Dihydropyridine (DHP) calcium channel blockers (CCBs) have been widely used to treat of several cardiovascular diseases. An excessive shortening of action potential duration (APD) due to the reduction of Ca2+ channel current (I(Ca)) might increase the risk of arrhythmia. In this study we investigated the electrophysiological effects of nicardipine (NIC), isradipine (ISR), and amlodipine (AML) on the cardiac APD in rabbit Purkinje fibers, voltage-gated K+ channel currents (I(Kr), I(Ks)) and voltage-gated Na+ channel current (I(Na)). The concentration-dependent inhibition of Ca2+ channel currents (I(Ca)) was examined in rat cardiomyocytes; these CCBs have similar potency on I(Ca) channel blocking with IC50 (the half-maximum inhibiting concentration) values of 0.142, 0.229, and 0.227 nM on NIC, ISR, and AML, respectively. However, ISR shortened both APD50 and APD90 already at 1 microM whereas NIC and AML shortened APD50 but not APD90 up to 30 microM. According to ion channel studies, NIC and AML concentration-dependently inhibited I(Kr) and I(Ks) while ISR had only partial inhibitory effects (<50% at 30 microM). Inhibition of I(Na) was similarly observed in the three CCBs. Since the I(Kr) and I(Ks) mainly contribute to cardiac repolarization, their inhibition by NIC and AML could compensate for the AP shortening effects due to the block of I(Ca).
Action Potentials ; Amlodipine ; Animals ; Antihypertensive Agents ; Arrhythmias, Cardiac ; Calcium Channel Blockers* ; Calcium Channels* ; Calcium* ; Cardiovascular Diseases ; Inhibitory Concentration 50 ; Ion Channels ; Isradipine ; Myocytes, Cardiac ; Nicardipine ; Purkinje Fibers ; Rats

The nursing process, composed of diagnosis, intervention and outcome, is practical and scientific approach. In addition, many studies on the nursing process have been performed. However, the nursing process has not applied to clinical fields. Therefore, we developed a nursing information system that supports nurses nursing diagnosis and intervention management. This system provides expected nursing diagnoses and interventions for subjective patients automatically so that nurses can make more accurate diagnoses and perform more adequate interventions. For that purpose, we have analyzed the relations of medical diagnoses and standardized nursing classifications and developed the outputs into a database system. In this study, we performed clinical tests for the system and verify the usefulness of the system with case database accumulated through the tests. We expect the system can be used in many hospitals efficiently after some upgrade based on the results of this study is completed.
Classification ; Diagnosis* ; Humans ; Information Systems ; Nursing Diagnosis* ; Nursing Process ; Nursing*

PURPOSE: The purpose of this study was to develop a home care nursing network system for operating home care effectively and efficiently by utilizing a wire-wireless network and mobile computing in order to record and send patients' data in real time, and by combining the headquarter office and the local offices with home care nurses over the Internet. It complements the preceding research from1999 by adding home care nursing standard guidelines and upgrading the PDA program. METHOD: Method/1 and Prototyping were adopted to develop the main network system. RESULT: The detailed research process is as follows : 1)home care nursing standard guidelines for Diabetes, cancer and peritoneal-dialysis were added in 12 domains of nursing problem fields with nursing assessment/intervention algorithms. 2) complementing the PDA program was done by omitting and integrating the home care nursing algorhythm path which is unnecessary and duplicated. Also, upgrading the PDA system was done by utilizing the machinery and tools where the PDA and the data transmission modem are integrated, CDMX-1X base construction, in order to reduce a transmission error or transmission failure.
*Computer Communication Networks ; *Home Care Services ; Humans ; *Information Systems ; *Nursing Care

PURPOSE: Purposes of this study were to identify non-value-added nursing activities (NVANAs) and to estimate the amount of time spent on NVANAs among total nursing activities. METHODS: Non-value-added nursing activities were identified though the use of a focus group. The nurses in the focus group were nurses working in a tertiary hospital. They discussed possible activities that could be NVANAs. Based on the focus group discussion, a pilot study was done to examine the actual occurrence of NVANAs in clinical settings. RESULTS: The focus group discussion showed that NVANAs occurred in ten categories of nursing performances including communication with physicians, communication with other departments, medications, equipment/supplies, nursing records, tests, admission, discharge, and transfer. Direct nursing activities accounted for 35.5% of total nursing activities while indirect nursing activities accounted for 64.5%. Of indirect nursing activities, 16% were NVANAs. Most NVANAs were related to communication and equipment/supplies. CONCLUSIONS: To improve the quality and efficiency of nursing activities, it is necessary to identify NVANAs and their causes. Results of this study suggest that improvement in the work process and nursing unit structure, support for equipment/supplies, and effective communication are needed to reduce NVANAs in tertiary hospitals in Korea.
Focus Groups ; Korea ; Nursing Records ; Pilot Projects ; Tertiary Care Centers

PURPOSE: This study was aimed to evaluate the performance of a community-based home care services model. METHOD: The subjects were 138 patients who have been enrolled during a 6 month's period, nursing records and nursing service bills. The data was collected by self report and chart review. The mean cost per visit was compared with those of hospitalization & clinic visit in the data from National Health Insurance Corporation. RESULT: A significant number of patients were bed ridden(63.8%) and unconscious(27.5%), and most of the patients had complex chronic diseases. Except nursing assessment, bed sore care was the most frequent nursing treatment(25.1%) in home care services. The mean cost per visit of home care services was 34,665 won, which was lower than those of hospitalization & clinic visit for medical aid. The patients were highly satisfied with the services by visiting nurse specialists. CONCLUSION: Community-based home care services provided cost-effective and satisfied services. Community-based home care services needs systematic supports to expand it's domain for promoting community health.
Ambulatory Care ; Chronic Disease ; Home Care Services* ; Hospitalization ; Humans ; National Health Programs ; Nurses, Community Health ; Nursing ; Nursing Assessment ; Nursing Records ; Nursing Services ; Pressure Ulcer ; Self Report ; Specialization

BACKGROUND: Established risk factors for coronary artery disease include smoking, hypertension, diabetes mellitus and hypercholesterolemia. However, these account for less than 50% of the actual incidence of coronary artery disease and the importance of other risk factors is being increasingly realized. It has been known that insulin resistance associated with hyperinsulinemia is a pivotal link to several risk factors of coronary artery disease, including hypertension, glucose intolerance, dyslipidemia and obesity. Recently both experimental and clinical studies have produced evidence suggesting that high plasma insulin level may promote the development of atherosclerotic vascular diseasa. Several prospective studies showed independently that high plasma insulin is associated with an increased risk of major coronary artery disease. In our study, plasma glucose, insulin and C-peptide level were determined with oral glucose tolerance test to assess the insulin resistance or hyperinsulinemia as a risk factory of coronary artery disease. METHOD: From September 1993 to April 1995, after excluding patients with hypertension, diabetes mellitus, hypercholesterolemia and obesity, 17 patients with significant coronary artery stenosis and 10 control subjects with normal coronary finding were selected among the 226 patients who undertook coronary angiography. In the 17 cases(M:F=15:2) of coronary artery disease group, the mean age was 54+/-10 years, and in the 10 cases(M:F=8:2) of control group, 51+/-9 years. All were matched for age, gender and body mass index. Blood pressure, lipid and lipoprotein were measured and smoking history was assessed. Glucose, insulin and C-peptide responses to oral glucose tolerance test were also determined. RESULT: 1) There was no significant difference in systolic and diastolic and diastolic blood pressure, total-cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol, ApoA and smoking history except ApoB between the subjects with coronary artery disease and normal control subjects. 2) In oral glucose tolerance test, the plasma glucose levels were not significantly different in the two groups. plasma insulin and C-peptide levels at 60 and 120 minutes were higher in the patient group than control, but the results lack statistical significance. The area under the insulin curve and C-peptide curve were larger in patient group than control, but the result lack statistical significance also. CONCLUSION: Although our study dose not prove the hypothesis that insulin resistance or hyperinsulinemia is statistically an independent risk factor for coronary artery disease, this study showed the tendency of insulinresistance to be correlated with development of coronary artery disease. As this study has limitations due to small sample size, further study is required to confirm the role of hyperinsulinemia using a larger sample size.
Apolipoproteins A ; Apolipoproteins B ; Blood Glucose ; Blood Pressure ; Body Mass Index ; C-Peptide ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Diabetes Mellitus ; Dyslipidemias ; Glucose ; Glucose Intolerance ; Glucose Tolerance Test ; Humans ; Hypercholesterolemia ; Hyperinsulinism ; Hypertension ; Incidence ; Insulin Resistance* ; Insulin* ; Lipoproteins ; Obesity ; Plasma ; Prospective Studies ; Risk Factors* ; Sample Size ; Smoke ; Smoking ; Triglycerides

No abstract available.
Dendritic Cells*

Hamartoma of the breast is a rare benign lesion presenting as palpable mass. They are, however, sometimes misdiagnosed by pathologist due to their resemblance to other benign or physiologic conditions of the breast. We report two cases of hamartomas of the breast. The clinical diagnosis was fibroadenoma in both cases. One patient was a 49-year-old woman presented with palpable mass for the duration of 5 months. Mammography showed a well demarcated round mass with homogeneous density which is slightly greater than the surrounding glandular tissue. Grossly it was a 3.5 3.0 2.0 cm sized round firm mass covered by thin fibrous tissue. Microscopically it was a well defined mass composed of variable amount of breast lobules, dilated ducts and adipose tissue surrounded by dense hyalinized connective tissue. The adipose tissue accounted for 30% of the entire lesion. Cellular atypism was not found. The other patient was a 18-year-old woman presented with palpable mass of the duration of 3 years, which was increased in size recently. Mammography demonstratesd a well delimited lobulated mass with lucent halo. Ultrasonography showed a well encapsulated low echoic mass admixed with high echoic areas. Grossly, it was a 4.0 4.0 2.0 cm sized well demarcated oval-shaped firm mass with translucent thin fibrous capsule.. Microscopic findings were similar to the former. The amount of adipose tissue was 20%.
Adipose Tissue ; Adolescent ; Breast* ; Connective Tissue ; Diagnosis ; Female ; Fibroadenoma ; Hamartoma* ; Humans ; Hyalin ; Mammography ; Middle Aged ; Ultrasonography

PURPOSE: This study was an analysis of the relationship between perception for appraisal of staff nurses in operating rooms and performance and organizational commitment. METHOD: The survey was conducted with 176 staff nurses in operating rooms in 2 hospitals in Seoul. Data were analyzed using frequency, one-way ANOVA, Pearson correlation analysis, and stepwise multiple regression. RESULT: 1. Perception for appraisal including accuracy and justice was significantly related to organizational commitment (r=.496, P=.000). Perception for appraisal including accuracy and justice was slightly related to performance (r=.220, P=.003). 2. In order to determine the percentage of the variance of performance and organizational commitment that could be predicted by perception for appraisal, perception for appraisal was entered in the regression equation. Accuracy accounted for 25% of the variance in the organizational commitment. To determine the percentage of the variance of performance that could be predicted by perception for appraisal and organizational commitment, the perception for appraisal and organizational commitment were entered in the regression equation. Organizational commitment accounted for 21% of the variance in the performance. Consequently accuracy predicted organizational commitment. Organizational commitment predicted performance. CONCLUSIONS: Findings indicate the need to increase accuracy of performance appraisal to promote organizational commitment and performance in perioperative nurses.
Operating Rooms ; Social Justice

PURPOSE: The purpose of this study was to identify the specific types and characteristics of gender role identity in view of male nursing students. METHOD: Q-methodology, a technique for extracting subjective opinions, was used. Forty participants completed the Q-sort activity, rating each statement relative to the others. The Q sample has two categories, representing masculinity and femininity, and each category has 20 statements, resulting in 40 adjectives. The collected data were analyzed by QUANL PC program. RESULTS: Three types of gender role identity of male nursing students were identified: 'Taciturn warmth type', 'assertive power type', 'empathic warmth type'. Despite the differences among the types in this research, male nursing students are likely to have the understanding and keep faith. CONCLUSION: Male nursing students were exposed to many problems because of the gendered culture of nursing education. To understand the male nursing students' gender role identity will help to promote adaptation in nursing field.
Education, Nursing ; Femininity ; Gender Identity* ; Humans ; Male ; Masculinity ; Nursing ; Q-Sort ; Students, Nursing*