PURPOSE: This study was done to identify the effect of nursing organizational culture on empowerment as perceived by new clinical nurses. METHODS: For the objective a sample of 175 new nurses from secondary/tertiary hospitals having not less than 250 beds located in B city was selected to complete a questionnaire. The collected data were analyzed using descriptive statistics, t-test, One-way ANOVA, Scheffe's test, Pearson correlation coefficients and simultaneous multiple regression with the SPSS 14.0 software program. RESULTS: As for nursing organizational culture as perceived by the respondent, relation-oriented culture had the highest average score (3.60+/-.63) out of a possible 5 points followed by hierarch-oriented culture, innovation-oriented culture and task-oriented culture with 3.45+/-.30, 3.19+/-.53 and 3.05+/-.46, respectively. The respondents' level of perceived empowerment was 3.06+/-.41. The factors influencing empowerment according to nursing organizational culture were innovation-oriented and relation-oriented culture in that order. These 2 variables were statistically significant predictors and explained 48.6% of the variance in empowerment. CONCLUSIONS: The results of this study indicate that emphasis should be given to nursing organizational culture strengthened by innovationoriented and relation-oriented culture, rather than task-oriented and hierarch-oriented culture, in order to foster harmonious empowerment among nurses at all levels.
Surveys and Questionnaires ; Organizational Culture ; Power (Psychology)

BACKGROUND: In previous our retrospective study, we concluded that administered fluid volume, duration of operation, operative procedures and anesthetic techniques were the major factors of postoperative urinary retention. However, the administered fluid volume, age, types and duration of the operation confined to hemorrhoidectomy was questioned as a precipitating factor. The high retention rate in spinal anesthesia is also questioned. METHODS: We investigated these possible precipitating factors of urinary retention in healthy patients (n=154) undergoing hemorrhoidectomy. The patients were randomly divided into three different anesthetic techniques: caudal (2% lidocaine 300 mg with 1 : 200,000 epinephrine), spinal (0.5% tetracaine 5 mg with epinephrine 0.1 mg or 5% lidocaine 40 mg) and general (enflurane, N2O, vecuronium). Urinary retentin was searched according to above factors following surgery. RESULTS: The overall urinary retention rate was 46.1%. The retention rate in patients with spinal anesthesia was higher than that in those with other anesthetic techniques (p<0.05). There was no significant difference between patients with lidocaine and tetracaine spinal anesthesia in urinary retention rate. The administered fluid volume in patients with urinary retention was significantly higher than that of patients without retention (p<0.05). Age, duration and types of hemorrhoidectomy did not significantly affect urinary retention rate. CONCLUSIONS: Restriction of fluid administration and avoidance of spinal anesthesia are necessary in reducing postoperative urinary retention following hemorrhoidectomy.
Anesthesia, Spinal ; Epinephrine ; Hemorrhoidectomy* ; Humans ; Lidocaine ; Precipitating Factors ; Retrospective Studies ; Surgical Procedures, Operative ; Tetracaine ; Urinary Retention*

The certificate of blood donation was introduced in 1975. Blood donor receives the certificate after donation. The person who has this certificate can receive one unit of blood component transfusion without charge in the hospital when he needs transfusion. The donor can use it for himself or anyone else whom it may concern, if necessary. This blood pre-deposit system in Korea is regulated by Transfusion Law. The government health insurance budget and pre-deposit foundation budget support the reimbursement fee for blood. Whenever blood centers collect blood from donors, they deposit 2,500 KRW into the pre-deposit foundation budget. The return rate of certificates was 15-28% and recently showed a gradual decrease to 13% due to the extension of coverage by government insurance for cancer patients, who are the main transfusion candidates. This system has contributed to the shift from paid donation to voluntary donation for the past 40 years. However, because this certificate imposes financial incentives for donors, the spirit of voluntary non-remunerated donation can be abused. If the transfusion fee is fully covered by government budget, it might be possible to discontinue the use of the certificate in order to implement true voluntary donation.
Blood Component Transfusion ; Blood Donors ; Budgets ; Fees and Charges ; Humans ; Insurance ; Insurance, Health ; Jurisprudence ; Korea ; Motivation ; Tissue Donors

Cisplatin has been widely used as chemotherapeutic agent for the treatment of cervical cancer, ovarian cancer, head and neck cancer and squamous cell carcinoma of lung. But cisplatin is highly toxic with nephrotoxicity, gastrointestinal toxicity, myelosuppression and neurotoxicity. The second generation drug of platinum compound, carboplatin was developed in 1980s to reduce side effects. Carboplatin has low nephrotoxicity but its major toxic effect is thrombocytopenia, In this study, the side effects of cisplatin and carboplatin were evaluated on 37 patients of cervical cancer in 169 chemotherpy cycles who were recieved combined VBP chemotherpeutic regimen consisting of cisplatin or carboplatin. Nephrotoxicity of grade 2 or over were 16% in cisplatin group and 1% in carboplatin group. Granulocytopenia of grade 2 or over were 34% in cisplatin group and 10% in carboplatin group. Thrombocytopenia of grade 2 or over were 7% in cisplatin group and 21% in carboplatin group. Gastrointestinal toxicity of grade 2 or over were 11% in cisplatin group and 0% in carboplatin group. This clinical study demonstrated that cisplatin has more toxic effects than carboplatin except thrombocytopenia.
Agranulocytosis ; Carboplatin* ; Carcinoma, Squamous Cell ; Cisplatin* ; Drug Therapy, Combination* ; Head and Neck Neoplasms ; Humans ; Lung ; Ovarian Neoplasms ; Platinum ; Thrombocytopenia ; Uterine Cervical Neoplasms

PURPOSE: This study was conducted to identify the factors that influence low back pain in nurses in Intensive Care Units (ICUs). METHODS: A descriptive-correlational design was used, with a convenience sample of 116 nurses from one university hospital in Seoul. The data collected were processed using SPSS Window 17.0 Program for actual numbers and percentages, differences in the dependent variable according to general characteristics, and mean, standard deviations, correlation coefficients and multiple regression analysis. RESULTS: The factor influencing low back pain in nurses in ICUs was functional ability (beta=.652). This one factor explained 41.9% of low back pain in nurses in ICUs. CONCLUSION: These results show that functional ability was related to nurses' low back pain in nurses in ICUs. These results further suggest that more research is needed to develop program involving functional ability to prevent and management of low back pain in nurses in ICUs.
Critical Care ; Intensive Care Units ; Low Back Pain

No abstract available.
Ultrasonography*

Exercise testing with Thallium imaging is widely used for the noninvasive evaluation of patients suspected of having coronary artery disease. However, many patients referred for stress testing connot exercise adequately for either physical or psychological reasons, and as a result may have nondiagnostic or suboptimal test results. Intravenous dipyridamole in conjunction with Thallium imaging is as effective alternative method without exercise. But, myocardial imaging using the standard scintillation camera technique(planner view) is hampered by superposition of proximal & distal cardial walls and by the segmental nature of myocardial ischemia. For this reason, Single Photon Emission Computed Tomography(SPECT) reslut in high specificity & sensitivity rates for the detection of coronar artery disease compared with conventional technique. So we performed dipyridamole Th-201 myocardial scintigraphy on 25 subjects who have suspicious angina or myocardial infarction instead of exercise Th-201 myocardial scintigraphy, and compared SPECT view with conventional plannar view. The results obtained are as follows : 1) T1-201 scintigraphic findings in 17 patients with suspicious angina were as follows ; redistribution defect was seen in 4 cases in plannar view and 13 cases in SPECT view. 2) T1-201 scintigraphic findings in 8 patients with myocardial infarction were as follows ; in planner view, perfusion defect was seen in all cases and 1 cases of them, redistribution defect was accompained, and in SPECT view, perfusion defect was seen in all cases and 6 cases of them, redistribution defect was accompained. 3) During dipyridamole infusion, the mean systolic & diatolic pressure decreased from 133+/-22.7/86+/-13.5 to 121+/-23.9/78+/-13.1mmHg and the heart rate increased from 68+/-12.4 to 84+/-12.4beats/min. 4) Adverse effects of dipyridamole were noted in 14(56%) of the subjects, but in 12 of these, the symptoms were mild in severity and subsided spontanously. To summarize, Dipyridamole-201 myocardial imaging is a useful and test for coronary artery disease, and the new tomographic technique, SPECT view, is more useful than the conventional plannar view.
Arteries ; Coronary Artery Disease ; Dipyridamole* ; Exercise Test ; Gamma Cameras ; Heart Rate ; Humans ; Myocardial Infarction ; Myocardial Ischemia ; Myocardial Perfusion Imaging ; Perfusion Imaging* ; Perfusion* ; Sensitivity and Specificity ; Thallium* ; Tomography, Emission-Computed, Single-Photon*

OBJECTIVES: Methylenetetrahydrofolate reductase (MTHFR) mutation are commonly associated with hyperhomocysteinemia, and through their defects in homocysteine metabolism, they have been implicated as a risk factor for recurrent spontaneous abortion. Recent report describe that 28-bp tandem repeat polymorphism in thymidylate synthase enhancer region (TSER) that influence enzyme activity would affect plasma homocysteine level. We have investigated the relationship between TSER genotype and plasma homocysteine level in 54 patients with recurrent spontaneous abortion. METHODS: Plasma homocysteine level was measured by fluorescent polarizing immunoassay. MTHFR mutation (C677T and A1298C) was identified by PCR-restriction fragment length polymorphism assay and TSER mutation was analyzed by PCR method. The data were analyzed using the program SAS 8.2 for Windows. RESULTS: Total homocysteine level was significantly higher in MTHFR 677TT genotype (9.80+/-3.87 mumol/L) than MTHFR 677CC genotype (8.14+/-1.74 mumol/L) in Korean patients with unexplained recurrent spontaneous abortion (p=0.0143). However, the plasma homocysteine level was not significantly different in the MTHFR 1298AA (8.42+/-2.65 mumol/L) and 1298CC (6.09+/-0.32 mumol/L; p=0.2058) and, TSER 2R2R (8.61+/-1.68 mumol/L) and 3R3R (8.05+/-2.81 mumol/L; p=0.9319) mutant genotypes, respectively. In this study, we found the combination effects of TSER and MTHFR C677T genotypes. Plasma homocysteine levels were the highest (11.47+/-4.66 mumol/L) in individuals with TSER 3R3R (8.05+/-2.81 mumol/L) and MTHFR 677TT (9.80+/-3.87 mumol/L) genotypes. Individuals with a combination of both TSER 2R2R/2R3R and MTHFR 677CC/CT genotypes (7.69+/-1.77 mumol/L) had lower plasma homocysteine levels than TSER 2R2R (8.61+/-1.68 mumol/L) and MTHR 677CC (8.14+/-1.74 mumol/L) genotypes, respectively. The effect of MTHFR polymorphism in the homocysteine metabolism appears to be stronger than that of TSER polymorphism. CONCLUSION: Although statistically not significant, we found the elevated level of plasma homocysteine in combined genotypes with TSER and MTHFR (C677T and A1298C) in Korean patients with unexplained habitual abortion. In this study, we reported the possibility that TSER polymorphism is a genetic determinant of plasma homocysteine levels in the Korean patients as well as MTHFR C677T polymorphism. A large prospective study is needed to verify our findings.
Abortion, Habitual ; Abortion, Spontaneous* ; Female ; Genotype ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Immunoassay ; Metabolism ; Methylenetetrahydrofolate Reductase (NADPH2) ; Plasma* ; Polymerase Chain Reaction ; Pregnancy ; Risk Factors ; Tandem Repeat Sequences ; Thymidylate Synthase*

This study was performed to evaluate the influence of clonidine pretreatment on the car- diovascular toxic effects of bupivacaine overdose induced by constant intravenous infusion. Thirty male rabbits were used for this study and they were divided into saline pretreatment group(15) and clonidine-pretreatment group(15). The changes of mean arterial pressure, heart rate and electrocardiogram by the bupivacaine-induced toxic effect during intravenous infusion of bupivacaine were observed. The results were as follows; 1. Mean arterial pressure was significantly decreased in clonidine-premedicated group compared with control group (P<0.01) before infusion of bupivacaine, but the times occuring 25% and 50% decrease of mean arterial pressure were significantly prolonged in clonidine group compared with control group (P <0.001 ). 2. Heart rate was significantly decreased in clonidine group compared with control group (P<0.01) before infusion of bupivacaine, but the times occuring 25% and 50% decrease of heart rate were significantly prolonged in clonidine group compared with control group (P< 0.001). 3. The times occuring the first QRS modification and first dysrhythmia and the final systole were significantly prolonged in clonidine group compared with control group (P < 0.001). In conclusion, clonidine given prophylactically delays the cardiotoxicity caused by bupivacaine overdose snd does not accentuate the subsequent hypotension.
Arterial Pressure ; Bupivacaine* ; Clonidine* ; Electrocardiography ; Heart Rate ; Humans ; Hypotension ; Infusions, Intravenous ; Male ; Rabbits* ; Systole

PURPOSE: The purpose of this study was to identify the attitude of nurses toward transsexuals. METHOD: The Q-methodology which provides a method of analyzing the subjectivity of each item was used. Twenty-nine nurses classified the 50 selected Q-statements into a normal distribution using a 9 point scale. The collected data was analyzed using the Quanl PC program. RESULT: Four types of attitudes toward transsexuals were identified. The first type (humanitarian acceptance) showed an attitude of respecting transsexuals as human beings and understanding and accepting their desires and difficulties. The second type (superficial understanding) understood the psychological conflicts and suffering of transsexuals but could not accept them as members of families or society. The third type (insufficient understanding) did not feel a sense of rejection toward transsexuals but showed a lack of understanding of their desires and difficulties. The fourth type (rejection) failed to understand the desires and difficulties of transsexuals and showed a sense of rejection toward them, in addition to regarding them as sexually immoral people. CONCLUSION: The results of the study indicate that different approaches of educational programs based on the four types of attitudes toward transsexuals are recommended.
Adult ; *Attitude of Health Personnel ; Demography ; Female ; Humans ; Models, Educational ; Nursing Staff/*psychology ; Q-Sort ; Questionnaires ; *Transsexualism