PURPOSE: This study conducted to identify the effect of learning organization construction and learning orientation on organizational effectiveness among hospital nurses. Method: Data was collected from convenient sample of 296 nurses who worked for the major hospitals in Seoul, Gyeonggi-do and Gangwoen-do. The self-reported questionnaire was used to assess the general characteristics, the level of the learning organization construction, learning orientation and organizational effectiveness. The data were analyzed using descriptive statistics, pearson's correlation coefficient and multiple regression. Result: The mean score of learning organization construction was 3.61(+/-.32), learning orientation got 3.26(+/-.39), and organizational effectiveness obtained 3.38(+/-.42). The learning organization construction affects of organizational effectiveness by 44.18% and learning orientation by 37.43%. CONCLUSION: This finding indicates that learning organization construction and learning orientation affects the nurses' organizational effectiveness in hospital.
Learning ; Orientation ; Surveys and Questionnaires

No abstract available.
Down Syndrome*

Cognitive behavioral therapy, first introduced by Beck in the 1950s to treat depression by integrating cognitive and behavioral therapies, is now an established psychotherapy technique used to treat insomnia, chronic pain, and anxiety. Currently, cognitive behavioral therapy is widely used to treat tinnitus in European countries, and the efficacy and safety of the treatment have been proven through randomized clinical trials and meta-analyses. Although interest in cognitive behavioral therapy for tinnitus is increasing in Korea, there are limited reports. Because many studies so far have targeted patients in Western countries, it is difficult to apply the same to domestic patients due to cultural and linguistic differences, the absence of standardized guidelines, and limitations in clinic hours. We experienced various cases in which tinnitus was effectively treated simultaneously with pharmacotherapy and cognitive behavioral therapy, so here we report an introduction to the program along with a literature review. Cognitive behavioral therapy was performed as a 4-week program in our hospital, and progress was evaluated through Visual Analogue Scales (VAS) and tinnitus handicap inventory (THI). After each weekly 20-minute individual counseling session, a take-home writing task was given to the patient. The main goal was to guide the patient to discover and correct automatic thoughts related to their tinnitus symptoms. This paper aimed to introduce a specific scheme on how to perform cognitive behavioral therapy for domestic tinnitus patients.

BACKGROUND: In contrast to childhood intussusception, the clinical features in adults are not typical, and the incidence of adult intussusception is low. This study was to evaluate the clinical features, diagnosis, and management of adult intussusception. METHODS: Thirty-seven cases of adult intussusception occurring between 1981 and 1996 in individuals older than 16 were investigated retrospectively. RESULTS: The most common age was in the 3rd decade (24.3%). Abdominal pain, nausea and vomiting, abdominal tenderness and palpable abdominal mass were common symptoms and physical findings in order of frequency. The duration of symptoms was less than 7 days in 54% of the cases. Correct preoperative diagnosis was made in 13.3% from 1981 to 1990 versus 72.7% from 1991 to 1996. This difference was caused by common use of abdominal ultrasound (US) and computed tomography (CT) during recent years. On exploration there were 27 cases of enteric (73%) and 10 cases of colonic (27%) intussusceptions and there were underlying lesions in 30 cases (81%). Two manual reductions only, 7 manual reductions and resections, including one reoperation after manual reduction only, 28 resections without manual reduction, and 1 ileocolostomy were performed. While only 2 cases (7.4%) of malignancy were identified among the enteric intussusceptions, there were 7 cases (70%) of malignancy among the colonic intussusceptions. CONCLUSIONS: With the advance of abdominal US and CT, preoperative diagnosis of adult intussusception was not so difficult. Because of high prevalence of underlying lesions in adult intussusception, operative management is mandatory. Resection without reduction is the most common method of operation and is recommended in edematous and ischemic enteric intussusceptions and in all colonic intussusceptions which have high malignant rate.
Abdominal Pain ; Adult* ; Colon ; Diagnosis* ; Humans ; Incidence ; Intussusception* ; Nausea ; Prevalence ; Reoperation ; Retrospective Studies ; Ultrasonography ; Vomiting

PURPOSE: The purpose of this study was to determine the feasibility of the implementation of prehospital advanced life support programs and share in-hospital medical direction center operation experience. METHODS: From Oct. to Dec. 2008, twenty fire safety centers in Seoul metropolitan city took part in a pilot implementation of advanced life support programs with medical services as follow: prehospital 12 lead ECG transmission for patients with chest pain, a prehospital CPAP (continuous positive airway pressure) program for patients with dyspnea, a prehospital stroke scale application for patients with neurologic problems, and real-time audio-visual information transmission for patients with traumatic injuries. RESULTS: A total of 6,741 patients were transported to hospitals by emergency response ambulances to twenty five different safety centers. Of the total number of patients, 304 received advanced life support management. The prehospital use of 12 lead ECG transmission was 57.89%, real-time ECG was 27.45%, continuous positive airway pressure was 20.60%, stroke scale was 25%, and real-time audio-visual information was 5.98%. A Delphi survey using a panel which was expert in prehospital implementation of advanced life support programs concluded that prehospital ECG transmission and stroke scale programs should be implemented. However, they decided against implementation of the continuous positive airway pressure and real-time audio-visual information programs. CONCLUSION: Overall, the feasibility of implementation of a prehospital conventional 12 lead ECG program was good and the Delphi survey concurred that the ECG transmission and prehospital stroke scale programs should be implemented.
Ambulances ; Chest Pain ; Continuous Positive Airway Pressure ; Dyspnea ; Electrocardiography ; Emergencies ; Emergency Medical Services ; Fires ; Humans ; Stroke

PURPOSE: The diameter of the abdominal aorta is an important criterion for making the diagnosis of abdominal aortic aneurysm. But the diagnostic criteria for the aortic diameters and the aneurysms are based on western people' s data, and there is scant data on this for Koreans. In this study, we measured a normal range of the abdominal aortic diameter of Korean adults and we classified the diameters according to age, gender and the body mass index (BMI). METHODS: The data is based on 496 patients (male: 281, female: 215) who had no evidence of vascular disease on abdominal multi detector computed tomography exams that were been done between October through December of year 2007 at our hospital. The abdominal aorta was measured at the smallest outer diameter of the infrarenal aorta and the upper bifurcation level. The age of the patients was from 20 to 70 years-old and the patients were divided into 6 groups by age. The patients were also divided into three groups according to their BMI (the low weight, normal weight and over weight groups). We computed the average and standard deviation of the aortic dimensions from each group. RESULTS: The average diameter at the infrarenal aorta was 18.32 mm and that at the upper bifurcation level was 17.25 mm. The males' average aortic diameter at the infrarenal aorta and at the upper bifurcation level was 19.23 mm and 18.10 mm, respectively, and those values for the females were 17.09 mm and 16.20 mm, respectively. In both the males and females, the diameter increased with increasing patient age (P<01). For the BMI, the diameter was larger for the higher BMI group. CONCLUSION: For the normal Korean population, the diameter of the abdominal aorta increases with aging and with an increased BMI, but the changes were relatively smaller as compared with the western normal range. More studies are needed to determine Koreans' normal range of the diameter of the abdominal aorta and this data can be applied to the diagnosis and treatment of abdominal aortic aneurysm.
Adult ; Aging ; Aneurysm ; Aorta ; Aorta, Abdominal ; Aortic Aneurysm, Abdominal ; Body Mass Index ; Female ; Humans ; Male ; Reference Values ; Vascular Diseases

Cervical spondylosis is a common degenerative disease of the cervical spine affecting the cervical vertebral bodies and intervertebral discs. During parotidectomy, the patient is placed in a supine position with the neck extended and head rotated to the contralateral side. This position could exacerbate pre-existing cervical spondylosis and cause cervical myelopathy. We present a case of postoperative quadriplegia secondary to cervical myelopathy after parotidectomy. A 68-year-old man without symptoms of cervical spondylosis underwent partial parotidectomy for a right parotid mass and subsequently developed quadriplegia 8 hours postoperatively. Magnetic resonance imaging revealed severe cervical myelopathy. Emergency laminoplasty was performed, and steroid therapy was initiated. He showed near-complete recovery six months later.

Cervical spondylosis is a common degenerative disease of the cervical spine affecting the cervical vertebral bodies and intervertebral discs. During parotidectomy, the patient is placed in a supine position with the neck extended and head rotated to the contralateral side. This position could exacerbate pre-existing cervical spondylosis and cause cervical myelopathy. We present a case of postoperative quadriplegia secondary to cervical myelopathy after parotidectomy. A 68-year-old man without symptoms of cervical spondylosis underwent partial parotidectomy for a right parotid mass and subsequently developed quadriplegia 8 hours postoperatively. Magnetic resonance imaging revealed severe cervical myelopathy. Emergency laminoplasty was performed, and steroid therapy was initiated. He showed near-complete recovery six months later.
Aged ; Emergencies ; Head ; Humans ; Intervertebral Disc ; Laminoplasty ; Magnetic Resonance Imaging ; Neck ; Quadriplegia ; Spinal Cord Diseases ; Spine ; Spondylosis ; Supine Position

BACKGROUND AND OBJECTIVES: The objective of this study was to find the possivility for quantification of ventricular dyssynchrony by analsis of myocardial velocity curve obtained with Doppler myocardial imaging (DMI) in patients with advanced heart failure. SUBJECTS AND METHODS: Doppler myocardial images at the apical 4 chamber and 2 chamber views were recorded in 28 patients with a left ventricular ejection fraction (LVEF) <45%, and in 18 normal controls. Time intervals from the onset of the QRS complex to the peak systolic velocity were measured at the mid-portion between the basal and mid segments of 4 different ventricular walls (septal, lateral, inferior and anterior);their maximal differences (DIFF) and standard deviation (STD) were calculated and compared. RESULTS: There were significant differences in the LVEF (30+/-8 vs. 63+/-4%, p<0.05) and QRS durations (117+/-35 vs. 92+/-9 msec, p<0.05) between the heart failure and control groups. The mean values of DIFF in the heart failure and control groups were 73+/-32 and 14+/-6 msec, respectively (p= 0.001). The DIFF and STD showed negative correlations with the LVEF (r=-0.773 with DIFF, r=-0.771 with STD, p<0.001) and positive correlations with the QRS duration (r=0.51 with DIFF, r=0.498 with STD, p<0.001). Fifteen of the patients with heart failure (54%) showed a QRS duration <110 msec; although their QRS duration was not significantly different from that of the normal controls (93+/-12 vs. 92+/-9 msec, p>0.05), but the DIFF, from the DMI, was significantly prolonged (61+/-35 vs. 14+/-6 msec, p=0.001). The QRS duration showed no significant correlation with the LVEF in the patients with a QRS duration <120 msec (r=-0.276, p= 0.103), but the DIFF showed a significant negative correlation in these patients (r=-0.769, p=0.001). CONCLUSION: The DIFF and STD, as measured by DMI, are useful in the quantification of ventricular asynchrony, and correlated with other indices known to reflect the left ventricular systolic function.
Echocardiography, Doppler ; Heart Failure* ; Heart* ; Humans ; Stroke Volume

Stones in the common duct occur in 10% to 15% of patients with cholelithiasis. In our case, coexistent cholelithiasis and choledocholithiasis were diagnosed by endoscopic retrograde cholangiopancreatography. The stone basket was easily introduced into the gallbladder and common bile duct, then fortunately removed stones. However, endoscopic retrograde cholelithiasis removal is known to be difficult because of the anatomical approach. We herein present a rare case of cholelithiasis successfully treated by retrograde endoscopic removal.
Cholangiopancreatography, Endoscopic Retrograde* ; Choledocholithiasis ; Cholelithiasis* ; Common Bile Duct ; Gallbladder ; Humans