No abstract available.
Echocardiography, Doppler* ; Heart Diseases* ; Heart*

BACKGROUND: It has been shown that L-type calcium channel blockers increase the muscle relaxation effects of non-depolarizing neuromuscular blocking agents whereas the potentiated neuromuscular blocking effects by L-type calcium channel blocker are resistant to reversal by neostigmine. The aims of this study were 1) to see whether the pretreatment of L-type calcium channel blocker, such as verapamil, aggravates the pipecuronium-induced muscle relaxation, 2) if so, to see whether these effects are reversed by anticholinesterase, such as neostigmine and edrophonium or potassium channel blocker, such as 4-aminopyridine. METHODS: The rat-phrenic nerve-hemidiaphragms (n=60) were prepared. Twenty microgram of pipecuronium was administered to all organ bath. All samples were divided into two groups according to the administration of 10uM of verapamil i.e. verapamil pretreated, non-pretreated group. The amounts of administered pipecuronium were gradually increased by 4ug until the force of twitch decreased to 10% of control value in both groups. Each group was subdivided into three groups according to the administration of 0.75 M of neostigmine, 12.4 uM of edrophonium or 40uM of 4-aminopyridine. RESULTS: The dose of pipecuronium required for the decrease of contractile force to 10% of control value was less in verapamil pretreated group than in non-pretreated group. And, the decrease of contractile force in both groups was more effectively reversed by 4-aminopyridine than neostigmine and edrophonium. CONCLUSIONS: Verapamil potentiates the pipecuronium-induced neuromuscular blockade and 4-aminopyridine is more effective to reverse verapamil pretreated, pipecuronium induced neuromuscular blockade.
4-Aminopyridine* ; Baths ; Calcium Channels, L-Type ; Edrophonium* ; Muscle Relaxation ; Neostigmine* ; Neuromuscular Blockade* ; Neuromuscular Blocking Agents ; Pipecuronium* ; Potassium Channels ; Verapamil*

BACKGROUND: To provide basic data to help construct regional EMSS. METHOD: Using preformed questionnaire, authors investigated prospectively data of 214 patients transferred directly to emergency medical center from other hospitals from May 11 to june 10,1998. RESULTS: 1. Total 214 patients were transferred directly to the emergency medical center of KNUH (14.4% of total), and 63.5% of patients excluding children were non-traumatic patients. 2. The peak age group was 5th decade (19.6%) with mean age of49.6 years old. The male to female ratio was 1.8 : 1. 3. The period between 08 : 00 to 16 : 00 was the most frequent arrival time of transfer patients (42.5%), and the proportion of patients for surgical departments were more common than those for other departments (53.7%). 4. the majority of patients were transferred from secondary hospitals (91.6%), but among them the proportion of mild non-traumatic and mild traumatic patients was 52.3%, and 72.0%. 5. The decision-maker for transfer was a patient himself or family members in 32.3% of severe and 26.8(/) of mild non-traumatic patients, compared with 37.5% of severe and 26.8% of mild traumatic patients. 6. The physician-to-physician communication prior to the patient's transfer was not carried out in 90.8% of severe and 85.9% of mild non-traumatic patients, compared with 75.0%of severe and 67.0%of mild traumatic patients. 7. The hospital ambulance was the most common mode of transfer (64.5%), but non-emergency vehicles such as a taxi or a private car was used for transfer in 21.5% of severe non-traumatic patients, and 12.5% in severe traumatic patients. 8. Transfer accompanied by medical personnel took place in 15.4% of severe non-traumatic patients, 25.0% in severe traumatic patients, and in 27.0% of severe non-traumatic patients, and 44.4% in severe traumatic patients transferred 4 by hospital ambulance. 9. Transfer took less than 1 hour in 66.9% of non-traumatic patients, and 45.2% of traumatic patients, but it took 1 hour or more in 27.7% of severe non-traumatic patients, and 43.7% of severe traumatic patients. 10. Transfer record accompanied the patient in 90.2% of total, but radiologic film and results of laboratory tests did not in 36.9% and 56.9% of severe non-traumatic patients, and in 12.5% and 43.7% of severe traumatic patients. CONCLUSION: It is considered that an appropriate triage system, interhospital transfer guidelines, good transfer records, cooperative interhospital communication, emergency medical information center, public information with education about regional EMSS, improvement of equipment in ambulance, and training of emergency personnel are necessary for effective and well-organized EMSS.
Ambulances ; Child ; Education ; Emergencies* ; Female ; Humans ; Information Centers ; Male ; Prospective Studies ; Surveys and Questionnaires ; Triage

BACKGROUND: The purpose of this study was to examine the frequency and characteristics of needlestick/sharps injuries (NSIs) in nursing students in Korea. METHODS: The study was based on a survey of questionnaires completed by 341 nursing students who had sustained at least one NSI during clinical practice in hospitals. RESULTS: The NSI incidence rate was 36.4%. Approximately half of the students reported two to four NSIs. Most (90.2%) of the NSIs occurred on the fingertips and were caused by a hollow-bore needle (46.8%) or lancet (45.8%). Some students were exposed to used needles contaminated with unknown pathogens (37.3%), HBs Ag (2.3%), Venereal Disease Research Laboratory (VDRL) (0.8%), or HIV (0.6%). Students cited the reason for injury as carelessness, inexperience, hastiness, or recapping. Almost two-thirds of students who reported having experienced an NSI knew about post-exposure treatment. However, only one-third of the students with NSIs completed an official report. CONCLUSION: Korean nursing students lack knowledge about injury prevention, report procedures, and treatment after NSI. A revised educational approach with emphasis on occupational risk, skill development, and injury reporting is necessary to prevent NSI and to ensure that students obtain post-exposure prophylaxis.
Dietary Sucrose ; HIV ; Humans ; Incidence ; Korea ; Needles ; Needlestick Injuries ; Post-Exposure Prophylaxis ; Sexually Transmitted Diseases ; Students, Nursing ; Surveys and Questionnaires

No abstract available.
Humans ; Urinary Tract*

We present a case of generalized syringoma in a 12-year-old healthy girl. The patient has numerous skin colored or yellowish papules on the face, neck, anterior chest, axillae and abdomen. She has a family history of eyelid syringoma occuring in her mother and maternal grandmother. Diagnosis was confirmed by characteristic histopathologic findings.
Abdomen ; Axilla ; Child ; Diagnosis ; Eyelids ; Female ; Humans ; Mothers ; Neck ; Skin ; Syringoma* ; Thorax

Empathy is an essential factor for establishing therapeutic relationship. Especially for pediatric nursing, the nurses need to know how to perceive children's feeling and thought and to express her understanding about them affectively. So, empathy is considered as an important concept in pediatric nursing. This study was attempted to measure the empathic ability of pediatric nurses by pediatric nurse and mothers of hospitalized children. The subject of this study consisted of 83 pediatric nurses and 106 mothers of hospitalized children in 4 hospitals in Seoul and 1 hospital in Kyung-Gi. Data were collected from Jan. 14 to Feb. 6, 1997, by the questionnaire method. The instrument for this study was the Empathic Construct Rating Scale : ECRS(60-item, 5 point scale). Data Were analyzed by descriptive statistics, t-test and ANOVA. Result of this study are summarized as follows : 1. Pediatric nurses perceived their empathic ability to be moderately high(Mn=3.71) The level of perceived empathic ability of the pediatric nurses showed no significance by general characteristics. 2. The mothers of hospitalized children perceived nurses' empathic ability to be moderate(Mn=3.27). The level of perceived nurses' empathic ability of the mothers of hospitalized children showed significant differences by the experience of hospitalization of the children and the age of the mothers. 3. The perceived nurses' empathic ability of the mothers was significantly low than of the pediatric nurses(t=6.50, P<.001). From the above results, it can be concluded. that the empathic ability of the pediatric nurses is not sufficient for caring children and mothers efficiently. So, the pediatric nurses' empathic ability is needed to improve through facilitative relationship training as refreshment in-service education program.
Child ; Child, Hospitalized ; Education ; Empathy* ; Gyeonggi-do ; Hospitalization ; Humans ; Mothers ; Pediatric Nursing ; Seoul ; Child Health ; Surveys and Questionnaires

Generalized distinct hyperpigrnented macules developed at 2. 7 years after starting photochemotherapy(psoralen and UVA) in a 66-year-old psoriatic male patient. The histopathologic feature of this macule was characterized as a lentiginous p roliferation. The significance and long term course of PUVA lentigo are still unknown. So, we will further monitor this patient continually for melanocytic dysplasias, including melanoma.
Aged ; Humans ; Lentigo* ; Lichen Planus ; Male ; Melanoma ; Mouth Mucosa

We present a case of familial benign chronic pemphigus in 50-year-old male patient who had had recurrent oozing, macerated and eroded skin lesions on the groin and scrotum for 20 years. At first, we diagnosed his case as scrotal eczema and/or intertrigo, but after repeated recurrance, it was confirmed as above disease by characteristic histopathologic findings.
Cytochrome P-450 CYP1A1 ; Eczema ; Groin ; Humans ; Intertrigo ; Male ; Middle Aged ; Pemphigus, Benign Familial* ; Scrotum ; Skin

Rupture of the anterior cruciate ligament is a serious injury that can cause severe degenerative change if untreated, and there are many controversies in its treatment. The authors experienced 126 patients of the anterior cruciate ligament rupture in the Department of Orthpaedic Surgery, Chung-Ang university from May 1985 to December 1992. Among them, we performed 36 anterior cruciate ligament reconstructions using bone-patellar tendon-bone autograft reinforced with Trevira ligament, an assumption that the artificial ligament acts as an internal splint during the vulnerable period of healing. Bone-patellar tendon-bone autograft was passed through the transosseous hole in the tibia, then across the knee and through the isometric path of lateral femoral condyle through a bone tunnel. Thereafter, the Trevira ligament was passed through the same tibial tunnel, but over the top route to the lateral femoral condyle. Of the 36 cases, 28patients (Group I: 15 cases of Mini-arthrotomy,Group II: 13 cases of Arthroscopic technique) with average follow up of 23.5 months (minimum 12 months, maximum 40 months) were analyzed. According to the Mullers criteria, the result were excellent in 12 cases (Group I: 5 cases; Group II: 7 cases), good in 14 cases(Group I: 9 cases ; Group II: 5 cases and fair in 2 cases (Group I: 1 case; Group II: 1 case). On stress roentgenograms by Telos arthrometer, the average difference of anterior displacement between the injured and normal sides were decreased to 2.3mm from average 9.1mm preoperatively (Group I: from 9.3mm to 2.6mm; Group II: from 8.8mm to 2.1mm). And subjectively, there was no difference between the injured and normal sides in 8 cases (Group I: 4 cases, Gruop II: 4 cases).
Anterior Cruciate Ligament ; Autografts ; Follow-Up Studies ; Humans ; Knee ; Ligaments ; Patellar Ligament ; Rupture ; Splints ; Tibia