The retraction of anterior teeth could be performed more easier by inducing of skeletal anchorage system rather than by conventional method on orthodontic treatment. But, we wonder how effective the system draws well without anchorage loss and draws anterior teeth aside posteriorly, and if the system can reduce the time, in comparison with the anchorage of posterior teeth. For that reason we have studied on the subject of patients, who were required the maximum anchorage on orthodontic treatment and the cases without crowding. The subjects of the experimental group are 35 areas of 20 people who were inserted miniscrews after Mx or Mn 1st premolar extracted. Also, the subjects of the control group are 81 areas of 45 people who were not inserted miniscrews. Compared the anchorage loss of experimental group with control one, we could get the result that the anchorage loss of experimental group is 1.034+/-0.891mm and control group is 2.790+/-1.882mm(P<0.01). Compared the space closing time of experimental group with control one, we could get the result that the space closing time of experimental group is 369.40+/-110.81days and control group is 406.56+/-231.63days. But the result of comparing space closing time has no significance in statistics. We recognized that the experimental group is more faster than the control group in the canine retraction velocity from the result ; the speed of a experimental group has as much as 0.60+/-0.23mm/30days while the speed of a control group has 0.44+/-0.35mm/30days(P<0.05). So, we could convince that orthodontic miniscrew is used effectively in the cases required the maximum anchorage.
Bicuspid ; Crowding ; Humans ; Tooth*

We recently observed a pancreatic islet cell adenoma with nesidioblastosis in a neonate which was confirmed after subtotal pancreatectomy. A nesidioblastosis, a term coined by Laidlaw in 1938 to describe the neoformation of islet tissue by differentiation of tortipotent pancreatic duct cell, is extremely rare as a cause of neonatal hypoglycemia. Persistent hypoglycemia which was temporarily responsive to hypertonic glucose therapy, convulsion, and apnea were noted frequently. Blood insulin level was elevated inappropriately with respect to the blood glucose level. Preoperative CBC, urinslysis, chest X-ray, serum electrolytes, and ECG were normal except low blood glucose leve(21mg%). The patient was not permedicated. With infusion of 15% D/W, anesthesia was induced by tracheal intubation with 3mg/kg of succinylcholine and was maintained by controlled ventilation with O2(3L/min)-N2O(3L/min)-halothane(1%) and pancuronium. Hyperglycemia and hypoinsulinemia were developed after pancreatectomy, these were controlled satisfactorily by administration of regular insulin. The patient was discharged with normal blood glucose level and no requirement of insulin at 38 days of postoperation.
Adenoma ; Anesthesia ; Apnea ; Blood Glucose ; Electrocardiography ; Electrolytes ; Glucose ; Humans ; Hyperglycemia ; Hypoglycemia ; Infant, Newborn* ; Insulin ; Intubation ; Islets of Langerhans ; Nesidioblastosis* ; Numismatics ; Pancreatectomy ; Pancreatic Ducts ; Pancuronium ; Seizures ; Succinylcholine ; Thorax ; Ventilation

Until recently edrophonium has not been used in clinical anesthesis because of its short duration of action and poor anticholinesterase activity. However there has been a renewed interest in the use of edrophonium for the reversal of the new intermediate acting relaxants, vecuronium and atracurium, which have a fast spontaneous recovery rate. Edrophonim in sufficient dosages may produce a fast onset of antagonism of non-depolarizing neuromuscular blockade with minimal muscarinic side effects. The porpose of this study was therefore to compare the efficiency of edrophonium and neostigmine in reversal of a profound neuromuscular blockad following continuous infusion of vecuronium (0.06 mg/kg/hr). Recovery of T1 and T4 twitch height, change of heart rate and mean arterial pressure were obsered after antagonism with control mixture group (n=10): neostigmine 0.04mg/kg and atropin 0.02 mg/kg, and experimental mixture group (n=9): edrophoninm 0.5mg/kg and atropine 0.007 mg/kg were evaluated respectively at the 10% spontaneous recovery of T1 twitch height. Recovery of T1 was more faster in the edrophonium group than in the neostigmine group but it was significant until 5 minutes after antagonism (p<0.05) and recovery of T4 was also significantly faster in the edrophonium group until 5 minutes after antagonism but thereafter, conversly faster in the neostigmine group than in the edrophonium(p<0.05). Changes of heart rate with +/-5% after edrophonium administration were observed. We conclude that edrophonium provides a more rapid antagonism within 5 minutes after antagonizing vecuronium infusion, and small change in heart rate, but no other any advantage in using edrophomine instead of neostigmine for reversal after 5 minutes.
Arterial Pressure ; Atracurium ; Atropine ; Edrophonium* ; Heart Rate ; Neostigmine* ; Neuromuscular Blockade ; Vecuronium Bromide*

No abstract available.
Pancreatic Diseases*

PURPOSE: This study was to develop, implement, and evaluate an e-learning education program for improving practical knowledge and preventing nursing errors and adverse events of nurses working in the operating room (OR). METHOD: The e-learning program was developed and evaluated according to the following processes: 1) preparation phase 2) implementation phase 3) evaluation phase. In evaluation phase, the effectiveness was analyzed based on the Kirkpatrick's model. RESULTS: The e-learning program consisted of OR basic nursing skills and techniques and nursing activities' manual based on the categories of nursing errors: surgical operation preparation, nursing skills and techniques, environment management, patient safety and comfort, and patient monitoring. The program was provided through on-line, http:// cafe.daum.net/pnuhorn, for 4 weeks. The mean score(percent) of participants' satisfaction was 21.24+/-1.71(68.2%). Their total knowledge level was significantly improved(Z=-3.00, p=.003) and specifically in the category of environment management(Z=-3.77, p<.001) and patient monitoring(Z=-2.46, p=.014). The occurrence of nursing errors or adverse events was a little decreased, but not statistically significant(Z= -3.10, p=.756). CONCLUSION: E-learning for nurses is one way of effective and efficient teaching-learning strategies. For better e-learning, it is important to develop the vital content of the education and objective measures for detecting nursing errors and adverse events.
Education* ; Education, Nursing, Continuing ; Humans ; Medical Errors ; Monitoring, Physiologic ; Nursing* ; Operating Rooms* ; Patient Safety ; Program Development ; Program Evaluation

Lithium, first used by Cade in 1949 for the treatment of mania, is now commonly used in several affective disorders. The precise mechanism of its action is not clearly understood but the side effects may be severe. Prolongation of succinylcholine and pancuronium which possible mechanism of interaction involves impaired acetylcholine synthesis and release at nerve terminal has been reported. The present report describes a case of prolonged neuromuscular blockade induced by succinylcholine in a manic depressive patient being treated with oral lithium carbonate.
Acetylcholine ; Bipolar Disorder ; Humans ; Juniperus ; Lithium Carbonate* ; Lithium* ; Mood Disorders ; Neuromuscular Blockade* ; Pancuronium ; Succinylcholine*

Vecuronium induced intense neuromuscular blockade was evaluated in 40 USA class l, ll adult patients using the post tetanic count (PTC) and train-of-four(TOF) methods. All patients were anesthetized with thiopental sodium, nitrous oxide(50%), and enflurane(1~2%). Neuromuscular monitoring commended immediately after administration of thiopental sodium. The ulnar nerve was stimulated using surface electrodes and the mechanical response of the adductor policis muscle recorded using the Acclograph, neuromuscular transmission monitor. TOF nerve stimulation was used every 15s. After supramaximal stimulation was achieved a bolus of vecuronium 0.1mg/kg was injected intravenously. The traches was intubated when TOF response was depressed to 95% or above to control twitch height and the lungs ventilated with a tidal volume of 10ml/kg and a rate of 14 b.p.m. The patients were allocated randomly to two groups of 20 patients each. Patients in control group were allowed to recover TOF response spontaneously, and in PTC group were applied tetanic stimulation(50Hz for 5s) at 7 minutes intervals during no TOF response. In PTC group, the tetanic stimulation was preceded by a 30s period of 1Hz stimulation on each occasion, which was continued after the 3s pause. Duration of no TOF response in each group, and relationship between first post tetanic twitch height of PTC and time to first reaction to TOF nerve stimulation in PTC group were measured. In the results, duration of no TOF response was shortened by tetanic stimulation(p<0.01). There was a close inverse correlation between first post tetanic twitch height or PTC and time to first reaction to TOF nerve stimulation (p<0.01). It was concluded that PTC method appeared to be a valuable supplement to TOF nerve stimulation in assessment and trend for vecuronium induced intense neuromusclular blockade.
Adult ; Electrodes ; Humans ; Lung ; Neuromuscular Blockade* ; Neuromuscular Monitoring ; Thiopental ; Tidal Volume ; Ulnar Nerve ; Vecuronium Bromide*

The myocardial infarction is usually associated with the coronary artery disease in adults. It is unusual in chilhood and young adult but occasionally associated with coronary vasculitis. Takayasu's arteritis produces a panaortits with thickening of the adventitia and narrowing of aorta. Narrowing of coronary arteries is due to extension into these arteries of the processes of inflammation that occur in aorta. We report here two cases of Takayasu's aortitis causing acute myocardial infarction. Case 1 is a 17-year-old girl presented with the inferior myocardial infarction and the cerebral infarction. Digital subtraction aortography showed a diffuse narrowing of the aorta and the obstruction of both subclavian arteritis, right carotid artery and both femoral arteries. Case 2 is a 19-year-old male patient with anterior myocardial infarction. Coronary cineangiogram showed the beak like appearance of the left main coronay artery.
Adolescent ; Adult ; Adventitia ; Animals ; Aorta ; Aortitis* ; Aortography ; Arteries ; Arteritis ; Beak ; Carotid Arteries ; Cerebral Infarction ; Coronary Artery Disease ; Coronary Vessels ; Female ; Femoral Artery ; Humans ; Inferior Wall Myocardial Infarction ; Inflammation ; Male ; Myocardial Infarction* ; Takayasu Arteritis ; Vasculitis ; Young Adult

PURPOSE: This study was conducted to investigate the effects of foot reflexzone massage on state - anxiety and discomfort of ovarian cancer patients receiving chemotherapy. METHOD: A quasi experimental design with a non equivalent control group and non synchronized design was used. The experiment was conducted from October 1, 2003 to September 30, 2004. The subjects consisted of 40 patients admitted to C University Hospital. Twenty subjects were assigned to the experimental group and received foot reflexzone massage everyday for 3 days. The other 20 subjects were in the control group and received routine care. Foot reflexzone massage was done on both feet of the subjects for 30 minutes for 3 days using standard protocol. The 'State-Anxiety Inventory' developed by Spielberger was used to measure the degree of state-anxiety. Discomfort was assessed using the 'Symptom Distress Scale' of McCorkle and Young. Data was analyzed by a SAS program using t-test, Wilcoxon signed rank sum test and Wilcoxon rank sum test. RESULTS: State-anxiety and discomfort of subjects receiving foot reflexzone massage were significantly lower than those of the control group. CONCLUSION: These findings indicate that foot reflexzone massage could be an effective nursing intervention for relieving state-anxiety and discomfort in ovarian cancer patients.
Anxiety ; Drug Therapy* ; Foot* ; Humans ; Massage* ; Nursing ; Ovarian Neoplasms* ; Research Design

PURPOSE: The study was done to investigate the effects of an exercise program on body composition, cardiopulmonary function and physical fitness in obese children. METHODS: Thirty nine children in grades 4, 5, and 6 in elementary school were employed: experimental group(20) and control group(19). The subjects in the experimental group participated in an exercise program for 8weeks, thirty five minutes per session, four times per week. This data was analyzed by ANCOVA and paired t-test. RESULT: The Height(F=2.615, p=0.027) of the experimental group was significantly different from the control group. Also, in the experimental group, there were significant differences of height(t=4.79, p=0.000), cardiac rate(t=-6.461, p=0.000), body mass index(t=-2.13 p=0.046), muscle strength(t=3.48, p=0.003), and muscle endurance(t=3.20, p=0.005). Otherwise, in the control group, there were significant differences of weight(t=2.27, p=0.036), waist-hip ratio(t=3.16, p=0.005), and muscle endurance(t=-2.38, p=0.030). CONCLUSION: Jumping rope improved the body composition, cardiopulmonary function, and physical fitness for obese children.
Blood Pressure ; *Body Composition ; Child ; *Exercise Therapy ; Female ; Heart Rate ; Humans ; Male ; Obesity/*therapy ; *Physical Fitness