No abstract available.
Colonoscopy* ; Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis*

Malignant hyperthermia is defined as a potentially fatal hypermetabolic syndrome characterized by hyperpyrexia, skeletal muscle rigidity, tachycardia, respiratory and metabolic acidosis, cyanosis etc. Any inhalation anesthetic agent or any skeletal muscle relaxant can trigger this acute catastrophic reaction. This case is presented of a 37 year old female patient in whom total gastrectomy was planed to perform under oxygen-nitrous oxide-isoflurane anesthesia with induction by thiopental sodium and succinylcholine. When administer of succinylcholine to induction, the jaw was very tight and the mouth was impossible to open. We retried with vecuronium and the jaw was slightly resistant to opening, but intubation was successfully performed. After induction, hyperpyrexia, tachycardia, increased end-tidal carbon dioxide developed. Anesthesia was terminated and vigorous emergency treatment was attempted. The patient was treated successfully with early detection and intensive care. According to decrease of temperature and normalization of arterial blood gas, the procedure continued with nontriggering agent, fentanyl. The etiologic factors, clinical features, treatment and preventive measures of malignant hyperthermia are discussed.
Acidosis ; Adult ; Anesthesia ; Anesthesia, General* ; Anesthetics ; Carbon Dioxide ; Cyanosis ; Emergency Treatment ; Female ; Fentanyl ; Fever ; Gastrectomy ; Humans ; Inhalation ; Critical Care ; Intubation ; Isoflurane ; Jaw ; Malignant Hyperthermia* ; Mouth ; Muscle, Skeletal ; Succinylcholine ; Tachycardia ; Thiopental ; Vecuronium Bromide

OBJECTIVE: The aim of this study was to assess the relationship between disease progression and expression of c-erbB-2 and S-100 protein positive dendritic cells in Cervical cancer. STUDY DESIGN: Tissues were analyzed from 100 patients. Each of them had invasive carcinoma(44), microinvasive(12), CIS(33), CIN(II) before treatment, c-erbB-2 oncoprotein expression and S-100 protein positive dendritic cell were confirmed by immunohistochemical staining. (Avidin-biotin complex method) RESULTS: C-erbB-2 immunostaining was significantly associated with disease progression (p<0.05). In case of CIN I, there was not noted stained specimen but in case of invasive carcinoma, 24 cases of stained specimen were noted. S-100 protein positive dendritic cell was not associated with disease progression of cervical carcinoma.(p>0.05) CONCLUSIONS: According to our results, c-erbB-2 is possible factor in Carcinogenesis of cervical carcinoma with progression of it. and S-100 protein positive dendritic cell was not associated with disease progression of cervical carcinoma.
Carcinogenesis ; Carcinoma, Squamous Cell* ; Cervix Uteri* ; Dendritic Cells* ; Disease Progression ; Female ; Humans ; S100 Proteins* ; Uterine Cervical Neoplasms

PURPOSE: This study was to determine the effects of foot reflexomassage on constipated college women for the treatment of constipation. METHOD: The researcher sampled nursing students attending a college of nursing science in Gyeonggi-Do, and checked if they were affected by constipation in reference to the Rome II criteria & CAS. They were randomly divided into an experimental group(15 subjects) and a control group(15 subjects). Foot reflexomassage was applied to the experimental group 10 times in 2 weeks : each time lasted 40 minutes. The frequency of defecation and severity of constipation by CAS were measured. The collected data was analyzed using the SPSS 11.5 program. RESULT: The CAS score of the experimental group was significantly lower after foot reflexomassage than those of the control group (p=.000). CONCLUSION: Foot reflexomassage can be considered an effective alternative treatment for constipated young women.
Complementary Therapies ; Constipation ; Defecation ; Female ; Foot* ; Gyeonggi-do ; Humans ; Nursing ; Students, Nursing

Propofol is limited in clinical use for induction of anesthesia, because of its high incidence of pain on injection. We sought to determine whether different methods could prevent this pain. 150 patients were allocated randomly into five groups. Group 1 was received room-air temperature propofol 2.5 mg/kg. Group 2 was received room-air temperature propofol 2.5 mg/kg mixed with 1 ml of 1%(10 mg) lidocaine. Group 3 was received room-air temperature propofol 2.5 mg/kg just after the injection of l ml of 1%(10 mg) lidocaine. Group 4 was received room-air temperature propofol 2.5 mg/kg mixed with 1 ml of 0.5%(5 mg) lidocaine. Group 5 was received propofol 2.5 mg/kg cooled to 0-4degrees C. The pain was classified as none, mild, moderate, or severe. All patients were questioned the degree of pain in an identical manner both at induction of anesthesia and as recalled in the recovery room. There was a significant reduction in the incidnce and severity of pain in the Groups 2 and 3, which were used 10 mg of lidocaine. But 23.3% of patients in the Group 2 and 30.0% of patients in the Group 3 still suffered unpleasant pain during the induction, and 20.0% and 26.7% of patients, respectively recalled in the recovery room. From the above results, we concluded that the pain from injection of propofol can be prevented by 1 ml of 1%(10 mg) lidocaine mixed with propofol or preinjection before propofol.
Administration, Intravenous* ; Anesthesia ; Humans ; Incidence ; Lidocaine ; Propofol* ; Recovery Room

BACKGROUND: Continuous monitoring blood culture systems (CMBCS) reduce the time and false negative rates of bacterial growth compared with the traditional manual blood culture systems which have been used in many hospitals yet. The purpose of this study is to evaluate the terminal subcultures monitored by Vital system compared with the manual system and to determine the guideline of terminal subcultures. METHODS: A retrospective study was conducted over a period of one year (from January to December 1995) with manual blood culture system and and sixteen months (from February 1996 to May 1997) with Vital system. All of the positive and negative blood bottles were done Gram staining and subcultured aerobically and anaerobically with 7-day terminal subculture protocol. All of the isolates were identified with API systems or ATB systems. RESULTS: Among 3,344 cases with the manual system, 305 cases (9.1%) were declared positive and 424 cases (8.8%) out of 4,822 cases with Vital system were positve. The terminal subcultures detected 48 cases (1.44%) in manual system and 9 cases (0.19%) in Vital system according to 7-day protocol. No statistical differences were observed in results among 5 day, 7 day and terminal subcultures. Those of false negative organisms were gram positive cocci (22 cases), Enterobacteriaceae (13 cases), non-fermenters (12 cases) and gram positive rod (1 case) with the manual system and gram positive cocci (4 cases), Entrobacteriaceae (1 case), non-fermenter (1 case) and yeasts (3 cases) with Vital system. CONCLUSIONS: These results suggest that terminal subculture of Vital systemnegative blood culture bottles is not necessary except S. aureus and fungus bacteremia on the basis of clinical situation.
Bacteremia ; Enterobacteriaceae ; Fungi ; Gram-Positive Cocci ; Retrospective Studies ; Yeasts

No abstract available.
Brain* ; Child* ; Humans ; Magnetic Resonance Imaging*

Merkel cell carcinoma (MCC) is an uncommon but potentially aggressive neuroendocrine carcinoma of the skin. It typically develops on sun-exposed areas of the head and neck, particularly the eyelid, periorbital region, and extremities. We report a case of unusually located MCC, presenting as a conjunctival mass, which has only been reported once in the English literature. An 83-year-old male presented with a 0.8 x 0.7 cm sized mass protruding from the lower fornix of the right conjunctiva. The mass was excised. The tumor was located in the submucosa without connection to the overlying mucosa. Light microscopic findings showed a carcinoma with undifferentiated small round cells and the presence of cytokeratin (CK AE1/3, CK7) and neuroendocrine markers. We established a diagnosis of MCC. As reported in the literature, the majority of MCCs are positive for CK20 but negative for CK7. But, this case showed an uncommon cytokeratin immunohistochemical profile of positive for CK7 and negative for CK20, suggesting a new immunophenotypic MCC variant.
Aged, 80 and over ; Carcinoma, Merkel Cell ; Carcinoma, Neuroendocrine ; Conjunctiva ; Extremities ; Eyelids ; Head ; Humans ; Keratins ; Light ; Male ; Mucous Membrane ; Neck ; Neuroendocrine Tumors ; Skin

The purpose of this study was to describe and understand how diabetics dealt with the result of the various changes of lifestyle. The grounded theory approach of qualitative research methods was used for building a substantive theory about that. The subjects of this study were 10 clients who experienced diabetes from 4 to 30 years. The data was collected from August 1999 to November 1999 through in-depth interviews utilizing home visitation and telephone interview technique then it was and analyzed simultaneously by a constant comparative method in which the new data was continuously coded into categories and properties according to Strauss & Corbin,s methodology. One hundred six concepts were found and they were grouped into 35 categories and then into 14 categories. The results were as follows difficulty, unable to overcome the changes, disposition, disease process, tiredness, supportive environment, perception, handling, concent- ration, mastering, endurance, avoidance, giving up and tailoring. The core phenomenon was 'tiredness' and these categories were synthesized into one core concept, the process of tailoring. The process of tailoring in diabetics consisted of: 1) going through difficulty of disease management 2) experiencing tiredness from the difficulty of disease management 3) perception of disease from tiredness 4) undergoing various self-management 5) controlling the process of tailoring by one's own method. Six hypotheses were derived from the relation of these concepts and four types were from intensity of tiredness, direction of disposition, type of disease process and the level of supportive environment and perception. This study offers better understanding on diabetic experiences and may facilitate more appropriate interventive strategies to provide support, information and knowledge. The nurses should utilize the results to help diabetics enjoy their lives without any trouble and must continuously develop nursing knowledges and skills.
Disease Management ; House Calls ; Interviews as Topic ; Life Style ; Nursing ; Qualitative Research ; Self Care

Imaging studies, notably ultrasound or MRI may aid in clinical evaluation. However, in some circumstances such imaging studies can be misleading. Here we are reporting with a brief review, an experienced case where uterine submucosal myoma with cystic degeneration is successfully diagnosed and treated with hysteroscopy.
Abortion, Missed* ; Diagnosis* ; Female ; Hysteroscopy ; Magnetic Resonance Imaging ; Myoma* ; Pregnancy ; Ultrasonography*