BACKGROUND: Breast cancer is increasing cause of cancer-related mortality among Korean women. Early detection and treatment are the most important strategy for reducing breast cancer mortality. Despite of its importance as a early detection method, a low percentage of women practice breast self-examination(BSE) regularly. The aim of this study was to describe the effectiveness of patient education on performing BSE regularly and to identify predisposing factors associated with these activities. METHODS: Sixty-six women who did not have experience in BSE in the past were randomly assigned to the experimental group and the control group. We taught BSE knowledge and skill about BSE using breast models and audiovisual equipment for experimental group in patient education class. Women in control group, however, were simply educated by their physician about BSE knowledge and skill with only educational booklet during their outpatient visits. We observed the difference in regular BSE performance proportion between two groups 6, 12 months later and analyzed the predisposing factors affecting on the education effect. Direct and telephone interview methods were used to gather the information. Data were analyzed with t-test, x2analysis and logistic regression using SAS 6.10, EGRET program. RESULTS: There were no differences in sociodemographic characteristics between study groups. They were followed for 12 months. At follow-up after 6 months 44.1% of women performed BSE regularly among experimental group and 18.8% of women did it among control group(OR=3.4, 95% Cl 1.1-10.4, p<0.05). At follow-up after 12 months proportion of women performed BSE regularly in experimental group(28.6%) was slightly higher than that of control group(22.2%), but that difference was not statistically significant. The prevalence of performing BSE regularly was higher among women who had experience in periodic health examination(OR =6.0, 95% Cl 1.9-18.8, p<0.01), who had experience in mammography(OR =4.0, 95% Cl 1.0-15.6, p<0.05). And the prevalence of performing BSE regularly also was higher among women who were older than 40 years old, married, had experience in cervical Pap. smear, had knowledge about BSE before education, have done exercise regularly, had less number of health risk factors, but without statistical significance. CONCLUSIONS: These results showed that of effectiveness of patient education on BSE, if we determine the effectiveness of BSE education with regular performance of BSE, is relatively low among Korean women. We could see, however, that if we use breast models for demonstration in addition to usual educational material, the effectiveness of BSE education can be more effective. We also recognized that effectiveness of BSE education will not be continued for long time without any maintenance strategy. There were lots of predisposing factors which could affect the effectiveness of BSE education positively or negatively. So, family physicians who plan BSE patient education at their clinics must consider these factors.
Adult ; Breast Neoplasms ; Breast Self-Examination* ; Breast* ; Causality ; Education* ; Female ; Follow-Up Studies ; Humans ; Interviews as Topic ; Logistic Models ; Mortality ; Outpatients ; Pamphlets ; Patient Education as Topic ; Physicians, Family ; Prevalence ; Risk Factors

The purpose of this study is to morphologically evaluate the results of arthroscopic meniscal repair by sec- ond-look arthroscopy. We performed the arthroscopic meniscal repair in 40 menisci of 39 knees between March 1994 and August 1997. Among them, 18 menisci of 17 knees were evaluated by second-look arthroscopy at 3 rnonths postoperatively. Lateral meniscus was 9 and medial meniscus was 9. The morpho- logical results were classified with completely healed, incompletely healed, and failed. The overall results showed that 13 menisci completely healed, 3 menisci incompletely healed, 2 menisci failed. The type of tear was 14 peripheral longitudinal tears, 1 oblique tear(incompletely healed), 1 transverse tear(completely healed with augmentation of fibrin clot), 1 tear at posterior tibial attachment, and 1 complex tear(completely healed). 3 menisci had associated lesions that had not been treated, of which 1 incompletely healed, 2 failed. Chronic cases, in which time interval between injury and repair was 6 weeks later, were 8 menisci(4 completely healed, 2 incompletely healed, and 2 failed). 10 long peripheral longitudinal tears of more fhan 2.5cm were resulted in 6 completely healed, 2 incompletely healed, and 2 failed. 5 longitudinal tear with a wide peripher- al rim(>2mm) were resulted in 1 completely healed, 2 incompletely healed, and 2 failed. The good result was expected when the tear was repaired in acute phase after injury and associated lesion was treated. For chronic tears, tears of avascular zone and wide longitudinal tears, the healing enhancement techniques such as fibrin clot insertion, abrasion of meniscus and synovium, and trephination must be taken into consideration.
Arthroscopy* ; Fibrin ; Knee ; Logic ; Menisci, Tibial ; Synovial Membrane ; Trephining

The result of interference with the conductibility of the spinal cord is one of the most disabling and distressing complications of splnal tuberculosis. This fact was recognized as early as in 1779, when Pott published. The antituberculous drugs and improved surgical treatment have made possible a more effective treatment than before and improved the prognosis but not solved all problems completely. The following results were shown by analysis of 63 cases of spinal tuberculosls with neurological symptom experienced in the Department of Orthopedic Surgery, Seoul National University in the past 9.5 years from Jan. 1970 to Jun. 1979. 1. Number of cases In child was 15. (29%). 2. Pulmonary and other tuberculous diseases were manifested in 29 cases (46%). 3. Regions of the spine inovolved were most common In thoracic spine (43 cases), especially lower thoracic spine. 4. There were 49 early and 14 late paraplegia 5. There were 24 complete and 39 incomplete paraplegia. 6. Spastic type was more common than flaccid type. 7. Anterior fusion was done in 55 cases and costotransversectomy in 8. 8. There were 36 cases (57%) of complete recovery and 8 of fallure. 9. The prognosis for recovery from paraplegia appeared to depend on age, duration, type and onset of paraplegia.
Child ; Humans ; Muscle Spasticity ; Orthopedics ; Paraplegia ; Prognosis ; Seoul ; Spinal Cord ; Spine ; Tuberculosis ; Tuberculosis, Spinal

No abstract available.

No abstract available.
Family Practice* ; Fatigue* ; Humans ; Pilot Projects* ; Prospective Studies*

BACKGROUND: Previous studies have suggested that regular exercise may increase bone mineral density. However, the effects on bone mineral density are different depending on the types of exercises and recent studies on the effects of different exercises on bone mineral density are insufficient. This study was conducted to assess the effects of 2 different exercises(Judo, Taekwondo) and physical fitness(back muscle strength, grip strength, broad jump, vertical jump, flexibility, sit ups) on regional BMD. METHODS: Subjects were healthy adults female volunteers aged 19 to 22 years and consisted of eight Judo athletes, twelve Taekwondo athletes, and eight nonathletic controls. We measured their bone mineral density of lumbar spine, femoral neck, femoral greater trochanter, Wards triangle, femoral shaft and distal radius using dual energy X ray absorptiometry and assessed their physical fitness. We investigated the mean differences of regional bone mineral density between the groups and the relationships between physical fitness and regional bone mineral density. RESULTS: ANCOVA revealed that there were significant differences in the regional bone mineral density between the groups. The Judo athletes group had significantly higher bone density of greater trochanter, femoral shaft, distal radius, femoral neck and lumbar spine than the control group and had significantly higher bone density of greater trochanter, femoral shaft and distal radius.than the Taekwondo atheletes group. There were no significant differences of bone density in all the regions between the Taekwondo atheletes and the control groups. Partial correlation coefficients between the back muscle strength and the bone density of Wards triangle, greater trochanter, distal radius, femoral neck, femoral shaft, and lumbar were 0.581, 0.570, 0.526, 0.502, 0.424, and 0.418, Respectively (P<0.05). Correlation coefficients between the broad jump and the bone density of femoral neck, greater trochanter, and femoral shaft were 0.577, 0.539, and 0.457, respectively(P<0.05). Correlations of the grip strength, flexibility, sit ups and vertical jump with bone density of all regions were not high(r< or=0.5). CONCLUSIONS: Different types of exercises showed different effects of bone density. The back muscle strength among the physical fitness factors was considered to be the most important predictor of bone density. In the future, further studies are necessary for the effects of other exercises on bone density.
Absorptiometry, Photon ; Adult ; Athletes* ; Back Muscles ; Bone Density* ; Exercise* ; Female* ; Femur ; Femur Neck ; Hand Strength ; Humans ; Martial Arts ; Muscle Strength ; Physical Fitness ; Pliability ; Radius ; Spine ; Volunteers ; Young Adult*

No abstract available.
Mass Screening* ; Uterine Cervical Neoplasms*

BACKGROUND: The functional dyspepsia gives rise to such a symptom similar to peptic ulcer without showing a noticeable lesion(e.g, gastric or duodenal ulcer) by endoscopy or upper GI serises, and it has been known that this is about twice as many as the peptic ulcer. However, there is no exact theory about its pathophysiology and it is suggested that multiple factors including genetic, physiologic, psychologic, environmental factors are engaged. Especially, in respect to the occurrence of functional dyspepsia and psychological factors, there have been many clinical studies over the world. But, we still need more studies in this country, therefore, this study has been initiated to give help patients of functional dyspepsia, invest.igating their characteristic traits through MMPI. METHODS: From March to September in 1996, the patients who visited the family medicine out-patients department of St. Marys hospital of Catholic Medical College were sampled in this study. There were 46 patients having a similar symptoms to peptic ulcer without showing pathologic lesions by endoscopy. Through an interview and some basic tests, the 41 controls who had no dyspeptic symptoms and were not affected to a noticeable physical or physiological disorders were selected for the normal reference group. The standardized MMPI of our country was applied to the whole object groups to get a result. Then each average value of the measure(mean T-score) was calculated, and the differences of the average value were analyzed by the t-test and chi-square test. And the psychological pattern analysis was done. RESULTS: In demographic aspects, there were no significant differences between the two groups. The mean T score for each measure of the two groups falls within the normal ranges with their values being of between 30 to 70. And the average of L, F, and K measure, known as the validity measure, did not give a significant differences between the two groups. The measure of Hs, D, and Hy have appeared significantly high in the patients group(p<0.01) and the Pd measure, too(p<0.05). While Mf, Pa, and Ma measure have not shown a significant differences, Pt, Sc, and Si measure have very significant differences(p<0.01). CONCLUSIONS: In the patient group with the functional dyspepsia, the measures of Hs, D, and Hy where they indicate a neurotic pattern have shown a very significantly high point as well as those of Pd, Pt, Sc, and Si where they indicate a psychotic pattern. This reveals that in the group of the functional dyspepsia neurotic or psychotic trends to attribute. However, it is very hard to define the characteristics of a group with just one test, so further study with more variable test will be necessary.
Dyspepsia* ; Endoscopy ; Humans ; MMPI* ; Outpatients ; Peptic Ulcer ; Psychology ; Reference Values

While renovating our traditional medical curriculum to integrated curricular system in 1996, we planned to introduce a course of problem-based learning (PBL) on tutorial basis after finishing 14 courses of the integrated medical curriculum for two years. One tutorial group was composed of one tutor and eight students, and 105 students of the second grade were divided into thirteen small tutorial groups. The period of PBL course was two weeks from December 1 to 14 in 1997. There were three interrelated steps for design of PBL course: course preparation, implementation, and evaluation which were conducted by PBL subcommittee consisted of nineteen teachers. Students were exposed to four clinical case modules, and they met in small tutorial room three times per week for two weeks. The PBL programme was evaluated by questionnaire survey method at the end of PBL course. We obtained satisfactory and positive results from reply of faculty and students. Since many teachers participated in planning, implementing, and evaluation of PBL, we could accumulate lots of knowledge and skills regarding the PBL, and it was a good opportunity to train expertise for PBL, test the feasibility changing to PBL curriculum. At this moment, our present integrated medical curriculum will be gradually converted to PBL system totally, and our experience will provide a good aid for other medical schools appling traditional medical curriculum to introduce PBL in their medical education.
Curriculum ; Surveys and Questionnaires ; Education, Medical ; Humans ; Problem-Based Learning* ; Schools, Medical

The anterior cruciate ligament(ACL) is one of the major stabilizers of knee motion. The ACL does not heal once torn, unlike many other biological tissues. Its absence can lead to severe joint instability which can lead to disruptions of secondary restraints around the knee and then progress to degenerative joint disease. Thus many authors advocate surgical intervention for a torn ACL in order to restore stability to the joint. Yet, there is still controversy as to best treatment for the ACL injuries. It is desirable to be considered for the patients age, the severity of the injury, and the future activity level of the patient to decide treatment. We analyzed thirty ACL acute injuries of twenty seven patients who had an ACL injury and treated surgically between Apr. 1986 and Dec. 1991 at St. Pauls Hospital. The results were as follows: 1. There were twenty five males and two females. The mean age was 33.4 years ranged, 15 to 52 years. 2. The anterior cruciate ligaments were torn at proximal portion in twenty two cases, at midportion and distal portion in four, respectively. 3. Two knees had isolated ACL injuries and twenty eight had combined injuries. 4. Twenty one out of twenty six cases treated with primary repair, and three out of four cases treated with reconstruction had good-excellent results.
Anterior Cruciate Ligament ; Female ; Humans ; Joint Diseases ; Joint Instability ; Joints ; Knee ; Male