No abstract available.
Urolithiasis*

Electroconvulsive therapy (ECT) is a safe and effective treatment not only for various mental disorders including depression, mania, and schizophrenia, but also for inadequacy and resistance to pharmacotherapy and the psychiatric emergences. The historical ups and downs of ECT treatment since its first introduction in 1938 were ended by the validation impacts of evidence-based medicine in the 1980s and by other clinical issues. Clinical research for the optimization of ECT to maximize therapeutic effects and to minimize adverse effects is ongoing to establish standardized procedures and educational programs through the ECT center. In addition, guidelines for ECT practices are also being developed for the clinical excellence of ECT practices in accordance with the recommendations of international organizations such as World Psychiatric Association and American Psychiatric Association. This article was prepared by reviews of the literature, direct observations of ECT practices abroad, and interviews with ECT experts around the world in order to enhance therapeutic effects with recently updated ECT practices under the belief that the most appropriate treatments should be provided to the patients in need.
Bipolar Disorder ; Depression ; Drug Therapy ; Electroconvulsive Therapy* ; Evidence-Based Medicine ; Humans ; Mental Disorders ; Schizophrenia

Endotoxin is a component of bacterial outer membrane. Endotoxin is generally a heat-stable toxin that has the various biological activities such as pyrogenicity, macrophage and complement activation. To determine the source of endotoxin contamination in our water processing and dialysate-delivery system in Korea, endoxin was monitored in tap water at the inlet of water softening, in processed water, at the inlet of dialysate proportioner and in the dialysate at the inlet and outlet of the dialyzer. The endotoxin levels were 24.9ng/ml at the inlet of water softening and 2.3ng/ml in processed water. The removal rate of endotoxin during water processing is 90.7%. Endotoxin concentration were 3.58ng/ ml at the inlet of dialyzer and 12.4ng/ml at the outlet of dialyzer. There was no statistically significant change between the inlet of dialyzer and the outlet of dialyzer. These result suggested that a reverse-osmosis system appeared necessary for decreasing endotoxin in tap water to a certain concentration, so the level of endotoxin in the dialysate would be minimal.
Bays ; Complement Activation ; Dialysis* ; Korea ; Macrophages ; Membranes ; Renal Dialysis* ; Water ; Water Softening

Anhidrotic ectodermal dysplasia is inherited as an X linked recessive trait. This disor der is characterized by hypotrichosis, hypodontia and hypohidrosis. The diagnosis is often delayed until the first or second year of life, after repeated episodes of potentially damaging high fever. In the newborn period, the diagnosis is more difficult, but early diagnosis is of importance in ensuring that the appropriate enivironment and medical measures be taken to avoid uncontrolled hyperthermia. We have experienced a case of anhidrotic ectoclermal dysplasia in an8-day-old male patient who showed charecteristic features including hypotrichosis, peeling or scaling of the skin, recurrent fever and a characteristic face. A skin biopsy from the right palm revealed no sweat gland strutures. A brief rview with related literature is also presented.
Anodontia ; Biopsy ; Diagnosis ; Early Diagnosis ; Ectodermal Dysplasia* ; Fever ; Humans ; Hypohidrosis ; Hypotrichosis ; Infant, Newborn ; Male ; Skin ; Sweat Glands

PURPOSE: A prolonged administration of etoposide increases its effectiveness on the suggestion that pralonged maintenance of low levels is an important factor in determining its activity. Many studies have been tried to define the efficacy of combination of oral etoposide with other chemotherapeutic drugs such as cisplatin, 5-FU, and ifosfamide in patients with advanced non-small cell lung cancer (NSCLC). In this study, we evaluated the effectiveness and toxicities of combination chemotherapy of oral etoposide with intravenous cisplatin and ifosfamide in advanced NSCLC patients. MATERIALS AND METHODS: Thirty-three patients with inoperable NSCLC who had measurable diseases and had not been treated with chemotherapeutic drug, were enrolled in this study (from May 1995 to April 1998). Treatment consisted of intravenous cisplatin (20 mg/m(2)/day, Day 1-3) and ifosfamide (1,800 mg/m(2)/day, Days 1-3) with Mesna (1,100 mg/m(2)/day, Days 1-3), and oral etoposide (50 mg/m(2)/day, Days 4-17). This treatment was repeated every 4 weeks. Patients showing stable disease or a better response were continued on treatment with the range of one to nine cycles (medium: 3 cycles). All patients were evaluated for the response, survival, and toxicity of this combination chemotherapy. RESULTS: Eleven patients showed either complete responses [CR, 3 (9%)] or partial responses [PR, 8 (24%)]. The median number of treatment cycles were 5 (range, 3-9) for responders and 2 (range, 1-7) for non-responders. The responders had median response duration of 10 months and the overall survival of 12 months. The overall survival of responders were longer than that of non-responders (median 19 vs 5 months, p 0.0232). The toxicities of this treatment were tolerable without treatment related death. Limiting toxicities were myelosuppression and oral mucbsities, Grade 3 or 4 leukopenia and oral mucosities were observed in 34% and 9%, respectively. CONCLUSION: The combination of cisplatin, ifosfamide, and oral etoposide produced encouraging response rates and median survival duration in patients with response. Further study of this combination is warranted in comparison with standard cisplatin+etoposide regimen or intravenous etoposide, cisplatin and ifosfamide regimen.
Carcinoma, Non-Small-Cell Lung ; Cisplatin* ; Drug Therapy, Combination* ; Etoposide* ; Fluorouracil ; Humans ; Ifosfamide* ; Leukopenia ; Mesna ; Small Cell Lung Carcinoma*

PURPOSE: Combination chemotherapy with cisplatin and etoposide have been considered as one of the chemotherpy regimen for non small cell lung cacer(NSCLC) with the response rate of 20~40%. Ifosfamide is one of the most active agent against NSCLC. And so, we initiated a phase II trial for advanced NSCLC to determine the effect of PIE(cisplatin, ifosfamide, etoposide) regimen. MATERIALS AND METHODS: 36 patients with inoperable non-small cell lung cancer who had no prior systemic chemotherapy were treated with combined ifosfamide (1,800 mg/m2 plus mesna 1,100 mg/m2 by intravenous continuous infusion daily for 3 days) with cisplatin (20 mg/m2 intravenous for 3 days) and etoposide (80 mg/m2 intravenous for 3 days). We evaluated the response rate, survival and toxicities of these patients. RESULTS: The objective response rate was 28%(CR; 2/36, 6%, PR; 8/36, 22%). Among 10 responders, 7 patients were in good ECOG performance status(0~1). The mean survival of all these patients were 43 weeks(8~141 weeks); the responding patients survived longer than the non-responders(median survival; 59 weeks vs 28 weeks, p<0.05). The toxicities of this regimen were acceptable without treatment related toxic death. CONCLUSION: We concluded that PIE regimen is effective in the treatment of advanced non-small cell lung cancer with acceptable toxicities and long-term follow up is warranted.
Carcinoma, Non-Small-Cell Lung ; Cisplatin* ; Drug Therapy ; Drug Therapy, Combination* ; Etoposide* ; Follow-Up Studies ; Humans ; Ifosfamide* ; Lung ; Mesna ; Small Cell Lung Carcinoma* ; Survival Rate

PURPOSE: We compared the results of electromagnetic navigation assisted total knee arthroplasty (TKA) with that of conventional TKA from the viewpoint of the postoperative limb alignment and the implant position. MATERIALS AND METHODS: We retrospectively analyzed 115 consecutive total knee arthroplasties that were done between September 2006 and June 2007. There were 65 navigation assissted cases and 50 conventionally implanted cases. We analyzed the postoperative radiologic results, the clinical results over one year follow up after surgery and the range of motion (ROM). RESULTS: The postoperative mechanical axis deviation showed no significant difference between the two groups. However, the tibial zone, as assessed by Kennedy and White's method were at zone C for 60 cases (92%) in the navigation group and for 40 cases (80%) in the conventional group (p=0.01). On the coronal plane, the implant position of the femoral component was 89.4+/-4.1degrees in the navigation group and 87.6+/-4.3degrees in the conventional group (p<0.01), and the implant position of the tibial component was 89.7+/-1.1degrees and 91.9+/-1.8degrees in each group, respectively (p<0.01), and this shows the better result in the navigation group. CONCLUSION: Electromagnetic navigation assisted TKA had similar clinical results on the short-term follow up as compared with conventional TKA. However, it radiologically showed a more satisfactory position of the implant and it displayed superiority in locating the precise position of the femoral and tibial components, and especially on the coronal plane.
Arthroplasty ; Axis, Cervical Vertebra ; Extremities ; Follow-Up Studies ; Knee ; Magnets ; Range of Motion, Articular ; Retrospective Studies

Antibiotics associated colitis due to Clostridium difficile is a common nosocomial infection associated with significant morbidity. In severe cases, pseudomembraneous colitis may be associated with intraperitoneal fluid accumulation. However, the characteristics of the fluid are seldom described. This case report describes pseudomembraneous colitis patient who was presented with low serum-ascites albumin gradients and lymphocytic ascites, without the evidence of infection, malignancy, or inflammatory peritoneal disease.
Anti-Bacterial Agents ; Ascites* ; Clostridium difficile ; Colitis* ; Cross Infection ; Humans ; Peritoneal Diseases

PURPOSE: This study was aimed at exploring the current status of graduate programs for an advanced practice nurse(APN) to recommend future directions of APN education. METHODS: A total of 142 students enrolled in seven APN specialty programs, 67 professors who were involved in APN education, and nine nurse administrators participated in the study. Data was collected by questionnaires and focus group interviews. RESULTS: The current definition of APN was found not to be specific enough to represent expected roles of APN in regards to knowledge, attitudes, roles, and skills. Standard curricula employed regardless of the area of APN specialty, lack of qualified clinical practice settings, as well as prepared instructors were found to be problematic. CONCLUSION: The following needs to be addressed: 1. redefining of APN roles, 2. tailoring specialty areas of APN, 3. consolidating educational programs, and 4. ensuring APN role models and faculty. Suggesting a CNS role in Korean APN, areas of APN should be rearranged toclarify their roles and educational programs need to be further developed to meet the expectations and quality of APNs. It is necessary to ensure APN's employment in the health care system by laws and policies to perform advanced nursing roles.
Adult ; Curriculum ; Education, Nursing, Continuing ; Education, Nursing, Graduate ; Educational Measurement ; Focus Groups ; Humans ; Interviews as Topic ; Middle Aged ; Nurse Clinicians/*education ; Nurse Practitioners/*education ; Nursing Evaluation Research ; Questionnaires ; Societies, Nursing ; Specialties, Nursing/*education

We report here on a case of performing a redo-operation for a 65-years-old male patient who had prosthetic endocarditis after reconstruction of the fibrous skeleton due to infective endocarditis 8 years earlier. An aortic annular abscess with a 1 cm sized subvalvular abscess and mobile mitral valve vegetation with destruction of the fibrous skeleton was shown on the preoperative echocardiography. An emergency operation was performed due to heart failure. Reconstruction of both the aortic and mitral annuli and the fibrous skeleton was done by using two separate bovine pericardial patches and then mechanical valves were implanted. The postoperative echocardiography shows no paravalvular leakage. The patient has been followed up with no symptoms.
Abscess ; Echocardiography ; Emergencies ; Endocarditis ; Heart Failure ; Heart Valve Prosthesis ; Humans ; Male ; Mitral Valve ; Reoperation ; Skeleton