BACKGROUND: Lidocaine has been used for spinal anesthesia in short surgical procedure. However, transient neurologic symptoms (TNS) frequently occur after spinal anesthesia with lidocaine. Mepivacaine which has a silimar duration of action and rare incidence of TNS may be an alternative to lidocaine for spinal anesthesia. This study was designed to compare the efficacy of hyperbaric 1.5% lidocaine and 1.5% mepivacaine for spinal anesthesia. METHODS: Sixty patients, ASA physical status I or II, scheduled for lower abdominal or lower extremity procedures under spinal anesthesia were randomly allocated into two groups. Lidocaine group received 2% lidocaine 75 mg with 10% dextrose 1.25 ml. Mepivacaine group received 2% mepivacaine 75 mg with 10% dextrose 1.25 ml. After intrathecal injection of the anesthetics, sensorimotor block and recovery, cardiovascular effect and quality of surgical anesthesia were evaluated. TNS was evaluated 1 day after the operation. RESULTS: Both groups were similar with regard to demographic data and surgical procedures. The onset of sensory and motor blocks was similar in both groups. Time to regression to L5 sensory level and complete resolution of motor blockade were significantly prolonged in mepivacaine group than in lidocaine group (p<0.05). The effect of cardiovascular system was similar in both groups. Fentanyl was required for 4 cases only in the lidocaine group. None of both groups developed TNS. CONCLUSIONS: Hyperbaric 1.5% mepivacaine produced longer duration of action than hyperbaric 1.5% lidocaine in spinal anesthesia. This study didn't prove what drug develops a higher incidence of TNS.
Anesthesia ; Anesthesia, Spinal* ; Anesthetics ; Cardiovascular System ; Fentanyl ; Glucose ; Humans ; Incidence ; Injections, Spinal ; Lidocaine* ; Lower Extremity ; Mepivacaine* ; Neurologic Manifestations

Purpose: This study aimed to evaluate the validity and reliability of the Korean version of the Readiness for Practice Survey (K-RPS). Method: The English Readiness for Practice Survey was translated into Korean using the Translation, Review, Adjudication, Pretesting, and Documentation (TRAPD) method. Secondary data analysis was performed using the dataset from the New Nurse e-Cohort study (Panel 2020) in South Korea. This study used a nationally representative sample of 812 senior nursing students. Exploratory and confirmatory factor analyses were also conducted. Convergent validity within the items and discriminant validity between factors were assessed to evaluate con-struct validity. Construct validity for hypothesis testing was evaluated using convergent and discriminant validity. Ordinary α was used to assess reliability. Results: The K-RPS comprises 20 items examining four factors: clinical problem solving, learning experience, professional responsibilities, and professional preparation. Although the convergent validity of the items was successfully verified, discriminant validity between the factors was not. The K-RPS construct validity was verified using a bi-factor model (CMIN/DF 2.20, RMSEA .06, TLI .97, CFI .97, and PGFI .59). The K-RPS was significantly correlated with self-esteem (r = .43, p < .001) and anxiety about clinical practicum (r = - .50, p < .001). Internal consistency was reliable based on an ordinary α of .88. Conclusion The K-RPS is both valid and reliable and can be used as a standardized Korean version of the Readiness for Practice measurement tool.

Purpose: It is essential to ensure the readiness for practice among undergraduate nursing students since the purpose of such education is to cultivate competent nurses who deliver high-quality and safe nursing. Astin's theory of student involvement suggests that this is affected by their personal factors and learning environment. Methods: We conducted a cross-sectional study between November 16, 2020 and December 21, 2020 which examined personal factors and aspects of the clinical learning environment among senior nursing students (n = 838) enrolled across 54 nursing schools in Korea. The participants were asked to fill out a self-administered online survey, which assessed demographic characteristics, self-esteem, depression, work-life balance, clinical learning environment, anxiety during clinical practicum, and readiness for practice. Readiness for practice was measured using the Casey-Fink Readiness for practice survey. We used structural equational modeling to test our hypothetical model. Results: The nursing students' readiness for practice was significantly affected by their self-esteem, work-life balance satisfaction, and clinical learning environment. Anxiety during clinical practicum directly influenced their readiness for practice. Conclusion Increasing self-esteem and work-life balance satisfaction, and improving their clinical learning environment by providing sufficient educational and clinical support, could help facilitate the transition from nursing schools to real-world practice for nursing students.

OBJECTIVE: The purpose of this study was to analyze the transverse dental compensation in reference to the maxillary and mandibular basal bones using cone-beam computed tomography (CBCT) and evaluate the correlations between transverse dental compensation and skeletal asymmetry variables in patients with skeletal Class III malocclusion and facial asymmetry. METHODS: Thirty patients with skeletal Class I (control group; 15 men, 15 women) and 30 patients with skeletal Class III with menton deviation (asymmetry group; 16 men, 14 women) were included. Skeletal and dental measurements were acquired from reconstructed CBCT images using OnDemand3D 1.0 software. All measurements were compared between groups and between the deviated and nondeviated sides of the asymmetry group. Correlation coefficients for the association between skeletal and dental measurements were calculated. RESULTS: Differences in the ramus inclination (p < 0.001), maxillary canine and first molar inclinations (p < 0.001), and distances from the canine and first molar cusp tips to the midmaxillary or midmandibular planes (p < 0.01) between the right and left sides were significantly greater in the asymmetry group than in the control group. In the asymmetry group, the ramus inclination difference (p < 0.05) and mandibular canting (p < 0.05) were correlated with the amount of menton deviation. In addition, dental measurements were positively correlated with the amount of menton deviation (p < 0.05). CONCLUSIONS: Transverse dental compensation was correlated with the maxillary and mandibular asymmetry patterns. These results would be helpful in understanding the pattern of transverse dental compensation and planning surgical procedure for patients with skeletal Class III malocclusion and facial asymmetry.
Compensation and Redress* ; Cone-Beam Computed Tomography* ; Facial Asymmetry* ; Humans ; Male ; Malocclusion* ; Molar

Purpose: This study examines the current status of a second-degree Bachelor of Science in Nursing (BSN) program in South Korea, identifies its advantages and limitations, and provides future directions for improving the program. Methods: A mixed-methods, sequential explanatory design was employed. A cross-sectional survey (n=28 faculty members, 122 enrolled students, 20 graduates) was conducted, followed by focus group interviews (n=six faculty members, 13 enrolled students, six graduates). Results: Among the 28 nursing colleges, 19 had a second-degree BSN program enrollment capacity of less than 10% of their total student capacity, whereas six colleges had a capacity ranging from 20% to 30%. The advantages of the program included producing nurses with diverse backgrounds, demonstrating a strong aspiration for the nursing profession, diligent attitude, and mature interpersonal skills among the second-degree BSN students. The limitations included inadequate support and resources for program operations, difficulties in ensuring the quality of classes and clinical practice, and limited opportunities for interaction with other students. Conclusion This study highlights the importance of establishing clear policies and guidelines for such programs and developing standardized curricula to ensure high-quality nursing education while accommodating an increasing number of students.

Purpose: This study examines the current status of a second-degree Bachelor of Science in Nursing (BSN) program in South Korea, identifies its advantages and limitations, and provides future directions for improving the program. Methods: A mixed-methods, sequential explanatory design was employed. A cross-sectional survey (n=28 faculty members, 122 enrolled students, 20 graduates) was conducted, followed by focus group interviews (n=six faculty members, 13 enrolled students, six graduates). Results: Among the 28 nursing colleges, 19 had a second-degree BSN program enrollment capacity of less than 10% of their total student capacity, whereas six colleges had a capacity ranging from 20% to 30%. The advantages of the program included producing nurses with diverse backgrounds, demonstrating a strong aspiration for the nursing profession, diligent attitude, and mature interpersonal skills among the second-degree BSN students. The limitations included inadequate support and resources for program operations, difficulties in ensuring the quality of classes and clinical practice, and limited opportunities for interaction with other students. Conclusion This study highlights the importance of establishing clear policies and guidelines for such programs and developing standardized curricula to ensure high-quality nursing education while accommodating an increasing number of students.

Purpose: This study examines the current status of a second-degree Bachelor of Science in Nursing (BSN) program in South Korea, identifies its advantages and limitations, and provides future directions for improving the program. Methods: A mixed-methods, sequential explanatory design was employed. A cross-sectional survey (n=28 faculty members, 122 enrolled students, 20 graduates) was conducted, followed by focus group interviews (n=six faculty members, 13 enrolled students, six graduates). Results: Among the 28 nursing colleges, 19 had a second-degree BSN program enrollment capacity of less than 10% of their total student capacity, whereas six colleges had a capacity ranging from 20% to 30%. The advantages of the program included producing nurses with diverse backgrounds, demonstrating a strong aspiration for the nursing profession, diligent attitude, and mature interpersonal skills among the second-degree BSN students. The limitations included inadequate support and resources for program operations, difficulties in ensuring the quality of classes and clinical practice, and limited opportunities for interaction with other students. Conclusion This study highlights the importance of establishing clear policies and guidelines for such programs and developing standardized curricula to ensure high-quality nursing education while accommodating an increasing number of students.

Purpose: This study examines the current status of a second-degree Bachelor of Science in Nursing (BSN) program in South Korea, identifies its advantages and limitations, and provides future directions for improving the program. Methods: A mixed-methods, sequential explanatory design was employed. A cross-sectional survey (n=28 faculty members, 122 enrolled students, 20 graduates) was conducted, followed by focus group interviews (n=six faculty members, 13 enrolled students, six graduates). Results: Among the 28 nursing colleges, 19 had a second-degree BSN program enrollment capacity of less than 10% of their total student capacity, whereas six colleges had a capacity ranging from 20% to 30%. The advantages of the program included producing nurses with diverse backgrounds, demonstrating a strong aspiration for the nursing profession, diligent attitude, and mature interpersonal skills among the second-degree BSN students. The limitations included inadequate support and resources for program operations, difficulties in ensuring the quality of classes and clinical practice, and limited opportunities for interaction with other students. Conclusion This study highlights the importance of establishing clear policies and guidelines for such programs and developing standardized curricula to ensure high-quality nursing education while accommodating an increasing number of students.

PURPOSE: The aim of the present study was to retrospectively evaluate the incidence of hypothyroidism in locally advanced head and neck cancer patients who received radiotherapy (RT) either with or without neck dissection. MATERIALS AND METHODS: From January 2000 to December 2005, 115 patients with locally advanced head and neck cancer and who received definitive RT or postoperative RT including standard anterior low-neck field were recruited to be part of this study. Nineteen patients had undergone ipsilateral neck dissection, whereas, 18 patients underwent bilateral neck dissection, and 78 patients were received RT alone. Patients' ages ranged from 28 to 85 years (median, 59 years) and there were a total of 73 male and 42 female patients. The primary tumor sites were the oral cavity, oropharynx, hypopharynx, larynx, and other sites in 18, 40, 28, 22 and 7 patients, respectively. Radiation dose to the thyroid gland ranged from 44 Gy to 66 Gy with a median dose of 50 Gy. Follow-up time ranged from 2 to 91 months, with a median of 29 months. RESULTS: The 1- and 3-year incidence of hypothyroidism was 28.7% (33 patients) and 33.0% (38 patients), respectively. The median time to detection of hypothyroidism was 8.5 months (range, 0 to 36 months). A univariate analysis revealed that neck node dissection was a risk factor for hypothyroidism (p=0.037). However, no factor was statistically significant from the results of a multivariate analysis. CONCLUSION: Patients treated for advanced head and neck cancer with radiotherapy with or without neck dissection will develop hypothyroidism. It is important to check the thyroid function periodically in these patientsespecially with the risk factor of neck node dissection.
Female ; Follow-Up Studies ; Head ; Head and Neck Neoplasms ; Humans ; Hypopharynx ; Hypothyroidism ; Incidence ; Larynx ; Male ; Mouth ; Multivariate Analysis ; Neck ; Neck Dissection ; Oropharynx ; Retrospective Studies ; Risk Factors ; Thyroid Gland

Increasing evidence suggests that many of the systemic responses that occur after injury and infection are related to elabolation of cytokines by the host. Cytokines are a diverse poup of polypeptides released from activated reticuloendothelial cells, which have multiple biological activities. But there is a paucity of information on the effect of anesthesia on plasma cytokine levels and little information on cytokine release following surgery. We studied plasma cytokine levels and hemodynamic parameters during anesthesia, surgery, and post operation 1 day. Sixty patients were studied. Patients were divided into two groups (G: general anesthesia with isofiurane, E:epidural anesthesia with 0.5% bupivacaine) according to the method of anesthesia. Venous samples were collected at the following time: a baseline sample 30 minutes before induction of anesthesia, at 10 minutes after induction of anesthesia, at 30 minutes after the induction of surgery, at 30 minutes after the end of anesthesia, and at 24 hours after the end of anesthesia. Arterial blood pressure and heart rate were measured at all time. Eight mililiter of peripheral blood was obtained for interleukin-6 studies in plain tubes. Plasma concentration of IL-6 was measured by IL-6 ELISA kit(Amershem Life Science, England). The results were as follows: 1) IL-6 did not change during general anesthesia but increased 30~40 fold at 30 minutes after the end of anesthesia and at 24 hours after the end of anesthesia. 2) IL-6 did not change during epidural anesthesia but increased 10~40 fold at 30 minutes after the end of operation and at 24 hours after the end of operation. 3) Arterial blood pressure and heart rate were unchanged during this experiment and there were no relationships between the change of interleukin-6 level and the arterial blood pressure and heart rate. The results suggest that the increment of IL-6 levels may be induced by the tissue damage or reaction of stress in operation with anesthesia. Isoflurane, NO2O and bupivacaine, however, may not increase the IL-6 level. Further researches will be needed that the effects of other anesthetics selection except isoflurane and bupivacane to IL-6 level and immunological mechanism.
Anesthesia* ; Anesthesia, Epidural ; Anesthesia, General ; Anesthetics ; Arterial Pressure ; Biological Science Disciplines ; Bupivacaine ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Heart Rate ; Hemodynamics ; Humans ; Interleukin-6* ; Isoflurane ; Peptides ; Plasma