This study was undertaken in order to examine the effect of hardiness on future stress-related physical symptoms in the female students in a longitudinal design. The subjects who participated in this study were 97 female nursing students (in the analysis of data after 1 year). The instruments used for this study were a survey of general characteristics, stress (43 items), hardiness(25 items), and physical symptoms(35 items). Analysis of data was done by use of mean and hierarchical multiple regression with the SAS program. The results of this study were as follows. 1) Main effects of hardiness on future stress-related physical symptoms was found. 2) The stress buffering effects of hardiness were not found.
Female ; Humans ; Longitudinal Studies* ; Nursing* ; Students, Nursing*

Replantation after crush amputation has a relatively low success rate. Thrombus formation due to vessel and tissue trauma is considered as the principal cause of failure. In the laboratory and clinically, we have been tried to improve the post-anastomosis patency rate in crushed microvasculature. To accomplish this, we have usually used several anticoagulant drugs. Extracts from the leaves of Ginkgo biloba (EGb) have been used therapeutically for centuries. EGb exerts a number of pharmacologic actions. Eighty rats were control group and another 80 rats were treated with EGb 761. The femoral arteries underwent crush injury with an energy of 0.4J, and the vessles in each group were divided and anastomosed by a standard microsurgical technique. Each group was comprised as follows: (1) control group(A1,A2): group A1(n=40); intraluminal saline irrigation, group A2(n=40); intraluminal saline irrigation+heparin 40 u/ml(IV). (2) EGb 761 treated group(B1, B2): groupB1(n=40); intraluminal saline irrigation, group B2(n=40); intraluminal saline irrigation + heparin 40 u/ml(IV). At postoperative 14 days, the patency rates were; group A1 20%, group A2 77.5%, group B1 47.5%, group B2 92.5%. These results were interpreted as follows: the patency rate was significantly increased in the EGb 761-only treated group(p>0.01), the heparin-only treated group(p>0.01), and the EGb 761 and heparin-combined at crushed microvessel surgery. However the patency rate of the EGb-only treated group was significantly lower than that of the heparin-only treated group(p>0.01). And in the EGb 761 and heparin-combined treated group compared to the heparin-only treated group, there was some patency rate increase in the combined treated group, but there was no significant difference between them(p=0.060).
Amputation ; Animals ; Anticoagulants ; Femoral Artery ; Ginkgo biloba* ; Heparin ; Microvessels* ; Pharmacologic Actions ; Rats* ; Replantation ; Thrombosis

PURPOSE: This study examined degrees of irrational parenthood cognition, post traumatic stress disorder (PTSD), spousal support, and quality of life and investigated factors that influence the quality of life of infertile women. METHODS: Research design was a cross sectional correlational survey with a total of 113 female patients receiving treatment for infertility. Data were collected from August 1 to November 30, 2015. The collected data were analyzed using t-test, ANOVA, Pearson's correlation, and multiple regression analysis. RESULTS: The mean score of the quality of life was 59.0±14.8. The quality of life was significantly associated with irrational parenthood cognition (r=-.70), post traumatic stress disorder (r=-.65), and spousal support (r=.56). The factors significantly affecting the quality of life in infertile women were irrational parenthood cognition (β=-.45), post traumatic stress disorder (β=-.34), and spousal support (β=.32). The explained variance by these factors was 70.4%, and the regression model was valid (F=89.81, p<.001). CONCLUSION: This study may contribute to the development of nursing intervention program to improve the quality of life of infertile women.
Cognition* ; Female ; Humans ; Infertility ; Nursing ; Quality of Life* ; Research Design ; Stress Disorders, Traumatic*

Late results of microvascular patency after crush or crush avulsion injury have been relatively poor. A key factor in the poor results may relate to the presence of damaged tissue, but the mechanism of this thrombus formation is still imcompletely understood. One current theory about the origin of thrombus after vessel trauma involves increased exposure of the subendothelial tissue to platelets that adhere and aggregate at the injury site, initiating thrombus formation. Most surgeons have usually used several anticoagulant drugs to prevent thrombosis for 2-3 weeks after trauma or microvascular repair. We thought that Ginkgo biloba extract (EGb 761), which has a number of pharmacologic actions, could promote microvasculature healing and prevent thrombosis. The femoral arteries of rats were dissected. Each group was as follows:-1. group A (n=10): intact group (not crushed vessel),2. group B (n=10); crushing injury (not EGb 761-treated group),3. group C (n=10); crushing injury (EGb 761-treated group). Group B and C underwent crush injury with the energy of 0.07J. We compared patency rate and histological examination. All arteries were patent at postoperative 14 days, and in histologic finding, group C (group with EGb 761 treatment among the crushed injury group) showed significant improvement of vascular endothelial and medial regeneration.
Animals ; Anticoagulants ; Arteries ; Femoral Artery ; Ginkgo biloba* ; Microvessels ; Pharmacologic Actions ; Rats ; Regeneration ; Thrombosis

PURPOSE: In skin flap surgery, surgeons often encounter distal ischemia of the flap. If a powerful free radical scavenger is used, it may reduce the formation of free radical and improves the survival of flap. Thus, the present study purposed to examine whether the survival of flap can be enhanced by administering melatonin, which is known to be a powerful free radical scavenger a antioxidant molecule. METHODS: We divided 40 Sprague-Dawley rats into 4 groups, 10 in each group. For the control group(n=10), we intraperitoneally injected only carrier solution once 30 minutes before the operation, and once a day for 7 days from the day of operation. Among the experimental groups, a group(n=10) was administered with dimethyl sulfoxide(DMSO), in another group(n=10), melatonin was intraperitoneally injected, and in the other(n=10) melatonin was intraperitoneally injected and applied topically(2cc of 1% melatonin) to the operation site. Caudally based skin flaps measuring 3x10cm2 were elevated on the mid-dorsum of the rats. and then repositioned. On the seventh postoperative day, the survival area of the flap was measured and tissues were examined under the light microscope. RESULTS: The control group, the DMSO group, the melatonin administration group and the melatonin administration and application group showed the mean survival rates of 55.26+/-9.2%, 70.29+/-7.47%, 81.45+/-4.14% and 86.1+/-1.52%, respectively, for 30cm2 of flap. Compared to the control group, the experimental groups showed a significantly high increase in survival area at significance level of 95%. CONCLUSION: In this study, the survival rate of flap was enhanced through the administration of melatonin after flap surgery. This suggests that melatonin not only functions as a powerful free radical scavenger and oxygen radical scavenger but also stabilizes and protects cells, and by doing so, enhances the survival of moderately injured ischemic sites in the distal end of flap.
Animals ; Dimethyl Sulfoxide ; Ischemia ; Light ; Melatonin ; Oxygen ; Rats ; Rats, Sprague-Dawley ; Skin ; Survival Rate

PURPOSE: Neurofibromatosis(NF) is an autosomal- dominant systemic disease. Up to fifty percent of patients with NF are reported to have concomitant vascular abnormalities. In the resection of a larger NF, the risk of uncontrolled hemorrhage is much higher due to the difficulty of hemostasis of large vessels within the tumor. We ligated the base of the giant NF with a simple loop- shaped ligation before removal of the giant NF in both buttocks. And then we successfully reduced the amount of hemorrhage during the operation. METHODS: A 46-year-old female patient presented for giant masses of both gluteal area, which has been growing slowly for the last ten years. Each mass was about 30x20 cm in size. After designing the elliptical resection margin, we tightened the tumor base by using continuous loop- shaped suture ligation(weaving the thread up and down in a loop-shaped pattern, leaving a space of 2cm between each loop) with a straight needle and prolene 2-0. After skin incision, we proceeded the dissection toward the central and inferior side of the mass obliquely while we avoided breaking large vascular sinuses. We resected the tumor in a wedged-shape. Subcutaneous tissue was sutured layer by layer and skin was closed by vertical mattress and interrupted suture. The loop-shaped ligation of the base was removed and compressive dressing was done with gauzes and elastic bandages. RESULTS: Postoperative complications such as infection, hemorrhage, hematoma, and dehiscence did not occur. Perioperatively the patient was sufficiently transfused with five units of blood and two units of fresh frozen plasma. During the subsequent 1 year follow-up, the functional and cosmetic results were excellent. CONCLUSION: A continuous loop-shaped suture ligation procedure along the base of the giant NF effectively reduced the amount of hemorrhage during the operation, made dissection and ligation of vessels easily and quickly, and shorten the operating time and postoperative recovery time.
Bandages ; Buttocks ; Cosmetics ; Female ; Follow-Up Studies ; Hematoma ; Hemorrhage ; Hemostasis ; Humans ; Ligation ; Middle Aged ; Needles ; Neurofibroma ; Plasma ; Polypropylenes ; Postoperative Complications ; Skin ; Subcutaneous Tissue ; Sutures

PURPOSE: Adenoid cystic carcinoma (ACC) is a rare malignant epithelial neoplasm derived from the salivary glands. In some cases, ACC may arise in other primary sites, such as skin. We report a case of adenoid cystic carcinoma arising the scalp skin of a 69-year-old woman. METHODS: A 69-year-old woman presented with a tender scalp nodule. A local wide excision was performed. Histopathologic examination revealed the adenoid cystic carcinoma with basaloid cells in a cribriform pattern. The resection margins were free of tumor. Two years later a tumor recurred in the scarred area. The lesion was removed surgically and the histopathological diagnosis of adenoid cystic carcinoma was again established. After two years, tumor recurred again and distant metastasis of the lung was diagnosed. A surgical wide excision was done and the close regular follow-up for recurrence was done. Two years later, third recurrence of the scalp was observed. We also performed the wide local excision with tumor free margin. RESULTS: We experience the recurrent adenoid cystic carcinoma of the scalp with pulmonary metastasis. We have performed the wide local excision for three times. The patient has been followed up for 10 years with regular work-up for recurrence and metastasis CONCLUSION: primary cutaneous adenoid cystic carcinoma is a rare skin neoplasm with a high potential for recurrence after local excision. The standard treatment of ACC is wide local excision with tumor-free margins established by permanent section.
Adenoids ; Aged ; Carcinoma ; Carcinoma, Adenoid Cystic ; Cicatrix ; Female ; Follow-Up Studies ; Humans ; Lung ; Neoplasm Metastasis ; Recurrence ; Salivary Glands ; Scalp ; Skin ; Skin Neoplasms

PURPOSE: In most cases of nasal bone fracture, closed reduction with internal or external splint fixation approach is selected. However, because of indiscriminate insertion of the internal splint without considering of anatomical difference or deformity, insufficient fixation happens frequently that need additional fixation. Therefore, we suggest a new method for providing adequate support in reduced nasal bone by carving Merocel(R) that is fixed for the anatomical structure. METHODS: Closed reduction and internal fixation with carved Merocel(R) was performed in 15 nasal bone fracture patients from March, 2010 to July, 2010. Each patient was evaluated by physical examination, facial photographic check, simple X-ray, and computerized tomography. On the first day post-operation, location of packing and amount of reduction were checked by follow up X-ray and computerized tomography. In addition, patients' symptoms were evaluated. During the 3-month post-op follow up at out-patient clinic, operator, 2 doctors in training and one assistant performed the objective evaluations by physical examination on nasal dorsal hump, nasal deviation, nasal depression, nasal breath difficulty, and nasal airway obstruction. A survey of subjective patients' satisfaction in 4-stages was also performed. RESULTS: The results of follow-up computerized tomography of the 15 patients revealed that 11 patients had good reduced state. Three patients with combined maxillary frontal process fracture had over reductions. A survey performed on the first day post-operation showed that 14 of 15 patients answered that their current symptoms were more than tolerable. At the 3-month follow-up physical exam, one case had a dorsal hump. However, there were no nasal deviations, nasal depressions, nasal breath difficulties, or nasal airway obstructions. Twelve of the 15 patients answered more than moderate on the 3-month survey. CONCLUSION: Intranasal packing after carving the Merocel(R) considering anatomical structure is a new effective method to promote proper-reduction, maintain stability, and minimize patients' symptoms by addition of a simple procedure.
Airway Obstruction ; Congenital Abnormalities ; Depression ; Follow-Up Studies ; Fractures, Closed ; Humans ; Nasal Bone ; Nasal Obstruction ; Outpatients ; Physical Examination ; Splints

PURPOSE: This study evaluated fracture resistance with regard to ferrule lengths and post reinforcement on endodontically treated mandibular premolars incorporating a prefabricated post and resin core. MATERIALS AND METHODS: One hundred extracted mandibular premolars were randomly divided into 5 groups (n=20): intact teeth (NR); endodontically treated teeth (ETT) without post (NP); ETT restored with a prefabricated post with ferrule lengths of either 0 mm (F0), 1 mm (F1), or 2 mm (F2). Prepared teeth were restored with metal crowns. A thermal cycling test was performed for 1,000 cycles. Loading was applied at an angle of 135 degrees to the axis of the tooth using a universal testing machine with a crosshead speed of 2.54 mm/min. Fracture loads were analyzed by one-way ANOVA and Tukey HSD test using a statistical program (α=.05). RESULTS: There were statistical differences in fracture loads among groups (P<.001). The fracture load of F2 (237.7 ± 83.4) was significantly higher than those of NP (155.6 ± 74.3 N), F0 (98.8 ± 43.3 N), and F1 (152.8 ± 78.5 N) (P=.011, P<.001, and P=.008, respectively). CONCLUSION: Fracture resistance of ETT depends on the length of the ferrule, as shown by the significantly increased fracture resistance in the 2 mm ferrule group (F2) compared to the groups with shorter ferrule lengths (F0, F1) and without post (NP).
Bicuspid* ; Crowns ; Tooth

PURPOSE: Adhesion after flexor tendon injury is a result of fibrosis between tendon and tendon sheath. This, finally interfere with gliding mechanism of tendon and results in functional problem of hands. Therefore, there have been many trials to reduce adhesion around the tendon. However, there is no standard procedure clinically practiced in hospitals. Mitomycin-C is an antineoplastic alkylating agent that decrease fibroblast proliferation and scar formation. It is commonly used in many surgery to reduce postoperative adhesion. This study was designed to observe the effect of Mitomycin-C on preventing adhesion in injured flexor tendon. METHODS: The deep flexor tendon of digit 2 and 4 in the left forepaw of 15 New Zealand White rabbits were subjected to partial tenotomy. In study group, injury site was exposed to a single 5-minute application of Mitomycin-C, and in control group was left untreated. Digit 2 and 4 in the right forepaw of each rabbit were considered as non-adhesion control group. After 2 weeks, the animals were sacrificed and digits were amputated for biomechanical test and histological study. RESULTS: In biomechanical study to measure yield point, mean yield point of non-adhesion control was 17.43+/-2.33 and 25.07+/-4.03 for adhesion control, which proves increase of adhesion in adhesion control group(p<0.05) in 95% confidence. In Mitomycin-C group, mean yield point was 12.71+/-4.97. Compared with adhesion control, there was decrease in adhesiveness in Mitomycin-C group(p<0.05) in 95% confidence. In histological study, the result of adhesion control revealed massive adhesions of bony structure, fibrotic tissue and tendon structure with ablation of the border. However in Mitomycin-C group, we could find increased fibrotic tissue, but adhesion is much lesser than adhesion group and borders between structures remain intact. CONCLUSION: This study suggests that Mitomycin-C can significantly reduce adhesion of injured flexor tendon in rabbit model.
Adhesiveness ; Animals ; Cicatrix ; Fibroblasts ; Fibrosis ; Hand ; Mitomycin ; Rabbits ; Tendon Injuries ; Tendons ; Tenotomy