PURPOSE: To compare chest radiographic findings of pulmonary tuberculosis in non-AIDS immunocom- promised adult patients with those in immunocompetent patients. MATERIAL AND METHOD: Eighty six patients who had pulmonary tuberculosis were included in the study. Of these, 41 were non-AIDS immunocompromised adult patients and 45 were immunocompetent adult patients. Chest radiographs obtained from 86 patients were retrospectively evaluated with regard to the followings ;the anatomic distribution and extent of tuberculous lesions, typical or atypical patterns of radiographic findings. We then compared the results in non-AIDS immunocompromised adult patients with those in immunocompetent adult patients. RESULTS: The characteristic manifestation of pulmonary tuberculosis was a tendency of pulmonary lesions to localize in the apico-posterior segments of the upper lobe and the superior segment of the lower lobe in both groups but more wide distribution such as the anterior segment and the lingular segment of the upper lobe and the basal segments of the lower lobe was frequently identified in non-AIDS immunocompromised adult patients, and also bilateral, multisegmental and multilobular extents were common findings. in immunocompetent adult patients, more common findings were in local exudative and productive lesions and several cavities in preferential sites. Atypical plain radiographic findings were more common in non-AIDS immunocompromised adult patients, and which were multiple cavitary lesions, wide extent of bronchogenic spread and tuberculous pneumonia, and .miliary disseminations and mass like lesions. CONCLUSIONS: Pulmonary tuberculosis in non-AIDS immunocompromised adult patients is characterized by frequent bilateral distribution, wide pulmonary extent, and atypical radiographic findings.
Adult* ; Humans ; Pneumonia ; Radiography, Thoracic ; Retrospective Studies ; Tuberculosis, Pulmonary*

No abstract available.
Amniocentesis* ; Cytogenetics*

OBJECTIVES: This study evaluated the stress of community residents using the General Health Questionnaire, GHQ-60, as an instrument of stress measurement. METHODS: The study included 2100 residents, aged 20 and over, living in three areas, a large city, a medium sized city and a rural area, between June and September 2001. A questionnaire interviewing method was used to collect data. The data were analyzed using a t-test, ANOVA, Pearson's correlation coefficients and multiple regression analysis. RESULTS: In this study, the degree of stress, as measured by the GHQ-60, was shown to be significantly higher in the following categories: females, people over 60 years old, people engaged in the primary industries and labor work, low incomes, the divorced and the bereaved, people who received no more than an elementary education, people who suffer from chronic diseases and non-exercisers. A factor analysis suggested that there were three factors of social dysfunction factors; psychosomatic symptom, and depression and anxiety. The social dysfunction factors was statistically significant for the groups described above. The factor of psychosomatic symptoms was statistically significant in the rural residents, and in the groups described above. The depression and anxiety factor was statistically significant in the large city residents, people aged between 20-29 years, students, unmarried persons, university graduates and those having suffered from chronic diseases. From the multiple linear regression analyses, chronic disease, exercise, gender and income, proved to be significant stress related factors. CONCLUSIONS: This study suggests that special attention should be given to the management of the chronic invalided, non-exercisers, females and small income earners, in order to maintain and promote the psychological health of residents in a community.
Anxiety ; Chronic Disease ; Depression ; Divorce ; Education ; Factor Analysis, Statistical ; Female ; Humans ; Linear Models ; Methods ; Single Person

OBJECTIVES: The critical pathways provide high quality of medical services in a cost-effective manner. To investigate the decrease in length of hospital stay and increase of cost effectiveness by using critical pathways, we compared hospital stay, cost of treatment, and the patient's satisfaction before and after critical pathway use. METHODS: We made a critical pathway team, which consisted of obstetric staff members, a resident, two nurses, a pharmacist, two clerical staff members. We made critical pathways for the medical team and patients. A prospective evaluation of a critical pathway for cesarean section was used as a comparison for control patients. RESULTS: The data for 305 patients with a critical pathway were compared to those of 136 control patients. The mean hospital stay is shorter in critical pathway patients than control patients. The cost of treatment decreased and differences between DRG (Diagnosed Related Groups) and cost of treatment increased in critical pathway patients. CONCLUSIONS: Using critical pathways in cesarean section decreased the duration of hospital stay and increased cost effectivesess. The critical pathways were useful as a means to minimize cost while increasing patient satisfaction.
Cesarean Section* ; Cost-Benefit Analysis ; Critical Pathways* ; Diagnosis-Related Groups ; Female ; Humans ; Length of Stay ; Patient Satisfaction ; Pharmacists ; Pregnancy ; Prospective Studies

No abstract available.
Embryonic Structures* ; Fluorescence* ; Humans* ; In Situ Hybridization* ; Preimplantation Diagnosis*

OBJECTIVES: Apoptosis is a process of active cell death, distinct from necrosis and characterized by specific morphological and biochemical features. Apoptosis induced by metals and metal-related deleterious conditions has only recently been studied. Although the toxic effects of heavy metals are well described, little is known about the mechanism of apoptosis via cadmium toxicity. Therefore, this study is designed to define the induction mechanism of apoptosis by which cadmium exerts its cytotoxic effect on human promyelocytic leukemic HL-60 cells. The cytotoxic effects of cadmium on HL-60 cells are studied in regards to apoptotic signal transduction pathways. METHODS: The mode of cadmium-induced apoptosis was investigated in HL-60 cells. HL-60 cells were treated with various concentrations of cadmium and antioxidants after which the viability of the cells were measured by MTT assay. The morphological features of cadmium- induced apoptosis were evaluated by fluoromicroscopy and the DNA fragmentation was analyzed using 1.5% agarose gel electrophorosis. Kinase activity was assayed by autoradiography and activity of NF-kappaB and nuclear proteins were measured by EMSA. RESULTS: Cadmium (125 microM) induces the characteristic morphological features of apoptosis, which are characterized by a shrinkage of the cytoplasm and a condensation of chromatin. In addition, cadmium induced the ladder pattern of DNA fragmentation. Antioxidants(Sodium nitroprusside, glutathione and N-acethylcysteine), which were not toxic to the cells, did not suppress apoptosis induced by cadmium. Cadmium enhances the expression of several classes of genes at elevated cytotoxic concentrations. Poly(ADP-ribose) polymerase(PARP) was predominantly in the fragmented form when doses of 125 microM were used. Since PARP is cleaved by CPP32 (caspase-3), we next determined if cadmium was capable of effecting changes in CPP32 activity. The results of these experiments showed that cadmium increased caspase-3 activity in a time dependent manner, corresponding to the time of appearance of fragmented PARP. Cadmium also increased the phosphotransferase activities of c-JUN N-terminal kinase (JNK). Furthermore, cadmium increased the activation of transcriptional factors including the activation of protein-1 (AP-1) and NF-kappaB . CONCLUSIONS: These results suggest that cadmium induces the apoptotic death of HL-60 cells via the activation of a DEVD-specific caspase, JNK and transcriptional factors such as AP-1 and NF-kappaB .
Antioxidants ; Apoptosis* ; Autoradiography ; Cadmium ; Caspase 3 ; Cell Death ; Chromatin ; Cytoplasm ; DNA Fragmentation ; Glutathione ; HL-60 Cells* ; Humans ; JNK Mitogen-Activated Protein Kinases ; Metals ; Metals, Heavy ; Necrosis ; NF-kappa B ; Nitroprusside ; Nuclear Proteins ; Phosphotransferases ; Poly Adenosine Diphosphate Ribose ; Sepharose ; Signal Transduction* ; Transcription Factor AP-1

OBJECTIVES: The purpose of this study was to examine the relationship of dental anxiety with oral health behavior and dental caries experience among adolescents. METHODS: The subjects were 469 teenagers (238 middle school students and 231 high school students) in 15 different schools located in 7 regions of Bucheon in Gyeonggi Province, Daejeon, and others. A survey and interviews were conducted to evaluate subjects' oral health behavior and dental anxiety. Dental anxiety was additionally assessed by Corah's Dental Anxiety Scale. The caries experience of subjects was examined. RESULTS: There were no regional differences in dental anxiety. Girls felt more dental anxiety than boys did. Adolescents who did not receive treatment even when they needed it felt more dental anxiety than those who did receive treatment. There were also statistically significant differences in dental anxiety according to the type of treatment received. Adolescents who received extraction treatment or underwent oral surgery experienced more dental anxiety than those who received orthodontic or aesthetic treatment. Those who had a toothache or who experienced gingival bleeding felt more dental anxiety than those who did not have those conditions. Subjects with poor perceived oral health also had more dental anxiety. The number of decayed teeth and filled teeth was significantly correlated with dental anxiety. CONCLUSIONS: In adolescents, dental anxiety is related to their oral health behavior, the type of conditions they present with, the treatment received, and dental caries experience. Therefore, the kind of systematic programs that could relieve adolescents of dental anxiety should be prepared.
Adolescent* ; Dental Anxiety* ; Dental Caries* ; DMF Index ; Female ; Gyeonggi-do ; Hemorrhage ; Humans ; Oral Health* ; Surgery, Oral ; Tooth ; Toothache

OBJECTIVES: The purpose of this study was to identify the status of dental care utilization among mothers and children from multicultural families and analyzing the related factors. METHODS: The subjects in this study were 131 mothers from multicultural families and 175 mothers from Korean (control) families who were selected by convenience sampling from the city of Nonsan. The dental care utilization among mothers and children from multicultural families and mothers and children from Korean families were compared. A questionnaire survey was conducted using the self-administration method for mothers from Korean families and by a face-to-face interviewing method for mothers from multicultural families. RESULTS: The proportion of subjects who visited the dentist's office in the past year was not different between the two groups of mothers. However, this proportion was lower in children from multicultural families than those from Korean families. The factors that influenced the visit to dental clinics were age and spouse's age among multicultural mothers and age, spouse's age, personal perceptions about oral health, and oral health concerns among Korean mothers. The factors that influenced dental clinic visits were mother's career, household income, education level of the mother, children's age, mother's dental clinic visits, mother's perception of children's oral health among multicultural children and father's age, marriage duration of parents, children's age, mother's dental clinical visit, and the mother's concerns about children's oral health among Korean children. CONCLUSIONS: Multicultural children visit the dental clinic a lot less than Korean children. Social economic factors such as household income, education level affect the use of dental clinic services by multicultural families.
Child* ; Chungcheongnam-do ; Dental Care* ; Dental Clinics ; Education ; Family Characteristics ; Humans ; Marriage ; Mothers* ; Oral Health ; Parents ; Surveys and Questionnaires

OBJECTIVES: This study investigated the busyness of dentists and analyzed factors related to busyness in these professionals. METHODS: The subjects were 243 practicing dentists. Surveys were carried out via mail. Busyness was measured by using the Mumma scale. The data were analyzed using the Kruskal-Wallis test. RESULTS: The dentists' busyness index was 1.91. Of the participants, 40% of practicing dentists wanted more patients, 30.8% did not overwork but did not want more patients, and 27.1% overworked and did not want more patients. The busyness index was significantly related to the number of dental hygienists and dentists. However, it did not differ with respect to the number of assistant nurses. CONCLUSIONS: The busyness index should be considered when developing relevant human resource plans.
Dental Hygienists ; Dentists* ; Humans ; Postal Service

BACKGROUND: In this report, we present the annual data of the intensive care unit (ICU) module of the Korean Nosocomial Infections Surveillance System (KONIS) from July 2008 through June 2009. METHODS: We performed a prospective surveillance of nosocomial urinary tract infections (UTI), bloodstream infections (BSI), and pneumonia (PNEU) at 101 ICUs in 57 hospitals using KONIS. Nosocomial infection (NI) rates were calculated as the numbers of infections per 1,000 patient-days or device-days. RESULTS: We identified 3,287 NIs during the study period: 1,787 UTIs (1,772 cases were urinary catheter-associated), 917 BSIs (797 were central line-associated), and 583 PNEUs (335 were ventilator-associated). The rate of urinary catheter-associated UTIs was 4.80 cases per 1,000 device-days (95% confidence interval, 4.58-5.03) and urinary catheter utilization ratio was 0.85 (0.849-0.851). Although the urinary catheter utilization ratios were lower in the hospitals with 400-699 beds than in the hospitals with 700-899 beds and more than 900 beds, the rates of urinary catheter-associated UTIs were higher in hospitals with 400-699 beds than in the larger ones. The rate of central line-associated BSIs was 3.27 (3.05-3.51) and the utilization ratio was 0.56 (0.559-0.561). The rate of ventilator-associated PNEUs was 1.86 (1.67-2.07) and the utilization ratio was 0.41 (0.409-0.411). The rate of ventilator-associated PNEUs was lower in July 2008-June 2009 than in July 2007-June 2008 and July 2006-December 2006. CONCLUSION: It appears that the KONIS influences the reduction in the rate of device-associated infections, especially ventilator-associated PNEU; therefore, ongoing targeted surveillance and infection control strategies are needed to control device-associated infections.
Cross Infection ; Gossypol ; Infection Control ; Critical Care ; Intensive Care Units ; Pneumonia ; Urinary Catheters ; Urinary Tract Infections