No abstract available.
Animals ; Cricetinae* ; Fertilization in Vitro* ; Humans*

Comflicting results have been reported on whether ketamine potentiates the neuromuscular effect of succinylcholine or other non-depolarizing agents. Notably, there has been no reported clinical evatuation of the influence of ketamine upon the neuromuscular action of vecuronium a new muscle relaxant. The present study was undertaken to estimate the influence of ketamine upon the neuromuscular action of vecuronium with a single bolus injection of ED95. Forty-five ASA class l or ll surgical patients were divided into three groups: l, ll and lll and were given thiopental sodium(5mg/kg), ketamine 3mg/kg and ketamine 5mg/kg as induction agents, respectively. The duration and recovery index of group ll and lll (35.20+/-2.30 and 16.20+/-1.37 min., 52.60+/-3.98 and 25.47+/-3.78min., respectively) were longer than those in group l (24.87+/-1.59 and 10.66 +/- 1.23 min.). But group l had a lower TOF ratio(27.40+/-3.09%) at 75% single twitch recovery than group ll and lll (41.87+/-3.25 and 45.27+/-3.67%, respectively). The increase in duration and the recovery index of group lll were greater than that of group ll. It was concluded that ketamine woudly potentiate the neuromuscular action of vecuronium in a dose-dependent manner. We suggest that combination of ketamine and vecuronium requires careful postoperative neuromuscular monitoring for the recovery from a vecuronium induced neuromuscular block.
Humans ; Ketamine* ; Neuromuscular Agents ; Neuromuscular Blockade* ; Neuromuscular Monitoring ; Succinylcholine ; Thiopental ; Vecuronium Bromide

PURPOSE: To define and correlate characteristic sonographic and pathologic findings in men with gynecomastia. MATERIALS AND METHODS: We reviewed medical records and sonographic findings of 26 patients with pathologically proven gynecomastia. All of the chief symptoms, physical findings and causes were categorized. Characteristic sonographic patterns of gynecomastia were analyzed and compared with pathologic findings. RESULTS: Gynecomastia was most common in the 20- to 40-year-old age group (50%) 6;palpable mass was found in 62% of all those cases. Gynecomastia was unilateral or asymmetrical in 22 men (85%), and was caused idiopathically in 21 (81%). The characteristic sonographic patterns correlated with pathologic findings were as follows : (1) focal subareolar smooth oval (or triangular) indistinct margined homogeneous hypoechoic(or isoechoic) patterns were found in 14cases (54%). Eight of these (57%) were of the florid type of gynecomastia (67%) ; (2) diffuse homogeneous hyperechoic (or isoechoic) patterns were found in five cases (19%) ; four of these (80%) were of the intermediate or fibrotic type : (3) involuting female breast parenchymal patterns were found in seven cases (27%), of which six(86%) were of the intermediate or fibrotic type. CONCLUSION: The characteristic sonographic patterns of gynecomastia correlate closely with pathologic types related to the duration of the condition. Ultrasonography isa useful primary diagnostic modality for the evaluation of gynecomastia.
Adult ; Breast ; Female ; Gynecomastia* ; Humans ; Male ; Medical Records ; Ultrasonography

PURPOSE: To correlate the atypical sonographic patterns of fibroadenoma of the breast with the pathologicfindings. MATERIALS AND METHODS: Among 203 surgically proven 43 which were sonographi-cally atypicalfibroadenomas, were retrospectively reviewed. The diagnostic criteria for atypical va riety, as seen onsonography, were an ill-defined margin, microlobulated or irregular shape, heterogeneous internal echo-pattern,posterior shadowing, micro-calcification, and clefts. The atypical sonographic patterns of these 43 fibroadenomaswere analysed and compared with the pathologic findings. RESULTS: Among 43 lesions, ill-defined margins orirregular shapes were seen in 15 c a s e s, heterogeneous internal echo-patterns in 27, posterior attenuation innine, and clefts in seven. Thirty-seven (86%) of the 43 were predominantly ductal or hada mixed ductal and stromalcomponent. Eleven (73.3%) of fifteen ill-defined margin or irregular shaped lesions were caused by interdigitationof surrounding normal breast parenchyma and mass. Twenty two (81.5%) of 27 heterogeneous internal echo-pat-ternswere related to dilated ducts, phyllodes features, collagen bundles, adenosis, mi-crocalcification, or fatvacuoles. Eight (88.9%) of nine posterior attenuations were caused by collagen bundles, microcalcification, ductalproliferation or dilatation. All seven cases showing clefts revealed phyllodes features and dilated ducts. CONCLUSIONS: Most atypical fibroadenomas had a redominantly ductal or mixed component. Ill-defined margin orirregular shape was mainly due to interdigitation of normal surrounding parenchyma. Variable histologic featureswere related to the het-erogeneous internal echo-pattern, posterior shadowing, and the clefts revealed by atypicalsonographic findings.
Breast Neoplasms ; Breast* ; Collagen ; Dilatation ; Fibroadenoma* ; Retrospective Studies ; Shadowing (Histology) ; Ultrasonography*

PURPOSE: This study was done to evaluate the effects of a recreation therapy program on burn rehabilitation patients to determine if the program is an effective nursing intervention which can affect mental health problems and heart rate variability. METHODS: Subjects were 54 hospitalized burn rehabilitation patients (25 in the control group, 29 in the experimental group). The experimental group participated 6 times in a recreation therapy program led by a qualified instructor. Brief symptoms inventory-18 (somatization, anxiety, depression) questionnaire, and heart rate variability were checked before and after the recreation therapy program. RESULTS: The mental health scale showed significant differences in somatization (p<.001), anxiety (p<.001) and depression (p<.001). There was no significant difference in heart rate variability (autonomic activity, autonomic balance, stress resistance, stress parameter and fatigue, mean heart rate, electro-cardiac stability). CONCLUSION: The findings from this study suggest that a recreation therapy program is an effective nursing intervention to decrease the level of mental health problems of burn rehabilitation patients. However, a subsequent study is needed to develop an intervention program that will induce the effect of physiological parameters like heart rate variability (HRV).
Anxiety ; Burns* ; Depression ; Fatigue ; Heart Rate* ; Heart* ; Humans ; Mental Health* ; Nursing ; Recreation Therapy* ; Recreation* ; Rehabilitation*

PURPOSE: The purpose of this study is to analyze how the experiences of nurses influence their role model function when they are mothers of children who in turn have become nurses or nursing students. METHOD: The subjects of this study were 12 nurses, 8 of their children who became nurses and another 4 children then in training to become one. Data were collected through in-depth personal interviews and subsequently analyzed through a phenomenological approach. RESULTS: Four main themes were identified as follows; 'Persuasion and dissuasion,' 'Proud but still pathetic,' 'As mom and senior nurse' and 'Great to pass it down.' CONCLUSION: The results of this study show that the nurse as mother could be a positive professional role model for her children. However, they tended to stress the arduous clinical routines and poor work conditions nurses currently experience. Should such routines and conditions improve, mothers who are nurses would be more willing to recommend the nursing profession to their children. Improving the professional environment is thus important because inter-generation nursing mobility provides a reliable resource to recruit qualified and dedicated nursing personnel.
Career Mobility ; Child ; Humans ; Intergenerational Relations ; Mothers ; Nursing ; Professional Role ; Qualitative Research ; Students, Nursing

No abstract available.
Thyroid Diseases* ; Thyroid Gland*

No abstract available.
Thyroid Diseases* ; Thyroid Gland*

No abstract available.
Adult* ; Humans ; Technetium Tc 99m Dimercaptosuccinic Acid* ; Tomography, Emission-Computed, Single-Photon* ; Urinary Tract Infections* ; Urinary Tract*

PURPOSE: To assess the usefulness of MRI in the preoperative diagnosis of breast implant-relatedcomplications. MATERIALS AND METHODS: Thirty four breast implants in 17 patients were examined. Eight breasts hada history of repeated surgery due to rupture and in eight others, simultaneous interstitial silicone injection hadbeen performed. MR images of the 34 implants were prospectively analyzed for implant-related complications,without prior clinical information, and the findings were compared with the results of surgery. RESULTS: Theimplant-related complications seen on MRI were infections in three cases, seromas in two, and implant malpositionin two. The linguine sign was seen in eight cases and intraparenchymal silicone in 17. Among the 32 removedimplants, rupture was genuine in ten cases (nine, extracapsular; one, intracapsular). In evaluating the MRfindings of implant rupture, the linguine sign showed 80% sensitivity, 100% specificity and 93.8% accuracy.Intraparenchymal silicon also revealed high sensitivity (90%), but relatively low specificity and accuracy (63.7%and 71.9%, respectively); this was due to the difficulty of differentiating granulomas still present after aprevious rupture from injected silicone material. MRI was useful for visualization of implant migration, thedirect relationship of extended or extruded silicone in extracapsular rupture and the localization of siliconegranulomas, as seen on multiplanar images. The extent of infection was clearly demonstrated on contrast enhancedscan. There was relatively good correlation between the degree of contracture seen on physical examination andthat seen on MRI. CONCLUSION: MRI was an effective and useful method for the preoperative evaluation ofimplant-related complications; degree of contracture was successfully predicted.
Breast Implants ; Breast* ; Contracture ; Diagnosis ; Granuloma ; Humans ; Magnetic Resonance Imaging* ; Physical Examination ; Prospective Studies ; Rupture ; Sensitivity and Specificity ; Seroma ; Silicones