The purpose of this study was to evaluate the reliability of 6-axis model surgery simulator (6AMSS) for orthognathic surgery. A rectangular parallelepiped plastic block was assembled to model-mounting plate of 6AMSS. Left-right (X), anterior-posterior (Y), up-down (Z) translation and pitching (empty set X), rolling (empty set Y) and yawing (empty set Z) rotation was planned and performed using 6AMSS. The actual translation and rotation were measured with dial gauge and precisional protractor, respectively. Comparison between the planned and actual movements of plastic block for each variable were made using paired t- test. Statistical analysis for X, Y, Z, empty set X, empty set Y and empty set Z movement have shown no significant differences between planned and actual movement (P > 0.05). This indicate that model surgery performed with the aid of the 6AMSS is accurate in 3D translation and rotation. The 6AMSS is practically useful for accurate fabrication of surgical splint for orthognathic surgery.
Orthognathic Surgery ; Plastics ; Splints

With the increasing number of surgery for incontinence, voiding dysfunction after anti-incontinence surgery will continue to be a problem. The patient with postoperative voiding dysfunction may present with primarily storage symptoms or voiding symptoms, or a combination of both. Detailed knowledge of the preoperative voiding status may aid in the diagnosis of voiding dysfunction. Diagnosis is based on history, physical examination, urinalysis and postvoid residual volume, but additional informations from urodynamic study and cystoscopy are useful. Patients with postoperative voiding dysfunction should be initially treated conservatively with intermittent or continuous catheterization, fluid restriction, anticholinergics and pelvic floor physiotherapy. When conservative treatment fails, surgical intervention should be done. It is important to distinguish between midurethral sling and other procedures because the timing and type of intervention vary. In case of midurethral sling, loosening or cutting the tape has had excellent results. Prevention of obstruction during surgery may be the best way to avoid reoperation.
Catheterization ; Catheters ; Cholinergic Antagonists ; Cystoscopy ; Humans ; Pelvic Floor ; Physical Examination ; Reoperation ; Residual Volume ; Suburethral Slings ; Urinalysis ; Urodynamics

PURPOSE:To investigate the pregnancy outcomes associated with delayed first childbearing METHODS:We evaluated retrospectively the clinical characteristics and pregnancy outcomes in primiparous mothers who delivered a fetus after more than 21 weeks of gestation in our hospital from January 2001 to December 2008. We enrolled only healthy primiparous mothers who have no underlying cardiovascular disease, hypertensive disorders complicating pregnancy and overt or gestational diabetes to remove the confounding factors which influence the pregnancy outcomes. Finally, 235 mothers aged 35 years and above and 1571 mothers aged 20~34 years were included in the study and the control groups, respectively. RESULTS:There were no differences in gestational age and birth weight between two groups. There was significantly higher incidence of cesarean section in the study group. (60.4% vs 39.4%, P= 0.000) The incidence of previous uterine operation history and placenta previa which were the indications of cesarean section were higher in the study group (3.0% vs 0.2%, P=0.000, 9.4% vs 5.2%, P=0.011). Antepartum and postpartum complications with the significantly higher incidence rates in study group were placenta previa and uterine myoma (6.0% vs 2.8%, P=0.010, 4.7% vs 1.2%, P=0.000) and wound complications (1.7% vs 0.3%, P=0.005), respectively. On the other hand, the neonatal outcomes and other antepartum/postpartum complications, such as the incidence of preterm labor, PROM and postpartum bleeding, of two groups were comparable (no significant differences were noted). CONCLUSION:Although incidence of placenta previa, cesarean section, uterine myoma and wound complication were higher in healthy old primiparous mothers, no differences were noted in neonatal outcomes compared to the young primiparous mothers. We conclude that elderly primiparous pregnancy in woman should not be considered as a high risk pregnancy on the basis of age alone.
Aged ; Birth Weight ; Cardiovascular Diseases ; Cesarean Section ; Diabetes, Gestational ; Female ; Fetus ; Gestational Age ; Hand ; Hemorrhage ; Humans ; Incidence ; Maternal Age ; Mothers ; Myoma ; Obstetric Labor, Premature ; Placenta Previa ; Postpartum Period ; Pregnancy ; Pregnancy Outcome ; Pregnancy, High-Risk ; Retrospective Studies

Lymphangiomas are congenital anomalies of the lymphatic system in which abnormal lymphatic channels are localized to form a benign mass. Lymphangiomas are classified into 3 types: simple, cavernous, and cystic (=cystic hygroma). Mixed forms may coexist. Cavernous lymphangiomas are very rare variants and characterized by penetration through the subcutaneous area between the muscular septa. Lymphangiomas are typically presented in the head, neck and axillary region, while cavernous lymphangiomas most commonly occur in the thorax or retroperitoneum. Although there are many papers about the cystic hygroma, a few cases of fetal thoracoabdominal cavernous lymphangioma have been reported. Accurate prenatal diagnosis and anatomical evaluation are important for delivery planning and prompt postnatal resuscitation. The anomaly was assessed by two dimensional (2D), three dimensional (3D), and real-time multiplanar four dimensional (4D) ultrasound. This case report confirms the usefulness of the 3D, real-time multiplanar 4D ultrasound to assess the mass extension and relationship with adjacent structures. We present a case of fetal thoracoabdominal cavernous lymphangioma diagnosed by 2D, 3D, real-time multiplanar 4D ultrasound with brief review of literatures.
Caves ; Head ; Lymphangioma ; Lymphangioma, Cystic ; Lymphatic System ; Neck ; Prenatal Diagnosis ; Resuscitation ; Thorax

It was evaluated the inhibitory action of quercetin-3-O-beta-D-glucuronopyranoside (QGC) on reflux esophagitis and gastritis in rats. QGC was isolated from the herba of Rumex Aquaticus. Reflux esophagitis or gastritis was induced surgically or by administering indomethacin, respectively. Oral QGC decreased ulcer index, injury area, gastric volume, and acid output and increased gastric pH as compared with quercetin. Furthermore, QGC significantly decreased gastric lesion sizes induced by exposing the gastric mucosa to indomethacin. Malondialdehyde levels were found to increase significantly after inducing reflux esophagitis, and were reduced by QGC, but not by quercetin or omeprazole. These results show that QGC can inhibit reflux esophagitis and gastritis in rats.
Animals ; Esophagitis, Peptic ; Gastric Mucosa ; Gastritis ; Hydrogen-Ion Concentration ; Indomethacin ; Lipid Peroxidation ; Malondialdehyde ; Omeprazole ; Quercetin ; Rats ; Rumex ; Ulcer

PURPOSE: Most technical difficulties in intracranial stenting are derived from the vascular resistance caused by the severe tortuousness of intracranial arteries. The purpose of this study was to develop a practical method for measuring vascular tortuousness so that it would be possible to predict technical difficulties requiring further technical support. MATERIALS AND METHODS: We developed a best-fit circle metrics which made measurement of vascular tortuousness feasible, which was called "curve index (CI)". We compared the curve index in 56 consecutive patients who underwent M1 stenting for symptomatic severe stenosis. The difference in the CI between the successful and the aborted groups was statistically compared by using the Mann-Whitney U test. ROC curve analysis was performed to evaluate the diagnostic performance of the best-fit circle metrics. RESULTS: There was no statistically significant difference between the successful and the aborted cases in the CIs of each curve segment. However, the sum of all CIs of the aborted group was significantly larger (3.49) than that of the successful group (2.53) (p=0.013). On ROC curve analysis, the area under the curve was 0.806. When we took the cut-off value to be 3, the sensitivity was 75% and the specificity 85%. CONCLUSION: We developed a practical method for measuring the CI of vessel curves in order to estimate the tortuousness of the internal carotid artery. A CI less than 3, therefore, indicates a favorable vascular curvature for the intracranial stenting procedure. A vessel having a higher curve index was more likely to be aborted.
Arteries ; Carotid Artery, Internal* ; Constriction, Pathologic ; Humans ; ROC Curve ; Sensitivity and Specificity ; Stents ; Vascular Resistance

PURPOSE: To evaluate radiological findings of non-calcified ductal carcinoma in situ (DCIS) and to correlate those with histological features. MATERIALS AND METHODS: From July 2002 to March 2006, 22 patients with histologically-proven non-calcified DCIS were included. Mammography was obtained in 19 patients, ultrasound in 18 patients, and both examinations in 15 patients. Radiological findings were evaluated according to the Breast Imaging Reporting and Data System by American College of Radiology. Histological tumor subtype and Van Nuys classification of DCIS were assessed. RESULTS: Histological subtypes consisted of mixed type in 11 patients (50%), comedo in 4 (18%), cribriform in 4 (18%), papillary type in 2 (9%), and solid in one (5%). According to Van Nuys classification, group 3 DCIS was observed in 13 (59%) patients. In the 19 patients who underwent mammography, 13 patients presented with abnormal findings: focal asymmetry in 7 patients (37%), masses in 4 (21%), skin thickening in one (5%), and architectural distortion in one (5%). In the 18 patients who had received breast ultrasound, a mass was present in 15 (83%) patients and ductal changes in 3 patients (17%). Sixty percent of patients with masses on ultrasound had group 3 DCIS and 100% of patients with ductal change had group 1 DCIS (p=0.017). CONCLUSION: Diagnosis of non-calcified DCIS by mammography is not an easy task due to the lack of typical malignant calcifications or masses. High resolution ultrasound can be useful for detecting non-calcified DCIS, and ultrasound findings are correlated with histological features.
Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms/metabolism/pathology/*radiography/*ultrasonography ; Calcinosis/metabolism/pathology ; Carcinoma, Intraductal, ; Female ; Humans ; Mammography ; Middle Aged

Central retinal artery occlusion (CRAO) typically causes severe and permanent visual loss in the affected eye and vision does not recover in 90% of the patients. It is believed that it occurs by occlusion of the central retinal artery with small emboli from atherosclerotic plaque of internal cerebral artery. Various methods have been introduced to recanalize the occluded artery and remove emboli but considered to fail except thrombolytic therapy. Retina is a part of the brain so basically CRAO is corresponding to acute occlusion of intracerebral artery and retinal ischemia is to cerebral stroke. Accordingly rapid procedure within therapeutic time window, choosing appropriate drugs and doses, reducing hemorrhagic and ischemic complications associated with neurovascular intervention is very important. However, clinical significance of CRAO is much different from that of acute cerebral arterial occlusion, therefore, neurointerventionists should perform this procedure within appropriate range of safety.
Arteries ; Brain ; Cerebral Arteries ; Humans ; Ischemia ; Plaque, Atherosclerotic ; Retina ; Retinal Artery Occlusion* ; Retinal Artery* ; Retinaldehyde ; Stroke ; Thrombolytic Therapy

OBJECTIVE: The purposes of this study were to analyze the current status of nursing informatics course and to develop the standardized curriculum in nursing informatics course based on competency. METHODS: Data were collected through two phases. In the first phase, a survey was conducted on 115 nursing institutions to analyze the current status of nursing informatics course. In the second phase, two-round delphi technique was developed to determine the priority and relative weight of contents in nursing informatics course. Final samples composed of both 43 nursing institutions and 11 nursing informatics experts. RESULTS: Out of 43 nursing schools, 13 nursing schools offered nursing informatics course. Nursing informatics was taught mostly to the second year and had 2 credits. About 54% of respondents disagreed that nursing informatics should be included in the license examination for Registered Nurse. The subject matrix by priority and relative weight and a standardized curriculum for nursing informatics were developed. CONCLUSION: Continuous application and revision of nursing informatics curriculum should be needed.
Competency-Based Education ; Curriculum* ; Surveys and Questionnaires ; Delphi Technique ; Licensure ; Nursing Informatics* ; Nursing* ; Schools, Nursing

Purpose: The present study aims to determine the clinical outcome of kidney transplantation and to provide data of long-term graft and patient survival. Methods: Between 1969 and 2005, 1,500 kidney transplants were performed at the Kangnam st. Mary's hospital. We analyzed the clinical characteristics and outcomes of kidney transplant recipients retrospectively. Results: The mean follow-up period was 112 months. Chronic glomerulonephritis was the leading cause of primary renal diseases, but the proportion of has increased from 1 % before 1985 to 6% afterwards. First renal transplantation was 94.5% (n=1418), and retransplantation was 5.4% (n=82). Type of donor source was mostly living-related, with the recent decrease in the number of living- unrelated donors. Currently, 72l patients are alive with functioning grafts, 297 cases had graft failure, 277 cases died, 205 cases were transferred or lost during follow-up. Main cause of graft failure was chronic allograft nephropathy (n=316). Overall, 1-, 5-, 10-, and 20-year graft survival were 92%, 81%, 66%, and 29% respectively. 1-, 5-, 10-, and 20-year patient survival were 93%, 88%, 81%, and 69% respectively. Conclusion: This review of 36-years experience in a single center showed that the graft survival has improved compared to the initial transplantation era.
Allografts ; Follow-Up Studies ; Glomerulonephritis ; Graft Survival ; Humans ; Kidney Transplantation ; Kidney* ; Korea* ; Retrospective Studies ; Risk Factors ; Tissue Donors ; Transplantation ; Transplants ; Unrelated Donors