A total of 213 fine needle aspirations from pulmonary lesions in 193 patients performed from January, 1986 to March, 1989 were analyzed. The cytologic diagnoses were unsatisfactory in 10, negative in 60, atypical in 6, suspicious in 11 and malignant in 126 cases. The cytologic types of the malignant cases were 47 squamous cell carcinomas, 40 adenocarcinomas, 10 small cell carcinomas, 6 large cell carcinomas and 10 metastatic tumors. They were verified by the histologic confirmation in 31 cases and by the clinical data in the remainder. There were 5 false-negative cases and none was false-positive, representing 96% sensitivity and 100% specificity. Primary lung cancers were accurately typed in 73% of histologically confirmed case. Cell blocks, prepared in 99 cases, were helpful in tumor typing of 11 cases.
Neoplasm Metastasis ; Lung Neoplasms

The purpose of the study was to test the effect of the health promotion program in middle women. The research design was a quasi experimental, nonequivalent control-group pretest-posttest design. The data were collected from February 24 to April 14, 1988. The subjects were midlife women, age 40 to 50 years who reside in Chonju city. The experimental group consisted of 41 subjects and the control group 40 subjects. The instruments used for the study were the Self Efficacy Scale and the Health Promotion Behavior Scale developed by Park(1995). The data was analyzed by SPSS/PC. The study result were as follows: Through the 7 week education program for health promotion, self efficacy and health behavior were effectively changed in middle-aged.
Education ; Female ; Health Behavior ; Health Promotion* ; Humans ; Jeollabuk-do ; Research Design ; Self Efficacy

No abstract available.
Humans ; Hypoglycemia* ; Infant* ; Infant, Newborn* ; Iron*

BACKGROUND: The goal of preoperative screening test is to reduce the perioperative morbidity by patients management in case of abnormal test results. But, in view of the low incidence of perioperative complication in otherwise healthy surgical population and cost of routine preoperative screening tests, further examination of their usefulness is required. METHODS: The charts of 1968 patients performed preoperative screening laboratory tests were reviewed to analyse the results of tests retrospectively. The preoperative screening laboratory tests are hemoglobin, platelet count, bleeding time, prothrombin time, partial thromboplastin time, chest X-ray, electrocardiography (ECG), liver function test (LFT), urinalysis, BUN and creatinine. In cases of abnormal results obtained, further studies (pulmonary function test (PFT), arterial blood gas analysis (ABGA), 2D- echocardiography, holter ECG, coronary angiography and abdominal sonography) were analysed. RESULTS: The incidence of abnormal results of total preoperative screening test is 4.5%. The incidence of abnormal results of ECG, chest X-ray, LFT, hemoglobin, and others are 8.3%, 7.8%, 3.7%, 2% and less than 1% in order. For further study, PFT was done in 58 patients, ABGA in 72 patients, 2D-echocardiography in 96 patients, and Holter ECG in 6 patients. CONCLUSION: This study has shown that routine preoperative laboratory screening tests provided little information. Therefore, further studies would be necessary to evaluate the cost-benefit of preoperative screening test compared with the other methods such as history taking and physical examinations that is needed little cost.
Bleeding Time ; Blood Gas Analysis ; Coronary Angiography ; Creatinine ; Echocardiography ; Electrocardiography ; Humans ; Incidence ; Liver Function Tests ; Mass Screening* ; Partial Thromboplastin Time ; Physical Examination ; Platelet Count ; Prothrombin Time ; Retrospective Studies ; Thorax ; Urinalysis

BACKGROUND: The goal of preoperative screening test is to reduce the perioperative morbidity by patients management in case of abnormal test results. But, in view of the low incidence of perioperative complication in otherwise healthy surgical population and cost of routine preoperative screening tests, further examination of their usefulness is required. METHODS: The charts of 1968 patients performed preoperative screening laboratory tests were reviewed to analyse the results of tests retrospectively. The preoperative screening laboratory tests are hemoglobin, platelet count, bleeding time, prothrombin time, partial thromboplastin time, chest X-ray, electrocardiography (ECG), liver function test (LFT), urinalysis, BUN and creatinine. In cases of abnormal results obtained, further studies (pulmonary function test (PFT), arterial blood gas analysis (ABGA), 2D- echocardiography, holter ECG, coronary angiography and abdominal sonography) were analysed. RESULTS: The incidence of abnormal results of total preoperative screening test is 4.5%. The incidence of abnormal results of ECG, chest X-ray, LFT, hemoglobin, and others are 8.3%, 7.8%, 3.7%, 2% and less than 1% in order. For further study, PFT was done in 58 patients, ABGA in 72 patients, 2D-echocardiography in 96 patients, and Holter ECG in 6 patients. CONCLUSION: This study has shown that routine preoperative laboratory screening tests provided little information. Therefore, further studies would be necessary to evaluate the cost-benefit of preoperative screening test compared with the other methods such as history taking and physical examinations that is needed little cost.
Bleeding Time ; Blood Gas Analysis ; Coronary Angiography ; Creatinine ; Echocardiography ; Electrocardiography ; Humans ; Incidence ; Liver Function Tests ; Mass Screening* ; Partial Thromboplastin Time ; Physical Examination ; Platelet Count ; Prothrombin Time ; Retrospective Studies ; Thorax ; Urinalysis

BACKGROUND: A retrospective study was performed to evaluate postoperative mortality within 30 days following surgery. METHODS: The records of 31,806 patients who received operation under general anesthesia were reviewed. RESULTS: 1) Postoperative deaths were 184 cases, the ratio of which was comprising 0.57% of all surgical operative cases. 2) The highest ratio of the mortality in age group was 51~60 years group which was 24.5%, and in physical status it was ASA class III which was 36.4%. The highest ratio to the mortality rate in postoperative days was 8~30 days which was 45.1%. 3) The most common causes of death was low cardiac output due to heart failure on operating theater, and hypovolemic shock within postoperative 2 days, and intracranial problem within postoperative 7 days, and pulmonary complication within postoperative 30 days. CONCLUSION: We conclude that fatality rate could be decreased by intensive and multidisciplinary care for postoperaive complications as respiratory and renal failure.
Anesthesia, General ; Cardiac Output, Low ; Cause of Death ; Heart Failure ; Humans ; Mortality ; Renal Insufficiency ; Retrospective Studies ; Shock

BACKGROUND: A light plane of general anesthesia is chosen for fetal safety during a cesarean section. Therefore an experience of wakefulness and pain perception is not infrequent and can be distressful to patients. The electroencephalogram-derived bispectral index (BIS) is a promising new method to assess anesthetic adequacy. This study was designed to assess the adequacy of general anesthesia and to evaluate the usefulness of the BIS in monitoring the awareness during a cesarean section. METHODS: Twenty one parturients undergoing general anesthesia for an elective caesarean section were examined. Anesthesia was induced with 4 mg/kg thiopental and 1 mg/kg succinylcholine, and then followed with a mixture of 50% N2O, 50% O2 and 0.8% enflurane at a flow of 4 L/min. Before administration of succinylcholine, a tourniquet was applied to the free arm and inflated to 250 mmHg. Responsiveness to verbal commands using the Tunstall isolated forearm technique was detected and the BIS was monitored throughout the study period. RESULTS: The incidence of responsiveness to verbal commands were 33% at the time of skin incision and fetal delivery respectively. BIS values of response to commands were significantly higher than that of no respose at both time points (p < 0.05). Fisher's exact test suggested that the BIS value less than 75 was related to unresponsiveness to verbal commands at time of skin incision (p < 0.05) and the BIS less than 85 at fetal delivery (p < 0.05). CONCLSIONS: These results suggest that adequate anesthesia is not provided with a mixture of 50% N2O, 50% O2 and 0.8% enflurane at a flow of 4 L/min at the time of skin incision and fetal delivery. In addition BIS could be a predictor of awareness during cesarean section under general anesthesia.
Anesthesia ; Anesthesia, General* ; Arm ; Cesarean Section* ; Consciousness Monitors* ; Enflurane ; Female ; Forearm ; Humans ; Incidence ; Pain Perception ; Pregnancy ; Skin ; Succinylcholine ; Thiopental ; Tourniquets ; Wakefulness

PURPOSE: The purpose of this research was to find out factors affecting job stress and job satisfaction of nurses working at the welfare centers. METHODS: This study was performed with 140 nurses who were working at or had retired within 1 year from general welfare centers in Seoul during the period from March 29 to February 29 2004. We used a questionnaire asking about general characteristics. work characteristics. stress factors and job satisfaction. We analysed 103 subjects who replied to the questionnaires. RESULTS: The mean job stress level was 2.84 out of 5 and. as for the sub-factors of job stress. income was 4.19, career development 3.69, service environment 3.26 and support system 1.90. The mean job satisfaction level was 3.32 out of 5 and. as for the sub-factors of job satisfaction, job control was 3.58, efficiency of organization 3.27, job burden and responsibility 2.92 and role ambiguity 2.25. When the nurses' job stress was compared according to their general and work characteristics. stress level was significantly high in nurses who had a short experience. were working at the department of senior welfare center. or were the only staff at their workplace (p<0.05). In addition. satisfaction level was significantly high in nurses who were working at the department of senior welfare center and medical welfare team. were the only staff at their workplace or had a heavy work load (p<0.05). According to the results of multiple regression analysis. job stress level was influenced by age (R2=0.212, p<0.01). and job satisfaction level by the number of staffs and work load (R2=0.272, p<0.1). CONCLUSIONS: The results of the study suggest that good atmosphere should be made up to communicate between the departments at the workplace in order to lessen job stress and enhance job satisfaction of nurses working at welfare centers. In addition. role division and job duties among special staffs should be reviewed in order to achieve high efficiency in performing job duties.
Atmosphere ; Job Satisfaction* ; Seoul ; Surveys and Questionnaires

The anesthesiologist is sometime presented with the problem of coagulation defects through the perioperative period. The possible causes of inappropriate hemostasis in this situation are numerous, and multiple mechanism may be simultaneously involved. Coagulation and fibrinolysis variables were measured in 15 patients who had undergone prolonged major surgery or received massive transfusion before and until 10 days after operation. Hemostactic surveys included platelet count, fibrinogen, prothrombin time, activated partial thromboplastin time, antithrombin lll, and fibrin degraduation products. No patients had major hemorrhage, thrombosis, or disseminated intravascular coagulation, but laboratory findings suggest that a hypercoagulable state existed even 10 days postoperatively. The results were as follows: 1) Platelet counts decreased just after operation, but significantly increased to 154% of the control value 7 days after operation and 204% 10 days postoperatively. 2) Prothrombin time was significantly prolonged just after operation compared to the control value, but returned to normal in 4 days postoperatively. 3) Fibrinogen decreased just after operation, but significantly increased to 165% of the control value 4 days after operation, 178% 7days after operation and 191% 10 days postoperatively. 4) Activated partial thromboplastin time was not changed through the entire period. 5) Antithrombin lll was not changed through the entire period. 6) Fibrin degradation product was within normal ranges before operation, but in 11 cases it exceeded normal range from 1 to 10 days postoperatively.
Disseminated Intravascular Coagulation ; Fibrin ; Fibrinogen ; Fibrinolysis* ; Hemorrhage ; Hemostasis ; Humans ; Partial Thromboplastin Time ; Perioperative Period ; Platelet Count ; Prothrombin Time ; Reference Values ; Thrombosis

To evaluate the technique to provide rapid onset of anesthesia and postoperative pain control for cesarean section, we have used spinal anesthesia and epidural analgesia with a 26-gauge, long spinal needle through a 18-gauge Tuohy needle(Espocan) for elective cesarean section in twenty cases, 0.5% heavy bupivacaine 8-12mg was injected through spinal needle for anesthesia during operation, and then spinal needle was removed and epidural catheter was inserted into the epidural space for postoperative pain control. Ten milliliters of bupivacaine 0.125% with 0.45 mg buprenorphine was injected into epidural space through epidural catheter at the time of pain recognition in postoperative period. The results were as follows; 1) There were 5 cases(25%) of hypotension after spinal anesthesia. 2) There were 4 cases(20%) of complaint of pain during operation. 3) The time from injection of 0.5% heavy bupivacaine to onset of anethesia to T4 level is 3.8+/-1.5 minutes and the time from induction of spinal anesthesia to deliverly of infant is 10.1+/-2.9 minutes. 4) Two cases of postoperative headache were noted, but they were mild and relieved spontaneously. 5) Other analgesics were needed in two cases at postoperative periods. The technique is recommended for the anesthesia of cesarean section because it allows rapid onset of anesthesia with spinal anesthesia and gives advantages of postoperative pain control with epidural catheter.
Analgesia, Epidural* ; Analgesics ; Anesthesia ; Anesthesia, Spinal* ; Bupivacaine ; Buprenorphine ; Catheters ; Cesarean Section* ; Epidural Space ; Female ; Headache ; Humans ; Hypotension ; Infant ; Needles ; Pain, Postoperative ; Postoperative Period ; Pregnancy