No abstract available.
Gastrectomy* ; Humans ; Quality of Life* ; Stomach Neoplasms*

No abstract available.
Ectopia Cordis* ; Ultrasonography*

PURPOSE: The purpose of this study was to examine the differences of the process of change, decision making, self-efficacy and perception of subjective health according to the stages of exercise behaviors suggested by transtheoretical models among older adults. METHOD: The subjects consisted of 291 older adults. Trained research assistants interviewed the older adults using structured questionnaires. ANOVA analyses with post hoc test were used to examine the mean differences for each stage of exercise behavior using SPSS for windows. RESULT: The subjects were divided into five stages of exercise behavior: 24.4% pre-contemplation, 12.4% contemplation, 17.9% preparation, 12.4% action, 33.0% maintenance stage. There were significant differences in process of change, decision making, self-efficacy and subjective health perception according to the exercise stage of change. 'Self-liberation' and 'stimulus control' were important strategies for intention of exercise, while 'reinforcing management' for the actual practice of exercise. 'Self-efficacy' was an effective strategy to change older adults from pre-contemplation to preparation stage. CONCLUSION: For exercise intervention, older adults should be classified into groups according to their stages of exercise behaviors and provided effective individualized intervention depending on their stage.
Adult* ; Aged ; Decision Making* ; Humans ; Intention ; Surveys and Questionnaires

The purpose of this study was to examine the effect of preceptorship on On the Job Training of new nurses. The research design was a retrospective survey and one group pre-post test design. The subjects were 49 entry nurses and 49 preceptors. The data were collected from Feburary 1, 1998 to December 1, 1998. One questionnair applied in this study consisted of general characteristics, the responses of new entry nurses and their preceptors and their qualities. The other questionnair consisted of job satisfaction of new entry nurses and preceptors and their competencies. The data were analyzed for frequencies, mean score, standard deviation, t-test, and ANOVA. The results of the study were as follows: 1) Preceptees's responses were that the nurses' affiliation of unit, cooperation of other nurses, and competencies of nursing skills improved after OJT applied preceptorship. 2) Preceptors's answers were that preceptor- ship had a positive effect on their continuing education. 3) While preceptees's job satisfaction scores were high in interaction, administration, and organization, they were low in autonomy and pay. 4) Pre-competency scores were the same as post-competency scores. 5) After preceptorship, preceptors responded that their nursing skill & communication competency increased, but their nursing administration competency decreased. 6) Finally, preceptorship's other effects were as follows: 1. Checklists for preceptee education at the nursing unit were developed separately. 2. It was proved that 'preceptor interview note' was effective on manage preceptorship. 3. We obtained duty overlap periods; medical- surgical units-1 month, 5 ICU-2 months, operation room-3 months. 4. We prepared a preceptor program based on the study results.
Checklist ; Education ; Education, Continuing ; Evaluation Studies as Topic ; Inservice Training ; Job Satisfaction ; Nursing ; Preceptorship* ; Research Design ; Retrospective Studies ; Ships

No abstract available.
Diagnosis* ; Hemangioma* ; Tomography, Emission-Computed, Single-Photon*

Background: The highly lipid soluble opioid, fentanyl, has a rapid onset and short duration of action. The present study was designed to examine the analgesic efficacy and side effects of the combination of fentanyl with morphine in patients using intravenous PCA. Methods: Patients were randomly assigned to receive one of three PCA regimens: M4 group (40 mg morphine+90 mg ketorolac+1.5 mg dorperidol), M2F2 group (20 mg morphine+200 ug fentanyl+90 mg ketorolac+1.5 mg dorperidol), or M2F4 group (20 mg morphine+400 ug fentanyl+90 mg ketorolac+1.5 mg dorperidol). All patients were given initial loading dose of 0.1 mg/kg morphine plus 1 mg droperidol at the end of surgery. Pain score, side effects, and overall satisfaction were assessed at 30 min, 1 hr, 8 hr, 24 hr, and 48 hr postoperatively. Results: The pain score was significantly higher in the M2F2 group than in the M4 group and M2F4 group during 1 hr and 8 hr postoperatively. The total opioid consumption was significantly greater in the M2F4 group than in the M4 group. Patient satisfaction was better in the M2F4 than other two groups. There were no differences in the overall incidence of side effects among three groups. Conclusions: The present results suggest that the combination of fentanyl with morphine for intravenous patient-controlled analgesia is a useful method, and the double dose of fentanyl in comparison with the equipotent morphine dose is recommended in the early postoperative period.
Analgesia, Patient-Controlled* ; Droperidol ; Fentanyl* ; Humans ; Incidence ; Morphine* ; Passive Cutaneous Anaphylaxis ; Patient Satisfaction ; Postoperative Period

Background: We hypothesized that intravenous lidocaine mixed with propofol may have an influence on anesthesia induction and hemodynamic responses to propofol induction and endotracheal intubation as well as propofol-induced pain on injection. Methods: Seventy-five patients were allocated to group L1 (2% lidocaine 1.5 mg/kg, n=25), group L2 (2% lidocaine 2 mg/kg, n=25) or group C (normal saline 0.05 mL/kg, n=25) according to the lidocaine dosage mixed with propofol 2 mg/kg. The pain on injection was scored as none, mild, moderate, and severe. The site of pain and recall of pain were also recorded. Loss of verbal response was observed during induction. Mean arterial blood pressure (MAP) and heart rate (HR) were recorded before anesthetic induction (baseline value), immediately before and after endotracheal intubation, and every min until 5 min thereafter. Results: Ninety-two percent of patients reported pain upon injection in group C, whereas 8% of the patients in group L1 and no patient in group L2. Loss of verbal response before injection of total dose of propofol was observed in 44% in group L2, 36% in group L1 and 28% in group C. Lowered MAP caused by propofol increased significantly after endotracheal intubation in all three groups (p<0.05). HR increased immediately and 1 min after endotracheal intubation in all three groups (p<0.05). Conclusions: Our results indicate that intravenous lidocaine 1.5 mg/kg or 2 mg/kg mixed with propofol 2 mg/kg significantly reduces the incidence and the degree of pain, but does not affect anesthesia induction and hemodynamic responses to propofol and tracheal intubation.
Anesthesia ; Arterial Pressure ; Heart Rate ; Hemodynamics* ; Humans ; Incidence ; Intubation* ; Intubation, Intratracheal ; Lidocaine* ; Propofol*

Extraskeletal Ewing's sarcoma is a rare primary malignant soft tissue tumor that has the same pathological characteristics of skeletal Ewing's sarcoma. It is known that the differential diagnosis of Ewing's sarcoma from undifferentiated rhabdomyosarcoma, neuroblastoma, reticulum cell sarcoma, and malignant lymphoma by the histologic studies only are not easy because their histologic findings are nearly similar each other. Therefore, immunohistochemical method, electron microscopic examination, cytogenetic study, or molecular gene study are used together to confirm the diagnosis. It chiefly involves the lower extremity, soft tissues of the paravertebral region, and adjacent chest wall. We recently experienced a case of extraskeletal Ewing's sarcoma of duodenum in a 21-year old female. The patient underwent Whipple's operation and postoperative combined chemotherapy were done.
Cytogenetics ; Diagnosis ; Diagnosis, Differential ; Drug Therapy ; Duodenum* ; Female ; Humans ; Lower Extremity ; Lymphoma ; Lymphoma, Non-Hodgkin ; Neuroblastoma ; Rhabdomyosarcoma ; Sarcoma* ; Sarcoma, Ewing ; Thoracic Wall ; Young Adult

The objective of this research was to compare the flushing effects using 1:1,000 diluted heparin or 0.9% normal saline in relation to needle gauge and frequency of IV medications. The comparative categories were clotting, duration of patency, and incidence of phlebitis. The design of research was a Nonequivalent Control group, Post test, Nonsynchrorized Design. The independent variable was 0.9% normal saline flushing the IV locks and the dependent variables were clotting, duration of patency, and incidence of phlebitis. Subjects were medical-surgical inpatients over 15 years old and with peripherally placed IVs who were hospitalized in a university medical center. Exclusion criteria included foreigners and those who were rejected for this research. The final sample for data analysis included 295 IV sites in 194 patients; 154 were in the saline group and 141 were in the heparin group. Subjects were assigned to have IV locks is flushed with 0.9% normal saline in the experimental group and to have IV lock flushed with 1:1,000 diluted heparin(100 units) in the control group. In order to increase reliability, the nurses who were assigned to the units involved in the study received an explanation on the standard method for locking an IV, recording method for observational data and criteria for the detection of phelbitis. Data were collected for a period of 2 weeks, from March 16, 2000 to March 29, 2000. Total duration of IV was defined the time of IV insertion to the time of discontinuation. Phlebitis was defined as the presence of the following : pain, swelling, erythema at the insertion site. Chi-square was used to determine the association between the degree of clotting, duration of patency, and incidence of phlebitis for the diluted heparine or the normal saline and needle gauge and frequency of IV medications. The results are summarized as follows : (a) There was difference in the degree of clotting between two groups(x2=5.882, p=.015). (b) There was no difference in the degree of duration of patency between two groups(x2=2.439, p=.295). (c) There was no difference in the incidence of phlebits between two groups(x2=0.190, p=.663). (d) There was difference in the degree of clotting(x2=6.209, p=.013) and in the degree of duration of patency(x2=6.978, p=.031) according the needle guage between the two groups. (e) There was difference in the incidence of phlebitis(x2=5.008, p=.025) according to the frequencies of IV injection between two groups.
Academic Medical Centers ; Adolescent ; Emigrants and Immigrants ; Erythema ; Flushing ; Heparin* ; Humans ; Incidence ; Inpatients ; Needles ; Phlebitis ; Statistics as Topic

BACKGROUNDS: Epidural anesthesia before surgical stimulus may reduce or prevent subsequent pain by preemptive analgesia. We studied the effect of varied concentration of a local anesthetic agent administered through epidural catheter before operation on preemptive analgesia after an abdominal hysterectomy. METHODS: Fourty-five patients scheduled for abdominal hysterectomy were blindly randomized to receive 10 ml of 0.5% bupivacaine (group I), 0.25% bupivacaine (group II) or saline (group III) respectively before induction of anesthesia. For postoperative pain control all patients received the same analgesic regimen which was 10 ml of 0.125% bupivacaine and buprenorphine 0.15 mg after resection of the uterus. Then the epidural catheter was connected with infusion pump containing 100 ml of 0.125% bupivacaine and buprenorphine 0.45 mg. Its infusion rate was 2 ml/hour. Pain was assessed using the Visual Analogue Scale (0 = no pain to 10 = intolerable pain) on rest, motion, cough and verbal rating scale at 1, 3, 6, 24 and 48 hour after operation. Side effects were recorded at the same time intervals. RESULTS: Using the ANOVA on ranksum test, pain scores 1 hour after operation differed between groups I and III (P<0.05). In VAS in motion, the pain scores 24 hours after operation differed between groups I and III (P<0.05). In VRS, the pain scores 3 hours after operation differed between groups II and III (P<0.05), and those 24 hours after operation differed between groups I and III (P< 0.05). The incidence of motor weakness using Chi-square test in group I differed from groups II, III (P< 0.05). CONCLUSIONS: Among the 45 patients who had a postoperative pain control after abdominal hysterectomy with initial bolus injection and then continuous infusion of epidural bupivacaine and buprenorphine, postoperative pain scores of patients who had preoperative epidural injection of 10 ml of 0.5% bupivacaine (n = 15) were lower than those of saline injected patients (n = 15), but those of patients with a preoperative epidural injection of 10 ml of 0.25% bupivacaine (n = 15) were not lower than those of saline injected patients.
Analgesia ; Anesthesia ; Anesthesia, Epidural ; Bupivacaine* ; Buprenorphine ; Catheters ; Cough ; Humans ; Hysterectomy ; Incidence ; Infusion Pumps ; Injections, Epidural ; Pain, Postoperative* ; Uterus