A 50 year-old woman was scheduled for clipping of giant middle cerebral artery (MCA) aneurysm. Preoperative four-vessel angiography and computed tomography scan revealed a giant aneurysm (3.5x3.3x3.5 cm) at bifurcation of right MCA. Induced hypotension and brain protection using sodium nitroprusside (SNP) and thiopental loading were planned to prevent cerebral damage during the operation. Before induction, esmolol, lidocaine and vecuronium were administered. Mask ventilation with isoflurane in N2O and O2 was performed over 5 minutes and then tracheal intubation was done. Anesthesia was maintained by isoflurane+N2O+O2 with pancuronium. Electrocardiography, pulse oxymetry, capnography, central venous pressure, evoked potential and invasive arterial blood pressure were monitored. She was hyperventilated intraoperatively with a PaCO2 around 30 mmHg. Perioperative hypotension was achieved with infusion of SNP (0.3~1.0 microg/kg/min). During the actual aneurysm surgery, mean arterial pressure was lowered to approximately 50 mmHg. Adjuvant drugs such as methylprednisolone, mannitol and furosemide to reduce intracranial pressure were also administered. This technique established good brain conditions during clipping of the aneurysm. A thiopental loading (4 mg/kg) was supplied while the aneurysm was approached. Satisfactory and well-controlled hypotension was obtained after thiopental and SNP. Postoperatively, the patient was transferred to the intensive care unit.
Anesthesia ; Aneurysm ; Angiography ; Arterial Pressure ; Brain ; Capnography ; Central Venous Pressure ; Electrocardiography ; Evoked Potentials ; Female ; Furosemide ; Humans ; Hypotension ; Intensive Care Units ; Intracranial Aneurysm* ; Intracranial Pressure ; Intubation ; Isoflurane ; Lidocaine ; Mannitol ; Masks ; Methylprednisolone ; Middle Cerebral Artery ; Nitroprusside ; Pancuronium ; Thiopental ; Vecuronium Bromide ; Ventilation

A total of 73 enucleated eyeballs is reviewed and analyzed clinicopthologically. These eyeballs were selected among the enucleated spceimens that had been removed at the Yeungnam University Hospital during a period of 10 years beginning from 1983 to 1992. Following results were obtained. 1) When the eyeballs were classified according to me direct cause of removal, the neoplasm was the most common single cause accounting for 26 cases(35.6%) out of 73 cases, followed by phthisis bulbi l6 cases(21.9%), trauma 10 cases(13.7%), glaucoma 8 cases(10.9%), inflammation 5 cases(6.8%), staphyloma 4 cases(5.5%), retinal detachment 1 cases(1.4%), Coat's disease 1 cases(1.4%), corneal disease 1 cases(1.4%) and choroidal hemorrhage 1 cases(1.4%). 2) 39 cases(53.4%) were male and 34(46.6%) were female. 23 cases(31.5%) were below 10 years of age, which was the highest rate. 3) The neoplastic lesion included retinoblastoma 20 cases(76.9%) in 26 neoplasms, malignant melanoma 4 cases(15.3%), hemagioblastoma of optic disc 1 cases(3.9%), adenocarcinoma of Meibomian gland 1 cases(3.9%). 4) Retinoblastoma was the commonest intraocular tumor accounting for 20 out of 26 cases, In growth pattern, 80.0% of the tumor grew endophtytically. True rosette were seen 60% of the retinoblastoma.
Female ; Male ; Humans ; Adenocarcinoma

PURPOSE: This study was done to examine the awareness and management practice of operating room nurses, to prevent nosocomial infection, to identify problems and to propose solutions. METHOD: The research tools used were the hospital infection control guideline and a modified version of the measurment tools used in the study of Cho (1998). The questionnaire consisted of questions on hand washing, personal hygiene and clothes control, cleaning and environment control, sterilizing supplies and disposal of contaminated materials. The collected data were analysed with the SPSS program. RESULTS: The mean score for domain-specific awareness of nosocomial infection control was 4.81 out of a possible 5 points. The highest score was for sterilizing supplies and disposal of contaminated materials. The mean score for domain-specific practices of nosocomial infection control was 4.40, out of a possible 5 points. Sterilizing supplies and disposal of contaminated materials had the highest scores. The mean score for awareness in all domains was higher than mean score for practice. Among the general characteristics of the nurses, high awareness was found only in the provision of infection control guidelines and it had shown statistically significant difference. Examination of relation of general characteristics to practice showed that for age, career, the provision of infection control guidelines, and experience in infection control education there were statistically significant differences in the scores. For the relation between awareness of nosocomial infection control and practice, positive correlation was found in all domains, thus high awareness leads to high practice. CONCLUSION: Considering the result of this research, plans are needed that promote virtual practice of hospital infection control.
Cross Infection* ; Education ; Equipment and Supplies ; Hand Disinfection ; Humans ; Hygiene ; Infection Control ; Operating Rooms* ; Surveys and Questionnaires

No abstract available.
Acrodermatitis*

PURPOSE: The main purpose of this study was to examine factors influencing depression in middle aged people in relation to powerlessness, social support, and sociodemographic variables. METHODS: The questionnaire survey was carried out with a convenience sample of 160 middle aged people in a community setting. The data analysis procedures included frequency, t-test, ANOVA, Pearson correlation coefficients, and stepwise multiple regression using depression as the dependent variable. RESULTS: The prevalence of depression was 44.4%. There were significant differences in depression by number of members in the family, education, economic status, and subjective health status. Powerlessness was significantly different according to gender, economic status, and subjective health status. and social support according to economic status and subjective health status. Depression showed significant correlations with powerlessness and social support. Stepwise multiple regression revealed that factors significantly affecting variance included economic status, number of members in the family, powerlessness, and social support. These factors explained 43% of variance in depression. CONCLUSION: The results of this study suggest that to prevent the occurrence of depression, socio-environmental aspects including economic state should be considered when developing interventions for middle aged adults.
Adult ; Depression* ; Education ; Humans ; Middle Aged* ; Prevalence ; Surveys and Questionnaires ; Social Class* ; Statistics as Topic

PURPOSE: The purpose of this study was to investigate factors determining health behavior for middle-aged adults in relation to stress coping behaviors, cognitive factors, social support, and sociodemographic variables. METHOD: The questionnaire survey was carried out on a convenience sample of 203 middle aged in a community settings. The data analysis procedure included frequency, t-test, ANOVA, Pearson correlation coefficient, and stepwise multiple regressions using health behavior as dependent variable. RESULT: Among the sociodemographic variables, factors such as sex, educational and eonomic levels were associated with the health behaviors. There were significant correlations between health behaviors and saliency of health, social support, and positive-stress coping behaviors. Stepwise multiple regression revealed that the factors such as positive-stress coping behaviors, saliency of health, sex, and education turned out to be significant affecting factors. Twenty eight percent of varience in health behavior was explained by these factors. CONCLUSION: Positive-stress coping methods were turned out to be the most important effective factors in practicing of health behaviors of middle aged. The necessity of an intervention considering the situation related to their stress and coping methods in middle aged so as to promote positive health behaviors was suggested.
Adaptation, Psychological* ; Adult* ; Education ; Health Behavior* ; Humans ; Middle Aged* ; Statistics as Topic ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to examine the relationship among subjective symptoms, depression, and stress coping behavior of university students. METHOD: The survey was carried out on a convenience sample of 298 university students. The questionnaire consisted of each scale for symptoms, depression, and stress coping behaviors. Data analysis procedure included the factor analysis for stress coping behaviors, and the correlation analysis describing a relationship among symptoms, depression, and stress coping behaviors. RESULT: There were significant correlations between depression and the three types of symptoms : general, psychological, and somatic symptom. Subjects using the negative-emotional-response coping and the self-control coping showed a more severe depression, and those using the problem-solving reappraisal coping and the positive-emotional-response coping showed a milder depression. Subjects using the negative-emotional-response coping complained of all 3 types of symptoms severely, and those using the positive-emotional-response coping complained of general symptoms mildly. Of five stress coping methods, the negative-emotional-response and the positive-emotional-response coping methods were related to both symptoms and depression significantly. CONCLUSION: This study suggests that the emotional-oriented coping method has more important role for university student's depression and their subjective symptoms than the problem-oriented coping or social supports seeking coping. Further study needs to be conducted to help students effective coping mechanism for good mental health. Also it is necessary for university students to recognize that their symptoms are associated with depression.

PURPOSE: The purpose of this study is to examine the factors that influence the clinical practice of nursing students and to identify the mediating effects of spiritual well-being in the relation between stress of clinical practice and burnout caused by clinical practice. METHODS: Data were collected by self-report questionnaires targeting 420 nursing students in three nursing colleges located in Gyeonggi and Chungnam province. RESULTS: Burnout of clinical practice according to general characteristics of the study subjects showed significant difference in religion (t=1.895, p=.049). Stress of clinical practice and burnout of clinical practice showed positive correlation (r=.42, p<.001), existential spiritual well-being showed negative correlation between stress of clinical practice (r=-.17, p<.001) and burnout of clinical practice (r=-.47, p<.001). In addition, religious spiritual well-being in spiritual well-being showed no mediating effects and existential spiritual well-being showed mediating effects between burnout in clinical practice stress. CONCLUSION: In order to alleviate the stress of clinical practice for burnout of clinical practice prevention of nursing students, solutions to improve the existential spiritual well-being will be required in the future.
Burnout, Professional ; Chungcheongnam-do ; Gyeonggi-do ; Humans ; Negotiating* ; Nursing* ; Spirituality ; Stress, Psychological ; Students, Nursing*

No abstract available.
Beckwith-Wiedemann Syndrome*

OBJECTIVE: This study was performed to evaluate the effects of mutiple indications and age on the likelihood of finding cervical lesion in large loop excision of transformation zone(LLETZ). METHOD: We reviewed the medical records of 471 evaluable LLETZ of cervix for cervical neoplasia at the Yonsei University College of Medicine, from April 1996 to August l998. The indications for the LLETZ were grouped as being for treatment(biopsy-proven disease)(indication A), significant discrepancy among cytologic and histologic results(indication B), unsatisfactory colposcopic finding(transformation zone not fully visualized)(indication C), possible microinva- sion(indication D), and combinations of the above. RESULTS: The prevalence rates of cervical lesion in performed LLETZ for indication A alone, for indication B alone, for a combination of indication A and C, for a combination B and C, and for indication D alone were 85.7%, 56.5%, 82.3%, 42.6%, 95%, respectively. The data were then reanalyzed to determine the likelihood of finding high-grade disease on LLETZ specimen. Overall, those with preoperative high-grade cytologic or histologic characteristics were much more likely to have high grade disease(78.1%) than were those with preoperative low-grade cytologic or histologic characteristics(27.2%)(p<0.001). The influence of age on the likelihood of identifying diasease on the LLETZ is undertermined. CONCLUSION: Neither age nor the preoperative grade of disease are good discriminators of the likelihood that disease will be found on a LLETZ specimen, However, patients with preoperative high-grade disease are much more likely than those with preoperative low-grade disease to have high-grade dysplasia or invasive cancer on LLETZ.
Cervix Uteri ; Female ; Humans ; Medical Records ; Prevalence