No abstract available.
HIV* ; Humans*

The purpose of this study was to identify the effect of individual emotional characteristics (empathetic concern and emotional contagion) on emotional labor (frequency of emotional display, intensity and variety of emotional display, surface acting, and deep acting) of school dietitians. Data was collected through a questionnaire survey of 309 school dietitians and then analyzed statistically by SPSS 18.0 package program. The results of this study were as follows: empathetic concern (3.93) occurred more often than emotional contagion (3.22) in school dietitians. The older (p < 0.001) and more experienced (p < 0.01) they were, the higher empathetic concern they had. It showed that married dieticians (p < 0.001), nutrition teachers (p < 0.01), and dieticians who were working in elementary schools (p < 0.01) had a higher rate of empathetic concern than single dieticians, non-nutrition teachers, and dieticians who were working in middle and high schools, respectively. Their level of emotional labor was the highest in deep acting (3.32), followed by surface acting (3.28), frequency (3.12), intensity and variety (3.09). According to multiple regression analysis, emotional contagion proved to be strongly significant and positively related to frequency of emotional display (beta = 0.257, p < 0.001). Both empathetic concern (beta = 0.117, p < 0.05) and emotional contagion (beta = 0.162, p < 0.01) were positively related to intensity and variety of emotional display, and empathetic concern (beta = 0.173, p < 0.01) had also an effect on deep acting. These results suggested that the emotional labor of school dietitians should be managed on the organizational viewpoint, not a personal matter.
Humans ; Surveys and Questionnaires

BACKGROUND: Perioperative noxious stimuli and inflammation may induce peripheral and central sensitization. Together, these changes contribute to the state of postinjury pain hypersensitivity found postoperatively. Preemptive analgesia may prevent nociceptive inputs generated during surgery from sensitizing central neurones and may therefore, reduce postoperative pain. We studied whether or not intravenous meperidine infusion before induction could affect postoperative pain and analgesic consumption when compared with intravenous meperidine infusion at peritoneum closure. METHODS: Female patients scheduled for cesarean section were randomly assigned to one of two groups for prospective study. Group I (n=10) received intravenous meperidine (0.5 mg/kg) 5 minutes before induction of anesthesia and group II (n=10) received the same treatment at peritoneal closure. Both groups had a continuous infusion of meperidine (5 mg/hr) immediately after intravenous bolus meperidine. Postoperative pain relief was provided with intravenous meperidine from a PCA system (Walkmed , Medex, USA). Postoperative visual analogue pain scores (VAS), meperidine consumption and side effects were examined and compared between the groups for two postoperative days. RESULTS: At two hours post surgery VAS at rest were below 3 in both groups and were not statistically significant. VAS on motion were slightly higher than VAS at rest in both groups and were not statistically significant. There was no significant difference in meperidine consumption. There were minor side effects such as nausea, somnolence, dizziness and pruritus, but no patients needed any treatment and all of them were satisfied. CONCLUSION: Preemptive or postincisional intravenous PCA with meperidine was equally effective for postoperative analgesia after cesarean section, with minor side effects. These results suggested that there was no reason for applying preemptive analgesia for cesarean section patients. Further studies will be needed to evaluate preemptive effects of intravenous meperidine or other analgesics in cesarean section patients.
Analgesia* ; Analgesics ; Anesthesia ; Central Nervous System Sensitization ; Cesarean Section* ; Dizziness ; Female ; Humans ; Hypersensitivity ; Inflammation ; Meperidine* ; Nausea ; Neurons ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Peritoneum ; Pregnancy ; Prospective Studies ; Pruritus

Medical license is to qualify a person for medical practice and to attribute him/her a privileged right in the practice. This privileged and exclusive right asks for protection from the side of a state and the state in turn needs qualified medical personnel in order to carry out her task of public health, one of the main duties of modern states. In Europe, physicians succeeded in obtaining medical license that guarantees the privileged right in a highly competitive medical market against other practitioners. The first regulation for medical license in Korea was made in 1900 when few Korean doctors trained in Western medicine was in practice. The regulation aimed at controlling traditional medical practitioners who had been practicing medicine without any qualification as a physician. The regulation was very brief, consisting of only seven articles. A newly revised regulation appeared in 1913 when Korea was under the occupation of Japan. The Japanese Government-General enacted a series of regulations about medical personnel, including dentists and traditional medical practitioners. This heralds its full-scale engagement in medical affaires in Korea. Unlike the case of European countries where medical license was obtained after a long struggle with other practitioners, in Korea, medical license was given to doctors too easily from the state. And this experience played a very important role in the formation of identity of Korean doctors.
English Abstract ; History of Medicine, 20th Cent. ; Korea ; Licensure, Medical/*history

BACKGROUND: It is difficult to manage intractable pain from advanced carcinoma of the upper abdomen. One method used to control pain associated with these malignancies is to block the splanchnic nerve. We investigated that VAS (visual analogue scale) difference before and after splanchnic nerve block (SNB) and pain relief day. Also we studied relationship between VAS before SNB and pain relief day. METHODS: A rewiew of 70 patients who took splanchnic nerve block (SNB) from September 1994 to February 1998 was carried out to assess age, sex, primary diseases, pain sites, VAS before and after SNB, date of diagnosis, date of SNB, date of death and pain relief day, etc. RESULTS: Of 70 patients, 44 were males and the remaining 26 were females. The causes of pain were stomach cancer 28 (40%), pancreatic cancer 18 (25%), gall bladder cancer 7 (10%), hepatoma 6 (8.6%) respcectively. Average day from diagnosis to SNB was 272 and average day from diagnosis to death was 341. So, patients died on the average 69 days after they took the splanchnic nerve block in pain clinic. VAS average before SNB was 8.01 and VAS average after SNB was 3.64. Patients felt pain relief during 35 days after SNB. Pain relief day of patients who had lower VAS before SNB was longer than that of patients who had higher VAS before SNB. CONCLUSION: Early application of splanchnic nerve block will make the patients endure the cancer pain more easily.
Abdomen ; Carcinoma, Hepatocellular ; Diagnosis ; Female ; Gallbladder Neoplasms ; Humans ; Male ; Pain Clinics ; Pain, Intractable ; Pancreatic Neoplasms ; Splanchnic Nerves* ; Stomach Neoplasms

PURPOSE: It is difficult at times to differentiate between a papillary carcinoma and benign papilloma of the breast, and papillomas can undergo malignant transformation. The authors investigated the expression of cyclin D1 and MIB-1 to assess the diagnostic value of these markers in distinguishing papillary carcinomas from papillomas of the breast, and in determining the clinical relevance of these markers as prognostic predictors. METHODS: The medical records of 38 patients treated for benign and malignant papillary lesions of the breast at Inje University Pusan Paik Hospital between January 1992 and December 1997 were reviewed. Immunohistochemical stains for cyclin D1 and MIB-1 were performed in 30 cases of papilloma and eight cases of papillary carcinoma of the breast. The authors performed a statistical analysis of the relationship between cyclin D1 and MIB-1 with respect to the size of tumors, pathologic lymph nodes, and postsurgical residual lesions, and the recurrence and survival rates. RESULTS: Breast cancer or ADH was associated with six cases (15.79%) of papillary lesions of the breast. The incidence of postsurgical residual lesions and their recurrence were 2.63% and 2.63% in all the patients with papillary lesions of the breast. The labeling index of cyclin D1 was significantly higher in the eight papillary carcinomas (36.7+/-27.0) than in the 30 papillomas (3.5+/-4.2) (P=0.001). There was a statistically significant difference betweenn the MIB-1 labeling index of the eight papillary carcinomas (4.9+/-5.9) and that of the 30 papillomas (0.4+/-1.4) (P=0.0225). The cyclin D1 and MIB-1 expressions of the single intraductalpapillomas and multiple papillomas were not different. In addition, there was no statistically significant difference of cyclin D1 and MIB-1 in the eight papillary carcinomas with respect to the associated pathologies, size, positive lymph nodes, recurrence or survival. CONCLUSION: These results suggest that cyclin D1 and MIB-1 might be useful markers for distinguishing papillary carcinomas from papillomas of the breast.
Breast Neoplasms ; Breast* ; Busan ; Carcinoma, Papillary ; Coloring Agents ; Cyclin D1 ; Cyclins* ; Humans ; Incidence ; Lymph Nodes ; Medical Records ; Papilloma ; Pathology ; Recurrence ; Survival Rate

PURPOSE: It is difficult at times to differentiate between a papillary carcinoma and benign papilloma of the breast, and papillomas can undergo malignant transformation. The authors investigated the expression of cyclin D1 and MIB-1 to assess the diagnostic value of these markers in distinguishing papillary carcinomas from papillomas of the breast, and in determining the clinical relevance of these markers as prognostic predictors. METHODS: The medical records of 38 patients treated for benign and malignant papillary lesions of the breast at Inje University Pusan Paik Hospital between January 1992 and December 1997 were reviewed. Immunohistochemical stains for cyclin D1 and MIB-1 were performed in 30 cases of papilloma and eight cases of papillary carcinoma of the breast. The authors performed a statistical analysis of the relationship between cyclin D1 and MIB-1 with respect to the size of tumors, pathologic lymph nodes, and postsurgical residual lesions, and the recurrence and survival rates. RESULTS: Breast cancer or ADH was associated with six cases (15.79%) of papillary lesions of the breast. The incidence of postsurgical residual lesions and their recurrence were 2.63% and 2.63% in all the patients with papillary lesions of the breast. The labeling index of cyclin D1 was significantly higher in the eight papillary carcinomas (36.7+/-27.0) than in the 30 papillomas (3.5+/-4.2) (P=0.001). There was a statistically significant difference betweenn the MIB-1 labeling index of the eight papillary carcinomas (4.9+/-5.9) and that of the 30 papillomas (0.4+/-1.4) (P=0.0225). The cyclin D1 and MIB-1 expressions of the single intraductal papillomas and multiple papillomas were not different. In addition, there was no statistically significant difference of cyclin D1 and MIB-1 in the eight papillary carcinomas with respect to the associated pathologies, size, positive lymph nodes, recurrence or survival. CONCLUSION: These results suggest that cyclin D1 and MIB-1 might be useful markers for distinguishing papillary carcinomas from papillomas of the breast.
Breast Neoplasms ; Breast* ; Busan ; Carcinoma, Papillary ; Coloring Agents ; Cyclin D1 ; Cyclins* ; Humans ; Incidence ; Lymph Nodes ; Medical Records ; Papilloma ; Papilloma, Intraductal ; Pathology ; Recurrence ; Survival Rate

PURPOSE: Cancer is a genetic disease caused by alterations in key regulators of cell growth and cell turnover. We investigated apoptotic cell death and cell proliferation in gastric adenomas and adenocarcinomas. MATERIALS AND METHODS: The TdT-mediated dUTP-biotin nick end labelling (TUNEL) method and immunohistochemistry for Ki-67 were performed, using paraffin-embedded tissues of 41 gastric adenomas and 100 gastric adenocarcinomas. These results were compared with histopathologic parameters. RESULTS: The Ki-67 labelling index was higher in adenocarcinomas than in adenomas and the apoptotic index was higher in adenomas than in adenocarcinomas. There were no significant difference between the apoptotic index/Ki-67 labelling index and clinicopathological parameters. CONCLUSION: We propose that cell proliferation is more closely associated with gastric adenocarcinomas than apoptosis is, but that neither has any clinical significance as a prognostic factor in gastric adenocarcinomas.
Adenocarcinoma* ; Adenoma* ; Apoptosis* ; Cell Death ; Cell Proliferation* ; Immunohistochemistry

This study was performed to observe the changes of glucose-related hormones and the morphological change including ultrastructure of the pancreatic islets in the male Otsuka Long-Evans Tokushima Fatty rat. Area under the curve (AUC) of glucose at the 30th (709 +/- 73 mg.h/dL) and at the 40th week (746 +/- 87 mg.h/ dL) of age were significantly higher than that at the 10th week (360 +/- 25 mg.h/ dL). AUC of insulin of the 10th week was 2.4 +/- 0.9 ng.h/mL, increased gradually to 10.8 +/- 8.3 ng.h/mL at the 30th week, and decreased to 1.8 +/- 1.2 ng.h/mL at the 40th week. The size of islet was increased at 20th week of age and the distribution of peripheral alpha cells and central beta cells at the 10th and 20th weeks was changed to a mixed pattern at the 40th week. On electron microscopic examination, beta cells at the 20th week showed many immature secretory granules, increased mitochondria, and hypertrophied Golgi complex and endoplasmic reticulum. At the 40th week, beta cell contained scanty intracellular organelles and secretory granules and apoptosis of acinar cell was observed. In conclusion, as diabetes progressed, increased secretion of insulin was accompanied by increases in size of islets and number of beta-cells in male OLETF rats showing obese type 2 diabetes. However, these compensatory changes could not overcome the requirement of insulin according to the continuous hyperglycemia after development of diabetes.
Animals ; Body Weight ; Diabetes Mellitus, Type 2/*metabolism/pathology ; Disease Models, Animal ; Glucagon/*metabolism ; Insulin/*metabolism ; Islets of Langerhans/*metabolism/pathology/ultrastructure ; Male ; Rats ; Rats, Inbred OLETF

BACKGROUND: It is well known that growth hormone (GH) stimulates animal growth, but studies on metabolic effects of growth hormone have recently been increasing. The purpose of this study was to clarify the effects of growth hormone treatment on body composition and glucose metabolism in hypophysectomized growth hormone-deficient rats. METHODS: The 20-week-old rnale Sprague-Dawley rats were hypophysectomized and replaced with cortisol and thyroxine for 8 weeks, then administered with recombinant human growth hormone for 2 weeks. Group 1 consisted of intact controls (n 15), while group 2 consisted of hypophysectomized controls (n 12), and group three consisted of those with GH treatment (n 13). The body weights, body composition, blood glucose levels, plasma insulin-like growth factor-I (IGF-I) levels, euglycemic hyperinsulinemic clamp test, and glycogen synthase activities in gastrocnemius muscle were measured before and after growth hormone treatment. RESULTS: Plasma IGF-I levels in GH-treated group increased to intact control group levels after 2 weeks of GH treatment. There were significant changes in body composition after the treatment (fat mass significantly decreased and lean body mass significantly increased). There were no changes in glucose metabolism in peripheral tissue after 2 weeks of GH treatment. CONCLUSION: Human GH treatment (4 IU/kg/day) in adult hypophysectomized GH-deficient rats changed the body composition, but did not alter the glucose metabolism in peripheral tissue.
Adult* ; Animals ; Blood Glucose ; Body Composition* ; Body Weight ; Glucose* ; Glycogen Synthase ; Growth Hormone* ; Human Growth Hormone ; Humans ; Hydrocortisone ; Insulin-Like Growth Factor I ; Metabolism* ; Muscle, Skeletal ; Plasma ; Rats* ; Rats, Sprague-Dawley ; Thyroxine