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)

The Muenke syndrome (MS) is characterized by unicoronal or bicoronal craniosynostosis, midfacial hypoplasia, ocular hypertelorism, and a variety of minor abnormalities associated with a mutation in the fibroblast growth factor receptor 3 (FGFR3) gene. The birth prevalence is approximately one in 10,000 live births, accounting for 8-10% of patients with coronal synostosis. Although MS is a relatively common diagnosis in patients with craniosynostosis syndromes, with autosomal dominant inheritance, there has been no report of MS, in an affected Korean family with typical cephalo-facial morphology that has been confirmed by molecular studies. Here, we report a familial case of MS in a female patient with a Pro250Arg mutation in exon 7 (IgII-IGIII linker domain) of the FGFR3 gene. This patient had mild midfacial hypoplasia, hypertelorism, downslanting palpebral fissures, a beak shaped nose, plagio-brachycephaly, and mild neurodevelopmental delay. The same mutation was confirmed in the patient's mother, two of the mother's sisters and the maternal grandfather. The severity of the cephalo-facial anomalies was variable among these family members.
Adult ; Asian Continental Ancestry Group/*genetics ; Child, Preschool ; Craniosynostoses/*genetics/surgery ; DNA Mutational Analysis ; Female ; Humans ; Hypertelorism/genetics ; Korea ; Male ; *Mutation ; Pedigree ; Phenotype ; Receptor, Fibroblast Growth Factor, Type 3/*genetics ; Skull/*abnormalities/surgery ; Syndrome ; Treatment Outcome

Purpose: Diabetes mellitus (DM) causes body fluid imbalance because of hyperglycemia, but there is a lack of research on the relationship between DM and body fluid imbalance in the Korean population. This study compared the differences in body fluid composition and dietary intake between individuals with type 2 DM (T2DM) and a normal control (NC) group without the disease. Methods: In this study, 36 subjects with T2DM and 21 without diabetes were divided into the T2DM and NC groups. The subjects were divided into four subgroups to assess differences in body fluid volume according to sex: men T2DM group (n = 24), men NC group (n = 9), women T2DM group (n = 12), and women NC group (n = 12). The body fluid composition was measured using bioelectrical impedance analysis, including intracellular water (ICW), extracellular water (ECW), total body water (TBW), ECW/ICW, and ECW/TBW. Nutrient intake was evaluated using their dietary records. Results: The results showed that the ECW/ICW and the ECW/TBW were significantly higher in the T2DM group compared to the NC group. Both men and women in the T2DM group showed significantly higher ECW/ICW and ECW/TBW than the respective NC group. The T2DM group had a higher carbohydrate, dietary fiber, vitamin A, vitamin C, sodium, and potassium intake per 1,000 kcal and lower total daily energy, fat, and cholesterol intake per 1,000 kcal than the NC group. Conclusion These results suggest a positive association between T2DM and body fluid imbalance. This study can be used widely as basic data for the evaluation and diagnosis of diabetic complications in the future.

The impingement syndrome has an anatomical character that occur against the anterior edge and the undersurface of anterior third of the acromion, coracoacromial ligament and acromioclavicular joint. The treatment consists of conservative and surgical things. We consider the surgical intervention only in cases fail to control pain by conservative treatment over 3 months(from Feb. 1990 to Jan. 1994). The author experienced 15 cases (14 pts) in positive impingement sign & test and evaluated by shoulder arthrography in all cases. 1. The mean age was 60 years ranged from 48 to 68 years and the average symptom duration was 23 months. 2. There were all positive impingement sign & test clinically. 3. There were partial tear of rotator cuff in 3 cases and complete tear in 12 cases radiologically. 4. The anterior acromioplasty with division of coracoacromial ligament was performed in all cases, additional rotator cuff repair in 3 cases and bicipital tenodesis in 2 cases. 5. At the follow up based on UCLA shoulder rating scale, results were excellent & good in 13(86%) and unsatisfactory in 2(14%) cases.
Acromioclavicular Joint ; Acromion ; Arthrography ; Decompression, Surgical ; Follow-Up Studies ; Ligaments ; Rotator Cuff ; Shoulder ; Tears ; Tenodesis

Chromosome 11q13 deletion syndrome has been previously reported as either otodental syndrome or oculo-oto-dental syndrome. The otodental syndrome is characterized by dental abnormalities and high-frequency sensorineural hearing loss, and by ocular coloboma in some cases. The underlying genetic defect causing otodental syndrome is a hemizygous microdeletion involving the FGF3 gene on chromosome 11q13.3. Recently, a new form of severe deafness, microtia (small ear) and small teeth, without the appearance of eye abnormalities, was also reported. In this report, we describe a 1-year-old girl presenting with ptosis of the left upper eyelid, right auricular deformity, high-arched palate, delayed dentition, simian line on the right hand, microcephaly, and developmental delay. In this patient, we identified a deletion in the chromosome 11q13.2-q13.3 (2.75 Mb) region by using an array-comparative genomic hybridization analysis. The deletion in chromosome 11q13 results in a syndrome characterized by variable clinical manifestations. Some of these manifestations involve craniofacial dysmorphology and require a functional workup for hearing, ophthalmic examinations, and long-term dental care.
Coloboma ; Congenital Abnormalities ; Congenital Microtia ; Deafness ; Dental Care ; Dentition ; Eye Abnormalities ; Eyelids ; Female ; Hand ; Hearing ; Hearing Loss ; Hearing Loss, Sensorineural ; Humans ; Microcephaly ; Nucleic Acid Hybridization ; Palate ; Tooth ; Tooth Abnormalities

OBJECTIVE: The purpose of this study was, at the time of delivery, to determine if an elevated plasma homocysteine level is associated with the development of preeclampsia and to investigate whether 677 (C->T) polymorphism in the 5, 10-methylenetetrahydrofolate reductase (MTHFR) gene, folate status and vitamin B12 levels are risk factors for the development of preeclampsia for Korean pregnant women. METHODS: DNA was extracted from whole blood of 191 healthy pregnant women and 84 preeclampsia patients. All samples were genotyped for the 677 (C->T) polymorphism in MTHFR gene by polymerase chain reaction (PCR-RELP). Serum levels of homocysteine, folate, and vitamin B12 were measured by high preformance liquid chromatography for homocysteine, and radioassay for folate and vitamin B12. RESULTS: Women with severe preeclampsia showed higher concentrations of serum homocysteine (10.5 micro mol/L) than healthy pregnant women (8.46 micro mol/L) and women with mild preeclampsia (8.24 micro mol/L) (p=0.09). For serum folate levels, women with severe (12.7 ng/ml) or mild (13.2 ng/ml) preeclampsia showed increased level compare to healthy pregnant women (9.23 ng/ml) (p=0.0046). Increased homocysteine level (>14 micro mol/L) was associated with preeclampsia (odds ratio=2.86, 95% confidence intervals: 1.27-6.45). CONCLUSION: These results are suggesting that hyperhomocysteinemia in pregnancy could be a risk factor of preeclampsia. Preeclampsia patients with higher serum folate level are speculated to represent a compensatory response to oxidative stress.
Chromatography, Liquid ; DNA ; Female ; Folic Acid ; Homocysteine ; Humans ; Hyperhomocysteinemia* ; Oxidative Stress ; Oxidoreductases ; Plasma ; Polymerase Chain Reaction ; Pre-Eclampsia* ; Pregnancy ; Pregnant Women ; Risk Factors ; Vitamin B 12

OBJECTIVE: If bowels and other structures are in the pathway of high-intensity focused ultrasound (HIFU) beam during magnetic resonance image-guided HIFU (MRgFUS) therapy, filling to the bladder and the rectum and then emptying the bladder (i.e., the BRB technique) is used to avoid them. A modified BRB technique might be useful method to using a uterine elevator method or by inducing uterus downward traction to lower the position of the uterus. METHODS: A total of 156 patients who had undergone MRgFUS surgery treatment for uterine fibroids from March 2015 to February 2016 were included in this retrospective study. Of the 156 patients, 40 were treated using a uterine elevator while 29 were treated using downward traction of uterus. HIFU was performed using Philips Achieva 1.5 Tesla MR and Sonalleve HIFU system. RESULTS: MRgFUS surgery was feasible with modified BRB technique in 69 cases. Using uterine elevator method, the intensity of HIFU for group with antefletxio uteri was significantly lower than that for the group without antefletxio uteri (105.37±17.62 vs. 118.71±26.88 W). The group with downward traction of uterus induced was found to have significantly lower intensity of HIFU compared to the group without downward traction of uterus induced (110.26±22.60 vs. 130.51±27.81 W). CONCLUSION: Modified BRB technique was useful in avoiding bowels and other structures located in HIFU beam pathway during MRgFUS treatment to ablate uterine fibroids.
Elevators and Escalators ; Humans ; Leiomyoma* ; Methods ; Rectum ; Retrospective Studies ; Traction ; Ultrasonography* ; Urinary Bladder ; Uterus

BACKGROUND: In the past, ABO incompatibility was an absolute contraindication for solid organ transplantation. However, multiple recent trials have suggested strategies for overcoming the reactions between graft antigens and recipient antibodies that cause graft rejection. In this study, we determined the usefulness of plasma exchange (PE) for removing anti-A/B antibodies that cause hyperacute/acute humoral graft rejection in patients undergoing ABO-incompatible kidney transplantation. METHODS: In our study, 12 patients underwent ABO-incompatible kidney transplantation. All recipients received pre-transplantation conditioning by PE or intravenous immunoglobulin (IVIG) administration. After pre-transplantation conditioning, anti-A/B antibody titers were evaluated, and transplantation was performed when the titer was below 1:8. To assess the transplantation outcome, anti-A/B antibody titers, creatinine level, estimated glomerular filtration rate (eGFR), and proteinuria levels were measured. RESULTS: Anti-A/B antibody titers were below 1:8 in all patients at the time of transplantation. eGFR measured on post-transplant day 14 showed that 10 patients had immediate recovery of graft function, while 2 patients had slow recovery of graft function. Short-term outcomes of ABO-incompatible kidney transplantation (measured as creatinine levels) after reducing anti-A/B antibody titers were similar to those of ABO-compatible kidney transplantation. After transplantation, the anti-A/B antibody titers were below 1:8 in 7 patients, but the remaining 5 patients required post-transplantation PE and IVIG treatment to prevent antigen-antibody reactions. CONCLUSIONS: With the increasing demand for kidney donations, interest in overcoming the ABO incompatibility barrier has increased. PE may be an important breakthrough in increasing the availability of kidneys for transplantation.
ABO Blood-Group System/*immunology ; Adult ; *Blood Group Incompatibility/immunology ; Creatinine/blood ; Female ; Glomerular Filtration Rate ; Graft Rejection/therapy ; Humans ; Immunoglobulins, Intravenous/therapeutic use ; Isoantibodies/immunology/physiology ; Kidney Transplantation/*immunology ; Male ; Middle Aged ; *Plasma Exchange ; Proteinuria ; Transplantation Conditioning ; Transplantation Immunology

PURPOSE: Previously, we developed a new method to calculate the flow rate in the hemodialysis vascular conduit based on Bernoulli's theory for surveillance of the arteriovenous fistula (AVF) function. However, the calculated flow rate would be different from the true flow rate because due to various factors. To compare the true flow rate, with intra- conduit pressure, and the calculated flow rate, an ex vivo experimental model was developed. METHODS: The arterial end of the vascular conduit was connected to a saline-filled bottle, with the venous end connected to a flow meter to control the flow rate. By monitoring the change in the true flow rate (Q) with the flow meter, each arterial and venous static pressure (pA, pV) and total pressure (pT) were observed. Using these parameters, the intra-conduit flow rates (QA, QV) were calculated by Bernoulli's equation. Finally, we compared the pA or pV with Q, and calculated the difference between the QA or QV and Q. RESULTS: There were no statistical differences between any of the pressure measurement during the 5 consecutive 5 experiments (P<0.05). The static pressure (pA or pV) was closely correlated with Q (pA, R2=0.950, P=0.000; pV, R2= 0.952, P=0.000). The calculated flow rate (QA or QV) was not in complete in accord with Q, but was closely correlated (QA, R2=0.961, P=0.000; QV, R2=0.961, P=0.000). CONCLUSION: The pressure measurement and calculated flow rate indicate the nature of the true flow rate in the vascular conduit.
Arteriovenous Fistula ; Models, Theoretical* ; Renal Dialysis