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*

Supernunmerary nipple is a developmental anomaly occuring alon, the course of the embryological milk lines. This entity has receieved little attention in the dermatologic literature and has been confused with a pigmented nevus in some cases. We have experienced two ease of the more unusual form of supern umerary nipple. According to the Kajavas classification, our caes are classified as polithelia pilosa and complete breast with nipple
Breast ; Classification ; LEOPARD Syndrome* ; Milk ; Nevus, Pigmented ; Nipples

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 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*

PURPOSE: The aim of this study was to conduct a systematic review and to describe the characteristics of child abuse screening instruments. METHODS: Articles regarding the development of a child abuse screening instrument were investigated using the systematic review method. A literature search using the keywords "child and abuse or maltreatment and instrument or screening tool" in English, and "child," "abuse," and "instrument" in Korean, was conducted of material published in PubMed, PsycINFO, CINAHL, SCOPUS, ERIC, and RISS. Database and bibliographic searches, and quality appraisal using the Quality Assessment of Diagnostic Accuracy Studies tool that included systemic reviews, yielded 17 records. RESULTS: Key elementary child abuse screening instruments were developed for physical, psychiatric, affective and sexual and child neglect assessment. The instruments' target populations were children at home and in institutions. The reviewed instruments had the advantage of diagnosing past, concurrent, and indirectly, potential child abuse. CONCLUSION: The results of this study demonstrate that child abuse screening instruments are available for screening and for assessment of abused children in various circumstances. This review of child abuse screening instruments offers evidence for the acceptable use of optimal psychometric tools for child abuse assessment and provides guidelines for child health nursing practice.
Child ; Child Abuse* ; Child Health ; Child* ; Health Services Needs and Demand ; Humans ; Mass Screening* ; Methods ; Nursing ; Psychometrics

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: In this study effects of a paternal participation program during cesarean section on paternal infant attachment were investigate. The experimental treatment was an integrative nursing intervention to promote father to infant attachment. METHODS: Study design was a non-equivalent control group posttest design. The program consisted of emotional support to spouse and father towards infant attachment immediately following cesarean birth. Participants were 66 men, partners of women with normal full term pregnancy having a cesarean section with spinal or epidural anesthesia, (experimental group, 34; control group, 32). The experiment was carried out from August 1 to October 30, 2010. Control group data were obtained from May 1 to June 30, 2012. Posttest was performed 72 hours after cesarean birth. A self-report questionnaire including a paternal attachment instrument was used. Data were analyzed using t-test, propensity score matching, and analysis of covariance with the SPSS/WIN 18.0 program. RESULTS: Total score for paternal infant attachment in the experimental group was significantly higher than the control group (p<.001). After matching, significant differences were found between the two groups through all subcategories. Adjusted mean score for paternal infant attachment verified experimental effects. CONCLUSION: Results indicate that this paternal participation program during cesarean section is effective in improving paternal infant attachment.
Anesthesia, Epidural ; Cesarean Section ; Fathers ; Female ; Humans ; Infant ; Male ; Parturition ; Pregnancy ; Propensity Score ; Surveys and Questionnaires ; Spouses