The purpose of this study was to identify the needs which were perceived by patients who were received spinal anesthesia for surgery. The subjects consisted of 50 adult patients who were admitted to 2 university hospitals and 2 general hospitals in Pusan city and 1 general hospital in Koje City for surgery under spinal anesthesia. Thirty eight percent of subjects received information about anesthesia before the operation. The instrument for this study was developed by the researcher based on literature and a pretest. Data were collected from December 10, 1999 to February 10, 2000 and were analyzed by content analysis. The results were that there were 533 meaningful statements in the needs of spinal anesthesia patients. The needs of spinal anesthesia patients had 51 items (preoperation (6), induction of nesthesia(5), intraoperation (27), postoperation(13)) and 6 categories (information, emotional welfare, physical welfare, post anesthetic management, control of physical environment, humane treatment). From the results, it can be concluded that: 1. In the pre-operation period, we have to explain anesthesia procedures, adequate position of anesthesia, duration before anesthesia wears off and sensation of paralysis. We have to supply emotional support to relieve anxiety because of anesthesia. 2. In induction of anesthesia, we have to support patient's position for anesthesia, and relieve anxiety so that patients participate in induction of anesthesia well. 3. In intra-operative period, we have to check the level of anesthesia, and keep up a comfortable position for operation and care for physical discomfort such as thirst, nausea, vomiting, dyspnea and to maintain body temperature of the patient. Since the patient is conscious, we have to communicate with the patient to relieve anxiety, maintain privacy, inform the patient of the process of the operation and encourage the surgeon to explain the outcome of the operation. The operating team needs the careful about what they say and to place the instrument well. We have to ventilate the room air and reduce noise. 4. In the post-operative period, we have to explain the purpose and duration of bed rest, complications of anesthesia and care for physical discomfort such as pain, dysuria, headache, backache. Also we have to maintain body temperature of the patient and maintain privacy.
Adult ; Anesthesia ; Anesthesia, Spinal* ; Anxiety ; Back Pain ; Bed Rest ; Body Temperature ; Busan ; Dyspnea ; Dysuria ; Gyeongsangnam-do ; Headache ; Hospitals, General ; Hospitals, University ; Humans ; Nausea ; Noise ; Paralysis ; Privacy ; Sensation ; Thirst ; Vomiting

BACKGROUND: Coagulase negative staphylococcus (CNS) spp. is a major pathogenic organism of nosocomial and community-acquired urianry tract infections, and causes infrctions in the immunocompromised host, and in particular, bloodstream infetions in patent with indwelling devices. High prevalance of methicillin resistance has been noticed in CNS which also have been recongnized as an important multidrug resistant pathogen. The optimal phenotypic method for detecting methicillin resistance still remains controversial, and new guidelines for detecting methicillin resistance of CNS was proposed by NCCLS in January 1999. We evaluated the relationship between mecA gene by PCR method and antimicrobial susceptibility tests according to the new NCCLS guidelines. METHODS: A total of 82 CNS isolates were examined for MICs and penicillin MICs by disk diffusion and agar dilution method according to NCCLS guidelines, and detections, and detection of mecA gene by PCR. RESULT: In disk diffusion method, 66 strains (80.5%) and 63 strains (76.8%) showed resistance to penicillin and oxacillin, respectively, and in agar dilution method, 71 strains(86.6%) and 53 strains (64.6%), respectively. In PCR method, mecA genes were detected in 49 strains(59.8%). Comparing with mecA gene detection by PCR method, the sensitivity of disk diffusion and agar dilution method was 95.8% and 89.8%, repectively. However, the sensitivity of disk diffusion and agar dilution method was 65.3% and 75.5%, respectively using previous NCCLS criteria. CONCLUSION: The new criteria of NCCLS detects the methicillin resistance induced by mecA gene more sensitively than previous one.
Agar ; Coagulase* ; Diffusion ; Immunocompromised Host ; Methicillin Resistance ; Oxacillin ; Penicillins ; Polymerase Chain Reaction ; Staphylococcus*

OBJECTIVES: Methylenetetrahydrofolate reductase (MTHFR) mutation are commonly associated with hyperhomocysteinemia, and through their defects in homocysteine metabolism, they have been implicated as a risk factor for recurrent spontaneous abortion. Recent report describe that 28-bp tandem repeat polymorphism in thymidylate synthase enhancer region (TSER) that influence enzyme activity would affect plasma homocysteine level. We have investigated the relationship between TSER genotype and plasma homocysteine level in 54 patients with recurrent spontaneous abortion. METHODS: Plasma homocysteine level was measured by fluorescent polarizing immunoassay. MTHFR mutation (C677T and A1298C) was identified by PCR-restriction fragment length polymorphism assay and TSER mutation was analyzed by PCR method. The data were analyzed using the program SAS 8.2 for Windows. RESULTS: Total homocysteine level was significantly higher in MTHFR 677TT genotype (9.80+/-3.87 mumol/L) than MTHFR 677CC genotype (8.14+/-1.74 mumol/L) in Korean patients with unexplained recurrent spontaneous abortion (p=0.0143). However, the plasma homocysteine level was not significantly different in the MTHFR 1298AA (8.42+/-2.65 mumol/L) and 1298CC (6.09+/-0.32 mumol/L; p=0.2058) and, TSER 2R2R (8.61+/-1.68 mumol/L) and 3R3R (8.05+/-2.81 mumol/L; p=0.9319) mutant genotypes, respectively. In this study, we found the combination effects of TSER and MTHFR C677T genotypes. Plasma homocysteine levels were the highest (11.47+/-4.66 mumol/L) in individuals with TSER 3R3R (8.05+/-2.81 mumol/L) and MTHFR 677TT (9.80+/-3.87 mumol/L) genotypes. Individuals with a combination of both TSER 2R2R/2R3R and MTHFR 677CC/CT genotypes (7.69+/-1.77 mumol/L) had lower plasma homocysteine levels than TSER 2R2R (8.61+/-1.68 mumol/L) and MTHR 677CC (8.14+/-1.74 mumol/L) genotypes, respectively. The effect of MTHFR polymorphism in the homocysteine metabolism appears to be stronger than that of TSER polymorphism. CONCLUSION: Although statistically not significant, we found the elevated level of plasma homocysteine in combined genotypes with TSER and MTHFR (C677T and A1298C) in Korean patients with unexplained habitual abortion. In this study, we reported the possibility that TSER polymorphism is a genetic determinant of plasma homocysteine levels in the Korean patients as well as MTHFR C677T polymorphism. A large prospective study is needed to verify our findings.
Abortion, Habitual ; Abortion, Spontaneous* ; Female ; Genotype ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Immunoassay ; Metabolism ; Methylenetetrahydrofolate Reductase (NADPH2) ; Plasma* ; Polymerase Chain Reaction ; Pregnancy ; Risk Factors ; Tandem Repeat Sequences ; Thymidylate Synthase*

BACKGROUND: The rapid emergence of multi-drug resistant pneumococcal strains has heightened the importance of reliable and convenient susceptibility testing methods. The newly-developed VITEK-2 (bioMerieux, Inc., Hazelwood, MO, USA) System includes the capability of performing rapid susceptibility testing of Streptococcus pneumoniae using specially configured cards. The objective of this study is to evaluate the performance of the VITEK-2 System for susceptibility testing of S. pneumoniae. METHODS: One hundred clinical strains of S. pneumoniae (18 penicillin susceptible strains, 32 intermediate strains, and 50 resistant strains) were tested, which had been isolated in Samsung Medical Center. Minimum inhibitory concentrations (MICs) for penicillin, cefotaxime, erythromycin, ofloxacin, chloramphenicol, tetracyclin, and vancomycin were determined by broth dilution method and VITEK-2 System using AST-P506 cards. The results obtained by VITEK-2 System were compared to those obtained by broth dilution method. RESULTS: Overall agreement of MICs determined by two methods was 93.0% within the range of one dilution. The best agreement was achieved with vancomycin (100%), and in descending order, 99% with ofloxacin, 97% with erythromycin, 94% with chloramphenicol, 89% with cefotaxime, 88% with tetracycline, and 85% with penicillin. There were 1.9% of very major error, 2.0% of major error, and 8.6% of minor error. The mean time for generation of susceptibility results was 9.6 hours. CONCLUSIONS: VITEK-2 System provided rapid and reliable determinations of susceptibility category for most antibiotics and would be helpful as a substitution of existing MIC methods.
Anti-Bacterial Agents ; Cefotaxime ; Chloramphenicol ; Erythromycin ; Microbial Sensitivity Tests ; Ofloxacin ; Penicillins ; Pneumonia ; Streptococcus pneumoniae* ; Streptococcus* ; Tetracycline ; Vancomycin

No abstract available.
Failure to Thrive*

No abstract available.
Intellectual Disability ; Rubinstein-Taybi Syndrome*

Ever since Mixter and Barr demonstrated the relationship between disk protrusion and radicular pain nearly 50 years ago, there has been a swing toward mechanical explanations for all problems of this type. Murphy has proposed that inflammation rather than mechanical pressure is the basis of back pain and sciatica, and that the causal irritant is likely to be a chemical product of disk degeneration. That administration of steroids reduces the inflammatory process is well known. The present study was undertaken to acess our experience in using epidural steroid injection ofr patients suffering from diskogenic low back pain. Ten patients with the clinical diagnosis of sciatica and with post larninectomy sequelae were referred to the anesthesia department of Maryknoll hospital. Our routine epidural injection of the lumbar spine(L3-4) consists of 2ml of 2% xylocaine and 120mg of methylprednisolone(Depo medrol). Following the injection of Depo Medrol patients were encouraged to ambulate actively and were asked to evaluate their subsequent pain relief. Of the 10 patients studied, all patients experience pain relief within 10 minutes of the epidural injection. A follow up study of these patients was done between 5 and 10 months after injection. The results were as follows: 1) 3 patients: Complete relief. 2) 3 patients: moderate relief. 3) 3 patients: no relief. 4) 1 patient: technical failure.
Anesthesia Department, Hospital ; Back Pain ; Diagnosis ; Follow-Up Studies ; Humans ; Inflammation ; Injections, Epidural ; Intervertebral Disc Degeneration ; Lidocaine ; Low Back Pain ; Methylprednisolone ; Sciatica ; Steroids*

PURPOSE: This study was done to examine the association among irrational belief, mental health, and self-efficacy, and explored the mediation of self-efficacy in the relationship between irrational belief and mental health of Korean soldiers. METHODS: A cross sectional study design was employed. The participants were 118 soldiers who signed consent forms. Data were analyzed using descriptive statistics, Pearson correlation coefficients, and multiple regression analysis. RESULTS: Irrational beliefs were positively correlated with mental health problems, and self-efficacy was negatively correlated with irrational beliefs and mental health problems. Self-efficacy acted as a mediator in the relationship between irrational beliefs and mental health problems. CONCLUSION: The study results suggest that effective interventions to reduce mental health problems of soldiers should apply strategies to change irrational belief and increase self efficacy. These results also provide more empirical support to the hypothesis that self-efficacy serves as a mediator in a mental health.
Consent Forms ; Humans ; Mental Health* ; Military Personnel* ; Negotiating* ; Self Efficacy

Sequence comparison of the RNA-dependent RNA polymerase of human caliciviruses (HuCVs) from Korean children with gastroenteritis revealed significant genetic variation among them. cDNA clones were produced from the HuCVs collected from pediatric population during a period of 1987-1994. The application of reverse transcription-polymerase chain reaction (RT-PCR) using primers directed to the RNA-dependent RNA polymerase region within ORF1 of Norwalk virus (NV) showed that 13.7% of HuCVs yielded PCR products of similar size to the NV prototype, NV8Flla/68/US, with exceptions of HuCV185/87/Korea and HuCV1115/90/Korea. Computer analyses showed that the PCR products had a continuous protein encoding frame on the positive strand, and contained GLPSG and YGDD amino acid motifs at the predicted distance from primers. Alignment of the amino acid sequences of HuCVs with previously published sequences for Snow Mountain agent (SMA), NV, and Sapporo/82/Japan indicated that these strains can be divided into four major genogroups. There were 10 (45%) SMA-like CVs, one (4.5%) NV-like HuCVs, two (9%) Sapporo-like HuCVs, and nine (41%) unidentified HuCVs. This fourth genogroup should be investigated further. HuCV185/87/Korea and HuCV1115/90/Korea, Sapporo-like CVs, were genetically distinct from previously characterized HuCVs and more closely related to known animal CVs. One of the animal CV-like strain, HuCV185/87/Korea, showed nucleotide and amino acid homology of only 67% and 73% with the prototype Sapporo/82/Japan. Further characterization of animal and human CV genomes and studies of possible cross-transmission of CVs from animals to humans are likely to be beneficial in understanding the epidemiology of HuCVs.
Amino Acid Motifs ; Amino Acid Sequence ; Animals ; Child ; Clone Cells ; DNA, Complementary ; Epidemiology ; Gastroenteritis ; Genetic Variation ; Genome ; Genotype ; Humans* ; Korea* ; Norwalk virus ; Polymerase Chain Reaction ; RNA Replicase ; Snow

PURPOSE: The purpose of this study was to identify gender role identity and stereotypes and to explore the relationship between gender role identity and stereotype among college students. METHOD: The subjects consisted of 245 college students in Daegu. Each participant was administered the KGRII of Lee, Kim, Koh(2002) and Sex Stereotype scales modified by Kim, Dongil(1999). The collected data were analyzed using descriptive statistics, ANOVA, x2-test, Sheffe test with SPSS 11.0 PC Program. RESULT: 1. For male students, masculinity type(32.4%) was most prevalent but for female students, feminity type (29.3%) was most common. 2. Female students were inclined to oppose traditional sex-role rather than male students. And the over 23 years old group tended to resist traditional sex-roles rather than other aged group. 3. The Androginy typed group had more progressive sex-role compared with undifferentiated typed group. CONCLUSION: These results suggest that gender role identity and sex stereotype were difference in sex and age. And the androgyny typed group had more progressive sex-role compared with other gender role identity typed group.
Daegu ; Female ; Gender Identity* ; Humans ; Male ; Masculinity ; Weights and Measures ; Young Adult