During thalamotomy, we have to use the various kinds of brain reference points. From 1989 to 1992, the authors performed streotactic thalamotomy or pallidotomy in 169 patients suffering from tremor. We measured and estimated the important intracerebral reference points. These data were very meaningful for stereotactic functional neurosurgery in the Korean medical community because it is obtained from Korean people. We have also estimated the average location of targets for tremor submission.
Brain ; Humans ; Neurosurgery ; Pallidotomy ; Statistics as Topic* ; Tremor

The large amount of hospital dat makes management complicated and nowadays the data can barely be managed without computerization. The authors classified and encoded the neurosurgical diseases to develop the "Autocode System", the automatic code transformation system using Fox-ProR, which is a database management program. Any diagnostic entity which is input by the user is transformed into a specific code automaticall. Such a procedure excludes the input error originating from mistyping or naming an unclassified entity. This program is not perfect yet, but it is thought to be effective in the neurosurgical department for data storage and searching. Further modification, functional improvement, and ultimately, unifying the system among the hospitals can make cooperative study and systematic data analysis possible.
Classification* ; Humans ; Information Storage and Retrieval ; Microcomputers* ; Neurosurgery ; Statistics as Topic

PURPOSE: This study was conducted to describe the effects of aroma inhalation on sleep and fatigue in night shift nurses. METHODS: The research design was one group pre-posttest design. The subjects were 17 night shift nurses who work at neurosurgery intensive care unit of K hospital of C university in Seoul. During three consequent night shifts, the participants were worn the Actigraph to measure the sleep pattern on their wrist since their first night shift work. The quality of sleep and fatigue was measured by survey when they awoke at 6 pm after second night shift work. And these measures were repeated during the night shifts in second and third week. Aroma inhalation was applied before going to bed after finishing each night shift work during second and third week. SPSS 12.0 program was used for data analysis. RESULTS: There were no statistically significant differences in sleep latency and total sleeping time. However, significant differences were found in the sleep efficiency, awakening number, sleep quality, subjective symptom and intensity of fatigue. CONCLUSION: These results showed that aroma inhalation had positive effects on the pattern and quality of sleep and reducing fatigue in night shift nurses.
Aromatherapy ; Fatigue ; Inhalation ; Intensive Care Units ; Neurosurgery ; Research Design ; Statistics as Topic ; Wrist

PURPOSE: This study was conducted to describe the effects of aroma inhalation on sleep and fatigue in night shift nurses. METHODS: The research design was one group pre-posttest design. The subjects were 17 night shift nurses who work at neurosurgery intensive care unit of K hospital of C university in Seoul. During three consequent night shifts, the participants were worn the Actigraph to measure the sleep pattern on their wrist since their first night shift work. The quality of sleep and fatigue was measured by survey when they awoke at 6 pm after second night shift work. And these measures were repeated during the night shifts in second and third week. Aroma inhalation was applied before going to bed after finishing each night shift work during second and third week. SPSS 12.0 program was used for data analysis. RESULTS: There were no statistically significant differences in sleep latency and total sleeping time. However, significant differences were found in the sleep efficiency, awakening number, sleep quality, subjective symptom and intensity of fatigue. CONCLUSION: These results showed that aroma inhalation had positive effects on the pattern and quality of sleep and reducing fatigue in night shift nurses.
Aromatherapy ; Fatigue ; Inhalation ; Intensive Care Units ; Neurosurgery ; Research Design ; Statistics as Topic ; Wrist

BACKGROUND: It is important to assess the level of consciousness in patients with brain injuries to determine modes of treatment and prognosis. We evaluated the Bispectral Index (BIS) to determine if it could be used as an objective tool for evaluation of the level of consciousness in brain-injured patients. We also compared the BIS values to clinical sedation scales such as the Glasgow Coma Scale (GCS), Richmond Agitation-Sedation Scale (RASS), and the Reaction Level Scale (RLS). METHODS: Thirty eight patients with brain injuries that were admitted to the neurosurgery intensive care unit (NSICU) were enrolled in this study. An investigator evaluated the clinical sedation scales (GCS, RASS, RLS), while a blind observer noted the BIS in the same patient. The BIS score was obtained three times at an interval of 5 hours. The BISs were measured for 1 minute at 5 min prior to the nursing assessment, during the nursing assessment, and at 5 min after the nursing assessment. The BISs used in the data analysis were the maximal, minimal, and mean values obtained during 1 min, which were defined as BISmax, BISmin, and BISmean. A Spearman's rank correlation coefficient was used to determine if the clinical sedation scales were correlated with the BIS scores. RESULTS: In 38 patients, the BISmax, BISmin, and BISmean were found to be significantly correlated with the GCS, RASS, and RLS. The BISmean had the highest correlation with GCS (r = 0.445, P < 0.01), while the BIS min had the lowest correlation with RLS (r = -0.278, P < 0.01). CONCLUSIONS: The results of BIS monitoring were found to be significantly correlated with sedation scales in patients with brain injuries. These findings suggest that BIS can be used as an objective and continuous method for assessment of the level of consciousness in patients with brain injury.
Brain ; Brain Injuries ; Consciousness ; Consciousness Monitors ; Glasgow Coma Scale ; Humans ; Intensive Care Units ; Neurosurgery ; Nursing Assessment ; Prognosis ; Research Personnel ; Statistics as Topic ; Weights and Measures

We report on the investigations and interventions conducted to contain an extended outbreak of Serratia marcescens bacteriuria that lasted for years in a neurosurgical intensive care unit (NSICU). A case-control study was performed to identify the risk factors for S. marcescens acquisition in urine. In case patients, urine sampling for tests and central venous catheterization were performed more frequently before the isolation of S. marcescens. Case patients were more frequently prescribed third-generation cephalosporins. Adherence to hand antisepsis was encouraged through in-service educational meetings and infection control measures, especially concerning the manipulation of indwelling urinary catheters, were intensified. The outbreak persisted despite the reinforcement of infection control measures. However, no patient has newly acquired the organism in the NSICU since December 2004. Multiple factors, including inadequate infection control practices and inappropriate antimicrobial usage, possibly contributed to the persistence of this S. marcescens outbreak. Healthcare workers should consistently follow infection control policies to ensure quality care.
Serratia Infections/*epidemiology/*prevention & control/transmission ; Risk Factors ; Risk Assessment/*methods ; Population Surveillance ; Neurosurgery/*statistics & numerical data ; Middle Aged ; Male ; Korea/epidemiology ; Intensive Care Units/*statistics & numerical data ; Infection Control/methods/statistics & numerical data ; Incidence ; Humans ; Follow-Up Studies ; Female ; Disease Transmission, Horizontal/prevention & control/statistics & numerical data ; Disease Outbreaks/prevention & control/statistics & numerical data ; Case-Control Studies ; Bacteriuria/*epidemiology/*prevention & control

We report on the investigations and interventions conducted to contain an extended outbreak of Serratia marcescens bacteriuria that lasted for years in a neurosurgical intensive care unit (NSICU). A case-control study was performed to identify the risk factors for S. marcescens acquisition in urine. In case patients, urine sampling for tests and central venous catheterization were performed more frequently before the isolation of S. marcescens. Case patients were more frequently prescribed third-generation cephalosporins. Adherence to hand antisepsis was encouraged through in-service educational meetings and infection control measures, especially concerning the manipulation of indwelling urinary catheters, were intensified. The outbreak persisted despite the reinforcement of infection control measures. However, no patient has newly acquired the organism in the NSICU since December 2004. Multiple factors, including inadequate infection control practices and inappropriate antimicrobial usage, possibly contributed to the persistence of this S. marcescens outbreak. Healthcare workers should consistently follow infection control policies to ensure quality care.
Serratia Infections/*epidemiology/*prevention & control/transmission ; Risk Factors ; Risk Assessment/*methods ; Population Surveillance ; Neurosurgery/*statistics & numerical data ; Middle Aged ; Male ; Korea/epidemiology ; Intensive Care Units/*statistics & numerical data ; Infection Control/methods/statistics & numerical data ; Incidence ; Humans ; Follow-Up Studies ; Female ; Disease Transmission, Horizontal/prevention & control/statistics & numerical data ; Disease Outbreaks/prevention & control/statistics & numerical data ; Case-Control Studies ; Bacteriuria/*epidemiology/*prevention & control

BACKGROUND: There were many statistical studies about skin tumors. However, no articles have been reported which focus on the scalp tumors up to the present. OBJECTIVE: The purpose of our study was to analyze the epidemiologic aspect of scalp tumors, and compare them with other data related to skin tumors. METHODS: A statistical analysis was made using 251 cases of scalp tumors which were confirmed by histopathological study from January 1993 to December 2002 at Seoul National University Hospital. RESULT: 1. In the 251 cases of scalp tumors, 197 cases (78.5%) were benign scalp tumors, and 54 cases (21.5%) were malignant scalp tumors. 2. Among the 197 cases of benign scalp tumors, the most common tumor was nevus sebaceus (19.3%), followed by seborrheic keratosis (13.7%), epidermal cyst (10.2%), trichilemmal cyst (9.1%), lipoma (7.7%), intradermal nevus (7.1%), neurofibroma (6.1%). 3. Among the 54 cases of malignant scalp tumors, the most common tumor was metastatic cancer (31.5%), followed by basal cell carcinoma (18.5%), angiosarcoma (9.3%), squamous cell carcinoma (9.3%), lymphoma (7.4%), and so on. 4. Male to female ratio of benign scalp tumor was 1.3:1 and that of malignant scalp tumor was 1.1:1 5. The distribution of age of benign scalp tumor was relatively even from childhood to old age, but that of malignant scalp tumor showed that about 70% of cases were over 4th decade. 6. The distribution of each department which performed scalp biopsy was the following ; department of dermatology (49.2%), plastic surgery (21.8%), neurosurgery (17.3%), general surgery (11.2%), pediatrics (0.5%) at benign scalp tumor and department of dermatology (37%), neurosurgery (20.4%), plastic surgery (16.7%), general surgery (7.4%), internal medicine (7.4%), urology (5.6%), otolaryngology (3.7%) and emergency medicine (1.9%) at malignant scalp tumor.
Biopsy ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Dermatology ; Emergency Medicine ; Epidermal Cyst ; Female ; Hemangiosarcoma ; Humans ; Internal Medicine ; Keratosis, Seborrheic ; Lipoma ; Lymphoma ; Male ; Neurofibroma ; Neurosurgery ; Nevus ; Nevus, Intradermal ; Otolaryngology ; Pediatrics ; Scalp* ; Seoul ; Skin ; Statistics as Topic* ; Surgery, Plastic ; Urology