PURPOSE: The purpose of this study was to examine the effects of workplace spirituality and organizational citizenship behavior on nurses' performance of nursing. METHODS: This study was done over a 6 month period, with 395 nurses participants from 5 different general hospitals with 400 beds in 4 regions of Korea. Data were gathered using self-reported questionnaires from July 23 to August 21, 2015. Data were analyzed using descriptive statistics, independent t-test, one way ANOVA, Pearson correlation coefficients, and multiple regression analyses with IBM SPSS 21.0 program. RESULTS: Nursing performance showed positive correlations with workplace spirituality and organizational citizenship behavior. The significant predictors of the nursing performance by nurses were a master's degree or higher (β=.26), civic virtue (β=.19), courtesy (β=.12), 40 years of age or older (β=.09), a sense of empathy (β=.07), and a bachelor's degree in nursing (β=.06). These variables explained 39.2% of the variance in nursing performance by nurses. CONCLUSION: Based on the outcomes of this study, there is a need to develop intervention programs that can inspire nurse to show spontaneous organizational citizenship behavior, and enhance their workplace spirituality. Related variables including academic credentials should also be taken into account.
Empathy ; Employee Performance Appraisal ; Hospitals, General ; Korea ; Nursing* ; Spirituality* ; Virtues

Background: Appropriate physician workforce projection through reasonable discussions and decisions with a broad view on supply and demand of the workforce, thus, is very important for high-quality healthcare services. The study expects to provide preliminary research data on the workforce diagnosis standard model for Korean physician workforce policy decision through more flexible and objective physician workforce projection in reflection of diverse changes in healthcare policy and sociodemographic environments. Methods: A low flow rate through the causal map was developed, and an objective workforce demand projection from 2019 to 2040 was conducted. In addition, projections by scenarios under various situations were conducted with the low flow rate developed in the study. Lastly, the demand projection of the physician workforce by region of 17 cities and provinces was conducted. Results: First, demand of physicians in 2019 was 110,665, 113,450 in 2020, 129,496 in 2025, 146,837 in 2030, 163,719 in 2035, and 179,288 in 2040. Second, the scenario for the retirement of baby boomers led to a decrease in the growth rate due to time delay. Third, Seoul and Gyeonggi-do account for a high percentage of demand, a very high upward trend was identified in Gyeonggi-do, and as a result, the projection showed that the demand of the physician workforce in Gyeonggi-do would worsen over time. Conclusion This study is meaningful in that rational and collective physician workforce supply and demand and its imbalance in workforce distribution were verified through various projections by scenarios and regions of Korea with System Dynamics.

Glassy cell carcinoma is a histologic subtype of cervical cancer with distinct pathologic features and it has an aggressive biologic course. It was first described by Glucksmann and Cherry in 1956 as a poorly differentiated adenoquamous carcinoma and commented on its poor prognosis, unresponsiveness to traditional modes of therapy, and often associated with pregnancy. The characteristic histologic features are defined as follows: 1) cells with a moderate amount of cytoplasm resembling ground glass, 2) a fairly distinct cell membrane that stains with eosin or PAS, 3) large nuclei with prominent nucleoli. We present two cases of glassy cell carcinoma of the cervix successfullyl treated by neoadjuvant chemotherapy and radical hyterectorny, with a brief review of literatures.
Cell Membrane ; Cervix Uteri* ; Coloring Agents ; Cytoplasm ; Drug Therapy* ; Eosine Yellowish-(YS) ; Female ; Glass ; Hysterectomy* ; Pregnancy ; Prognosis ; Prunus ; Uterine Cervical Neoplasms

PURPOSE: Although its incidence has decreased with the widespread use of less invasive surgical techniques including laparoscopic surgery, postoperative ileus remains a common postoperative complication. In the field of urologic surgery, with the major exception of radical cystectomy, few studies have focused on postoperative ileus as a complication of laparoscopic surgery. The present study aims to offer further clues in the management of postoperative ileus following urological laparoscopic surgery through an assessment of the associated risk factors. METHODS: The medical records of 267 patients who underwent laparoscopic surgery between February 2004 and November 2009 were reviewed. After excluding cases involving radical cystectomy, combined surgery, open conversion, and severe complications, a total of 249 patients were included for this study. The subjects were divided into a non-ileus group and an ileus group. The gender and age distribution, duration of anesthesia, American Society of Anesthesiologists Physical Status Classification Score, body mass index, degree of operative difficulty, presence of complications, surgical procedure and total opiate dosage were compared between the two groups. RESULTS: Of the 249 patients, 10.8% (n = 27) experienced postoperative ileus. Patients with ileus had a longer duration of anesthesia (P = 0.019), and perioperative complications and blood loss were all correlated with ileus (P = 0.000, 0.004, respectively). Multiple linear regression analysis showed that the modified Clavien classification was an independent risk factor for postoperative ileus (odds ratio, 5.372; 95% confidence interval, 2.084 to 13.845; P = 0.001). CONCLUSION: Postoperative ileus after laparoscopic urologic surgery was more frequent in patients who experienced more perioperative complications.
Age Distribution ; Anesthesia ; Body Mass Index ; Cystectomy ; Humans ; Ileus ; Incidence ; Laparoscopy ; Linear Models ; Medical Records ; Postoperative Complications ; Risk Factors ; Urology

PURPOSE: The aim of this research was to compare surgical outcomes and complications of obese and non-obese patients who underwent open radical nephrectomy (ORN) and laparoscopic radical nephrectomy (LRN). MATERIALS AND METHODS: The data of 26 ORN patients and 30 LRN patients between January 2006 and December 2008 were analyzed. Patients with a body mass index (BMI) of 25.0 kg/m2 or more were defined as obese, and those with a BMI of <25.0 kg/m2 were defined as non-obese. All patients were divided into two groups according to the criteria above to compare demographic and clinical and pathologic parameters. RESULTS: The mean BMIs of the 15 obese patients in the ORN group and the 13 obese patients in the LRN group were 26.8+/-1.1 and 27.7+/-2.4, respectively. LRN was enormously effective for lowering estimated blood loss (EBL) and postoperative days compared with ORN. Operation times and EBL in ORN were affected by obesity, both of which were increased. In contrast, the data of both LRN groups indicated similar outcomes. The perioperative data of obese patients revealed LRN to have reduced blood loss (143.0+/-62.7 vs. 446.7+/-222.4 ml, p=0.001) and not significantly different postoperative days (7.3+/-2.2 vs. 8.4+/-1.5 days, p=0.065). Operation time, however, did not differ significantly among obese patients between ORN and LRN. The complications due to LRN had no relation with obesity, whereas ORN had an increased complications rate (34.6% vs. 3.8%). CONCLUSIONS: This study shows that LRN is more effective than ORN for both obese and non-obese patients with regard to perioperative outcomes and complication rates.
Body Mass Index ; Carcinoma, Renal Cell ; Humans ; Laparoscopy ; Nephrectomy ; Obesity

There are diverse surgical methods for treating large bladder stones, such as transurethral cystolithotripsy (TUCL), percutaneous suprapubic cystolithotripsy (PCCL), open surgery, and laparoscopic methods. We report here a case of two large bladder stones treated by using a combined surgical method of a laparoscopic approach and direct visual lithotripsy.
Chimera ; Laparoscopy ; Lithotripsy ; Surgical Procedures, Minimally Invasive ; Urinary Bladder ; Urinary Bladder Calculi

BACKGROUND: One of the difficulties we have in the management of anesthesia for the optimal liver transplantation is involved in coagulopathy. The purpose of this paper is to observe and investigate the variation of the heparin effects occurred before and after the fulfillment of reperfusion done in terms of native thromboelastogram (nTEG) or heparinase-guided Thromboelastogram (hgTEG). METHODS: In 134 patients who had a living related liver transplantation, by grouping them into four according to the presence or the absence of heparin effects, we are to observethe effects on the quantity of transfusion which each group shows and clinical variables like CTP score, UNOS classification, PT, and preoperative platelet count. RESULTS: It is found that 54 out of 134 patients (40.3%) had heparin effects before the reperfusion, while 101 (75.4%) had the effects after the reperfusion to the grafted liver. It is showed that there was no significant difference in a comparison between groups involved with packed red blood cell transfused, fresh frozen plasma, platelet concentrates, fluid by RIS. In the comparison between groups involved in clinical factors, it is disclosed that although there was no significant difference in four factors, that is, CTP score, UNOS classification, PT, and preoperative platelet count. CONCLUSIONS: We can confirm that the occurrence of heparin effect after reperfusion is remarkably increasing compared to that of heparin effect before reperfusion. Also, it can be reported that heparin effects can occur frequently during liver transplantation, but they have no direct relation to transfusion.
Anesthesia ; Blood Platelets ; Classification ; Cytidine Triphosphate ; Erythrocytes ; Heparin* ; Humans ; Liver Transplantation* ; Liver* ; Plasma ; Platelet Count ; Reperfusion* ; Transplants

Endometrial carcinoma is the most common female genital organ malignancy in western countries and the incidence is increasing in Korea. Endometrial carcinoma frequently develops under the condition of excessive prolonged estrogenic stimulation in the absence of progesterone but the molecular mechanisms of carcinogenesis remain unknown. Recent advances in molecular biology have led to the concept that carcinoma arise from the accumulation of a series of gene alterations involving activation of proto-oncogenes and inactivation of tumor suppressor genes. The p53, one of tumor suppressor genes, is located on chromosome 17p. Alteration of p53 gene is observed in a wide variety of human cancer. Immunohistochemistry is considered as a simple and useful method to detect p53 overexpression in surgical pathologic specimens and close correlation of p53 expression with the presence of mutations in the gene has been demonstrated. In order to observe the expression of p53 protein, immunohistochemical studies were performed in 28 cases of endometrial carcinoma, 33 cases of endometrial hyperplasia, and 8 cases of disordered proliferative phase endometrium were used as a control group. The results were as follows: 1. The expression rate of p53 protein were 57.1% (16/28) in endometrial carcinoma and 12.1% (4/33) in endometrial hyperplasia but 8 cases of disordered proliferative phase endome-trium revealed negative reaction. 2. The expression rates of p53 protein were 47.4% (9/19) in early stage and 77.8% (7/9) in advanced stage of endometrial carcinoma. 3. According to histologic grade of endometrial carcinoma, the expression rates of p53 protein were 58.4% (10/7) in G1, 62.0% (5/8) in G2, and 33.3% (1/3) in G3. 4. The expression of p53 protein of simple hyperplasia were 12.5% (2/16) and that of complex hyperplasia were 11.8% (2/17). In conclusion, it could be suggested that p53 gene alteration might play a role in carcinogenesis of endometrium and mutation of p53 gene might be a relatively late event in tumor progression. Further study will be required to clarify the role of p53 in the carcinogenesis of the endometrium.
Carcinogenesis ; Endometrial Hyperplasia* ; Endometrial Neoplasms* ; Endometrium ; Estrogens ; Female ; Genes, p53 ; Genes, Tumor Suppressor ; Genitalia ; Humans ; Hyperplasia ; Immunohistochemistry ; Incidence ; Korea ; Molecular Biology ; Progesterone ; Proto-Oncogenes

Endometrial carcinoma is the most common female genital organ malignancy in western countries and the incidence is increasing in Korea. Endometrial carcinoma frequently develops under the condition of excessive prolonged estrogenic stimulation in the absence of progesterone but the molecular mechanisms of carcinogenesis remain unknown. Recent advances in molecular biology have led to the concept that carcinoma arise from the accumulation of a series of gene alterations involving activation of proto-oncogenes and inactivation of tumor suppressor genes. The p53, one of tumor suppressor genes, is located on chromosome 17p. Alteration of p53 gene is observed in a wide variety of human cancer. Immunohistochemistry is considered as a simple and useful method to detect p53 overexpression in surgical pathologic specimens and close correlation of p53 expression with the presence of mutations in the gene has been demonstrated. In order to observe the expression of p53 protein, immunohistochemical studies were performed in 28 cases of endometrial carcinoma, 33 cases of endometrial hyperplasia, and 8 cases of disordered proliferative phase endometrium were used as a control group. The results were as follows: 1. The expression rate of p53 protein were 57.1% (16/28) in endometrial carcinoma and 12.1% (4/33) in endometrial hyperplasia but 8 cases of disordered proliferative phase endome-trium revealed negative reaction. 2. The expression rates of p53 protein were 47.4% (9/19) in early stage and 77.8% (7/9) in advanced stage of endometrial carcinoma. 3. According to histologic grade of endometrial carcinoma, the expression rates of p53 protein were 58.4% (10/7) in G1, 62.0% (5/8) in G2, and 33.3% (1/3) in G3. 4. The expression of p53 protein of simple hyperplasia were 12.5% (2/16) and that of complex hyperplasia were 11.8% (2/17). In conclusion, it could be suggested that p53 gene alteration might play a role in carcinogenesis of endometrium and mutation of p53 gene might be a relatively late event in tumor progression. Further study will be required to clarify the role of p53 in the carcinogenesis of the endometrium.
Carcinogenesis ; Endometrial Hyperplasia* ; Endometrial Neoplasms* ; Endometrium ; Estrogens ; Female ; Genes, p53 ; Genes, Tumor Suppressor ; Genitalia ; Humans ; Hyperplasia ; Immunohistochemistry ; Incidence ; Korea ; Molecular Biology ; Progesterone ; Proto-Oncogenes

PURPOSE: To comparatively analyze treatment-related adverse events and the treatment dropout rate between immunochemotherapy and target therapy in Korea. MATERIALS AND METHODS: Forty-nine subjects with metastatic renal cell carcinoma (21 target therapy recipients and 28 immunochemotherapy recipients) who underwent either 6-week cycles of sunitinib treatment (50 mg once daily for 4 weeks on and 2 weeks off) or 8-week cycles of immunochemotherapy (combination of interleukin [IL]-2, interferon [IFN]-alpha, and 5-fluorouracil [FU]) were enrolled. Treatment-related toxicity was objectively graded and quantitative analysis was performed with a scoring system. Patient compliance was categorized into three classes (1: administration as scheduled, 2: dose modification required, 3: discontinuation required). RESULTS: Compared with those of the immunochemotherapy group, subjects of the sunitinib-treatment group had higher occurrence rates of mucositis-stomatitis (43% vs. 10%), hand-foot syndrome (38% vs. 0%), diarrhea (33% vs. 14%), and hypertension (33% vs. 14%). According to the toxicity-grade-based scoring system, the total incidence and severity of toxicities were not significantly different between the two groups (p>0.05), whereas high-grade hematologic toxicities were more frequent in the immunochemotherapy group. The dropout rate of the immunochemotherapy group was significantly higher than that of the sunitinib group (administration as scheduled: 52% vs. 21%, p=0.026; discontinuation required: 19% vs. 50%, p=0.037). CONCLUSIONS: The results of this study are indicative of a comparable treatment-related toxicity profile of sunitinib and greater adherence to the treatment protocol in comparison with immunochemotherapy in patients with metastatic renal cell carcinoma (mRCC).
Carcinoma, Renal Cell ; Clinical Protocols ; Diarrhea ; Fluorouracil ; Hand-Foot Syndrome ; Humans ; Hypertension ; Immunotherapy ; Incidence ; Indoles ; Interferons ; Interleukins ; Korea ; Patient Compliance ; Patient Dropouts ; Pyrroles