No abstract available.
Femoral Fractures* ; Hip Dislocation* ; Hip*

PURPOSE: The purpose of this study was to investigate the reality, status of clinical nurses' emotional labor and the relationship with physical discomfort, burnout, depression and social support. METHODS: A thousand three hundred sixteen clinical nurses from 42 hospitals nationwide participated in this study. Questionnaires were developed for evaluating the reality and status of emotional labor of clinical nurses after interviewing focus groups and reviewing literatures. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient. RESULTS: Ninety eight percent of nurses had answered having emotional labor and they experienced 82 times per year, 9.6 times during last a month which means they experience it every other day. The one who provoke emotional labor were patients, guardians, physicians, supervisor, and colleagues in sequence. Eighty percent of nurses had intention to leave their jobs after experiencing emotional labor. They were doing more surface acting than deep acting of emotional labor. CONCLUSION: Clinical nurses in Korea experienced excessively high level of emotional labor and delayed responding to clients' requests due to lack of time for caring each patient was revealed as one of the main causes of emotional labor.
Depression ; Focus Groups ; Humans ; Intention ; Korea

The incidences of posttraumatic avascular necrosis of the femoral head were variably reported. In 1980, Calandruccio reported its incidence of 14% in nondisplaced femoral neck fracture and 50% in displaced ones. In general, the prophylactic methods, such as core decompression, bone graft and trochanteric osteotomy were recommended for the treatment of early stages of femoral head avascular necrosis(Ficat-Arlet stage 1 or 2), while the primary replacement surgery for the advanced ones (Ficat-Arlet stage 3 or 4). One of our authors(Y.K. Chung) has performed five cases of corticocancellous bone grafts using combined autogenous free fibular graft and iliac cancellous bone graft, for the post-traumatic femoral head AVN from January 1985 to December 1989 at our hospital, and the following results are obtained: 1. Among the forty nine displaced adult femoral neck fractures, there were five eases of avascular necrosis(10. 2%). 2. There were three male patients and two female ones, and the average age of injury was 48 years old(30 to 57). 3. According to the type of fractures, there were four cases of subcapital fracture and one of transcervical fracture. All of the patients were performed closed reduction and internal fixation with compression hip screw system, including additional Knowles pinning in two cases. 4. Histological study with the excised femoral head, showed that there was no bony union between the grafted cancellous bone and the necrotic head, and the grafted bone has been changed to amorphous necrotic tissue. However, we found a solid consolidation of the grafted bone and the femoral neck portion.
Adult ; Decompression ; Female ; Femoral Neck Fractures ; Femur ; Femur Neck ; Head ; Hip ; Humans ; Incidence ; Male ; Necrosis ; Osteotomy ; Transplants

PURPOSE: We had examined the effect of high dose MTX loaded acrylic cement in the treatment of type II collagen induced arthritis. MATERIALS AND METHODS: we used inbreed rat(16weeks - 20weeks) and divided into control group and experimental groups. inbreed rat was induced arthritis by prepared collagen through injection at the tail base. The control group was injected with collagen only. but the experimental groups were inserted intraperitoneally MTX-loaded acryl cement: 25mg, 20mg, 15mg, and 10mg MTX in acrylic cement (0.5gm) respectively. The histopathologic results were investigated to determine the effect of MTX on the 3rd, 7th, 14th, 28th, 42th, and 56th day after inserting high dose MTX loaded acrylic cement which was inserted intraperitoneally 2weeks later of collagenase injection RESULTS: The arthritis index of the MTX-loaded groups had reduced than arthritis index of the control group according to the dosage and In histopathological test, the experimental group injected with 15mg, 20mg, and 25mg of MTX had distinctive effects, compared to the control group, as dosage chronologically. CONCLUSION: The treatment of high-dose MTX loaded acrylic cement might be effective on rheumatoid arthritis managment.
Animals ; Arthritis* ; Arthritis, Rheumatoid ; Collagen ; Collagen Type II* ; Collagenases ; Methotrexate* ; Rats* ; Tail

PURPOSE: To evaluate the relation of the location and cell type of lung cancer to the location and degree in coexistent emphysema on high-resolution computed tomography (HRCT) scans. MATERIALS AND METHODS: Ninety-eight of 209 lung cancer patients having HRCT scans were retrospectively analyzed to assess the total lung emphysema and peritumoral regional emphysema. Single and primary lung cancers were included. The clinical data, including sex, age, smoking history and the pathologic cancer subtype, were recorded to correlate with the HRCT findings. The lobar distribution, central-peripheral predominance, surrounding parenchymal abnormality for cancer, cephalocaudal predominance, and subtype for emphysema were analyzed on HRCT. Using a CT scoring method, we scored the whole lung emphysema and peritumoral emphysema, and correlated the grading of emphysema with pulmonary functional values. RESULTS: Sixty-nine of 98 patients with lung cancer (71%) had emphysema. Lung cancer with emphysema was significantly higher in men than in women, and was significantly related to smoking. The mean age of cancer patients without emphysema was significantly lower than that of cancer patients with emphysema (68 yrs vs. 61 yrs, p=0.0006). Emphysema of grade I (0-25%) was found in 52 cases, grade II (25-50%) in 15, and grade III (50-75%) in 2. Total emphysema score was paralleled to peritumoral emphysema score in 64.3%, while the remaining patients had a higher peritumoral emphysema score (grade II or III) than total emphysema score (grade 0 or I). There was no statistical correlation in the developmental location between the emphysema and the lung cancer (significant correlation was only noted in grade II group of total emphysema score). The incidence of non-small cell carcinoma tended to be higher than that of small cell carcinoma in the two groups. CONCLUSION: The possibility of lung cancer in patients with pulmonary nodule, coexisting emphysema, and especially in elderly patients having a history of smoking must be clarified on HRCT. The location or type of lung cancer was not significantly correlated to the location or the degree of coexistent emphysema.
Aged ; Carcinoma, Small Cell ; Emphysema* ; Female ; Humans ; Incidence ; Lung Neoplasms* ; Lung* ; Male ; Pulmonary Emphysema ; Research Design ; Retrospective Studies ; Smoke ; Smoking

This study covers comparison and examination of the clinical results of visual acuity recovery, astigmatic change and comparison of patients who underwented extracapsular cataract extraction(ECCE) with insertion of posterior chamber lens(PCL) or phacoemulsification(PE) with insertion of posterior chamber lens. Among 1446 patients who underwented ECCE with PCL or PE with PCL from April. 1983 to December, 1987. 623 patients being followed up their conditions during 6 months were selected. Visual acuity, astigmatism and keratometry were followed up at preoperative and postoperative period of 1 week, 1 month, 2 months, and 6 months. The results were as follows. 1. In PE with PCL, the recovery of visual acuity is earlier than in ECCE with PCL. 2. In PE with PCL, the post operative change of astigmatic axis to the against the rule is more rapid than in ECCE with PCL. 3. In PE with PCL, recovery of astigmatism is earlier than in ECCE with PCL and the amount of astigmatism is lower than in ECCE with PCL.
Astigmatism ; Axis, Cervical Vertebra ; Cataract Extraction* ; Cataract* ; Humans ; Phacoemulsification ; Postoperative Period ; Visual Acuity

BACKGROUND: Calcium antagonists are highly effective agents for lowering high blood pressure and play a very important role in the treatment of Patient with ischemic heart disease and various other cardiovascular disorder. Manidipine, a dihydropyridine-type ccalcium channel blocker, is a potent relaxant of the arteriolar smooth muscle. We studied ths new calcium channel blocker to evaluated the efficacy and safety in patients with essectial hypertension. METHODS: Twenty patients(ten women and ten men;range of age, 30-66 years old)with mild-to-moderate essential hypertension were enrolled in this study. After a placebo run-in phase of two weeks duration, 5mg-20mg manidipine once daily orally was administered for eight weeks. RESULTS: 1) At the end of 8 weeks of manidipine therapy, systolic and diastolic blood pressure were significantly reduced from 160.1+/-11.8/105.5+/-5.1mmHG in sitting, 160.1+/-12.1/104.5+/-5.4mmHG in supine, 157.1+/-17.0/104.1+/-5.3mmHg in standing to 128.4+/-10.1/85.2+/-5.7mmHg in sitting, 129.1+/-10.2/84.2+/-5.9mmHg in supine, 128.1+/-12.8/86.7+/-5.9mmHg in standing(p<0.01). 2) The pulse rate did dnot change significantly. 3) The reduction of mean systolic and diastolic blood pressur at the end of 8 weeks were 31.5+/-14.5/20.3+/-7.4mmHg in sitting. 4) There was no serious side effect except mild symptom, mild headache(6 casem 30%) and facial flushing(1 case, 5%). CONCLUSION: These results indicate that manidipine is an effective and safe antihypertensive agent in the treatment of mild and moderate essential hypertension.
Blood Pressure ; Calcium ; Calcium Channels ; Female ; Heart Rate ; Humans ; Hypertension* ; Muscle, Smooth ; Myocardial Ischemia

Progressive ischemia can result in gangrenous changes of the tissues. Most commonly the digits are affected initially, but progression to the hand is not unusual. Small amounts of infection superimposed on a severe chronic ischemic state can progress very rapidly to gangrene. Clinically, dry and wet gangrene should be differentiated. Dry gangrene represents mummification of tissue, and active purulent tissue and cellulitis are absent. Wet gangrene is characterized by active infection with cellulitis and purulent tissue planes and is an indication for urgent amputation to prevent ascending infection. We experienced a case of dry gangrenous extremity due to septic shock after anethesia.
Amputation ; Cellulitis ; Extremities* ; Gangrene ; Hand ; Humans ; Ischemia ; Shock, Septic*

Twenty patients with symptomatic congenital cysts in the liver, kidney, thyroid, and lower neck underwent, ultrasound guided percutaneous aspiration through a drainage catheter with temporary instillation of 95% ethanol into the cyst. Our procedure was based on the method as described by Bean and Rodan(16) in 1985. Additionaly, two othe steps were odded to prevent the dilutional effect of residual cyst fluid. One was the preliminary washing of the cyst with alcohol. The other was to treat with 30% replacement of alcohol every 10 minutes during the treatment secession. Minot complications of transient temperature elevation and hziness occurred, butj no major complications were encountered. After the alcohol treatment follow up examinations were performed with computed tomography or ultrasonography at 6 weeks. 6 months. 9 months and 15 months. Although there was diminished size, recurrence was noted in 6 of twenty patients(30%) at 6 weeks and one of twenty patients(5%) at 6 months. There was no recurrence at 9 months and 15 months. The results indicated that percutaneous aspiration and alcohol sclerotherapy are safe and effective therapy for symptomatic congenital cysts.
Catheters ; Cyst Fluid ; Drainage ; Ethanol ; Follow-Up Studies ; Humans ; Kidney ; Liver ; Methods ; Neck ; Recurrence ; Sclerotherapy* ; Thyroid Gland ; Ultrasonography

Congenitally corrected transposition of the great arteries is a rate congenital heart disease. In this discase, there is discordance between both the atria and ventricles and the ventricles and great vessels. The anatomic left ventricle lies on the rightside and is connected to the pulmonic trunk, whereas the anatomic right ventricles lies on the left side and functions as the systemic ventricle. Most patients have associated another cardiac anomalies and conduction disturbance.Less commonly, ventricular extrasystoles, paroxismal supraventricular tachycardia, WPW preexitaion and atrial fibrillation may be obserced. We report an adult case of congenitally corrected transposition of great arteries associated with paroxysmal atrial fibrillation and heart failure.
Adult* ; Arteries* ; Atrial Fibrillation* ; Chymopapain ; Heart Defects, Congenital ; Heart Failure* ; Heart Ventricles ; Heart* ; Humans ; Tachycardia, Supraventricular ; Transposition of Great Vessels ; Ventricular Premature Complexes