PURPOSE: The purpose of this study was to identify the process of overcoming the intention toward turnover experienced by career nurses. METHODS: Data were collected from 10 career nurses though in-depth interviews about their experiences. The main question was "How do you describe your experience of the process of overcoming intention to turnover as a career nurse?" Qualitative data from field and transcribed notes were analyzed using Strauss & Corbin's grounded theory methodology. RESULTS: From the participants' statement, 127 concepts, 34 subcategories and 13 categories were extracted through the open coding process. The core category was discovered to be 'back to the original place'. Phenomenon was identified as 'reached the threshold that cannot be withstood' and this series of process was categorized as having four stages: 'conflict', 'meditation', 'discovery' and 'conquest'. There were three types of overcoming turnover intention in career nurses, 'adjustment', 'compromise', 'self-led'. CONCLUSION: The results of this study produced useful information about the needs of career nurses during the process of overcoming turnover intention based on their stage and overcoming types of turnover intension. Ultimately this study may help decrease the turnover intention of career nurses.
Clinical Coding ; Intention

STUDY DESIGN: A retrospective analysis was performed on 40 patients who had had previous lux bar spine surgeries. OBJECTIVE: To determine what factors most influenced surgical outcome and to analyze results in a series of revision lumbar surgeries. SUMMARY OF BACKGROUND DATA: Satisfactory surgical outcome of the revision lumbar surgery range from 28% to 82% and are rarely comparable to primary surgery. Many factors predicting outcome from repeat lumbar surgery haute been listed. METHODS: Forty patients were analyzed who had had previous lumbar surgeries. The patients were classified into 5 groups according to diagnosis: 3 Infection,5 instability,8 nonunion, 14 HNP and 10 spinal stenosis. of 40 patients,33 patients(82.5%) underwent fusion with instrumentation for repeat surgery. Their clinical course was followed for a minimum of 1 year. The number of surgery on each mpatient was 1.3 times on an average. RESULTS: Overall, 80% of patients had a satisfactory result. Obviously extruded or sequestrated HNP in MRI findings, complete block of contrast with severe radiculopathy and/or myelopathy in spinal stenosis, complete decompression, neurolysi s and fusion with instrumentation, and longer than 6 month pain relief after precious surgery were correlated with satisfactory outcome. However, the number of precious operation, age, repair of pseudarthrosis , no abnormality at surgery and combined multiple degenerative joint disease were significantly correlated with poor surgical outcome. The most common complication during repeat surgery was dural tear in 5 cases(12.5%). CONCLUSIONS: Success rate of revision surgery was low as compared to primary operation. Therefore, erroneous diagnosis and faulty surgical technique understandably lead to failure, and precise attention to preoperative and intraoperative detail can minimize these sources of error.
Decompression ; Diagnosis ; Humans ; Joint Diseases ; Magnetic Resonance Imaging ; Pseudarthrosis ; Radiculopathy ; Reoperation ; Retrospective Studies ; Spinal Cord Diseases ; Spinal Stenosis ; Spine* ; Tears

This study was done to evaluate the effect reducing artificial dead space on intubated children. Data were collected from July 1st, 1998 to August 31st, 1999. The subjects were selected from a pediatric intensive care unit of 'S' hospital and intubated with 3.5 mm or 4.5 mm endotracheal tube after open heart surgery. They were composed of 34 patients : 17 patients were assigned to the experimental group and the rest of them were placed in the control group. The artificial airway volume was minimized in the experimental group, and the control group maintained the artificial airway volume. ETCO2, PaCO2, SPO2 were measured as indicators of pulmonary ventilation. The tools of this study were GEM-Premier and Space-Lab patient monitors. The data were analyzed using the SPSS/PC+ program. The Chi2 -test was used to find general characteristics. The t-test was used to test the homogenety of the pulmonary ventilation status and mechanical ventilation setting before intervention between the two groups. Also, the paired t-test was used to examine the hypothesis. The results can be summerized as : 1. CO2 can be expelled effectively from the body in case artificial dead space was decreased. 2. As the artificial dead space was reduced, the difference between ETCO2 and PaCO2 was decreased, in other words pulmonary ventilation was improved. 3. If the artificial dead space occupied above 15 percent of tidal volume, the effect of CO2 was retention revealed in the body. 4. If the artificial dead space occupied below 1.5 percent of tidal volume, there was no dead space effect. Based on the results, the following is suggested to be applied practically : 1. A kind of the ventilator circuit acting artificial dead space should be removed from the intubated children with mechanical ventilaion. 2. The endotracheal tube should not be cut because extra-body space of the endotracheal tube did not have an effect on the dead space of the intubated children. Since the researcher could not cover this aspect in the study, they recommend the following. 1. The study should be extended to the other pulmonary disease patients for the effect of improving pulmonary ventilation. 2. Also, further studying with a more narrow interval in the extra-body space of the artificial airway will be able to explain the point of artificial dead space with proper ventilation.
Child* ; Humans ; Intensive Care Units ; Lung Diseases ; Pulmonary Ventilation* ; Respiration, Artificial* ; Thoracic Surgery ; Tidal Volume ; Ventilation ; Ventilators, Mechanical

No abstract available.
Hysterectomy*

A 70-year-old female who was diagnosed as myxoid chondrosarcoma by fine needle aspiration of a pleural mass is described. She presented with left chest discomfort of 4 months' duration and aggravating dyspnea and chest pain for 2 months. Chest X-ray and CT scan revealed a large lobulated low density mass invading chest wall at the left pleural cavity and massive pleural fluid. Fine needle aspiration was done under the impression of mesothelioma or metastatic cancer. The aspirates from the mass were very cellular and composed of isolated or clustered forms of large plump cells. Abundant cytoplasm was bluish opaque and the margin was rounded in the isolated cells, whereas clustered cells show ill-defined cell borders and aggregating tendency. The nuclei were eccentric, round to ovoid, and had fine chromatin pattern and multiple small nucleoli. Cellular pleomorphism or mitotic figure was not definite. These findings were consistent with cytologic features of chondrosarcoma. Final diagnosis was confirmed as myxoid chondrosarcoma by mediastinoscopic biopsy and the tumor showed strong positivity for S-100 protein.
Aged ; Biopsy ; Biopsy, Fine-Needle ; Chest Pain ; Chondrosarcoma ; Chromatin ; Cytoplasm ; Diagnosis ; Dyspnea ; Eosinophils* ; Female ; Humans ; Mesothelioma ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Pleural Cavity ; S100 Proteins ; Thoracic Wall ; Thorax ; Tomography, X-Ray Computed

Restrictive dermopathy is a rare autosomal recessive disorder in which rigidity or tautness of the skin from the second trimester causes a fetal akinesia deformation sequence (FADS) and early death. Characteristic features include taut skin with prominent subcutaneous vessels, widely open fontanelles and cranial sutures, distinctive facies, flexion contractures, pulmonary hypoplasia, sparse eyelashes and and eyebrows, thin dysplastic clavicles. The histologic abnormalities of the skin are located in a thin dermis, consisting of compactly arranged collagen fibers, scanty elastic fiber. The dermoepidermal junction is flat, and epidermal appendages are absent, miniaturized or immature. The presence of adipose tissue may be increased. We report on the first Korean case of restrictive dermopathy with typical clinical features and histological findings.
Adipose Tissue ; Clavicle ; Collagen ; Contracture ; Cranial Sutures ; Dermis ; Elastic Tissue ; Eyebrows ; Eyelashes ; Facies ; Female ; Humans ; Pregnancy ; Pregnancy Trimester, Second ; Skin

Hemimegalencephaly is a rare congenital malformation of the cortical development arising from abnormal proliferation of anomalous neuronal and glial cells. The characteristic clinical manifestations are macrocephaly, psycomotor retardation, intractable seizure and hemihypertrophy of face, body and extremities, but musculoskeletal deformities are reported only in case of epidermal nevus syndrome. We report a case of hemimegalencephaly that was associated with foot deformity, without symptoms and signs of epidermal nevus syndrome.
Congenital Abnormalities ; Extremities ; Foot Deformities ; Foot Deformities, Congenital ; Macrocephaly ; Malformations of Cortical Development ; Neuroglia ; Neurons ; Nevus ; Nevus, Sebaceous of Jadassohn ; Seizures

BACKGROUND: Adverse cutaneous drug reactions (ACDRs) are common and are responsible for increased morbidity, mortality, and socioeconomic costs. OBJECTIVE: The purpose of our study was to investigate the common drugs and clinical patterns related to ACDRs using an electronic drug adverse reaction reporting system at a single secondary referral center. METHODS: We conducted a retrospective analysis of the ACDR database between January 2014 and April 2016 at the Ilsan Paik Hospital. RESULTS: The study analyzed 320 patients with ACDRs (male:female ratio=93:227; mean age 50.8±17.8 years). Using a Korean causality evaluation algorithm, the percentage of drugs with a possible relationship with ACDRs was calculated to be 50.6%, while the percentage with a probable relationship was 44.7%. Antibiotics (44.0%), radiocontrast media (15.1%), and non-steroidal anti-inflammatory drugs (NSAIDs) (14.3%) were the most commonly implicated drugs. Antibiotics, including cephalosporins (30.6%) and quinolones (10.2%), were responsible for the majority of the ACDRs. Acetic acid (5.9%) and propionic acid (5.9%) derivatives of NSAIDs were also common causative agents. The most common clinical presentations were maculopapular exanthema (33.4%), pruritus (30.9%), and urticaria (25.7%). Severe ACDRs were significantly associated with older age, eosinophilia, and underlying heart and renal diseases (p<0.05). CONCLUSION: Antibiotics, radiocontrast media, and NSAIDs were identified as common causes of ACDRs. Older age, eosinophilia, heart disease, and renal disease were associated with severe ACDRs.
Acetic Acid ; Adverse Drug Reaction Reporting Systems ; Anti-Bacterial Agents ; Anti-Inflammatory Agents, Non-Steroidal ; Cephalosporins ; Contrast Media ; Diethylpropion ; Drug-Related Side Effects and Adverse Reactions ; Eosinophilia ; Exanthema ; Heart ; Heart Diseases ; Humans ; Mortality ; Pruritus ; Quinolones ; Retrospective Studies* ; Secondary Care Centers* ; Urticaria

OBJECTIVES: Our objective was to examine and evaluate the psychological health of the residents of Taean during the cleanup of the Hebei Spirit (HS) oil spill and to review some factors associated with the results. METHODS: A community survey of 71 men and women was conducted 8 weeks after the HS oil spill. Questionnaires used were the PWI (Psychological Well-being Index) scale for psychosocial distress, the CES-D (Center for Epidemiologic Studies-Depression) scale for depressive symptoms, and a questionnaire created to assess suicidal impulses. RESULTS: The overall prevalence of high-risk psychosocial distress among the study group was 64.2%. The percentages of respondents with scores on the CES-D Scale above 16 and above 21 were 77.6% and 62.7%, respectively. The percentage of respondents categorized as having suicidal impulses was 18.3%. When compared with unexposed groups in the general population taken from various sources, the residents of Taean were 6.5 times as likely to have high stress and 9.4-9.7 times as likely to be depressed. No significant difference in the rate of suicidal impulse was found between the residents of Taean and the general population. Factors associated with high stress, depression, and suicidal impulses were age, a change in income, educational level, number of days working on the cleanup, and positive responses to questions about "affected daily activity" and "hospital visit due to work on cleanup." CONCLUSIONS: The results suggest that the HS oil spill had a significant impact on the psychological health of residents of Taean, but the comparability of the unexposed groups is a limitation of the study.
Adult ; Aged ; Depression ; *Disasters ; Environmental Exposure ; Environmental Pollution ; Female ; Humans ; Male ; *Mental Health ; Middle Aged ; Oceans and Seas ; *Petroleum ; Questionnaires ; Risk Factors ; Stress, Psychological ; Suicide, Attempted

Splenic infarction is a rare disease and usually detected as a complication of SBE, atrial fibrillation, hemoglobinopathy, or myeloproliperative disorders. Although thrombotic event, such as deep vein, cerebral or renal thrombosis, is a frequent complication of SLE, there have been only a couple of cases documenting splenic infarction complicated in SLE. This is, to our knowledge, the first case report describing isolated splenic infarction in pediatric SLE. The splenic infarction was diagnosed on abdominal CT, 99mTc-RBC splenic scan, and abdominal USG, and resolved with anticoagulant therapy. And we discussed about the possibility of antiphospholipid syndrome as a cause of the infarction in this case.
Antiphospholipid Syndrome ; Atrial Fibrillation ; Cerebral Veins ; Female* ; Hemoglobinopathies ; Humans ; Infarction ; Lupus Erythematosus, Systemic* ; Rare Diseases ; Splenic Infarction* ; Thrombosis ; Tomography, X-Ray Computed