Background: Cerebral palsy is due to static encephalopathy during perinatal period. Selective dorsal rhizotomy (SDR) involves selective division of posterior nerve roots to reduce spasticity and improve function in children with spastic cerebral palsy. Anesthesia during SDR must preserve muscle contraction in response to direct electrical stimulation of the dorsal nerve roots. We did this study to get the better management of anesthesia for SDR. Methods: Anesthetic records were reviewed for 16 patients who underwent SDR during January 1996 to August 1997. Demographic data; anesthetic drugs and doses; changes of vital signs and end tidal CO2; dorsal root stimulation; postoperative pain control were analysed. Results: The mean age of patients was 4.9+/-1.7 years old. The mean weight was 16.3+/-4.0 kg. The under 1 MAC concentration of isoflurane and 2~3 mcg/kg/hr fentanyl did not interfere with electrophysiologic monitoring. Esophageal temperature was increased significantly during electrical stimulation of dorsal roots. End tidal CO2 concentration had a tendency to increase after electrical stimulation too. Direct installation of 10~15 mcg/kg intrathecal morphine prior to dural closure, and postoperative 0.5 mcg/kg/hr fentanyl had a good postoperative analgesia without complication. Conclusions: Isoflurane and fentanyl during anesthesia, and intrathecal morphine with continuous infusion of fentany postoperatively are suggested a good anesthetic method for SDR.
Analgesia ; Anesthesia ; Anesthetics ; Cerebral Palsy ; Child ; Electric Stimulation ; Fentanyl ; Humans ; Isoflurane ; Morphine ; Muscle Contraction ; Muscle Spasticity ; Pain, Postoperative ; Rhizotomy* ; Spinal Nerve Roots ; Vital Signs

This study was conducted to find and compare the effects of dietary habits on and obesity indices and nutrition intakes among four hundreds and seven healthy adults males subjects. Subjects were classified as regular meal group(RMG) and irregular meal group(IRMG). Two hundreds and thirteen subjects of RMG had regularly 3times meal(time and amount) per 1 day during more than last 6 month. One hudred and ninety four subjects of IRMG(n=194) were not had regularly meal during last 6 month. Obesity indices were BMI(Body Mass Index), WHR(Waist Hip Ratio) and PIBW(Percentage of Ideal Body Weight). And the mean BMI, WHR and PIBW of RMG and IRMG were 23.1, 0.91, 104.8 and 24.7, 0.93, 112.9. PIBW of IMG were significantly lower than IRMG(p<0.01). The mean daily intakes of starches, seeds, meats, eggs, fishes, milk, fats and processed food intakes of RMG were significantly lower than IRMG. And the mean daily intakes of vegetables, mushrooms and beverages intakes of the IRMG were significantly lower than RMG. Energy intake of RMG and IRMG were 1978.2kcal and 1988.2kcal. For nutrient intake, vitamin C intake of IRMG was significantly lower than RMG. But niacin and cholesterol intake of RMG were significantly lower than the IRMG. Meal regularity was mainly related with obesity indices and nutrition intakes. Therefore, it might be necessary to manage meal regularity to prevent obesity and chronic disease in Korean adult males.
Adult* ; Agaricales ; Ascorbic Acid ; Beverages ; Cholesterol ; Chronic Disease ; Eggs ; Energy Intake ; Fats ; Fishes ; Food Habits* ; Hip ; Humans ; Male* ; Meals ; Meat ; Milk ; Niacin ; Obesity* ; Ovum ; Starch ; Vegetables

Purpose: The aim of this study was to investigate the influence of daily life functions, anxiety, and depression on pain catastrophizing among patients undergoing lumbar spinal surgery. Methods: This study was a cross-sectional descriptive research. The participants were 136 patients undergoing lumbar spinal surgery at one general hospital. They were surveyed using structured questionnaires on daily life functions, anxiety, and depression related to pain catastrophizing. Data were analyzed using t-test, ANOVA, Pearson correlation coefficients, and stepwise multiple regression analysis. Results: The results indicate that pain catastrophizing was negatively correlated with all sub-domains of daily life functions, such as low back pain, low back function, gait ability, social life functions, and mental health, whereas it was positively correlated with anxiety and depression. However, only mental health, a sub-domain of daily life functions after surgery, was found to have a significant effect on pain catastrophizing. Conclusion This study confirmed that mental health-related daily life functions after surgery were predictors of pain catastrophizing. Therefore, to alleviate pain catastrophizing in patients undergoing lumbar spinal surgery, it is necessary to develop nursing interventions that can assist with mental health-related daily life functions after surgery as well as physical recovery.

No abstract available.
Hand* ; Humans

PURPOSE: This study was done to investigate compliance with health behaviors among patients who are hypertensive. METHOD: The participants in this study were 121 outpatients with hypertension. Compliance with health behaviors was measured using a questionnaire developed by the researchers. Data were analyzed using t-test, ANOVA, Duncan's multiple range test and chi-square test. RESULTS: According to the general characteristics of the participants, compliance with medication and diet was higher among women than men, among high school graduates than middle school graduates or those with lower academic qualifications, and among those who were unemployed compared to those who were employed. Compliance with alcohol abstinence or not smoking was higher among women than men, and among those who were unemployed compared to those who were employed. According to the risk factors of hypertension, compliance with health behaviors was significantly higher in those who had associated diseases. The participants in the group with a hypertension morbidity period longer than 10 years did exercise more than 3 times a week and regularly weighed themselves once or more a week. The item showing highest compliance concerning medication and diet was "Take prescribed drugs regularly", while the one showing lowest was "Take drugs with knowledge about their side effects".
Alcohol Abstinence ; Compliance* ; Diet ; Female ; Health Behavior* ; Humans ; Hypertension ; Male ; Outpatients ; Surveys and Questionnaires ; Risk Factors ; Smoke ; Smoking

BACKGROUND: Purinergic and cholinergic agonists elicit negative-inotropic and chronotropic effects, anticip-ating their protective action from the damage of overloaded myocardium. However, the actions of the agents during the ischemic insults are not yet clearly informed. The aim of this study was to investigate the role of the purinergic and cholinergic agonists on the simulated ischemic myocardium of the rat atrial fiber preparations. METHOD: Various action potential parameters (maximum diastolic potential MDP;action potential amplitude APA;velocity of phase 0 depolarization dV/dtmax;action potential duration APD90) were measured and compared in electrically paced, normal (NPSS) and modified physiological salt solution (MPSS) superfused rat atrial fibers in vitro, using conventional 3M-KCl microelectrode technique. Ischemia-simulated modified physiologic solutions were prepared by changing the solution's composition. RESULTS: Hypoxic-and/or hyperkalemic-MPSS decreased all the action potential (AP) variables. However, no significant changes of the AP variables were developed by the acidic-or glucose-free MPSS. Adenosine (Ado) and cyclopentyladenosine (CPA) only decreased the APD90 in a dose-dependent manner. Acetylcholine (Ach) and carbachol (Cch) hyperpolarized the MDP, increased the dV/dtmax with certain doses, and decreased the APD90 dose-depen-dently. The potency for APD90-decrease was greater in order, CPA>Cch>Ach>Ado. Ado and CPA did not affect the hypoxic, hypokalemic MPSS-induced dV/dtmax-decrease. On the other hand, Ach and Cch sig-nificantly inhibited the dV/dtmax-decrease by the hypoxic hypokalemic-MPSS. Ado, CPA, Ach and Cch sig-nificantly augmented the hypoxic, hypokalemic MPSS-induced APD90-decrease. The inhibition by the Ach and Cch on the MPSS-induced dV/dtmax-decrease was not affected by DPCPX, but atropine significantly attenuated the inhibition by the cholinergic agonists. DPCPX inhibited the augmentation by the Ado and CPA on the MPSS induced APD90-decrease, and atropine inhibited the effect of the cholinergic agonists. CONCLUSION: Both purinergic and cholinergic agonists not only shorten the AP duration by themselves but also enhance the AP-shortening effect elicited by the ischemia, and therefore, it is inferred that both agonists prevent further tissue damage from the ischemic insults.
Acetylcholine ; Action Potentials ; Adenosine ; Animals ; Atropine ; Carbachol ; Cholinergic Agonists* ; Hand ; Ischemia ; Microelectrodes ; Myocardium* ; Rats*

Endoscopic injection sclerotheraphy(EIS) was an effective method for treatment of bleeding esophageal varices. However, it might be associated with some undesirable complications. Endoscopic variceal ligation(EVL) is a recently developed method for control of active variceal bleeding and eradicating esophageal varices with similar efficacy and minimal risk of complications compare to EIS. We performed EVL in 40 patients who had recently bled from esophageal varices. Total 198 variceal ligations were performed during 64 separate EVL session. Control rate of acute bleeding was 90%(36 of 40patients) and 4 patients died after EVL because of failure of bleeding control. Rebleeding following initiation of EVL occured in 5 patients-three patients were successfully controlled by EVL, one patient was controlled but eradication was impossible and one patient died. Varices were eradicated or reduced to grade I in 31(86.1%) of 36 survivors by 1-9 ligation(mean 5.0) in l-4 EVL sessions(mean 1.6). After EVL, there were mild complications-mild substernal discomfort in 4 patients, mild dysphagia in 2 patients and fever in 2 patients. These results suggest that EVL is a safe and effective method for treatment of bleeding and eradication of esophageal varices with less complication.
Deglutition Disorders ; Esophageal and Gastric Varices* ; Fever ; Hemorrhage* ; Humans ; Ligation* ; Survivors ; Varicose Veins

Behcet's syndrome has been known as multisystemic disease caused by nonspecific immune mediated vasculitis, but it's precise etiology is not yet identified. Among the various systemic manifestations, pericardial effusion is extremely rare, and pericardial tamponade caused by massive pericardial effusion in Behcet'sydrome has not been reported in the literature. We report a case of Behcet's syndrome manifested as SVC syndrome due to SVC and right atrial thrombus with massive pericardial effusion resulting cardiac tamponade with the review of the literature.
Behcet Syndrome* ; Cardiac Tamponade ; Pericardial Effusion* ; Superior Vena Cava Syndrome* ; Thrombosis ; Vasculitis ; Vena Cava, Superior*

PURPOSE: The purpose of the study was to identify the adequacy of enteral feeding, and the reason and prevalence of under-nutrition, and to determine the relationships between caloric intake and resulting nutritional parameters among neurosurgical intensive care unit (ICU) patients. METHODS: The participants for this descriptive study were 47 neurosurgical ICU patients who had enteral feeding initiated after ICU admission. Data were collected from the initial day of enteral feeding for 7 days. Data related to enteral feeding, feeding interruptions or delay, prealbumin, and transferrin were collected. RESULTS: The mean age of the participants was 56.62 years. Twenty-six patients did not receive their feeding formula more than once during 7 days, and 11 had interruptions more than 6 times. The mean number of feeding interruptions was 3.23 (SD= 4.47). On the average, only 76.44% of the estimated energy requirement was provided by enteral feeding to the patients. The frequency of underfeeding was 52.17% with respect to enteral feeding. The most frequent reason for the feeding interruption was observation before and after intubation and extubation, which was unavoidable. The next most common reason was gastrointestinal bleeding, mostly due to old clots or trace, followed by residual volume less than 100 mL. Changes in prealbumin and transferrin levels for 7 days between the underfed and adequately fed groups were not statistically significant. CONCLUSION: The management of enteral feeding by nurses was overprotective because of the unpredictable nature of ICU patients in terms of their underlying disease process. The management of feeding intolerance needs to be evidence-based and nurses must consistently follow the protocol that has been supported as a useful measure.
Energy Intake ; Enteral Nutrition ; Hemorrhage ; Humans ; Critical Care ; Intensive Care Units ; Intubation ; Malnutrition ; Neurosurgical Procedures ; Nutritional Support ; Prealbumin ; Prevalence ; Residual Volume ; Transferrin

PURPOSE: The purpose of this study was to determine characteristics of nursing science and identify expected outcomes from baccalaureate graduates, and to develop accreditation standards and criteria reflecting the characteristics of the nursing profession. METHODS: A methodological research design was utilized in this study. Related literature reviews and the nursing education program goals and objectives of the 99 nursing schools in Korea were analyzed. A cross-sectional survey research design was utilized to test the validity of the developed characteristics of the nursing profession and their accreditation criteria and standards. The face validity was from the advisory committee and public committee hearing. RESULTS: The characteristics of nursing science were defined with five concepts including humanity, scientific knowledge, professionalism, therapeutic relationship, and facilitating well-being. The expected outcomes from graduates were identified as providing holistic nursing, critical thinking, establishing professionalism and leadership, construction of a therapeutic relationship, and skilled nursing practice. Finally6 standards and 14 criteria reflecting the unique characteristics of the nursing profession were developed for accreditation. These proposed accreditation standards and criteria are a challenge to promote the quality of nursing science.
Accreditation/organization & administration/*standards ; Cross-Sectional Studies ; Curriculum/standards ; Education, Nursing, Baccalaureate/organization & administration/*standards ; Humans ; Nursing Methodology Research ; Organizational Objectives