Purpose: The purpose of this study was to provide basic data to understand the organizational culture of nurses by categorizing nurses' experience of coping with bullying in the workplace through Q methodology and analyzing the characteristics of each type, and to induce correct policy measures and interventions to create an atmosphere created in the nursing clinical field to be more advanced and positive. Methods: To form the Q population, focus group interviews were conducted with nurses working for more than six months at two general hospitals in Seoul and Gyeonggi. Interviews were conducted by 12 nurses introduced to participants who can provide researchers with a wealth of information on workplace bullying experiences without filtration. In addition, the Q population was extracted by reviewing the results. Based on the results derived from this, 38 Q statements in total were extracted. Forty clinical nurses were required to classify Q sample statements, and the data collected through this were analyzed using the pc-QUANAL program. Results: As a result of the analysis, a total of five types of clinical nurses' experiences of coping with bullying in the workplace were identified: ‘tense emotion-based tolerance response,’ ‘positive thinking-based self-effort response’, ‘individualistic thinking-based passive response’, ‘support system-based emotional expression response’ and ‘active response centered on problem-solving’. Conclusion The derived response types are expected to be guidelines for suggesting strategies to eradicate bullying in the workplace at the organizational level, individual level, prevention level, and organizational culture level.

PURPOSE: To evaluate the CT findings of pleural dissemination in primary lung cancer and the limitations of CT scanning in detecting pleural dissemination in primary lung cancer. MATERIALS AND METHODS: Primary lung cancer with pleural dissemination was diagnosed in 68 patients and confirmed by pleural biopsy, cytology and surgery, and these cases were the subject of this study. Adenocarcinoma accounted for 49, squamous cell carcinoma for 13 and small cell carcinoma for six. Eight CT features, namely the amount of pleural effusion, the contour, extent andlocation of pleural thickening, the shortest distance between pleura and mass, pleural calcification, pleural tailsign and the extent of extrapleural fat proliferation, were evaluated. RESULTS: Pleural effusion was noted in 51 of 68 patients(75%), though in most cases(70%), the amount of this was small. Among 42 patients(62%) in whom thickened pleura, were noted, pleural thickening was thin and irregular in 22(52%), thick and irregular in 16(38%), and thin and regular in 4(10%). The extent of pleural thickening was multifocal in 22 patients(52%),diffuse in 16(38%), and circumferential and single in two(5%). Pleural thickening was more frequently noted at theposterior than the anterior pleura. Pleural abutting was seen in 53 patients(78%). In ten patients(15%), chest CTscans revealed no perceptible pleural abnormalities. CONCLUSION: If in primary lung cancer, the primary lung masscontacts the pleura, and if pleural thickening, even when slight, shows marginal irregularity, pleuraldissemination should be considered. Although CT scanning is very useful for the detection of pleural disseminationin primary lung cancer, about 15% of patients showed no perceptible pleural abnormalities. Other diagnosticmodalities such as thoracoscopy are mandatory for the correct diagnosis of pleural dissemination in primary lung cancer.
Adenocarcinoma ; Biopsy ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Diagnosis ; Humans ; Lung Neoplasms* ; Lung* ; Pleura ; Pleural Effusion ; Thoracoscopy ; Thorax ; Tomography, X-Ray Computed

BACKGROUND: This study aimed to investigate the neuromuscular effects of 0.6 mg/kg rocuronium under desflurane anesthesia in patients with and without renal failure. METHODS: The neuromuscular effects of rocuronium 0.6 mg/kg under desflurane anesthesia were investigated in 20 patients with renal failure undergoing renal transplantation surgery and in 20 patients with normal renal function. Neuromuscular transmission was monitored using acceleromyography with single stimuli at 0.1 Hz. The onset and 25%, 75%, and 95% twitch recovery times, the recovery of the train-of-four ratio to 70% (TOF70), and the recovery index (25-75%) were recorded. RESULTS: Block onset was similar in the groups. The 25%, 75% and 95% twitch recovery times, the TOF70 time, and the recovery index were found to be prolonged in patients with renal failure compared to those with normal renal function (e.g. TOF70: 123.1 +/- 49.1 vs. 68.7 +/- 15.5 min) (P<0.001). A very strong association between the time to TOF70 and the diagnostic duration of renal failure was found (R2 = 0.79, P<0.001). CONCLUSIONS: The duration of action of a bolus dose of 0.6 mg/kg rocuronium under desflurane anesthesia was increased significantly in patients with end-stage renal failure compared to that of healthy controls and was prolonged according to the duration of renal failure.
Androstanols ; Anesthesia ; Humans ; Isoflurane ; Kidney Failure, Chronic ; Kidney Transplantation ; Neuromuscular Agents ; Renal Insufficiency

PURPOSE: The aim of this study was to investigate the clinical and radiological incidence of parastomal hernia. METHODS: We reviewed, retrospectively, 83 patients with end colostomy operated on from January 2003 to June 2009 at Ajou University hospital. Age, sex, surgical procedure type, body mass index (weight/length2), stoma size, and respiratory co-morbidity were documented. We compared the incidence of radiological and clinical parastomal hernia. RESULTS: There were 47 males (56.6%) and 36 females (43.4%). During an overall median follow-up of 30 months (range, 6 to 45 months), 24 patients (28.9%) developed a radiological parastomal hernia postoperatively and 20 patients (24.1%) presented clinical symptoms. Using computed tomography (CT) classification, the groups were as follows: type 0 (40, 48.2%), type Ia (19, 22.9%), type Ib (8, 9.6%), type II (4, 4.8%) and type III (12, 14.5%), with 63 asymptomatic patients and 20 symptomatic patients. The aperture size was significantly different between symptomatic and asymptomatic patients (76.45 mm vs. 49.41 mm; P = 0.000). There was a significant correlation between aperture size and the radiological type (P = 0.003). CONCLUSION: This study showed the incidence of radiological parastomal hernia is acceptable compared to previous studies. CT classification may be useful to evaluate parastomal hernia.
Colostomy ; Female ; Follow-Up Studies ; Hernia ; Humans ; Incidence ; Male ; Retrospective Studies ; Somatotypes

BACKGROUND: To investigate the efficacy of antiplatelet activity of low dose ticlopidine, we compared the antiplatelet effect of low dose ticlopidine with a high dose. METHODS: Fourteen healthy volunteers were divided into two series. Volunteers in series I were medicated ticlopidine 250 mg twice a day (group 1) for first 7 days. After drug free interval for another 7 days, single dose of ticlopidine 250 mg a day (group 2) was medicated for the third 7 days. Same medica-tion schedule was taken with different doses in series II, single dose of 250 mg ticlopidine (group 3) for the first 7 days, and divided dose of ticlopidine 250 mg a day (group 4) for the third 7 days after medication free interval of 7 days. Platelet aggregation effect was evaluated by optical method using ADP and collagen reagent at before and after the medication schedule. Differences of platelet aggregation effect between the four groups were analyzed. RESULTS: Five and 4 could accomplish the full medication schedule of two groups in each series. Mean of platelet aggregation effect of group 1 (44.4%) was more decreased than other groups, 61.2% in group 2, 71.0% in group 3, and 62.7% in group 4. However, there was no significant differences of platelet aggregation effect by nonparametric statistical analysis between group 1 and 2, 3 and 4 in each series. CONCLUSIONS: This finding suggests that single low dose ticlopidine may have the similar antiplatelet aggregation effect as the high dose one.
Adenosine Diphosphate ; Appointments and Schedules ; Collagen ; Healthy Volunteers ; Platelet Aggregation ; Ticlopidine* ; Volunteers

The IRB approval number should be corrected.

No abstract available.
Cholinesterase Inhibitors ; Oculomotor Nerve Diseases* ; Oculomotor Nerve* ; Snake Bites* ; Snakes*

PURPOSE: In patients with colorectal cancer, preoperative staging using various imaging technologies is important for establishing the treatment plan and predicting the prognosis. Although computed tomography (CT) has been used most widely, the versatility of CT accuracy was primarily because of the lack of specialization. In this study, we aimed to identify whether any advancement in abdominal CT accuracy in the prediction of local staging has occurred. METHODS: Between December 2014 and November 2015, patients with colorectal cancer were retrospectively enrolled. All CT findings were retrospectively reported. A total of 285 patients were included, and their retrospectively collected data were retrospectively reviewed, focusing on a comparison between preoperative and postoperative staging. RESULTS: The overall prediction accuracy of the T stage was 55.1%, with overstaging occurring in 63 (22.1%) and understaging in 65 patients (22.8%). The sensitivity and specificity were 90.0% and 68.4%, respectively. The overall prediction accuracy of the N stage was 54.7%, with overstaging occurring in 89 (31.2%) and understaging in 40 patients (14.1%). The sensitivity and specificity were 71.9% and 63.2%, respectively. The CT accuracies by pathologic stage were 0%, 62.2%, 25.3%, and 81.2% for stages 0 (Tis N0), I, II, and III, respectively. CONCLUSION: CT has good sensitivity for detecting colon cancers with tumor invasion beyond the bowel wall. However, detection of nodal involvement using CT is unreliable. In our opinion, abdominal CT alone has limitations in predicting the local staging of colorectal cancer, and additional technologies, such as CT plus positron emission tomography and/or colonography, will improve its accuracy.
Colonic Neoplasms ; Colorectal Neoplasms* ; Humans ; Neoplasm Staging ; Positron-Emission Tomography ; Prognosis ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed

BACKGROUND: Cilostazol leads to inhibition of platelet aggregation and to vasodilatation. It is widely used for the secondary prevention of cerebral infarction. However, headache is a well-known adverse effect of cilostazol, and these headaches may be caused by the vasodilation of the cerebral artery. The goal of our study was to assess the frequency and severity of headaches following cilostazol treatment and to evaluate factors related to the development of these headaches. METHODS: Seventy patients with cerebral infarction were included in this study. We measured the carotid intima media thickness (IMT), the distensibility of the carotid artery (CAD), the brachial ankle index (ABI), and the brachial ankle pulse wave velocity (PWV) in order to quantify the degree of atherosclerosis and arterial stiffness. Patients were then given 100 mg of cilostazol in tablet form twice daily. For three days, we evaluated headache incidence and severity using a verbal rating scale (0-10). RESULTS: Twenty three (32.9%) patients reported headache during cilostazol medication and 7 patients had severe headache. Women were more likely to develop headaches than men (p=0.03). In addition, the mean IMT was lower in subjects with cilostazol-induced headache than in the headache-free subjects (0.8+/-0.1 vs 1.01+/-0.2 mm, p=0.001), while CAD was higher in these subjects (0.3+/-0.1 vs 0.25+/-0.1, p=0.03). There was no difference in PWV and ABI. CONCLUSIONS: Lower carotid IMT, increased CAD, and female gender may be associated with the development of cilostazol-induced headache in patients with cerebral inafarction, but not the systemic arterial stiffness.
Animals ; Ankle ; Atherosclerosis ; Carotid Arteries ; Carotid Intima-Media Thickness ; Cerebral Arteries ; Cerebral Infarction ; Female ; Headache ; Humans ; Incidence ; Male ; Platelet Aggregation ; Pulse Wave Analysis ; Secondary Prevention ; Tetrazoles ; Vascular Stiffness ; Vasodilation

PURPOSE: With the introduction of H. pylori eradication and proton pump inhibitor, the operative treatments for the acute or chronic complications of peptic ulcer, such as perforation, bleeding and stricture, have decreased. Also owing to the development of non-operative treatment such as interventional endoscopic treatment, the surgical approach to the acute complications, like perforation and bleeding, has diminished. The non-operative treatments for the stricture and obstruction of chronic peptic ulcer in part related to discontinuation of medication have not been satisfactory. We analyzed the clinical outcomes of the patients who underwent operative treatment for outlet obstruction with peptic ulcer. Materials of Methods: From January 1994 to December 2007, we reviewed 31 patients who had been operated on at the National Medical Center for peptic ulcer obstruction. We excluded the cases of adhesive obstructions that were caused by a former ulcer operation and also the cases of obstructions found during emergency operations for treating perforation and bleeding. We classified the surgical treatment group into the bypass operation group and the surgical resection group. We evaluated the effects of the operations by the Visick score. The recurrences were confirmed only by the endoscopic observation of peptic ulcer. RESULTS: The number of patients in the bypass operation group was 6 (19.4%) and that of resection group was 25 (80.6%). The mean age was 57.5 (25~81) years. The number of male patients was 29 (93.5%) and the number of females was 2 (6.5%). The mean symptom duration was 29.6 months. There were 19 smokers (61.3%), 6 NSAID users (19.4%) and 7 H. pylori positive patients (22.6%). Two patients underwent endoscopic balloon dilatation with no success. The locations of lesion were the stomach, the duodenum and both in 9, 20 and 2 cases, respectively. There were operative complications in 13 cases (41.9%), recurrent ulcers in 2 cases (6.5%), and reoperations in 4 cases. The mean Visick score was 1.8 (1~4). There were no statistically significant clinicopathologic differences between the bypass operation group and the resection group. The two groups had 1 case each of recurrence. Although the bypass group had a greater complication rate (83.3%) than the resection group (32%), this was not statistically meaningful (P=0.175). The mean Visick score was 3.0 in the bypass group and 1.6 in the resection group, so the resection group was better (P=0.001). CONCLUSION: For a case of chronic peptic ulcer with outlet obstruction, even though it has been reported that endoscopic balloon dilatation worked well, surgery is still regarded as an important treatment. If you consider the patients' satisfaction and the difficulty of diagnosing malignant ulcers, surgical resection should be recommended more often than a bypass operation.
Adhesives ; Constriction, Pathologic ; Dilatation ; Duodenum ; Emergencies ; Female ; Gastric Outlet Obstruction ; Hemorrhage ; Humans ; Male ; Peptic Ulcer ; Proton Pumps ; Recurrence ; Stomach ; Ulcer