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Increasing Vietnamese-American physicians' knowledge of cervical cancer and Pap testing: impact of continuing medical education programs. | cation (CME) seminars on cervical cancer for association members. Experts gave lectures and answered questions about screening; diagnosis; and treatment to train physicians to identify risk factors; recommend Pap tests; and evaluate and conduct follow up of abnormal tests. To evaluate the seminars; we administered pre- and post-CME pencil-and-paper questionnaires. Data analysis employing the McNemar chi-squared test demonstrated significant changes in knowledge and understandingfrom pre- to post-CME in mult | 15682781 | [
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Increasing Vietnamese-American physicians' knowledge of cervical cancer and Pap testing: impact of continuing medical education programs. | iple areas. Results suggest that CME seminars can significantly increase Vietnamese physicians' knowledge about cervical cancer diagnosis and treatment. | 15682781 | [
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People with diabetes: knowledge, perceptions, and applications of recommendations for diabetes management. | The purpose of this paper is to report results of the People with Diabetes survey conducted as part of the REACH 2010: Charleston and Georgetown Diabetes Coalition. The pilot data revealed that African Americans (AAs) (N=80) reported fewer A1c; lipid; and kidney testing; feet and eye exams; and less nutrition and diabetes self-management counseling during 1999-2000 than did Caucasians (Cs) (N=23). The survey was repeated in 2002 when data were collected from a convenience sample of 160 AAs and 150 Cs using | 15682782 | [
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People with diabetes: knowledge, perceptions, and applications of recommendations for diabetes management. | the revised self-reported survey instrument. African Americans (AAs) were significantly likely to report that their understanding of results for the kidney function test were good as compared to Cs (P<.001) and were more likely to report receiving nutrition education (P=.003). Otherwise; there were no significant differences between AAs and Cs on the remaining items in the survey. Since REACH 2010 was actively involved in the AA community for 2 years between the pilot survey and the repeated survey; these r | 15682782 | [
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People with diabetes: knowledge, perceptions, and applications of recommendations for diabetes management. | esults were anticipated and are also reflected in results of chart audits conducted within healthcare systems used by the same AA population. | 15682782 | [
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Community empowerment to reduce childhood immunization disparities in New York City. | This paper reports on the impact of the community-based Start Right program on childhood immunization coverage in 2 communities of color in New York City. Fully launched in 2002; Start Right operates through the major social service programs of its 23 member organizations. Immunization promotion strategies are based on the following guiding principles: community leadership; integration with community programs; parental empowerment; peer health educators; tracking and feedback; and linkage with health provid | 15682783 | [
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Community empowerment to reduce childhood immunization disparities in New York City. | ers. By September 2003; 2;433 children under age 5 years (14% of that age group in the community) were enrolled in Start Right. The rates for the cohort of children enrolled in 2003 were substantially higher than for those enrolled in 2002. Among the 2003 cohort of 19- to 35-month-old children; the coverage rate was 88%; significantly more than national rates: 75% for total population; 68% for African Americans; and 73% for Hispanics. The rate for our 2003 enrollment cohort exceeded the rate for New York Ci | 15682783 | [
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Community empowerment to reduce childhood immunization disparities in New York City. | ty (78%) but did not exceed the New York City average for Hispanics (79%). Of the 2003 enrollment cohort; the Washington Heights children had the highest rates for enrollment (89.6%); exceeding New York City rates. Parents reported a high level of satisfaction with the program. | 15682783 | [
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Proving ROI: experts urge DMOs to run a tighter ship. | nan | 15682784 | [
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Health plans turn their attention to the costs, complications of osteoporosis. | Even as the Surgeon General takes America's health care system to task for its failure to respond to red flags for this disease; a few pioneering health care organizations are devising new ways to get people diagnosed and treated before costs and complications escalate. At the same time; researchers are calling for treatment regimens that Americans can consistently follow. | 15682785 | [
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Employers look to wellness programs to help tame costs. | Employers concerned about absenteeism; worker productivity; and employee retention are being targeted by a new breed of DM program that may take longer to deliver an ROI but offers value in other ways as well. Rather than tackling chronic disease; these new programs hope to engage employees in the process of reducing risk before more severe problems set in. | 15682786 | [
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Using provider and member incentives to boost quality. | Studies show physicians have mixed feelings about incentives aimed at boosting their performance. But when properly designed; incentives can not only improve quality; but nurture relationships with the provider network as well. A new report offers guidance on how to fashion an incentive program that will get results. | 15682787 | [
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Role of Barr bodies obtained from oral smears in the determination of sex. | Barr body is an inactivated X chromosome in the normal female somatic cell. Inactivation of these chromosomes is known as Lyonization. Lyonization has both genetic and clinical significance. Barr body can be easily identified with ordinary stains. It also helps in identifying the sex of an individual when used judiciously. A review is made on the lyonization of Barr body and its utility in sex determination. | 15682788 | [
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Cell death does not herald epithelial involution ("atrophy") in oral sub mucous fibrosis: a TEM study. | The disease progression in oral submucous fibrosis (OSF) seems to be in a biphasic manner; along both fibroblastic and keratinocytic lineages. The epithelial malignancy is considered to be a sequel of connective tissue changes. "Atrophy" of epithelium makes it amenable to the effect of oral carcinogens. This concept looks rather simplistic in the light of the current understanding of epithelial cell biology. So the concept of epithelial "atrophy" needs redressal against the backdrop of recent investigations | 15682790 | [
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Cell death does not herald epithelial involution ("atrophy") in oral sub mucous fibrosis: a TEM study. | . 12 cases of clinically and histologically advanced OSF cases (M:F = 4:8) who were habitual areca-quid chewers comprise the study group. 5 (M:F=1:4) non-OSF; non-areca-nut chewing healthy volunteers; constituted the control group. Biopsy was done and the sections were processed for light and electron microscopy. Cell countings were made based on established criteria for apoptosis and necrosis under the high resolution of a TEM and electron micrographs were taken. The Apoptotic Index (A1) calculated for the | 15682790 | [
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Cell death does not herald epithelial involution ("atrophy") in oral sub mucous fibrosis: a TEM study. | diseased mucosa was 3.0 +/- 1.3 and for the control was 2.1 +/- 1.5 (X2 = 1.21; df= 1; p>0.05). The necrotic indices (NI) were respectively; 2.5 +/- 0.6 and 2.0 +/- 1.3 (X2 = 0.24; df = 1; p>0.05). The Absolute Cell death Index (ACI); which is the cumulative figure of apoptosis and necrosis indices; was 5.5 and 4.2 respectively for diseased and normal samples (X2 = 1.8; df = 1; p>0.05). The inability to compute an increased ACI in OSF epithelium; when compared to normal; goes against the concept of epithel | 15682790 | [
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Cell death does not herald epithelial involution ("atrophy") in oral sub mucous fibrosis: a TEM study. | ial "atrophy". Atrophy envisages an increased apoptotic cell death of keratinocytes; induced by the same signals that caused atrophy and this may contribute to loss of cell of an entire organ. This basic concept in pathology seems to be unfounded with disease. This prompted us for an alternative concept in favour of a reduced proliferation index of the adult stem cell compartment of the oral epithelium. So this study favours the concept of epithelial hypoplasia; rather than atrophy; which causes thinning of | 15682790 | [
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Cell death does not herald epithelial involution ("atrophy") in oral sub mucous fibrosis: a TEM study. | surface epithelium in advanced OSF. | 15682790 | [
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Estimation and comparison of significant caries index and the pattern of sugar consumption among 12-year-old school going children of two different socioeconomic strata. | The purpose of this study was to estimate and compare the Significant Caries Index (SiC); the pattern of sugar consumption; and to know the oral hygiene practices in a sample of 200; 12-year-old school going children of two different social classes residing in both urban and rural areas. The subjects were divided into two social classes based on the per capita monthly income. Twenty-four hour dietary records of five consecutive days were obtained from each subject. The results showed that all the subjects b | 15682791 | [
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Estimation and comparison of significant caries index and the pattern of sugar consumption among 12-year-old school going children of two different socioeconomic strata. | rushed daily. More number of children belonging to social class I and urban area brushed twice a day. While there were no significant differences in DMFT among the study groups; SiC index was higher in males; subjects of social class I; and urban residents. Sweet score; Total sugar exposure and Between-meal sugar exposure were more in males; subjects of social class I; and urban residents; whereas At-meal sugar exposure was more in females; subjects of social class II; and rural residents. From a preventive | 15682791 | [
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Estimation and comparison of significant caries index and the pattern of sugar consumption among 12-year-old school going children of two different socioeconomic strata. | point of view; males; subjects of higher socioeconomic background; and urban residents seem to be the most important target groups for dental health communication programs focusing on the frequency of sugar consumption and dietary counselling. | 15682791 | [
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Evaluation of radiographic predictors to assess the rate of mandibular residual ridge resorption. | Sixty healthy clinical edentulous patients (thirty male and thirty female) were chosen for the study. Panoramic and lateral cephalometric radiographs were taken of each patient. The amount of bone loss was estimated from the panoramic radiographs as per the formula proposed by Wical and Scoop. The rate of mandibular residual resorbed ridge (RRR) expressed as percentage of bone loss per year was then computed. The correlation between the mandibular RRR and gonial cortical thickness and the percentage of cort | 15682792 | [
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Evaluation of radiographic predictors to assess the rate of mandibular residual ridge resorption. | ical bone at the symphysis was tested. These parameters were also compared between the male and female patients. The rate of mandibular RRR; expressed as percentage of bone loss per year; was found to be indirectly correlated with the cortical thickness at gonion as measured from the panaromic and the lateral cephalometric radiographs. The values of students 't' test for mean differences between the female and the male patients with respect to the rate of mandibular RRR and the cortical thickness at the gon | 15682792 | [
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Evaluation of radiographic predictors to assess the rate of mandibular residual ridge resorption. | ion were found to be statistically significant. | 15682792 | [
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[Anesthetic management of patients with dilated cardiomyopathy undergoing non-cardiac surgery]. | A considerable amount of data are available regarding cardiac risk in patients with coronary artery disease; but not with patients with cardiomyopathy; undergoing non-cardiac surgery.Reports of the anesthetic management of patients with dilated cardiomyopathy (DCM) undergoing non-cardiac surgery were identified using Medline and the Igaku-chuou-zassi (Japana Centra Revuo Medicina) database (1981-2001). The data were analyzed in terms of patient characteristics; methods of intraoperative care; and clinical o | 15682796 | [
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[Anesthetic management of patients with dilated cardiomyopathy undergoing non-cardiac surgery]. | utcome.Seventy-three patients were included. The mean value of the preoperative left ventricular ejection fraction (EF) was 31%. About 70% of patients revealed poor ventricular function (EF < 35%). EF did not correlate with the severity of congestive heart failure (CHF). Major complications occurred in 6 cases and minor ones in 23 cases. A history of CHF; advanced NYHA classification and lack of preoperative diagnosis of DCM were suggested as perioperative risk factors.Careful planning is inevitable in anes | 15682796 | [
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[Anesthetic management of patients with dilated cardiomyopathy undergoing non-cardiac surgery]. | thesia for patients with DCM; although the rate of major perioperative complications is relatively low. Evaluation of cardiac reserve is more important than the resting value of ejection fraction. In order to clearly elucidate risk factors for adverse perioperative outcomes; further analysis will be necessary as more cases are documented. | 15682796 | [
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[Analysis by computer simulation of double breathing during pressure support ventilation]. | Pressure support ventilation (PSV) usually provides good patient-ventilator synchrony; but asynchrony is sometimes encountered. Double breathing is one form of asynchrony in which the ventilator assists two or more times during a single inspiration of the patient.Double breathing was analyzed using a computer simulation.In an obstructive lung model; inspiratory support was terminated just after the beginning of the inspiration lasting until inspiratory effort triggering the ventilator again. One of the caus | 15682797 | [
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[Analysis by computer simulation of double breathing during pressure support ventilation]. | es of this premature termination was that the compressed and consumed volume in the circuit created a high peak inspiratory flow setting. The other cause was oscillation of the airway pressure. Reducing the circuit volume; slowing the inspiratory rise time; or decreasing the termination criteria could prevent this phenomenon. In a restrictive lung model; the time-constant of the lung was so short that the inspiratory flow finished early and double breathing occurred. It was difficult to prevent this phenome | 15682797 | [
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[Analysis by computer simulation of double breathing during pressure support ventilation]. | non by adjusting the circuit assembly or respiratory parameters.Double breathing during PSV was considered to be closely associated with obstructive or restrictive lung. If the problem arises and cannot be resolved by adjusting ventilatory parameters; the ventilatory mode must be changed. | 15682797 | [
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Talon cusp: an overview with case reports of 3 clinical variants. | Talon cusp is a dental anomaly; which is present as an accessory cusp and is seen both in the deciduous and permanent dentition. It may occur unilaterally or bilaterally and has been reported mostly in maxillary teeth; with a few cases occurring in the mandible. Talon cusp is usually asymptomatic; however; there are many clinical problems associated with it. Talon cusp is clinically manifested in three forms: talon; semi-talon and trace talon. In this article; we present four case reports of talon cusp with | 15682793 | [
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Talon cusp: an overview with case reports of 3 clinical variants. | an overview of different clinical variants of talon cusp; classification; etiopathogenesis; associated syndromes; clinical problems; and treatment modalities. | 15682793 | [
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Oral verruca vulgaris: report of a rare case. | The common wart or verruca vulgaris are lesions of childhood caused by HPV 2; 4; and 40. These are benign; elevated; firm nodules with characteristic papillomatous surface projections. The most common site of occurrence is the finger. Oral lesions are relatively rare and are usually caused by auto inoculation from lesions on the fingers and hands. We herewith report a case of oral verruca vulgaris that occurred in a middle-aged individual without any wart like lesions elsewhere in the body. | 15682794 | [
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[Influence of epidural lidocaine injection on vecuronium-induced neuromuscular blockade]. | We investigated vecuronium-induced neuromuscular blockade in patients with continuous epidural lidocaine injection and those without epidural lidocaine.Lower thoracic epidural injection of lidocaine was commenced at a rate of 2-3 mg x kg(-1) x h(-1) following its bolus injection (1.5-2 mg x kg(-1)) only in epidural group. Neuromuscular function was monitored by acceleromyographic train-of-four (TOF) responses of the adductor pollicis muscle to ulnar nerve stimulation after induction of general anesthesia.Ne | 15682798 | [
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[Influence of epidural lidocaine injection on vecuronium-induced neuromuscular blockade]. | uromuscular block was obtained by vecuronium 0.1 mg x kg(-1) as an intubating dose and was maintained 5-10% of baseline first twitch (T 1) of TOF responses by continuous vecuronium administration. The maximum depression of T 1 response and onset time obtained by vecuronium 0.1 mg x kg(-1) were not different between the groups; but mean clinical duration from administration of the first dose to T 1 recovery to 5% of baseline was significantly prolonged in group with epidural lidocaine (49.5 min); compared to | 15682798 | [
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[Influence of epidural lidocaine injection on vecuronium-induced neuromuscular blockade]. | that without lidocaine (32.3 min). Furthermore; maintenance dose of vecuronium obtained in the group with epidural lidocaine (0.034 mg x kg(-1) x h(-1)) was significantly smaller than that in the group without lidocaine (0.060 mg x kg(-1) x h(-1)).Based on our results; we conclude that lidocaine injected continuously into the epidural space potentiates vecuronium-induced neuromuscular block. | 15682798 | [
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Cemento ossifying fibroma. | Cemento ossifying fibroma is a benign; non odontogenic tumour of the jaw; a subdivision of fibro-osseous lesions. The age of occurrence is between 20 and 40 years. It has a female to male predilection of 2:1. A rare case of cemento ossifying fibroma involving maxilla and mandible in a 30 years old female is presented with a discussion on its clinical and radiographical features; computed tomograph scan findings; histopathological presentation with a review of literature. | 15682795 | [
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[Postoperative nausea and vomiting caused by epidural infusion following gynecological laparoscopic surgery: fentanyl and ropivacaine versus ropivacaine alone]. | Patients who undergo gynecological laparoscopic surgery often begin to eat and ambulate soon after surgery. However; postoperative nausea and vomiting (PONV) can postpone recovery.We prospectively investigated the incidence of PONV; along with oral intake and ambulation in patients who received an epidural infusion following gynecological laparoscopic surgery with combined epidural and general anesthesia. Forty patients were randomly and equally divided into 2 groups: group R; who received patient-controlle | 15682799 | [
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[Postoperative nausea and vomiting caused by epidural infusion following gynecological laparoscopic surgery: fentanyl and ropivacaine versus ropivacaine alone]. | d epidural analgesia (PCEA) with 0.2% ropivacaine; and group FR; who received a continuous epidural infusion of 0.2% ropivacaine with fentanyl (CEA). PONV and pain were scored during the early (0-6 hours) and late (6-24 hours) postoperative periods.PONV incidence and scores were significantly lower in group R (5.3%) than group FR (70.6%) during the late period. Further; patients in group R ate significantly more than group FR at both lunch and dinner; and 2 patients could not ambulate the day after surgery | 15682799 | [
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[Postoperative nausea and vomiting caused by epidural infusion following gynecological laparoscopic surgery: fentanyl and ropivacaine versus ropivacaine alone]. | in the FR group. There was no significant difference in analgesia requested between the 2 groups.We found that PCEA with ropivacaine alone resulted in a significantly lower incidence of PONV and did not disturb eating and ambulation following gynecological laparoscopic surgery; as compared to patients who received CEA. | 15682799 | [
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[Effects of low dose colforsin daropate hydrochloride in patients undergoing off-pump coronary artery bypass grafting]. | We evaluated retrospectively the effectiveness of low dose colforsin daropate hydrochloride (CDH) in 12 patients undergoing off-pump coronary artery bypass grafting (CABG).Low dose CDH was administered intravenously at a rate of 0.05-0.1 microg x kg(-1) x min(-1) from sternotomy to the end of coronary artery anastomosis. Hemodynamic measurements were made before infusion of CDH; and before; during; and after coronary artery anastomosis.Heart rate was significantly higher before; during and after the anastom | 15682800 | [
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[Effects of low dose colforsin daropate hydrochloride in patients undergoing off-pump coronary artery bypass grafting]. | osis compared with the value before the infusion of CDH. Heart rate was also significantly higher after the anastomosis compared with the value before the anastomosis. Systolic blood pressure; mean pulmonary pressure; right atrial pressure and pulmonary artery wedge pressure showed no significant changes after the start of infusion of CDH. Cardiac output was significantly higher before; during and after the anastomosis compared with the value before the infusion of CDH. Systemic vascular resistance was sign | 15682800 | [
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[Effects of low dose colforsin daropate hydrochloride in patients undergoing off-pump coronary artery bypass grafting]. | ificantly lower before and during anastomosis compared with the value before the infusion of CDH.Infusion of low dose CDH prevents the elevations of mean pulmonary artery pressure; right atrial pressure and pulmonary artery wedge pressure without reducing systolic bood pressure during coronary artery anastomosis. Cardiac output was significantly increased; and SVR as well as PVR were significantly decreased after the infusion of CDH. In patients undergoing off-pump CABG; we recommend infusion of low dose co | 15682800 | [
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[Effects of low dose colforsin daropate hydrochloride in patients undergoing off-pump coronary artery bypass grafting]. | lforsin daropate hydrochloride from sternotomy to the end of coronary artery anastomosis. | 15682800 | [
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[Lessons learned from anesthetic management of pheochromocytoma resection: a report of three cases]. | The anesthetic management of patients with pheochromocytoma; in which drastic hemodynamic changes may occur; is still a challenge to even the most experienced anesthesiologist; although the perioperative mortality has been reduced remarkably. We report three patients who developed unexpected major complications during elective resection of a pheochromocytoma. The Case 1 patient was a 46 year-old woman who developed ventricular tachycardia immediately after administration of ephedrine for transient hypotensi | 15682801 | [
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[Lessons learned from anesthetic management of pheochromocytoma resection: a report of three cases]. | on induced by excessive phentolamine. Even a mild beta adrenergic agent may cause extraordinary stimulation to myocardium under alpha blockade. The Case 2 patient was a 44 year-old man who needed intensive vasodilating therapy due to an exaggerated cardiovascular response to intraoperative surgical stress. He developed severe metabolic acidosis resembling hyperdynamic shock before resection of the tumor; although blood pressure was controlled within the expected range. The Case 3 patient was a 60 year-old w | 15682801 | [
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[Lessons learned from anesthetic management of pheochromocytoma resection: a report of three cases]. | oman who did not receive preoperative alpha blocker therapy because she lacked cardiovascular symptoms. However; she revealed a high level of systemic vascular resistance after induction of general anesthesia and needed moderate inotropic support to compensate for an abrupt reduction of vascular resistance after resection of the tumor. The pathophysiology of the disease is complex and anesthetic care must be tailored in accordance with each patient's situation. | 15682801 | [
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[Anesthetic management with propofol during pheochromocytoma resection under bispectral index monitoring]. | In three patients undergoing pheochromocytoma resection under propofol/fentanyl anesthesia; bispectral index (BIS) was monitored for assessment of hypnotic effect. In two patients; arterial blood concentrations of propofol were measured by high performance liquid chromatography (HPLC); and compared with those of the estimated blood concentrations. Until resection of the tumor; propofol was infused at a rate of 10 mg x kg(-1) x hr(-1). After resection of the tumor; propofol dosage was reduced to 3-6 mg x kg( | 15682802 | [
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[Anesthetic management with propofol during pheochromocytoma resection under bispectral index monitoring]. | -1) x hr(-1); keeping the BIS values around 60. Rapid infusion of fluid and norepinephrine was required to maintain blood pressure after removal of the tumor in two patients. In one patient; blood pressure was maintained well without rapid infusion of fluid or vasopressor. Arterial blood concentration of propofol after resection of the tumor was equal to the estimated blood concentration (3.04 vs 3.02 microg x ml(-1)) in a patient without rapid infusion of fluid. In a patient with rapid infusion of fluid; t | 15682802 | [
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[Anesthetic management with propofol during pheochromocytoma resection under bispectral index monitoring]. | he arterial blood concentration was lower than the estimated blood concentration (2.59 vs 3.58 microg x ml(-1)). The anesthetic depth can not be estimated accurately by hemodynamic changes in the patients undergoing pheochromocytoma resection. BIS monitoring should be recommended for adjustment of propofol dosage after pheochromocytoma resection. | 15682802 | [
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[Cardiac arrest during bilateral inguinal herniorrhaphy under epidural anesthesia]. | A 73-year-old man with hyper gamma-globulinemia was scheduled for bilateral herniorrhaphy and hemorroidectomy. In preoperative examination; the serum concentrations of gamma-globulin and total protein were 7.31 g x dl(-1) and 11.9 g x dl(-1). Although platelet count was 6.5 x 10(4) x microl(-1); epidural anesthesia was selected to minimize hemodynamic changes which could increase a risk of thrombosis. Epidural catheters were inserted at T 12-L 1 and L 4-5. Analgesia level checked by a pin prick was T 4 afte | 15682803 | [
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[Cardiac arrest during bilateral inguinal herniorrhaphy under epidural anesthesia]. | r administering 10 ml of 2% lidocaine; 7 ml into T 12-L 1 and 3 ml into L 4-5. Bilateral herniorrhaphy started simultaneously. When bilateral peritoneum was stretched; heart rate suddenly decreased to 40 beats x min(-1). Although 0.5 mg of atropine was immediately administered intravenously; cardiac arrest was observed for several seconds and the patient was unconscious for about 10 seconds. After stopping surgery; heart beat and consciousness recovered immediately. By administration of 10 mg of ephedrine; | 15682803 | [
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[Cardiac arrest during bilateral inguinal herniorrhaphy under epidural anesthesia]. | blood pressure increased to 130/80 mmHg with heart rate of 55 beats x min(-1). Vagal reflex induced by bilateral inguinal herniorrhaphy might cause cardiac arrest. We should be careful for vagal reflex during bilateral herniorrhaphy. | 15682803 | [
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[Intermittent complete left bundle branch block during general anesthesia]. | We report a case of intermittent complete left bundle branch block (CLBBB) which occurred during general anesthesia. An 83-year-old female was scheduled for upper lobectomy of the right lung under general anesthesia. Her preoperative 12-lead ECG showed atrial fibrillation and ST-depression in V4-6. Anesthesia was induced with propofol and pentazocine; and maintained with 0.5-1.5% isoflurane; 0-50% nitrous oxide in oxygen under close monitoring and appropriate respiratory management. The operation was perfor | 15682804 | [
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[Intermittent complete left bundle branch block during general anesthesia]. | med uneventfully. Several minutes after the end of surgery; on converting her into the supine position from the left lateral decubitus position; widened QRS complexes; later diagnosed as CLBBB; appeared on ECG. At that time; heart rate was 92 beats x min(-1). After the administration of esmolol hydrochloride; heart rate decreased rapidly in a few minutes and ECG returned to normal conduction from CLBBB. We diagnosed this as rate-dependent intermittent CLBBB. Although intermittent CLBBB continued until the n | 15682804 | [
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[Intermittent complete left bundle branch block during general anesthesia]. | ext day; the patient was asymptomatic and cardiac enzymes were within normal ranges. The intermittent CLBBB; which occasionally occurs during anesthesia; makes the diagnosis of myocardial ischemia and acute myocardial infarction difficult. The present case suggests that esmolol can be used effectively and safely to distinguish CLBBB as a benign disorder from myocardial ischemia in a patient with CLBBB. | 15682804 | [
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[Pneumothorax during retroperitoneoscopic nephrectomy: a case report]. | A 54-year-old female patient was scheduled for retroperitoneoscopic nephrectomy. Anesthesia was induced with propofol and maintained with nitrous oxide/sevoflurane and epidural anesthesia. One hour after the start of the surgery; arterial oxygen saturation suddenly decreased from 99% to 94%. Because her oxygenation gradually improved and hemodynamics was stable; the operation was continued. After the end of the surgery; left pneumothorax was found on a chest X ray. The patient was extubated following thorac | 15682805 | [
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[Pneumothorax during retroperitoneoscopic nephrectomy: a case report]. | ocentesis that had improved her pneumothorax and oxygenation. There is no report of pneumothorax in retroperitoneoscopic nephrectomy; as far as we know; although several cases have been reported in laparoscopic nephrectomy. We must be careful of pneumothorax in both laparoscopic and retroperitoneoscopic nephrectomy. | 15682805 | [
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[Two tracheal tubes inserted for endotracheal tube replacement in a patient with severe obstructive sleep apnea: a case report]. | A 34-year-old obese; small-jawed and short-necked woman; had severe obstructive sleep apnea syndrome (OSAS) with bronchial asthma. A surgical removal of a lingual tumor using a laser knife was scheduled under general anesthesia with sevoflurane. A small diameter tracheal tube for laser surgery (internal diameter (ID) of 5.5 mm) was used. The tube was inserted using bronchofiberscopy under spontaneous respiration. Extubation was designed to be performed when the patient resumed adequate spontaneous respirati | 15682806 | [
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[Two tracheal tubes inserted for endotracheal tube replacement in a patient with severe obstructive sleep apnea: a case report]. | on and was awake. However; her ventilation deteriorated postoperatively as spontaneous breathing continued (PaO2 98 mmHg; PaCO2 88 mmHg at FIO2 1.0). This seemed to have been induced by worsened patient-ventilator synchrony and increased airway resistance due to the use of a small diameter tube. We decided to replace the tube with the one with larger diameter. An ID 7.5 mm tube was inserted with the use of fiberscope through the opening of the vocal cord while the tube for laser surgery was left in space. A | 15682806 | [
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[Two tracheal tubes inserted for endotracheal tube replacement in a patient with severe obstructive sleep apnea: a case report]. | fter confirming that the two tubes were inserted securely; the tube for laser surgery was withdrawn. The patient's ventilation improved significantly afterwards and the extubation was performed successfully. Our method for replacing a tracheal tube seemed to be effective and safe. | 15682806 | [
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[Double-lumen tracheostomy tube (Tracheopart) used in two patients for one-lung ventilation under general anesthesia]. | Double-lumen tracheostomy tube (Tracheopart; RUSCH) is now available in Japan. We used the device to perform one-lung ventilation in two patients with previous laryngectomy and permanent tracheostomy. Reliable fixation and observation of the right position during the operation are especially important throughout the procedure. We think that this device needs more improvements regarding its size and length. | 15682807 | [
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[Surgical volume and mortality due to intraoperative critical incidents at Japanese Society of Anesthesiologists certified training hospitals: an analysis of the annual survey in 2002]. | We have previously showed that surgical volume affects mortality due to intraoperative critical incidents among patients undergoing cardiac surgery; the surgery with the highest risk; using data obtained by the annual survey in 2001 conducted by the Japanese Society of Anesthesiologists (JSA). In this study; we investigated whether surgical volume affects mortality due to intraoperative critical incidents independent of the surgical site.We investigated this relationship using data obtained from the 2002 an | 15682808 | [
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[Surgical volume and mortality due to intraoperative critical incidents at Japanese Society of Anesthesiologists certified training hospitals: an analysis of the annual survey in 2002]. | nual survey conducted by the Subcommittee on Surveillance of Anesthesia-related Critical Incidents; JSA. Between January 1; 2002 and December 31; 2002; 1;987;988 patients were registered from 704 training hospitals certified by the JSA. Intraoperative critical incidents occurred in 2;844 patients. Of these; 804 patients died within 7 postoperative days. The overall mortality was 4.61 per 10;000 anesthetics. Hospitals were divided into 5 groups according to their annual surgical cases: Group A; fewer than 1; | 15682808 | [
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[Surgical volume and mortality due to intraoperative critical incidents at Japanese Society of Anesthesiologists certified training hospitals: an analysis of the annual survey in 2002]. | 000 (62 hospitals); Group B; 1;000-1;999 (204 hospitals); Group C; 2;000-3;999 (288 hospitals); Group D; 4;000-5;999 (110 hospitals); Group E; more than 6;000 (40 hospitals). Hospitals were also divided into 2 groups according to mortality: Group 1; under 20.00 per 10;000 anesthetics (672 hospitals); Group 2; equal to or higher than 20.00 per 10;000 anesthetics (32 hospitals). Total number of deaths in Group 2 was 158. Mortality was expressed as the mean (95% confidence interval). Statistical analysis was p | 15682808 | [
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[Surgical volume and mortality due to intraoperative critical incidents at Japanese Society of Anesthesiologists certified training hospitals: an analysis of the annual survey in 2002]. | erformed using chi-square test and Fisher test. A p value of <0.05 was considered significant.The mortality rates in Groups A-E were 14.89 (8.48-21.3); 3.86 (3.05-4.67); 3.88 (3.19-4.57); 4.04 (3.20-4.88); and 3.12 (2.19-4.05) per 10;000 anesthetics; respectively. Average surgical cases and mortality in Group 1 were 2;789 (2;775-3;002) and 3.24 (2.90-3.58); respectively; while those in Group 2 were 1;672 (1;243-2;101) and 22.18 (30.58-45.94); respectively. If all patients in Group 2 (n=53;509) had been trea | 15682808 | [
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[Surgical volume and mortality due to intraoperative critical incidents at Japanese Society of Anesthesiologists certified training hospitals: an analysis of the annual survey in 2002]. | ted in the hospitals of Group 1; 139-143 deaths might have been avoided.Surgical volume was shown to affect mortality independent of the surgical site. Hospitals with low surgical volume should pay significant attention to improving surgical outcomes. These results also suggest that centralization or regionalization should be discussed from the perspective of socio-economical problems as well as patient safety. | 15682808 | [
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[A case of ulcerative colitis successfully treated with low-dose warfarin for portal vein thrombosis after colectomy]. | nan | 15682812 | [
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[A case of mesenteric cavernous hemangioma showing interestingly image study]. | nan | 15682813 | [
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[Study on the 8 cases with supplemental hemostatic treatments after small intestinal biopsy]. | nan | 15682814 | [
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[A case of valproate-associated hyperammonemia with chronic hepatitis C]. | nan | 15682815 | [
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[A case of agenesis of the left hepatic lobe complicated with hypogenesis of the anterior segment of the right hepatic lobe]. | nan | 15682816 | [
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[A case of secondary non-Hodgkin's lymphoma of the colon after the treatment for Hodgkin's disease]. | nan | 15682817 | [
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[Study on solvent abuse among junior high school students in Saitama, Japan]. | The purposes of this study were to estimate the prevalence of past solvent abuse among junior high school students in Saitama prefecture and to investigate smoking and drinking as "gateway drugs" for solvent abuse.The survey was conducted from Dec 2002 to Jan 2003; in 3 junior high schools in Saitama; using anonymous self-reporting to preserve privacy. A total of 2;049 (93.2%) students responded to our questionnaire. Two groups were categorized and analyzed according to history of solvent abuse in the past. | 15682819 | [
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[Study on solvent abuse among junior high school students in Saitama, Japan]. | To investigate "gateway effects" of smoking and drinking; we analyzed their relationship with solvent abuse; order of precedence of usage and confounding factors.The prevalence of history of solvent abuse was 1.1% of the total. There were notable differences depending on sex and grade. 1.9% of male students had some experience as compared to only 0.3% of female students. An increase was evident according to grade (grade 1-0.6%; grade 2-0.8%; grade 3-2.1%) and there was a strong association between smoking; | 15682819 | [
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[Study on solvent abuse among junior high school students in Saitama, Japan]. | drinking and solvent abuse. The order of precedence of solvent abuse could not be established because some users had first experienced smoking; drinking and solvent abuse in the same grade and there was also a high recall bias among the subjects. A number of respondents also reported the reverse order; of experiencing solvent abuse before smoking and drinking. The user group was habitual smokers were recommended to smoke by their parents; spent longer periods in solitude; witnessed solvent abuse and had a | 15682819 | [
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[Study on solvent abuse among junior high school students in Saitama, Japan]. | friend who abused solvents. After adjusting for confounding factors using multiple logistic regression analysis; a relationship between smoking and solvent abuse remained but not the relationship with drinking.The study conformed that there is solvent abuse among junior high school students; even in the lowest grade. Health education must focus on this fact and the finding that the user group reflects peer pressure and is faced with poor communication and advice from their families. Therefore health educati | 15682819 | [
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[Study on solvent abuse among junior high school students in Saitama, Japan]. | on focused on life skills and social support considering family ties must be emphasized. It could not be established which was first experienced; but a strong relationship between smoking and solvent abuse was observed even after multivariable analysis. On the other hand; the results suggested that habitual drinking is not a "gateway drug" to solvent abuse. | 15682819 | [
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[The effects of increased dietary calcium intake on bone mineral density in long-term lactating women, and recovery of bone loss caused by long-term lactation with low calcium diet]. | The purpose of this study was to examine the efficacy of an increased calcium (Ca) diet for preventing bone mineral loss in long-term lactating women; considering bone metabolism; and recovery of bone loss caused by long-term lactation with low dietary Ca intake.Two groups of long-term (> 12 mon.) lactating women ... one with an enhanced Ca intake (Group M; n = 22) and the other with diet feeding no cow's milk and no milk products (Group N; n = 16) ... and a control group of 21 non-lactating postpartum wome | 15682820 | [
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[The effects of increased dietary calcium intake on bone mineral density in long-term lactating women, and recovery of bone loss caused by long-term lactation with low calcium diet]. | mg/day in the M group. 2. After lactating for one year; the N group demonstrated significant decrease in BMD; with both 1 and 2 babies; whereas the M group had no significant change. 3. The BMD in the N group returned to initial levels at 0.5 approximately 1 year post-weaning; 4. In the N group; compared with the M group; the urinary Hydroxyproline/creatinine ratio was significantly higher at the initial measurement and half a year thereafter; while urinary Ca/ creatinine ratio was significantly lower after | 15682820 | [
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[The effects of increased dietary calcium intake on bone mineral density in long-term lactating women, and recovery of bone loss caused by long-term lactation with low calcium diet]. | a year. However; there were no significant differences between the M and C groups. 5. Serum bone alkaline phosphatase was significantly higher in the M group compared with the C group.Bone loss during long-term lactation can be prevented with adequate dietary Ca intake. Once lost; recovery to initial levels occurs 0.5 approximately 1 year post-weaning. | 15682820 | [
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[A study by the Delphi technique of expected competencies of public health nurses working in government organizations]. | The purpose of this study was to clarify; using the Delphi technique and by the consensus of Experts; the expected competencies of Public Health Nurses (PHNs) working in government organizations according to their number of years' experience.Experts were nurses who had a PHN license in academic; administration and service areas. The criteria for selecting are as follows: Academic: professors of community nursing department; in nursing college. Administration: chief PHNs working in prefectural government org | 15682821 | [
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[A study by the Delphi technique of expected competencies of public health nurses working in government organizations]. | anization; with the role of supervising and controlling PHNs. Service: recommended by each administration Expert and fulfilling all the following 3 points; (1) PHN experience of 10 years or more in a government organization; (2) a supervisory position over at least one junior PHN; and (3) an effective practical record as a PHN. 209 Experts who were chosen by the specified criteria were approached for their participation. At Round 1; Experts were asked to list competencies important for PHN under 3 headings: | 15682821 | [
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[A study by the Delphi technique of expected competencies of public health nurses working in government organizations]. | knowledge; skills and attitudes. From the response in Round 1; competency items were categorized. A list was obtained and used in Round 2; when Experts were asked to select and rate the importance of competencies for 4 ranges of PHN years of experience. At Round 2; these competencies were analyzed on the basis of importance. At Round 3; Experts were asked whether they agree or not with the results of Round 2. The criterion for consensus was set as an agreement rate of 90%.Of the total; 63 agreed to partici | 15682821 | [
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[A study by the Delphi technique of expected competencies of public health nurses working in government organizations]. | pate; 14 in the academic; 23 in the administration and 26 in the service area. Response were turned 63 from all at Round 1; 52 at Round 2 and 44 at Round 3. The result clarified the expected competencies into 47 items and 7 categories related to their importance in the experience year ranges. The 7 categories were: Conducting nursing processes; Conducting community health activities; Providing health care; Management; Information application; Human relations; and Personal characteristics. The very important | 15682821 | [
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[A study by the Delphi technique of expected competencies of public health nurses working in government organizations]. | competencies PHNs should have were regarded as follows: (1) At 1-3 years' experience; PHNs should have 2 categories (2) At 4-10 years; they should have the 5 categories (3) At 11-20 years they should have all 7 categories (4) At 21 or more years they should have at least 6 categories. At all levels PHNs were required to have the 2 categories of Providing health care and Personal characteristics.It was expected as PHNs gain experience they should obtain wider and more faranding competencies stepwise; from b | 15682821 | [
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[Relationship between utilization of health notebooks and the elderly population rate among Japanese municipal governments]. | Health conditions are changing rapidly in aging societies and an essential health service by municipal governments is to promote the utilization of health notebooks in support of the health of individuals. The objective of this study was to clarify the relationship between utilization of health notebooks and rates for elderly among Japanese municipal governments.Questionnaires on the utilization of health notebooks were mailed to all 3;255 municipal governments in Japan. The 2;445 that filled in all items o | 15682822 | [
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[Relationship between utilization of health notebooks and the elderly population rate among Japanese municipal governments]. | n the questionnaire were enrolled in this study. Questions concerned opportunities for utilizing health notebooks when residents received health education/guidance; health examinations; home visits; or welfare service. If they answered "Frequent use" for these opportunities; one point was given. Furthermore; if they answered that they filled in the results of residents' health examination into health notebooks; one point was given. If a municipal government got 4 points or more; this municipality was classi | 15682822 | [
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[Relationship between utilization of health notebooks and the elderly population rate among Japanese municipal governments]. | fied as "health notebooks frequently used".The percentage of municipalities defined as "health notebooks frequently used" was higher among municipal governments with a high rate of elderly residents than with a lower rate. The odds ratio for being classified as "health notebooks frequently used" was higher among municipal government with high rates for the elderly and public health nurses per elderly person than with low rates.With increase in the percentage of elderly residents; municipal governments need | 15682822 | [
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[Relationship between utilization of health notebooks and the elderly population rate among Japanese municipal governments]. | to promote their health services in support of residents' health. To improve the utilization of health notebooks; municipalities should increase the number of public health nurses. | 15682822 | [
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[A quantitative and qualitative study on effective information flow for infectious disease control in welfare facilities for the elderly]. | To clarify factors associated with effective information tranges among staff of welfare facilities for the elderly; and to propose measures for an appropriate information flow system in welfare facilities and public health centers; communication channels and methods; and encouraging factors and barriers were investigated in terms of a printed medium on the control and management of scabies infections.A self-administered questionnaire survey and an interview survey were conducted with the staff of welfare fa | 15682823 | [
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[A quantitative and qualitative study on effective information flow for infectious disease control in welfare facilities for the elderly]. | cilities for the elderly where "Control and management manual of scabies infection" had been distributed by the Tama-Tachikawa Public Health Center in Tokyo. A self-administered questionnaire was sent to managers and chief practitioners of 66 facilities. Respondents were obtained from 66 managers and chief practitioners (response rate: 84.8%); and 831 practitioners (response rate: 53.1%). The questionnaire consisted of 20 items for managers and 18 items for chief practitioners; including experience of scabi | 15682823 | [
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[A quantitative and qualitative study on effective information flow for infectious disease control in welfare facilities for the elderly]. | es epidemics in facilities; training experience for the use of "Control and management manual of scabies infection;" measures for information gathering; and current information flow within the facility. A semi-structured interview survey was conducted with the manager and/or chief practitioner and practitioners in five facilities. The number of respondents was 10. The interview questions included job description; scabies control measures; dissemination of the manual to the staff; use of the manual; flows of | 15682823 | [
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