PURPOSE: The study purposes were to describe the process of developing the Korean versions of the Six Dimension Scale of Nursing Performance (Six-D) and Student Nurse Stress Index (SNSI) and psychometric evaluation of the two measurements. METHODS: This was a methodology study using a descriptive cross-sectional design with 51 nursing students in 4th year of university. Internal consistency reliability was assessed using Cronbach alphas. Construct validity was determined by exploring correlations among Six-D, SNSI, objective structured clinical examination (OSCE), self-efficacy and grade point average (GPA). RESULTS: Internal consistency reliability of Six-D and SNSI was acceptable with Cronbach's alpha of .95 and .82. Correlation analysis to determine construct validity revealed that Six-D presented positive correlations with OSCE (r=.109~.272) and self-efficacy (r=.005~.161) and negative correlation with GPA (r=-.246~-.394), although all were not statistically significant. SNSI presented all negative correlations with OSCE (r= -.007~-.238), self-efficacy (r=-.246~-.394), and GPA (r=-.092~-.426) and were mostly statistically significant except OSCE. CONCLUSION: Six-D needs more evidence to confirm validity to predict observed clinical competency and theoretical relationships with self-efficacy and GPA. However, SNSI presented trends of expected relationships with relevant variables. Therefore, further research is recommended in testing validity of Six-D with other student populations.
Asthma ; Humans ; Psychometrics ; Students, Nursing

OBJECTIVES: To develop and evaluate time series models to predict the daily number of patients visiting the Emergency Department (ED) of a Korean hospital. METHODS: Data were collected from the hospital information system database. In order to develop a forecasting model, we used, 2 years of data from January 2007 to December 2008 data for the following 3 consecutive months were processed for validation. To establish a Forecasting Model, calendar and weather variables were utilized. Three forecasting models were established: 1) average; 2) univariate seasonal auto-regressive integrated moving average (SARIMA); and 3) multivariate SARIMA. To evaluate goodness-of-fit, residual analysis, Akaike information criterion and Bayesian information criterion were compared. The forecast accuracy for each model was evaluated via mean absolute percentage error (MAPE). RESULTS: The multivariate SARIMA model was the most appropriate for forecasting the daily number of patients visiting the ED. Because it's MAPE was 7.4%, this was the smallest among the models, and for this reason was selected as the final model. CONCLUSIONS: This study applied explanatory variables to a multivariate SARIMA model. The multivariate SARIMA model exhibits relativelyhigh reliability and forecasting accuracy. The weather variables play a part in predicting daily ED patient volume.
Crowding ; Emergencies ; Emergency Medical Services ; Forecasting ; Hospital Information Systems ; Humans ; Models, Statistical ; Seasons ; Weather

No abstract available.
Plasmapheresis* ; Postpartum Period* ; Pregnancy*

In the late 1950, Greifenstein and associates have studied the properties of phenylcyelohexylamine derivatives and reported that these chemicals produced amnesia, analgesia, catatonia and catalepsy. Phencyclidine was the first of these drugs used in clinical anesthesia, but convulsive movement as well as excitatory behavior discouraged the use of the agent in human beings. Continued research for a more suitable derivative of phencyclidine with similar analgesic action, but shorter duratoin and lesser psychotomimetic action led McCarthy and Chen to investigate the pharmacologic properties of a large series of compounds. One of these, 2-ochlorophenylcyclohexylamine, was shown to have some advantages. Ketamine hydrochloride, chemically related to both phencyclidine and cyclohexylamine, proved to be more satisfactory for clinical anesthesia. Clinical investigations were begun in 1965 by Dominos group who first termed it dissociative anesthesia. As noted by Pender, the clinical signs of anesthesia with ketamine are completely different from those seen with conventional intravenous agents and gaseous compounds. Ketamine acts rapidly on intravenous or intramuscular administration to produce a state chracterized by catalepsy, analgesia and amnesia. It is devoid of sedation, hypnotic or convulsive properties. Normal pharyngeal-laryngeal reflexes are maintained and skeletal tone remains normal or increased. Since the introduction of ketamine by Domino's group, numerous reports have appeared to explain various aspects of the cardiovascular response(increased cardiac output, hypertention, little or no change in peripheral resistance) and respiratory response. However there are few reports on the effect of ketamine on intestinal motility. Thus we have made a study to observe the effect of ketamine on the intestinal motility of chickens. Strips of isolated muscle, 1 cm long, from adult fowl weighing l.2-1.5 kg and isolated smooth muscle of a patient with stomach cancer, were suspended in a muscle chamber containing Tyrode's solution into which was bubbled oxygen gas. The solution was. kept constant at 38 degrees C and contraction of the preparations was recorded on a polygraph. After being washed several times with fresh solution, the muscle strips attained constant motility and tonus. Ketamine and other drugs were added in various concentrations to the chamber. The results are as follows: 1) Ketamine did not exert any effect on human intestinal motility. It relaxed fowl intestinal muscle strips and potentiated the effect of epinephrine, norepinephrine, and isoproterenol. 2) The relaxing effects of ketamine on fowl intestinal muscle strips were not abolished by adrenergic blocking agents. 3) Ketamine demonstrated anticholinergic effect on the intestinal motility of the human and fowl. From the above results, it may be concluded that ketamine exerts a anticholinergic effect and depressant effect on intestinal motility of fowl without relation to adrenergic receptors.
Adrenergic Antagonists ; Adult ; Amnesia ; Analgesia ; Anesthesia ; Cardiac Output ; Catalepsy ; Catatonia ; Chickens* ; Cyclohexylamines ; Epinephrine ; Gastrointestinal Motility* ; Humans ; Isoproterenol ; Ketamine* ; Muscle, Smooth ; Norepinephrine ; Oxygen ; Phencyclidine ; Receptors, Adrenergic ; Reflex ; Stomach Neoplasms

In 10 anesthetized and paralyzed rabbits, cardiovascular variabled(blood pressure, pulse rate), rectal temperature and arterial blood gase tension were investigated during high frequency oscillatory ventilation(about 17hz). During high frequency oscillation(HFO) blood pressure, rectal temprerature and blood gas tension remained stable and were not different from the control values( intermittent positive pressure ventilation IPPV). The PaO2/FIO2 ratio remained unchanged during the experiment in spite of changing airway pressure. We observed that HFO provided adequate ventilation and oxygenation without altering cardiovascular dynamics. High frequency oscillatory ventilation appears to be a promising new way of achieving gas exchange with minimal risk of barotrauma to the lung.
Barotrauma ; Blood Pressure ; Intermittent Positive-Pressure Ventilation ; Lung ; Oxygen ; Rabbits ; Ventilation*

The Guillain-Barre syndrome is characterized by Bymmetrical rapidly, ascending paralysis that occasionally leads to respiratory embarrassment and death. We atudied 16 patients diagnosed as Guillain-Barre syndrome admitted to ICU at Severance Hospital from, January 1981 to April 1986. All patients were managed by respirators and 10 cases were tracheostomised. In addition to antibioticts with steroid therapy, rigid or fiheroptic bronchoscopy and plasma exchange were performed. The results were as follows ; 1) The 16 cases consist of 9 males and 7 females. 2) Prodromal symptoms were URI, fever, and gastrointestinal symptoms. 3) Diagnosis was 7ased on clinical symptoms, CSF studios and nerve conduction study. 4) Treatments included airway maintenance with ventilators, trachestomy, antibiotics with steroid therapy, rigid or fiberoptic bronchoscopy and plasma exchange. 5) Pulmonary complications (aspiration pneumonia, pneumoia, atelectasis, laryngeal ede-ma) and cardiovascular complications (hypertension, tachycardia, bradycardia, fever) were observed. However, there was no death in this group. ln conclusion, respiratory care and otter supportive therapy are of prime importance in the management of Guillain-Barre Syndorme.
Anti-Bacterial Agents ; Bradycardia ; Bronchoscopy ; Diagnosis ; Female ; Fever ; Guillain-Barre Syndrome* ; Humans ; Male ; Neural Conduction ; Otters ; Paralysis ; Plasma Exchange ; Pneumonia ; Prodromal Symptoms ; Pulmonary Atelectasis ; Tachycardia ; Ventilators, Mechanical

PURPOSE: To evaluate whether or not previously known CT criteria for differentiating malignant and benign pleural diseases are useful in the differentiation of diffuse malignant pleural diseases and tuberculosis. MATERIALS AND METHODS: We retrospectively analyzed CT scans of 42 patients comprising 20 cases of malignant pleural diseases and 22 cases of tuberculous pleural diseases, according to previously known CT criteria for differentiating malignant and benign pleural diseases. RESULTS: The most common shape of pleural effusion was crescentic in malignant pleural diseases and loculated in tuberculosis. The aggressive nature of pleural effusion, pleural rind, and pleura thickenign was 1.5 times more frequently observed in malignant pleural diseases than in tuberculosis. Smooth thickening or smooth nodular pleural thickening and extrapleural deposition of fat were 1.5 times more frequently found in tuberculous than in malignant pleural diseases. Interruption of pleural thickening was found twice as frequently in malignant pleural diseases as in tuberculosis. Decreased lung volume was found twice as frequently in tuberculous as in malignant pleural diseases. Anatomical mediastinal pleural involvement was three times, and irregular nodular pleural thickening nine times more frequent in malignant pleural diseases than in tuberculosis. The sensitivity and specificity of CT findings above 70%, and thus suggesting malignant pleural diseases, were as follows: 1) aggressive nature of pleural fluid collection extending to the azygoesophageal recess or tongue of the lung (51.5%, 75%); 2) involvement of anatomical mediastinal pleura (69.2%,73.7%); 3) irregular nodular pleural thickening (87.5%, 69%). CONCLUSION: Although there in overlap between previously known CT criteria for the differentiation of benign and malignant pleural diseases, the aggressive nature of pleural fluid collection extending to the azygoesophageal recess or tongue of the lung, the involvement of anatomical mediastinal pleura and irregular nodular pleural thickening may suggest malignant pleural diseases.
Humans ; Lung ; Pleura ; Pleural Diseases* ; Pleural Effusion ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; Tongue ; Tuberculosis*

PURPOSE: To evaluate the usefulness of cerebral blood flow measurement applied to perfusion weighted image with short-scan time single shot gradient echo-planar technique in measuring cerebral blood volume(rCBV) of normal rabbits. MATERIALS AND METHODS: With 2.1-3.6 kg weighted rabbits, image is acquired when they are in supine position in children positioner. Perfusion weighted image is acquired to 44 seconds per 1 second successively. After 4 seconds later, Gd-DTPA 2ml are injected into int. jugular vein with 2 ml per second and normal saline is also injected after that. Same technique is applied 2 times per 30 minites in same rabbit. After Image is obtained in two part of cerebral cortex at vertex, convexity, in one of basal ganglia with choosing about 3-5mm2 areas. Curve of signal intensity changes in time sequence is drawn. After this images are transmitted by PC and software IDL, regional cerebral blood volume is measured with imaging processing program made by us. RESULTS: With 22 of 24 rabbits, satisfactory 1-2 signal intensity versus time curve is made. Cerebral blood capacity and contrast media stay time (ST) is measured in two cerebral cortex and basal ganglia refering in parietal cerebral cortex. Mean focal cerebral blood flow capacity ratio in cortex was 0.97+/-0.35 and in basal ganglia, 0.99+/-0.37, mean contrast media stay time in cortex was 9.83+/-1.63 sec and in basal ganglia, 9.42+/-1.14 sec, but there was no statistically significant difference between two areas (p=0.05). CONCLUSION: In cerebral cortex and basal ganglia, there is no difference in mean focal blood volume and mean contrast stay time. Therefore, PWI is useful in cerebral blood flow and early diagnosis, prognosis of cerebral ischemic disease. Hereafter, it is helpful in analysing cerebral blood flow changes with comparison difference in rCBV between normal tissue and ischemic tissue, and that with DWI finding in infarcted patient.
Basal Ganglia ; Blood Volume* ; Cerebral Cortex ; Child ; Contrast Media ; Early Diagnosis ; Gadolinium DTPA ; Humans ; Jugular Veins ; Perfusion ; Prognosis ; Rabbits* ; Rabeprazole ; Supine Position

Approximately 80-85% of D-negative (D-) persons produce anti-D antibodies after exposure to D-positive (D+) red blood cells (RBCs). Previously, anti-D was the most commonly detected Rh antibody, but its incidence has greatly decreased due to the prophylactic use of Rh immunoglobulin (RhIG). Anti-D antibody formation may occur following RhD-incompatible organ transplantation when D- recipients are exposed to D+ RBCs that originate from a donor organ. As a large volume of donor blood may be contained within the transplanted organ, the use of a large amount of RhIG is required in RhD-incompatible liver transplantation. Here, we describe the use of a large amount of RhIG to treat a patient following RhD-incompatible liver transplantation. This patient was a 71-yr-old woman with hepatitis C virus-related liver cirrhosis, who had an A/D- blood type. The donor was her grandson, whose blood type was O/D+. The recipient's preoperative anti-D antibody test was negative. One unit of O/D- irradiated leukoreduced RBCs and three units of A/D- fresh frozen plasma were transfused during liver transplantation. An equal amount (12,000 IU) of RhIG was infused intravenously, immediately after liver transplantation and a second time on post-operation day 1. The anti-D titer was 1:64 on the first post-operation day, and had increased to 1:128 by the following day. By 1 month after the surgery, the titer had decreased to 1:4. In this case of liver transplantation, RhIG was actively used to prevent RhD sensitization and the subsequent occurrence of adverse events associated with RhD-incompatible liver transplantation.
Antibodies ; Antibody Formation ; Erythrocytes ; Female ; Hepatitis C ; Humans ; Immunoglobulins* ; Incidence ; Liver Cirrhosis ; Liver Transplantation* ; Organ Transplantation ; Plasma ; Tissue Donors ; Transplants

No abstract available.
Endoderm* ; Endodermal Sinus Tumor*