PURPOSE: Span of Control defines the scope of the managers' responsibilities to manage nursing staff. This study was done to measure span of control of front-line nurse managers (FLNMs) in Korea hospitals resulting in improvement in their work efficiency. METHODS: A sample of 203 FLNMs from five tertiary hospitals was recruited and completed the questionnaires. Data were analyzed using χ²-test, Fisher's exact test, independent t-test, ANOVA, Scheffé, and Pearson correlation coefficient. RESULTS: FLNMs had ‘narrow’ (n=8, 4.3%), ‘appropriate’ (n=161, 87.0%), and ‘wide’ (n=16, 8.6%) span of control. Span of control had significant correlations with the number of nurses (r=.63, p<.001), the number of non-nurses (r=.53, p<.001), units (r=.52, p<.001), staff (r=.83, p<.001), and programs (r=.67, p<.001). CONCLUSION: The research findings indicate that attention should be given to unit complexity, program diversity, total staff, and skills. Moreover, administrators of hospital and nursing departments need to provide systematic support in accordance with FLNMs’ wide span of control.
Administrative Personnel ; Humans ; Korea ; Nurse Administrators* ; Nursing ; Nursing Staff ; Personnel Management ; Tertiary Care Centers

PROPOSE: A specific criterion or comprehensive criteria for the condition of nocturnal erection, which can be considered as an abnormal erection mechanism or organic erectile dysfunction(ED), remain to be established. Thus, it was decided to verify the tenability of the currently referred criteria by performing nocturnal erection tests on volunteers with normal sexual cravings and erection capabilities. MATERIALS AND METHODS: This study was performed on 58 volunteers aged 20 years or older, with a normal sexual life and without past perversion. An IIEF questionnaire was used for verification of normalcy. Only the results from the volunteers who had had more than 4 sexual intercourses during the past 4 weeks, and had attained satisfaction, were reflected in the final report. All subjects completed three sessions of 3 nights of recording using the RigiScan device during the 3 day period. The volunteers were excluded if they woke due to the pressure of the ring or when they had less than 6 hours sleep during the test. RESULTS: The average number and period of erections were 3.7+/-1.7 times and 91+/-53.3 minutes and the average hardness of the distal part and base of the penis were 61+/-25.1 and 73.7+/-22.1% respectively. The average number of erections and maintained duration were 3.7 and 91 minutes, respectively. With more than 40% hardness, the distal part and base of the penis stayed erect for 62.3+/-37.0 and 74.1+/-46.5 minutes, while these figures for an erection were 57.7+/-35.7 and 72.8+/-46.3 minutes, respectively, as confirmed by greater than 60% hardness. Therefore, 56 of the 58(96.5%) failed to satisfy more than one of the criteria and 44(75.8%) did not meet the Brandley's nocturnal erection criterion standard. CONCLUSIONS: Our results were below the criteria for the existing erection test, which means there is the likelihood that these standards are overly high for Korean adult males. Apparently not all cases failing to reach the existing standard level of the nocturnal erection test should be considered as ED, with greater discretion required in the diagnosis for patients with ED.
Adult ; Diagnosis ; Erectile Dysfunction ; Hardness ; Humans ; Male ; Penis ; Surveys and Questionnaires ; Volunteers

No abstract available.
Child* ; Hearing Loss, Sensorineural* ; Humans ; Temporal Bone*

PURPOSE: We studied the voiding dysfunction after surgical treatment of female stress urinary incontinence and diagnosis and treatment. MATERIALS AND METHODS: Three hundred women with stress urinary incontinence underwent surgical procedure between January 1998 and December 2004. Ninety two patients(30.6%) experienced the postoperative voiding dysfunction. As the primary procedure for the management of postoperative voiding dysfunction alpha-blockers medication and clean intermittent catheterization(CIC) were performed. Then, hegar dilation and urethral pull-down procedure were performed as a secondary measure. For the patients who showed persistent obstructed symptoms, cutting of mesh or sling materials were performed. RESULTS: In 57 patients, symptoms improved by alpha-blockers medication and CIC. The others were received hegar dilation and urethral pull-down procedure, and 29 patients were improved. 6 patients were not controlled by conservative treatment, of which 3 patients underwent cutting of mesh or sling. De novo urgency was developed in 12 patients. Anticholinergics were taken, symptoms were diminished in 10 patients after 5 months of medication. CONCLUSION: Most voiding dysfunction after surgery may be effectively managed by conservative treatment. In cases of failure, hegar dilation and urethral pull-down procedure may be useful within postoperative first weak. Finally, cutting of mesh or sling must be considered in patient whose the secondary measure is failed.
Cholinergic Antagonists ; Diagnosis ; Female* ; Humans ; Urinary Incontinence*

PURPOSE: Endoscopic retrograde cholangiopancreatography (ERCP) may provide more definite diagnosis, preoperative guidance, and endoscopic therapy in many children with known or suspected disorders of the pancreas and biliary tract. But the reports about the ERCP in children are rare, so this study is conducted to evaluate the indication, efficacy and safety of the ERCP in children. METHODS: Twenty nine ERCPs in 19 children were included in this study from July, 1994 to Dec, 1996. The children were nine boys and ten girls and their mean age was 6.9 years old (24 months-14 years). The examination was performed in 16 children under general anesthesia while the other 3 adolescent under conscious sedation with Olympus JF or JF1T duodenoscope. We evaluated the indication, efficacy and complication of the ERCPs. RESULTS: All cannulations were successful except one and endoscopic sphincterotomy (EST) was done in 12 children. Among 19 children, we could confirm the clinical diagnosis in 6, add the additional information in 5, revise the diagnosis in 4 (operation guidance in 3), but give no diagnosis in 4 even after ERCP. The diagnosis after ERCPs are choledochol cyst (4), choledochocele (1), bile duct stricture (1), GB and CBD stone (1), pancreatitis with biliary sludge (5), chronic pancreatitis (2) and pancreatic fistula (1). We could achieve therapeutic goal in 8 children after therapeutic ERCP in 11 children. As complications of ERCP, pancreatitis developed in 2 children, moderate delayed hemorrhages requiring transfusion in 2, retroduodenal perforation in 1 and cholangitis in 1 child. No fatality was observed and all complications improved after supportive cares. Most of the complications developed after EST. CONCLUSIONS: All ERCPs were successful, although most of them were done under general anesthesia. In this study we could conclude that ERCP may provide more definite diagnosis, preoperative guidance, and endoscopic therapy in many children with known or suspected disorders of the pancreas and biliary tract. But special care should be paid especially after EST.
Adolescent ; Anesthesia, General ; Bile ; Bile Ducts ; Biliary Tract ; Catheterization ; Child* ; Cholangiopancreatography, Endoscopic Retrograde* ; Cholangitis ; Choledochal Cyst ; Conscious Sedation ; Constriction, Pathologic ; Diagnosis ; Duodenoscopes ; Female ; Hemorrhage ; Humans ; Pancreas ; Pancreatic Fistula ; Pancreatitis ; Pancreatitis, Chronic ; Sphincterotomy, Endoscopic

PURPOSE: Endoscopic retrograde cholangiopancreatography (ERCP) may provide more definite diagnosis, preoperative guidance, and endoscopic therapy in many children with known or suspected disorders of the pancreas and biliary tract. But the reports about the ERCP in children are rare, so this study is conducted to evaluate the indication, efficacy and safety of the ERCP in children. METHODS: Twenty nine ERCPs in 19 children were included in this study from July, 1994 to Dec, 1996. The children were nine boys and ten girls and their mean age was 6.9 years old (24 months-14 years). The examination was performed in 16 children under general anesthesia while the other 3 adolescent under conscious sedation with Olympus JF or JF1T duodenoscope. We evaluated the indication, efficacy and complication of the ERCPs. RESULTS: All cannulations were successful except one and endoscopic sphincterotomy (EST) was done in 12 children. Among 19 children, we could confirm the clinical diagnosis in 6, add the additional information in 5, revise the diagnosis in 4 (operation guidance in 3), but give no diagnosis in 4 even after ERCP. The diagnosis after ERCPs are choledochol cyst (4), choledochocele (1), bile duct stricture (1), GB and CBD stone (1), pancreatitis with biliary sludge (5), chronic pancreatitis (2) and pancreatic fistula (1). We could achieve therapeutic goal in 8 children after therapeutic ERCP in 11 children. As complications of ERCP, pancreatitis developed in 2 children, moderate delayed hemorrhages requiring transfusion in 2, retroduodenal perforation in 1 and cholangitis in 1 child. No fatality was observed and all complications improved after supportive cares. Most of the complications developed after EST. CONCLUSIONS: All ERCPs were successful, although most of them were done under general anesthesia. In this study we could conclude that ERCP may provide more definite diagnosis, preoperative guidance, and endoscopic therapy in many children with known or suspected disorders of the pancreas and biliary tract. But special care should be paid especially after EST.
Adolescent ; Anesthesia, General ; Bile ; Bile Ducts ; Biliary Tract ; Catheterization ; Child* ; Cholangiopancreatography, Endoscopic Retrograde* ; Cholangitis ; Choledochal Cyst ; Conscious Sedation ; Constriction, Pathologic ; Diagnosis ; Duodenoscopes ; Female ; Hemorrhage ; Humans ; Pancreas ; Pancreatic Fistula ; Pancreatitis ; Pancreatitis, Chronic ; Sphincterotomy, Endoscopic

BACKGROUND: This study was designed to evaluate the effects of continuous infusion of ondansetron on postoperative nausea and vomiting (PONV) in patients receiving intravenous patient controlled analgesia (IV-PCA) following laparoscopic gynecological surgery. METHODS: Sixty ASA class I and II patients scheduled for gynecological laparoscopic surgery were randomly divided into the following 3 groups that received the specified dosages of ondansetron mixed with IV-PCA: placebo (group 1), ondansetron 8 mg (group 2), ondansetron 16 mg (group 3). The incidences of nausea, vomiting, visual analogue scale (VAS), and side effects were then recorded in the recovery room, 24 h, 48 h and 72 h postoperatively. RESULTS: There were no significant differences in the occurrence of nausea between group 1 and 2. However, the incidence of nausea in group 3 was significantly lower than in group 1 at 24 h and 48 h after surgery. In addition, significant differences in the occurrence of vomiting were observed among the three groups. However, with the exception of pruritus, no side effects were observed in any of the groups. CONCLUSIONS: IV-PCA mixed with 16 mg of ondansetron effectively prevented nausea at 24 h and 48 h after gynecologic laparoscopic surgery.
Alfentanil ; Analgesia ; Analgesia, Patient-Controlled ; Female ; Gynecologic Surgical Procedures ; Humans ; Incidence ; Laparoscopy ; Nausea ; Ondansetron ; Postoperative Nausea and Vomiting ; Pruritus ; Recovery Room ; Vomiting

We present two cases of symptomatic lower pole moiety ureteropelvic junction obstruction (UPJO) in a partially duplicated collecting system that were successfully treated with minimally invasive endourologic procedures. In the first case, we performed retrograde endopyelotomy with the Acucise(R) ureteral cutting balloon device, and in the latter case, we performed percutaneous nephrolithotomy and antegrade endopyelotomy because of the presence of multiple renal stones. Subsequent intravenous pyelography confirmed marked resolution of the obstruction, and both patients remained asymptomatic during 1 year of follow-up.
Follow-Up Studies ; Humans ; Nephrolithiasis ; Nephrostomy, Percutaneous ; Surgical Procedures, Minimally Invasive ; Ureter ; Urography

The combination of Congenital central hypoventilation syndrome with Hirschsprung's disease, also known as Haddad syndrome, belongs to the family of diseases now designated as Neurocristopathies. We have experienced a case of Haddad syndrome in a male infant who presented with repetitive abdominal distension, bilious vomiting, and sleep apnea. Following colon study and rectal biopsy disclosed the absence of the ganglion cell. And the infant could not be weaned from mechanical ventilation since birth because of the absence of effective, spontaneous respiration during sleep. As he was diagnosed as Haddad syndrome, tracheostomy and ileostomy were performed consecutively. At the age of 4 months, he was relatively healthy but remained ventilator-dependent. We report the first Korean case of Haddad syndrome with a brief review of the related literature.
Biopsy ; Colon ; Ganglion Cysts ; Hirschsprung Disease ; Humans ; Hypoventilation ; Ileostomy ; Infant ; Male ; Parturition ; Respiration ; Respiration, Artificial ; Sleep Apnea Syndromes ; Tracheostomy ; Vomiting

BACKGROUND: The aim of this study was to evaluate the safety and analgesic efficacy of polmacoxib 2 mg versus placebo in a superiority comparison or versus celecoxib 200 mg in a noninferiority comparison in patients with osteoarthritis (OA). METHODS: This study was a 6-week, phase III, randomized, double-blind, and parallel-group trial followed by an 18-week, single arm, open-label extension. Of the 441 patients with knee or hip OA screened, 362 were randomized; 324 completed 6 weeks of treatment and 220 completed the extension. Patients were randomized to receive oral polmacoxib 2 mg (n = 146), celecoxib 200 mg (n = 145), or placebo (n = 71) once daily for 6 weeks. During the extension, all participants received open-label polmacoxib 2 mg. The primary endpoint was the change in Western Ontario and McMaster Universities (WOMAC)-pain subscale score from baseline to week 6. Secondary endpoints included WOMAC-OA Index, OA subscales (pain, stiffness, and physical function) and Physician's and Subject's Global Assessments at weeks 3 and 6. Other outcome measures included adverse events (AEs), laboratory tests, vital signs, electrocardiograms, and physical examinations. RESULTS: After 6 weeks, the polmacoxib-placebo treatment difference was −2.5 (95% confidence interval [CI], −4.4 to −0.6; p = 0.011) and the polmacoxib-celecoxib treatment difference was 0.6 (CI, −0.9 to 2.2; p = 0.425). According to Physician's Global Assessments, more subjects were “much improved” at week 3 with polmacoxib than with celecoxib or placebo. Gastrointestinal and general disorder AEs occurred with a greater frequency with polmacoxib or celecoxib than with placebo. CONCLUSIONS: Polmacoxib 2 mg was relatively well tolerated and demonstrated efficacy superior to placebo and noninferior to celecoxib after 6 weeks of treatment in patients with OA. The results obtained during the 18-week trial extension with polmacoxib 2 mg were consistent with those observed during the 6-week treatment period, indicating that polmacoxib can be considered safe for long-term use based on this relatively small scale of study in a Korean population. More importantly, the results of this study showed that polmacoxib has the potential to be used as a pain relief drug with reduced gastrointestinal side effects compared to traditional nonsteroidal anti-inflammatory drugs for OA.
Arm ; Celecoxib* ; Electrocardiography ; Hip ; Humans ; Knee ; Ontario ; Osteoarthritis* ; Outcome Assessment (Health Care) ; Physical Examination ; Vital Signs