The purpose of this study was to identify the degree knowledge of myocardial infarction(MI) among the general population and to provide a direction for developing public health education programs. The subjects for this study were 187 people who lived in Seoul or Wonju City, Korea. The data were collected by questionnaire from Nov. ito Dec.5, 1997. The questionnaire was developed by the researcher based on a literature review, It consisted of 34 items of which nine items were on .iology, ten items on preventive measures, ten items signs & symptoms, five items on pain area. Analysis the data was done using descriptive statistics, t-test and ANOVA with the SPSS PC program. The results of the study are as follows: 1. The scores for knowledge of etiology(5.94), preventive measures(7.13), signs & symptoms(5.33) and area of pain(1.62). The highest score for knowledge about MI was preventive measures. the lowest score was for area of pain. Almost half of the subjects were not aware that 'hyperglycemia'and 'fatigue'can cause a MI. Also more than half of the subjects were not aware that 'reduced high carbohydrated diet'can prevent ML So this study showed that the general population has a need for more information about the relationship of hyperglycemia to MI. Less than half of the subjects knew that 'alteration in sleep pattern(49.4%)'. 'nausea, vomiting. indigestion(36.4%)''pain in the area of radiation and not in the chest(24.2%)' are sign & symptom of MI. Most of the people are aware that pain will be College of Nursing, Yonsei University Department of Nursing, Wonju College of Medicine. Yonsei University Department of Nursing. College of Medicine. Dankook University slightly to the left of the sternum(733%) but were not aware that pain may also radiate to the shoulder or arm(74.8%), neck or teeth(90.6%) Also 35% of the subjects think there is no treatment for an MI after it has occurred. 2. In the relationship between social demographic characteristics and degree of knowledge, there were significant differences due to sex, education level, and marital status. 3. This study showed hat most subjects got their in formation about MI from T.V. and radio(62.7%), but the score for knowledge was not high. The following are suggested based on the above results 1) It is necessary to reinforce information about signs & symptoms, area of pain and treatment of MI in public education programs, because people who do not know that their symptoms represent a heart at tack will delay seeking care and medical attention, 2) Because there are significant differences between knowledge and demographic characteristic(sex. education level, marital status), it is necessary to develop effective health education programs to consider these characteristics. Also we need behavioral strategies to change lifestyle and prevent more people from entering the MI high risk group. 3) Patients are almost always frightened and fearful which can cause a fatal delay. Education should focus on the emotional reasons behind people's resistance to calling the emergency medical system. 4) Educational programs need to target the potential witnesses rather than the individuals who suffer cardiac symptoms, focusing on the independent role that family members should take in the face of cardiac symptoms. Families of high risk group members, particularly their spouses, should receive special education about handling changes in cardiac symptoms. 5) Further studies are needed to identify factors which can cause patients to delay seeking treatment and to investigate the adaptive coping strategies of MI patients & their families when they have signs & symptoms.
Education ; Education, Special ; Emergencies ; Gangwon-do ; Health Education ; Heart ; Humans ; Hyperglycemia ; Korea ; Life Style ; Marital Status ; Myocardial Infarction* ; Neck ; Nursing ; Public Health ; Seoul ; Shoulder ; Spouses ; Vomiting ; Surveys and Questionnaires

BACKGROUND: The failure to achieve satisfactory anesthesia following the administration of local anesthetic agents in acute inflammatory tissues is a recognized clinical phenomenon. Many inflammatory mediators can reduce the threshold of nociception during inflammation, and histamine, one of the most important inflammatory mediator, may attenuated local anesthetic effect during inflammation. The purpose of this study was to investigate if histamine can antagonize a lidocaine induced nerve block in vitro. METHODS: Recordings of the compound action potentials (CAP) of A-fiber components were obtained from the isolated sciatic nerves of male Sprague-Dawley rats. The nerve sheath of the sciatic nerve was removed and desheathed nerve was mounted in a recording chamber. Single pulse stimuli (0.5 msec, supramaximal stimuli) were repeatedly applied (2 Hz) to one end of the nerve and CAP recordings were made at the other. The effect of histamine on the suppression of CAP by lidocaine and the effect of histamine on the recovery time to the nerve block by lidocaine were measured. RESULTS: Compared with the baseline amplitude, the amplitudes of CAP were 11.7+/-4.1% for the lidocaine group, 18.3+/-4.6% for the lidocaine histamine 0.05% group, and 26.1+/-5.6% for the lidocaine histamine 0.5% group. Nerve block recovery times were: 38.6+/-3.5 min for the modified Krebs group, 29.8+/-4.2 min for histamine 0.05% in the modified Krebs group, and 19.2+/-1.1 min for histamine 0.5% in the modified Krebs group. CONCLUSIONS: Histamine shortened the recovery time induced by lidocaine. We suggest that histamine may significantly attenuate the effects of local anesthetics in inflammed tissue.
Action Potentials ; Anesthesia ; Anesthetics ; Anesthetics, Local ; Histamine* ; Humans ; Inflammation ; Lidocaine* ; Male ; Nerve Block* ; Nociception ; Rats, Sprague-Dawley ; Sciatic Nerve

No abstract available.
Epidemiologic Studies* ; Humans ; Infant, Newborn*

This study was done to understand nonpharmacologic pain management for pediateric patients and nurses' knowledge and attitudes toward it. The aim of this study was that which method did the patient's use according to the nurses' age, and how did they effectively use these methods in their field. The subjects of this study were 77 nurses working in the Pediatric unit in the Kyung Medical Center from September 2 to 15, 1999 using questionnaire form. The results of this study were as follows : 1. We divided the subjects into four groups : Younger than one year old, 1-6 years, 6-12 years, 12-18 years group. In the group younger one year old, most of the nurses participating in this study used speaking in soft quiet tones, supportive touch, toys, pacifiers. In the group of 1-6 years, they used speaking in soft quiet tones, toys, distracting attention, story talking, and visual stimulus. In the group of 6-12 years. they used pop-up books, providing information, cold therapy, speaking in soft quiet tones, supportive touch. In the group of 12-19 years, most of them used providing information, controling respiration and supportive touch. 2. The effective nursing intervention used in their field are speaking in soft quiet tones, pacifiers and nesting with blanket in the group of younger than one year old. Un the group of 1-6 years old, speaking in soft quiet tones, toys, and supportive touch were effective method in the control of nonpharmacologic pain management. In the group of 6-12 years old, story talking, supportive touch, and speaking in soft quiet tones were effective method and in the group of 12-18 years old, providing information, cold therapy and supportive touch were effectively used to control nonpharmacologic pain management. 3. To compare the general characteristics and non-pharmacologic pain nursing intervention, in the group of younger than one year, touching stimuli is widely used. In the groups of 1-6, and 6-12 years old, visual and audio method were widely used. In the group of 12-18 years old, sensitive intervention were used as well as education, information and guided imagery. In conclusion, there was no significant difference in nurses' demographic characteristics, child's age and nonpharmacologic pain management. There was significant difference only in the nurses working area, that is nurses working in the surgical department used more audio-visual-tactile pain management methods than medical department.
Child* ; Cryotherapy ; Education ; Humans ; Imagery (Psychotherapy) ; Nursing* ; Pacifiers ; Pain Management ; Play and Playthings ; Respiration ; United Nations ; Child Health ; Surveys and Questionnaires

BACKGROUND: Interactions between nimodipine, a calcium channel blocker, used perioperatively for the treatment of subarachnoid hemorrhage, and vecuronium, rocuronium, and atracurium were studied with phrenic nerve-hemidiaphragm preparations of rats. METHODS: Male 200-300 g Sprague-Dawley rats were randomly allocated into four groups (control, NMD(5), NMD(50) and NMD(500) group, n = 10, respectively) according to the nimodipine concentration, and three groups (control, NMD(2D) and NMD(7D), n = 10, respectively) according to the pretreatment duration. A square wave 0.1 Hz supramaximal stimuli was applied to the phrenic nerve-hemidiaphragm preparation and the twitch height response was recorded with mechanomyography. The dose-response curves were measured, and ED(5), ED(50), ED(90), and ED(95) of each vecuronium, rocuronium, and atracurium in different concentrations of nimodipine of 5, 50, and 500 ng/ml and rocuronium in pretreatment with nimodipine 2.5 mg/kg/d for 2 and 7 days were calculated using an inhibitory sigmoid Emax model. RESULTS: The dose-response curves of rocuronium and atracurium were significantly shifted to the left in NMD(500) group, and significantly shifted to the right in NMD(7D) group (P < 0.05). In NMD(500) group, ED(50), ED(90), and ED(95) of rocuronium and atracurium were significantly reduced, and those of rocuronium in NMD7D group were significantly increased compared with the control group (P < 0.05). CONCLUSIONS: Nimodipine 500 ng/ml in the phrenic nerve-hemidiaphragm preparation of rat increased sensitivity to rocuronium and atracurium, and the dose-response curve was significantly shifted to the left, but following pretreatment for 7 days, nimodipine decreased the potency of rocuronium, and the dose-response curve was significantly shifted to the right.
Animals ; Atracurium* ; Calcium Channels ; Colon, Sigmoid ; Humans ; Male ; Nimodipine* ; Rats* ; Rats, Sprague-Dawley ; Subarachnoid Hemorrhage ; Vecuronium Bromide*

No abstract available.
Anencephaly* ; Humans

PURPOSE: The purpose of this study was to examine stress, coping, and immune response effects of a psychosocial intervention program based on the PNI model and Stress-Appraisal-Coping for Korean patients with breast cancer. METHODS: A nonequivalent control group pretest-posttest design was used. The participants who had survived breast cancer and lived in Wonju city and the surrounding area were assigned to an intervention group (N=21) or a control group(N=18).We conducted a 12-week intervention, 2 hours a day weekly, and measured the variables at baseline, six and twelve weeks later. Dependent variables are: stress, anxiety-depression and anger, and immune response. RESULTS: Patients in the psychosocial intervention program reported significantly less stress perception (U=31.500, p=.023), more problem solving ability and less problem avoidance in coping (U=20.500, p= .013; U=29.500, p=.040), and less anxiety-depression (U=22.000, p=.023). No difference, however, was found in anger and immune responses between the two groups. Intervention effects were evident at week 6 and 12 for anxiety-depression, and at week 6 for problem avoidance in coping, the same time that NK cell counts and the T8 decreased. CONCLUSIONS: These results suggested positive effects of a psychosocial intervention program. However, the results are inconclusive due to the small sample.
Stress, Psychological/etiology/*therapy ; *Social Support ; Middle Aged ; Humans ; Female ; Breast Neoplasms/*psychology ; Adult ; *Adaptation, Psychological

BACKGROUND: The use of 3 syringe pumps for one patient has disadvantages. To avoid errors and confusion associated with 3 separate infusions, we conducted a feasibility study of total intravenous anesthesia (TIVA) using a 1 syringe pump to deliver a 3-in-1 mixture containing fixed proportions of propofol, alfentanil and atracurium. METHODS: The 3-in-1 mixture was obtained by mixing 400 mg propofol, 2.5 mg alfentanil, 40 mg atracurium, and totally 80 ml with a 5% dextrose solution. Light microscopy was used to compare emulsion instability of the 3-in-1 with a control mixture. In 40 ASA physical status 1 patients, bolus infusions of 0.5 ml/kg of the 3-in-1 mixture were given for induction of anesthesia. All patients were subsequently intubated and ventilated with an oxygen. Immediately after induction, the maintenance infusion rate was initially set at 2 ml/kg/hr for the first 5 to 10 minutes followed by 1 ml/kg/hr. If inadequate anesthetic depth or muscle relaxation was suspected clinically, a 5 ml bolus of the 3-in-1 mixture (rescue solution) was administered followed by a 10% stepwise increase in the infusion rate. Ten to fifteen minutes before the expected time of completion of surgery, the infusion rate of the 3-in-1 mixture was reduced to 0.5 ml/kg/hr and was stopped at the end of surgery. RESULTS: The 3-in-1 mixtures remained stable for up to 5 hours after preparation. Induction and maintenance of anesthesia were smooth, intubation conditions satisfactory, and intraoperative hemodynamic changes acceptable. Recovery from anesthesia and neuromuscular blockade was rapid. There were no major intra- or immediate postoperative complications. CONCLUSIONS: It may be feasible to provide TIVA using the 3-in-1 mixture for induction and maintenance of anesthesia.
Alfentanil* ; Anesthesia ; Anesthesia, Intravenous* ; Atracurium* ; Feasibility Studies ; Glucose ; Hemodynamics ; Humans ; Intubation ; Microscopy ; Muscle Relaxation ; Neuromuscular Blockade ; Oxygen ; Postoperative Complications ; Propofol* ; Syringes

BACKGROUND: Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae are main pathogens of bloodstream infection. We compared the epidemiology of ESBL-producing E. coli and K. pneumoniae. METHODS: From January 2003 through March 2007, we retrospectively investigated the clinical characteristics and comorbidities of patients with bloodstream infection by ESBL-producing E. coli and K. pneumoniae. RESULTS: During the study period, 79 patients (54 with E. coli and 25 with K. pneumoniae) with blood cultures positive for ESBL-producing E. coli or K. pneumoniae were studied. When comparing the source of bloodstream infections, urinary tract infections (UTIs) were more commonly caused by E. coli (24% vs. 0; P=0.007), and respiratory tract and soft tissue infection (36% vs. 15%; P=0.04, 12% vs. 0; P=0.03, respectively) were more commonly associated with K. pneumoniae. Among hospital-acquired bloodstream infection, third-generation cephalosporin was more commonly used in patients with E. coli than patients with K. pneumoniae (81% vs. 24%, P<0.001). Medical devices (central venous catheter and urinary catheter) were more commonly used in patients with K. pneumoniae. CONCLUSION: ESBL-producing E. coli bloodstream infection is more common in urinary tract infections. ESBL-producing K. pneumoniae is more common in respiratory tract infections and in skin and soft tissue infections. In hospital-acquired infections, ESBL-producing E. coli bloodstream infection is more common in biliary tract infection. ESBL-producing E. coli was more commonly associated with prior frequent antibiotics use and K. pneumoniae was more commonly associated with use of medical devices.
Anti-Bacterial Agents ; beta-Lactamases ; Biliary Tract ; Catheters ; Comorbidity ; Epidemiology* ; Escherichia coli* ; Humans ; Klebsiella pneumoniae* ; Pneumonia ; Respiratory System ; Respiratory Tract Infections ; Retrospective Studies ; Skin ; Soft Tissue Infections ; Urinary Tract Infections

BACKGROUND: Since recent economic crisis(IMF) in Korea, the number of new homeless is increasing(that is, 'IMF style homeless'). There are only few studies on the health problem of this uniquely formed population. We have attempted to estimate the problem of health behavior and health status of this population. METHODS: Some homeless who agreed to enter the asylum during the winter were taken for medical check-up in Sungbuk Community Health Center from November to December, 1998. The participants filled up a self-reported questionnaire and physical examination, laboratory test, and chest x-ray were performed. RESULTS: Among 'IMF style homeless', the prevalence of hypertension(30.9% in primary screening, 7.3% in secondary screening), diabetes mellitus(9.4% in primary screening, 3.5% in secondary screening), syphilis(7.3%), and hepatitis B antigen carrier(5.3%) was higher than among the general population. But we could not find statistical difference according to the duration of homelessness. We found higher smoking rate and higher alcohol drinking amount per week in homeless than in the general population. The amount of alcohol drinking per week was larger among those who had been homeless for more than 3 months(p< 0.01). CONCLUSION: The prevalence of chronic diseases in homeless was higher than in the general population, but statistical difference according to the duration of homelessness could not be found. The longer the duration of homelessness, the larger the amount of alcohol drinkin was seeng.
Alcohol Drinking ; Chronic Disease ; Community Health Centers ; Health Behavior ; Hepatitis B ; Homeless Persons ; Humans ; Korea ; Mass Screening ; Physical Examination ; Prevalence ; Seoul* ; Smoke ; Smoking ; Thorax ; Surveys and Questionnaires