PURPOSE: This study was conducted to provide background information on nursing interventions to further enhance the quality of nursing practice and related professions, based on those performed for stroke patients. METHODS: The analysis was performed in light of 84 researches papers on nursing intervention published between 1990 and 2010, and based on NIC(Nursing Interventions Classification) and NOC(Nursing Outcomes Classification). RESULTS: 1. The quasi-experimental design was used as the most primary form of research design across 69 papers that constitute 82% of the total. 2. The number of nursing intervention methods identified throughout 84 research papers was 144. Based on the NIC that 90(62.5%) of those interventions fell into the physiological basic domain while 53(36.8%) belonged to the behavioral domain. 2) Interventions on activity and exercise management, physical comfort promotion, patient education conducted by class level of NIC were 40(27.78%), 34(23.61%), and 31(21.53%) respectively. 3) Outcomes of mobility, psychological well-being, energy maintenance, health & life quality measured by class of NOC among 317 dependent variables 79(24.92%), 64(20.19%), and 63(19.87%) respectively. CONCLUSION: Most interventions were classified as belonging to few particular domain types, which triggers needs for the development and application of multidisciplinary intervention methods through a more collective approach.
Humans ; Clinical Trial ; Korea ; Light ; Nursing Research ; Patient Education as Topic ; Quality of Life ; Research Design ; Stroke

Metastatic tumors to the heart are far more frequent than primary tumors of the heart. Cardiac metastasis may be detected up to 30 percent of patients with fatal lung cancers. Metastatic cancer to the heart is difficult to suspect. Where cardiac metastasis is diagnosed ante-mortem, signs and symptoms of the primary cancer are usually the presenting features and the presence of cardiac involvement is often incidentally detected. We experienced a case of 35-year-old woman with metastatic lung cancer invading the left atrium via pulmonary vein, which was not proved pathologically. She presented with hemoptysis and chest pain. Transthoracic echocardiography demonstrated massive cardiac infiltration with tumor and decreased cardiac wall motion, correlating with the chest CT findings, which were also remarkable for the presence of intracardiac mass and direct invasion to adherent pericardium, pulmonary vein and left atrium. We suggest that careful examination of 2D echocardiography can be noninvasive and valuable tool for diagnosis of metastatic cancer to the heart.
Adult ; Carcinoma, Large Cell* ; Chest Pain ; Diagnosis ; Echocardiography ; Female ; Heart ; Heart Atria* ; Hemoptysis ; Humans ; Lung Neoplasms ; Lung* ; Neoplasm Metastasis* ; Pericardium ; Pulmonary Veins ; Tomography, X-Ray Computed

Skeletal muscles are known to have tolerance to ischemia, but a prolonged ischemia can cause damage to muscular tissues. The ischemia-reperfusion injury results from the oxygen free radicals released by leucocytes and formed by the reaction of hypoxanthine and xanthine oxidase. Superoxide dismutase (SOD), one of major antioxidant enzymes ocurring in the various tissues of the body metabolizes or scarvanges the oxygen free radicals. Although many studies reported difference in tolerance to ischemia and reperfusion between white and red muscles, some other investigators failed in finding such difference. The present study was performed to examine effects of graded periods of ischemia and reperfusion on the cellular ultrastructure and activity of SOD in white and red muscles. The Sprague-Dawley rats (200~250 g) were used as experimental animals. Under pentobarbital (50 mg/kg IP) anesthesia, incision was made on lower abdomen and left common iliac artery was occluded by means of a vascular clamp for 2, 4 and 6 hour (hrs). Thereafter, the superficial portion of mid-belly of anterior tibial muscle and soleus muscles were excised at 0, 24 and 72 hrs after onset of reperfusion. The specimens were sectioned into slices, 2 mm in length, 1 mm in width and thickness. Some specimens were prepared for electron microscopic observation and others for determination of SOD activity by using antihuman Cu, Zn- and Mn-SOD antibodies. The results obtained were as follows. 1. In anterior tibial muscle, areas with loose electron-density and dilated cristae were observed in the mitochondria immediately after 2 hrs of ischemia, while widened intermyofibrillar spaces and dilated cisternae of sarcoplasmic reticulum were seen after 2 hrs and 24 hrs reperfusion. When subjected to 2 hrs ischemia and 72 hrs reperfusion, no significant change was found in the cellular ultrastructure. 2. In soleus muscle, electron density was loose in the matrix of mitochondria immediately after 2 hrs of ischemia, while cisternae of sarcoplasmic reticulum were dilalated after 2 hrs of ischemia and 24 hrs reperfusion. Following 2 hrs of ischemia and 72 hrs reperfusion, the electron microscopic findings were similar to those of normal rats. 3. The changes in cellular ultrastructure were more prominent in both the 4 hrs and 6 hrs ischemia groups, in which degree of ultrastructural changes were proportional to duration of reperfusion. 4. In anterior tibial muscle, trace or weak immunoreactivities of Cu, Zn- and Mn-SOD were seen, whereas trace immunoreactivity of Cu, Zn-SOD and trace or weak immunoreactivity of Mn-SOD were observed in soleus muscle. 5. The immunoreactivities of Cu, Zn- and Mn-SOD were not altered in 2 hrs ischemic and 72 hrs reperfused group, while they were increased slightly in 2 hrs ischemic and 24 hrs reperfused group. 6. In both muscles, the activity of SOD increased following 4 hrs or 6 hrs ischemia and 24 hrs or 72 hrs reperfusion. The changes in immunoreactivity of Mn-SOD were not different between two muscles, whereas immunoreactivity of Cu, Zn-SOD were higher in anterior tibial muscle. Consequently, it is suggested that significant ischemia reperfusion injuries are produced after 4~6 hrs ishemia followed by 24 hrs or 72 hrs reperfusion, that anterior tibial muscle is more susceptible to ischemic reperfusion injury and that the ischemic-reperfusion injury is closely related with activity of SOD.
Abdomen ; Anesthesia ; Animals ; Antibodies ; Free Radicals ; Humans ; Hypoxanthine ; Iliac Artery ; Ischemia* ; Mitochondria ; Muscle, Skeletal ; Muscles* ; Oxygen ; Pentobarbital ; Rats* ; Rats, Sprague-Dawley ; Reperfusion Injury ; Reperfusion* ; Research Personnel ; Sarcoplasmic Reticulum ; Superoxide Dismutase ; Xanthine Oxidase

BACKGROUND AND OBJECTIVES: The Epstein-Barr virus (EBV) is a human herpes virus which causes certain type of lymphoma and some epithelial neoplasm such as undifferentiated nasopharyngeal carcinoma. However, the role of EBV as a causative factor in other head and neck tumor especially, in laryngeal squamous cell carcinoma is not fully elucidated. The aim of this study was to analyze the relationship between the prescence of EBV in laryngeal squamous cell carcinoma and clinicopathologic characteristics. MATERIALS AND METHODS: 65 cases of laryngeal squamous cell carcinoma were retrieved from formalin-fixed, paraffin-embedded blocks and analyzed for EBV by immunohistochemical staining. Results : The EBV was detected in 26(40%) of the 65 patients with laryngeal squamous cell carcinoma and 2(10%) of the 20 control ases. In 26 cases of EBV-positive patients, 13(46.4%) cases were supraglottic cancer and 13(35.1%) cases were glottic cancer. CONCLUSION: These results suggest that EBV may possibly play an etiologic role in the pathogenesis of laryngeal squamous cell carcinoma.
Carcinoma, Squamous Cell* ; Head ; Herpesvirus 4, Human* ; Humans ; Lymphoma ; Neck ; Neoplasms, Glandular and Epithelial

BACKGROUND/AIMS: Obstructive jaundice is developed from the cholangiocarcinoma, biiliary tract stone, biliary benign stricture and pancreatic head cancer and is rapidly progress to cholangitis or sepsis. So early decompression, accurate diagnosis and treatment are very important. Percutaneous transhepatic choledocoscopy (PTCS) and endoscopic retrograde choledocoscopy (ERCS) have been used for evaluation of the obstructive jaundice. We performed, through the PTCS, electrohydraulic lithotripsy (EHL) for biliary tract stone rernoval, biopsy for diagnosis of biliary stric and self expandible metalic coil stent (EndocoilTM stent, Instent Co.) insertion on biliary stricture to evaluate the usefullness of PTCS in patients with obstructive jaundice. METHODS: Between Auguest 1994 and September 1995, PTCS was performed in 37 patients with obstructive jaundice. First, percutaneous transhepatic biliary drainage (PTBD) with 7Fr. drainage tube was done. Three days later, we exchainged the 7Fr. drainage tube with 16Fr.. Seven days later, through the PTCS, we performed EHL, biopsy and EndocoilTM stent insertion.
Biliary Tract ; Biopsy ; Cholangiocarcinoma ; Cholangitis ; Constriction, Pathologic ; Decompression ; Diagnosis ; Drainage ; Head and Neck Neoplasms ; Humans ; Jaundice, Obstructive ; Lithotripsy ; Sepsis ; Stents

Bleeding frorn the duodenal varix is an unusual event. Upper gastrointestinal endoscopy is the diagnostic procedure of choice in diagnosing duodenal varices. If performed during active bleeding, it can differentiate between esophageal and duodenal varices as the source, which has important therapeutic implications. A thorough examination of the duodenum for varices is important in an upper gastrointestinal hemorrhage. Treatment modalites for bleeding duodenal varices are sclerotherapy, varix suture ligation, portocaval shunt, and duodenal resection. Although endoscopic sclerotherapy has lirnited success in controlling active duodenal varix as initial treatment, endoscopic injection sclerotherapy is a useful first-line therapeutic measure in the treatment of bleeding duodenal varices. In this study we present a case of a ruptured duodenal varix, which was defected by an endoscopy, in a 61-year-old male. An endoscopic examination showed small and nonbleeding esophageal varices and a prominant ulcerated varix was identified in the 2nd portion of the duodenum. Endoscopic sclerotherapy was performed by injecting ethanolamine oleate into the varix. Our report demonstrate that endoscopic sclerotherapy can be efficient even in the presence of acute bleeding and that it can provide a definitive method of curing of a bleeding duodenal varix.
Duodenum ; Endoscopy ; Endoscopy, Gastrointestinal ; Esophageal and Gastric Varices ; Ethanolamine ; Gastrointestinal Hemorrhage ; Hemorrhage* ; Humans ; Ligation ; Male ; Middle Aged ; Oleic Acid ; Sclerotherapy* ; Sutures ; Ulcer ; Varicose Veins*

BACKGROUND AND OBJECTIVES: Cardiovascular disease is a leading cause of death in patients on long-term dialysis and cardiac mortality decreases after renal transplantation. The aim of this study was to investigate the effects of successful renal transplantation on cardiac structure and function assessed by echocardiography. MATERIAL AND METHOD: Eighteen adult chronic renal failure patients who were taken renal transplantation in our hospital were included. They were submitted to two echocardiographic evaluations at preoperative time and postoperative time (mean: 23months). RESULTS: At the time of transplantation, 18 patients had undergone hemodialysis through a fistula (mean: 44months). At postoperative follow up, blood urea nitrogen/creatinine were decreased and mean hemoglobin level was increased. And systolic/diastolic blood pressure were decreased. Left ventricular mass index, left ventricular posterior wall thickness and septal wall thickness were decreased and ejection fraction was increased by echocardiography. Diastolic function did not improve. Hemodialysis duration and preoperative blood urea nitrogen/creatinine level affected ejection fraction change. CONCLUSION: We observed significantly decreased left ventricular mass index, increased ejection fraction after renal transplantation. We found that the patients who had been onlonger hemodialysis and higher preoperative blood urea nitrogen/creatinine level showed marked improvement of ejection fraction buy echocardiography.
Adult ; Blood Pressure ; Cardiovascular Diseases ; Cause of Death ; Dialysis ; Echocardiography* ; Fistula ; Follow-Up Studies ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation* ; Mortality ; Renal Dialysis ; Urea

Clinical experiences of pulmonary artery aneurysm are distinctly rare and current knowledge is mainly derived from autopsy findings. Pulmonary artery aneurysms are associated with congenital heart disease, most frequently patient ductus arteriosus, followed in decreasing order by ventricular septal defect, atrial septal defect. In the remaining cases, such aneurysms are associated mainly with secondary acquired lesions, such as Behcet's disease, bacterial endocarditis, syphilis, tuberculosis, atherosclerosis, vasculitis, hypertension, trauma. Angiography was the gold standard for diagnosing pulmonary artery aneurysms, but MRI imaging has been potentially useful diagnostic modality in demonstrating aneurysm and other fine pathologic processes with high resolution. Surgery was main, but there are no firm guidelines for optimal treatment of pulmonary artery aneurysm. We experienced a case of pulmonary artery aneurysm with pulmonary hypertension in a 58 year-old female and observed for 2 years. The aneurysmal size was 5.19 cm initially and inreased to 5.5cm for two years, accompanying by pulmonary hypertension. We report this case of pulmonary artery aneurysm with a brief review of literature.
Aneurysm* ; Angiography ; Atherosclerosis ; Autopsy ; Ductus Arteriosus ; Endocarditis, Bacterial ; Female ; Heart Defects, Congenital ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Hypertension ; Hypertension, Pulmonary* ; Magnetic Resonance Imaging ; Middle Aged ; Pathologic Processes ; Pulmonary Artery* ; Syphilis ; Tuberculosis ; Vasculitis

Central pontine myelinolysis (CPM)is a demyelinating disorder that affects pons and is characterized by disturbance of consciousness, quadriparesis, and mutism and has been considered to have poor prognosis. It commonly occurs in patients with rapidly corrected hyponatremia. However, hypoglycemia induced CPM has been rarely reported. Diagnosis is confirmed by MR imaging. Here we report a case of CPM after severe hypoglycemia without any electrolyte disturbance in a patients with diabetic nephropathy.
Consciousness ; Demyelinating Diseases ; Diabetic Nephropathies* ; Diagnosis ; Humans ; Hypoglycemia* ; Hyponatremia ; Magnetic Resonance Imaging ; Mutism ; Myelinolysis, Central Pontine* ; Pons ; Prognosis ; Quadriplegia

BACKGROUND AND OBJECTIVES: The survival rate of laryngeal cancer has improved in recent day. But in case of advanced cancer, radical destructive surgery is required for survival. So early detection of laryngeal cancer prevent from this disastrous condition. In this point of view, mass screening test for early detection of laryngeal cancer is necessary. Screening tests using voice has many advantages of being simple, non invasive, and requiring less space. In this system, the most important factor is the selection of acoustic parameters to be used in voice analysis. Thus authors studied the acoustic parameters that can differentiate normal, benign, malignant laryngeal diseases by an acoustic analyzing system and we also checked the availability of parameters. MATERIALS AND METHODS: We evaluated the voice analyzed data from 25 laryngeal malignancy patients, 33 benign laryngeal disease patients, 35 normal control who visited PNUH otolaryngology department from October 1996 to May 1998. A computerized speech lab. 4300B (CSL) was used to carry out the analysis of each voice sample and statistical analysis, ANOVA. Canonical analysis and cumulative frequency curve were used. RESULTS: The statistically significant parameters that can differentiate normal and malignant laryngeal disease groups were 15 parameters and can differentiate normal and benign laryngeal disease group were 9 parameters and that can differentiate benign and malignant laryngeal disease group were 7 parameters. CONCLUSION: We consider that these parameters and detection programs may be effective in development of a screening system using voice only. Developing diagnostic tools and programs would need further study of phonetics and voice engineering.
Acoustics* ; Diagnosis, Differential* ; Fibrinogen ; Humans ; Laryngeal Diseases ; Laryngeal Neoplasms ; Mass Screening ; Otolaryngology ; Phonetics ; Survival Rate ; Voice*