The purpose of this study was to analysis of nursing interventions performed by the ICU nurses to the patients with cerebrovascular disorder practically from one university hospital in Seoul. The data were collected from 15 nurses with 86 cerebrovascular disorder cases from one ICU with the questionaire to write frequency of nursing care done by the surveyee from May. 2, 2000 to July, 3, 2000 and the list of 66 nursing interventions selected out of 433 NIC(Nursing Interventions Classification) of Iowa University which were translated into Korean(44 items) and core nursing interventions by ICU nurses(22 items: Kim, Su-Jin, 1997). The data were analysed with SPS8 program. The results are as follow: 1. The most frequently used nursing interventions were vital sign monitoring, fall prevention, cerebral edema management, dysreflexia management, neurologic monitoring, cardiac care, communication enhancement, technology management, bed rest care. respiratory monitoring in rank. 2. The most frequently used nursing intervention domains were 'Physiological: Complex', 'Physio-logical:basic', 'Behavior', 'Safty', 'Health system' in rank. In the domain of physiological: basic, the most frequently used nursing interventions were bed rest care, urinary elimination management, tube care: urinary, physical restraints in rank. In the domain of physiological: complex, the most frequently used nursing interventions were cerebral edema management, dysreflexia management, neurologic monitoring, cardiac care in rank. In the domain of behavior, the most frequently used nursing interventions were communication enhancement. touch, active listening in rank. In the domain of safty. the most frequently used nursing interventions were vital sign monitoring, fall prevention in rank. In the domain of health system, the most frequently used nursing interventions were technology management. specimen management in rank. 3. some difference of the frequency practicing the nursing interventions according to the shift of duties was found. For example, medication administration was common at day duty, touch was practiced at evening duty, temperature regulation was performed.
Bed Rest ; Brain Edema ; Cerebrovascular Disorders* ; Humans ; Iowa ; Nursing Care ; Nursing* ; Restraint, Physical ; Seoul ; Vital Signs

OBJECTIVES: Risperidone is a new antipsychotic drug developed to overcome the therapeutic limitation of conventional antipsychotics. It responses to negative as well as positive symptoms by blocking both dopaminergic and serotonergic receptors, causing no significant side effects such as agranulocytosis and seizure. It is, however, not known whether it induces any serious cardiovascular side effects as evoked by other conventional antipsychotic drugs. The aims of this study were to evaluate the effect of risperidone on cardiovascular function, and to discuss the factors affecting the cardiovascular function. METHODS: For 42 patients(22 males and 20 females) diagnosed as schizophrenia, schizophreniform disorder or schizoaffective disorder according to the DSM-IV classification, the cardiovascular fuctions such as heart rate, systolic and diastolic blood pressure, PR interval, QRS interval and QT inerval were successively checked before and after 2 weeks and 4 weeks risperidone administration. Furthermore, variables such as body weight, Brief Psychiatric Rating Scale(BPRS), Clinical Global Impression(CGE), Extrapyramidal Symptom Rating Scale(ESRS), Anticholinergic Rating Scale(ARS), serum cholesterol level, serum triglyceride level, serum high-density-lipoprotein level, serum WBC, serum Hb, serum platelet level, prothrombin time and partial thromboplastin time were also analyzed before and after 2 weeks and 4 weeks risperidone administration. RESULTS: 1) Risperidone treatment resulted in a significantly decreased heart rate and increased QT interval after 4 weeks administration(p<0.005 respectively). 2) The scores of BPRS and CGI were significantly decreased after 2 weeks and 4 weeks risperidone adminisration as compared with baseline(p<0.001 respectively). The scores of ESRS and ASRS were significantly increased after 2 weeks and 4 weeks risperidone administration as compared with baseline(p<0.001 respectively). 3) There were positive correlations between heart rate after 4 weeks and total dose(p<0.05). Blood pressure was significantly(p<0.05) correlated with sex(higher in male) and significantly(p<0.05) positive correlated with body weight. QT interval was significantly(p<0.05) correlated with sex(longer in female) and smoking history(shorter in smokers). CONCLUSIONS: Risperidone could induce significant change in heart rate and Q-T interval. Therefore, the cardiovascular safety for risperidone should be reconsidered according to the duration and dosage increase.
Agranulocytosis ; Antipsychotic Agents ; Blood Platelets ; Blood Pressure ; Body Weight ; Cholesterol ; Classification ; Diagnostic and Statistical Manual of Mental Disorders ; Heart Rate ; Humans ; Male ; Partial Thromboplastin Time ; Prothrombin Time ; Psychotic Disorders ; Risperidone* ; Schizophrenia ; Seizures ; Smoke ; Smoking ; Triglycerides

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The morphologic abnormalities of the endocrine pancreas that underlie persistent neonatal hyperinsulinemic hypoglycemia and are included under the heading "nesidioblastosis" appears to be heterogeneous. This characteristic morphologic finding is ductuloinsular complexes showing endocrine cells budding off the ductoepithelium and merging with adjacent endocrine cell clusters. A case of nesidioblastosis associated with hyperinsulinemic hypoglycemia occurred in a 6/365 year-old male neonate. Microscopic finding of near totally resected pancreas revealed irregular sized islets and ductuloinsular complexes, both of which contained hypertrophied B cells with a few mitosis. Because of persistent hypoglycemia after first operation, he received second operation 8 days after. This histologic finding was more severe comparative to that of first operation. According to these findings, the pathogenesis of nesidioblastosis may be congenital or developmental defect of a kind of compensatory mechanism by unknown stimuli to acquire persistent hypoglycemia.
Male ; Infant, Newborn ; Humans

Chronic illness requiring attention and management during a long period of time puts great burden onto patients, their family and society. For patients with chronic illnesses, providing social support is the most important, and the fundamental support comes from their spouses. Amount and quality of support from spouses seems to differentiated according to the sex of patients. Female patients tend to believe that their spouses are not very supportive. Therefore, the researchers assessed the burden of husbands of female arthritis patients to discover the factors that result in greater burden. Also, they developed a theoretical model of husbands' care for their wives through a qualitative research into husbands' experience. Method 1: The study material was 650 female arthritis patients registered in an arthritis clinic. The questionnaire about the disease experience of female arthritis patients and the burden of husbands were sent. Returned questionnaires numbered 210(32.3%) and 27 were excluded because of inadequate answers. The remaining 183 questionnaires were analyzed. The mean age of the patients was 51 years and the mean age of spouses was 55 years. The mean marital period was 28 years. The average duration since diagnosis was 9.1 years. Education level was varied from primary school to graduate school, and average income/month was 1,517,300 won. Method 2: Initial questionnaire studies on the burden of husbands were performed. Among 183 responding husbands, 23 consented to participate for a qualitative research. Data was obtained by direct and telephone interviews. The mean age of participants was 58 years, and the educational level and socioeconomic status also varied. Result: 1. Husbands' burden: The average burden was 57.68 with a range of 6-96. 2. Burden and general characteristics: The husband's burden correlated with the age of the patients, numbers in the family, therapy methods, patient's level of discomfort, patient's disease severity, patient's level of dependence and the husband's understanding of the level of severity. 3. Linear correlation analysis on burden: The husbands' burden is explained in 22.5% by husband's recognition of level of severity and husbands' age. 4. There were four patterns of the burden on husbands: both objectve burden and subjective burden were high(pattern I), both of objectve burden and subjective burden were low(pattern II), objective burden was high but subjective burden was low(pattern III), objective burden was low but subjective burden was high(pattern IV). The pattern was correlated with the family income, educational level of the patients and their husbands, therapy methods, patient's level of discomfort, patient's disease severity, patient's level of dependence and husband's understanding of level of severity. 5. The core category of the caring experience of the husbands with arthritis patients was "companionship". The causal factor was the patients' experience due to symptoms : physical disfigurement, pain, immobility, limitation of house chores, and limitation of social activities. Contextural factors are husbands' identification of housework and husbands' concern about the disease. The mediating factors are economic problems, fear of aging, feeling of limitation and family support. The strategy for interaction is mind control and how to solve emotional stress. The "companionship" resulted from caring activities, participation of household activities, helping patients' to coping with emotional experience. 6. Companionship is established through the process of entering intervention, and caring state of mind. Entering intervention is the phase of participation of therapy and involvement of houseworks. The caring phase consists of decision on therapy, providing therapy, providing direct care, and taking over the household role of wife. Through caring phase, the changing phase set a stage in which husbands consolidate the relationship with their wives, and are reminded of the meaning of marriage. As a result, in changing phase, husbands' companionship is enhanced. In conclusion, nursing care of chronic illnesses should include a family member especially the spouse. All information on disease shoud be provided to patients and whole family member. Strong support should also be provided to overcome difficulties in taking over role of other sex. Then the quality of life of patients and families will be much improved.
Aging ; Arthritis ; Chronic Disease* ; Diagnosis ; Education ; Family Characteristics ; Female ; Housekeeping ; Humans ; Interviews as Topic ; Marriage ; Models, Theoretical ; Negotiating ; Nursing Care ; Qualitative Research ; Quality of Life ; Surveys and Questionnaires ; Social Class ; Spouses* ; Stress, Psychological

This study was performed to investigate nurses' perception for nutrition education. The subjects of this study were 197 nurses and 94 nursing assistants working at hospitals in the Kyung-nam area. The survey was conducted by using a self-administered questionnaire in November, 2001. The results were as follows : Sixty-seven point seven percent of the subjects were nurse, 32.3% were nursing assistant. Average age of subjects was 26.9 years old, average nursing experience was 5.7 years, and 70.7% of the subjects graduated from a junior college. The average nutrition knowledge score was 14.3+/-2.5 out of possible 20 points. Seventy-four point two percent of the subject responded that nutrition education is very necessary for patient, and positive responses in the nurse were higher than that nursing assistant(p<0.001). Only 8.6% of the subjects had nutrition education training. The perceptions about a suitable person for nutrition counseling and nutrition education indicated dietitian(69.3%) and nurse(21.3%). Fifty-two point eight percent of the subjects responded that they would not participate in nutrition education themselves and the main reason for this was that they believed lack of expert knowledge(43.4%), and that such courses should be taught by specialist(40.5%). Forty-eight point eight percent of subjects had nutrition counseling experience for patient, and nurses, married nurses and those over 2 years of nursing careers had significantly higher nutrition counseling experience for patient than nursing assistant, unmarried nurses and those under 2 years of nursing careers(p<0.05~p<0.001)
Counseling ; Education* ; Gyeongsangnam-do* ; Humans ; Nursing ; Surveys and Questionnaires ; Single Person

PURPOSE: This study was to evaluate effect of an educational program based upon experiment for smoking prevention in middle school students. METHOD: A quasi-experimental design was used. The participants were 107 middle school students (53 in the experimental group, 54 in the control group). Students in the experimental group participated in three 45-minute educational programs over a period of 2 weeks. The dependent variables were measured before and 2 & 4 weeks after the treatment. The data were analyzed using 2 test, Fisher's exact test, t-test, and repeated measures ANOVA. SPSS was used to aid analysis. RESULTS: 1) The experimental group showed higher levels of knowledge of smoking prevention compared to the control group. However this program did not affect their attitude towards smoking. 2) There was a higher possibility of smoking in the future among the students who had smoked than those who had not. 3) The majority (84.9%) of the experimental group said that the program was effective. CONCLUSION: Knowledge of smoking for the experimental group was increased, so it is assumed that the program itself had a positive effect on the students. To change attitudes regarding smoking, smoking prevention programs need to be conducted repeatedly, not just temporarily.
Humans ; Smoke* ; Smoking*

OBJECTIVES: The alcohol dependence in elderly people has been prevalent because of increase in geriatric population. However, it is difficult to find out alcohol dependence in the aged, because they have less specific clinical features as compared with adult alcoholics. The aims of this study were to screen alcohol dependence among elderly Koreans and to know the clinical characteristics of Korean delerly alcoholics. METHODS: The questionnaires translated into Korean such as Michigan Alcoholism Screening Test(MAST-K), the Brief MAST and the MAST-Geriatirc Version(MAST-KG) were used to screen alcohol dependence in the elderly alcoholic inpatients aged over 60(N=43), adult alcoholic inpatients within 20-59 Yrs of age(N=60), which were compared with age matched normal healthy aged(N=18) or adult controls(N=45). The demographic data such as sex, age, education, occupation, socioeconomic status, marital status, numbers of children, dwelling and religion as well as alcohol history such as duration of alcohol drinking, onset age, family history, impulsivity, somatic illness and motivation were also obtained to identify characteristic features of Korean aged alcoholics by structured interviews. RESULTS: 1) The aged alcoholics had the charateristic features of more in males, lower age, low education levels, more in blue-collar workers, lower socioeconomic class, more in single few babies, more living alone, having no religion without statistical significance. 2) The onset age of alcohol dependence was significantly higher in the aged alcoholics(45.3+/-13.6Yrs) than in the adult alcoholics(27.7+/-8.7Yrs)(p<0.0001). The duration of problematic alcohol drinking was significantly longer in the aged alcoholics(22.0+/-15.1Yrs) than in adult alcoholics(14.2+/-8.4Yrs)(p<0.01). Otherwise, there were no significant difference between aged and adult alcoholics in the family history, imulsivity, somatic illness and motivation. 3) The mean score of the MAST-K was significantly higher in the aged alcoholics(20.6 +/-5.4) than in the normal aged(6.7+/-4.4)(p<0.0001), which was significantly lower than in the adult alcoholics(26.2+/-8.0)and in normal adult controls(9.5+/-3.2)(p<0.05). The mean score of the Brief MAST was significantly lower in the aged alcoholics(9.3+/-3.5) than in the adult alcoholics(14.5+/-6.6)(p<0.0001). The mean score of the MAST-KG was significantly higher in the aged alcoholics(10.6+/-3.5) than in the normal aged(4.8+/-4.3)(9<0.0001). The former was significantly lower than in adult alcoholics(12.9+/-4.3)(p<0.005), and the mean score was 4.5+/-2.8 in normal adult controls. 4) The items which showed statistically significant differences between aged alcoholics and normal aged controls could be found in 10 items of the MAST-K(item 2, 3, 4, 5, 11, 14, 17, 21, 22 and 23). 2 items of the Brief MAST(items 2 and 9), and 7 items of the MAST-KG(items 6, 13, 18, 19, 22, 23 and 24)(p<0.01). CONCLUSIONS: The scores of the MAST-K, the Brief MAST and the MAST-KG were significantly lower in the aged alcoholics than those in the adult alcoholics(p<0.05). The statistically significant differences between aged alcoholics and normal aged controls could be found in 10 items of the MAST-K, 2 items of the Brief MAST and 7 items of the MAST-KG. Therefore, a briefer rating scales around 10 items are needed to screen alcohol dependence among Korean elderly people.
Adult ; Age of Onset ; Aged ; Alcohol Drinking ; Alcoholics ; Alcoholism* ; Child ; Education ; Humans ; Impulsive Behavior ; Inpatients ; Korea* ; Male ; Marital Status ; Mass Screening* ; Michigan* ; Motivation ; Occupations ; Surveys and Questionnaires ; Social Class ; Weights and Measures

Atherosclerotic heart disease is a major source of cardiovascular morbidity and mortality in adult populations. To assess the prevalence of anatomical and functional abnormalities of the heart in such patients, we studied total 50 subjects with atherosclerotic heart disease by echocardiography and compared with 27 control subjects. We found significant change(p<0.05) of aortic root dimension, left ventricular mass, mitral valve E-F slope, E-point septal separation, and functional measurements show significant change in ejection fraction and fractional shortening of left ventricle. Characteristically, abnormal septal movement reveals in 70% of patients including paradoxical, flat & diminished, hyperactive motion, and among them paradoxical movement is the most frequent. Also left ventricular posterior wall movement is abnormal in 30% of the patient group. The prevalence of echocardiographic abnormalities is 80 percentile of total, which include 30 percentile subjects with only echocardiographic abnormalities without abnormality in 12-lead ECG, chest X-ray and laboratory findings. And these abnormalities can be detected well by echocardiography before they were otherwise apparent.
Adult ; Echocardiography* ; Electrocardiography ; Heart Diseases* ; Heart Ventricles ; Heart* ; Humans ; Mitral Valve ; Mortality ; Prevalence ; Thorax

PURPOSE: We performed dynamic MR imaging using GdDTPA to find characteristic enhancement pattern of hepatic hemangioma distinguishing from hepatocellular carcinoma. METHODS AND MATERIALS: 28 hepatic hemangiomas and 10 hepatocellular carcinomas were evaluated. Serial dynamic scans after Gd-DTPA(0.1mmol/kg) intravenous injection were obtained by using 0.5T machine and analyzed contrast-to-noise ratio(CNR) of the lesion and enhancement pattern on each scan. RESULTS: Hepatic hemangiomas had positive CNR from 1-2 minute images, and revealed typical "fill-in phenomenon" on early phase with prolonged enhancement in 26 cases(92.8%), and early homogeneous enhancement with isointensity on delayed phase in 2 cases(7.2%) of small hemangiome~ Hepatocellular carcinomas revealed inhomogeneous enhancement with hypointensity on delayed phase in 10 cases(100%) and 3 cases (30%) of capsular enhancement. CONCLUSION: Hepatic hemangioma can be easily distinguished from hepatocellular carcinoma by using Gd DTPA enhanced dynamic MR imaging according to its typical enhancement pattern of "fill-in phenomenon" and prolonged enhancement.
Carcinoma, Hepatocellular ; Diagnosis, Differential* ; Gadolinium DTPA ; Hemangioma* ; Injections, Intravenous ; Magnetic Resonance Imaging*