The purpose of this study was to find out the effeet of midazolam and fentanyl on oxygcn saturation by pulse oximetry in surgical patients under spinal anesthesia. The subjects of this study were 83 patients who were operated on under spinal anesthesia, at a general hospital in Pusan. from December 1st, 1997 to March 31st, 1998. The subjects of Group 1 were 53 patients who did not receive either of midazolam and fentanyl. The subjects of Group 2 were 21 patients who received midazolam. The subjects of Group 3 were 9 patients who received both midazolam and fentanyl. Oxygen saturation was measured with a pulse oximeter by time series. The collected data were analyzed by the SPSS / PC~ program and the results of the study were as follows 1. There were no significant differences among the three experimental groups in terms of age or cardiopulmonary disease. 2. Among the three groups, there were statistically significant differences in Sp02 at 5 minutes after starting the operation or after intravenous injection of drugs. The SpO2 mean for Group 3 was 92.4%, for Group 2 it was 97.7%. and for Group 1 it was 98.2%. 3. Hypoxemia cases occurred in 88.9% of Group 3, 28.6% of Group 2, and 17.0% of Group 1, respectively. It is concluded that oxygen saturation mo4oring should be done routinely to all patients under ~spinal anesthesia, especially during operating tim4. and patients receiving midazolam and fentanyl should be monitored closely. After monitoring oxygen should be administered to all patients who developed hypoxemia.
Anesthesia ; Anesthesia, Spinal* ; Anoxia ; Busan ; Fentanyl* ; Hospitals, General ; Humans ; Injections, Intravenous ; Midazolam* ; Oximetry ; Oxygen*

Nevus sebaceus of Jadassohn is a hamartoma of the skin with the potential to develop benign and malignant neoplasms. This case was characterixed by multiple basal cell epitheliomas, clinically one reddish nodule and multiple pigmented papules, arising in the nevus sebaceus. Histologically, epithelial papillomatous hyperplasia and high-positioned hyperplastic sebaceous glands were found, and tumor nests consisting of basaloid cells with peripheral palisading arrangements were mainly situated in the upper dermis without significant infiltrative growth. We report a rare case of nevus sebaceus with multiple basal cell epitheliomas in the right cheek of a 49-year-old woman.
Carcinoma, Basal Cell* ; Cheek ; Dermis ; Female ; Hamartoma ; Humans ; Hyperplasia ; Middle Aged ; Nevus* ; Nevus, Sebaceous of Jadassohn* ; Sebaceous Glands ; Skin

No abstract available.
Lymphangioma, Cystic* ; Turner Syndrome* ; Ultrasonography*

OBJECTIVES: Hyposexuality is defined as diminished sexual drive or libido. There has been little research into the sexuality in patients with obstructive sleep apnea (OSA). We investigated the prevalence and relating factors for hyposexuality in OSA men. METHODS: Consecutive 182 male (mean age 48.3 y) were enrolled who were newly diagnosed with OSA through polysomnography. All completed Symptom checklist-90-Revised (SCL-90-R), Epworth Sleepiness Scale (ESS), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Subjects were divided into non-hyposexuality (score 0) and hyposexuality (score > or =1) groups according to the question "Loss of sexual interest or pleasure" in SCL-90-R. RESULTS: 110 of 182 subjects (60.4%) answered hyposexuality (score > or =1). Significant correlations were found between hyposexuality and following factors; age (rho=0.248), BDI (rho=0.450), BAI (rho=0.410), ESS (rho=0.221), and percentage of non-REM stage 3 (N3%) (rho=-0.184). Apnea-hypopnea index was significantly correlated with nocturia (rho=0.320), ESS (r=0.230), N1% (r=0.596), N2% (r=-0.540), N3% (r=-0.195), and lowest oxygen saturation (r=-0.641). Comparing two groups, hyposexuality group showed significantly lowered total sleep time (380.2 min vs. 359.1 min), and sleep efficiency (83% vs. 76%). The severity of hyposexuality was correlated with BDI (rho=0.330), BAI (rho=0.253), and N3% (rho=-0.215) in subjects with hyposexuality. After controlling for age, polysomnographic parameters were not correlated with hyposexuality. CONCLUSIONS: About half of untreated OSA male subjects reported diminished libido. Age, daytime sleepiness, mood disorders, and decreased sleep quality were associated with hyposexuality. Of these, aging process was the most important factor for hyposexuality.
Aging ; Anxiety ; Depression ; Humans ; Libido ; Male ; Mood Disorders ; Nocturia ; Oxygen ; Polysomnography ; Prevalence ; Sexuality ; Sleep Apnea, Obstructive*

Callus is a nonpenetrating circumscribed hyperkeratosis produced by repeated friction or pressure. It occurs on parts subjected to intermittent pressure, particularly on the palms and soles, and particularly over the bony prominences of the joints. In painful callosities of the feet, ill-fitting shoes and orthopedic problems of the foot (bunions, exostoses) are some of the etiological factors to be considered. Gout is a condition of inborn metabolic and/or acquired form of the disease characterized by hyperuricemia, tophaceous deposits of sodium urate and recurrent attacks of arthritis. We present a case of callus caused by tophi. The patient was a 45-year-old man who had complained of a painful, well-demarcated, hyperkeratotic plaque on the heel of the left foot for 18 months. After the tophi beneath overlying whitish thickened skin had been removed, the skin lesion disappeared and to date has not recurred.
Arthritis ; Bony Callus* ; Callosities ; Foot ; Friction ; Gout ; Heel ; Humans ; Hyperuricemia ; Joints ; Middle Aged ; Orthopedics ; Shoes ; Skin ; Uric Acid

Venous hemangioma is a vascular tumor that has been reported by such diverse names as; "cirsoid aneurysm", "arteriovenous hemangioma", "acral arteriovenous tumor" according to the author's opinions of its origin and histopathologic classification. It is benign and rarely biopsied, and it is also rarely reported in dermatology literature. We present two cases of venous hemangioma. The first case was a 64-year-old man who was presented with an elliptical dark-red plaque with overlying several grouped papules on the left periorbital area which had been present for 7 years. The second case was a 56-year-old man who was presented with a single red papule on the right postauricular area which had been present for 4 months. Histopathologically, there were a well-circumscribed proliferation of thick-walled muscle-containing blood vessels in the dermis. Intermingled with the thick-walled blood vessels, there were also thin-walled dilated blood vessels. In both cases, the thick-walled blood vessels resembled arteries, but they lacked elastic fibers on the Verhoeff van Gieson stain.
Arteries ; Blood Vessels ; Classification ; Dermatology ; Dermis ; Elastic Tissue ; Hemangioma* ; Humans ; Middle Aged

Histiocytosis X(Langerhans cell histiocytosis) is a rare prolifertive disorder of Langerhans cells that includes Lettere-Siwe disease, Hand-Shiiller-Christian his ase and eosinophilic granuloma. Since many authors have reported in anintermediate and poarl classified form histiocytosis X has a namenclatural had nosologic problem. We report a case benign cutaneous variant of histiocytisis X. A four-month-old boy had shown multiple skin-colour papules on the trunk, head and nik for one month. Extensive in- vestigations failed to detcct any systemic involvement. The clixron microscopic findings of the skin biopsy specimen were Qefinitely diagnostic for histiocytosi. X Since he did not sbow evidence of internal organ involvernent and any further progression of he skin lesion, no therapy was given. Over the next two months the disease underwent spontane us and complete remission.
Biopsy ; Eosinophilic Granuloma ; Head ; Histiocytosis* ; Histiocytosis, Langerhans-Cell* ; Humans ; Langerhans Cells ; Male ; Remission, Spontaneous* ; Skin

No abstract available.
Leiomyoma* ; Vulva*

No abstract available.
Leiomyoma* ; Vulva*

PURPOSE: The purpose of this study was to explain the role transition process to nurse case managers (NCMs) for Medical-aid beneficiaries in Korea. METHODS: Fourteen NCMs were interviewed regarding their experiences of becoming proficient in the new role of case manger. Data were analyzed through the application of grounded theory. RESULTS: 'Taking root in a barren land' was the core category explaining the role transition process of NCMs. They engaged in four stages: launching, trial and error, proficiency, and wait-and-see stages. NCMs showed not only fear but also passion for case management practice. Despite their passion and effort, NCMs went through a period of trial and error. After becoming skilled, NCMs went through a stage of wait-and-see often because of job insecurity related to temporary position or few opportunities for promotion. Factors influencing NCMs' role transition process included their understanding of client characteristics, belief in case management, and support from their colleagues and families. CONCLUSION: NCMs experience many challenges in the process of becoming proficient NCMs. To help with their role transition, there is a need for education programs, preceptorship programs, research on their roles and functions, and regulation for securing NCMs' employment and career stability.
Case Management ; Humans ; Interviews as Topic ; Job Satisfaction ; Medical Assistance ; Nurses/*psychology ; Professional Role/psychology ; Qualitative Research