BACKGROUND: Compared with conventional routes of delivering potent analgesics to postoperative patients, transdermal administration of fentanyl offers the advantages of simplicity and noninvasiveness. The analgesic efficacy and safty of transdermal fentanyl patch (TDFP) were evaluated postoperatively. METHOD: TDFP releasing 25 mcg/hr (Group 1) or placebo (Group 2) were applied to 40 women 6 hours before total abdominal hysterectomy under the general anesthesia. Postoperatively, self-administered intravenous fentanyl was maintained with a 20-mcg incremental dose and a 10-min. locking interval. Each group was assessed following 48 hours with respects to vital signs, VAS pain scores, hourly-used fentanyl doses, satisfaction scores and side effects. RESULT: VAS observed 24 hours, 36 hours after operation were significantly lower in group 1 than group 2. Hourly-used fentanyl doses were significantly lower in group 1 than group 2 at 2 hours, 6 hours, 12 hours and 24 hours after operation. The incidence of side effects were similar between group 1 and group 2. CONCLUSION: TDFP-25 mcg applied 6 hours before operation provides supplementary analges-ia after the postoperative period without significant side effects such as respiratory depression.
Administration, Cutaneous ; Analgesics ; Anesthesia, General ; Female ; Fentanyl* ; Humans ; Hysterectomy* ; Incidence ; Postoperative Period ; Respiratory Insufficiency ; Vital Signs

PURPOSE: When recurrent dissociated vertical deviation (DVD) is cosmetically objectionable after superior rectus recession is used to surgically treat DVD, inferior rectus resection or superior rectus re-recession should be considered. The effect of re-recession of the superior rectus was, therefore, evaluated as a treatment of recurrent DVD. METHODS: We retrospectively reviewed the medical records of 9 eyes from 7 patients who had undergone superior rectus re-recession as a second surgery due to recurrence after superior rectus recession for DVD. RESULTS: The mean follow-up period after re-recession of the superior rectus was 32.1 (22~66) months. The preoperative mean deviation was 16.0 prism diopters (PD), and the postoperative mean deviation was 4.9PD. According to the classification of recurrent DVD by Scott, the surgical results of five eyes were excellent (0~4PD), those of 2 eyes were good (10~14PD), and those of 2 eyes were fair. The mean corrected DVD was 4.1PD per 1 mm recession. CONCLUSIONS: Postoperatively, 7 of 9 eyes (77.7%) were aligned within 9PD. In cases of recurrent DVD, superior rectus re-recession yielded satisfactory results with minimum surgery on the superior rectus. The results of this study will be helpful in deciding surgical amount of superior rectus re-recession to be performed.
Eye ; Follow-Up Studies ; Humans ; Medical Records ; Recurrence ; Retrospective Studies

PURPOSE: To study the efficacy of unilateral rectus resection in the surgical treatment of undercorrected or recurrent strabismus. METHODS: A retrospective chart review of patients who had undergone a unilateral rectus resection with at least 6 months (mean 35.6 months) of postoperative follow-up was performed. RESULTS: A resection of a single rectus muscle was undergone by 92 patients: 70 underwent a unilateral resection of the medial rectus and 22 underwent a unilateral resection of the lateral rectus. The mean preoperative deviations of patients were 23.6+/-5.9 prism diopters (PD). The amount of unilateral medial rectus resection ranged from 3 to 7 mm and unilateral lateral rectus resection ranged from 5 to 10 mm. The satisfactory surgical result was considered to be any deviation within 8 PD. The success rates were 81.4% in the unilateral medial rectus resection group and 72.7% in the unilateral lateral rectus resection group. The satisfactory surgical result of the group of preoperative deviation less than or equal to 20 PD was 93.2%, the group of greater than 20 PD and less than or equal to 25 PD was 65.6% and the group of greater than 25 PD was 68.8%. This difference in results between three groups was statistically significant (p=0.006). CONCLUSIONS: The unilateral rectus resection is an effective procedure for the treatment of undercorrected or recurrent strabismus with small to moderate preoperative deviations.
Follow-Up Studies ; Humans ; Reoperation* ; Retrospective Studies ; Strabismus*

This is a case report of a cystic hygroma with polycystic kidney in a fetus which was suspected by ultrasonography and was confirmed by autopsy. Recently, we have experienced this case in 25-year old woman repeatedly and we report that with a brief review of relevant literature.
Adult ; Autopsy ; Female ; Fetus ; Humans ; Lymphangioma, Cystic* ; Polycystic Kidney Diseases* ; Ultrasonography

PURPOSE: This study was designed to investigate the effects of a network program to prevent obesity and improve dietary habits for patients taking antipsychotics or antidepressants. METHOD: Thirty-seven patients in two hospitals were assigned to a control group (21 patients) or an intervention group (16 patients). The intervention group was evaluated to analyze the effect of the network program for six weeks after the program. RESULT: There was a difference in the rate of increased body weight between the control group and the intervention group. Notably, the body weight of both groups before the intervention was significantly increased. However, after the intervention the body weight of the intervention group rarely increased, whereas, the body weight of the control group was significantly increased as expected. There was an observed difference in diet between the control group and the intervention group. After the intervention, caloric intake per day of the intervention group decreased. Also, the duration of the meal of the intervention group after the intervention was longer than before. CONCLUSION: The network program for preventing obesity and improving dietary habits of patients taking antipsychotics or antidepressants was effective. The study shows that a network program can be an important part of a nursing intervention in clinical practice.
Weight Gain/drug effects ; Schizophrenia/drug therapy ; Obesity/chemically induced/*prevention & control ; Mood Disorders/drug therapy ; Male ; Humans ; Female ; Energy Intake ; Diet, Reducing ; Antipsychotic Agents/*adverse effects ; Antidepressive Agents/*adverse effects ; Adult ; Adolescent

This study examined the effects of a brown rice vegetarian diet and outdoor walking exercise program on body composition and blood lipid parameters in collegians. The mean age of respondents was 21.8 yrs (males) and 21.7 yrs (females). During the ten-day program, the respondents lived in a dormitory and had three meals. The respondents exercised one hour in the morning (6:20~7:20 am) and attended one and a half hour evening lecture (7:00~8:30 pm) everyday. The brown rice vegetarian diet consisted of brown rice, whole grain bread, beans, fresh vegetables, and fresh fruits contained 2043.2+/-112.7 kcal (97.3% of RNI), 66.7 g protein (133.3% of RNI), 33.6 g dietary fiber (168.2% of RNI), vitamin A (194.2% of RNI), vitamin B1 (245.5% of RNI), vitamin B2 (225.1% of RNI), niacin (233.7% of RNI), vitamin B6 (277.1% of RNI), folic acid (128.4% of RNI), vitamin C (334.6% of RNI), iron (131.9% of RNI), zinc (112.4% of RNI) and calcium (60.3% of RNI). The results showed that there were significant increases in body weight (P<0.05) and BMI (P<0.05) in males and body weight (P<0.05) and lean body mass (P<0.01) in females. In addition, there were significant decreases in total cholesterol (P<0.001), LDL cholesterol (P<0.001), TG (P<0.05), and HDL-cholesterol (P<0.001) in males and total cholesterol (P<0.01) and LDL-cholesterol (P<0.01) in female. The ten day brown rice vegetarian diet rich in fiber and outdoor walking exercise program significantly increased body weight and decreased total cholesterol and LDL-cholesterol in collegians.
Ascorbic Acid ; Body Composition ; Body Weight ; Bread ; Calcium ; Edible Grain ; Cholesterol ; Cholesterol, LDL ; Surveys and Questionnaires ; Diet, Vegan ; Dietary Fiber ; Fabaceae ; Female ; Folic Acid ; Fruit ; GTP-Binding Proteins ; Humans ; Iron ; Male ; Meals ; Niacin ; Riboflavin ; Thiamine ; Vegetables ; Vitamin A ; Vitamin B 6 ; Walking ; Zinc

Primary malignant lymphoma of the appendix is an unconnnon neoplasm although the gastrointestinal tract is the most common extranodal site of malignant lymphoma. We report a case of primary malignant lymphoma of the appendix in a 54-year-old male, who presented with pain in the right lower abdomen. An appendectomy was performed. The appendix measured 9.5 cm in length and 5.5 cm in diameter. Cut sections showed a solitary circumferential mass in the appendiceal lumen. Light microscopic features were compatible with malignant lymphoma of diffuse large cell type(Working Formulation) and the immunophenotype was B cell type.

Proliferations of the endometrial glands form a continuum from focal glandular crowding through simple hyperplasia, complex hyperplasia and atypical hyperplasia to frank adenocarcinoma. But objective criteria to distinguish these proliferative endometrial lesions are not clear-cut and terminology is confusing. The p53 protein is a nuclear phosphoprotein that can regulate cell proliferation and suppress tumor growth. Mutation in the p53 gene have been reported in a variety of human tumors, and in selected malignancies overexpression of p53 has been associated with poor prognosis. In this study we examined a series of endometrial proliferative lesion, including hyperplasia, adenocarcinoma, and adenomyosis to determine whether or not p53 is overexpressed in these lesions. In the result, p53 immunoreactivity was observed in 3 of 17 (17.6%) simple hyperplasia, one of 6 (16.6%) complex hyperplasia, none of 3 (O%) atypical hyperplasia, 6 of 13 (46.1%) adenocarcinoma and none of 10 (O%) adenomyosis. In conclusion, p53 mutation seems to play a role in oncogenesis of endometrial adenocarcinoma in early phase but there was no significant relationship between p53 overexpression and histologic grade of adenocarcinoma.
Adenocarcinoma* ; Adenomyosis ; Carcinogenesis ; Cell Proliferation ; Crowding ; Endometrial Hyperplasia* ; Female ; Genes, p53 ; Humans ; Hyperplasia ; Prognosis

PURPOSE: The purpose of this study was to define and clarify the concept of reality shock in new graduated nurses. METHODS: The hybrid model was used to develop the concept of reality shock. The model included a field study. The participants were 9 newly graduated nurses with a nursing career spanning less than a year. RESULTS: The reality shock in newly graduated nurses was identified to have three dimensions and seven attributes. Specifically: 1) the dimension of performance included two attributes (conflict between theory and practice, and being overwhelmed by the workload), 2) the dimension of relationship included three attributes (loss of support, embarrassment from interference, and relational withdrawal), 3) the dimension of expectations included two attributes(value confusions and incongruity in personal life). CONCLUSION: Newly graduated nurses' reality shock was defined as a state of incongruence in their entire life that the new nurses experienced owing to value confusions that occurred due to the conflicts between theory and practice in an unfamiliar work environment, getting overwhelmed by the workload, and withdrawing establishing relationships with others due to the loss of support and excessive interference. These findings could help develop intervention strategies to decrease reality shock in newly graduated nurses.
Humans ; Nursing ; Shock*

PURPOSE: The purpose of this study was to identify factors that affect reality shock in new nurses. METHODS: Participants were 216 newly graduated nurses with less than 1 year experience in 5 university and 10 general hospitals in Busan, Ulsan and Gyeongnam, A self-report questionnaire was completed by the nurses between November 18 and December 25, 2013. Data were analyzed using t-test, ANOVA and hierarchial multiple regression analysis with the SPSS/WIN 21.0 Program. RESULTS: Average scores for work environment and environmental reality shock were 2.63+/-0.33 and 2.66+/-0.43 points respectively. Regression analysis showed that with the nurses' demographic and work characteristics controlled, work environment explained 4.2% of the reality shock. Factors significantly affecting reality shock included nurses' changing residence because of job (beta=.21, p=.001), whether they were able to work on the unit of their choice (beta=-.13, p=.031) and whether they had a choice in days off (beta=-.14, p=.038). CONCLUSION: When these factors are considered, reduction in nurses' reality shock requires improvement in work environment, placing new nurses in a department of their choice and allowing them a choice in off-duty days. These measures would also help achieve organizational goals and develop the new nurses as professional nurses.
Busan ; Hospitals, General ; Organizational Objectives ; Surveys and Questionnaires ; Shock* ; Ulsan