This study was performed to evaluate the effect that screw number and length have on the ability of two types of plate to resist vertical masticatory force. Five trials were done with two, four, or six screws, using screws 4 mm, or 12 mm in lenght and mini bone plates or mini compression plates. The fractured ribs were subjected to increasing weights until failure. With the mini bone plate, increasing the number of screws increased the weight resisted than screw length. For the mini compression plate, increasing screw length and the number of screws increased weight resisted.
Bite Force ; Bone Plates ; Mandibular Fractures* ; Ribs ; Weights and Measures

During hemorrhagic shock, liver is susceptible to ischemia and decreased hepatic energy charge results in decreasing arterial ketone body ratio(AKBR). Reperfusion after hemorrhagic shock can greatly amplify the generation of toxic oxygen metabolites. As a result, the fluxes of these highly toxic metabolites can overwhelm the endogenous antioxident defense mechanisms and lead to tissue injury. In order to observe the effect of glutathione(GSH) on the AKBR in hemorrhagic shock, dogs(n=16) were anesthetized with 1% enflurane in 02. We pretreated glutathione (100 mg/kg) intravenously before hemorrhagic shock in glutathione (GSH) group (n=8). Shock was induced with bleeding and mean arterial pressure was maintained 50 mmHg for 30 minutes. Recovery from shock was done with transfusion of preserved blood and maintained for 30 minutes. We measured arterial ketone bodies and ketone body ratio before, during and after shock, and compared them to control group (n=8) which was not pretreated with glutathione. AKBR during and after hemorrhagic shock in GSH group (0.8 and 1.0) were higher than those in control group (0.5 and 0.8). Light microscopic examination of liver biopsy revealed less portal degeneration during and after hemorrhagic shock in GSH group than control group. Pharmacologic modulation of hepatocytic function with glutathione before hemorrhagic shock has shown some beneficial effect with protection of decreased AKBR and histological change during and after hemorrhagic shock.
Animals ; Arterial Pressure ; Biopsy ; Defense Mechanisms ; Dogs* ; Enflurane ; Glutathione* ; Hemorrhage ; Ischemia ; Ketone Bodies ; Liver ; Oxygen ; Reperfusion ; Shock ; Shock, Hemorrhagic*

BACKGROUND: Family counseling is an essential part of family practice in which patients are cared in psychosocial dimension as will as in physical dimension and the family is dealt with as a whole unit. However, it is little applied in practice. The department of family medicine has made efforts to activate family counseling. This study was done to estimate the patients response on the effect of family counseling that we have performed, and to investigate what clinical problems counseling was held and in what situations the counseling was perceived to be useful by the patients. We hope this study will be useful to establish some useful data and ideas for the development of family counseling in family practice in Korea. METHODS: The subjects of this study are 53 households who received family counseling at the department of family medicine from Oct. 1, 1994 to May 31, 1995. 64 households received counseling during this peroid, but 11 persons who could not be reached by the phone were excluded. Patients demographic charateristics, patients chief complaints, physicians assessrnent on the complaints and major prolems presented in the counseling sessions were identified from the medical records. Patients own estimation of the effect of counseling and the reasons for termination of counseling were inquired through the telephone interview. Finally the association between the usefulness of counseling and some factors was statistically analyzed. RESULTS: Subjects were predominently women(84.9%), especially middle aged. The most common chief complaint was headache complained by 10 subjects (18.9%), and the second and the third were abdominal pain complained by 8 (15.1%) and chest discomfort complained by 7(13.2 %), respectively. The list of physicians assessment included depression(34.0%), physical symptom per se without any assessment(20.8%), family problem(15.1%), somatization(13.2%), and anxiety(9.45). More than half of the subjects(60.4%) had only one session, 26.4% two sessions and 7.5% more than 4 sessions. The most common problem presented in the counseling was marital conflict(28.3%), the second was trouble with in-laws(15.1%), and the third was chronic illness in the family(9.4%). 32.1% replied that the counseling was very helpful, 28.3% somewhat helpful, 17% little helpful, 20.8% never helpful, and 1.9% not sure. The session was experienced to be more useful in the group of duration of symptom less than 6 months, than in the group of longer duration(p<0.05), and in the group with motivation for counseling than in the group without motivation(p<0.05). CONCLUSIONS: About 60% of subjects replied the counseling was useful to them. Symptom duration and patients motivation to participate in counseling showed significant association with the effect of family counseling.
Abdominal Pain ; Chronic Disease ; Counseling* ; Family Characteristics ; Family Practice ; Headache ; Hope ; Humans ; Interviews as Topic ; Korea ; Medical Records ; Middle Aged ; Motivation ; Thorax

BACKGROUND: Family counseling is an essential part of family practice in which patients are cared in psychosocial dimension as will as in physical dimension and the family is dealt with as a whole unit. However, it is little applied in practice. The department of family medicine has made efforts to activate family counseling. This study was done to estimate the patients response on the effect of family counseling that we have performed, and to investigate what clinical problems counseling was held and in what situations the counseling was perceived to be useful by the patients. We hope this study will be useful to establish some useful data and ideas for the development of family counseling in family practice in Korea. METHODS: The subjects of this study are 53 households who received family counseling at the department of family medicine from Oct. 1, 1994 to May 31, 1995. 64 households received counseling during this peroid, but 11 persons who could not be reached by the phone were excluded. Patients demographic charateristics, patients chief complaints, physicians assessrnent on the complaints and major prolems presented in the counseling sessions were identified from the medical records. Patients own estimation of the effect of counseling and the reasons for termination of counseling were inquired through the telephone interview. Finally the association between the usefulness of counseling and some factors was statistically analyzed. RESULTS: Subjects were predominently women(84.9%), especially middle aged. The most common chief complaint was headache complained by 10 subjects (18.9%), and the second and the third were abdominal pain complained by 8 (15.1%) and chest discomfort complained by 7(13.2 %), respectively. The list of physicians assessment included depression(34.0%), physical symptom per se without any assessment(20.8%), family problem(15.1%), somatization(13.2%), and anxiety(9.45). More than half of the subjects(60.4%) had only one session, 26.4% two sessions and 7.5% more than 4 sessions. The most common problem presented in the counseling was marital conflict(28.3%), the second was trouble with in-laws(15.1%), and the third was chronic illness in the family(9.4%). 32.1% replied that the counseling was very helpful, 28.3% somewhat helpful, 17% little helpful, 20.8% never helpful, and 1.9% not sure. The session was experienced to be more useful in the group of duration of symptom less than 6 months, than in the group of longer duration(p<0.05), and in the group with motivation for counseling than in the group without motivation(p<0.05). CONCLUSIONS: About 60% of subjects replied the counseling was useful to them. Symptom duration and patients motivation to participate in counseling showed significant association with the effect of family counseling.
Abdominal Pain ; Chronic Disease ; Counseling* ; Family Characteristics ; Family Practice ; Headache ; Hope ; Humans ; Interviews as Topic ; Korea ; Medical Records ; Middle Aged ; Motivation ; Thorax

PURPOSE: Extended-spectrum β-lactamase-producing bacteria-induced urinary tract infections are increasing and require more potent antibiotics such as carbapenems. We evaluated the clinical significance of extended-spectrum β-lactamase urinary tract infection in children younger than 5 years to select proper antibiotics and determine prognostic factors. Differences were compared between age groups. METHODS: We retrospectively studied 288 patients with their first febrile urinary tract infection when they were younger than 5 years. Patients were divided into extended-spectrum β-lactamase-positive and extended-spectrum β-lactamase-negative urinary tract infection groups. Clinical characteristics and outcomes were compared between the groups; an infant group was separately analyzed (onset age younger than 3 months). RESULTS: Extended-spectrum β-lactamase urinary tract infection occurred in 11% patients who had more frequent previous hospitalization (P=0.02) and higher recurrence rate (P=0.045). During the antimicrobial susceptibility test, the extendedspectrum β-lactamase-positive urinary tract infection group showed resistance to third-generation cephalosporins; however, 98% patients responded clinically. In the infant group, extended-spectrum β-lactamase-positive urinary tract infection occurred in 13% patients and was associated with a longer pre-onset hospitalization history (P=0.002), higher C-reactive protein level (P=0.04), and higher recurrence rate (P=0.02) than that in the older group. CONCLUSION: Extended-spectrum β-lactamase urinary tract infection requires more attention because of its higher recurrence rate. The antimicrobial susceptibility test demonstrated resistance to third-generation cephalosporins, but they can be used as first-line empirical antibiotics because of their high clinical response rate. Aminoglycosides can be second-line antibiotics before starting carbapenems when third-generation cephalosporins do not show bactericidal effects for extended-spectrum β-lactamase urinary tract infection.
Aminoglycosides ; Anti-Bacterial Agents ; Bacteria* ; C-Reactive Protein ; Carbapenems ; Cephalosporins ; Child ; Hospitalization ; Humans ; Infant ; Recurrence ; Retrospective Studies ; Urinary Tract Infections* ; Urinary Tract*

PURPOSE: Extended-spectrum β-lactamase-producing bacteria-induced urinary tract infections are increasing and require more potent antibiotics such as carbapenems. We evaluated the clinical significance of extended-spectrum β-lactamase urinary tract infection in children younger than 5 years to select proper antibiotics and determine prognostic factors. Differences were compared between age groups. METHODS: We retrospectively studied 288 patients with their first febrile urinary tract infection when they were younger than 5 years. Patients were divided into extended-spectrum β-lactamase-positive and extended-spectrum β-lactamase-negative urinary tract infection groups. Clinical characteristics and outcomes were compared between the groups; an infant group was separately analyzed (onset age younger than 3 months). RESULTS: Extended-spectrum β-lactamase urinary tract infection occurred in 11% patients who had more frequent previous hospitalization (P=0.02) and higher recurrence rate (P=0.045). During the antimicrobial susceptibility test, the extendedspectrum β-lactamase-positive urinary tract infection group showed resistance to third-generation cephalosporins; however, 98% patients responded clinically. In the infant group, extended-spectrum β-lactamase-positive urinary tract infection occurred in 13% patients and was associated with a longer pre-onset hospitalization history (P=0.002), higher C-reactive protein level (P=0.04), and higher recurrence rate (P=0.02) than that in the older group. CONCLUSION: Extended-spectrum β-lactamase urinary tract infection requires more attention because of its higher recurrence rate. The antimicrobial susceptibility test demonstrated resistance to third-generation cephalosporins, but they can be used as first-line empirical antibiotics because of their high clinical response rate. Aminoglycosides can be second-line antibiotics before starting carbapenems when third-generation cephalosporins do not show bactericidal effects for extended-spectrum β-lactamase urinary tract infection.
Aminoglycosides ; Anti-Bacterial Agents ; Bacteria* ; C-Reactive Protein ; Carbapenems ; Cephalosporins ; Child ; Hospitalization ; Humans ; Infant ; Recurrence ; Retrospective Studies ; Urinary Tract Infections* ; Urinary Tract*

Angiogenesis is essential for tumor growth and metastasis, however, the prognostic value of neovascularization is undetermined. The aim of this study is to evaluate the prognostic significance of microvessel density (MVD) and vascular endothelial growth factor (VEGF) expression in breast carcinomas. An immunohistochemical stains for CD 31 (DAKO) to estimate MVD and VEGF (Santa Cruz) were done on 40 cases of invasive breast carcinoma. MVD was calculated as an average count of vessels per 200 power field in the most vascularized areas. VEGF expression was interpreted according to staining intensity and number of positive cells. Mean MVD was 35, and MVD was not correlated with lymph node metastasis or histologic grade, but high MVD (mean MVD>35) showed an increasing tendency in cases with larger size, negative ER/PR, and positive cathepsin D. All of the cases showed VEGF expression, but VEGF expression was not correlated with tumor size, histologic grade, lymph node metastasis, ER/PR status, and cathepsin D expression. These results suggest that MVD and VEGF expressions are not reliable prognostic factors.
Breast Neoplasms* ; Breast* ; Cathepsin D ; Coloring Agents ; Lymph Nodes ; Microvessels* ; Neoplasm Metastasis ; Vascular Endothelial Growth Factor A*

The CD8(+)CD28(+) T cells have known to mediate major histocompatibility complex class I-restricted cytolysis and to secret an HIV-1 inhibitory factor. As HIV infection lead to dramatic changes within the cellular immune system, the cellular cytotoxicities decrease in the duration of the HIV infection. To determine the importance of the cellular cytotoxicities in long-term nonprogression, we tried to compare CD28 expression on total T, CD4(+) T, and CD8(+) T cells as one of methods for cellular cytotoxicity measurements between long-term nonprogressor and normal person or between long-term nonprogressor and rapid progressor. The median percentages and counts of CD4(+) T cells of the norrnal, the long-term nonprogressor, and the rapid progressor groups were 39.9 and 0.96 * 10(9) cells/L, 24.6 and 0.58 * 10(9) cells/L, 9.9 and 0.15 * 10 cells/L, respectively. As a result of comparison of the cells having CD28 surface molecules on CD8(+) T cells in the long-term nonprogressor and the rapid progressor group, they showed over 5 times lower than that in the normal group. Especially, the long-term nonprogressor regarded to the healthy HIV-infected patient showed much lower CD28 expression on total T, CD4(+) T, and CD8(+) T cells than those of the normal person. The proportions of CD4'CD28 T and CD3CD28 T cell subsets showed the significant difference between the LTNP and the RP group. In conclusion, although HIV-infected patients were LTNPs having the steady CD4(+) T cell counts and no clinical symptoms, we suggested that HIV led to abnormality within the lymphocyte subsets such as the altered expression of CD28 molecules on various T cell subsets and this result would cause deficiency of host immune function and failure of control of HIV replication by anergy in T cell subsets.
Cell Count ; HIV ; HIV Infections ; HIV-1 ; Humans ; Immune System ; Lymphocyte Subsets ; Major Histocompatibility Complex ; T-Lymphocyte Subsets* ; T-Lymphocytes

PURPOSE: The study was done to identify factors influencing Yangsaeng in elders. METHODS: Data were collected by questionnaires from 907 elders in D metropolitan city. Measures were Yangsaeng, perceived health status, self-efficacy, and self esteem. Data were analyzed using frequencies, means and standard deviation, t-test, one-way ANOVA, Pearson correlation coefficients, and stepwise multiple regression with SPSS/WIN 13.0 version. RESULTS: The mean score for Yangsaeng the participants was 3.56, out of a possible 5. There were significant differences in Yangsaeng according to age, education level, monthly income, marital status, family structure, and periodic health examination. Yangsaeng correlated positively with perceived health status, self-efficacy and self-esteem. According to the research, factors influencing Yangseng in elders were self-esteem, perceived health status, self-efficacy, family structure, and marital status. CONCLUSION: The positive correlation between Yangsaeng and health promotion behavior and perceived health status, self-efficacy, and self-esteem identified in this study can have an impact on strategies to improve the health of Korean elders. Therefore, the results can be used as a reference for future studies.
Aged ; Aged, 80 and over ; Attitude to Health ; Family Relations ; Female ; *Health Promotion/economics ; Health Status ; Humans ; Male ; Marital Status ; Quality of Life ; Questionnaires ; Self Efficacy

The chest radiographs and angiograms were retrospectively evaluated in 47 patients with pulmonary atresia (PA) and ventricular septal defect (VSD) to determine the characteristic findings of major aortopulmonary collateral arteries (MAPCSs) on the chest radiographs. Of 47 patients, 23 had MAPCAs and 24 had only PDA for blood supply of whole right and left lung. Chest radiographs enabled identification of 16 of 23 patients with MAPCAs. The most common finding of MAPCAs was inappropriately large peripheral pulmonary vasculature (n=16, 69.6%). The other findings were tortuosity of pulmonary vasculature (n=12, 52.2%), focal unevendistribution of pulmonary vasculature (n=12, 52.2%), and two descending pulmonary arteries (n=4, 17.4%). When chest radiographs showed two or more findings of MAPCAs, MAPCAs could be differentiated from PDA with statistical significance (p<0.005). It is concluded that chest radiographs may help to identify MAPCAs before angiography if two-dimensional echo ardiography suggests PA with VSD.
Angiography ; Arteries* ; Heart Septal Defects, Ventricular* ; Humans ; Lung ; Pulmonary Artery ; Pulmonary Atresia* ; Radiography, Thoracic ; Retrospective Studies ; Thorax*