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

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

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.

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

Hereditary hemorrhagic telangiectasia, also known as Osler-Weber-Rendu disease, is an autosomal dominant disorder of the fibrovascular tissue. It is characterized by the classic triad of mucocutaneous telangiectasias, recurrent hemorrhages, and familial occurrence. The cutaneous manifestation appear clinically as punctuate, linear, or splinter-like telangiectasias of the upper body, oral, and nasal mucous membranes, and nail beds. A 73-year-old woman presented with purpuric, punctuate, and tiny macules on the finger tips of both hands and the tongue. The skin lesions were discovered about 50 years previously. She had a family history of cutaneous telangiectasia. Also, she had episodes of recurrent epistaxis, gastrointestinal bleeding, and anemia. The gastroendoscopy revealed gastric angiodysplasia of the fundus and body of the stomach. The histopathologic study showed dilated capillaries lined by flat endothelial cells in the papillary dermis. From these findings, we diagnosed this case as hereditary hemorrhagic telangiectasia, which has rarely been reported in the dermatologic literature.
Aged ; Anemia ; Angiodysplasia ; Capillaries ; Dermis ; Endothelial Cells ; Epistaxis ; Female ; Fingers ; Hand ; Hemorrhage ; Humans ; Mucous Membrane ; Nails ; Skin ; Stomach ; Telangiectasia, Hereditary Hemorrhagic ; Telangiectasis ; Tongue

PURPOSE: This study was conducted to investigate the neurocognitive functioning of children with intracranial germ cell tumor (IGCT) prior to receiving proton beam therapy (PBT), and to identify differential characteristics of their neurocognitive functioning depending on tumor location. As a secondary object of this study, neurocognitive functions were followed up at 1-2 years after PBT to examine early post-treatment changes. MATERIALS AND METHODS: Between 2008 and 2014, 34 childrenwith IGCT treatedwho received PBT atNational Cancer Center, Korea were enrolled in this study. Standardized neurocognitive tests of intelligence, memory, and executive functioning were performed with baseline psychological assessments using the Child Behavior Checklist (CBCL). Follow-up assessments after PBT were conducted in 20 patients (T2). The results were analyzed based on the locations of tumors, which included the suprasellar, pineal gland, basal ganglia, and bifocal regions. RESULTS: The neurocognitive function of IGCT patients was significantly lower than that of the normal population in performance intelligence quotient (p=0.041), processing speed (p=0.007), memory (p < 0.001), and executive functioning (p=0.010). Patients with basal ganglia tumors had significantly lower scores for most domains of neurocognitive functioning and higher scores for CBCL than both the normal population and patients with IGCT in other locations. There was no significant change in neurocognitive function between T1 and T2 for all types of IGCT patients in first 1-2 years after PBT. CONCLUSION: Tumor location significantly affects the neuropsychological functioning in patients with IGCT. Neuropsychological functioning should be closely monitored from the time of diagnosis in IGCT patients.
Basal Ganglia ; Brain Neoplasms ; Checklist ; Child Behavior ; Child* ; Cognition ; Diagnosis ; Follow-Up Studies ; Germ Cells* ; Humans ; Intelligence ; Korea ; Memory ; Neoplasms, Germ Cell and Embryonal* ; Pineal Gland ; Proton Therapy

This study was performed to investigate the effect of gastric banding surgery on the improvement of glycated hemoglobin (HbA(1c)) of morbidly obese (MO) patients with type 2 diabetes mellitus (T2DM) with the consideration that obesity was associated with insulin resistance and T2DM. We retrospectively reviewed the medical records of 38 MO with T2DM patients and 50 MO patients. Pre-surgery and post-surgery data were analyzed a year later. The medical data from these patients, including sex, age, height, weight, body composition, HbA(1c), triglyceride, total cholesterol, aspartate transaminase (AST), and alanine transaminase (ALT) were measured. There were significant reductions of body weight and body mass index (BMI), body fat, body fat percentage, waist-hip ratio, visceral fat, and obesity in each group before and after gastric banding surgery. Results of AST, ALT, and HbA(1c) had significant reductions in each group. For HbA(1c), treatment rate was 71% in the MO group with T2DM with significant reduction of 22.8%. It is thought that a gastric banding surgery is one of the breakthrough methods not only for weight loss but also for the prevention of complication of the obese patients with T2DM. Thus, gastric banding surgery could be effective in controlling HbA(1c) in obese patients with type 2 diabetes mellitus.
Adipose Tissue ; Alanine Transaminase ; Aspartate Aminotransferases ; Body Mass Index ; Body Weight ; Cholesterol ; Diabetes Mellitus, Type 2* ; Hemoglobin A, Glycosylated ; Humans ; Insulin Resistance ; Intra-Abdominal Fat ; Medical Records ; Obesity ; Retrospective Studies ; Triglycerides ; Waist-Hip Ratio ; Weight Loss