This quasi -experimental study was intended to test the effect of self-help group program, which is one of the way to enhance adaptation and quality of life to mastectomy patients. Data was collected from July 14, 1998 to Oct. 31, 1998 at two Medical Center in Seoul. The subjects for this study were the patients who had undergone mastectomy and were follow-up: 14 in experimental group and 14 in control group matched with age and treatment. The instruments for this study were adaptation in Lee(1994)'s physical symptom questionnaire, Zung's Self-rating Depression Scale (SDS, 1965), and Self-rating Anxiety Scale (SAS, 1970), quality of life in Spranger(1996)'s and No(1988)'s Quality of Life Questionnaire. The self-help group program for mastectomy patients was developed based on literature review and pilot study by the investigator. The subjects of experimental group were participated in 6 weeks self - help group program and were received arm and shoulder exercise, informational support, and interpersonal support by group members. The control group were received no intervention. Both group answered questionnaires prior to intervention and 6 weeks later. The data analyzed by frequency, chi-test, Mann-Whitney U test, Wilcoxon Signed Rank test, Pearson's Correlation Coefficient and Stepwise Multiple Regression using SPSS WIN. The results are as follows; Hypothesis 1, The experimental group with the self-help group program will have a higher score on adaptation state than control group. was not supported. But the posttest score of anxiety and depression in experimental group were declined and the depression score was reduced relatively. Hypothesis 2, The experimental group with the selp-help group program will have a higher score on quality of life than control group. was not supported. But the posttest score of quality of life in experimental group was reduced relatively. Hypothesis 3, The higher adaptation state of mastectomy patients, the higher quality of life. was supported(r=.80, p .001). Additionally, the lower physical symptom, depression and anxiety, the higher quality of life. And depression, which was the main predictor of quality of life, accounted for 59.5%, depression and anxiety accounted for 65.5% of the variance in quality of life. In conclusion, when the self-help group program was intervened to mastectomy patients, it was tended to increase quality of life and to reduce depression and anxiety. So self-help group program can be considered useful nursing intervention effect on adaptation and quality of life of mastectomy patients. With discussion, I suggest repeated further research on self-help group with appropriate sample size and longitudinal study. Also during adjuvant therapy, it is needed to develop convenient method to be supported from peer group and family, such as computer mediated support group.
Anxiety ; Arm ; Depression ; Follow-Up Studies ; Humans ; Longitudinal Studies ; Mastectomy* ; Nursing ; Peer Group ; Pilot Projects ; Quality of Life* ; Surveys and Questionnaires ; Research Personnel ; Sample Size ; Self-Help Groups* ; Seoul ; Shoulder

PURPOSE: This study is to analyze the research trends centering on the theses related to CAT released in nursing of Korea. METHOD: The researcher collected the academic degrees and theses published on the book of the academic society from 1980 to 2001, and examined 88 domestic dissertations on nursing science of the CAT. RESULT: 1) By department, the results were: the nursing thesis 88(43.3%), medical field 45(22.1%), psychology-counseling education 28(14%). 2) In the type of the CAT in nursing, the results were: acupressure 28(31.5%), Dan-Jeon Breathing 14(15.7%), aroma therapy 5(5.6%) in order. 3) The number of theses increased every year after 1997. 4) As for the type of study design, the results were: the experimental research had the most(47), and the survey research(30). 5) As for the subject, the results were: patients with disease(44), healthy adults(29), literature(9) and medical staff were only 6 theses. 6) In the theme of the theses, the results were: the effect of therapy(76), the experience of therapy(26), adaptation of nursing of therapy(11) and literature review were 7. CONCLUSION: More research needs to be encouraged in the unsatisfactory fields. Researches should be conducted to extend into the practical fields as Korean nursing mediation, project for the establishment of health policies should be conducted.
Acupressure ; Animals ; Aromatherapy ; Cats ; Education ; Health Policy ; Humans ; Korea* ; Medical Staff ; Negotiating ; Nursing* ; Respiration

PURPOSE: Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen in the intensive care units (ICUs). The purpose of this case-control study is to identify risk factors for acquisition of MRSA during ICU stays in patients with and without MRSA. METHOD: The study was conducted in a 16 beds-neurosurgical intensive care unit of a 2200-bed tertiary care university hospital in Seoul, Korea. Medical record and Critical Classification Scoring System were reviewed retrospectively in patients who were admitted more than 3 days from August 1, 2003 to May 30, 2004. Cases and controls were matched for age and gender. The obtained specimens were nasal swab and sputum. RESULT: There were 950 patients' admissions during the period. Among them, MRSA was isolated from twenty-three patients who were considered as hospital acquired. Artificial airway (p=.045), frequency of suction (p=.002), nasogastric tube (p=.004), wound drain (p=.045), and vancomycin (p=.019) were risk factors for MRSA acquisition in univariate analysis. Frequency of suction (p=.012, OR 3.5) was revealed as the only risk factor in multivariate conditional logistic regression. CONCLUSION: Our findings give support to recent studies that suggest that frequent physical contact may increase the nosocomial acquisition of MRSA in a neurosurgical ICU.
Case-Control Studies* ; Classification ; Humans ; Intensive Care Units ; Critical Care* ; Korea ; Logistic Models ; Medical Records ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Retrospective Studies ; Risk Factors* ; Seoul ; Sputum ; Suction ; Tertiary Healthcare ; Vancomycin ; Wounds and Injuries

Background: Postoperative sore throat is a complaint after general anesthesia of multifactorial etiology. The laryngeal mask airway (LMA) reduces sore throat and discomfort during maintenance of the airway and make patients more comfortable. The purpose of this study was to compare effect of patient's position during operation on postoperative sore throat after the use of LMA. Methods: The fifty three patients were randomly divided into two groups. Group 1 (n=30) was underwent general anesthesia with supine position and group 2 (n=23) with prone position. After the LMA was positioned in the hypopharynx and the cuff inflated, fiberoptic laryngoscope was immediately passed down through the LMA. Number of attempts, degree of postoperative sore throat and other complications were also noted. Results: The incidence of postoperative sore throat after the use of LMA was 10% in supine position and 4% in prone position. But the difference between the groups was not statistically significant. All of the reported sore throats were rated as mild. Conclusions: Postoperative sore throat after the use of LMA is mild and the incidence is not affected by the prone position during the operation.
Anesthesia, General ; Humans ; Hypopharynx ; Incidence ; Laryngeal Masks* ; Laryngoscopes ; Pharyngitis* ; Prone Position* ; Supine Position

One of the indications of outpatient surgery is chemical peeling of the face. It usually requires deep sedation with analgesia of short duration. For this purpose we tried to use ketamine(1 mg/kg) and midazolam(0.1 mg/kg) but experienced frequent hypertension and tachycardia. We tried to use beta blocker, esmolol for the of control blood pressure and heart rate. The patients were divided into two groups. In control group, eighty-five patients were anesthetized with bolus intravenous injection of I mg/kg of ketamine and 0.1 mg/kg of midazolam. In esmolol group, eighty-three patients reed a continuous infusion of esmolol(500 mcg/kg/min for initial dose, followed by 200 mcg/kg/min for maintenance) in addition to midazolam(0.1 mg/kg) and ketamine(1 mg/kg). During operation, we observed systolic, diastolic blood pressure and peripheral oxygen saturation(SaO2). All patients were allowed to breathe spontaneously. There was no case of airway obstruction and SaO2 value was over 98% in most cases. So we investigated the effects of esmolol on blood pressure,heart rate,emergence sequelae and patients acceptance in the anesthesia with ketamine and midazolam in the patient of facial chemical peeling. The results were as follows: 1) No one could recall. 2) There were no differences on the status of mood, emotion and patient's positive acceptance between two groups 3) Blood pressure and heart rate were increased during anesthesia with midazolam and ketamine. But esmolol attenuated this response, significantly(P<0.05). We concluded that esmolol added benefits of control of blood pressure and heart rate in the anesthesia of facial chemical peeling. But the control of the high blood pressure is not so easy, so it is needed to find out the optimal dosage of esmolol for complete blocking of the sympathetic response without complications.
Airway Obstruction ; Ambulatory Surgical Procedures ; Analgesia ; Anesthesia* ; Blood Pressure ; Deep Sedation ; Heart Rate ; Humans ; Hypertension ; Injections, Intravenous ; Ketamine* ; Midazolam* ; Oxygen ; Tachycardia

PURPOSE: The purpose of this study was to analyze trends in complementary and alternative therapy in nursing research in Korea. METHOD: The researchers examined academic theses and dissertations published from 1990 to 2002, and 151 articles were used for the analysis. RESULT: Nursing research on CAT increased rapidly from 1995. Articles with quantitative research designs made up 93.9% of the total and there were more experimental studies than non-experimental studies. Patients who had surgery, mental disorders, renal failure, hypertension, arthritis, dementia & cancer were the most frequently participants in studies on CAT. The type of CAT used in nursing research were mind-body therapy (65.8%), manual healing therapy (28.7%), phamacologic & biological therapy (3.7%), bioelectromagnetics (0.9%) and herbal therapy (0.9%). In 44 articles both psychological and physiological parameters were used as dependent variables. In 34 articles only physiological parameters were used and in 13 only psychological parameters. The most frequently used physiological parameters in CAT were pain, physiological function and vital signs, while the most used psychological parameters were anxiety, depression and stress. CONCLUSION: More studies about CAT are needed to extend the role and fields for professional nursing. There is a need to conduct qualitative studies in nursing about the experiences of patients who receive CAT and nurses who use CAT.
Animals ; Anxiety ; Arthritis ; Biological Therapy ; Cats ; Dementia ; Depression ; Humans ; Hypertension ; Korea* ; Mental Disorders ; Mind-Body Therapies ; Nursing Research* ; Nursing* ; Phytotherapy ; Renal Insufficiency ; Research Design ; Vital Signs

BACKGROUND: The minimal effect of etomidate on cardiovascular function sets it apart from other rapid fast-acting induction agents. Clinically, etomidate has been reported to cause minimal effects on systemic hemodynamics and PVR. There are few reports of direct effects of etomidate in pulmonary vessels or other vascular beds. METHODS: We studied the effects of etomidate on the tension of the aortic smooth muscle using an isolated rat thoracic aortic preparation. We studied the cumulative effect of etomidate in a rat thoracic aorta after phenylephrine (PE) pretreating, the cumulative effect of phenylephrine (PE) in a rat thoracic aorta with or without endothelium after etomidate pretreating, the effect of L-NAME and indomethacin and metylene blue in a rat thoracic aorta contractile response for phenylephrine after etomidate pretreating, and the effects of etomidate on a phenylephrine and ECF Ca2 induced contraction in a rat thoracic aorta. RESULTS: Etomidate produced dose-dependent relaxation and these relaxation responses were significantly less in a thoracic aorta with denuded endothelium than in a thoracic aorta with intact endothelium. Response of PE contraction with etomidate was increased by pretreatment with L-NAME and methylene blue, but was decreased by pretreatment with indomethacin in intact endothelium. Response of PE contraction had no significant change in Ca2 free, but Etomidate significantly attenuated the response of PE contraction to Ca2 entry. CONCLUSIONS: We have found that vasodilation produced by etomidate is endothelium-dependent and this effect is related with cyclooxygenase inhibition and also guanylate cyclase activation. In addition, a relaxation effect is caused by an extracellular Ca2 influx blockade through receptor-operated calcium channels.
Animals ; Aorta, Thoracic* ; Arteries ; Calcium Channels ; Endothelium ; Etomidate* ; Guanylate Cyclase ; Hemodynamics ; Indomethacin ; Methylene Blue ; Muscle, Smooth ; NG-Nitroarginine Methyl Ester ; Phenylephrine ; Prostaglandin-Endoperoxide Synthases ; Rats* ; Relaxation ; Vasodilation

No abstract available.
Humans ; T-Lymphocytes*

PURPOSE: The nuclear factor-kappa B (NF-kappa B) has been known to regulate the inflammatory and immune process by transcription of inflammatory intermediates. The purpose of the present study is to show the difference in activity of NF-kappa B and its inhibitory factor-I kappa B alpha in patients with rheumatoid arthritis, osteoarthritis and normal control subjects. MATERIALS AND METHODS: Synovial membrane samples were obtained at the time of orthopedic surgery from the knees of 7 patients with RA and 7 patients with OA. Two control samples were obtained from an amputee with no history of arthritis. We designed the primer of the subunit p65 of NF-kappa B and I kappa B alpha, measured the activity of them by RT-PCR, and analyzed the expression of NF-kappa B by immunohistochemical staining. RESULTS: From the results of RT-PCR, the expression levels of NF-kappa B was found to be higher in synovial tissues obtained from patients with RA than from synovial tissue obtained from patients with OA, and the least from the control group. The expression levels of I kappa B alpha were not different statistically among the three groups. Immunohistochemical staining for the NF-kappa B was dominant in synovial tissue from patients with RA. The result of immunohistochemical staining was similar to the results of RT-PCR for NF-kappa B. The localization of the staining was predominantly nuclear. CONCLUSION: In this study, activity of NF-kappa B of rheumatoid arthritis was higher than the other group, but expressions of I kappa B alpha were no different between the diseases. Further studies about specific inhibitors of NF-kappa B will benefit the development of rheumatoid arthritis regimens with greater efficacy.
Amputees ; Arthritis ; Arthritis, Rheumatoid* ; Humans ; I-kappa B Proteins* ; Knee ; NF-kappa B* ; Orthopedics ; Osteoarthritis* ; Synovial Membrane

Staphylococcus aureus is the most common bacterium present in upper respiratory tract, and the toxins it produced are involved in allergic inflammation pathogenesis. In this study, we investigated the clinical significance of IgE in association with staphylococcal superantigens in allergic asthma with rhinitis (BAwAR) and allergic rhinitis alone (AR). We recruited 100 patients with BAwAR (group I), 100 patients with AR (group II), and 88 healthy controls (group III). Patients were clinically diagnosed by physicians, and were sensitized to house dust mites. Specific IgE antibodies to staphylococcal superantigen A (SEA), B (SEB), and toxic shock syndrome toxin-1 (TSST-1) were measured using the ImmunoCAP system. Other clinical parameters were retrospectively analyzed. All specific IgE antibodies to SEA, SEB, and TSST-1 were detected most frequently in group I (22%, 21%, and 27%), followed by group II (11%, 14%, and 21%) and group III (4.5%, 3.4%, and 2.3%). Absolute values of serum specific IgE to SEA, SEB, and TSST-1 were also significantly higher in group I (0.300+/-1.533 kU/L, 0.663+/-2.933 kU/L, and 0.581+/-1.931 kU/L) and group II (0.502+/-2.011 kU/L, 0.695+/-3.337 kU/L, and 1.067+/-4.688 kU/L) compared to those in group III (0.03+/-0.133 kU/L, 0.03+/-0.14 kU/L, and 0.028+/-0.112 kU/L). The prevalence of serum specific IgE to SEA was significantly higher in group I compared to group II (P=0.025). Blood eosinophil counts were significantly higher in patients with specific IgE to SEA or SEB, and higher serum levels of specific IgE to house dust mites were noted in patients with specific IgE to TSST-1. In conclusion, the present study suggested that IgE responses to staphylococcal superantigens are prevalent in the sera of both BAwAR and AR patients. This may contribute to an augmented IgE response to indoor allergens and eosinophilic inflammation.
Allergens ; Antibodies ; Asthma* ; Eosinophils ; Humans ; Immunoglobulin E* ; Inflammation ; Prevalence* ; Pyroglyphidae ; Respiratory System ; Retrospective Studies ; Rhinitis* ; Shock, Septic ; Staphylococcus aureus ; Superantigens*