The behavioral disturbances such as agitation, aggression and wandering oc-curred in the geriatric patients have imposed much burdens on the caregivers. The origin of the behavioral disorders in the geriatric patients were identified to be based on the multidimensional interaction of the biological, psychological and social factors. There are no satisfactory instrum-ents for assessment of behavioral disorders in the geriatric patients. Furthermore, the functional assessments are also required to evaluate the environmental events to influence the problem beh-aviors in the geriatric patients.
Aggression ; Caregivers ; Dihydroergotamine ; Humans

No abstract available.
Anesthesia ; Dihydroergotamine ; Methyl Ethers

BACKGROUND: We designed this study to find the appropriate dose of fentanyl for the prevention of emergence agitation in pediatric tonsillectomy patients under sevoflurane anesthesia. METHODS: Sixty pediatric patients receiving sevoflurane anesthesia for tonsillectomy was assigned to 3 groups. Fentanyl 0.5microgram/kg (group 1), 1.0microgram /kg (group 2), or 1.5microgram/kg (group 3) was administered intravenously 10 min before the end of surgery. Agitation score was checked at the postanesthesia care unit. RESULTS: The results showed a lower incidence of severe agitation in groups 2 and 3 than in group 1. There was no difference between groups 2 and 3. CONCLUSIONS: For preventing emergence agitation after sevoflurane anesthesia, we recommend using fentanyl in a dose of more than 1.0micrgram/kg.
Anesthesia* ; Dihydroergotamine* ; Fentanyl* ; Humans ; Incidence ; Tonsillectomy*

Behavior disturbances in dementia have many causes, and it is difficult to judge the effectiveness of any method as well as to classify and choose the right agents or methods of treatment. Because agitated behavior disturbances are intermittent phenomena, it is not certain that the change of symptom is response of treatment or incidental. We should help elderly people with risk of dementia, including the preventive intervention and various treatment strategies for the last stages of life. To the comprehensive treatment of behavioral disturbance of patients with dementia, adequate medical resources are essential through organized medical delivery system as well as environmental modification, family management and pharmacotherapy.
Aged ; Dementia ; Dihydroergotamine ; Drug Therapy ; Humans

< 0.05). The incidence of emergence agitation was 17% in the subtenons lidocaine injection group, which was significantly lower than in the control group (36%) (P < 0.05). CONCLUSIONS: A lidocaine injection into the subtenons space reduces emergence agitation after sevoflurane anesthesia in pediatric strabismus surgery.
Anesthesia* ; Anxiety* ; Dihydroergotamine* ; Incidence ; Lidocaine* ; Strabismus*

PURPOSE: The purpose of this study was to determine the relationship between assessed pain, functional status, and emotional status in elderly women with dementia. METHODS: The method was a descriptive correlational design. Subjects were sampled from 75 elderly women with dementia who were resident in nursing home. and their pain, functional status(physical function, cognitive function), emotional status(depression, agitation) were measured. The collected data were analyzed for correlations between pain and functional status and for emotional status using the SPSS 11.0 statistical program. RESULTS: The pain degree of the aged women in dementia were as follows; between 0 and 27 points, average 4.04 points, which was a possible point extent. Looking at the grades in detail items, the wry face expression was shown highest, an average of 0.84 points. The relation with cognitive function was(r=-.259, p<.025) a minus relation. And the relation with physical function was (r=.406, p<.001) a plus one. The relation with depression was (r=.462, p<.001), plus one. And (r=.592, p<.001) a plus relation was found with agitation. CONCLUSION: Pain is associated with impaired functional and emotional status. Major efforts are needed to improve nursing assessment and management of pain in this cognitive impaired population.
Aged* ; Dementia* ; Depression* ; Dihydroergotamine* ; Female ; Humans ; Nursing Assessment ; Nursing Homes

PURPOSE: This aim of this phenomenological study was to describe and understand the experience of spiritual conflict in hospice nurses by identifying the meanings and structures of the experience. METHODS: Participants were 12 nurses working for one year or more at hospice units of general hospitals in a metropolitan city and experiencing of spiritual conflict as hospice nurses. Over six months data were collected using individual in-depth interviews and analyzed with the method suggested by Colaizzi. RESULTS: The experience of spiritual conflict in participants was organized into three categories, six theme-clusters, and 13 themes. The participants felt existential anxiety on death and a fear of death which is out of human control and skepticism for real facts of human beings facing death. They also experienced agitation of fundamental beliefs about life with agitation of the philosophy of life guiding themselves and mental distress due to fundamental questions that are difficult to answer. Also they had distress about poor spiritual care with guilty feelings from neglecting patients' spiritual needs and difficulties in spiritual care due to lack of practical competencies. CONCLUSION: Findings indicate the experience of spiritual conflict in hospice nurses is mainly associated with frequent experience of death in hospice patients. The experience of spiritual conflict consisted of existential anxiety, agitation of fundamental beliefs and distress over poor spiritual care. So, programs to help relieve anxiety, agitation and distress are necessary to prevent spiritual conflict and then spiritual burnout in hospice nurses.
Anxiety ; Dihydroergotamine ; Hospices* ; Hospitals, General ; Humans ; Methods ; Philosophy ; Qualitative Research

OBJECTIVE: Dementia symptoms (cognitive function, daily-living function, and neuropsychiatric symptoms) become more serious over time, which is likely to increase caregiver burden. The aim of this study is to investigate which dementia-related symptoms, and how the progression of these symptoms, have influenced caregiver burden during a 1-year follow-up assessment. METHODS: A total of 110 patients with dementia were assessed for their cognitive function, daily-living function, and neuropsychiatric symptoms. Caregivers were assessed for their caregiver burden. Bivariate analyses were conducted between caregiver burden and dementia patients' symptoms, in order to examine which particular symptoms were significantly associated with caregiver burden at the baseline. A multiple regression analysis was then conducted with each significantly associated variable with a view to identifying determinants, influencing caregiver burden. Additionally, bivariate analyses were conducted between the changes in caregiver burden and the changes in patients' symptoms, to investigate which patient variable could best describe caregiver burden from baseline to the 1-year follow-up. A multiple regression analysis was conducted with each significantly-associated change in symptom, in order to identify determinants that influence a change in caregiver burden. RESULTS: Neuropsychiatric symptoms, such as irritability, aberrant motor-behavior, delusions and disinhibition were found to be significant predictors of caregiver burden at baseline, according to multiple regression analysis. In addition, changes in neuropsychiatric symptoms, such as delusions, agitation and memory-related functioning in daily-living significantly predict a change in caregiver burden. CONCLUSION: Our results demonstrate that neuropsychiatric symptoms and memory impairment in daily-living functions are significant predictors of an increase in caregiver burden.
Caregivers* ; Delusions ; Dementia* ; Dihydroergotamine ; Follow-Up Studies* ; Humans ; Memory

Subaortic left brachiocephalic vein is a rare congenital anomaly that is sometimes found in the normal population. We report here on a case of subaortic left brachiocephalic vein that was detected incidentally by performing contrast transesophageal echocardiography (TEE) with using agitated saline and computed tomography (CT).
Brachiocephalic Veins* ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Dihydroergotamine ; Echocardiography, Transesophageal

BACKGROUND: Behavioral and psychological symptoms (BPS) following acute middle cerebral artery (MCA) infarcts are not uncommon, but these have been considered to be less important than physical disability. The purpose of this study is to evaluate the characteristics of BPS following acute MCA infarcts by using the Korean version of neuropsychiatric inventory (K-NPI). METHODS: Fifty-one patients with acute MCA infarcts were studied using the K-NPI scale. We investigated newly developed BPS after the onset of MCA infarcts by interviewing the primary caregiver of each patient. We then evaluated factors related to the BPS such as lesion laterality and various characteristics of the subjects. RESULTS: The most common BPS following acute MCA infarcts was depression. It was present in 69% of the patients, followed by anxiety (61%), agitation (39%), apathy (29%) and irritability (25%). Depression and anxiety were associated with left MCA lesion, whereas apathy was associated with right lesion. Patients with recurrent MCA infarcts more often had depression and anxiety than those without (p=0.03, p=0.04, respectively). Patients with MCA infarcts caused by cardioembolism more often had irritability and disinhibition than those with other subtypes (p=0.01, p=0.02, respectively). CONCLUSIONS: BPS is frequently observed following acute MCA infarcts. Therefore, early and adequate assessment of post stroke BPS and appropriate therapy may be important in patients with MCA infarcts.
Anxiety ; Apathy ; Caregivers ; Depression ; Dihydroergotamine ; Humans ; Middle Cerebral Artery* ; Stroke