Recently atypical antipsychotics have been used as first line agent in the treatment of schizophrenia, and also played a significant role in the treatment of many kinds of psychiatric disorders. The pharmacokinetic and pharmacodynamic properties of these newer antipsychotics are well know through preclinical and early clinical trials. However, it is important to note the limitations of the results due to its relatively short experience. Clozapine is eliminated principally by the hepatic P450 1A2 and 3A4 cytochrome enzymes. 1A2 inducers such as carbamazepine and smoking can reduce its half-life, while 1A2 inhibitors such as SSRIs especially fluvoxamine can increase its duration of action. Carbamazepine should be avoided in a patient on clozapine because of carbamazepine's potential effects on bone marrow. Benzodiazepines tend to increase the chances of sedation delirium and respiratory depression. Risperidone is metabolized to 9-hydroxyriperidone by the hepatic P450 2D6 cytochrome enzymes. Fluoxetine and paroxetine, 2D6 inhibitors interfere with metabolism, but 9-hydroxyrisperidone has similar biological activity as parental drug, so it has little affect on the outcome. Olanzapine shows minimal capacity to inhibit cytochrome P450 isoenzymes and shows minimal chance of drug interaction. It is eliminated principally by the hepatic P450 1A2 and 2D6 cytochrome enzymes.
Antipsychotic Agents* ; Benzodiazepines ; Bone Marrow ; Carbamazepine ; Clozapine ; Cytochrome P-450 Enzyme System ; Cytochromes ; Delirium ; Drug Interactions* ; Fluoxetine ; Fluvoxamine ; Half-Life ; Humans ; Isoenzymes ; Metabolism ; Parents ; Paroxetine ; Respiratory Insufficiency ; Risperidone ; Schizophrenia ; Smoke ; Smoking

Canalith repositioning maneuver is effective to treat benign paroxysmal positional vertigo(BPPV). This case showed complicated form of the BPPV such as changes of canalolithiasis to cupulolithiasis, involvement of one canal to two canals and from unilateral to bilateral involvement during the reposition maneuver. This patient was diagnosed as left lateral canalolithiasis at first. After left barbecue maneuver, the type was changed to the right posterior cupulolithiasis. Semont maneuver was performed and then the type of BPPV was changed to combined type with right posterior canalolithiasis and left lateral canalolithiasis. We performed left barbecue maneuver and right Epley maneuver. Then the type of BPPV was changed to left lateral cupulolithiasis. After Brandt-Daroff maneuver and left barbecue maneuver, nystagmus and dizziness disappeared finally.
Dizziness ; Humans

449 hospital patients with no pathologic brain CT findings, 30 yrs of age or older, were selected for the study of cerebral atrophy during the 30 months, from January 1980 to June 1983, at dept. of internal medicine, Hanyang Univ. hospital & following results were obtained. 1) Thoses in male group, A gradually progressive increase in the degree of cerebral atrophy score in the 3rd, 4th & late 5th decades was followed by a dramatic increase in the late 6th & 7th decades. 2) Those in female group, A gradually progressive increase in the degree of cerebral atrophy.
Atrophy* ; Brain* ; Female ; Humans ; Internal Medicine ; Male

449 hospital patients with no pathologic brain CT findings, 30 yrs of age or older, were selected for the study of cerebral atrophy during the 30 months, from January 1980 to June 1983, at dept. of internal medicine, Hanyang Univ. hospital & following results were obtained. 1) Thoses in male group, A gradually progressive increase in the degree of cerebral atrophy score in the 3rd, 4th & late 5th decades was followed by a dramatic increase in the late 6th & 7th decades. 2) Those in female group, A gradually progressive increase in the degree of cerebral atrophy.
Atrophy* ; Brain* ; Female ; Humans ; Internal Medicine ; Male

PURPOSE: The increased prevalence of dyslipoproteinemia in obese children probably contributes to the high risk of cardiovascular disease associated with being overweight. The genetic makeup is possible one of the factors that influence the impact of obesity on lipid metabolism. A relation between apolipoprotein E (Apo E) polymorphism and lipid metabolism has been convincingly demonstrated in large population. The purpose of this study was to determine whether Apo E polymorphism also influences the risk of dyslipidemia in obese children. METHODS: We studied 89 obese children with weight-for-height excess of 40% by obesity index. We measured the serum concentration of total cholesterol, triglyceride, HDL-cholesterol, LDL- cholesterol, Lipoprotein (a) (Lp(a)), apolipoprotein A (Apo A) and Apo B after overnight fasting. Apo E gene polymorphism of the 89 obese children and 30 control students were analyzed by ARMS (amplication refractory mutation system) method. RESULTS: The frequency of etsilon2, etsilon3, and etsilon4 allele were 9.7%, 82.3% and 8.0%, respectively in children. There was no significant difference between Apo E allele frequency of obese children and those of nonobese children. The serum concentrations of total cholesterol, LDL-cholesterol and Apo B were lower in etsilon2 genotype. The obese children with etsilon4 genotype had higher frequency of hypertriglyceridemia, increased level of Lp(a) and decreased level of HDL-cholesterol than other types. There was no evidence of EKG abnormality and cardiovascular complications in obese children. CONCLUSION: Our data demonstrated that obesity is associated with an increase in the risk of lipoprotein abnormalities and that the serum concentrations of total cholesterol, LDL-cholesterol and Apo B were influenced by Apo E genotypes.
Alleles ; Apolipoproteins B ; Apolipoproteins E ; Apolipoproteins* ; Arm ; Cardiovascular Diseases ; Child* ; Cholesterol ; Dyslipidemias ; Electrocardiography ; Fasting ; Gene Frequency ; Genotype ; Humans ; Hypertriglyceridemia ; Lipid Metabolism ; Lipoprotein(a) ; Lipoproteins ; Obesity ; Overweight ; Plasma* ; Prevalence ; Triglycerides

The purpose of this phenomenological study was to explore and describe the experience of people with HIV/AIDS. Three men and three women with HIV/AIDS participated in the study. They were asked open-ended and descriptive questions in order for them to talk about their experience in their own terms. Interviews were audiotaped and transcribed to maintain data integrity and to reduce perceptual bias. The transcripts were analyzed by the Colaizzi method. Member checks from the participants were used to validate the emergent themes. Seven themes emerged from the analysis. 1. People with HIV/AIDS have a strong impact and emotional reaction when receiving positive HIV test results. 2. All people with HIV/AIDS attempt to conceal HIV infection because of fear of stigma or rejection. 3. After the initial brief traumatic reaction to HIV/AIDS diagnosis, all participants feel lonely because they had no one to express or share their own experiences. 4. People with HIV/AIDS reflect on their life, think about the death and dying process and they become depressed. 5. Most participants feel that the family members who know his/her diagnosis are a big source of support. 6. According to the normativeness of infection route of HIV, the degree of guilty feeling differs among participants. 7. Although all participants think medication is a lifeline, the adherence to medication is not maintained because of side effects, denial and concealment of HIV/AIDS. The results of this study may help nurses and other health care workers to implement more efficient nursing strategies for people with HIV/AIDS by more deeply understanding their experience.
Bias (Epidemiology) ; Delivery of Health Care ; Denial (Psychology) ; Diagnosis ; Female ; HIV ; HIV Infections ; Humans ; Male ; Nursing

PURPOSE: The aim of the study was to explore nurses' experience of person-centered relational care in the context of critical care. METHODS: Key interview questions were developed based on the human-to-human relationship model suggested by Travelbee. Data were collected through in-depth interviews with a purposive sample of 11 nurses having more than 2 years of working experience in intensive care units. An interpretative phenomenological analysis was conducted to analyze the data. RESULTS: Four super-ordinate and nine sub-ordinate themes were identified. Emerged super-ordinate themes were as follows: (1) encountering a live person via patient monitoring systems; (2) deep empathic connection; (3) humanistic and compassionate care, and (4) accompanying the journey to the end. Study findings revealed that nurses in intensive care units experienced ‘balancing emotions’ and ‘authenticity’ in caring when entering human-to-human relationships with dying patients. The phenomenon of person-centered relational care in intensive care units was found to subsume intrinsic attributes of empathy, compassion, and trust, similar to the central concepts of Travelbee's theory. CONCLUSION: The interpretative findings in this study provide deeper understanding of Travelbee's human-to-human relationship model. The technological environment in intensive care units did not hinder experienced nurses from forming human-to-human relationships. These themes need to be emphasized in critical care nursing education as well as in nursing management. The results of this study will contribute to understanding nurse-patient caring relationships in depth, and help improve the quality of nursing care in intensive care units.
Critical Care Nursing ; Critical Care ; Education ; Empathy ; Humans ; Intensive Care Units ; Monitoring, Physiologic ; Nurse-Patient Relations ; Nursing ; Nursing Care ; Qualitative Research

PURPOSE: The aim of the study was to explore nurses' experience of person-centered relational care in the context of critical care. METHODS: Key interview questions were developed based on the human-to-human relationship model suggested by Travelbee. Data were collected through in-depth interviews with a purposive sample of 11 nurses having more than 2 years of working experience in intensive care units. An interpretative phenomenological analysis was conducted to analyze the data. RESULTS: Four super-ordinate and nine sub-ordinate themes were identified. Emerged super-ordinate themes were as follows: (1) encountering a live person via patient monitoring systems; (2) deep empathic connection; (3) humanistic and compassionate care, and (4) accompanying the journey to the end. Study findings revealed that nurses in intensive care units experienced ‘balancing emotions’ and ‘authenticity’ in caring when entering human-to-human relationships with dying patients. The phenomenon of person-centered relational care in intensive care units was found to subsume intrinsic attributes of empathy, compassion, and trust, similar to the central concepts of Travelbee's theory. CONCLUSION The interpretative findings in this study provide deeper understanding of Travelbee's human-to-human relationship model. The technological environment in intensive care units did not hinder experienced nurses from forming human-to-human relationships. These themes need to be emphasized in critical care nursing education as well as in nursing management. The results of this study will contribute to understanding nurse-patient caring relationships in depth, and help improve the quality of nursing care in intensive care units.

PURPOSE: This study was done to identify trends in leadership-related research by reviewing studies on hospital nurses in South Korea.METHODS: The research was conducted from April 2 to 14, 2018 and search databases were RISS, KISS, DBpia, KM base, NAL, and NDSL. Search terms were ‘leadership’ and ‘nursing’ in the Korean language, and total 141 papers were selected.RESULTS: Analysis of the research on leadership showed that 96.4% of research methods were quantitative research, and 60.3% were predictive researches. For study settings, 46.2% were general hospitals, 96.5% were staff nurses. In the study of leadership variables, 60.3% were independent variables and recent leadership was used as a mediating variable (4.3%) and a moderating variable (2.8%). Among the leadership types, self-leadership (31.2%) was the most common, and the main variable related to leadership was job satisfaction (25.8%).CONCLUSION: These results provide useful data for deriving new research ideas about nursing leadership. Furthermore, this study has significance for providing the evidence for developing new leadership programs and policies in nursing organizations.
Hospitals, General ; Job Satisfaction ; Korea ; Leadership ; Negotiating ; Nursing ; Nursing Research

OBJECTIVE: We developed a Clinical Document Architecture(CDA) Generator module based on CDA standard for the interchange of radiological reports. METHODS: This paper describes CDA standard, the template of radiological report, CDA Generator module, and the Web-form report using an Extensible Stylesheet Language(XSL) style-sheet. And the CDA Generator module is integrated into a existing Picture Archiving Communication System(PACS) Viewer. RESULTS: Radiological reports based on CDA standard are used to interchange between different health institutions, and also presented in an Extensible Markup Language (XML) compatible web browser. CONCLUSION: The proposed module and concept in this paper may be a utility in improving health care delivery and can also be used to integrate with other Digital Imaging and Communication in Medicine(DICOM) Structured Report (SR) compliant PACS systems.
Delivery of Health Care ; Web Browser