PURPOSE: The purpose of this study was to explore the relationship between moral distress, physical symptoms, and burnout among clinical nurses. METHODS: Data were collected by self-report questionnaires targeting 140 nurses from a university hospital in Chungju. The data were analyzed by, Kruskal-Wallis, Pearson correlation coefficient, and stepwise multiple regression. RESULTS: Moral distress due to the general characteristics of the participants showed a statistically significant difference at the current working department (χ2=36.01, p<.001). Hospital nurses' moral distress had a statistically significant correlation with burnout (r=.358, p<.001) and physical symptoms (r=.440, p<.001). Factors influencing hospital nurses' burnout, pro were physical symptoms, moral distress, and marital status, accounting for 36% of the variance. CONCLUSION: The findings indicate that moral distress and physical symptoms influence burnout among hospital nurses. Therefore, interventions for burnout among hospital nurses should include an empowerment program to reduce physical symptoms and moral distress.
Burnout, Professional ; Chungcheongbuk-do ; Marital Status ; Power (Psychology)

PURPOSE: To develop and test the validity and reliability of the Korean version of the Moral Distress Scale-Revised (KMDS-R) to assess its applicability to Korean hospital nurses. METHODS: The KMDS-R was articulated through forward-backward translation methods. Internal consistency reliability, construct and criterion validity was calculated using SPSSWIN(19.0). Survey data were collected from 188 nurses from a university hospital in Gangwon-do, South Korea. RESULTS: The KMDS-R showed reliable internal consistency with a Cronbach's alpha of .69-.87 and a Guttman Split-half of .69-.82 for the total scale. Factor loading of the 21 items on the five subscales ranged from .41-.80. The KMDS-R was validated by factor analysis and explained 63% of moral distress for Korean hospital nurses. Criterion validity compared to Yoo's MDS showed significant correlation. CONCLUSION: The results suggest promising evidence of the KMDS-R's reliability and validity. It is used to measure moral distress for Korean hospital nurses.
Gangwon-do ; Korea ; Reproducibility of Results*

No abstract available.

Upper extremity replantation is relatively less commonly performed than finger or hand replantation. We have experienced one case of forearm replantation and one case of upper arm replantation. After the replantation, limb volume at the biceps brachii muscle level below the replantation level appeared to be appropriate, however, the motor function of the muscles and the sensitivity were disappointing. For replantation of forearm and upper arm, restoration of the motor function and sensitivity of the extremity below the amputation level as well as the morphologic reconstruction have to be considered.
Amputation ; Arm* ; Extremities ; Fingers ; Forearm* ; Hand ; Muscles ; Replantation* ; Upper Extremity

BACKGROUND: In athlete's heart, functional and structural alteration are main features. We studied electrocardiograms(ECG's) and echocardiograms(UCG's) in soccer players before and after intensive training. METHODS: Fifteen soccer players with the mean age and career of 19.3 and 8.5 years,respectively,underwent intensive training for 5-5.5 months, which included running of 2 km daily during the last 2-2.5 months. Comparisons of ECG's and UCG's recorded before and after the training were made. RESULTS: The major abnormal finding in pre-training ECG's was high voltage being seen in 40% of the cases, and in UCG's left ventricular(LV) dilatation and/or hypertrophy or asymmetrical septal hypertrophy(ASH) were noted in approximately 80% of the cases. The incidences of these finding after the intensive training were essentially unchanged, and the mean of pre-and post-training fractional shortening(FS) and LV and left atrial dimensions were similar. The high voltage in ECG's showed no close correlation with LV dilatation or hypertrophy on UCG's. After the training, however, the mean values of the thickness of LV posterior wall and ventricular septum along with LV mass were significantly increased, and the right ventricular dimension was significantly decreased. CONCLUSIONS: The most frequent finding in ECG's and UCG's in soccer players, before and after intensive training,were high voltage, LV dilatation and /or hyperophy with or without ASH. The intensive training of 5-5.5 months duration caused no change in F8,but caused significant increase in the thickness of LV posterior wall and ventricular septum, and LV mass.
Dilatation ; Electrocardiography* ; Heart ; Hypertrophy ; Incidence ; Running ; Soccer* ; Ventricular Septum

PURPOSE: Peroxisome proliferator-activated receptor gamma (PPAR-gamma) has been shown to play an important role in the control of inflammatory responses acting on macrophages, mast cells, T cells and eosinophils. A novel PPAR-gamma ligand, KR62980 have been recently focused on due to the lower undesirable effects than other PPAR-gamma ligands such as rosiglitazone and pioglitazone. The present study was aimed to investigate the effects of KR62980 on nasal symptoms and immunopathological profiles in allergic nasal mucosa in murine allergic rhinitis model. METHODS: BALB/c mice were sensitized and challenged intranasally with ovalbumin (OVA). KR62980 was administered intraperitoneally or orally 3 hours before each intranasal OVA challenge. RESULTS: Administration of KR62980 significantly decreased the number of nasal rubbing, nasal sneezing, ova-specific IgE and total IgE in serum, secretion of Interleukin (IL)-4, IL-5, and IL-17 from the spleen and eosinophilic infiltration in the nasal mucosa. KR62980 decreased the expression of IL-4, IL-5 and IL-10 mRNAs in the nasal mucosal tissue, while, it elevated the level of IL-10 and IFN-gamma in splenocyte culture. KR62980 seemed to decrease IL-17 level in local and systemic level even though it did not reach to statistical significance. The anti-inflammatory effect was more definite when the KR62980 was administered intraorally than intraperitoneally. CONCLUSIONS: A novel PPAR-gamma ligand, KR62980 can attenuate OVA-induced allergic inflammation in mice mainly through modulation of Th2 cytokines. This finding suggests that PPAR-gamma might have a role in the treatment of allergic rhinitis.
Animals ; Cytokines ; Eosinophils ; Immunoglobulin E ; Inflammation ; Interleukin-10 ; Interleukin-17 ; Interleukin-4 ; Interleukin-5 ; Interleukins ; Ligands ; Macrophages ; Mast Cells ; Mice* ; Mucous Membrane ; Nasal Mucosa ; Ovalbumin ; Ovum ; Peroxisomes* ; PPAR gamma ; Rhinitis* ; RNA, Messenger ; Sneezing ; Spleen ; T-Lymphocytes

Electrocardiographic findings in 18 cases of hypertrophic obstructive cardiomyopathy(HOCM) were compared with those in 20 hypertensives with disproportinate septal hypertrophy(DSH) and in 20 normal controls. In conventional 12 leads electrocardiograms, abmormal Q waves were seen only in 6 cases of HOCM and none in the remadinder. The R waves were tallest in leads V4 in 6 cases(33%) of HOCM, 3(15%) hypertensives with DSH, and 4(20%) of the controls. The correlations of the QRS voltages with echocardiographically measured left ventricular dimension, interventricular septal thickness and left ventricular mass were significant in the hypertensives with DST and normal controls, but insignificant in patients with HOCM. We conclude that these electrocardiographic differences in patients with HOCM from the others would be caused by uneven distribution of hypertrophied muscle mass in the left ventricule and/or by the altered depolarization in hypertrophied cardiac muscles.
Cardiomyopathy, Hypertrophic* ; Electrocardiography* ; Humans ; Hypertension* ; Myocardium

Staphylococcus schleiferi has been infrequently reported as a human pathogen. We experienced the case of vascular access infection by Staphylococcus schleiferi in a 65-year-old hemodialysis patient. Metastatic infection occurred despite the removal of infected focus and appropriate antibiotic therapy. This case highlights the importance of considering Staphylococcus schleiferi as a true pathogen in vascular access infection with hemodialysis patients.
Aged ; Humans ; Renal Dialysis* ; Staphylococcus*

BACKGROUND: We attempted to study functional and structural changes in the hearts of volleyball players and cardiac effects of a short-term intensive training as disclosed by electrocardiograms(ECG's) and echocardiograms(UCG's). METHODS: In 12 volleyball players of a university team with the mean age and career of 19.9 and 9.2 years, respectively, comparisons of ECG's and UCG's M-mode & Doppler, were made before and after an intensive training of 8 weeks duration. The players have been trained 2-3 hours daily almost year around for many years, and the intensive and comprehensive training given for the current study was 3 hours daily, which included strenuous interval training of 20-30 minutes. The training was divided into two successive sessions. For the first session, the players ran 4km daily as a part of the training for 2 weeks. The second session included repetition of runnging at their maximal speed with short intermissions of stationary running for 6 weekes. RESULTS: The major findings in ECG's were sinus bradycardia(25.0%) and high voltage(33.3%), and those in M-mode UCG's were left ventricular(LV) hypertrophy, LV dilatation or left atrial dilatation being seen in all cases, alone or in combinations. After the training however, there were no significant changes in the incidences of these abnormal findings in ECG's & UCG's, and also in the mean of various echocardiographic parameters reflecting cardiac functions. The E and A waves in Doppler UCG's also showed no changes. The slight but significant changes after the training were limited to the increases in the mean of the sum of S wave in V1 & R wave in V5, and left atrial dimensions. CONCLUSION: In volleyball players who have been regularly trained for many years, the major findings in ECG's were sinus bradycardia and high voltage. Those in UCG's were LV hypertrophy. LV dilatation or left atrial dilation being seen in all cases, alone or in combinations. Nonetheless, after the intensive training of 8 weeks duration, the incidences of these abnormal findings in ECG's and UCG's remained essentially similar, and slight but significant changes were limited to the increases in the sum of S wave in V1 & R wave in V5, and left atrial internal dimensions. These facts suggest that in the regularly trained volleyball players, a short-term intensive training induces only limited cardiac changes as disclosed by ECG's and UCG's.
Bradycardia ; Dilatation ; Echocardiography ; Electrocardiography* ; Heart ; Hypertrophy ; Incidence ; Running ; Volleyball*

PURPOSE: This study aimed to determine the oncologic efficacy of gonadotropin-releasing hormone (GnRH) agonist treatment concurrent with chemotherapy in a neoadjuvant setting. METHODS: A retrospective analysis was performed on 332 cases of invasive breast cancer in patients who were <40 years old at diagnosis and received GnRH agonists concurrent with neoadjuvant chemotherapy (GnRH agonist group) or neoadjuvant chemotherapy alone (neochemotherapy-alone group) from December 2010 to September 2014. Pathologic complete response rates (pCR) and Ki-67 changes were evaluated between the two groups. RESULTS: Median age was 32+/-3.9 and 36+/-3.0 years in the GnRH agonist group and neochemotherapy-alone group, respectively (p<0.001). After adjustment for tumor size, grade, lymph node metastasis, hormone receptor (HR) status, and chemotherapy regimen, the GnRH agonist group exhibited a higher pCR rate with an odds ratio (OR) of 2.98 (95% confidence interval [CI], 1.37-6.34) and a greater decrease in Ki-67 expression after treatment (p=0.05) than the neochemotherapy-alone group. For HR-negative tumors, the GnRH agonist group showed a higher pCR rate (multivariate OR, 3.50; 95% CI, 1.37-8.95) and a greater decrease in Ki-67 expression (p=0.047). For HR-positive breast cancer, the pCR rate, change in Ki-67 index, and clinical response were higher, and preoperative endocrine prognostic index scores were lower, in the GnRH agonist group, but these did not reach statistical significance. CONCLUSION: Concurrent administration of GnRH agonists during neoadjuvant chemotherapy improved pCR rates and suppressed Ki-67 expression, especially in HR-negative tumors.
Breast Neoplasms* ; Breast* ; Diagnosis ; Drug Therapy* ; Gonadotropin-Releasing Hormone* ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Odds Ratio ; Polymerase Chain Reaction ; Retrospective Studies