OBJECTIVE: To evaluate the current status and new trends in gynelcological pelviscopy in Korea. METHODS: A survey was conducted and analyzed based on 20997 cases of operative pelviscopy hom May, 1985 to February, 1998 reported from twenty four university hospitals in Korea. RESULTS: The results obtained were ss followings; 1) 45.9 % of the total cases was 30 to 39 years old age group and it was the most dominant age group, 2) The previous operative history was found in 10.9% of the tota1 cases and included cesarean section(30.0%), ectopic pregnancy(20.3%), etc. 3) The operative indications were diagnostic(26.2%), myoma uteri(23.1%), ectopic pregnancy(21.4%), adnexal mass(18.4%), etc. In cases of diagnostic indication, the most common post-operative diagnosis of pelviscopic surgery was tubal pregnancy(30,6%). 4) The operative titles were salpingectomy(25.1%), hysterectomy(19.9%), salpinghorectomy(19.8%), etc. 5) The complications of operative pelviscopy were composed of subcutaneous emphysema(0.58%), preperitoneal bleeding(0.3%), bladder injury(0,3%), bowel injury(0.3%), etc. 6) lhe survey showed that 57.1% of the respondents desired more than 1 year of period for well peration between the operator and the assistant. 56.7% of respondents indicated that the surgical technique of the operator was the most important factor for a successful pelvisocopic surgery. 7) The most beneficial effect of the pelviscopy included the comfortableness of the patient(40.0%), cosmetic effect(22.8%), decrease of complications(14.2%), etc. CONCLUSION: The modem methods of operative pelviscopy have been successfully used in the treatment of gynecological disease. Today, pelviscopic surgery is being applied in almost all the cases of gynecological disease. Hence, the majority of pelviscopy techniques and pracedures being performed by surgeon must be taught in the controlled setting of a residency or a fellowship training program.
Adult ; Surveys and Questionnaires ; Diagnosis ; Education ; Fellowships and Scholarships ; Hospitals, University ; Humans ; Internship and Residency ; Korea* ; Modems ; Myoma ; Urinary Bladder

No abstract available.
Tretinoin*

Kawasaki disease is an acute vasculitis of infancy and early childhood characterized by high fever, rash, mucositis, lymphadenopathy and coronary artery damage. The failure to indentify a causative organism using convetional culture and serological techniques, and the lack of response to antibiotics indicate that the disorder is probably not due to any known bacterial or viral pathogens. During the acute phase of the disease, the alterations of T and B cell functions, changes of cytokine and immunoglobulin levels have been reported. This study was performed to investigate the changes of immunoglobulins levels in patients with Kawasaki disease. IgG, IgA, IgM and IgG subclasses were measured using immunoprecipitation and EIA in the sera of patients with Kawasaki disease. The results were as follows: 1) Acute phase reactants such as CRP and ESR were significantly increased in Kawasaki patients compared to those in control patients(p<0.01). 2) Serum IgG levels in Kawasaki disease were markedly increased than those in control patients, while serum IgA and IgM levels showed no significant changes (P: No Significance). 3) IgG1 and IgG4 were predominantly increased increased in the sera of Kawasaki patients, while IgG2 and IgG3 were not significantly increased (P: No Significance). With these results, unidentified infectious organism with abnormal immune response could be suggested as an etiologic factor of Kawasaki disease.
Acute-Phase Proteins ; Anti-Bacterial Agents ; Child* ; Coronary Vessels ; Exanthema ; Fever ; Humans ; Immunoglobulin A ; Immunoglobulin G* ; Immunoglobulin M ; Immunoglobulins ; Immunoprecipitation ; Lymphatic Diseases ; Mucocutaneous Lymph Node Syndrome* ; Mucositis ; Vasculitis

BACKGROUND: The combination of psoralen and UVA (PUVA) as a model of photochemotherap, has been used in a wicle variety of cutaneous disorders such as psoriasis, vitiligo, mycosis fungoides and atopic dermatitis. The mechanism of PUVA of psoriasis is based on the fact. that PUVA causes photoconjugation of psoralens to DNA and a subsequent suppression of mitosis, DNA synthesis, and keratinocyte proliferation. Although PUVA apparently inhibits keratinocytie proliferation and is effective therefore in the treatment of psoriasis, PUVA increases pigmentations by stimulating melanocyte proliferation and melanin synthesis in vivo. OBJECTIVE: We tried to investigate the PUVA effects on the proliferation and different,iation in cultured human keratinoc tes and melanocytes. METHODS: We examined morphologic changes, and the number of the cultured human keratinocytes and melanoiytes and melanin contents in a control group and experimental group. (UVA group, 8-MOP group and PUVA group). i.e., UVA group was exposed to UVA at 60mJ, of. 8-MOP group was acJded at dose of 2 x 10 M to medium for 30 minutes. PUVA group was exposed to UVA at 60mJ, of after adding in 8 MOP at Zx 10 M for 30 minutes. RESULTS: 1. Morphologic changes of cultured human keratinocytes and melanocytes. There were no significent changes between the control group and the experimental groups in keratinocytes and melanocytes after 24, 48 and 72 hours culture. The number and length of meianocyte dendrites showecl no significant differences between the groups after 24, 48 and 72 hours culture(p>0.05). 2. Proliferation of cultured human keratinocytes and melanocytes 1) The number of keratinocytes in 8-MOP and PUVA groups decreased significantly more than in the control and LVA groups at 72nd hour after culture (p<0.01). 2) The number of melnocytes showed no differences between the groups at 72nd hour after culture (p>0.05). 3. Melanin contents in iultured human melanocytes The melanin contents increased significantly in the PUVA groups compared to that in the other groups at 72nd hour after culture (p<0.01). CONCLUSION: In culturel human keratinocytes, PUVA has no effect on the morphology and differentiation, hut inhibit proliferation. In cultured human melanocytes, PUVA has no effect on morphology and proliferation, but it increases the melanin contents.
Dendrites ; Dermatitis, Atopic ; DNA ; Ficusin ; Humans* ; Keratinocytes* ; Melanins ; Melanocytes* ; Methoxsalen ; Mitosis ; Mycosis Fungoides ; Pigmentation ; Psoralens ; Psoriasis ; Vitiligo

PURPOSE: This study was done to identify self-directed learning readiness, achievement goal orientations, learning satisfaction and learning achievement, and to evaluate the factors affecting learning achievement for nursing students using a web-based Health Assessment e-Book. METHODS: The research design was a cross-sectional study with a structured questionnaire and data were collected before using the web-based Health Assessment e-Book and 1 week after finishing. The participants were 80 nursing students who were taking the Health Assessment class from March to June 2009. RESULTS: Mean score for subjective learning achievement was 31.26 and for objective learning achievement, 69.25. Subjective and objective learning achievement were positively correlated with self-directed learning readiness, mastery goal, attitude toward distance education, and learning satisfaction. In subjective learning achievement, learning satisfaction and mastery goal were significant predictive factors and explained 64% of the variance. Objective learning achievement was significantly predicted by learning satisfaction and self-directed learning readiness, which explained 24% of the variance. CONCLUSION: Learning satisfaction, mastery goal and self-directed learning readiness were found to be very important factors associated with learning achievement for nursing students using a web-based Health Assessment e-Book. To provide high quality and effective web-based courses and to improve nursing students' learning achievement and learning satisfaction, educators should consider the learner's characteristics from the initial stages of lecture planning.
Adult ; *Computer-Assisted Instruction ; Cross-Sectional Studies ; *Education, Nursing, Baccalaureate ; Educational Status ; Female ; Humans ; Internet ; *Learning ; Male ; Personal Satisfaction ; Questionnaires ; Students, Nursing/*psychology

PURPOSE: The purpose of this study was to determine whether psychological distress is an independent risk factor for recurrent cardiac events in patients with coronary artery disease (CAD). METHODS: A prospective cohort of studies that measured psychological distress and the incidence of recurrent cardiac events in the adult population were included. Three computerized databases were assessed (PubMed, CINAHL, and PSYCINFO). Meta-analysis was conducted using a random-effects model to determine summary estimates of risks of major recurrent cardiac events associated with each psychological distress. Of 506 publications identified, 33 met inclusion criteria, and 24 studies were used to estimate effect size of psychological distress on recurrent cardiac events. RESULTS: Mean number in the research sample was 736 and mean time of follow-up was 4.0 years. Depression, anxiety, anger, and hostility as psychological factors were studied. According to estimation of effect size using random model effect, depression (OR=1.39, 95% CI: 1.22-1.57), anxiety (OR=1.22, 95% CI: 0.96-1.56), and anger/hostility (OR=1.29, 95% CI: 1.07-1.57) CAD patients in significantly increased risk for recurrent cardiac events. CONCLUSION: Finding suggests that psychological distress in forms of depression, anxiety, anger, and hostility impact unfavorably on recurrent cardiac events in CAD patients.
Aged ; Aged, 80 and over ; Anger ; Anxiety ; Cohort Studies ; Coronary Artery Disease/*psychology ; Databases, Factual ; Depression ; Female ; Hostility ; Humans ; Male ; Prospective Studies ; Recurrence ; Risk Factors ; *Stress, Psychological

PURPOSE: The purpose of this study is to examine the impact of type D personality on health status and health promoting behaviors in middle-aged women. METHODS: A cross-sectional study design was used with 220 middle aged women. All participants completed 3 measuring tools: a 14-item Type D Personality Scale, a 12-item Short Form Health Survey Questionnaire version 2, and Health Promoting Lifestyle Profile-version II. All were completed in November 2010. RESULTS: The prevalence of type D personality was 34.5%. Type D women had significantly lower physical (p=.020) and mental health status (p<.001) compared with non-type D women. In addition Type D women reported significantly poorer performance of health responsibility (p=.015), physical activity (p=.001), nutrition (p=.027), spiritual growth (p<.001), interpersonal relations (p<.001) and stress management (p<.001) techniques in health behaviors than non-type D women. CONCLUSION: Type D personality is a vulnerability factor that affects health status and is associated with poor health promoting behaviors in middle aged women. Therefore, screening for Type D personality is important to detect women at risk for health status and quality of life in community settings in Korea.
Cross-Sectional Studies ; Female ; Health Behavior ; Health Surveys ; Humans ; Interpersonal Relations ; Korea ; Life Style ; Mass Screening ; Mental Health ; Middle Aged ; Motor Activity ; Prevalence ; Quality of Life ; Surveys and Questionnaires

Chronic iron overload is associated with life-threatening complications, such as cardiomyopathy, liver cirrhosis, diabetes, hypothyroidism, hypoparathyroidism and hypogonadism. We experienced a case of secondary hemosiderosis with hepatic fibrosis in a 8-year-old boy who had been transfused 56 pints of packed red blood cells for a supportive therapy of acute myelogenous leukemia for a 27-month period. Intramuscular injection of Desferroxamine (40mg/kg/ day) was done for 9 months, however, there was no sign of improvement in hepatic size, consistency, and in liver biopsy findings. Except for mild thrmobocytopenia which seems to be the result of hypersplenism, the boy remained in remission for 3 2/3 years. We think, the prompt use of Desferroxamine therapy may be needed to avoid iron overload, if patients recieved multiple transfusions and high serum ferritin level.
Biopsy ; Blood Transfusion ; Cardiomyopathies ; Child ; Deferoxamine ; Erythrocytes ; Ferritins ; Fibrosis* ; Hemosiderosis* ; Humans ; Hypersplenism ; Hypogonadism ; Hypoparathyroidism ; Hypothyroidism ; Injections, Intramuscular ; Iron Overload ; Leukemia, Myeloid, Acute* ; Liver ; Liver Cirrhosis ; Male

PURPOSE: The purpose of this study was to evaluate the cognitive effects of chemotherapy in patients with breast cancer. METHODS: Using several databases, prospective studies were collected up to August 2011. Of 2,106 publications identified, 12 met the inclusion criteria, and 8 studies were used to estimate the effect size of chemotherapy on cognitive impairment. RESULTS: Twelve studies were done since 2005 and most of the research was performed in Europe or North America. Eight studies were used to generate effect size across the cognitive domains of attention/concentration, verbal and visual memory, executive function, visuospatial skill, language, and subjective cognitive function. Each of the cognitive domains showed small effect sizes (-0.02 ~ -0.26), indicating diminished cognitive function for the chemotherapy group compared with non-chemotherapy groups. CONCLUSION: Finding suggests that breast cancer patients who undergo chemotherapy may experience mild cognitive decline. Further study is needed to generate knowledge and guideline for interventions to address chemotherapy related cognitive impairment in these patients.
Antineoplastic Agents/adverse effects/*therapeutic use ; Breast Neoplasms/*drug therapy ; Cognition Disorders/*physiopathology ; Databases, Factual ; Female ; Humans ; Language Tests ; Memory, Short-Term ; Neuropsychological Tests

BACKGROUND: The testes are one of the most common extramedullary sites of relapse in boys with acute lymphoblastic leukemia(ALL). The reported incidence of isolated testicular relapse varies from 3 to 40%. If these patients are treated exclusively with testicular irradialion, a systemic relapse occurs within a few months. Recently, the use of intensive chemotherapy and testicular irradiation improved the survival rate for boys with testicular leukemia. So, we performed this study to identify clinical manifestations, disease free survival and prognostic factors of testicular leukemia in children. METHODS: We reviewed 33 patients of testicular leukemia among total 410 boys with ALL diagnosed at the Department of Pediatrics, Seoul National University Children's Hospital from Jan. 1970 to Aug. 1996. Testicular leukemia was confirmed by testicular biopsy in all 33 patients. These patients were treated with combined local testicular irradiation(2,400~2,500 cGy/8~12fractions) and systemic chemotherapy. Two patients, in whom testicular relapse was diagnosed before 1979, unilateral orchiectomy of the involved site and testicular irradiation of the opposite site were performed. Probability estimates of disease free survival (DFS) were calculated by the method of Kaplan and Meier, and the relationship of prognostic factors to DFS was compared using the chi-square test in survival analysis. RESULTS: In 410 boys with ALL, testicular leukemia occurred in 33 patients(8%). Of 33 patients, 6 patients presented with testicular involvement at initial diagnosis, 16 patients had testicular relapse while still receiving chemotherapy and 11 patients had testicular relapse 3 to 57 months(median : 15 months) after cessation of chemotherapy. The median age of 33 patients was 7.4 yrs(9 months~18 yrs) and median WBC count 7,600/ L(2,700~270,000/L). All patients presented with painless testicular enlargement and testicular leukemia was confirmed by testicular biopsy. Among 33 patients, 2 had prior CNS relapse and 11 had concomitant bone marrow and/or CNS relapse. Twenty nine patients were treated with combined local testicular irradiation and systemic chemotherapy. Eleven had second relapse(6 bone marrow, 3 CNS, 2 opposite testis). Seventeen have been followed until now: 6 patients on chemotherapy and 11 patients(37.9%) in complete remission for 48.5+/-22.3 months(19~86 months). The 3 year DFS for 29 patients was 55.3%+/-10.1%. The following prognostic factors showed no significant association with DFS in testicular relapse : age and WBC count at initial diagnosis, age at testicular relapse, and concomitant relapse. Whether testicular relapse occurred on initial therapy or off initial therapy has prognostic value in predicting DFS. The 3 year DFS for boys with testicular relapse on and off initial therapy were 40.0%+/-12.9% and 78.8%+/-13.4%, respectively(P: 0.046). CONCLUSION: With the use of chemotherapy and testicular irradiation, prolonged second re mission can be achieved in many patients with testicular leukemia. The patients with testicular relapse off initial therapy fared significantly better than patients on therapy. So, to improve the DFS for boys with testicular leukemia, a better understanding of its biology and prognostic factors is needed.
Biology ; Biopsy ; Bone Marrow ; Child ; Diagnosis ; Disease-Free Survival ; Drug Therapy ; Humans ; Incidence ; Leukemia ; Missions and Missionaries ; Orchiectomy ; Pediatrics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Recurrence ; Seoul ; Survival Rate ; Testis