Keloids are abnormally healed skin wounds that develop in the subpapillary layer of the dermis. They are a lesion with wide, raised and deep scars. They exceed the original dimensions of the wound and grow mounds upon mounds of collagen in a pseudotumor fashion. Their treatment may take several forms such as surgery, intralesional injection of steroid, compression, superficial irradiation, and combination therapy. However, absolute method is nothing until now. Recently, the cryosurgery shows relatively good effect in treatment, so we tried the clinical experience with cryosurgery in the treatment of keloids. Material and methods: During the past 2 years, we treated 20 individuals of the keloids with severe itching and pain. The age ranged from 5 to 45 years old. Only 6 cases were biopsied before and after cryotherapy. The cryosurgery set we used was Toitu model CR 201 N₂O gas (tip temperature in ­80℃) and was applied directly on the lesion about 4 to 5 minutes with slight compression. After cryosurgery in keloids, the following results were obtained: 1. It is both quick and easy method. 2. It is causes little or no pain and no loss of blood. 3. Integumentary normalization is rapid. The new scar tissue is smaller, and more elastic and soft. 4. The pain, itching and paresthesia commonly associated with keloid is usually disappeared. 5. Other treatment can be used after cryosurgery. 6. Histologic picture after cryosurgery is similar with the result of steroid injection. 7. The mechanism of the cryosurgery in keloids is the result of the direct tissue destroying action and cryoimmunologic reaction.
Cicatrix ; Collagen ; Cryosurgery* ; Cryotherapy ; Dermis ; Injections, Intralesional ; Keloid* ; Methods ; Paresthesia ; Pruritus ; Skin ; Wounds and Injuries

A research survey was conducted on 112 nursing educational institutes with three year associate and four ear baccalaureate programs and 36 institutes with master programs to determine the status of computer and informatics education in Korea. Seventy-seven(68.8%) of the 112 schools with associate and baccalaureate programs responded and 20(55.6%) of 36 schools with master program responded. Out of 77 institutions only 16 schools indicated that Nursing Informatics was offered as a separate course. It was taught mostly to the first year or the second year students and number of credits ranged from 1 to 3 while 2 credit being the most popular one. Further analysis of the syllabus indicated that the contents covered by different schools varied from school to school. They were computer basics, internet and communication, application program, the concept and the elements of the nursing informatics, utilization of nursing informatics in nursing practice, education, research, and administration, and health information system. Sixty schools out of 77 addressed computer related subjects in their curriculum. Computer related subjects were taught mostly to the first year students as a 2 credits class. Contents covered in computer related subjects were computer basics, internet and communication, and application program. Strategies for the implementation of nursing informatics in nursing education and exemplary programs are presented based on the findings.
Academies and Institutes ; Curriculum ; Ear ; Education* ; Education, Nursing ; Health Information Systems ; Humans ; Informatics ; Internet ; Korea* ; Nursing Informatics* ; Nursing*

No abstract available.
Blood Platelets* ; Cardiopulmonary Bypass*

No abstract available.
Fistula*

Collision tumors of the colon are rare. A 54-year-old man was referred to our hospital for the evaluation of hematochezia. Colonoscopy demonstrated the presence of about 3 cm sized mass in the rectosigmoid junction. After surgical resection, the colonic lesion was histologically composed of two discrete lesions: adenocarcinoma in the superficial layer and poorly differentiated neuroendocrine carcinoma in the deeper layer. We report this case of colonic collision tumor (adenocarcinoma and neuroendocrine carcinoma) with a review of the literature.
Adenocarcinoma/*diagnosis/pathology ; Antigens, CD/metabolism ; Antigens, Differentiation, T-Lymphocyte/metabolism ; Carcinoma, Neuroendocrine/*diagnosis/pathology ; Colonic Neoplasms/*diagnosis/pathology ; Colonoscopy ; Humans ; Male ; Middle Aged ; Positron-Emission Tomography and Computed Tomography ; Synaptophysin/metabolism ; Tomography, X-Ray Computed

OBJECTIVES: The purpose of this study is to investigate the clinical significance of activity of daily living(ADL) and to identify the influencing factors on ADL in elderly patients admitted to the hospital-based acute geriatric care unit. METHODS: We studied a total of 279 patients aged 65 years and older who admitted to the Acute Elderly Care Unit at Seoul National University Bundang Hospital between May, 2004 and April, 2005. Comprehensive geriatric assessment including medical, psychosocial and functional evaluation was performed by the geriatric team. RESULTS: Most of the patients need ADL(62.7%) and IADL(68.8%) assistance. Dependent ADL patients were older (p<0.01), admitted via emergency room(p<0.01), demented(p<0.01), and associated with depression(p<0.01), malnutrition(p<0.01), and stroke(p<0.05) compared to independent ADL group. The length of stay was also significantly increased in dependent ADL group(p<0.01) and six-month mortality rate was higher in dependent ADL group(p<0.01). In correlation analysis, MMSE-KC score(r=0.708, p<0.01), nutritional state(r=0.581, p<0.01), the length of stay(r=-0.433, p<0.01), depression(r=-0.309, p<0.01), the numbers of chronic disease(r=-0.287, p<0.01), age (r=-0.236, p<0.01) showed significant association with ADL. In multivariate analysis, cognitive impairment(OR=5.80), emergent admission(OR=4.33), over the 75 years old age(OR=3.33), malnutrition(OR=2.86), and depression(OR=2.61) were identified as the independent influencing factors on ADL dependency. CONCLUSION: ADL dependency is common in elderly inpatient and significantly associated with poor prognosis. Identifying and controlling the influencing factor on ADL decline may improve the patients' functional status and clinical outcome.
Activities of Daily Living ; Aged* ; Cognition ; Depression ; Emergencies ; Geriatric Assessment ; Humans ; Inpatients ; Length of Stay ; Mortality ; Multivariate Analysis ; Prognosis ; Seoul

Tremendous efforts have been made to develop better vaccines and diagnostic markers for the effective control of tuberculosis. Recently, we reported that the Triton X-100 soluble protein (TSP) of Mycobacterium tuberculosis induced strong T-cell proliferation and IFN-gamma production in humans, and also conferred a significant level of protection against tuberculosis in a mouse model. In this study, the TSP was prepared by Triton X-100 extraction of Mycobacterium tuberculosis bacilli, which was followed by Triton X-114 phase partitioning. Western blot analysis using sera of 177 active pulmonary tuberculosis patients and 323 healthy individuals revealed that the TSP contained a immunodominant 40-kDa antigen specifically reacting with some sera from pulmonary tuberculosis patients. The 40-kDa antigen was purified by ion-exchange chromatography, and partially characterized by two-dimensional gel electrophoresis and N-terminal sequencing. Results of this study suggest that 40-kDa molecule of the TSP antigen from the cell suface of Mycobacterium tuberculosis can be used as a serodiagnostic marker as well as a potential vaccine candidate against tuberculosis.
Animals ; Blotting, Western ; Chromatography, Ion Exchange ; Electrophoresis, Gel, Two-Dimensional ; Humans ; Mice ; Mycobacterium tuberculosis* ; Mycobacterium* ; Neptune* ; Octoxynol* ; T-Lymphocytes ; Tuberculosis ; Tuberculosis, Pulmonary ; Vaccines

BACKGROUND: Left ventricular dysfuction is common in immediate postoperative periods after surgical correction of heart diseases with chronic left ventricular volume overload. We speculated postoperative changes of left ventricular volume and unction in patients with patent ductus osus(PDA) who had underwent surgical repair at ages older than 16 years. Factors influencing postoperative left ventricular volume and function were also analyzed. MATERIAL AND METHOD: From August 1989 to August 1999 thirty-siz adult patients with PDA 28 females and 8 males. were enrolled in this study. Their age ranged from 16 years to 57 years(mean :32 years). Types of surgical repair were division with primary closure in 22, division with patch closure in 6, internal obliteration using cardiopulmonary bypass in 4 and ligation in 4. Aortic clamping was combined during surgical repair in 22(61%) and cardiopulmonary bypass was used in 8(22%) Two-dimensional echocardiography studies were performed in 34(94%) preoperatively and in 25(66%) immediate postoperatively to assess postoperative changes of left ventricular internal dimensions. left ventricular volume and ejection fraction. Duration of postoperative follow-up ranged from 1 month to 99 months (mean:22 months) and 10 patients underwent 16 echocardiographic evaluation during this period. RESULT: Preoperative and postoperative left ventricular systolic dimensions(LVIDs) were 42+/-8.0mm and 42+/-8.3mm left ventricular diastolic dimensions(LVIDd) were 64+/-10.0mm and 56+/-7.4mm left ventricular end systolic volumes(LVESV) were 62+/-19cc (z=1.87+/-0.06) and 59+/-24cc(z=1.78+/-0.08) left ventricular end diastolic volumes(LVEDL) were 169+/-40cc(z-1.17+/-0.1) and 112+/-29cc(z=0.85+/-0.1) and ejection fractions(EF) were 66+/-6.7% and 48+/-12.6% respectively. There were statistically significant differences between preoperative and postoperative values in LVDIDd(p=0.001) LVEDV(p=0.001) and EF(p=0.0001) while no significant difference is LVIDs and LVESV. Postoperative depression of ejcection fraction was significantly related with z-score of preoperative LVESV and LVEDV by univariateanalysis while LVEDV only was significant risk factor for postoperative LV dysfunction by multiple regressioin analysis (deltaLVEF=-13.3-4.62xLVEDV(z), p=0.001) During the follow-up periods ejection fractions become normalized in all except one patients. CONCLUSION: Left ventricular function is usually deteriorated after the surgical correction of PDA in adult age and preoperative LVEDV is a major determinant of postoperative LV function.
Adult* ; Cardiopulmonary Bypass ; Constriction ; Depression ; Echocardiography ; Female ; Follow-Up Studies ; Heart Diseases ; Humans ; Ligation ; Male ; Postoperative Period ; Risk Factors ; Ventricular Function, Left

BACKGROUND/OBJECTIVES: In this study, we investigated the beneficial effects of skate cartilage extracts containing chondroitin sulfate (SCS) on hyperlipidemia-induced inflammation and oxidative stress in high cholesterol diet (HCD)-fed mice in comparison with the effects of shark cartilage-derived chondroitin sulfate (CS).MATERIALS/METHODS: Low-density lipoprotein receptor knockout (LDLR-KO) mice were fed HCD with an oral administration of CS (50 and 100 mg/kg BW/day), SCS (100 and 200 mg/kg BW/day), or water, respectively, for ten weeks. RESULTS: The administration of CS or SCS reduced the levels of serum triglyceride (TG), total cholesterol (TC), and LDL cholesterol and elevated the levels of high-density lipoprotein cholesterol, compared with those of the control group (P < 0.05). Furthermore, CS or SCS significantly attenuated inflammation by reducing the serum levels of interleukin (IL)-1β and hepatic protein expression levels of nuclear factor kappa B, inducible nitric oxide synthase, cyclooxygenase-2, and IL-1beta (P < 0.05). In particular, the serum level of tumor necrosis factor-alpha was reduced only in the 100 mg/kg BW/day of SCS-fed group, whereas the IL-6 level was reduced in the 100 and 200 mg/kg BW/day of SCS-fed groups (P < 0.05). In addition, lipid peroxidation and nitric oxide production were attenuated in the livers of the CS and SCS groups mediated by the upregulation of hepatic proteins of antioxidant enzymes, such as superoxide dismutase, catalase, and glutathione peroxidase (P < 0.05). CONCLUSIONS These results suggest that the biological effects of SCS, similar to those of CS, are attributed to improved lipid profiles as well as suppressed inflammation and oxidative stress induced by the intake of HCD.

Mycobacterium tuberculosis is a potent inducer of cytokine production by mononuclear phagocytes, which are an important cellular component in the first line immune defence. In this study, the cell wall-associated Triton X-100 soluble protein (TSP) antigens, TSP-H37Rv, TSP-H37Ra, TSP-K, and TSP-BCG, were isolated from M. tuberculosis H37Rv, M. tuberculosis H37Ra, M. tuberculosis K-strain, and M. bovis BCG, respectively. The monocytes were isolated from the peripheral blood mononuclear cells of healthy individuals and were co-cultured with each TSP antigens and the secretory proteins of M. tuberculosis (PPD and 30-kDa antigen) to measure the production of cytokines; tumor necrosis factor (TNF)-a, interleukin (IL)-12, IL-8 and monocyte chemotactic protein-1 (MCP-1). The TSP-H37Rv antigen- stimulated monocytes showed higher level of TNF-a and IL-12 production compared to those of other TSP antigens and PPD. Especially, IL-12 production in response to the TSP-H37Rv antigen was significantly elevated in comparison with that of PPD-stimulated monocytes (TSP-H37Rv, 255.5+/-256.9 pg/ml; PPD, 55.7+/-55.4 pg/ml). However, the 30-kDa antigen did not induce TNF-alpha expression and also showed the lowest level of cytokine and chemokine production by monocytes. MCP-1 and IL-8 production were similarly increased in response to all TSP antigens and the PPD antigen. The production of IL-12 by the TSP-H37Rv antigen stimulation was significantly increased in PPD reactors than that in the non-reactor group, while the levels of other cytokines stimulated with each TSP antigens, 30-kDa and PPD antigen were not significantly different between the tuberculin reactor and the non-reactor groups. These results suggest that the cell wall-associated TSP antigen isolated from M. tuberculosis H37Rv acts as a more potent IL-12 inducer than the PPD antigen in innate immune response and thus it could further activate the Th1-mediated immune responses effectively against M. tuberculosis infection.
Chemokine CCL2 ; Cytokines ; Humans* ; Immunity, Innate ; Interleukin-10* ; Interleukin-12* ; Interleukin-8* ; Interleukins ; Monocytes* ; Mycobacterium bovis ; Mycobacterium tuberculosis* ; Mycobacterium* ; Neptune* ; Octoxynol* ; Phagocytes ; Tuberculin ; Tuberculosis ; Tumor Necrosis Factor-alpha*