PURPOSE: The purpose of this study was to investigate the effects of upper extremity exercise training on the motor activity, the ADL and the health related quality of life. METHOD: A non-equivalent pretest-posttest design was used. Study subjects were conveniently selected 40 hemiplegic patients(20 experimental subjects, 20 control subjects) who had been enrolled in two community health centers. After biofeedback training the subjects of experimental group were given constraint-induced movement, involving restraint of unaffected U/E in a sling for about 6 hours over a period of two weeks, while at the same time intensively training the affected U/E. Outcomes were evaluated on the basis of motor activity(amount, quality) of plegic side, DL(ADL, IADL) and health related QOL(SF-36). RESULTS: 1. After 2 weeks of treatment, the amount of use and the quality of motor activity of affected U/E were significantly higher in subjects who participated in exercise training than in subjects in the control group. 2. There were no significant differences in ADL and IADL between experimental and control groups. 3. After 2 weeks of treatment. the health related QOL was significantly higher in subjects who participated in exercise training than in subjects in the control group. CONCLUSION: The above results state that the U/E exercise training could be an effective intervention for improving the motor activity and the health related QOL of chronic hemiplegic patients. Long-term studies are needed to determine the lasting effects of constraint-induced movement.
Activities of Daily Living* ; Biofeedback, Psychology ; Community Health Centers ; Humans ; Motor Activity* ; Quality of Life ; Upper Extremity*

BACKGROUND: The afferent and efferent pathways of fentanyl cough response (FCR) and central organization are poorly understood at present. The aim of this study was to investigate the pretreatment effects of morphine, propofol, atropine, and midazolam on FCR. METHOD: The 120 healthy patients were randomly assigned to six equal pretreatment groups. They received 2ug/kg fentanyl rapidly through a peripheral venous catheter. The patients in each group were pretreated before the time necessary for peak plasma levels with different drugs as follows: group 1, no premedication; group 2, morphine 0.05 mg/kg iv; group 3, morphine 0.05 mg/kg iv naloxone 0.01mg/kg iv; group 4, propofol 0.5 mg/kg iv; group 5, atropine 0.01 mg/kg iv; group 6, midazolam 0.05 mg/kg iv. The patients were observed for any coughing or side effects, including oxygen desaturation, bronchoconstriction, chest wall rigidity and seizure. RESULT: 40% of patients in group 1 (control) had a cough response to fentanyl. Group 2 (morphine) and group 3 (morphine naloxone) showed a reduced FCR of 10%. The incidence of coughing was 60% of the patients in group 4 (propofol), 30% in group 5 (atropine), and 40% in group 6 (midazolam). These were not statistically significant. CONCLUSION: FCR is not altered by pretreatment with propofol, atropine, or midazolam, but morphine inhibits cough response and this antitussive effect was not antagonized by naloxone.
Atropine* ; Bronchoconstriction ; Catheters ; Cough* ; Efferent Pathways ; Fentanyl* ; Humans ; Incidence ; Midazolam* ; Morphine* ; Naloxone ; Oxygen ; Plasma ; Premedication ; Propofol* ; Seizures ; Thoracic Wall

BACKGROUND: We observed fentanyl known as centrally-acting antitussive agents provoke a cough response in some patients at induction of anesthesia. This may be of clinical importance. METHOD: 121 patients (ASA class I) were assigned randomly to 4 groups. Each group was given different doses of fentanyll Group 1 (n=30); 0.5ug/kg, Group 2 (n=30); 1ug/kg, Group 3 (n=33); 2ug/kg, Group 4 (n=28); 4 g/kgl, within 1 second through a peripheral venous cannula before induction of anesthesia. All patients were observed carefully in order to detect a cough response and any side effects. RESULT: The incidences of FCR (Fentanyl Cough Response) were 0% in Group 1, 10.0% in Group 2, 30.3% in Group 3, and 39.3% in Group 4. The ED50 of FCR was 4.25ug/kg. The mean onset-time from the end of fentanyl administration to the beginning of coughing was 12.5 seconds. FCR was decreased with aging, but not affected by weight, height, or smoking. Other serious side effects were not accompanied. CONCLUSION: Fentanyl can evoke the pulmonary chemoreflex dose-dependently and the ED50 was 4.25 g/kg.
Aging ; Anesthesia ; Antitussive Agents ; Catheters* ; Cough* ; Fentanyl* ; Humans ; Incidence ; Reflex* ; Smoke ; Smoking

BACKGROUND: Korean Journal of Anesthesiology was published in 1968 and its volume has been increased every year. The purpose of this study was to investigate and to clarify the trend of increasing volumes for 28 years (1968~1996) as quantitative analysis. METHODS: Using computerized index of Korean Journal of Anesthesiology (""ART""), the trend, volumes and cumulative records (top ranked 22 frequently cited key words, 16 persons and 10 departments of University) were calculated. Some key words such as ""Anesthetic techniques: spinal, Anesthetics, intravenous:, Anesthetics, volatile: halothane, Complications:"" was traced every year for grasping the trend of academic concerns. RESULTS: 1. Total volumes of articles were about 3,000 (1968~1996). The volumes were increased slowly until 1976 and steeply since 1986. 2. The ratio of clinical case reports has been decreased every year. 3. Key words ""Anesthetic techniques"", ""Surgery"" and ""Complications"" were more frequently cited than the others. 4. Tracing some key words showed their vitality in anesthetic fields. 5. The personal top ranked number of records revealed each author's contribution to Korean Journal of Anesthesiology and the number of records in each department of University could be used as an index of academic activity. CONCLUSIONS: The extent of the increasing volumes was great especially from 1986 to 1996 and the proportion of original articles has been increased every year. The frequency of the investigated key words showed their own vitality in the field of anesthesiology. The rank according to personal and departmental records suggested the possibility of reflecting a measure of academic concerns and activity.
Anesthesiology* ; Anesthetics ; Anesthetics, Intravenous ; Halothane ; Hand Strength ; Humans

PURPOSE: The purpose of this study was to investigate the effects of exercise training using biofeedback and constraint-induced movement on the upper extremity function of hemiplegic patients. METHOD: A non-equivalent pretest-posttest design was used. Study subjects were a conveniently selected group of 40 hemiplegic patients(20 experimental subjects, 20 control subjects) who have been enrolled in two community health centers. After biofeedback training the subjects of experimental group were given constraint-induced movement, involving restraint of unaffected U/E in a sling for about 6 hours in a day over a period of two weeks, while at the same time intensively training the affected U/E. Outcomes were evaluated on the basis of the U/E motor ability(hand function, grip power, pinch power, U/E ROMs), and motor activity(amount, quality). RESULT: 1. After 2 weeks of treatment, the motor abilities of affected U/E(hand function, grip power, pinch power, ROMs of wrist flexion, elbow flexion and shoulder flexion/extension) were significantly higher in subjects who participated in exercise training than in subjects in the control group with no decrement at 4-week follow-up. However, there was no significant difference in wrist extension between experimental or control group. 2. After 2 weeks of treatment, the amount of use and the quality of motor activity of affected U/E were significantly higher in subjects who participated in exercise training than in subjects in the control group with no decrement at 4-week follow-up. CONCLUSION: The above results state that exercise training using biofeedback and constraint-induced movement could be an effective intervention for improving U/E function of chronic hemiplegic patients. Long-term studies are needed to determine the lasting effects of constraint-induced movement.

PURPOSE: The purpose of this study was to investigate the effects of aromatherapy on the level of anxiety and fatigue in student nurses who were undergoing their first clinical practice. METHOD: A non-equivalent, control group, pretest-posttest design was used. A convenience sample of 42 student nurses were selected. They were assigned to experimental and control groups. The aromatherapy using lavender, geranium and camomile was given to the experimental group for four consecutive days while the control group only rested. RESULT: 1.Anxiety scores for the experimental group were significantly lower than those of the control group on the 2nd, 3rd and 4th days of clinical practice. 2. Fatigue scores for the experimental group were significantly lower than those of the control group on the 2nd, 3rd and 4th day of clinical practice. CONCLUSION: The results support the conclusion that aromatherapy using selected essential oils is an effective intervention for relieving anxiety and fatigue in student nurses experiencing their first clinical practice. However differences between aromatherapy and massage were not clear. Further investigation needs to be done.
Anxiety* ; Aromatherapy* ; Chamomile ; Fatigue* ; Geranium ; Humans ; Lavandula ; Massage ; Oils, Volatile

Monoamine oxidase inhibitors (MAOI) have been widely used as antidepressants. Recently, there has been renewed interest in MAO inhibitors. The activity-guided fractionation of extracts from Angelica keiskei Koidzumi (A. keiskei K.) led to the isolation of two prenylated chalcones, xanthoangelol and 4-hydroxyderricin and a flavonoid, cynaroside. These three isolated compounds are the major active ingredients of A. keiskei K. to inhibit the MAOs and DBH activities. Xanthoangelol is a nonselective MAO inhibitor, and a potent dopamine beta-hydroxylase (DBH) inhibitor. IC50 values of xanthoangelol to MAO-A and MAO-B were calculated to be 43.4 microM, and 43.9 microM. These values were very similar to iproniazid, which is a nonselective MAO inhibitor used as a drug against depression. The IC50 values of iproniazid were 37 microM, and 42.5 microM in our parallel examination. Moreover, IC50 value of xanthoangelol to DBH was calculated 0.52 microM. 4-Hydroxyderricin is a potent selective MAO-B inhibitor and also mildly inhibits DBH activity. The IC50 value of 4-hydroxyderricin to MAO-B was calculated to be 3.43 microM and this value was higher than that of deprenyl (0.046 microM) used as a positive control for selective MAO-B inhibitor in our test. Cynaroside is a most potent DBH inhibitor. The IC50 value of cynaroside to DBH was calculated at 0.0410 microM. Results of this study suggest that the two prenylated chalcones, xanthoangelol and 4-hydroxyderricin isolated from A. keiskei K., are expected for potent candidates for development of combined antidepressant drug. A. keiskei K. will be an excellent new bio-functional food material that has the combined antidepressant effect.
Angelica* ; Antidepressive Agents ; Chalcones ; Depression ; Dopamine beta-Hydroxylase ; Inhibitory Concentration 50 ; Iproniazid ; Monoamine Oxidase ; Monoamine Oxidase Inhibitors ; Oxidoreductases* ; Selegiline

BACKGROUND: Intraoperative oculocardiac reflex (OCR) and postoperative nausea and vomiting (PONV) are common problems of pediatric strabismus surgery. Propofol is thought to increase the incidence of OCR in spite of profound antiemetic effect. The goal of this study was to assess, in pediatric strabismus surgery, the incidence of OCR and PONV in a propofol with and without nitrous oxide (N2O) anesthesia. METHODS: Children (1~14 yr.'s) undergoing strabismus surgery as in patients were randomly allocated to two anesthetic techniques: propofol with 60% N2O and propofol with air instead of N2O. All children received iv fentanyl 2 microgram/kg, atropine 0.015 mg/kg and 1% lidocaine 1.5~2 ml before propofol 2.5 mg/kg injection. Anesthesia was maintained with three stage infusion method of propofol with and without N2O by groups after intubation with atracurium 0.4 mg/kg. A significant OCR was defined as an acute decrease in heart rate of 20% or greater associated with traction on an ocular muscle. RESULTS: Data on 224 children were analyzed. An intraoperative OCR was elicited in 41 (36.9%) of the 111 children in the N2O group and in 66 (58.4%) of the 113 children in Air group, while 14 (12.6%) and 12 (10.6%) developed PONV in the N2O group and the Air group in the subsequent 24 hr. period. The OCR was more frequent during medial rectus muscle correction (62.5%) than in lateral rectus muscle correction (39.5%). There was no significant correlation between OCR and PONV. CONCLUSIONS: We conclude that propofol with N2O anesthesia was effective in reducing the incidence of intraoperative OCR with a similarly excellent postoperative antiemetic effect in pediatric strabismus surgery compared to propofol without N2O anesthesia.
Anesthesia ; Antiemetics ; Atracurium ; Atropine ; Child ; Fentanyl ; Heart Rate ; Humans ; Incidence ; Intubation ; Lidocaine ; Nitrous Oxide ; Postoperative Nausea and Vomiting* ; Propofol ; Reflex, Oculocardiac* ; Strabismus* ; Traction

PURPOSE: The aim of this study was to develop and to analyze the task of gerontological nurse practitioners (GNPs) in Korea. METHODS: The definition of GNP and job description was developed based on developing a curriculum (DACUM) by 7 panels who have experienced in DACUM analysis and gerontological nursing. One hundred sixty nurses who were working at long term care facilities were participated. The questionnaire included frequency, importance, and difficulty of duties, tasks, and task elements. The data were collected in November 2006, analyzed by descriptive statistics. RESULTS: The job description of GNPs in Korea revealed 5 duties, 23 tasks, and 86 task elements. On the all five duties, the highest duty in frequency and in importance was professional nursing care (3.25+/-0.35, 3.49+/-0.29). But the highest duty in difficulty was research (3.24+/-0.46). 'Prevent health problem (3.42+/-0.43, 3.56+/-0.33)', 'Teach other staffs (2.83+/-0.77, 3.39+/-0.43)', 'Develop the evidence-based standards (2.43+/-0.76, 3.22+/-0.43)', 'Develop the self (2.81+/-0.65, 3.26+/-0.42)', and 'Participate the team activities' were the highest score in frequency and in criticality of tasks. 'Provide emotional support to older adults and families (3.16+/-0.41)', 'Counsel older adults and their families (3.14+/-0.49)', 'Do clinical research (3.32+/-0.49)', 'Quality insurance (3.25+/-0.49)', and 'Build collaborative system (3.18+/-0.47)' were perceived the most difficult tasks. CONCLUSION: The political efforts for the legislation of role and task of GNPs were needed.
Adult ; Attitude of Health Personnel ; Female ; Geriatric Nursing/*organization & administration ; Humans ; *Job Description ; Nurse's Role ; Nurse-Patient Relations ; Nursing Staff/psychology ; Questionnaires ; *Task Performance and Analysis

PURPOSE: This study was aimed to investigate the health related quality of life and related factors of organ transplant recipients. METHOD: The participants were 188 people who had liver(86), kidney(81), or heart(24) transplanted. Data on the demographic characteristics, transplantation-related characteristics, symptom frequency or discomfort measured by Transplant Symptom Frequency and Symptom Distress Scale by Lough et al(1987), and health related quality of life measured by SF-36(version 2) were collected. RESULT: Overall health related quality of life score was 492.1 for 100scoring and, 344.9 for norm based. Physical functioning showed the highest quality of life score (77.5) and vitality showed the lowest(51.1). The kidney transplanted showed the highest quality of life (504.4) and the heart transplanted showed the lowest(426.7) Quality of life was related with occupation(p=.016) and symtom discomfort(p<.0001). CONCLUSION: The health related quality of life of transplated patients was lower than the norm of American. Further studies need to be done to identify the norm of Korean and to investigate the effect of releving symptom discomfort on the increasing the health related quality of life.