No abstract available.
Benzalkonium Compounds* ; Dermatitis, Contact*

BACKGROUND: It has been suggested that diabetic patients are under high oxidative stress and plasma MDA concentration is a reliable marker for oxidative stress. However, some studies showed that plasma MDA is not a good marker for oxidative stress. Reeently, the total radical-trapping antioxidant parameter (TRAPc) has been proposed as a marker for the overall antioxidant property of plasma samples. Therefore, in this study, we tried to evaluate whether MDA and TRAPc are reliable markers of the oxidative stress-antioxidant system or not. METHODS: The plasma samples from 67 type 2 diabetic patients and 31 normal subjects were collected. The plasma MDA, protein-bound SH groups, uric acid and vitamin C were determined by fluorophotometry or spectrophotometry. Plasma vitamin E concentration was analyzed by HPLC. Calculated TRAP (TRAPc) were determined by the proposed calculation methods. RESULTS: 1. Diabetic patients had significantly lower TRAPc, compared with normal subjects. 2. SH groups, uric acid, vitamin C and vitamin E were not different between the two groups. 3. MDA and MDA/TG were significantly higher in diabetic subjects. CONCLUSION: From the results of this study, TRAPc seems to be a reliable parameter of overall plasma antioxidant system and the plasma MDA may be used as a marker of oxidative stress, but further long-term logitudinal studies are needed.
Ascorbic Acid ; Chromatography, High Pressure Liquid ; Fluorophotometry ; Humans ; Oxidative Stress ; Plasma ; Spectrophotometry ; Uric Acid ; Vitamin E ; Vitamins

Cutaneous metastasis from the tumors of internal organs is rare, but often gives a clue to diagnosis. Metastasis to the abdominal skin including umbilicus has frequently originated from a tumor of the large bowel, ovary, stomach and pancreas. We report two cases of metastatic adenocarcinoma developed on the abdominal wall. One at the umbilicus clarified the origin as a pancreatic carcinoma, and the other at the sites of previous laparascopy and paracenthesis was originated from an ovarian cancer.
Abdomen ; Abdominal Wall ; Adenocarcinoma* ; Diagnosis ; Female ; Neoplasm Metastasis ; Ovarian Neoplasms ; Ovary ; Pancreas ; Skin* ; Stomach ; Umbilicus

No abstract available.
Antigens, Surface* ; Oncogenes*

BACKGROUND: Paramedian approach is more useful than midline approach when degenerative changes are encountered in the interspinous structure and when ideal positioning of the patient can not be achieved. The purpose of this study was to determine the guideline of depth from skin to subarachnoid space by midline or paramedian approach in Korean adult. METHODS: The distance from skin to subarachnoid space was measured in 47 patients recieving spinal anesthesia by midline approach and 30 patients by paramedian approach at L3-4 level. RESULTS: The mean depth to subarachnoid space was 5.44+/-0.47 cm in midline approach. In paramedian approach by 18.0degrees of caudal and 18.5degrees of lateral angle, mean depth was 6.24+/-0.60 cm. There were significant correlation between depth and weight, and depth and ponderal index. In ages over 50 years old, difficult cases were significantly more in midline approach than in paramedian approach. CONCLUSIONS: Measurement of factors as weight or ponderal index can be used to predict the depth. Paramedian approach is more useful than midline approach in ages over 50 years old.
Adult* ; Anesthesia, Spinal* ; Humans ; Middle Aged ; Needles* ; Punctures* ; Skin ; Subarachnoid Space

OBJECTIVE: The aim of this study was to develop a decision support system that helps school nurses manage health problems they encounter while caring for the elementary and secondary school students, and evaluate usability of it. METHODS: Knowledge was aquired by literatures review and interviews with senior school nurses and was validated by another group of school nurses. The Omaha System was used as a standardized nursing terminology to describe nursing diagnoses and interventions. The system was developed under the Windows environment. C++ was used as a program language and MS Structured Query Language as a database. To investigate usability of the system, 30 school nurses in elementary and secondary schools were recruited and asked to apply it to nursing problems they encountered in actual students care setting. RESULTS: The decision support system with seven major signs and symptoms was developed. It automatically makes a nursing diagnosis based on the input data, and also provides nursing interventions with evidence. It was proven that the system was very useful for school nurses to manage students` health problems. CONCLUSION: The system will contribute to development of expert knowledge concerning student's health problems and improve the quality of school nursing and professionalism.
Expert Systems ; Humans ; Nursing ; Nursing Care* ; Nursing Diagnosis ; Nursing Process ; School Nursing

BACKGROUND: A noninvasive method for estimating cardiac output was tested in dogs. The technique is based on a differential CO2 Fick equation applied during normal ventilation and 50 seconds of partial rebreathing using additional dead space. We compared the cardiac output measured by the CO2 rebreathing method vs. the thermodilution technique. METHODS: Seven mongrel-dogs (24.6 +/- 0.4 kg) were studied, anesthesia was induced and maintained with a pentobarbital 25 mg/kg IV bolus injection followed by an infusion of 5 mg/kg/h. Mechanical ventilation was accomplished with a Servo 900C ventilator with FiO2 0.6 to maintain normocarbia. A fiberoptic pulmonary artery catheter was introduced via an external jugular vein for continuous monitoring of the cardiac output by the thermodilution method. Also cardiac output was measured by using partial CO2 rebreathing method. A continuous infusion of 0.5% bupivacaine was started at 0.5 mg/kg/min via the venous infusion port of the pulmonary catheter. Bupivacaine was infused continuously until mean arterial pressure decreased to 60 mmHg or less for at least 5 seconds. RESULTS: The total measured cardiac outputs (n = 72) were distributed over the range of 1.03-7.72 L/min by thermodilution method and 1.6-7.3 L/min by CO2 rebreathing. The correlation coefficients between both cardiac outputs was 0.6, the mean difference was 0.27 +/- 0.81 L/min. CONCLUSIONS: The cardiac output measured by CO2 rebreathing method was well correlated with cardiac output by thermodilution method.
Anesthesia ; Animals ; Arterial Pressure ; Bupivacaine ; Cardiac Output* ; Catheters ; Dogs ; Jugular Veins ; Pentobarbital ; Pulmonary Artery ; Respiration, Artificial ; Thermodilution* ; Ventilation ; Ventilators, Mechanical

PURPOSE: The purpose of this study was to evaluate the effects of clinical practice and simulation-based practice for obstetrical nursing in terms of self-efficacy, practice satisfaction, and practice stress. METHODS: A non-equivalent control group post test design was used. The participants were 171 junior nursing students, 103 in the experimental group, and 68 in the control group. Simulation-based practice consisted of nursing assessment during labor, nursing assessment and intervention for normal and high risk mother, nursing education for mother and family during labor, and open lab. The experimental group participated in simulation-based practice for two days and the control group participated in clinical practice at delivery room for two weeks. RESULTS: The experimental group showed higher level of self-efficacy (p=.043), practice satisfaction (p<.001) and practice stress (p=.003) compared to the control group. CONCLUSION: Simulation-based practice is an effective learning method for obstetrical nursing and can be used as the alternative for clinical practice. However, stress management strategies are needed for simulation-based practice.
Delivery Rooms ; Education, Nursing ; Humans ; Learning ; Mothers ; Nursing Assessment ; Obstetrical Nursing ; Personal Satisfaction ; Pyridines ; Students, Nursing ; Thiazoles

The purpose of this study was to identify the relationship between the clinical response to neoadjuvant chemotherapy and PCNA and VEGF protein expression, apoptosis and its related gene expression such as Bcl-2 and Bax in cervical cancer. We retrospectively reviewed 30 patients with locally advanced or bulky cervical cancer treated with three courses of neoadjuvant chemotherapy followed by radical hysterectomy or radiation therapy at Seoul National University Hospital from June 1995 to June 1998. The specimen were obtained before chemotherapy by colposcopy directed biopsy. The protein expressions of Bcl-2, Bax, VEGF and PCNA were examined by immunohisto- chemical staining and the apoptosis was examined by TUNEL staining. These results were compared with chemotherapeutical response which was evaluated by colposcopy or CT/MRI. There were 2 CR(complete response), 19 PR(partial response) and 9 NC(no change) and there was no progressive disease. There was no significant difference between responder and nonresponder according to the age, tumor size and FIGO stage. The 3 year survival rates of responder and nonresponder were 90.0% and 66.7% respectively and there was significant difference between two groups(p=0,015). The expression of Bcl-2 and Bax was positive in 23.3%(7/30) and 46.7%(14/30). The expression of VEGF was positive in 83.3%(25/30). PCNA PI(positive index), defined as PCNA positive cells in percentage was more than 25.0% in 20 cases. Apoptotic index, defined as the number of the cells undergoing apoptosis per 1,000 tumor cells, ranged from 3 to 53(mean 22.3). Although there was no significant relationship between the clinical response to neoadjuvant chemotherapy and the expre- ssion of Bcl-2, Bax, VEGF and PCNA PI, apoptotic index was significantly higher in responder than nonresponder when the cutoff value of positive was defined as apoptotic index more than 5(p=0.032). In conclusion, the evaluation of the pattern of apoptosis before neoadjuvant chemothera- py is potentially useful for the prediction ofz tumor response to neoadjuvant chemotherapy for cervical cancer.
Apoptosis* ; Biopsy ; Colposcopy ; Drug Therapy* ; Gene Expression ; Humans ; Hysterectomy ; In Situ Nick-End Labeling ; Proliferating Cell Nuclear Antigen* ; Retrospective Studies ; Seoul ; Survival Rate ; Uterine Cervical Neoplasms* ; Vascular Endothelial Growth Factor A*

PURPOSE: This study was done to explore the process of accepting CATs among nurses who experienced CATs in Korea. METHODS: Grounded theory methodology was utilized. Data were collected from 10 nurses during individual in-depth interviews. Theoretical sampling was used until the data reached saturation. Data were analyzed using the constant comparative analysis method. RESULTS: The core category emerged as "resolving the doubt and integrating" explaining the process of accepting CATs. The nurses engaged in three stages: need awareness, look for solution and integration. Causal conditions were interest as a nursing intervention and orthodox medical limitations. Context was lack of basis for application and increase in social interest. Strategies were new knowledge acquisition, having a strong will, combined with existing knowledge, and individualized intervention. Intervening conditions were others' eye, exhaustion for nurses and physical environment. Consequences were expanding of the nursing role and improved nurse satisfaction. CONCLUSION: The results of the study should facilitate application of CATs in nursing practice. To help nurses who are interested in CATs, there is a need for education programs, and further research on CATs.
Adult ; *Attitude of Health Personnel ; Awareness ; *Complementary Therapies ; Female ; Humans ; Interviews as Topic ; Middle Aged ; *Models, Theoretical ; Nurse's Role ; Nurses/*psychology ; Social Support