Background: Burnout syndrome (BOS) is defined by the World Health Organization (WHO) as a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. This study aims to create the Korean version burnout syndrome scale (KBOSS) that conforms to WHO’s definition of BOS and present the cut-off points for screening. Methods: We developed the KBOSS based on WHO’s definition of BOS. An online survey was conducted through a specialized online research company. We recruited 444 workers for this research. The validity of the KBOSS was assessed using factor analysis and Pearson’s correlation. The KBOSS reliability was assessed using Cronbach’s alpha coefficient. The cut-off points for each of the three dimensions were derived using the upper quartile score. Results: The validity and reliability of the KBOSS were good. Regarding reliability, the scale’s overall Cronbach’s alpha was 0.813. Cronbach’s alpha of each three-dimension was as follows: exhaustion, 0.916; cynicism, 0.865; and professional inefficacy, 0.819. The cut-off points of BOS three dimensions are exhaustion ≧ 21; cynicism ≧ 18; and inefficacy ≧ 15. Conclusion The developed questionnaire (KBOSS) can be a useful tool for screening of BOS.

PURPOSE: This study was done to explore recognition of accreditation for nursing education, job satisfaction and intention to change teaching area for faculty in Fundamentals of Nursing. METHODS: Participants were 104 faculty members teaching Fundamentals of Nursing. Each participant responded to a questionnaire. Data were collected from June 25 to October 25, 2016, and analyzed using SPSS 23.0 for descriptive statistics, t-test, ANOVA, and Pearson correlation coefficient. RESULTS: The participants' recognition of accreditation in nursing education was 3.45±0.81 out of 5 and in the sub-items, the score for quality improvement in professors in Fundamentals of Nursing was lowest at 3.21±1.03. Job satisfaction was 3.30±5.30, and intention to change teaching area was 2.62±1.00. Attributes related to practice appear to be major reasons why participants intended to change their teaching area and scores for intention to change teaching area were medium or higher. CONCLUSION: Results indicate that it is necessary to develop strategies to improve job satisfaction and reduce intention to change teaching area for faculty with less experience in Fundamentals of Nursing education. Development of strategies, management and support are needed to improve young professors' job satisfaction and reduce intention to change teaching area.
Accreditation* ; Education ; Education, Nursing* ; Intention* ; Job Satisfaction* ; Nursing* ; Quality Improvement

BACKGROUND: Kojic acid was used for decades in the cosmetic industry as an antimelanogenic agent. However, there are two major drawbacks of Kojic acid, one is cytotoxicity and second are instability on storage. These limitations led the scientist to synthesize the active Kojic acid peptides. OBJECTIVE: In the present study, we synthesize and investigate the effect of five Kojic acid peptides to overcome the limitation of Kojic acid. METHODS: The peptide was analyzed and purified by high-performance liquid chromatography and matrix-assisted laser desorption ionization time of flight mass spectroscopy. Further, the tyrosinase activities of the Kojic acid and Kojic acid peptides were compared. The toxicity was measured and the melanin content is recorded in B16F10 mouse melanoma cells. RESULTS: Maximum tyrosinase activity was measured by Kojic acid peptides. Therefore, Kojic acid peptides were subjected to melanin assay and cytotoxicity assay and finally the stability of the Kojic acid peptide was measured. CONCLUSION: It was observed that this newly synthesized Kojic acid peptide is stable and potent to inhibit the tyrosinase activity and melanin content of B16F10 mouse melanoma cells without exhibiting cell toxicity. Together, these preliminary results suggest that a further exploration is being needed to establish Kojic acid peptide as antimelanogenic agent.
Animals ; Chromatography, Liquid ; Mass Spectrometry ; Melanins ; Melanoma ; Mice ; Monophenol Monooxygenase ; Peptides

A 44-year-old man, who had a history of myocardial infarction (MI) due to thrombotic occlusion of right coronary artery (RCA) aneurysm, visited emergency department presenting with ST-segment elevation myocardial infarction (STEMI). The patient had been on oral anticoagulant therapy (warfarin) from the first thrombotic event, but the medication had been recently changed to aspirin 4 months before the second event. Emergent coronary angiography revealed thrombotic total occlusion of RCA with heavy thrombotic burden from middle RCA to the ostium of the posterior descending branch. Combination pharmacotherapy was performed with anticoagulants (heparin), fibrinolytics (urokinase), and Glycoprotein IIb/IIIa antagonists (abciximab), in addition to mechanical thrombosuction. However, on hospital day 2, the patient complained recurrent chest pain and again underwent coronary angiography, which revealed distal embolization of large thrombus to the posterior lateral branch. Coronary flow was recovered after repeated mechanical thrombosuction was performed. This case has shown the importance of aggressive combination drug therapy, accompanied by mechanical thrombosuction in patient with myocardial infarction due to thrombotic occlusion of coronary artery aneurysm and the importance of unceasing life-long anticoagulant therapy in those particular patients.
Adult ; Aneurysm* ; Anticoagulants ; Aspirin ; Chest Pain ; Coronary Aneurysm ; Coronary Angiography ; Coronary Occlusion* ; Coronary Vessels* ; Drug Therapy ; Drug Therapy, Combination ; Emergency Service, Hospital ; Glycoproteins ; Humans ; Myocardial Infarction* ; Thrombectomy ; Thrombosis ; Warfarin*

STUDY DESIGN: A prospective study. OBJECTIVES: To report the results of new designed dual growing rods system for progressive pediatric spinal deformity. SUMMARY OF LITERATURE REVIEW: The current expandable spinal implant system appears effective in controlling progressive pediatric spinal deformity, allowing for spinal growth. However, there was no report concerning the growing rod in Korea. MATERIALS AND METHODS: Between 2010 and 2011, seven pediatric patients, who had a minimum of 1year follow-up, had undergone surgery for spinal deformity correction with a dual growing rods technique. We analyzed the demographic and radiologic data, including height, weight, age at surgery, diagnosis, number of lengthening, Cobb's angle of the major curve, thoracic kyphosis angle, lumbar lordosis angle, T1-S1 length, instrumented segment length, and complications, from the preoperative period to the last follow up period. RESULTS: Four male and three female patients with 5 neuromuscular scoliosis, 1 idiopathic juvenile osteoporosis and 1 spondyloepiphyseal dysplasia had underwent corrective surgery with dual growing rods. The mean age at the initial surgery was 11.6 years (7-13.8). The mean follow-up duration was 19.3 months (12-24), and the mean lengthening procedure time was 2.8 (2-4) for every patient. Cobb's angle of scoliosis curve was corrected from preoperative 80.2degrees(55-136) to 37.6degrees (15-81) on the last follow-up. Thoracic kyphosis angle and lumbar lordosis angle were changed from preoperative 48.7degrees(12-101) and 38.3degrees(9-72) to 44.5degrees(12-75) and 18.8degrees(1-46) on the last follow-up, respectively. Growth length during the follow-up period was measured as instrumented segment is 46 mm (33-59) and T1-S1 segment is 82 mm (66-98). Complications, such as breakage of rod in 3 cases and soft tissue infection in 1 case, occurred during the follow-up period. CONCLUSIONS: New designed dual growing rods system for pediatric patients with progressive spinal deformity is an effective and relatively safe method because of adequate correction and acceptable rate of complications.
Animals ; Congenital Abnormalities ; Female ; Follow-Up Studies ; Humans ; Kyphosis ; Lordosis ; Male ; Osteochondrodysplasias ; Osteoporosis ; Preoperative Period ; Prospective Studies ; Scoliosis ; Soft Tissue Infections

STUDY DESIGN: Case report. OBJECTIVES: We report a very rare case of the inferior accessory ossicle of the anterior arch of the atlas misdiagnosed as anterior arch fracture. SUMMARY OF LITERATURE REVIEW: It is necessary to know the existence of inferior accessory ossicle of the anterior arch of the atlas, even though it is extremely rare. MATERIALS AND METHODS: A 29-year-old woman was referred to our emergency service unit with symptoms of neck pain and scalp laceration, after being involved in a car accident. She was diagnosed as the inferior accessory ossicle of the anterior arch of the atlas, by multiple diagnostic mordalities. RESULTS: The symptom of neck pain was relieved spontaneously, and her symptom has been relieved at her latest visit, as a follow up within 3 months. CONCLUSIONS: It is important to be aware of cervical anatomical variants because we commonly confuse it with other pathologic conditions, such as a fracture and thus, misdiagnose the condition.
Adult ; Emergencies ; Female ; Follow-Up Studies ; Humans ; Lacerations ; Neck Pain ; Scalp

Pneumocephalus is defined as the presence of air or gas within the cranial cavity. It is usually associated with disruption of the continuity of the skull after head and facial trauma, neuro or otorhinolaryngologic surgery, and rarely, spontaneously. But a case of pneumo-hydrocephlus, a special subtype of pneumocephalus, has been rarely reported. This is a case of a 26-year-old quadriplegic patient who traumatic brain injury with left frontoparietal skull bone fracture and epidural hemorrhage with developed of pneumo-hydrocepahlus in the ventricle 6 months after injury. The mechanism of this case can be explained by the "inverted bottle" hypothesis. Clinical observation suggests that the leakage of cerebrospinal fluid through the ventricle-peritoneal shunt tube caused negative pressure gradient differences resulting in the inflow of outside air into the ventricle through fissures created by concealed fracture of the skull base.
Adult ; Brain Injuries ; Fractures, Bone ; Head ; Hemorrhage ; Humans ; Pneumocephalus ; Skull ; Skull Base ; Ventriculoperitoneal Shunt

Anterior spinal artery syndrome refers to the paralysis of the bilateral upper extremities, bladder dysfunction and the sensory deficit of pain and temperature below the level of injury. A 64 year-old female got a cardiac arrest event after stent insertion into the coronary artery. After CPR, she underwent the motor deficit (Z-T) of the bilateral upper extremities without any sensory deficit; proprioception, vibration and pain. The brain MRI showed no abnormality, but high signal intensity was detected in C3-C7 level by T2 sagittal plane and at the anterior horn area of gray matter by axial view of spine MRI. The ventilator has been applied after CPR. By the fluoroscopy, the movement of the diaphragm was decreased, and the nerve conduction study of both phrenic nerves showed no responses.
Animals ; Anterior Spinal Artery Syndrome ; Brain ; Cardiopulmonary Resuscitation ; Coronary Vessels ; Diaphragm ; Female ; Fluoroscopy ; Heart Arrest ; Horns ; Humans ; Neural Conduction ; Paralysis ; Phrenic Nerve ; Proprioception ; Respiratory Paralysis ; Spinal Cord ; Spinal Cord Ischemia ; Spine ; Stents ; Upper Extremity ; Urinary Bladder ; Ventilators, Mechanical ; Vibration

"Trigger finger at the wrist" is a rare phenomenon. The main symptom consists in a triggering at the wrist produced by finger motion. Its etiology and presentation may vary. One of etiology, some anomalies of muscle can cause this disease. Triggering finger at the wrist with carpal tunnel syndrome by abnormal the belly of the flexor digitorum superficialis has been reported. But most cases of it have been reported by orthopedic surgeons. We are presenting the case of 28 year old male patient who had abnormal flexor digitorum superficialis in carpal tunnel which was diagnosed by using ultrasonography.
Carpal Tunnel Syndrome ; Fingers ; Humans ; Male ; Muscles ; Orthopedics ; Wrist

OBJECTIVE: To improve the quality of life of the disabled population by decreasing the incidence of complications and chronic diseases and improving self-care abilities according to individual diseases through health status evaluation and basic survey. METHOD: The basic clinical information of 1,378 regional severely-disabled patients were collected along with information regarding functional level, activities of daily living, nutritional status, and management of complications which were distinguished into 3 stages (good, moderate, poor), which were correlated into scores (1-3 points) that were used to assess a collaborative score (5-15 points) that represented their health status. Health behavior and blood tests were also done. RESULTS: Health status were evaluated based on sex, grade of disability, age, frequency of exercise and type of disability, which revealed that female sex, brain disorder, 1st grade disability, total lack of exercise, old age disabled patients were relatively poor in terms of health status. CONCLUSION: Health status of the severely-disabled showed differences according to sex, age, grade of disability, type of disability, and frequency of exercise, and health programs designed to screen and follow up the severely-disabled person with poor health status as well as manage their accompanying diseases and complications are needed.
Activities of Daily Living ; Brain Diseases ; Chronic Disease ; Female ; Health Behavior ; Hematologic Tests ; Humans ; Incidence ; Nutritional Status ; Quality of Life ; Self Care