BACKGROUND: The goal of this study was to demonstrate the effect of esmolol to prevent reflex tachycardia occurred during sodium nitroprusside(SNP) induced hypotension. METHODS: Thirty patients were randomly assigned to the SNP group(n=15) received continuous infusion of SNP at 2.72+/-0.56 mcg/kg/min or combined SNP and esmolol(SNP-ESM) group(n=l5) received combined continuous infusion of SNP at 1.54+/-0.34 mcg/kg/min and esmolol at 200 mcg/kg/min for 1 hour to maintain a 20~25% reduction of mean arterial pressure(MAP) from baseline. Heart rate(HR) and MAP were measured at baseline, during hypotensive period(5, 10, 20, 30, 60 min) and after hypotensive period(70, 80, 90,1 20 min). RESULTS: SNP-induced hypotension resulted in significant(P<0.001) increases in heart rate during hypotensive period and MAP after the end of SNP infusion. However, infusion of SNP-ESM resulted in significant(p<0.05) reduction in heart rate and SNP requirement during hypotensive period, and rebound hypertension was not observed after the end of induced hypotension. CONCLUSIONS: SNP-ESM infusion is a safe and effective pharmacologic means and provides several advantages over single SNP that include reduction in SNP requirement, no reflex tachycardia during induced hypotension and no rebound hypertension following hypotensive period.
Heart Rate* ; Heart* ; Humans ; Hypertension ; Hypotension* ; Nitroprusside* ; Reflex ; Sodium* ; Tachycardia

BACKGROUND: The goal of this study was to demonstrate the effect of esmolol to prevent reflex tachycardia occurred during sodium nitroprusside(SNP) induced hypotension. METHODS: Thirty patients were randomly assigned to the SNP group(n=15) received continuous infusion of SNP at 2.72+/-0.56 mcg/kg/min or combined SNP and esmolol(SNP-ESM) group(n=l5) received combined continuous infusion of SNP at 1.54+/-0.34 mcg/kg/min and esmolol at 200 mcg/kg/min for 1 hour to maintain a 20~25% reduction of mean arterial pressure(MAP) from baseline. Heart rate(HR) and MAP were measured at baseline, during hypotensive period(5, 10, 20, 30, 60 min) and after hypotensive period(70, 80, 90,1 20 min). RESULTS: SNP-induced hypotension resulted in significant(P<0.001) increases in heart rate during hypotensive period and MAP after the end of SNP infusion. However, infusion of SNP-ESM resulted in significant(p<0.05) reduction in heart rate and SNP requirement during hypotensive period, and rebound hypertension was not observed after the end of induced hypotension. CONCLUSIONS: SNP-ESM infusion is a safe and effective pharmacologic means and provides several advantages over single SNP that include reduction in SNP requirement, no reflex tachycardia during induced hypotension and no rebound hypertension following hypotensive period.
Heart Rate* ; Heart* ; Humans ; Hypertension ; Hypotension* ; Nitroprusside* ; Reflex ; Sodium* ; Tachycardia

Although selective serotonin reuptake inhibitors (SSRIs) have been widely used in both psychiatry and other medicine, few cases have been reported SSRI-related hyperprolactinemia and/or galactorrhea. We experienced one case which showed both galactorrhea and hyperprolactinemia following treatment with paroxetine. In the case, a 37-year-old multiparous woman reported galactorrhea after 8-weeks paroxetine treatment for her depression. After 1 month prescription of bromocriptine, dopamine agonist, as well as switching medication from paroxetine to venlafaxine, serotonin-norepinephrine reuptake inhibitor, both galactorrhea and hyperprolactinemia were disappeared. Both hyperprolactinemia and galactorrhea have not been observed even after the cessation of bromocriptine prescription.
Adult ; Bromocriptine ; Cyclohexanols ; Depression ; Dopamine Agonists ; Female ; Galactorrhea ; Humans ; Hyperprolactinemia ; Paroxetine ; Pregnancy ; Prescriptions ; Serotonin Uptake Inhibitors ; Venlafaxine Hydrochloride

No abstract available.
Fascioliasis* ; Humans*

PURPOSE: This study was done to provide basic data for education of elementary school students on life-respect and peer bullying prevention. METHODS: Participants were 5th and 6th grade elementary school students. Data from the questionnaires of 218 participants were analyzed. RESULTS: 1) The mean score for degree of life-respect was 4.23 (+/-0.38). The types of peer bullying were 'defenders of victims' (3.19+/-0.93), 'bullies' (2.04+/-0.72), 'victims' (1.91+/-0.84), 'bystanders' (1.79+/-0.80), and 'bully-followers' (1.66+/-0.60). 2) There was a significant difference in the degree of life-respect according to gender (t=-2.410, p=.017). Likewise, in the degree of peer bullying, among the type of 'bullies' there were significant differences according to grade (t=-2.285, p=.004), and gender (t=3.191, p=.002). Also, among the types of 'bully-followers' there were significant differences according to gender (t=2.053, p=.041), and having a religion or not (t=3.319, p=.001). 3) There was a significant correlation between life-respect and types of peer bullying. CONCLUSION: The results of this study provide helps for more effective provision of educational programs regarding life-respect and peer bullying.
Bullying* ; Child ; Education ; Humans ; Peer Group ; Value of Life ; Surveys and Questionnaires

Purpose: This study aimed to develop standardized guidelines for telephone consultations and assess the impact of computerization on clinical utility. Methods: Guidelines for patient classification were developed for 14 symptoms, validated by experts, and integrated into a real-time computer program. Patient classification involved categorizations of ‘observation,’ ‘outpatient,’ and ‘emergency’.Subsequent to computerization, a survey was conducted to evaluate its usefulness. Results: Items with an Item-Content Validity Index (I-CVI) score of 0.75 or lower were removed or adjusted within the guidelines. Analysis of 200 consultation records indicated that lung cancer (87 cases) was the most common disease and the most prevalent symptom was pain (57 cases). Among 93 cases classified as ‘observation’, 6 patients visited the emergency room. Among 30 cases categorized as ‘outpatient’, 24 patients visited a clinic, and 6 patients visited the emergency room. Of the 19 cases classified as ‘emergency’, 18 patients actually visited the emergency room. User satisfaction from 12 nurses was very high, with an average score of 3.7/4. Conclusion Due to the standardized telephone triage and the concurrent implementation of a computerized program, healthcare professionals can conveniently and comprehensively analyze big data pertaining to patients’ symptoms. Ultimately, nurses were able to receive help with more specialized telenursing.

OBJECTIVES: Maternal depression has a detrimental effect on baby growth. Recent reports suggest that depressive symptoms are more likely to occur during pregnancy than in the postpartum period. In Korea, there are relatively few studies of depression during pregnancy compared to those related to postpartum depression. The purpose of this study is to identify factors associated with antenatal depression. METHODS: The study included 143 pregnant women who had completed the Korean version of the Edinburgh Postnatal Depression Scale (K-EPDS), the Korea-Marital Satisfaction Inventory's global distress scale, the Rosenberg Self-Esteem Scale, and the Connor-Davidson Resilience Scale-2. Based on the K-EPDS scores, we divided the participants into two groups. Logistic regression was performed to identify factors associated with antenatal depression. RESULTS: Thirty (21%) of the subjects were evaluated as being depressed, pregnant women. Pregnant women with high self-esteem and marital satisfaction were less likely to have depression. Similarly, those who are younger and those with an abortion history were more likely to have depression. Past psychiatric history and family history were not significantly different between the two groups. CONCLUSION Dissatisfaction with marriage, low self-esteem, younger age, and abortion history were closely related to the presence of antenatal depression. The results of this study can be used as baseline data for the development of family-based education programs and early antenatal depression policies.

Background/Aims: Secondary infection with influenza virus occurs in critically ill patients and is associated with substantial morbidity and mortality; however, there is limited information about it in patients with severe coronavirus disease 2019 (COVID-19). Thus, we investigated the clinical outcomes of and risk factors for secondary infections in patients with severe COVID-19. Methods: This study included patients with severe COVID-19 who were admitted to seven hospitals in South Korea between February 2020 to February 2021. Multivariate logistic regression analyses were performed to assess factors associated with the risk of secondary infections. Results: Of the 348 included patients, 104 (29.9%) had at least one infection. There was no statistically significant difference in the 28-day mortality (17.3% vs. 12.3%, p = 0.214), but in-hospital mortality was higher (29.8% vs. 15.2%, p = 0.002) in the infected group than in the non-infected group. The risk factors for secondary infection were a high frailty scale (odds ratio [OR], 1.314; 95% confidence interval [CI], 1.123 to 1.538; p = 0.001), steroid use (OR, 3.110; 95% CI, 1.164 to 8.309; p = 0.024), and the application of mechanical ventilation (OR, 4.653; 95% CI, 2.533 to 8.547; p < 0.001). Conclusions In-hospital mortality was more than doubled in patients with severe COVID-19 and secondary infections. A high frailty scale, the use of steroids and application of mechanical ventilation were risk factors for secondary infection.

PURPOSE: The purpose of this study was to identify level of recognition of the importance, satisfaction and contribution of APNs' role by physicians, nurses, and advanced practice nurses. METHOD: Perceived importance and satisfaction were measured with a 23-item questionnaire on APN role with 5 subcategories. APNs' contribution was investigated using a 13-item outcome questionnaire developed by the researchers. Between August 15 and October 31, 2009, the researchers collected data from 68 physicians, 265 nurses, and 23 APNs all working in a single tertiary hospital. Data were analyzed using descriptive statistics, Kruskal-Wallis Test with Bonferroni's Correction and scatter plot. RESULT: The importance (3.24~3.39, 4 point scale), satisfaction (3.02~3.13, 4 point scale), and contribution of APNs' role (3.39~4.12, 5 point scale) were well recognized by the health care professionals. All the three health care professional groups rated APNs' contribution high in medical service management, continuity of care, patient accessibility, improvement in patient satisfaction, and patient and family education. 'Importance-Satisfaction Analysis' showed that patient data management by APNs needed greater effort. CONCLUSIONS: The findings show that the importance, satisfaction, contribution of APNs' role are recognized, and indicate a need for further development of APNs' role through efforts to overcome the gaps identified through this research.
Continuity of Patient Care ; Delivery of Health Care ; Humans ; Patient Satisfaction ; Surveys and Questionnaires ; Tertiary Care Centers

OBJECTIVE: To evaluate the relationship between postoperative sensory change on lower extremities and clinical factors associated with gynecologic operation. METHODS: We retrospectively reviewed 38 cases of patients with postoperative complaints of pain or dysthesis on lower extremities, especially anterolateral thigh from March 1993 through December 1999 at Gyeongsang National University Hospital, Department of Obstetrics and Gynecology. The electromyography (EMG) and nerve conduction velocity (NCV) were performed in all 38 patients. According to the result of EMG and NCV, patients were divided into control group (n=28) which in that with normal finding in electrodiagnosis and study group (n=10) who showed femoral cutaneous nerve injury in electrodiagnosis. Clinical characteristics (age, height, weight and operative history), operative methods, skin incisional method, operative time and postoperative diagnosis were reviewed in each group. RESULTS: There were significant differences in patient's body weight, height, skin incisional method and operative method between control and study group. Height was 152.5cm [150.3-155.6] in study group and 157.5cm [153.4-159.2] in control group (p-value = 0.020). Weight was 46.9kg [43.4-58.0] in study group and 57.0kg [54.4-58.1] in control group (p-value=0.004). Skin incisional method in study group was done by 6 cases (60%) of infraumbilical mid-line vertical incision and in control group by 5 cases (17.9%) (p-value = 0.019). In operative method, radical hysterectomy was 4 cases (40%) in study group and 2 cases (7.1%) in control group (p-value=0.031). But no correlation was observed in post-operative diagnosis, operative time, blood loss and transfusion between two groups. CONCLUSION: It was suggested that Lateral femoral cutaneous nerve was compressed by pelvic retractor during the gynecologic operation. Patient's body weight, height, skin incisional method and operative method may play a role of compressive factor on Lateral femoral cutaneous nerve, increasing Meralgia Paresthetica.
Body Weight ; Diagnosis ; Electrodiagnosis ; Electromyography ; Gynecology ; Humans ; Hysterectomy ; Lower Extremity ; Neural Conduction ; Obstetrics ; Operative Time ; Retrospective Studies ; Skin ; Thigh