PURPOSE: This study was a descriptive correlation study to increase understanding of, and relationships among critical thinking disposition, clinical decision making and job satisfaction of cancer center nurses. METHOD: The participants in this study were 150 nurses working in one cancer center located in Gyeonggi Province. The statistic program, SPSS WIN17.0 was used for data analysis and data were analyzed using t-test, ANOVA, and Pearson correlation. RESULTS: The critical thinking disposition of the participants showed statistically significant differences according to areas of practice (F=4.426, p=.005), and current position (F=9.346, p=.000). For clinical decision making of the participants, statistically significant differences were found according to current position (F=10.667, p=.000). Furthermore, for job satisfaction, there were statistically significant differences according to income (F=6.779, p=.002), length of career (F=2.701, p=.033) and current position (F=5.423, p=.005). There were significant positive correlations for critical thinking disposition with clinical decision making, and with job satisfaction. CONCLUSION: The results of the study indicate that to improve clinical decision making and job satisfaction of cancer center nurses, it is necessary to increase critical thinking disposition. To make this change, appropriate programs are needed to increase critical thinking and clinical decision making of general cancer center nurses.
Decision Making ; Job Satisfaction ; Statistics as Topic ; Thinking

A case of intradural spinal lipoma without congenital abnormalities is presented. A 37 year-old male was admitted to our hospital because of paralysis of both legs and sphincteric disturbance. Neurologic findings were spastic paraplegia, hypesthesia on the level of T10, 11 dermatoma, anesthesia below the level of T12 dermatoma, Beevor's sign, bilateral ankle clonus and Babinski sign. Plain thoracolumbar spine X-ray showed widening of the interpedicular distances of T10, 11 in A-P view, and scalloping in the posterior aspect of the bodies of T10, 11 in lateral view. Myelogram showed widening of the dye column and double cup-like filling defect at the level of the T12 spinal body. Total laminectomy was performed from L1 through T9. The tumor located from T10 to T12 of the spinal level intradurally, and also diffusely infiltrated the cord, making complete removal impossible. The histopathologic examination confirmed the lipoma. The patient was discharged without improvement of neurologic deficits.
Adult ; Anesthesia ; Ankle ; Congenital Abnormalities ; Humans ; Hypesthesia ; Laminectomy ; Leg ; Lipoma* ; Male ; Neurologic Manifestations ; Paralysis ; Paraplegia ; Pectinidae ; Reflex, Babinski ; Spinal Cord* ; Spine

The authors experienced a case of plasma cholinesterase variant who received succinylcholine, atracurium and reversal with pyridostigmine, and showed prolonged neuromuscular blockade postoperatively, and was ventilated artificia1ly until complete recovery. The patient and her two children later gave samples of blood. The patients blood revealed very low plasma cholinesterase activity of 0.11 IU/L(normal range; 5-12 IU/L) and dibucaine number of 33. In consideration of her childrens plasma cholinesterase activities and dibucaine numbers, we suggest that she has genetically abnormal plasma cholinesterase and probably her genotype is E E or E E.
Atracurium ; Child ; Cholinesterases ; Dibucaine ; Genotype ; Humans ; Neuromuscular Blockade* ; Plasma* ; Pyridostigmine Bromide ; Succinylcholine

Atrial fibrillation in mitral stenosis(MS) may be cause of error in calculation of mitral valve area(MVA) by Doppler derived pressure half-time(PHT) method. This is due to changes of peak velocity and diastolic slope in mitral inflow Doppler spectrum in cases of assoociated with atrial fibrillation. However, few data exist regarding the effect of atrial fibrillation on the validity of this method. Two hundreds and three patients with mitral stenosis were studied by Doppler echocardiography and two-dimensional echocardiography(2DE) to assess whether atrial fibrillation affected the calcullation of MVA. Total patients was divided into four groups according to the accompanied mitral or aortic regurgitation. Ninety patients had mitral stenosis only(group 1), 45 patients had mitral stenosis only(group 2), 54 patients were combined with aortic regurgitation(group 3) and 14 patients were combined with both mitral and aortic regurgitation(group 4). And then, each group was divided into sinus rhythm subgroup and atrial fibrillation subgroup respectively. In total patients, Doppler echocardiographic indices(pressure half-time, mean pressure gradient, peak pressure gradient and peak velocity) were correlated significantly with 2DE-MVA in both patients with sinus rhythm and patients, with atrial fibrillation(P<0.005). In group 1 patients, Doppler echocardiographic indices were significantly correlated with 2DE-MVA in both patients with sinus rhythm and patients with atrial fibrillation(P<0.005). In group 2 patients, these Doppler derived indices were significantly correlated with 2DE-MVA in both patients with sinuns rhythm and patients with atrial fibrillation(P<0.005). In group 3 patients, only pressure half-time was significantly correlated with 2DE-MVA in both patients with sinus rhythm and patients with atrial fibrillation(P>0.005). In group 4 patients, pressure half-time was significantly correlated in patients with atrial fibrillation(P<0.005). Therefore, Doppler echocardiography can estimates mitral valve area in patients with mitral stenosis associated with mitral and aortic regurgitation regardless of presence of the atrial fibrillation.
Aortic Valve Insufficiency ; Atrial Fibrillation* ; Echocardiography ; Echocardiography, Doppler* ; Humans ; Mitral Valve ; Mitral Valve Stenosis*

Mitral pressure half-time(PHT) is widely used as an independent measure of mitral valve area(MVA) in patients with mitral stenosis. However, few data exist regarding the effect of mitral regurgitation and aortic regurgitation on the validity of this method. Two hundreds and three patients with mitral stenosis were studied by Doppler echocardiography and 2 dimensional echocardiography(2 DE) to assess whether mitral regurgitation and aortic regurgitation affected the calculation. Ninety patients had mitral stenosis only, 45 patients were combined with mitral regurgtation, 54 patients were combined with aortic regurgitation and 14 patients were combined with both mitral and aortic regurgitation group. Doppler PHT and 2DE estimates of MVA correlated well in total patients(r=0.903) and mitral stenosis only group(r=0.924). Good correlations were maintained in patient subgroups combined with mitral or aortic regurgitation(r=0.867 and 0.911, respectively) and both mitral and aortic regurgitation(r=0.843). Thus, measurement by Doppler PHT may reflect accurately the MVA as determined by 2DE regardless of presence of mitral and/or aortic regurgitation.
Aortic Valve Insufficiency ; Echocardiography, Doppler* ; Humans ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Stenosis*

The spontaneous contrast echo (SCE) is a phenomenon that the contrast effect appears spontaneously on 2D-echocardiography without intravenous contrast material. This appears when hemostasis is in the cardiac cavity and the tendency for thrombosis formation may be increased. The SCE can be observed in the patient with severe mitral stenosis, postprosthetic valvular replacement or left ventricular enlargement. We report 4 cases of SCE on two-dimensional echocardiogram in the patient with severe mitral & aortic valvular disease.
Echocardiography* ; Hemostasis ; Humans ; Mitral Valve Stenosis ; Thrombosis

PURPOSE: This study was performed to examine the effects of image filter on observer performance by counting the number of holes at each wedge step on a radiographic image. MATERIALS AND METHODS: An aluminum step wedge with 11 steps ranged in thickness from 1.5 mm to 16.5 mm in 1.5 mm increments was fabricated for this study. Each step had 10 notched holes with 1.0 mm diameter on the bottom of the step wedge which were ranged in depths from 0.1 mm to 1.0 mm in 0.1 mm increments. Digital radiographic raw images of the aluminum step wedge were acquired by using CCD intraoral sensor. The images were processed using several types of noise reduction filters and kernel sizes. Three observers counted the number of holes which could be discriminated on each step. The data were analyzed by ANOVA. RESULTS: The number of holes at each step was decreased as the thickness of step was increased. The number of holes at each step on the raw images was significantly higher than that on the processed images. The number of holes was different according to the types and kernel sizes of the image filters. CONCLUSION: The types and kernel sizes of image filters on observer performance were important, therefore, they should be standardized for commercial digital imaging systems.
Aluminum ; Noise ; Radiographic Image Enhancement ; Radiography, Dental ; Task Performance and Analysis

We present the methods of analysis of left ventricular wall motion by 2-dimensional echocardiography using computerized system. Quantiative analysis of left ventricular wall motion abnormalities depents on the used reference method, because the heart shifts and rotates within thorax during the cardiac cycle. To access left ventricular wall motion abnormalities, we studied 60 subjects(normal; 30 subjects, abnormal; 30 subjects)with 5 different floating reference methods correcting for traslation and/or rotation in two echocardiographic views. (apical 4-chamber view and apical 2-chamber view) In the first the endocardial tracings of enddiastole and endsystole in 30 normal subjects were stored in VAX-11-780 main computer and the data of these 30 normal subjects were plotted to obtain a 95% confidence interval for measured normal fractional change every five degree according to 5 reference methods. In the second, 30 patients with abnormal left ventricular wall motion analyzed and the results were compared with a 95% confidence interval. We assessed that left ventricular wall motion by visual and computerized quantitative anlysis were in close relationship according to optimal reference method. We suggested that computerized quantitative analysis of left ventricular wall motion by 2-dimensional echocardiography was clinically useful method and translation of the midpoint of mitral anulus with rotation according to center of mass was the most specific and sensitive new method of evaluating left ventricular wall motion abnormalities.
Echocardiography* ; Heart ; Humans ; Thorax

BACKGROUND: Postoperative nausea and vomiting (PONV) is the major cause of patient's discomfort after surgery. Dexamethasone and ondansetron have been known to have some preventive effects on PONV. The purpose of this study was to compare the effects combination therapy of these drugs in the prevention of PONV after tympanomastoidectomy which has been known to be a high risk factor of PONV. METHODS: Ninty patients scheduled tympanomastoidectomy under general anesthesia were included. Patients were randomly divided into three groups and received dexamethasone 5 mg (group D), ondansetron 4 mg (group O), or dexamethasone 5 mg plus ondansetron 4 mg (group DO) at 30 min before the end of operation. The degree of PONV was assessed at 6 h, 12 h, 24 h, and 48 h after operation. RESULTS: The degrees of nausea in group DO during 0-6 h and 6-12 h were lesser than those of other groups. The overall incidences of nausea were 73% (group D), 62% (group O), and 23% (group DO, P < 0.05). The degrees of vomiting in group O and DO during 0-6 h were lesser than those of group D. The overall incidences of vomiting were 37% (group D), 17% (group O), and 7% (group DO, P < 0.05). CONCLUSIONS: The combination of dexamethasone and ondansetron is more effective than single use of each drug for the prevention on PONV after tympanomastoidectomy.
Anesthesia, General ; Dexamethasone* ; Humans ; Incidence ; Nausea ; Ondansetron* ; Postoperative Nausea and Vomiting* ; Risk Factors ; Vomiting

To assess the etiology and clinical course of moderate and severe pericardial effusions, we reviewed 118 consecutive patients seen in the cardiology department of the Kyunghee Medical Center from January, 1984 to July, 1988. 1) The common etiologies of pericardial effusions were tuberculosis(25.4%), malignancy(18.8%), uremia(16.2%), heart failure(14.4%), idiopathic(7.7%) and collagen vascular disease(5.1%). The lung cacer(77.2%) and breast cancer(9.1%) comprised most of the etiology of malignant pericardial effusion. The adenocarcinoma was the most common histologic entity of lung cancer. 2) Collapses of right atrium, right ventricle or both were seen in 17 case(14.4%), and the causes of collapses were malignancy(35.5%), idiopathic(11.8%) and uremia(11.8%). 3) The causes of constrictive pericarditis were : tuberculosis(42.9%), idiopathic(28.6%), malignancy(14.3%) and uremia(14.3%). 4) The percentages of improved cases were determined in 55 patients by echocardiography twice, 30th day after treatment and the last follow up day. It revealed 84%/96% in tuberculosis, 85.7%/0% in malignancy, 66.7%/83.3% in uremia, 83.3%/83.3% in heart failure, 100%/100% in both myxedema and myocardial infarction, and 33.3%/33.3% in collagen vascular disease at both follow up day. We conclude that the most common etiology of the pericardial effusions is still tuberculosis in Korea and the most common etiology of cardiac tamponade is malignancy, even though the suspected patients without echocardiography have been excluded can be a limitation of this study. The pericardial effusions by tuberculosis, uremia or heart failure responded well to the adequate treatment and response in malignancy or collagen vascular disease was not good.
Adenocarcinoma ; Breast ; Cardiac Tamponade ; Cardiology ; Collagen ; Echocardiography ; Follow-Up Studies ; Heart ; Heart Atria ; Heart Failure ; Heart Ventricles ; Humans ; Korea ; Lung ; Lung Neoplasms ; Myocardial Infarction ; Myxedema ; Pericardial Effusion* ; Pericarditis, Constrictive ; Tuberculosis ; Uremia ; Vascular Diseases