Arrest are selected, and the communication treatment protocols are prepared for development of DSL model for this items. The DSL will help the communications between the patients and emergency medical dispatchers, and will make the medical dispatcher control the situation by providing a patient with medical instructions before his arrival.
Clinical Protocols ; Emergencies* ; Heart ; Humans ; Logic

The carcinoid tumor of the ampulla of Vater is extremely rare. We report a case of 57-year old male with carcinoid tumor of ampulla of Vater. This patient had been presented with bronchial asthma for one year. Abdominal CT finding revealed diffuse dilatation of common bile duct and pancreatic duct, and also ampullary soft mass protruded into duodenal lumen. The correct diagnosis was made preoperatively by endoscopic retrograde cholangiography with biopsy. Pancreatico- duodenectomy with lymph nodes dissection was performed. Malignant carcinoid tumor originating from ampulla of Vater was diagnosed with pericholedochal lymphatic metastasis. Surgical removal led to complete resolution of asthmatic symptoms.
Ampulla of Vater* ; Asthma ; Biopsy ; Carcinoid Tumor* ; Cholangiography ; Common Bile Duct ; Diabetes Mellitus ; Diagnosis ; Dilatation ; Humans ; Insulin Resistance ; Lymph Nodes ; Lymphatic Metastasis ; Male ; Middle Aged ; Obesity ; Pancreatic Ducts ; Polymerase Chain Reaction ; PPAR gamma ; Tomography, X-Ray Computed

PURPOSE: In this study differences in levels of performance and importance of nursing jobs were explored in relation to levels of work experience. METHOD: The sample was chosen by convenient sampling (N=363) and a cross-sectional study design was used. Frequencies and percentages were used for descriptive statistics. ANOVA was utilized to examine differences in performance and importance of nursing jobs among three groups of nurses, divided based on levels of work experience (less than 1 year, 1 to 4 years, and 5 or more years). RESULTS: Regarding performance of nursing jobs, novice nurses provided more support for patients, but provided less assessment of patients (i.e., investigation of levels of nutrition and exercise, and observation of verbal, and non-verbal behavior, and levels of cognition). Regarding the importance of nursing jobs, nursing linked to exercise and activities, and post-operative and excretion care were considered to be less important among novice nurses than among experienced nurses. CONCLUSION: Different training programs should be developed and provided to nurses according to levels of work experience. By doing so, it will be feasible to minimize differences in quality of nursing care triggered by different levels of work experience.
Cross-Sectional Studies ; Employee Performance Appraisal ; Hospitals, General ; Humans ; Nursing Care ; Nursing Staff

BACKGROUND AND OBJECTIVES: There are several factors affecting the result of the ossiculoplasty such as the severity of the pathology, the operating technique and the reconstruction material, etc. So far, most of the ossicular materials that have been developed were not perfect and some of the commercialized materials are not suitable for Koreans. We investigated the dimensions of the Korean ossicles and the space between the handle of the malleus and the plane of the stapes in order to standardize the artificial ossicles to fit Koreans. MATERIALS AND METHODS: Sixteen cadaveric Korean temporal bones which did not have any pathology of tympanic membrane and ossicles were used for this study. We dissected the temporal bones and measured the related dimensions of ossicles under a surgical microscope. RESULTS: The dimensions of the part of ossicles are as follows: (1) length (mm),1) malleus head 3.46+/-0.57, neck 0.91+/-0.17, handle 4.40+/-0.29: 2) incus short process 2.42+/-0.35, long process 3.31+/-0.57: 3) stapes head and neck 0.79+/-0.19, height of crura 2.24+/-0.34: (2) diameter (long, short) (mm), stapes head 0.95+/-0.20, 0.73+/-0.11, footplate 2.91+/-0.20, 1.38+/-0.16. The distance between the stapes head and the malleus handle was 3+/-0.3 mm, and between the stapes footplate and the malleus handle 5.1+/-0.4 mm. The angle between a line from the malleus handle to the head of stapes and a perpendicular line of stapes footplate passing the center of stapes head was 29+/-7 degree. The angle between a line from the malleus handle to the stapes footplate and a perpendicular line of stapes footplate passing the center of stapes head was 17+/-5 degree. CONCLUSION: We collected normal data of dimensions of the Korean ossicles from cadaveric temporal bones. The differences in the dimensions between ossicles of the Korean and the non-Koreans were observed. The observed data from this study should be useful in the development of the artificial ossicular materials suitable for the Koreans.
Cadaver ; Head ; Incus ; Malleus ; Neck ; Pathology ; Stapes ; Temporal Bone ; Tympanic Membrane

Situs ambiguous is rare congenital anomaly in adults. In 2 adult patients who admitted for different cardiac problems, situs ambiguous with polysplenia was detected. A 42-year-old male admitted for radio frequent catheter ablation of atrial fibrillation, and he had left-sided inferior vena cava (IVC), hepatic segment of IVC interruption with hemiazygos continuation, multiple spleens and intestinal malrotation. And in a 52-year-old female case who was hospitalized due to infective endocarditis after implanting pacemaker for sick sinus syndrome, multiple spleens, left-sided stomach, bilateral liver with midline gallbladder, and left-sided IVC were found. Those findings were consistent with situs ambiguous with polysplenia, but their features were distinctive.
Adult ; Atrial Fibrillation ; Catheter Ablation ; Endocarditis ; Female ; Gallbladder ; Heterotaxy Syndrome ; Humans ; Liver ; Male ; Middle Aged ; Sick Sinus Syndrome ; Spleen ; Stomach ; Vena Cava, Inferior