OBJECTIVES: The purpose of this study was to investigate influences on employment preparation in dental hygiene students. METHODS: A self-reported questionnaire was completed by 386 dental hygiene students in South Korea from November 1 to 30, 2016. For data analysis, the study used independent t-tests, one-way analysis of variance, Pearson correlation analysis, and regression analysis among others. RESULTS: Students with higher grades tended to have major satisfaction, instruction participation, and employment preparation (P < 0.001). Higher parental monthly income was related to higher major satisfaction (P < 0.001). Employment preparation was significantly positively related to major selection motive, major satisfaction, and instruction participation. CONCLUSIONS: In order to encourage dental hygiene students to prepare for employment, it is necessary to create a better academic environment and develop a variety of employment preparation education programs. I think that the active interest of the country, society, school, and family will have a positive impact on employment preparation.
Education ; Employment ; Humans ; Korea ; Oral Hygiene ; Parents ; Statistics as Topic

BACKGROUND: The authors performed this study to investigate the hemodynamic effect of nicardipine using an esophageal Doppler monitor (EDM) during gynecologic laparoscopic surgery. METHODS: Forty patients scheduled to undergo gynecologic laparoscopic surgery, were divided into two groups; the control group (Group C) and the nicardipine group (Group N). Pneumoperitoneum was initiated using CO2 gas and the intraperitoneal pressure was kept under 12 mmHg. Hemodynamic parameters at critical points were measured using EDM, i.e., before skin incision (T1), 5, 10 and 15 min after the initiation of pneumoperitoneum (T2, T3 and T4), and 5 min after deflation (T5). RESULTS: Mean arterial pressure (MAP) was significantly lower in Group N patients than in Group C patients at 5 and 10 min after the initiation of pneumoperitoneum (T2 and T3) (P < 0.05). No significant heart rate (HR) differences were observed between the two study groups. Cardiac output (CO), peak velocity (PV) and corrected flow time (FTC) were significantly higher in Group N at 10 min after the initiation of pneumoperitoneum (T3) (all P < 0.05). CONCLUSIONS: The nicardipine continuous infusion at 0.5?2.0microg/ kg/min is effective at attenuating hemodynamic changes after pneumoperitoneum during gynecologic laparoscopic surgery.
Arterial Pressure ; Cardiac Output ; Heart Rate ; Hemodynamics ; Humans ; Laparoscopy ; Nicardipine ; Organothiophosphorus Compounds ; Pneumoperitoneum ; Skin

Recently, laparoscopic techniques are being increasingly used for retroperitoneal surgery. These procedures are considered relatively safe and non-invasive, however, there exists a small but important risk of developing complications related to insufflation with carbon dioxide (CO2). A 51-year-old female patient was admitted for retroperitoneal laparoscopic nephrectomy under general anesthesia. About 60 minutes after carbon dioxide pneumoperitoneum, the patient's oxygen saturation decreased. A chest x-ray was taken in the operating room, which showed pneumothorax in the right lung. We concluded that anesthesiologists should be aware of the occurrence of pneumothorax during the retroperitoneal laparoscopic procedure careful monitoring and appropriate management are needed.
Anesthesia, General ; Carbon Dioxide ; Female ; Humans ; Insufflation ; Laparoscopy ; Lung ; Middle Aged ; Nephrectomy* ; Operating Rooms ; Oxygen ; Pneumoperitoneum ; Pneumothorax* ; Thorax

BACKGROUND: The aim of this study was to evaluate the effect of aging on the hemodynamic response to endotracheal intubation during the induction of anesthesia. METHODS: Fifty patients with American Society of Anesthesiologists physical status classification 1 or 2 were enrolled and allocated according to age to either group N (35-44 years, not elderly, n=25) or group E (65-74 years, elderly, n=25). The patients were administered 3 minimum alveolar concentrations of sevoflurane for 5 minutes for the induction of anesthesia. Systolic arterial pressure (SAP) and heart rate (HR) were recorded before (baseline), immediately after (T0), and at 1-minute intervals during the first 4 minutes after endotracheal intubation (T1-T4). RESULTS: SAP increased by 15.4% and 10.8%(p<0.05) from the baseline at T0 and T1, respectively, in group N, and by 21.6%, 17.8%, and 11.8%(p<0.05) from the baseline at T0, T1 and T2 respectively, in group E. The SAP increases at T0, T1 and T2 were significantly greater in group E than in group N (p<0.05). The HR increases at T0 and T1 were significantly greater for group N than for group E (p<0.05). CONCLUSION: We recommend that anesthesiologists vigilantly monitor and attenuate adverse hemodynamic responses for at least 5 minutes after endotracheal intubation especially in elderly patients, particularly because significant systolic hypertension can occur in this age group.
Aged ; Aging* ; Anesthesia* ; Arterial Pressure ; Classification ; Heart Rate ; Hemodynamics* ; Humans ; Hypertension ; Intubation ; Intubation, Intratracheal*

OBJECTIVES: Organophosphates make their clinical effects after absorbed through gastrointestinal tract, lungs and skin. We commonly see the gastrointestinal tract and lung as routes of organophosphates (OP) intoxication, but there have been few reports that said the skin as a route OP intoxication. We have experienced many patients that showed OP intoxication symptoms during or after the control of pine gall midge. So we analyzed the clinical characteristics of the patients and evaluated the route of OP intoxication. METHODS: We analyzed retrospectively 26 cases who were diagnosed as 'OP intoxication after control of pine gall midge' from June 1 1995 to July 31 1996. RESULTS: 1) The mean age of the cases, mean duration of work and mean initial cholinesterase level were 52 years, 11.9 days, 318.2U/L respectively. And the over all ratio of male to female was 11:15. 2) All cases were engaged in drug injection and 7 cases (32%) weared mask. Face and upper body were excluded from protective clothings. 3) The cardinal symptoms were diarrhea and dizziness followed by nausea, vomiting, headache, anorexia, paralysis in order of frequency. 4 Directly contributing factors to symptom onset were rain, excessive sweating due to hot weather and direct contact. 5) Most of cases (92%) were recovered completely. 2 cases died during hospitalization due to acute respiratory failure and sepsis. Mechanical ventilation were applied in 4 cases for mean 12 days. In 2 cases, there were neurobehavioral changes as delayed neurologic sequelae. CONCLUSION: We have concluded that the route of organophosporus intoxication after the control of pine gall midge was skin (transdermal absorption). Sufficient education and protective measures should be done for preventing organophosporus intoxication in the control of pine gall midge.
Anorexia ; Cholinesterases ; Clothing ; Diarrhea ; Dizziness ; Education ; Female ; Gastrointestinal Tract ; Headache ; Hospitalization ; Humans ; Lung ; Male ; Masks ; Nausea ; Organophosphates ; Paralysis ; Rain ; Respiration, Artificial ; Respiratory Insufficiency ; Retrospective Studies ; Sepsis ; Skin ; Sweat ; Sweating ; Vomiting ; Weather

BACKGROUND: The goal of this study was to determine the optimal target-controlled concentration of remifentanil combined with desflurane, by using a more widely and decreasing end-tidal concentration of desflurane. METHODS: Ninety ASA I patients, who underwent general anesthesia for elective orthopedic or extremity surgeries, were registered and randomly allocated to receive either a target-controlled concentration of 1 ng/ml (group R1), 2 ng/ml (group R2) remifentanil, or desflurane only without remifentanil infusion (group D). Mean arterial pressure (MAP) and heart rate (HR) were recorded at 5-min intervals from after a 10-15 min period of surgical incision to before a 10-min period prior to the end of an operation. End-tidal concentration of desflurane was increased or decreased in proportion to the changes in MAP and HR. If the value of bispectral index (BIS) was from 60-62 for more than 2 min or systolic blood pressure would fall below 90 mmHg, the patient was excluded from the study to prevent a risk of "explicit awareness" and shock. RESULTS: The end-tidal desflurane concentration was lower in the group receiving 1 ng/ml (5.2 +/- 0.5 vol%; P < 0.001) and 2 ng/ml remifenanil (4.4 +/- 0.5 vol%; P < 0.001) compared to patients in group D (7.9 +/- 0.5 vol%). CONCLUSIONS: We recommend the use of 2 ng/ml or less remifentanil combined with desflurane for decreasing concentrations of desflurane without significant side effects, during the "maintenance" phase, and not during the induction phase of general anesthesia.
Anesthesia, General ; Arterial Pressure ; Blood Pressure ; Extremities ; Heart Rate ; Humans ; Isoflurane ; Orthopedics ; Piperidines

BACKGROUND: This study was conducted to develop a pre-discharge group education program for liver transplant patients, and to contribute to improving the knowledge and performance of self-management after discharge. METHODS: This investigation was a methodological study consisting of analysis, design, development, operation, and evaluation stages. RESULTS: The constituent items of the pre-discharge group education program for liver transplant patients include medication management, infection management, emergency management, outpatient management, complication management, nutrition management, exercise management, wound and drainage management, disability registration, and sex life. The pre-discharge group education program for liver transplant patients was conducted once a week, 30 minutes for the coordinator, 40 minutes for the clinical nurse specialist (including 10 minutes for wound and drainage management), 30 minutes for pharmacists, 20 minutes for the nutritionist, and 20 minutes for social workers. Additionally, the contents of the lecture announced by PowerPoint were made the same as the booklet. The overall knowledge level before and 3 months after the pre-discharge group education program for liver transplantation patients increased significantly from 17.32±1.53 to 19.74±0.89. At the 3-month time point, the overall compliance was 77.39±3.04 out of 80. Overall satisfaction was 9.32±0.93 on a scale of 10. Finally, the need for medication was the highest at 3 months. CONCLUSIONS: It is expected that this program can be utilized in the clinical field as an effective nursing education intervention.
Compliance ; Drainage ; Education* ; Education, Nursing ; Emergencies ; Humans ; Liver Transplantation ; Liver* ; Methods ; Nurse Clinicians ; Nutritionists ; Outpatients ; Pamphlets ; Pharmacists ; Self Care ; Social Work ; Social Workers ; Wounds and Injuries

BACKGROUND: Studies have shown that tracheal intubation can be facilitated safely and effectively after induction of anesthesia with hypnotic and opioid without employing any muscle relaxants. Remifentanil is a new, ultra-short acting, selective mu-receptor agonist. The goal of our present study was to evaluate the appropriate induction dose of remifentanil with propofol for tracheal intubation without employing any muscle relaxants. METHODS: We have assessed intubating conditions in three groups of 45 ASA I or II Patients. Each group received intravenous dosage of 2 mg/kg of propofol with remifentanil 1microgram/kg (Group I), 2microgram/kg (Group II) or 3microgram/kg (Group III), respectively. No muscle relaxant was administered. Intubating conditions were assessed based on jaw relaxation, vocal cord position, vocal cord movement, airway reaction, and movement of limbs. Intubating conditions, mean arterial blood pressure and heart rate were measured just before induction (T00, baseline), before intubation (T0), 1 minute after intubation (T1), 2 minutes after intubation (T2) and 3 minutes after intubation (T3). RESULTS: Intubating conditions were clinically acceptable in 26.7, 86.7 and 93.3% of patients, after 1, 2 or 3microgram/kg administration of remifentanil, respectively. Clinically acceptable intubating conditions were significantly more in Group II and III when compared with Group I (P<0.05). Both HR (heart rate) and MAP (mean arterial pressure) were significantly lower in Group III when compared with Group I before intubation (T0), 1 minute after intubation (T1), 2 minutes after intubation (T2) and 3 minutes after intubation (T3) (P<0.05). CONCLUSIONS: We conclude that 2-3microgram/kg of remifentanil may reliably provide 'good' to 'excellent' conditions for tracheal intubation when administered after administration of 2 mg/kg propofol. The conditions for intubation were significantly better in patients receiving 2 mg/kg of propofol followed by 2-3microgram/kg of remifentanil than those receiving 1microgram/kg of remifentanil.
Anesthesia ; Arterial Pressure ; Extremities ; Heart Rate ; Hemodynamics* ; Humans ; Intubation* ; Jaw ; Propofol* ; Relaxation ; Vocal Cords

BACKGROUND: It is often difficult to make a diagnosis of cardiac ischemia in patients attending emergency department (ED) with symptoms of acute coronary syndromes (ACS) because existing cardiac markers are not sensitive for reversible myocardial ischemia. Ischemia modified albumin (IMA) has recently been shown to be an early and sensitive marker of myocardial ischemia. We investigated the usefulness of ischemia modified albumin (IMA) as an early triage marker for ACS and tried to establish a newly standardized albumin-adjusted IMA index which has been expected to be more sensitive and accurate than conventional IMA value. METHODS: We enrolled 209 consecutive patients (men 95, women 114) who presented to the ED with symptoms suggestive of ACS from June to July, 2005. All patients were classified to ACS group (n=42) and others (n=167) based on diagnosis of cardiologists. The ideal cutoff value of IMA was calculated by the receiver operating characteristic (ROC) curve analysis and diagnostic utilities of combination tests (myoglobin, CK-MB, troponin T and EKG) were compared with those of IMA. The albumin-adjusted IMA index was calculated and applicated from the results of correlation assay between serum albumin concentration and IMA value. RESULTS: Mean IMA level (U/mL) of ACS group was significantly higher than that of non-ACS group (P<0.05) and sensitivity and specificity was 92.9% and 35.9% at a cutoff value of 85.1 U/mL, respectably. In combination with conventional cardiac markers, the sensitivity increased to 96.3%. IMA value had a negative lnear relationship with serum albumin concentration (YIMA= -23.1Xalbumin+200, R=0.99) and albumin-adjusted IMA index was calculated as [IMA index = serum albumin conc. (g/dL) x 23 + IMA (U/mL) -100]. The sensitivity and specificity was 97.6% and 34.1% at a cutoff value of 83.3 IMA index, respectively. CONCLUSIONS: IMA is a useful sensitive marker for the identification of ACS in patients with normal cardiac markers and EKG finding and follow-up combination testing may be required to rule out other diseases. The calculated albumin-adjusted IMA index is recommended to make a diagnosis of ACS more sensitively.
Acute Coronary Syndrome* ; Diagnosis ; Electrocardiography ; Emergency Service, Hospital ; Female ; Follow-Up Studies ; Humans ; Ischemia* ; Mass Screening* ; Myocardial Ischemia ; ROC Curve ; Sensitivity and Specificity ; Serum Albumin ; Triage ; Troponin T

Myotonic dystrophy is an autosomal-dominant inherited neuromuscular disorder that's characterized by slowly progressive muscular dystrophy, muscle weakness and myotonia. The clinical features may vary from just cataracts to involvement of multiple organ systems such as various muscles, the heart, lung and intestine. Its most common complication is postoperative respiratory failure. We encountered a patient who developed sudden unexpected peripartum cardiomyopathy (PPCM) and respiratory failure due to presumed myotonic dystrophy after cesarean section. We report here on our clinical experience with this malady and we include a brief review of the medical literature on myotonic dystrophy.
Cardiomyopathies ; Cataract ; Cesarean Section ; Female ; Heart ; Humans ; Intestines ; Lung ; Muscle Weakness ; Muscles ; Muscular Dystrophies ; Myotonia ; Myotonic Dystrophy ; Peripartum Period ; Pregnancy ; Respiratory Insufficiency