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