OBJECTIVE: To evaluate the efficacy of laparoscopic surgery in the treatment of deep endomtriosis, we have studied 30 cases of deep endometriosis. Endometriosis is classified into superficial(<1mm), intermediate(2-4mm), deep(>5mm) and very deep(>10mm) endometriosis by the infiltration depth from the peritoneal surface. In the treatment of deep endometriosis, medical hormonal therapy is not effective, so surgical treatment is required. There are many difficulties in surgiacal treatment ; hard lesion to excise, ditsorted pelvic anatomy after excision, easy to damage to ureter and uterine artery, and limitation for potentially morbid procedure to whom wants to conceive. Especially laparoscopic surgery in the treatment of deep endometriosis is very difficult because it is impossible to know the depth by palpation. In deep endometriosis type II, the lesion is concealed due to rectal adhesion to cul de sac, uterosacral ligament and in type III, the lesion is regarded as a small lesion or missed due to invagination into pelvic floor. The authors compared the laparoscopic surgery with laparotomy to evaluate the efficacy of laparoscopic surgery in the treatment of deep endomtriosis. METHODS: Deep endometriosis, 30 cases out of 102 cases, which were histologically comfirmed as endometriosis were studied. The authors compared the laparoscopic surgery(15 cases) with laparotomy(15 cases) in the surgical treatment of deep endometriosis for operation procedure, operation time, hospital stay and symptoms improvement. RESULTS: The mean operation time of laparoscopic surgeries in deep endometriosis was 178.7(+/-43.1)min while type I, II and III in deep endometriosis took 148.5(+/-21.2)min, 162.0(+/-30.7)min and 245.0(+/-36.1)min respectively and took a little more time than laparotomy. Mean hospital stay in laparoscopic surgeries was 5.7(+/-1.8)days and laparotomy took 10.0(+/-2.3)days that was statistically significant. CONCLUSION: If patients are chosen adequately and operator's skills are satisfactory, laparoscopic surgery is very valuable in the treatment of deep endometriosis. More datas will be required to confirm the efficacy.
Endometriosis* ; Female ; Humans ; Laparoscopy* ; Laparotomy ; Length of Stay ; Ligaments ; Palpation ; Pelvic Floor ; Ureter ; Uterine Artery

We are calling the erupting ground water as drug water or mineral water in Korea and thinking those water and food making water. Authors tried to investigate the evidence of contamination by user on the 10 erupting ground water and gained following results: 1. All of the mineral waters on 10 area in Seoul were unfittable to drinking water standard. 2. In the view of the bacteriology 80% were contaminated by coliform group. 3. The highest value of the free carbon dioxide contents were 652.96 ppm at Sam Sun Mineral Water.
Bacteriology ; Carbon Dioxide ; Drinking Water ; Groundwater ; Korea ; Mineral Waters* ; Seoul* ; Solar System ; Thinking ; Water

No abstract available.
Hemodynamics* ; Hepatocytes* ; Ischemia* ; Liver* ; Urokinase-Type Plasminogen Activator* ; Verapamil*

No Abstract Available.
Cadaver* ; Humans* ; Spinal Cord* ; Spine*

No abstract available.
Cervical Ripening* ; Female ; Pregnancy

No abstract available.
Colon* ; Polyps*

BACKGROUND: The effects of a muscle relaxant may differ in elderly compared with young adult patients for a variety of the pharmacokinetic and pharmacodynamic reasons. Atracurium is eliminated by nonorgan dependent pathway, Hofmann elimination and ester hydrolysis. So there are some arguments for age-related differences. The purpose of this study was to compare the differences of the onset and duration of atracurium in young and elderly. METHODS: Eighteen young adults (21-54 yr) and 18 elderly (>65 yr) patients anesthetized with nitrous oxide and enflurane. Atracurium (0.5 mg/kg) was given and then intubation was performed after T1 response was blocked more than 80%. Neuromuscular relaxation was measured by the first twitch of train-of-four (T1) response at the adductor pollicis after supramaximal stimulation of ulnar nerve at 2Hz every 12 sec. The onset (disappearance of T1) and duration of 5, 25, 50, 75% recovery time of T1 and recovery index (time for 25-75% recovery of T1) were recorded. RESULTS: Onset of block was not significantly different between the young and elderly. Recovery time of 5, 25, 50, 75% and recovery index were not prolonged in elderly compared with young adults. CONCLUSIONS: There were no significant differences between young and elderly adults in onest time, recovery time of 5, 25, 50, 75% and recovery index when atracurium is used in a single bolus dose. The results suggest that atracurium in elderly patients has similar onset and action duration compared with younger patients.
Adult ; Aged* ; Atracurium* ; Enflurane ; Humans ; Hydrolysis ; Intubation ; Nitrous Oxide ; Relaxation ; Ulnar Nerve ; Young Adult

No abstract available.
Breast Neoplasms* ; Breast*

PURPOSE: To describe the lived experience of nursing students when faced with clinical judgment in a nursing practicum at the hospital. METHODS: A descriptive research design was utilized. Participants were 79 students in the clinical practicum. Participant consent was obtained for ethical protection. Data were collected from August to December 2007 using a semi-structured questionnaire. Content analysis was utilized for data analysis. RESULTS: Two categories and 5 themes were extracted from the data for 'difficult' and 'easy' clinical judgments. For the student category, the two themes were 'knowledge' and 'skill', while the three themes for the clinical education environment category were, 'judgment of clinical symptoms and signs', 'differences between theory and practice' and 'human relationships'. For coping, 2 categories and 5 themes were extracted for the difficult clinical judgment situation, while one category and one theme were found for the easy clinical judgment situation. CONCLUSION: To develop students' clinical judgment, there is need to develop the method of clinical skills using simulation in clinical teaching. For future research, a study on factors affecting clinical judgment of nursing students in hospitals is needed.
Clinical Competence ; Humans ; Judgment ; Research Design ; Statistics as Topic ; Students, Nursing ; Surveys and Questionnaires

Nerve conduction studies help delineate the extent and distribution of the neural lesion. The nerve conduction was studied on upper (median, ulnar and radial nerves) and lower (personal, posterior tibial and sural nerves) extremities in 83 healthy subjects 23 to 66 years of age, and normal values were established (Table 1). The mean motor terminal latency (TL): median, 3.6 (±0.6) milliseconds; ulnar, 2.9 (±0.5) milliseconds; radial nerve, 2.3 (±0.4) milliseconds. Mean motor nerve conduction velocity (MNCV) along distal and proximal segments: median, 61.2 (±9.1) (W-E) and 57.8 (±13.2) (E-Ax) meters per second; ulnar, 63.7 (±9.1) (W-E) and 50.6 (±10.0) meters per second. Mean sensory nerve conduction velocity (SNCV): median, 34.7 (±6.7) (F-W), 63.7 (±7.1) (W-E) and 62.8 (±12.3) (E-Ax) meters per second; ulnar, 38.0 (±6.7) (F-W), 63.4 (±7.5) (W-E) and 57.0 (±10.1) (E-Ax) meters per second; radial, 45.3 (±6.8) (F-W) and 64.2 (±11.0) (W-E) meters per second; sural nerve, 43.4 (±6.1) meters per second. The amplitudes of action potential and H-reflex were also standardized. Mean H latency was 28.4 (±3.2) milliseconds. And, the fundamental principles, several factors altering the rate of nerve conduction and clinical application of nerve stimulation techniques were reviewed.
Action Potentials ; Adult* ; Extremities ; H-Reflex ; Healthy Volunteers ; Humans ; Neural Conduction* ; Radial Nerve ; Reference Values ; Sural Nerve