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 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

While most dermal melanocytoses are congenital or have an onset in early childhood, there is an acquired group with a late onset. We describe a case of aldolescent onset, unilateral, macular dermal melanocytosis on the hand. A 16-year-old girl presented with a 10-month history of gray-bluish pigmentation on the right palm and the volar side of the right fourth finger. The light microscopic studies showed spindle-shaped dermal melanocytes. The S-100 protein staining of these cells was positive and CD68 staining was negative. Dermal melanocytosis of the macular type, as observed in our case, is very rare.
Adolescent ; Female ; Fingers ; Hand* ; Humans ; Melanocytes ; Pigmentation ; S100 Proteins

The purpose of this study was to examine the frequency of eutaneous disorders in patients with chronie renal failure presently on hemodialysis(HD). The results were as follows. 1. Cutaneous lesions were present in all 78(100% ) patients with chronic renal failure. 2. The frequency of msjor cutaneous problems associated with chronic renal failure was as follows: xerosis(82.1%), pruritus(74.4%), nail changes(74.4%), hyperpigmentation(70.5 % ), xerostomia(42.3'Yo), poor wound healing(37.2%), easy bruisability(30,8%), hypotrichosis(21.896), and purpura(14.1 % ). 3. Cutaneous problems which appeared after the initiation of HD were. appearance of new pigmented nevi or lentigines(9 patients), appearance or aggravation of acne(6), contact dermatitis at AV fistula site(2), gynecomastia(1), extensive flat warts(1), extensive tinea versicolor(1), and extensive vitiligo(1). 4. Among 55 patients with hyperpigmentation, 11 patients reported decreased pigmentation following HD. In 15 patients, hyperpigmentation worsened following HD, and in 9 patients hyperpigmentation first appeared after HD was initiated. 5. Cutaneous disorders favorably affected by HD were as follows: easy bruisability(3/ 24), xerostomia(3/33), gingival friability(2/7), and hypotrichosis(5/17). 6. Poor wound healing and xerosis were not improved by HD. 7. Among 58 pruritic patients, 7 patients were improved after HD, 7 patients became worse during each HD, and 3 patients were not pruritic only for 2 to 3 days after each HD. Four patients experinced pruritus only during each HD. 8. There was no significant statistical difference between the frequency of pruritus and xerosis and the levels of blood urea nitrogen, calcium, phosphorus, and parathyroid hormone.
Blood Urea Nitrogen ; Calcium ; Dermatitis, Contact ; Fistula ; Humans ; Hyperpigmentation ; Kidney Failure, Chronic* ; Nevus, Pigmented ; Parathyroid Hormone ; Phosphorus ; Pigmentation ; Pruritus ; Renal Dialysis* ; Renal Insufficiency ; Tinea ; Wound Healing ; Wounds and Injuries

BACKGROUND: Allergic diseases are characterized by immediate - and late - phase reactions to various allergens by the selective activation of a subset of CD4 + T cells. In response to allergen, T cells isolated from atopic donors are biased to low levels of IFN - y and high levels of IL - 4, and vice versa by T cells from non - atopic donor. Objective : The aim of this study was to evaluate the patterns of IL - 4 and IFN - y production after Der p I stimulation and the effect on the cytokine production from T cells by budesonide, disodium cromoglycate and cyclosporin A in atopic and non - atopic individuals. MATERIAL AND METHOD: Seven Der p I specific atopic and 7 non - atopic individuals were selected. We decided the 50% inhibiting concentration of each immunomodulator by lymphocyte proliferation assay, and measured their effects on the cytokine production in vitro by intracellular IL - 4, IFN - y staining and flow cytometry. Results and CONCLUSION: There was significant difference on stimulation index ( SI ) of production of IFN - y as well as IL-4 after Der p I stimulation between atopic and non-atopic individuals ( IL - 4 ; 1.57 +/- 0.7 : 0.98 +/- 0.2, p = 0.026, IFN - r : 1.45 +/- 0.5 : 0.95 +/- 0.2, p = 0.048 ). The synthesis of IL - 4, and IFN - r were significantly inhibited after the stimulation of every immunomodulators in atopic individuals, DSCG couldnt inhibit IL - 4 and IFN - r in nonatopic individuals. There was no significant difference in the inhibiting effect of these immunomodulators in both of them.
Allergens ; Bias (Epidemiology) ; Budesonide ; Cromolyn Sodium ; Cyclosporine ; Dust* ; Flow Cytometry ; Humans ; Immunologic Factors ; Interferons* ; Interleukin-4 ; Lymphocytes ; Pyroglyphidae* ; T-Lymphocytes* ; Tissue Donors

Condyloma acuminatum is a common viral disease which is transmitted by sexual intercourse. We experienced a case of condyloma acuminatum occurring in a patient of systemic lupus erythematosus who has been treated with various immunosuppressive agents for 10 years. This condylorna acuminatum was unusual in that it was very rapidly growing, recurrent and reluctant to various treatrnents. We investigated the type of human papillomavirus by Southern blot hybridization and schieved partial improvement by bleomycin intralesional injection together with 5-FU topical application.
Bleomycin ; Blotting, Southern ; Coitus ; Fluorouracil ; Humans ; Immunosuppressive Agents ; Injections, Intralesional ; Lupus Erythematosus, Systemic ; Virus Diseases