BACKGROUND: Pain is among the most prevalent symptoms experienced by patients with cancer. Severe pain is incompatible with quality of life. Although cancer pain can be effectively treated in 70-90% of patients with the principle of pain management, between 60% and 70% of cancer patients pain is inadequately treated. Both knowledge and attitudes of medical professionals are important for effective pain management. This study was designed to survey residents knowledge and attitudes toward cancer pain management in order to offer the basic data for researching the problems and education program of cancer pain management. METHODS: In February 1997, we surveyed 116 residents practising in 7 departments of one university hospital, including physicians and surgeons, with a case-oriented questionnaire assessing knowledge and attitudes toward cancer pain management. RESULTS: The percentage of residents choosing the correct answer for knowledge about pain management was, pain in the drug abuser(42.2%), equianalgesic dosing(47.4%), physical dependence(50.9%), WHO analgesic ladder(61.2%), neuropathic pain(62.9%), around the clock dosing(69.8%). The percentage of residents choosing answer for attitude toward cancer pain management ; upper limit to opioid prescription(46.5%), reluctance to prescribe morphine(45.7%), need of education for pain management(99.1%). Fear of side effects was the most frequent reason of their reluctance to prescribe opioids(80.4%.) Physicians had higher level of knowledge than surgeons(P=0.004). CONCLUSIONS: This study shows the presence of barriers to adequate pain control in Korea as identified in other countries. There is the lack of konwledge about cancer pain management and doctors are reluctant to prescribe because of negative attitudes towards pain management. This suggests a need for not simply offering knowledge but problemsolving education and training of pain management.
Education ; Humans ; Korea ; Pain Management* ; Quality of Life ; Surveys and Questionnaires

No abstract available.
Humans ; Infant, Newborn ; Meningitis, Bacterial*

No abstract available.
Seizures*

No abstract available.
Arrhythmias, Cardiac*

OBJECTIVE: The objectives of this study were to evaluate the reliability of the Korean version of Spinal Cord Independence Measure (SCIM) and to compare the sensitivity of the SCIM to functional changes of spinal cord injury (SCI) patients with that of the Functional Independence Measure (FIM). METHOD: Seventeen subjects with SCI were studied. The SCIM was translated and modified to convert as SCIM Korean-version. All patients were evaluated with the SCIM and the FIM by two raters every other week. To determine inter-rater reliability, the relationship between the SCIM scores obtained by two raters was evaluated by Kappa coefficient and linear regression. To determine relative sensitivity of the test to functional changes, changes in the scores on the SCIM and FIM were compared by McNemar test. RESULTS: The Kappa coefficient of the various individual tasks in SCIM ranged between 0.63 and 1.00. High correlations were also found between the total SCIM scores for the paired raters (r=0.99, p<0.01). The SCIM detected all the functional changes detected by FIM total scoring, but in 3 (14%) of 22 sequential test batteries, the FIM missed changes detected by SCIM total scoring. CONCLUSION: These results demonstrated that the SCIM is reliable and more sensitive than the FIM in reflecting the functional changes of SCI patients.
Humans ; Linear Models ; Spinal Cord Injuries* ; Spinal Cord*

PURPOSE: To evaluate the efficacy of combined treatment of metallic biliary stent placement and radiotherapy in malignant biliary obstruction. MATERIALS AND METHODS: Between January 1992 and February 1994, 22 patients with malignant biliary obstruction were treated with metallic biliary stent placement and radiotherapy. The causes of the obstruction included cholangiocarcinoma(n=14), gallbladder carcinoma(n=4), colon cancer(n=2), pancreatic head cancer (n=1), and stomach cancer(n=1). According to the sites of obstruction level, patient were divided into 2 groups; hilar obstruction(n=18) and common bile duct obstruction(n=4). The patients received dose of 45 Gray/18 fraction by external radiotherapy and 20Gy/8f by high dose rate brachytherapy with iridium--192 source through percutaneous transhepatic biliary drainage(PTBD) catheter. The duration of stent patency after placement, survival period and survival rate by Kaplan Meier method were calculated in dead and alive patients, respectively. RESULTS: In all 22 patients, the duration of stent patency was 5.5(1.3--18.5)months. Survival periods after stent placement and PTBD were 5.3(2.0--8.5 )months and 7.9(4.0--14.7)months respectively in 9 dead patients and 7.7(1.3--21.0)months and 9.5(2.3--23.0)months in 13 alive patients. In all 22 patients, the survival rates in 6, 12 and 18 months were 78.9%, 47.5 % and 35.6 %, respectively. CONCLUSIONS: The results with combined metallic biliary stent placement and radiotherapy for the palliative treatment of malignant biliary obstruction in this study was more favorable, as compared with those of the other authors with only metallic biliary stent placement.
Brachytherapy ; Catheters ; Colon ; Common Bile Duct ; Gallbladder ; Head and Neck Neoplasms ; Humans ; Palliative Care ; Radiotherapy* ; Stents* ; Stomach ; Survival Rate

No abstract available.
Gestational Age* ; Humans ; Infant, Newborn*

No abstract available.
Humans ; Infant, Newborn* ; Respiration, Artificial ; Survival Rate ; Ventilators, Mechanical*

The aim of this research was to study the effect of intermittent polymerization on marginal adaptation by comparing the marginal adaptation of intermittently polymerized composite to that of continuously polymerized composite. The materials used for this study were Pyramid (Bisco Inc., Schaumburg, U.S.A.) and Heliomolar (Ivoclar Vivadent, Liechtenstein). The experiment was carried out in class II MOD cavities prepared in 48 extracted human maxillary premolars. The samples were divided into 4 groups by light curing method; group 1- continuous curing (60s light on with no light off); group 2- intermittent curing (cycles of 3s with 2s light on & 1s light off for 90s); group 3- intermittent curing (cycles of 2s with 1s light on & 1s light off for 120s); group 4- intermittent curing (cycles of 3s with 1s light on & 2s light off for 180s). Consequently the total amount of light energy radiated was same in all the groups. Each specimen went through thermo-mechanical loading (TML) which consisted of mechanical loading (720,000 cycles, 5.0 kg) with a speed of 120 rpm for 100 hours and thermocycling (6000 thermocycles of alternating water of 50degrees C and 55degrees C). The continuous margin (CM) (%) of the total margin and regional margins, occlusal enamel (OE), vertical enamel (VE), and cervical enamel (CE)) was measured before and after TML under a x 200 digital light microscope. Three-way ANOVA and Duncan's Multiple Range Test was performed at 95% level of confidence to test the effect of 3 variables on CM (%) of the total margin: light curing conditions, composite materials and effect of TML. In each group, One-way ANOVA and Duncan's Multiple Range Test was additionally performed to compare CM (%) of regions (OE, VE, CE). The results indicated that all the three variables were statistically significant (p < 0.05). Before TML, in groups using Pyramid, groups 3 and 4 showed higher CM (%) than groups 1 and 2, and in groups using Heliomolar, groups 3 and 4 showed higher CM (%) than group 1 (p < 0.05). After TML, in both Pyramid and Heliomolar groups, group 3 showed higher CM (%) than group 1 (p < 0.05). CM (%) of the regions are significantly different in each group (p < 0.05). Before TML, no statistical difference was found between groups within the VE and CE region. In the OE region, group 4 of Pyramid showed higher CM (%) than group 2, and groups 2 and 4 of Heliomolar showed higher CM (%) than group 1 (p < 0.05). After TML, no statistical difference was found among groups within the VE and CE region. In the OE region, group 3 of Pyramid showed higher CM (%) than groups 1 and 2, and groups 2,3 and 4 of Heliomolar showed higher CM (%) than group 1 (p < 0.05). It was concluded that intermittent polymerization may be effective in reducing marginal gap formation.
Bicuspid ; Dental Enamel ; Humans ; Polymerization ; Polymers ; Water

The aim of this research was to study the effect of intermittent polymerization on marginal adaptation by comparing the marginal adaptation of intermittently polymerized composite to that of continuously polymerized composite. The materials used for this study were Pyramid (Bisco Inc., Schaumburg, U.S.A.) and Heliomolar (Ivoclar Vivadent, Liechtenstein). The experiment was carried out in class II MOD cavities prepared in 48 extracted human maxillary premolars. The samples were divided into 4 groups by light curing method; group 1- continuous curing (60s light on with no light off); group 2- intermittent curing (cycles of 3s with 2s light on & 1s light off for 90s); group 3- intermittent curing (cycles of 2s with 1s light on & 1s light off for 120s); group 4- intermittent curing (cycles of 3s with 1s light on & 2s light off for 180s). Consequently the total amount of light energy radiated was same in all the groups. Each specimen went through thermo-mechanical loading (TML) which consisted of mechanical loading (720,000 cycles, 5.0 kg) with a speed of 120 rpm for 100 hours and thermocycling (6000 thermocycles of alternating water of 50degrees C and 55degrees C). The continuous margin (CM) (%) of the total margin and regional margins, occlusal enamel (OE), vertical enamel (VE), and cervical enamel (CE)) was measured before and after TML under a x 200 digital light microscope. Three-way ANOVA and Duncan's Multiple Range Test was performed at 95% level of confidence to test the effect of 3 variables on CM (%) of the total margin: light curing conditions, composite materials and effect of TML. In each group, One-way ANOVA and Duncan's Multiple Range Test was additionally performed to compare CM (%) of regions (OE, VE, CE). The results indicated that all the three variables were statistically significant (p < 0.05). Before TML, in groups using Pyramid, groups 3 and 4 showed higher CM (%) than groups 1 and 2, and in groups using Heliomolar, groups 3 and 4 showed higher CM (%) than group 1 (p < 0.05). After TML, in both Pyramid and Heliomolar groups, group 3 showed higher CM (%) than group 1 (p < 0.05). CM (%) of the regions are significantly different in each group (p < 0.05). Before TML, no statistical difference was found between groups within the VE and CE region. In the OE region, group 4 of Pyramid showed higher CM (%) than group 2, and groups 2 and 4 of Heliomolar showed higher CM (%) than group 1 (p < 0.05). After TML, no statistical difference was found among groups within the VE and CE region. In the OE region, group 3 of Pyramid showed higher CM (%) than groups 1 and 2, and groups 2,3 and 4 of Heliomolar showed higher CM (%) than group 1 (p < 0.05). It was concluded that intermittent polymerization may be effective in reducing marginal gap formation.
Bicuspid ; Dental Enamel ; Humans ; Polymerization ; Polymers ; Water