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

This study was done to analyze the trends of research on stroke in Korea. to suggest future direction. for research on stroke. This article reviewed 75 nursing research papers on stroke done since 1990 to 2000 by examining them according to the period of publication or presentation. research design, type of subjects, measurement variables. the intervention outcome of experimental research, and theme of qualitative research. The research were as follows: 1. 26 of 75 studies were composed of master thesis and dissertation of graduate school. There were 53 nonexperimental research. 15 experimental research and 7 qualitative studies design. 2. Stroke patients subject' Characteristic were 44 and Family and Spouses of caregiver support were 28 of total studies. 3. Most measurement instruments used for research were translated and redesigned it into Korean that developed by foreigners, and development measurement instruments used Kang's ADL. 4. Family support and Social support was shown the frequently among correlational research. 5. Methodological research were development of an evaluation tool for the quality of nursing care in stroke patients. caregiver support of development of nursing intervention list. and Home care Nursing Intervention protocol. and development of client selection criteria based on the needs of services to be offered. 6. The experimental research of intervention were mostly education nursing intervention. rehabilitation program on functional recovery. support nursing intervention. and applying a home care protocol on the nursing care intervention. 7. Theme of qualitative research were family experience, home care in family experience, soobal expenence, illness experience. hope of Stroke patients and so on. Phenomenologic methodology and Granded Theory was designed of Qualitative research. On the basis of the above finding the following recommendations are made: 1. It's necessary to develop a reliable and variable measurement tool for stroke patients and family care of stroke patients. 2. It's necessary to study the comparison of Nursing Studies of stroke research abroad, the replication to establish the effect of nursing intervention stroke patients and family care of stroke patients.
Activities of Daily Living ; Caregivers ; Education ; Emigrants and Immigrants ; Home Care Services ; Hope ; Humans ; Korea* ; Nursing Care ; Nursing Research ; Nursing* ; Patient Selection ; Publications ; Qualitative Research ; Rehabilitation ; Research Design ; Spouses ; Stroke*

Though basal cell carcinoma is the most frequent and increasing malignant tumor of the skin in Korea, its pathological analysis has been done only on the small numbers. So, we did a comprehensive pathologic study on the 283 patients with basal cell carcinoma diagnosed in the Department of Pathology, Seoul National(233cases) and Chung-Ang(50cases) University Hospital during 1975-1992. The age distribution was ranged from 15 to 84 years with highest incidence rate in the age group of 5th-8th decades and 83.7% of all patients were over 40 years of age. Sex difference was not noted. The most common site was face occuring in 235 out of 283cases(83.0%) especially in the eyelid(25.5%), nose(17.9%) and cheek(16.6%). The most frequent histopathologic type was solid type(54.0%) followed by mixed(23.9%), adenoid(7.5%), and metatypical(4.7%). Among 51 mixed type, all showed solid components with adenoid(51.0%) followed by morphea(25.5%) and metatypical type(13.7%). And among 14 recurrent cases, solid type is found in 50% of cases. The characteristic clinicopathological findings are solid arrangement of tumor cells with various histological pattern and predominant occurence on the face.
Incidence

PURPOSE: The purpose of this study was to describe stage distribution of current and former smokers and to analyze significant variables that used by adolescents at each stage using the Transtheoretical Model. METHODS: A cross-sectional study was performed with 145 students attended to five high schools in one rural area. The survey instruments included stages and processes of change, decisional balance, self-efficacy, and knowledge related to smoking. RESULTS: Among the participants, 47.6% were in the precontemplation and contemplation stages, 20.7% were in the preparation stage, and the other 31.7% were in the action and maintenance stages. Analysis of variance tests revealed that behavioral processes, pros and cons of smoking, and self-efficacy were significantly associated with the stages of smoking cessation, while among 10 processes of change, self-reevaluation, self-liberation, and reinforcement management were significantly different by the stages. CONCLUSIONS: The study results suggest that smoking cessation programs should emphasize behavioral strategies, self-efficacy, and decisional balance to help students adopt and maintain smoking cessation
Adolescent ; Cross-Sectional Studies ; Humans ; Rural Population* ; Smoke ; Smoking ; Smoking Cessation*

PURPOSE: This study is to determine the effects of Colorectal Neoplasms patients' stage, location of disease, functional status (physiological factor), mood (psychological factor), and social support (situational factor) on their symptom experience, and to verify the relationship between symptom experience and the quality of life. METHODS: The Theory of Unpleasant Symptoms was the framework for the study. A descriptive correlational design was used in analysis of data obtained from a sample of 113 Colorectal Neoplasms patients who were undergoing chemotherapy. RESULTS: Total mood disturbance and symptom experiences were negatively correlated with physical component score (PCS) and mental component score (MCS) of quality of life (r −.33 to r=−.51, p<.001; r=.40 to r=.50, p<.001). Multiple regression analysis revealed that the functional status and symptoms interference variables explained 29.2% of the variance in PCS of quality of life. Symptoms interference and age explained 30.6% of the variance in MCS of quality of life. CONCLUSION: Although overall depression levels were low in this sample, these findings suggest that insomnia and fatigue are related to depression and that depression is more closely associated with quality of life than are insomnia and fatigue.
Colorectal Neoplasms* ; Depression ; Drug Therapy ; Fatigue ; Humans ; Quality of Life* ; Sleep Initiation and Maintenance Disorders

PURPOSE: This study is to define the structural patterns of pregnancy motivation of married women. METHOD: Q-methodology was used on 110 statements collected from interviews with women and a literature review. 38 Q-samples were selected. The Q-samples were administerd to 30 randomized P-sample. RESULT: Data analysis of Q-type obtained by QUANL program shows three types of subjectivity in the perception of pregnancy motivation. Type 1, "Family-connection strengthening", Pregnancy motivation is characterized by the tendency to make home, to tie family member, to connect couple firmly. Type 2,"Self-satisfaction", Women of this type take pleasure and happiness from child rearing in terms of being a mother and having maternal affection. Type 3, "Self-centered", This type of pregnancy motivation puts on high emphasis on self achievement and they make a family planning suitable for the maternal role. CONCLUSION: The stronger was women's pregnancy motivation, the more positive were women's pregnancy experience and maternal role attainment. Therefore, When nurses take care of pregnancy women, they should understand the women's psycho-social aspects and then apply a program of nursing intervention to the pregnant women, It is necessary to continue to study on social and psychological problems related to pregnancy.
Child ; Child Rearing ; Family Planning Services ; Female ; Happiness ; Humans ; Korea* ; Mothers ; Motivation* ; Nursing ; Pleasure ; Pregnancy* ; Pregnant Women ; Statistics as Topic

PURPOSE: The aim of this study was to examine the health-related behaviors related to a family history of cancer (FHCA) among Korean women underwent cancer screening. MATERIALS AND METHODS: A total of 8,956 women who underwent cancer screenings during 2001-2011 at the National Cancer Center, Korea, were analyzed. The association between health-related behaviors and a FHCA were assessed using multivariate logistic regression. RESULTS: Compared to women with no FHCA, women with FHCA were more likely to smoke (adjusted odds ratio [aOR], 1.32; 95% confidence interval [CI], 1.06 to 1.65), to be exposed to passive smoking (aOR, 1.21; 95% CI, 1.15 to 1.65), and less likely to engage in regular exercise (aOR, 1.20; 95% CI, 1.01 to 1.41). Combined effects of selected health behaviors for FHCA were significant, although no statistically significant interactions were observed between selected health behaviors. Compared to women with no FHCA, women with FHCA were more likely to simultaneously smoke and be exposed to passive smoking (aOR, 1.65; 95% CI, 1.17 to 2.31) and to simultaneously smoke and be physically inactive (aOR, 1.62; 95% CI, 1.00 to 2.64). CONCLUSION: The study found that women with a FHCA exhibited unhealthy behaviors compared to women without FHCA. Higher emphasis on lifestyle modifications using a new standardized tool is strongly recommended for those with a FHCA, as well as individuals who are at high risk, together with their family members.
Early Detection of Cancer ; Female ; Health Behavior* ; Humans ; Korea ; Life Style ; Logistic Models ; Mass Screening ; Odds Ratio ; Smoke ; Tobacco Smoke Pollution

This study was carried out in order to examine the urinary excretion of electrolytes (Na, K) and their relationship with blood pressure, and to estimate the amount of daily salt intake in a rural community. From January to March in 1987, a mobile screening team visited 40 villages, and carried out health screening of 537 adult volunteers whose age were over 30 years and collected 12-hours overnight urine. To determine the completeness of collection, the urinary creatinine was measured. If the creatinine excretion was beyond the range given to the age group, the sample was excluded from the analysis as an imcomplete collection; 345 samples were remained for analysis. This study revealed the following results. 1. The mean excretion amounts of urinary electrolytes for 12 hours were Na 193.5 mEq, K 20.8 mEq, creatinine 1.0 g. The mean ratio of electrolytes were Na/K 9.84, Na/creatinine 0.44, K/creatinine 0.046. 2. Both the mean excretion amount of K and the mean ratio of K/creatinine were less in hypertensives than in normotensives. K excretion also showed a tendency towards a decrease in inverse proportion to systolic blood pressure when it exceeded 120 mmHg. There was no significant difference between the hypertensives and normotensives in Na excretion. The sodium to potassium ratio increased in proportion to systolic blood pressure. 3. The meand daily salt excretion amount was 22.4 g. Assuming that 90% of the intake was excreted, the estimated amount of daily salt intake was 24.9 g.
Adult ; Blood Pressure ; Creatinine ; Electrolytes ; Humans ; Hypertension ; Mass Screening ; Potassium ; Rural Population ; Sodium ; Volunteers

PURPOSE: This study was done to verify the reliability and validity of the Korean version of DMCI in Korean adolescents. METHODS: A methodological study design was used with Cronbach's alpha for reliability, and an exploratory factor analysis and contrasted groups approach for construct validity. DMCI was translated into Korean and tested with a sample of 406 adolescents in Korea. The data were analyzed using Cronbach's alpha, item correlation with total, principal component factor analysis, and t-test. RESULTS: The translated content of the DMCI was validated by nursing faculty members and translation equivalency was obtained. The Cronbach's alpha of the DMCI simplified with 18 items was .78. The factor analysis revealed three factors explaining 41.5% of total variance and the corresponding factors were self-observation (21.6%), self-judgement (11.4%), and self-confidence (8.6%). The mean score for the DMCI in the aggression group was significantly lower than the non-aggression group. CONCLUSION: Results of this study suggest that the Korean version of DMCI can used as a reliable and valid measure to assess decision making competency in Korean adolescents.
Adolescent ; Aggression ; Decision Making ; Faculty, Nursing ; Humans ; Korea ; Reproducibility of Results ; Child Health

Myopathy is a well known side effect of corticosteroid therapy. We report a case of iatrogenic steroid therapy induced myopathy in a 79-year-old female who had taken steroids for more than three years due to treatment for degenerative osteoarthritis. She complained of severe proximal muscle wasting and lower extremities weakness. Also, she had typical features of Cushing syndrome such as moon face, buffalo hump and easy bruising. Needle electromyogram showed no abnormal spontaneous activities in both lower extremities, but peripheral nerve conduction study showed motor conduction defect of both deep peroneal and tibial nerves. And, low SNAP (sensory nerve action potential) of both superficial peroneal and sural nerves, which were compatible with peripheral polyneuropathy in both lower extremities. The muscle biopsy revealed a pronounced muscle fiber atrophy, fatty degenerative change and selective type 2 fiber depletion on ATPase staining in pH 9.4 buffer. She was treated isotonic exercise physical therapy and slowly improved. After three months later, she complained sudden onset of chest discomfort and died due to congestive heart failure.
Adenosine Triphosphatases ; Aged ; Atrophy ; Biopsy ; Buffaloes ; Cushing Syndrome* ; Female ; Heart Failure ; Humans ; Hydrogen-Ion Concentration ; Lower Extremity ; Muscular Diseases* ; Needles ; Osteoarthritis ; Peripheral Nerves ; Polyneuropathies* ; Steroids ; Sural Nerve ; Thorax ; Tibial Nerve