Postoperative colonoscopy is an effective tool for management of colonic adenomas. Authors analyzed the pattern of colonic adenomas detected during follow-up colonoscopy after colorectal cancer surgery and evaluated the characteristics of adenornas, risk groups, and effective fo1low-up schedule. Study group were 222 patients and colonoscopy was performed 389 times. Patterns of adenornas were analyzed by variables as age, sex, preoperative serum CEA level, location of primary colorectal cancer, Borrmann type, Duke's stage, histologic differentiation, DNA ploidy, recurrence and histology. Metachronous adenomas were detected in 79 patients(35.6%) and both metachronous and syachronous adenomas were observed in 29 cases(13.1%). High risk variables for adenomas were male, old age and presence of synchronous adenoma. There were 2 patients with maligant change of adenomas. Yearly follow-up by complete colonoscopy over 3 years or more is recommended and follow-up interval should be shortened in the high risk groups.
Adenoma* ; Appointments and Schedules ; Colon ; Colonic Neoplasms ; Colonoscopy ; Colorectal Neoplasms* ; DNA ; Follow-Up Studies ; Humans ; Male ; Ploidies ; Recurrence

BACKGROUND: Respiratory depression with high dose of propofol during induction is one of the major complications. We studied the effects of midazolam as premedicant on frequency and duration of apnea and frequency of loss of consciousness in relation to single dose of propofol. METHODS: We selected 194 adult patients who had clear consciousness and no depression of respiration. We allocated patients randomly to control group and midazolam group. In midazolam group, we injected 0.06mg/kg of midazolam intravenously 10min before induction, and in control group, we did nothing. Under mask oxygenation with 100% oxygen, we administered a bolus of propofol (1, 1.5, 2 mg/kg to subgroup 1, 2, 3 respectively) intravenously. The change of respiration and loss of consciousness were observed. RESULTS: The frequency and duration of apnea increased with the dose of propofol in both control and midazolam group. But there were no difference between groups except frequency of apnea with 1.5 mg/kg of propofol. In control group, frequency of loss of consciousness increased with the increasing dose of propofol. But in midazolam group, nearly all the patients was slept without difference by the dose. CONCLUSIONS: Premedication with midazolam reduce the sleeping dose of propofol to induce anesthesia, so the frequency and duration of apnea which is caused by high dose of propofol can be decreased.
Adult ; Anesthesia ; Apnea* ; Consciousness ; Depression ; Humans ; Masks ; Midazolam* ; Oxygen ; Premedication ; Propofol* ; Respiration ; Respiratory Insufficiency ; Unconsciousness*

No abstract available.
Brain Stem* ; Glioma*

Glycogen storage diseases(GSD) are inherited disorders affecting glycogen metabolism and type I GSD is due to the absence or deficiency of glucose-6-phosphatase(G6Pase) enzyme in the liver, kidney, and intestinal mucosa. The defect leads to inadequate hepatic conversion of G6P to glucose and thus make affected individuals susceptible to fasting hypoglycemia, and the accumulation of glycogen occurs in the liver and other organs. Type Ia is the most common form of GSD and clinically growth retardation may manifest of GSD itself rather than growth hormone deficiency(GHD), but we experienced a case of type I GSD with GHD in a 14-year-o1d male. The height was 125 cm, compatible with 50 th percentile of height of 8 years of age. He has doll-like face with fat cheek, relatively thin extremities, and metabolic acidosis, hyperuricemia, hypoglycemia, hyperlipidemia. GH stimulation test with clonidine and L-dopa revealed that the patient had decreased GH secretion. After laboratory work up including liver biopsy, he was diagnosed as type I GSD. Hypoglycemia was managed with frequent feeding with high starch diet(uncooked cornstarch). Metabolic acidosis and hyperuricemia were treated with sodium bicarbonate, allopurinol and probenecid. The patient is being followed at out-patient clinic with clinical improvement after of diet therapy and GH administration.
Acidosis ; Allopurinol ; Biopsy ; Cheek ; Clonidine ; Diet Therapy ; Extremities ; Glucose ; Glycogen Storage Disease* ; Glycogen* ; Growth Hormone* ; Humans ; Hyperlipidemias ; Hyperuricemia ; Hypoglycemia ; Intestinal Mucosa ; Kidney ; Levodopa ; Liver ; Male ; Metabolism ; Outpatients ; Probenecid ; Sodium Bicarbonate ; Starch

PURPOSE: The purpose of this study was to investigate Korean blue-collar workers' Health-related Quality of Life (HRQoL) and influencing factors in Korean blue-collar workers. METHODS: Participants in this study were 109 Korean blue-collar workers. The survey included health-related, work-related, and psycho-social factors. SF-36 was used to measure HRQoL. The data were analyzed using Pearson's correlation, and hierarchical multiple regression analysis. RESULTS: In the hierarchical linear regression model, when subjects' psycho-social variables were included in the regression model, R2 change was statistically significant. The significant predictors for HRQoL were education level (beta=.26, p=.023), depression (beta=-.38, p<.001), and self-efficacy (beta=.23, p<.001). CONCLUSION: The results of this study indicate that health care providers must have priority to consider psycho-social variables, especially depression and self-efficacy to improve HRQoL in Korean blue-collar workers.
Depression ; Education ; Health Personnel ; Humans ; Linear Models ; Quality of Life*

OBJECTIVE: This study aimed to develop a Korean oriental nursing terminology set for nursing documentation in electronic nursing record systems. METHODS: This study was conducted in two steps. The primary terminology set was constructed by extracting terms from textbooks and materials about oriental nursing (2,708 terms). Then the appropriateness of terms as an oriental nursing vocabulary was reviewed by four teams of oriental nursing experts and practitioners. In addition, the frequency of uses of terms was examined in oriental nursing. Data were summarized using descriptive statistics. RESULTS: Of 2,708 terms, 25.4% (n=688) were evaluated as appropriate and high-use oriental nursing terms by all expert teams. Among the terms, 24.1% (n=166) were nursing action terms representing acupuncture, moxibustion, cupping, massage, treatment and observation, medication administration, health promotion, and others. The others (75.9%) were nursing phenomenon terms representing drugs, medical materials, instruments, tests, theories, disease names, syndrome differentiation, and signs and symptoms. The proportion of terms used only in oriental nursing was 52.3%. CONCLUSION: A total of 688 terms were identified as appropriate oriental nursing terms, as well as high-use terms. This terminology set can be used for the basic data to develop a formal terminology set in oriental nursing practice.
Acupuncture ; Health Promotion ; Massage ; Moxibustion ; Nursing Records ; Nursing* ; Vocabulary

Virus associated hemophagocytic syndrome, class ll histiocytoses, characterized by high fever, severe constitutional symptoms, abnormal liver function and coagulation, perigheral blood pancytopenia and histiocytic hyperplasis with prominent hemophagocytosis in bone marrow and lymph nodes has been reported and associated with active viral infection. It is non-malignant and reversible. It must be differentiated from histiocytic medullary reticulosis because of the inappopriateness of immunosuppressive of cytotozic therapy which is the therapeutic method for HMR, but is contraindicated in the treatment of VAHS. This paper describes two patients whose clinicopathology was compatible with the diagnosis of virus associated hemophagocytic syndrome.
Bone Marrow ; Diagnosis ; Fever ; Histiocytosis ; Humans ; Liver ; Lymph Nodes ; Lymphohistiocytosis, Hemophagocytic* ; Pancytopenia

Hyperglycemia has been noted to occur in pediatric patients undergoing cardiac surgery with hypothermia. Because even moderate hyperglycemia during cerebral ischemia may predispose patients to an increased risk of neurologic deficit, the authors wished to determine whether the large dosage of fentanyl might contribute significantly to the decrease in blood glucose, The authors examined 20 infants who underwent cardiac surgery with small dosage of fentanyl(Group I, n= l0) or large dosage of fentanyl (Group II, n=10), none of whom received dextrose in the clear cardiopulmonary bypass pump prime, maintenance iv fluids, or cardioplegic solution. Blood samples were obtained after induction, during cardiopulmonary by-pass, after cardiopulmonary bypass and after operation. There was no hypoglycemia during the entire surgical periods in all patients. During cardio-pulmonary bypass in group I and group II, after cardiopulmonary bypass, after operation in group II, blood glucose levels were significantly decreased compared with after induction values(p<0.05). Compared with group L the rates of changes from the values after induction were significant during cardiopulmonary bypass and after operation in group II(p<0.05). In conclusion, large dosage of fentanyl is valuable in control the hyperglycemia during open heart surgery in infants.
Blood Glucose* ; Brain Ischemia ; Cardioplegic Solutions ; Cardiopulmonary Bypass ; Fentanyl ; Glucose ; Heart* ; Humans ; Hyperglycemia ; Hypoglycemia ; Hypothermia ; Infant* ; Neurologic Manifestations ; Thoracic Surgery*

BACKGROUND: Even though there were developments in various treatment techniques for acute arterial occlusion this disease still has high rate of mortalities and limb amputations. We investigated the combined diseases symptoms location of occlusion type of treatment complication and prognosis in our patients. MATERIAL AND METHODS: This study recruited 48 patients (42 men, 6 women, mean age 57.7 years) who received the operation from January 1995 toDecember 1998. We investigated the post-operation course via medical record review or telephone interview with patients or their family members. RESULT: The most common combined diseases were atherosclerosis in 30 patients. other diseases were 17 diabetes mellitus 16 hypertension and 12 atrial firillation. Pain and clod sensation were noticed in all patients paresthesia in 5 patients fibrillation. Pain and cold sensation were noticed in all patients paresthesia in 5 patients and lower extremity paralysis in 11 patients. In 29 patients the time interval from the onset of symptom to admission was over 72 hours and 15 patients were admitted within 24 hours. The distribution of arterial occlusion location was at 28 femoral arteries 14 popliteal arteries and 6 iliac arteries. All the patients were received embolectomy and 5 patients were received additional bypass grafting. Postoperative complications were 12 reocclusions. 6 compartment syndromes 6 skin necrosis and 2 acute renal failure. The mortality rate was 16.7% (8/48) and the amputation rate was 25%. CONCLUSION: This study revealed 25% reocclusion 25% limb amputation and 16.7% mortaliyt. To improve the prognosis of acute lower extrements arterial occlusion early diagnosis and understand the underlying diseases prompt treatment and operation additional operation including interventional radiologic examination and thorough postoperative care would be appreciated.
Acute Kidney Injury ; Amputation ; Atherosclerosis ; Compartment Syndromes ; Diabetes Mellitus ; Early Diagnosis ; Embolectomy ; Extremities ; Female ; Femoral Artery ; Humans ; Hypertension ; Iliac Artery ; Interviews as Topic ; Lower Extremity ; Male ; Medical Records ; Mortality ; Necrosis ; Paralysis ; Paresthesia ; Popliteal Artery ; Postoperative Care ; Postoperative Complications ; Prognosis ; Sensation ; Skin ; Transplants

PURPOSE: This study was done to develop a bereaved family care program by identifying characteristics of a grief healing process in a child loss. METHOD: The subjects were five bereaved mothers who have lost their children with cancer. Data was collected with in-depth interviews using grief phase assessment tool and grief reaction assessment tool from 1, February, 2001 to 31 August, 2002. Data was analyzed on the basis of two tools. RESULT: Process of grief in general was as follows: evading phase was within one week - one month, confrontation phase was 5 - 12 months, and reconciliation phase was after 9 months and still going on when the study was finished. Grief reaction in five (physical, cognitive, emotional, social, and spiritual) dimensions was stabilized when the phase moved into reconciliation phase. Influencing factors were intimacy and expectation towards child, social support, personality, prior loss experience, coping style, religion, culture, family cohesion, openness of communication, and stress events. CONCLUSION: These results suggest that a bereaved family care program considering characteristics of Korean culture should be developed and activated.