Breast cancer is the second leading cause of cancer death in women. Unfortunately, the frequency of breast cancer and mastectomy are increasing in Korea. The purpose of the study is to analyze the results of breast reconstruction using free transverse rectus abdominis myocutaneous(TRAM) flap and to suggest the operative technique for more satisfactory results. 19 patients underwent immediate breast reconstruction from 1990 to 1998, and we experienced 2 cases of bilateral immediate reconstruction of breasts following mastectomy. We have performed the free TRAM flaps based on the deep inferior epigastric vessels using microvascular technique. TRAM flap included very small portion of rectus sheath and muscle-so called muscle sparing technique. So it reduced markedly donor site morbidity. The postoperative course of these cases was uneventful with minor complication. The free TRAM flap was an excellent method of immediate breast reconstruction using autogenous tissue and provided satisfactory outcome. The goals of the immediate breast reconstruction after mastectomy are to restore body image, to achieve near normal shape of breast, and to reduce the complications. This paper represents our experience of immediate breast reconstruction using free TRAM flap, and technical options to get more satisfactory result and reduce the complications. We think this method could be regarded as the first choice for immediate breast reconstruction.
Body Image ; Breast Neoplasms ; Breast* ; Female ; Humans ; Korea ; Mammaplasty* ; Mastectomy ; Rectus Abdominis* ; Tissue Donors

No abstract available.

No abstract available.
Hemorrhage*

PURPOSE: This study aimed to investigate job satisfaction, organizational commitment and turnover intention among male nurses in South Korea. METHODS: Data were collected in May, 2013 and a total of 150 male hospital nurses participated in this study. Job satisfaction, organizational commitment and turnover intention were measured using a structured questionnaire. Collected data were analyzed using SPSS/WIN 20.0 for windows. RESULTS: There were statistically significant correlations between job satisfaction and organizational commitment (r=.74, p<.001), job satisfaction and turnover intention (r=-.56, p<.001), and organizational commitment and turnover intention (r=-.69, p< .001). There was a statistically significant difference in job satisfaction of participants according to education, work unit, and salary. Organizational commitment showed significant difference according to age, education, work unit, and salary. Turnover intention was significantly different according to duration of employment in the hospital, and salary. The most influential factor for turnover intention was organizational commitment (beta=-.69, p<.001). This factor accounted for 47.8% of the variance in turnover intention. CONCLUSION: The results of this study indicate that to reduce turnover intention for men in nursing, it is necessary to increase job satisfaction, and organizational commitment.
Education ; Employment ; Humans ; Intention* ; Job Satisfaction* ; Korea ; Male ; Nurses, Male* ; Nursing ; Surveys and Questionnaires ; Salaries and Fringe Benefits

No abstract available.
Pulmonary Atelectasis*

PURPOSE: To describe the appearance and average thickness of the internal anal sphincter with anal endosonography in healthy Korean adults. MATERIAL AND METHODS: 184 subjects(male: 96, female: 88) with no history of anorectal disease or surgery were studied with anal endosonography. The average thickness of internal sphincter was meas ured at the mid-anal canal. For the internal sphincter, which is often asymmetric, the thickness of each 4 part(12, 3, 6 and 9 o'clock direction) were measured in left lateral decubitus position. RESULTS: The anal wall was well visualized in 5 layers(mucosa, submucosa, internal anal sphincter, intersphincteric plane, external anal sphincter) with anal endosonography. The anal endosonogram showed the internal anal sphincter as a homogenous, well-defined, hypoechoic, circular band, and slightly asymmetric. The average thickness of the internal anal sphincter in the area of mid-anal portion was 2.0 0.3 mm(range: 1~3 mm). There was no sexual difference; however, a significant positive correlation with age was found in average thickness of the internal anal sphincter. The correlation with lean body mass was not found. CONCLUSION: The internal anal sphincter is well-visualized, best defined structure by anal endosonography. Average thickeness of the sphincter in Korean appeared to be the same as in the Western.
Adult* ; Anal Canal* ; Endosonography ; Female ; Humans

Extensive laceration of the lung itself has relatively little attention as a threat to life compared with other intrathoracic organ injuries. The incidence of pulmonary laceration extensive enough to require thoracotomy is rare, but is higher than expected. The diagnosis of extensive pulmonary laceration may be difficult, but this injury should be suspected with attention and early thoracotomy can be carried out in indicated cases. Recently, thoracoscopy has assumed a major role in the management of a variety of surgical diseases of the chest. We experienced a case of extensive pulmonary laceration caused by nonpenetrating trauma, which underwent lobectomy by thoracoscopic surgery. A 21-year-old man who was injured in a motocycle accident was brought to Emergency Room from the scene by an ambulance, and complained of chest pain and dyspnea. A chest roentgenogram showed a hemothorax and fractures of the posterior ends of the right seventh, eighth, and ninth ribs. A chest tube was inserted. Thirteen hundred ml of blood was drained through the chest tube during the next one hour. Emergency right mini-thoracotomy revealed extensive laceration of the lower lobe extending to the pulmonary hilum. The lower lobe was the most badly torn. A lower lobectomy was done by video-assisted thoracic surgery (VATS). He complained less postoperative pain and the postoperative course was uneventful.
Ambulances ; Chest Pain ; Chest Tubes ; Diagnosis ; Dyspnea ; Emergencies ; Emergency Service, Hospital ; Hemothorax ; Humans ; Incidence ; Lacerations* ; Lung ; Pain, Postoperative ; Ribs ; Thoracic Surgery, Video-Assisted ; Thoracoscopy ; Thoracotomy ; Thorax ; Young Adult

Purpose: This study aimed to assess the impact of metaverse-based content for teaching core nursing skills (CNSC) to undergraduate nursing students. Methods: A non-equivalent control group was selected using a non-synchronized design. A total of 71 participants (34 in the experimental group and 37 in the control group) were recruited between May and June 2023 in Gwangju Metropolitan City. The CNSC included scenarios focused on drain management. Data analysis was conducted using SPSS version 25 for Windows. Results: Upon completing the CNSC, significant differences were observed between the groups in core nursing skills knowledge (t=7.97, p<.001), confidence in performing core nursing skills (t=5.79, p<.001), and clinical competency (t=2.26, p=.003). Conclusion The findings suggest that the CNSC designed for undergraduate nursing students was effective in enhancing their knowledge of core nursing skills, confidence in skill performance, and clinical competency.

Purpose: This study aimed to assess the impact of metaverse-based content for teaching core nursing skills (CNSC) to undergraduate nursing students. Methods: A non-equivalent control group was selected using a non-synchronized design. A total of 71 participants (34 in the experimental group and 37 in the control group) were recruited between May and June 2023 in Gwangju Metropolitan City. The CNSC included scenarios focused on drain management. Data analysis was conducted using SPSS version 25 for Windows. Results: Upon completing the CNSC, significant differences were observed between the groups in core nursing skills knowledge (t=7.97, p<.001), confidence in performing core nursing skills (t=5.79, p<.001), and clinical competency (t=2.26, p=.003). Conclusion The findings suggest that the CNSC designed for undergraduate nursing students was effective in enhancing their knowledge of core nursing skills, confidence in skill performance, and clinical competency.

Purpose: This study aimed to assess the impact of metaverse-based content for teaching core nursing skills (CNSC) to undergraduate nursing students. Methods: A non-equivalent control group was selected using a non-synchronized design. A total of 71 participants (34 in the experimental group and 37 in the control group) were recruited between May and June 2023 in Gwangju Metropolitan City. The CNSC included scenarios focused on drain management. Data analysis was conducted using SPSS version 25 for Windows. Results: Upon completing the CNSC, significant differences were observed between the groups in core nursing skills knowledge (t=7.97, p<.001), confidence in performing core nursing skills (t=5.79, p<.001), and clinical competency (t=2.26, p=.003). Conclusion The findings suggest that the CNSC designed for undergraduate nursing students was effective in enhancing their knowledge of core nursing skills, confidence in skill performance, and clinical competency.