Nurses experience role conflict between nursing theory that they learned in school and clinical nursing practice. This conflict lead to lower self-image, self-esteem, job dissatisfaction. Also, the professionalism of nurses is estimatable by the grade of autonomy. The professional autonomy requires individual and professional obligation about her decision and performance. A lack of professional autonomy results in the job dissatisfaction. Job dissatisfaction leads to absenteeism, increased proneness to mental and physical illness and higher turnover rates. The purpose of this study was o investigate professional autonomy and self-concept of clinical nurses. Data were collected from 262 clinical nurses in P city from June 1 to June 30, 1996. The instruments used for this study were made by Arthur(1990) and Schutzenhofer(1983). The data were analyzed for frequency and percentage, mean, SD, t-test, ANOVA, Pearson's correlation coefficient, stepwise multiple regression, using SAS PC+ Program. The findings were as it follows : 1. The mean of professional autonomy and self-concept were 152+/-18.48, 70.65+/-8.20(2.62), respectively. These showed mid level of professional autonomy and self-concept. 2. Professional autonomy of clinical nurses was found to vary significantly according to total years of clinical experience(F=4.49, p<0.01), position(F=3.49, p<0.05), and state under study for the degree(F=3.83, p<0.05). Professional self-concept was found to vary significantly according to age(F=3.52, p<0.05), marital status(F=7.39, p<0.001), total years of clinical experience(F=3.59, p<0.05), position(F=5.22, p<0.01), the expectant period being on the duty as clinical nurse(F=8.34, p<0.001), and motivation of choosing nursing(F=5.17, p<0.001). 3. The statistical relationship between clinical nurses' profession autonomy and self-concept was found as positive correlation9r=0.42246, p<0.001). 4. Professional autonomy was the highest factor predicting professional self-concept(17.85%). Professional autonomy and marital status accounted for 20.60% in professional self-concept of clinical nurses. In conclusion, Professional autonomy and self-concept of clinical nurses showed significantly positive relationship. Therefore, nursing education needs to develop programs and policies to increase professional autonomy and self-concept of clinical nurses.
Absenteeism ; Education, Nursing ; Humans ; Marital Status ; Motivation ; Nursing ; Nursing Theory ; Professional Autonomy*

With the advent of faster scan time and new computer program, a scanning technique called “dynamic computedtomography” has become possible. Dynamic CT consists of performing multiple rappid sequence scans after injectionof contrast material. The authors have evaluated the clinical usefulness of CT and dynamic CT of 93 patients withbrain infarction and/or ischemia during the period of 17 months from April 1983 to Aug. 1983 to Aug. 1984 inDepartment of Radiology, Chonbuk National University Hospital. The results were as follows; 1. The agedistribution ranged from 18 years to 78 years. Among them the most common age group was between 50 years and 59years(40.9%). 2. The sites of brain infarction were cerebral lobes(63 cases,68), basal ganglia(15 cases, 16.1%)and mlultiple sites(6 cases, 6.4%). The common affected site was middle cerebral artery territories. 3. Thecontrast enhancement of acute infarction was noted in 14 cases(17.5%) which occured commonly between 3 days and 2weeks from ictus. 4. The patterns of time-density curve in brain infarction and/or ischemia were as follow: a .Depression of slow wash-in phase was 20 cases(59%). b. Lower peak concentration was 17 cases(50%), c. Lower anddelayed peak concentration was 7 cases(21%), d. No definite peak concentration was 6 cases(18%). First threepatterns of time-density curve were thought as relatively characteristic curve of brain infarction and/orischemia. 5. Two cases that showed negative findings on precontrast CT scan appeared to be positive findings ashypodensity on postcontrast CT scan and were confirmed as brain infarction by dynamic CT. 6. The diagnostic entityof dynamic CT scan were as follows: a. large artery thrombotic infarction were 23 cases (58%). b. lacunarinfarction were 6 cases (15%). c. ischemia were 5 cases (13%), d. normal were 5 cases(13%), In six cases oflacunar infarction which was doubtful hypodensity on pre-and postcontrast CT scan had a marked difference in CT#(HU) on absolute scale graph of dynamic CT, so diagnosis of lacunar infarction could be made easily. 7. Theclinical values of dynamic CT consist in not only diagnosis of lacunar infarction but also evaluation ofeffectiveness of medical or surgical treatment.
Arteries ; Brain Infarction ; Brain ; Depression ; Diagnosis ; Humans ; Infarction ; Ischemia ; Jeollabuk-do ; Middle Cerebral Artery ; Stroke, Lacunar ; Tomography, X-Ray Computed

Schwannoma or neurilemmoma is an uncommon neoplasm, and it is derived from the peripheral nerve sheath. These tumors most frequently occur in the head, neck and flexor surfaces of the upper and lower extremities, while the porta hepatis and retroperitoneum are rarely implicated. We report here on a case of benign schwannoma in the porta hepatis with compression of the common bile duct, and this was successfully treated by surgical excision. The patient was a 63-year-old woman who had a slow growing upper abdominal mass for 3 years. The abdominal CT scan showed a 12 cm-sized cystic mass with a solid portion, and this was accompanied with intrahepatic bile duct dilatation. Abdominal exploration revealed a yellowish, cystic, encapsulated mass attached to the inferior vena cava, portal vein, the common bile duct and the liver. There has been no evidence of recurrence during 36 months of follow-up.
Bile Ducts, Intrahepatic ; Common Bile Duct ; Dilatation ; Female ; Follow-Up Studies ; Head ; Humans ; Liver ; Lower Extremity ; Middle Aged ; Neck ; Neurilemmoma ; Peripheral Nerves ; Portal Vein ; Recurrence ; Vena Cava, Inferior

The size of spinal canal is mesured to detect the lumbar spinal stenosis syndrome and expanding intraspinaltumors by CT. This study was desinged for taking accurate measurement of the normal lumbar spinal canal in Koreanadults. The anteroposterior diameter, interpediculate distance and cross-sectional area of lumbar spinal canalwere measured in 110 normal adults. The results were as follows; 1. The window center that showed identical valueconsistent with actual measurement of phantom was between + 160HU and + 240HU and the window width was below +300HU. 2. In anteroposterio diameter, upper part of the canal was larger value than that of middle and lowerparts, but in interpediculate distance, lower part of the canal revealed larger value than that of upper andmiddle parts. There was no significant difference in cross-sectional area. 3. All measurements male were largerthan those of female at all levels of the spinal canal and 42 measurements(58%) were significant statisstically.4. Compared with Americans, Korean showed lower value in anteriopsterior diameter and cross-sectional area buthigher value in interpediculate distance. 5. Above results should contribute to making an another criteria fordiagnosing the lumbar spinal stenosis in Koreans.
Adult ; Asian Americans ; Female ; Humans ; Male ; Spinal Canal ; Spinal Stenosis

PURPOSE: To evaluate the success rates according to the shape of rhinostomy after endonasal dacryocystorhinostomy. METHODS: We analyzed 131 patients (188 cases) who had undergone endonasal dacryocystorhinostomy with a minimum follow-up of 6 months. After surgery, all cases were classified into flat, alcove, concave, or concealed concave types according to Jane's rhinostomy classification. Patency to irrigation and improved symptoms were considered indicative of a successful outcome. RESULTS: There were 81 flat type patients (125 cases), 31 alcove type patients (42 cases), 19 concave type patients (21 cases), and no cases were classified as concealed concave type. The success rates were 75.2%, 85.7%, 81.0% respectively, and the most common cause of failure was the formation of granulation within the ostium. The success rates did not significantly vary according to the shape of rhinostomy (p=0.144). CONCLUSIONS: The success rates after endonasal dacryocystorhinostomy of flat, alcove, and concave types in turn were 75.2%, 85.7%, and 81.0%.
Dacryocystorhinostomy ; Follow-Up Studies ; Humans

PURPOSE: To determine the intraocular pressure (IOP) lowering effects on the change of anterior chamber depth (ACD), corneal thickness, corneal cell area and density in normal eyes. METHODS: We investigated 58 eyes of 29 volunteers for this study whose refractive error was +/-3 D, IOP was below 21 mmHg, anterior segment and fundus was within normal limit. All of them had normal visual fields. They were randomly classified into two groups. Anterior chamber depth, IOP, central corneal thickness, cell density, cell area, and coefficient of variation of corneal endothelium were measured by single observer in each group. After oral medication of 50% glycerin 1 cc/kg (body weight) in group 1 and Diamox 500 mg and K-contin 600 mg in group 2, IOP, anterior chamber depth, central corneal thickness, cell density, cell area, and coefficient of variation were measured at 1, 2, and 3 hours. RESULTS: In glycerin group after 1 hour, decreased IOP was stastically significant (P<0.05). In Diamox group after 2 hours, decreased IOP was stastically significant (P<0.05). But the change of anterior chamber depth, central corneal thickness, cell density, cell area, and coeff icient of variation was not stastically significant (p>0.05). There was no significant correlation between decreased IOP and the change of anterior chamber depth, central corneal thickness, cell density, cell area, and coefficient of variation. The IOP change was not statistically different between the two groups. CONCLUSIONS: There was no stastically significant correlation between decreased IOP in normal range and the change of ACD, central corneal thickness, cell density, cell area, and coefficient of variation.
Acetazolamide ; Anterior Chamber* ; Cell Count ; Endothelium, Corneal ; Glycerol ; Intraocular Pressure* ; Reference Values ; Refractive Errors ; Visual Fields ; Volunteers

Situs inversus refers to a mirror image of the viscera, while situs solitus is defined as the normal anatomical situation. Several cases of successful liver transplantation for situs inversus recipients have been reported, and modifications of the standard surgical techniques were used. We report here on a case of cadaveric liver transplantation in an end-stage liver disease patient with situs inversus. The donor liver was rotated clockwise 90 degrees to the left with the right lobe lying in the left upper quadrant and the left lobe pointing down into the left iliac fossa. The donor's suprahepatic vena cava was oversewn and the infrahepatic vena cava anastomosed end to side to the recipient's inferior vena cava. The postoperative course was good until the postoperative 26th day, when rupture of a hepatic artery pseudoaneurysm occurred. An emergency laparotomy was done and the hepatic artery was ligated. Despite the hepatic artery ligation, the liver function recovered quite well. But sudden intracranial hemorrhage developed on the postoperative 28th day and sadly, the patient expired on the postoperative 30th day. Complete preoperative evaluation of the recipient is essential for the operative planning, and careful donor selection should be attempted to obtain a smaller graft to allow maximum flexibility for placing the donor liver. The use of a reduced-sized graft should be considered in the case for which a smaller graft is not available. In conclusion, adult situs inversus is no longer a contraindication for a liver transplant, although technical difficulties do exist for this procedure.
Adult ; Aneurysm, False ; Cadaver ; Deception ; Donor Selection ; Emergencies ; Hepatic Artery ; Humans ; Intracranial Hemorrhages ; Laparotomy ; Ligation ; Liver Diseases ; Liver Transplantation* ; Liver* ; Pliability ; Rupture ; Situs Inversus* ; Tissue Donors ; Transplants ; Vena Cava, Inferior ; Viscera

PURPOSE: Adverse sexual experiences such as erectile dysfunction (ED), loss of libido, and ejaculation disorders have been consistent side effects of 5-alpha reductase inhibitors (5ARI). The aim of this study was to evaluate the effects of 5ARI (finasteride) treatment on semen parameters and contraction of the corpus cavernosum and seminal vesicles in male rabbits. MATERIALS AND METHODS: Adult male New Zealand White rabbits (n=10) were randomized into 2 groups: finasteride-treatment (5ARI) group and vehicle-treatment (control) group. The 5ARI group received daily oral finasteride (10 mg/day) by gavage for 4~6 weeks, and the control group received the same concentration of the vehicle. The semen volume and semen parameters between the 2 groups were compared; thereafter, contraction or relaxation responses of smooth muscle strips of the corpus cavernosum and seminal vesicles were observed in an organ bath. RESULTS: Semen magnesium (14.2 vs 5.1 mg/dl) and protein (2.2 vs 1.6 g/dl) concentrations were significantly lower in the 5ARI group than in the control group. The concentrations of other parameters such as electrolytes (Na/K/Cl), fructose, and citrate did not differ between the 2 groups. The contractile responses to norepinephrine (NE) significantly increased in the 5ARI group compared to the control group and the relaxation responses to acetylcholine (ACh) or sodium nitroprusside (SNP) also increased in the 5ARI group. The contractile responses of the seminal vesicular strips to NE significantly decreased in the 5ARI group compared with the control group. CONCLUSIONS: The results suggest that finasteride may decrease contraction of seminal vesicle tissue and alter semen parameters. The effect of finasteride on erectile tissue was double-faced; enhancing both contraction and relaxation. Further study is needed in this respect.
5-alpha Reductase Inhibitors ; Acetylcholine ; Adult ; Citric Acid ; Contracts ; Ejaculation ; Electrolytes ; Erectile Dysfunction ; Finasteride ; Fructose ; Humans ; Libido ; Magnesium ; Male ; Muscle, Smooth ; Nitroprusside ; Norepinephrine ; Oxidoreductases ; Rabbits ; Relaxation ; Semen ; Seminal Vesicles

Meckel's diverticulum is an embryologic derivative of the omphalomesenteric duct and the most commonly encountered congenital anomaly of the gastrointestinal tract, affecting 1% to 2% of the general population. Although this prevalence is relatively low, Meckel's diverticulum is occasionally encountered as an incidental identification during abdominal exploration and can be associated with several life-threatening disease states, such as massive intestinal bleeding, intestinal obstruction, or on rare occasion, perforation. The management of a Meckel's diverticulum found incidentally on laparotomy is controversial because the rate of complications developing from the diverticulum remains uncertain. The data in this report are based on 18 cases of Meckel's diverticulum which were treated at the Department of Surgery, InJe University Sanggye Paik Hospital, during the 7 years between January 1990 and December 1996. The results are as follows: 1) The overall sex ratio of males to females was 5 : 1 and in the symptomatic group, the ratio was 6 : 1. 2) Ninety percent of the patients were under 40 years of age, and 56% were under 10. 3) The diverticula were located from 20 cm to 100 cm proximal to the ileocecal valve, and the average range was 53 cm from the ileocecal valve. Fifteen cases were located at the antimesenteric border, and 3 cases at the mesenteric border of the ileum. 4) The lengths of the diverticula ranged from 1cm to 6cm, and the diameters ranged from 0.5 cm to 4.5 cm. 5) Appendicitis and intestinal obstruction were the most frequent preoperative diagnoses in the symptomatic group. 6) The common complications were intestinal obstruction and inflammation. 7) Heterotopic tissues were found in three patients and all of them were ectopic gastric mucosa. 8) The treatment was a diverticulectomy or a segmental resection of the involved bowel. 9) Postoperative complications were found in three of the asymptomatic group: two early intestinal obstructions and one wound infection.
Appendicitis ; Choristoma ; Diagnosis ; Diverticulum ; Female ; Gastric Mucosa ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Ileocecal Valve ; Ileum ; Inflammation ; Intestinal Obstruction ; Laparotomy ; Male ; Meckel Diverticulum* ; Postoperative Complications ; Prevalence ; Sex Ratio ; Vitelline Duct ; Wound Infection

This study evaluated the pharmacokinetic profile and therapeutic efficacy of piroxicam (PX), a long acting non-steroidal anti-inflammatory drug for the treatment of arthritis, following intra-articular (IA) injection in comparison to the pharmacokinetic profile and therapeutic efficacy of PX after intramuscular (IM) injection. In the pharmacokinetic study in rats, systemic exposure and pharmacokinetic parameters of PX after a single IA dose were compared with systemic exposure and pharmacokinetic parameters of PX after administration of the same dose IM (0.6 mg/kg). The anti-inflammatory and analgesic effects of IA PX were evaluated simultaneously in a monoiodoacetate-induced osteoarthritis rat model. The plasma PX concentration rapidly rose following IA injection, and it was comparable to the plasma PX concentration following IM injection, suggesting the rapid efflux of the drug molecule from the joint cavity. However, in the efficacy study, the IA PX administration significantly reduced the knee swelling by reducing the level of prostaglandin E2 in the joint, compared to that following administration of IA vehicle and after administration of the IM PX dose. In addition, we found that the anti-inflammatory and anti-nociceptive efficacies of IA PX were synergistically increased upon co-treatment with hyaluronic acid (HA), a potent agent for the treatment of osteoarthritis, at the weight ratio of 1:1 or 1:2, and these effects were more pronounced than those following administration of HA or PX alone. In conclusion, this study demonstrated the efficacy of the IA use of PX alone and/or in combination with HA in osteoarthritis.
Animals ; Arthritis ; Dinoprostone ; Hyaluronic Acid ; Injections, Intra-Articular ; Joints ; Knee ; Models, Animal ; Osteoarthritis ; Pharmacokinetics* ; Piroxicam* ; Plasma ; Rats*