Despite current practice there is no evidence to demonstrate the efficacy of intraurethral 2% lidocaine gel as an anesthetic for rigid cystoscopy. To evaluate the usefulness of lidocaine on decreasing pain associated with cystoscopy, we performed a randomized controlled study comparing 2% lidocaine gel with a plain water based lubricant. Pain was recorded on a visual analogue scale by the patient and by the physician. Physician perception of pain experienced by the patient was compared with the actual pain experienced. We found decrease in pain perception in men following lidocaine gel instillation with a 5 or 10 minute dwell time compared to instillation of the plain lubricant.
Anesthetics ; Cystoscopy* ; Humans ; Lidocaine* ; Male ; Pain Perception ; Water

We present a case of acquired tracheoesophageal fistula (TEF) which was found during induction of general anesthesia for clipping of aneurysm. The patient had been intubated with endotracheal tube for 10 days and then done tracheotomy for 45 days. Thereafter, TEF was confirmed by MRI and treated with fistula repair and tracheal fenestration. Acquired TEF can occur under the condition of prolonged tracheal intubation with high cuff pressure (>30 mmHg) and can also result from intratracheal neoplasm, mediastinitis, and other tracheal or esophageal damages. If unrecognized during anesthetic induction, TEF can cause gastric dilatation and rupture, pulmonary aspiration and respiratory failure. So early diagnosis and proper management is very important whenever TEF is suspected during anesthetic induction.
Anesthesia, General ; Aneurysm ; Early Diagnosis ; Fistula ; Gastric Dilatation ; Humans ; Intubation ; Magnetic Resonance Imaging ; Mediastinitis ; Respiratory Insufficiency ; Rupture ; Tracheoesophageal Fistula* ; Tracheotomy

The incidence of conjoined twins is so rare that few anesthesiologists have an opportunity of managing them. Especially in Korea, there are only a few reports describing the anesthetic management for surgical separation of newborn conjoined twins. We experienced the successful anesthetic management for surgical separation of thoraco-xiphopagus conjoined twins without any particular problems. After applying the noninvasive monitors (ECG, pulse oximeter), one of the twins (twinA) with congenital heart disease was administered with intravenous ketamine for induction of anesthesia and intubated without neuromuscular blocker. Anesthesia was maintained with N2O-O2 and hand ventilation using Mapleson D breathing circuit. After maintaining airway of the twinA, the twinB was intubated and maintained with the same manner. Eighteen days after the separation procedure, the twinA with congenital heart disease died and the other one, twinB has been alive with normal growth and development.
Anesthesia ; Growth and Development ; Hand ; Heart Defects, Congenital ; Humans ; Incidence ; Infant, Newborn ; Ketamine ; Korea ; Neuromuscular Blockade ; Respiration ; Twins, Conjoined* ; Ventilation

PURPOSE: This study was done to identify factors based on the theory of planned behavior that predict smoking cessation in elderly smokers following a stroke. METHOD: Between March and May 2013, data related to intention, attitude toward the behavior, subjective norm, and perceived behavioral control, were collected through questionnaire from 223 elders who smoked and who had a stroke. Data analysis was performed using PASW (SPSS) 18.0 program, and included t-test, one-way ANOVA, Pearson correlation coefficients, and multiple stepwise liner regression analysis. RESULTS: Results showed a positive correlation between intention and attitude toward the behavior (r=.494, p<.001), subjective norm (r=.390, p<.001), and perceived behavioral control (r=.189, p=.005). These variables such as perceived behavior control, subjective norm, number of cigarettes per day, and usefulness of quitting smoking explained 50% of intention to quit smoking. CONCLUSION: The results of this study indicate that there is a need to develop smoking cessation nursing strategies for elderly smokers following a stroke in order to provide effective counseling on subjective norm and perceived behavioral control.
Aged* ; Behavior Control ; Counseling ; Humans ; Intention* ; Nursing ; Surveys and Questionnaires ; Smoke* ; Smoking Cessation ; Smoking* ; Statistics as Topic ; Stroke* ; Tobacco Products

PURPOSE: This study was done to explore clinical competence and factors related to competence in nursing students. METHODS: Data were collected using structured questionnaires from 210 students in three different schools located in D, B and P metropolitan cities, Korea. Data were using PASW (SPSS) 18.0 program, and included t-test, one-way ANOVA, Pearson correlations coefficients, and multiple regression analyses. RESULTS: There were positive correlations between clinical competence and ego-resilience (r=.40. p<.001), critical thinking dispositions (r=.58, p<.001), and self-leadership (r=.14, p=.043). Variables such as critical thinking dispositions, ego-resilience, satisfaction with clinical practice education, health status and academic performance explained 48% of variance in clinical competence. CONCLUSION: According to the above results, a specific education program for clinical competence of student nurses is needed to increase critical thinking dispositions, ego-resilience, satisfaction with clinical practice education, health status and academic performance.
Clinical Competence* ; Education ; Health Education ; Humans ; Korea ; Leadership ; Mental Competency ; Surveys and Questionnaires ; Students, Nursing* ; Thinking

PURPOSE: This study was done to examine sexual autonomy of college students. METHOD: Between October 2012 and November 2012, data related to self-efficacy, health knowledge, attitude to sex, and sexual autonomy orientation, were collected by questionnaire from 232 students. The data analysis was performed using PASW (SPSS) 18.0 program, and included t-test, one-way ANOVA, Pearson correlation coefficients, and multiple stepwise liner regression analysis. RESULTS: The results showed a positive correlation between self-efficacy and sexual autonomy (r=.56, p<.001), sexual health knowledge (r=.50, p<.001), and attitude to sex (r=.29, p=.001). These 4 variables accounted for 48.7% of the variance in sexual autonomy among college students. CONCLUSION: The results of this study indicate that there is a need to develop mental health nursing strategies for college students in order to provide effective counseling on sexuality and sexual health matters.
Counseling ; Humans ; Mental Health ; Orientation ; Surveys and Questionnaires ; Reproductive Health ; Sexuality ; Statistics as Topic

Benign solitary schwannoma of the chest wall is a rare disease of nerve sheath origin A 43-year-old female patient was admitted to our hospital for right upper quandrant pain Chest X-ray shows nonspecific finding, ultrasonography & CT scan revealed a solid tumor on the right lateral chest wall. On aspiration needle biopsy, this mass was turned out to be a schwannoma of the right lateral chest wall. This mass was excised surgically in an encapsulated state by right lateral thoracotomy. Histological section revealed a typical schwannoma, which is characterized by Antoni A and Antoni B tissues of high & low cellularity.
Adult ; Biopsy, Needle ; Female ; Humans ; Neurilemmoma* ; Rare Diseases ; Thoracic Wall* ; Thoracotomy ; Thorax* ; Tomography, X-Ray Computed ; Ultrasonography

Large numbers of reports have shown that thermal injury (TI) causes a wide spectrum of defects in immune response that lead to a high susceptibility to various opportunistic infections. However, it is still a matter of debate whether TI induces Th2 polarization or global impairment in Th1/Th2 response. In this study, TI in a mouse model was induced by exposing shaved dorsal skin to boiling water and cytokine production was analyzed. At day 2 of injury, whole spleen cells and T cells were collected and then stimulated with an anti-CD3 antibody. The levels of cytokine secretion were determined by cytokine ELISA. Production of IFNgamma and IL 4 by whole spleen cells from injured mice were concurrently decreased when compared to those from sham-injured controls. Proportional changes in T, B, and T-subset cells were not accompanied. Using purified T cells devoid of accessory cells (AC), it was shown that those defects resulted primarily from lowered T cell potentials. By using mixed cultures of sham T and TI-AC and vice versa, it was revealed that AC also acted as inhibitor cells in IFNgamma and IL 4 production in less extent. Blockade of glucocorticoid signals rendered the T cells partially resistant to TI-induced inhibition in IFNgamma and but not IL 4 production. These results clearly demonstrate that TI induces overall suppression in Th1 and Th2 response through T cell dysfunction together with the inhibition of AC activity, and that reduction in only IFNgamma but not IL 4, production may be caused, in part, by corticosteroid hormone that is secreted prominently during trauma.
Animals ; Enzyme-Linked Immunosorbent Assay ; Mice ; Opportunistic Infections ; Skin ; Spleen ; T-Lymphocytes ; Water

No abstract available.
Paragonimiasis*

BACKGROUND: The incidence of reported nontyphoidal Salmonellosis has increased during last decade in Korea. Salmonella typhimurium and Salmonella enteritidis are two major serotypes in nontyhoidal Salmonella. To determine the nature of potential outbreak S. typhimurium infection in a community, we retrospectively evaluated clinical and epidemiologic features of S. typhimurium infections and performed pulsed-field gel electrophoresis(PFGE) to investigate a genetic relatedness of S. typhimurium isolated in Guro Hospital. METHODS: From May 1998 to April 1999, a total of 20 S. typhimurium strains were isolated from 18 patients. PFGE patterns were analyzed for 20 S. typhimurium strains Clinical and epidemiological features were evaluated from their medical records. RESULTS: Seventy two percent(13/18) were acute gastroenteritis, and 11 %(2/18) were enteric fever and 16 %(3/18) were intussusception. Seventy eight percent(14 of 18) of patients were six years old or less than. There were two major type(A, B) on PFGE analysis. Eight of 20 strains showed identical PFGE type(A1). Eleven strains were subtypes of A1. One strain showed different type(B). Similarity coefficients between A1 and its subtypes were all over 0.765 and they showed close genetic distance on dendrogrm. Antibiogram of Al eight strains were various. CONCLUSIONS: High genetic relationship among 20 S. typhimurium strains for a year in Guro area indicates that they were possibly originated from one clone and that there might be a common source of infection. More efforts should be directed toward the epidemiological investigation of the cases to detect outbreaks and prevent further spread of the infection.
Clone Cells ; Disease Outbreaks ; Gastroenteritis ; Humans ; Incidence ; Intussusception ; Korea ; Medical Records ; Microbial Sensitivity Tests ; Molecular Epidemiology* ; Retrospective Studies ; Salmonella enteritidis ; Salmonella Infections ; Salmonella typhimurium* ; Salmonella* ; Tertiary Care Centers* ; Typhoid Fever