No abstract available.
Angina, Stable* ; Tumor Necrosis Factor-alpha*

No abstract available.

BACKGROUND: Induced hypotension is effective in decreasing blood loss and providing better visibility in the surgical field. Extensive epidural block to T4 with intravenous infusion of low-dose epinephrine allows mean arterial pressure to 50 mmHg. We investigated the effects of hypotensive epidural anesthesia comparing with normotensive epidural anesthesia during total hip arthroplasty. METHODS: 40 patients scheduled for total hip arthroplasty under epidural anesthesia were randomly divided into two groups. In hypotensive group, 0.5% bupivacaine 20cc was injected into L1-2 epidural space and if sensory block reached to T4, then epinephrine 1~5 g/min was intravenously injected with continuous infusion pump. As a result, mean arterial pressure was maintained 50 mmHg, and heart rate, 55~80bpm. In normotensive group, 0.5% bupivacaine 20cc was injected into L4-5 epidural space, and sensory block reached to T8. Therefore blood pressure was maintained within 20% of preoperative baseline. RESULTS: There was apparent difference in blood loss between two groups (hypotensive group: 259 +/- 75 ml, normotensive group: 803 +/- 144*ml) (*:p<0.05). In addition, in the case of hypotensive epidral group, transfusion was not required and CVP, heart rate were not changed postoperatively. Cardiac, renal, and cerebral function were preserved too. CONCLUSIONS: Hypotensive epidural anesthesia with low dose of epinephrine infusion is safely lowering mean arterial pressure to 50 mmHg. This technique is associated with low blood loss, reduction in perioperative transfusion requirements, and has no side effects on CNS, liver, kidney and heart function.
Anesthesia, Epidural* ; Arterial Pressure ; Arthroplasty, Replacement, Hip* ; Blood Pressure ; Bupivacaine ; Epidural Space ; Epinephrine ; Heart ; Heart Rate ; Humans ; Hypotension ; Infusion Pumps ; Infusions, Intravenous ; Kidney ; Liver

BACKGROUND: The increase of smoking prevalence in adolescents Is serious problem because of physical and psychological influences furthermore, fixation of smoking habit. This study is aimed at providing applicable basic information to setting up the education programs and strategies to prevent smoking among high school students by analysing smoking behavior and its related factors. METHODS: 835 students from one senior high school in Taegu completed a self administerd questionnaire during school hours in May, 1996. 813 questionnaires with adequate responses were analyzed using SPSS/PC program. All students were asked class years, school satisfaction, school performance score, number of their three best friends who smoke, smoking status of their fathers, religion, allowance, alcoholic drinks, addicting drug use, Zung's self-rating depression scale(SDS) and Zung's self-rating anxiety scale(SAS), Smokers were asked amount of smoking, motives for smoking, when they started smoking, Fagerstrom score. RESULTS: Of the 813 students in the sample 135(16.6%) were current smokers. About the amount of smoking, 59.3% smoked less than 5 cigarettes/day. About the motives of smoking, 34.8% started smoking through the solicitation by friends or for making friends. About when they started smoking, 52.6% started smoking before entrance into senior high school. The related factor with smoking Included class years, school satisfaction, school performance score, numbers of three best friends who smoke, allowance, alcoholic drinking, addicting drug use, SDS. Predictor of smoking were number of three best friends who smoke, number of alcoholic drinking, and allowance. The related factors of nicotine dependency were amount of smoking, allowance, when they started smoking. Predictor of nicotine dependency were amount of smoking, number of three best friends who smoke. CONCLUSIONS: The related factors with smoking included class years, school satisfaction, school performance score, number of three best friends who smoke, allowance, alcoholic drinking, addicting drug use, and SDS. Predictors of smoking were number of three best friends who smoke, number of alcoholic drinking, and allowance.
Adolescent ; Alcoholics ; Anxiety ; Daegu* ; Depression ; Drinking ; Education ; Fathers ; Friends ; Humans ; Male* ; Nicotine ; Prevalence ; Smoke* ; Smoking* ; Surveys and Questionnaires

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

PURPOSE: The Pediatric Risk of Mortality(PRISM) III score was developed from the Physiologic Stability Index(PSI) to assess pediatric ICU mortality and Provide an objective data as a severity index. Although the PRISM score has been applied to many comparisions and analyses in previous studies, there are few reports applied to pediatric intensive care patients in Korea. To evaluate the effectiveness of the PRISM III score as a severity index for expecting mortality and find important variables influencing mortality, we applied this scoring scale to pediatric neurologic patients admitted to the ICU and analyzed the data statistically. METHODS: Data collection was done by careful review of medical records and scored each clinical variable. The outcome at discharge was determined as non-survival, survival, and hopeless discharge. Determination of mortality in the hopeless discharge group was done within 48 hours after discharge by telephone interview. The study populations were classified into four groups; CNS infection(26 patients), acute encephalopathy(31 patients), status epilepticus(35 patients) and cerebrovascular disorder(4 patients). The difference of the PRISM III score between the survival group and non-survival group was compared by using the nonparametric Mann~Whitney test in the entire study population and for each diagnostic group. To confirm the degree of fitness between the actual mortality and Predicted mortality, the Hosmer-Lemeshow goodness-of-fit test, a multiple logistic regression model was used. All clinical variables used for scoring were compared for survivals and non-survivals by the Chi-square test. f values <0.05 were considered significant. RESULTS: The PRISM III score was significantly higher in the non-survival groups than in the survival group. Predicted mortality from the PRISM III score has fitted to actual mortality According to the results of analyses in each diagnostic groups, the PRISM III score was higher in non-survivals of the acute encephalopathy and CNS infection groups, but statistically insignificant in the cerebrovascular disorders and status epilepticus groups. The important variables of the PRISM III score associated with mortality were mental state, Pupil reflex, systolic blood pressure, acidosis, blood sodium level blood creatinine level, blood glucose level, and PT/PTT. , CONCLUSION: The PRISM III score is helpful in predicting mortality in pediatric intensive care neurologic patients, especially those in the acute encephalopathy or the CNS infection groups. However, this score was not useful in the status epilepticus group, and insignificant in cerebrovascular group. Due to the smallness of the study group, more massive and comprehensive studies are needed as a follow up to this study.
Acidosis ; Blood Glucose ; Blood Pressure ; Cerebrovascular Disorders ; Creatinine ; Data Collection ; Follow-Up Studies ; Humans ; Critical Care* ; Interviews as Topic ; Korea ; Logistic Models ; Medical Records ; Mortality* ; Pupil ; Reflex ; Sodium ; Status Epilepticus

PURPOSE: The purposes of this study were to compare postmortem fetal MRI findings with autopsy findings and to assess whether postmortem MRI can replace autopsy. MATERIALS AND METHODS: The study group consisted of 13 stillborn fetuses, seven that died immediately after birth, and five terminated because of anomalies seen on prenatal sonograms. A total 17 were male, and eight were female, and their gestational ages were from 20 to 41 (average; 28.2) weeks. Spin-echo T1-and T2-weight-ed axial, sagittal, and coronal MR images were obtained, and autopsy findings were divided into major and mi-nor. A major finding was defined as an anomaly or syndrome which caused fetal death or termination of the pregnancy; minor findings were classified, on the basis of gross inspection, as internal or external. MR images were retrospectively analyzed by two radiologists unaware of the autopsy findings, and by comparison with these, the postmortem MRI detection rates for major and minor findings was then determined. RESULTS: In seven of 25 fetuses, MR imaging revealed major findings, a detection rate of 100%. There were two cases of anencephaly, two of trisomy-18, and one each of hydrops fetalis with large cystic hygroma, diaphrag-matic hernia, and Dandy-Walker malformation. Twenty-three of 60 minor findings (38.3%) were detected by MRI. The detection rates for external and internal findings were 29.6%(8/27) and 45.5%(15/33), respectively. CONCLUSION: Although a limitation of our study is the low detection rate for minor findings, postmortem fetal MRI may help diagnose the major cause of fetal death.
Anencephaly ; Autopsy* ; Dandy-Walker Syndrome ; Female ; Fetal Death ; Fetus ; Gestational Age ; Hernia ; Humans ; Hydrops Fetalis ; Lymphangioma, Cystic ; Magnetic Resonance Imaging* ; Male ; Parturition ; Pregnancy ; Retrospective Studies

STATEMENT of PROBLEM: As a standard means of diagnostics, an orthopantomogram(OPT) permits to measure the vertical and mesiodistal dimension of available bone at the desired implant site with the help of suitable radioopaque references. Based on the clinical investigation of the dentition and the edentulous sites, information upon the width of the implant site can be obtained and documented in the dental scheme. Both findings permit together systematic primary planning for endosteal implants. PURPOSE of STUDY: Contents of the present article are the representation of a semiquantitative classification of available bone with the aim to simplify the primary phase of a systematic implant planning. RESULTS: Thus the ASCII-system permits a clear protocol of bone findings for the implant case with all information available during the primary appointment for treatment planning as a basis of further diagnostic and therapeutic measures. CONCLUSION: With the ASCII system, important parameters such as alveolar height and subcrestal alveolar width can be documented systematically, easily and time saving in the dental scheme as a basis for exact treatment planning.
Classification* ; Dentition

PURPOSE: This study was conducted to identify factors affecting nurses' burnout in secondary general hospitals. METHODS: Data were collected through structured questionnaires from 241 nurses working at the secondary general hospitals with below 400 beds in the P, C, and S city between April and May, 2009. Data analysis was done with independent t test, ANOVA, Pearson correlation coefficient, and multiple stepwise multiple regression with SPSS WIN v 17.0. RESULTS: Burnout was significantly different according to religion, age, clinical experiences, and shift work. Burnout score of the subjects was 58/100. Burnout of the subjects were positively correlated with job stress and negatively correlated with hardness, self efficiency, self esteem, spiritual wellbeing, social support, and job satisfaction. The explained variances for burnout was 51.8% and factors affecting nurses' burnout in secondary general hospitals were job stress, hardness, self efficiency, job satisfaction and shift work. CONCLUSION: These results showed the significant factors fo nurses' burnout in secondary general hospitals. These findings can be utilized to development of strategies for reducing job stress and enhancing hardness, self efficiency and job satisfaction.
Hardness ; Hospitals, General ; Job Satisfaction ; Surveys and Questionnaires ; Self Concept ; Statistics as Topic

BACKGROUND: Massive bleeding, inability to identify important landmarks and structures, and necessity for a blood transfusion have been the usual problems of hemangioma excision. OBJECTIVE: We introduce a CO2 laser excision technique as a surgical method for the treatment of hemangioma of the lips and demonstrate its benefits. METHODS: In 4 patients with nevus flammeus of hemiface and accompanying hemangioma of the lips, excision of the hemangioma was performed using a focused beam from a CO2 laser under local anesthesia. RESULTS: Excellent to good results were achieved with minimal blood losses in all patients. No or minimal post-operative pain and edema and no significant complications were observed. CONCLUSION:The CO2 laser excision technique is recommended since it renders less textural change, greater volume reduction, hemostasis and an overall good cosmetic outcome than defocused modes or conventional scalpel surgery.
Anesthesia, Local ; Blood Transfusion ; Edema ; Hemangioma* ; Hemorrhage ; Hemostasis ; Humans ; Lasers, Gas* ; Lip* ; Port-Wine Stain