PURPOSE: The purpose of this study was to examine the effects of forced air warming on intraoperative and postoperative body temperature, postoperative shivering and pain in patients undergoing laparoscopic cholecystectomy. METHODS: A quasi-experimental design with nonequivalent control group was utilized. Fifty eight patients scheduled for laparoscopic cholecystectomy were recruited and assigned to the experimental group (n=29) or control group (n=29). For the experimental group, forced air warming was applied from right after induction and up to one hour after surgery. Body temperature, shivering score and pain score were measured in both groups at 15 minute intervals. Data were collected from September, 2013 to April, 2014. Data were analyzed using t-test, Bonferroni test and repeated measures ANOVA. RESULTS: The experimental group showed higher body temperature than the control group during surgery. After surgery the experimental group showed higher body temperature, lower shivering and less pain compared to the control group. CONCLUSION: Results show that forced air warming is effective in enhancing body temperature and reducing shivering and pain. Therefore, forced air warming is recommended as an operative nursing intervention.
Body Temperature* ; Cholecystectomy, Laparoscopic* ; Humans ; Nursing ; Shivering*

BACKGROUND: Infection of hepatitis B virus(HBV) is one of the most important cause of the liver diseases in Korea, although HBV infection tends to be decreased. Diagnostic kits more accurately detecting HBV infection have been required'in order to diagnose and prevent the HBV infection. Recently LG Chemical Ltd. developed new diagnostic kits for HBsAg, anti-HBs and anti-HBc, using HBV from Korean patients. We evaluated these new kits by comparing them with microplate enzyme immunoassay (EIA) from BehringTU(Germany) and microparticle EIA (MEIA) from AbbottTM(USA). METHOD: Sera from 1,500 healthy blood donors and 500 patients were obtained to test HBsAg, anti- HBs and anti-HBc using diagnostic kits from AbbottTM, BehringTM and LG Chemical Ltd. We analyzed the results of 3 manufacturers and confirmed the discordant results of HBsAg by Southern hybridization after HBV PCR and those of anti-HBs by neutralization assay with HBsAg from LGTM. We also evaluated the reproducibility and detection limit. RESULTS: Of 1,500 healthy blood donors, HBsAg was positive in 34 (2.3%), representing completely the same results from 3 manufacturers. However, of 500 patients, 7 (1.4%) had discordant results; HBsAg was positive in all 7 sera tested with BehringTM and positive in only one tested with AbbottTM and LGTM, respectively. HBV DNA was not detected in all 7 discordant results of HBsAg, so false positive results totaled 7 (1.4%) with BehringTM and 1 (0.2%) with AbbottTM and LGTM, respectively. Of 2,000 sera, the results of anti-HBs and anti-HBc from 3 manufacturers were same in 1,876 (93.8%) and in 1,949 (97.5%), respectively. Results of HBsAg, anti-HBs and anti-HBc from 3 manufacturers were constant on repeating tests. When testing the detection limit, BehringTM kits for HBsAg and anti-HBs retained significantly higher sensitivity than AbbottTM and LGTM. On the other hand, BehringTM kit for anti-HBc showed significantly lower sensitivity than AbbottTM and LGTM. CONCLUSION: The diagnostic kits for HBV developed by LG Chemical Ltd. showed comparable results with those by AbbottTM or BehringTM and will be useful as screening blood donors or detecting patients with HBV infection.
Blood Donors ; DNA ; Hand ; Hepatitis B Surface Antigens ; Hepatitis B* ; Hepatitis* ; Humans ; Immunoenzyme Techniques ; Korea ; Limit of Detection ; Liver Diseases ; Mass Screening ; Polymerase Chain Reaction

PURPOSE: Intraductal papilloma (IDP) is a benign breast disease with malignant potential, for which complete surgical excision is usually recommended. The aim of the present study was to investigate predictive factors for upgrading patients with a benign papillary lesion (BPL). METHODS: This study was an observational study using a prospectively collected cohort. In total, 13,049 patients who underwent a core needle biopsy (CNB) for a breast lesion between January 2009 and May 2015 were enrolled. We reviewed all patients with pathologically confirmed BPL from a CNB. RESULTS: Surgical treatment was performed for 363 out of a total of 592 lesions. According to the pathological differences, the lowest upgrade rate was shown in IDP without atypia (without atypia, 6.0%; with atypia, 26.8%; papillary neoplasm, 31.5%; p<0.001). The univariate analysis showed that, in IDP without atypia, the age at diagnosis, size of BPL on ultrasonography, and density on mammography were associated with upgrading. The multivariate analysis revealed that age >54 years and lesion size >1 cm were significantly associated with upgrade to malignancy (odds ratio [OR]=4.351, p=0.005 and OR=4.236, p=0.001, respectively). CONCLUSION: The indications for surgical treatment can be defined as age >54 years and mass size >1 cm, even in IDP without atypia in the CNB results; this also includes cases of IDP with atypia or papillary neoplasm. Therefore, we suggest that close observation without surgery is sufficient for younger women with a small IDP without atypia.
Biopsy ; Biopsy, Large-Core Needle* ; Breast Diseases ; Breast Neoplasms ; Breast* ; Cohort Studies ; Diagnosis ; Female ; Humans ; Mammography ; Multivariate Analysis ; Observational Study ; Papilloma, Intraductal ; Prospective Studies ; Ultrasonography

OBJECTIVE: To evaluate the association of maternal age with occurrence of fetal chromosomal abnormalities in Korean pregnant women of advanced maternal age (AMA). METHODS: A retrospective review of the amniocentesis or chorionic villous sampling (CVS) database at Gangnam and Bundang CHA Medical Centers, between January 2001 and February 2012, was conducted. This study analyzed the incidence of fetal chromosomal abnormalities according to maternal age and the correlation between maternal age and fetal chromosomal abnormalities in Korean pregnant women > or =35 years of age. In addition, we compared the prevalence of fetal chromosomal abnormalities between women of AMA only and the others as the indication for amniocentesis or CVS. RESULTS: A total of 15,381 pregnant women were selected for this study. The incidence of aneuploidies increased exponentially with maternal age (P<0.0001). In particular, the risk of trisomy 21 (standard error [SE], 0.0378; odds ratio, 1.177; P<0.001) and trisomy 18 (SE, 0.0583; odds ratio, 1.182; P=0.0040) showed significant correlation with maternal age. Comparison between women of AMA only and the others as the indication for amniocentesis or CVS showed a significantly lower rate of fetal chromosomal abnormalities only in the AMA group, compared with the others (P<0.0001). CONCLUSION: This study demonstrates that AMA is no longer used as a threshold for determination of who is offered prenatal diagnosis, but is a common risk factor for fetal chromosomal abnormalities.
Amniocentesis ; Aneuploidy ; Chorion ; Chromosome Aberrations ; Down Syndrome ; Female ; Humans ; Incidence ; Maternal Age ; Odds Ratio ; Pregnant Women ; Prenatal Diagnosis ; Prevalence ; Retrospective Studies ; Risk Factors ; Trisomy

Takayasu's arteritis is a chronic vasculitic disease of the aorta, its major branches and the pulmonary arteries, resulting in stenosing, occlusive or aneurysmal lesion. While the precise etiology of Takayasu's disease is unknown, an autoimmune mechanism or active tuberculous inflammation have been suggested. It is more common in young oriental women but has a rare incidence in children. We experienced a case of Takayasu arteritis type IV in an 8years old girl. The diagnosis was made by physial examination and digital substraction aortography(DSA) which showed narrowing of left common carotid artery, right subclavin artery and left renal artery. The perfusion defect at posterior segment of right upper lobe was noted in lung perfusion scan. Medical treatment and percutaneous transluminal angioplasty(PTA) were performed. In addition to case report, a brief review of literature was added.
Aneurysm ; Angioplasty* ; Aorta ; Arteries ; Carotid Artery, Common ; Child ; Diagnosis ; Female ; Humans ; Incidence ; Inflammation ; Lung ; Perfusion ; Pulmonary Artery ; Renal Artery ; Takayasu Arteritis*

BACKGROUND: The product of oxygen-free radicals inf1ict oxidative injuries on healthy cells. Antioxidants such as superoxide dismutase(SOD), glutathione peroxidase, and reduced glutathione(GSH) are present in almost all cells and play important roles in metabolism, transport, and cellular protection. We measured blood GSH levels in healthy controls and patients with non insulin dependent diabetes mellitus(NIDDM) for evaluation of the clinical usefulness of GSH. METHODS: Erythrocyte GSH levels were measured in fifty healthy controls and thirty NIDDM patients with diabetic retinopathies by Beutler's method. We also tested within-run precision, between-run precision, linearity and recovery rate to evaluate this method measuring erythrocyte GSH levels. RESULTS: The GSH levels (mean +/-SD) of NIDDM patients (5.03+/-0.67mumo1/Hb) were significantly lower than those of healthy control group (6.46+/-0.85mumo1/Hb)(P<0.001). The results of within-run precision and between-run precision when stored at 4degrees Cwere excellent (coefficient of variation were 2.79% and 2.42%, respectively), however, when stored at the room temperature the GSH levels were sharply declined. The linearity and recovery rate were acceptable. CONCLUSIONS: The prescision, linearity, and recovery rate of GSH measurement were excellent. The GSH levels in NIDDM patient group were reduced, and this probably contributes to the defective defense mechanism against increased oxidative stress. Additional measurement of other antioxidants such as superoxide dismutase and glutathione Peroxidase may be required to clarify the pathologic significance of glutathione metabolism in various diseases.
Antioxidants ; Diabetes Mellitus, Type 2 ; Diabetic Retinopathy ; Erythrocytes* ; Glutathione Peroxidase ; Glutathione* ; Humans ; Insulin ; Metabolism ; Oxidative Stress ; Superoxide Dismutase ; Superoxides

PURPOSE: Octreotide, a potent synthetic somatostatin (SM) analogue, was recently evaluated and found to have a beneficial effect in thyroid eye disease (TED). Lanreotide (LRT: Somatuline(R)), a new SM analogue, is more active and has a much longer duration of action. The aim of this study was to report the therapeutic effect of LRT on the treatment of TED. METHODS: Four patients of mean age 42.5 years had severe acute thyroid-related ophthalmopathy symptoms. The NOSPECS system was applied in this study to evaluate the response to treatment. They received 40 mg LRT i.m. every 2 weeks over a period of 3 months. RESULTS: All of them showed a significant improvement of acute inflammatory symptoms in both eyes. The average of TED score was 3.6, while it was 6.3 before the injection. Average clinical activity score of pre-injection was 4.1 and it markedly decreased to 1.3, and the self assessment score was 1.4, which means a moderate satisfaction. The amount of proptosis was found to decrease about 3.0 mm. CONCLUSIONS: We report our clinical experience that LRT has a beneficial effect on active TED and it is a good therapeutic modality for medical treatment.
Exophthalmos ; Eye Diseases ; Humans ; Octreotide ; Self-Assessment ; Somatostatin ; Thyroid Gland*

Background/Aims: Integrated relaxation pressure (IRP) is a critical diagnostic criterion to define achalasia. However, there are some cases with typical symptoms and signs of achalasia but with normal IRP. The aim of this study is to evaluate the clinical characteristics of patients with achalasia with normal IRP and outcomes after peroral endoscopic myotomy (POEM). Methods: Patients with achalasia were collected in whom POEM was performed from November 2014 to April 2018 at CHA Bundang Medical Center. Achalasia with normal IRP was defined by findings compatible to achalasia in Eckardt score, endoscopy with endoscopic ultrasound, high-resolution manometry, impedance planimetry (EndoFlip), and timed esophagogram. Results: POEM was performed in 89 patients with achalasia; among them, 24 (27%) patients were diagnosed with achalasia with normal IRP. Patients with achalasia with normal IRP were older, had longer duration of symptom, and had a more tortuous esophagus. In EndoFlip, the distensibility index and cross-sectional area were higher in patients with normal IRP. Therapeutic outcomes showed no statistically significant differences. On correlation analysis, IRP had negative correlations with age, disease duration, and distensibility index. Conclusions Patients with achalasia of normal IRP value were older and had longer disease duration and higher distensibility index and crosssectional area than patients with achalasia with abnormal relaxation of lower esophageal sphincter. Therapeutic outcomes were not different between the 2 groups.

Purchasing professionals utilize a e-commerce to sell or buy better products with good price. The marketers of agricultural products recognized that e-commerce has made significant inroads, and the Internet is fast becoming an essential tool for purchasing. The purpose of this research was to assess the realities of internet shopping malls of agricultural products including the actual condition of the sites, payment methods, order methods, membership and shipping methods. The results show that operating internet shopping mall of agricultural products are operated poorly in terms of buyer-seller relationship, payment and distribution. The results also provide some practical implication for marketers regarding the establishment of database, improvement of distribution and internet shopping mall operation, and importance of education on e-business for agricultural markets.
Education ; Internet* ; Ships

Infertility, defined as 1 year of unprotected coitus without conception, affects approximately 10 to 15% for couples of reproductive age. Approximately 35% of these cases are attributable to male factor infertility. A major cause of male infertility is chromosome abnormality, such as 47 chromosomes with an XXY karyotype. Early surveys of infertile males showed that the incidence of major chromosome abnormality in infertile males in azoospermic patients. When patients are treated for male infertility, a chromosome analysis including a search for abnormality at the DNA level, should be performed. We have experienced a case of autosomal reciprocal translocation in azoospermic patient. So we report this case with a brief review of literatures.
Azoospermia ; Chromosome Aberrations ; Coitus ; DNA ; Family Characteristics ; Fertilization ; Humans ; Incidence ; Infertility ; Infertility, Male ; Karyotype ; Male