No abstract available.
Breast Neoplasms* ; Breast* ; Drug Resistance, Multiple* ; Genes, MDR*

PURPOSE: This paper studies the influence of the case-management program on the change of blood sugar, lifestyle, and knowledge level of diabetes mellitus (DM) for medium-sizedenterprise employees suffering from DM. METHOD: Subjects, divided into experimental and control groups, are 59 workers with FBS higher than 126mg/dl or under DM medication treatment in the medium-sized enterprises, being managed by two distinct university hospital group occupational health management service teams. The case management program for DM patients consists of 6 different processes in which each subject is treated. RESULT: FBS decreased in the experimental group after the program, while that of the control group increased significantly. In the experimental group, the amount of smoking, the frequency of drinking and the amount of drinking per week decreased. Also, the knowledge level for DM and the change of nutrition management showed significant increase. In the control group, the amount of smoking increased and the frequency of drinking, the amount of drinking and nutrition level did not change significantly. And the knowledge level for DM decreased. CONCLUSION: We expect that taking this case management program for DM management may significantly improve diabetic patients' overall health.
Blood Glucose ; Case Management ; Diabetes Mellitus ; Drinking ; Humans ; Life Style ; Occupational Health ; Smoke ; Smoking ; Stress, Psychological

No abstract available.
Adult* ; Epiglottitis* ; Humans

All-ceramic restorations have become an attractive alternative to porcelain-fused-to-metal crowns. In-Ceram, and more recently IPS Empress 2 were introduced as a new all-ceramic system for single crowns and 3-unit fixed partial dentures. But their strength and marginal fit are still an important issue. This study evaluated the fracture resistance and marginal fit of three systems of 3 unit all-ceramic bridge fabricated on prepared maxillary anterior resin teeth in vitro. The 3 all-ceramic bridge systems were: (1) a glass-infiltrated, sintered alumina system (In-Ceram) fabricated conventionally, (2) the same system with copy-milled alumina cores (copy-milled In-Ceram), (3) a heat pressed, lithium disilicate reinforced glass-ceramic system (IPS Empress 2). Ten bridges of each system with standardized design of framework were fabricated. All specimens of each system were compressed at 55degree at the palatal surface of pontic until catastrophic fracture occurred. Another seven bridges of each system were fabricated with standard method. All of the bridge-die complexes were embedded in epoxy resin and sectioned buccolingually and mesiodistally. The absolute marginal discrepancy was measured with stereomicroscope at x50 power. The following results were obtained: 1. There was no significant difference in the fracture strength among the 3 systems studied. 2. The Weibull modulus of copy-milled In-Ceram was higher than that of In-Ceram and IPS Empress 2 bridges. 3. Copy-milled In-Ceram (112micrometer) exhibited significantly greater marginal discrepancy than In-Ceram (97micrometer), and IPS Empress 2 (94micrometer at P=0.05. 4. The lingual surfaces of the ceramic crowns showed smaller marginal discrepancies than mesial and distal points. There was no significant difference between teeth (incisor, canine) at P=0.05. 5. All-ceramic bridges of three systems appeared to exhibit sufficient initial strength and acceptable marginal fit values to allow clinical application.
Aluminum Oxide ; Ceramics ; Crowns ; Denture, Partial, Fixed ; Hot Temperature ; Lithium ; Tooth

Purpose: We wanted to evaluate the clinical and radiologic results of acetabular revision using the acetabular reinforcement ring and also the allograft impaction in the acetabulum having deficient bone stock. Material and Methods: Nineteen hips revision arthroplasty were performed in 18 patients (9 males and 9 females) with using an acetabular reinforcement ring and allograft between July 1993 and December 2003. The patients were followed for an average of 64 months (range: 24-153). The mean age at the time of arthroplasty was 59 years old (range: 34-76). The causes of revision were aseptic loosening of the acetabular component in 16 cases, severe progressive osteolysis around the acetabular component in 2 cases and Girdlestone state after infected total hip arthroplasty in one case. The acetabular deficiency was type II in 5 hips, type III in 13 hips, and type IV in one hip according to the AAOS classification. The clinical results were evaluated using the modified Harris hip score, and the radiologic results were evaluated by assessing the preoperative and serial follow-up radiographs. Results: The mean preoperative Harris hip score of 47 was improved to 86 points at the latest follow-up. Periacetabular osteolysis was found in 2 cases, which did not progress at follow-up. The anatomic hip center was restored after revision arthroplasty (p<0.05). Complications were dislocation in 2 cases, breakage of the hook of the Ganz ring in one case, heterotopic ossification in one case and femoral artery injury in one case. All cases showed stable fixation of the acetabular component and good remodelling of the impacted allograft. There was neither recurrence of dislocation nor progression of the acetabular component loosening on the radiographs. Conclusion: Acetabular revision with acetabular reinforcement ring and allograft impaction showed satisfactory clinical and radiologic results with restoration of the hip center and consolidation of the allograft.
Acetabulum* ; Allografts* ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Classification ; Dislocations ; Femoral Artery ; Follow-Up Studies ; Hip ; Humans ; Male ; Ossification, Heterotopic ; Osteolysis ; Recurrence

A 20 year old woman with noninsulin-dependent diabetes mellitus (NIDDM) developed an extensive warty and focally cauliflower like mass located at anogenital area. Its histopathologic study and in situ DNA hybridization revealed this lesion an ordinary condyloma acuminatum without large bulbous downward proliferation of which HPV type was 6 and/or 11. The mass lesion was successfully treated by excision and electrodesiccation under spinal anesthesia. Intermittent recurrence of several papular condylomata acuminata was observed during a follow up period of 6 months, which were easily cured by podophylline application on each occasion.
Anesthesia, Spinal ; Brassica ; Condylomata Acuminata ; Diabetes Mellitus, Type 2* ; DNA ; Female ; Follow-Up Studies ; Humans ; Podophyllin ; Recurrence ; Young Adult

PURPOSE: This study was to develop, implement, and evaluate an e-learning education program for improving practical knowledge and preventing nursing errors and adverse events of nurses working in the operating room (OR). METHOD: The e-learning program was developed and evaluated according to the following processes: 1) preparation phase 2) implementation phase 3) evaluation phase. In evaluation phase, the effectiveness was analyzed based on the Kirkpatrick's model. RESULTS: The e-learning program consisted of OR basic nursing skills and techniques and nursing activities' manual based on the categories of nursing errors: surgical operation preparation, nursing skills and techniques, environment management, patient safety and comfort, and patient monitoring. The program was provided through on-line, http:// cafe.daum.net/pnuhorn, for 4 weeks. The mean score(percent) of participants' satisfaction was 21.24+/-1.71(68.2%). Their total knowledge level was significantly improved(Z=-3.00, p=.003) and specifically in the category of environment management(Z=-3.77, p<.001) and patient monitoring(Z=-2.46, p=.014). The occurrence of nursing errors or adverse events was a little decreased, but not statistically significant(Z= -3.10, p=.756). CONCLUSION: E-learning for nurses is one way of effective and efficient teaching-learning strategies. For better e-learning, it is important to develop the vital content of the education and objective measures for detecting nursing errors and adverse events.
Education* ; Education, Nursing, Continuing ; Humans ; Medical Errors ; Monitoring, Physiologic ; Nursing* ; Operating Rooms* ; Patient Safety ; Program Development ; Program Evaluation

PURPOSE: Intussusception is a very common pediatric problem and needs early management. This study evaluated the risk factors of intussusception in infants and children for early diagnosis and treatment. METHODS: 216 cases of pediatric intussusception occurring between 1993 and 1999 in Mokpo Catholic Hospital were investigated retrospectively. 164 patients treated with barium reduction comprised the barium reduction (BR) group and 52 patients treated with manual reduction or bowel resection was operation (OP) group. RESULTS: The age incidence under 1 year old was 108 patients (65.9%) in BR group, 45 patients (86.5%) in OP group. Male to female ratio was 1.8:1 in BR and 1.7:1 in OP, respectively. In the seasonal distribution spring was more common in both group (34.1%, 34.6%). 60.4% in BR group, 76.9% in OP group were revealed leukocytosis above 10.000/mm3 in serum. Previous combined diseases were upper respiratory infection (31.7%, 42.3%), acute gastroenteritis (1.2%, 1.9%) and multiple familial polyposis (0.5% in BR group). The frequent symptoms and signs were bloody stool (86.0%,92.3%), abdominal pain and irritability (86.6%, 82.7%), vomiting (76.9%, 67.3%), and abdominal mass (56.7%, 76.9%). Tachycardia was 12.2% in BR and 44.2% in OP. In plain abdominal radiography, intestinal obstructive pattern was present in 5.5% of BR group and 53.8% of OP group. Success rate of barium reduction within 24 hours after symptom appearance was 82.3%. Within 24-48 hours was 61.1%, above 48 hours was 25%. There was a statistically significant difference between BR group and OP group of patients under 1 year old, with tachycardia, symptoms for longer than 48 hours and obstructive pattern on plain abdominal radiography (p<0.05). Of surgical cases, 84.6% were idiopathic. The common anatomical type was ileo-colic type (53.9%). The methods of operation were manual reduction (94.2%) and bowel resection (5.8%). Postoperative complications occurred in 4 cases; 3 cases of wound infection and 1 case of pulmonary complication. Recurrence rate was 12.8% in BR group. CONCLUSION: Risk factors of high incidence such as under 1 year old, severe obstructive pattern on the plain abdominal radiograph, symptoms for longer than 48 hours, and tachycardia, were related with a low success rate of barium reduction. Therefore, a gentle barium enema is recommended in high risk patients for diagnosis and prompt surgical intervention.
Abdominal Pain ; Barium ; Child* ; Diagnosis ; Early Diagnosis ; Enema ; Female ; Gastroenteritis ; Humans ; Incidence ; Infant* ; Intussusception* ; Jeollanam-do ; Leukocytosis ; Male ; Postoperative Complications ; Radiography, Abdominal ; Recurrence ; Retrospective Studies ; Risk Factors ; Seasons ; Tachycardia ; Vomiting ; Wound Infection

This study was performed to evaluate the changes of serum IgG4 level in children with allergic diseases. Serum Ige, IgG and IgG4 level were measured using enyzme immunoassay (IgE) and radial immunodiffusion method (IgG and IgG4) in 21 children with bronchial asthma, allergic rhinitis or urticaria Eosinophil counts in peripheral blood and the values of serum IgE were significantly increased in allergic patients. The values of IgG4 in allergic patients were also increased compare to those in controls (24.23mg/dl versus 20.33mg/dl). But the values of IgG4 were not significantly correlated to either IgG or IgE levels. Further studies will be needed for measuring allergen specifie IgE and IgG4 levels considering the onset of diseases, methods and duration of treatment.
Asthma ; Child ; Eosinophils ; Humans ; Hypersensitivity ; Immunoassay ; Immunodiffusion ; Immunoglobulin E ; Immunoglobulin G* ; Rhinitis ; Urticaria

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