No abstract available.
Humans

PURPOSE: This research study explores the job stress, job satisfaction, and health of women who works in the professional work place and identify the influence of the job stress and job satisfaction on the mental health status focused on the social and psychological structure of the workplace. METHOD: 535 participants of registered nurses and teachers from 10 General Hospitals and 15 Middle and High School located in Seoul, Korea were completed the modified version of the short form Work-family stress inventory of questionnaire as used for job stress and mental health problems and perceived overall health status and job satisfaction. RESULT: Job stress was significantly correlated with job satisfaction, overall health, and mental health. There were also significant group differences in job stress and job satisfaction between nurses and teachers. Multiple regression only moderately supported the effect of job stress and job satisfaction on the mental health of professional working women. Also marital status demonstrated a significant factor of group differences in job stress, work-family stress, job satisfaction, and mental health problem. CONCLUSION: These results suggest that job stress in the work place has profound impact on job satisfaction and health of women who work in the professional job. This study also identified major sources and types of work-related stress on women's health which should be considered in a management for health promotion.
Female ; Health Promotion ; Hospitals, General ; Humans ; Job Satisfaction* ; Korea ; Marital Status ; Mental Health ; Surveys and Questionnaires ; Seoul ; Women's Health ; Women, Working ; Workplace

PURPOSE: The purpose of this study was to analyze changes in the work patterns of nurses working in tertiary hospitals in Seoul, Korea. METHOD: Structured self-administered questionnaires were sent to the nursing department of each hospital, and distributed to nurses. The questionnaires were designed to identity changes in work patterns, frequency of contact inside & between departments, and interpersonal relationship inside & between departments. And also variables for analysis included the followings; acknowledgement of convenience, information applicability, willingness to participate in, and job satisfaction after implementation of a Hospital Information System. A total of 249 nurses from 13 hospitals replied. RESULTS: Changes in direct nursing time showed the most improvement and the frequency of contact was decreased while interpersonal relationships among coworkers was improved. As most nurses expressed a positive opinion of the HIS including its convenience, and information applicability, their willingness to participate in it and job satisfaction, it can be concluded that the implementation of the HIS has resulted in positive influences in the work patterns of clinical nurses.
Hospital Information Systems ; Information Systems* ; Job Satisfaction ; Korea ; Nursing ; Surveys and Questionnaires ; Seoul* ; Tertiary Care Centers*

We report considerations related with surgery through 2 cases of acute apendicitis with COVID-19 infection. In November and December 2020, two patients infected with COVID-19 developed acute apendicitis and underwent emergency surgery. In case 1, an 84-year-old woman was asymptomatic and diagnosed with acute apendicitis on the 20th day of infection. She was discharged after surgery without complication. In contrast, case 2 was a 69-year-old male patient with pneumonia treated with antibiotics, steroids and remdesivir. After surgery, he was hospitalized for a long duration due to persistent pneumonia and wound complications. We should perform appendectomy in well-established negative pressure operating rooms, personal protective equipment, and protocols. Since the physical examination and blood tests were limited, image examination like computed tomography scan should be considered if acute apendicitis is suspected. If the patient has pneumonia before surgery, it can get worse after surgery, and complications such as wound infections can occur.

Duplicated gallbladder (GB) is a rare congenital disease. Surgical management of a duplicated GB needs special care because of concurrent bile duct anomalies and the risk of injuring adjacent arteries during surgery. An 80-year-old man visited an emergency room with right upper quadrant abdominal pain. Computed tomography (CT) revealed cholecystitis with a 2-bodied GB. Because of this unusual finding, magnetic resonance choledochopancreatography was performed to detect possible biliary anomalies. The 2 GB bodies were unified at the neck with a common cystic duct, a so-called V-shaped duplicated GB. The patient's right posterior hepatic duct joined the common bile duct (CBD) near the cystic duct. The patient underwent laparoscopic cholecystectomy without adjacent organ injury, and was discharged uneventfully. Surgeons should carefully evaluate the patient preoperatively and select adequate surgical procedures in patients with suspected duplicated GB because of the risk of concurrent biliary anomalies.
Abdominal Pain ; Aged, 80 and over ; Arteries ; Bile Ducts ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Cholecystitis ; Cholecystitis, Acute* ; Common Bile Duct ; Cystic Duct ; Emergency Service, Hospital ; Gallbladder* ; Hepatic Duct, Common ; Humans ; Laparoscopy ; Neck ; Patient Rights ; Surgeons

Ectopic opening of the pancreatic and bile ducts (EOPBD) into the duodenal bulb is an extremely rare congenital anomaly with unknown clinical implications. We presented a case of gallbladder cancer with EOPBD into the duodenal bulb. A 57-year-old male was referred to our hospital with intermittent right upper abdominal pain. Endoscopic retrograde cholangiopancreatography and magnetic resonance cholangiopancreatography showed individual EOPBD into the duodenal bulb with no papillary structure, and a focal nodular lesion in the gallbladder. A follow-up abdominal computed tomography scan 9 months later revealed a slight increase in the size of the fundal nodule, which was suspected as gallbladder cancer. An intraoperative frozen biopsy identified the nodular lesion as adenocarcinoma involving the cystic duct, and the patient underwent radical cholecystectomy including bile duct resection with hepaticojejunostomy. EOPBD is an extremely rare condition that can be associated with gallbladder malignancy as well as benign disease. Clinicians should follow up carefully and consider surgical treatment for suspected malignant lesions.
Abdominal Pain ; Adenocarcinoma ; Bile Ducts* ; Bile* ; Biopsy ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangiopancreatography, Magnetic Resonance ; Cholecystectomy ; Cystic Duct ; Follow-Up Studies ; Gallbladder Neoplasms* ; Gallbladder* ; Humans ; Male ; Middle Aged ; Pancreatic Ducts

PURPOSE: This study was designed to retrospectively identify prognostic factors of survival among breast cancer patients with 10 or more metastatic lymph nodes (LNs).METHODS: The study included 58 patients with 10 or more metastatic LNs who received standard treatment from January 2005 to December 2015. To identify the prognostic factors, we analyzed the difference of disease-free survival (DFS) according to clinicopathologic factors.RESULTS: The 5-year DFS and overall survival rates in all patients were 55% and 69%, respectively. Tumor size, number of metastatic LNs and ratio of metastatic to total LNs were associated with poorer prognosis. DFS was significantly poorer in patients with >15 than ≤15 metastatic LNs (hazard ratio [HR], 4.60; 95% confidence interval [CI], 1.38–15.32) and with LN ratio >0.64 than ≤0.64 (HR, 26.13; 95% CI, 3.16–215.80) A scoring system based on these factors was significantly prognostic of survival outcomes.CONCLUSION: This study identified factors of survival in breast cancer patients with extensive LN metastasis. Patients with unfavorable factors may require modified management to improve their clinical outcomes.
Breast Neoplasms ; Breast ; Disease-Free Survival ; Humans ; Lymph Nodes ; Lymphatic Metastasis ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Survival Rate

PURPOSE: We investigated the long-term oncologic outcomes of laparoscopic gastrectomy (LG) and open gastrectomy (OG) for advanced gastric cancer (AGC) with a 5-year follow-up period.METHODS: Clinical data of 180 patients (109 LG and 71 OG) who underwent radical D2 gastrectomy for AGC at Gyeongsang National University Hospital between 2007 and 2009 were included. Survivals and predictors of these outcomes were analyzed.RESULTS: The mean follow-up period was 54.3 months. Recurrence was observed in 68 patients (37.8%). The 5-year disease-free survival (DFS) rate was 52.2% for all patients, 39.4% in the OG group, and 60.6% in the LG group. The 5-year DFS rates for OG and LG with respect to pathological stage were stage I, 87.5% and 84.2%, respectively (P=0.684); stage II, 55.0% and 77.3%, respectively (P=0.032); and stage III, 23.3% and 34.8%, respectively (P=0.265). The 5-year overall survival (OS) rate was 52.8% for all patients, 40.8% in the OG group, and 60.6% in the LG group. The 5-year OS rates for OG and LG with respect to pathological stage were stage I, 87.5% and 84.2%, respectively (P=0.753); stage II, 55.0% and 77.3%, respectively (P=0.034); and stage III, 25.6% and 34.8%, respectively (P=0.302). For survival, TMN cancer stage was statistically independent prognostic factors.CONCLUSION: Our analysis revealed that LG for AGC had acceptable long-term oncologic outcomes comparable to the outcomes of conventional OG. Cancer stage was independent risk factors associated with survival.
Cohort Studies ; Disease-Free Survival ; Follow-Up Studies ; Gastrectomy ; Humans ; Recurrence ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms

PURPOSE: Whether subtotal or total colectomy with primary anastomosis (PA) is safer than Hartmann procedure (HP) for left-sided colon cancer obstruction or perforation remains controversial. The purpose of this study was to compare postoperative morbidity, mortality, and defecation frequency between PA and HP for left-sided colon cancer obstruction or perforation.METHODS: This retrospective study enrolled 54 patients from January 2014 to February 2018 who underwent emergency surgery due to left-sided colon cancer obstruction or perforation.RESULTS: PA was carried out in 20 patients while HP was performed for 34 patients. Thirty-day mortality did not show significant difference between the two groups (15.0% vs. 14.7%, P=1.000). No anastomotic leakage occurred in PA group while three (8.8%) cases of stump leakage occurred in HP group. Stoma repair was performed for 13 cases (44.8%) and stoma reformation was performed for one case in HP group (7.7%). Stoma related complications occurred in five cases (17.24%). For patients after stoma repair, defecation frequency at 3 months after operation was 2.91±2.88 times per day in PA group and 2.86±2.63 times per day in HP group. At 1 year after operation, defecation frequency was changed to 1.40±1.12 times per day in PA group and 1.17±0.39 times per day in HP group.CONCLUSION: Primary ileosigmoid or ileorectal anastomosis for left-sided colon cancer obstruction or perforation is safe, and shows similar outcome of defecation frequency compared to HP.
Anastomotic Leak ; Colectomy ; Colon ; Colonic Neoplasms ; Defecation ; Emergencies ; Humans ; Mortality ; Retrospective Studies

PURPOSE: The purpose of this study was to determine the prognostic factors and risk scorings that could have an impact on the in-hospital mortality of acute mesenteric ischemia (AMI). METHODS: Forty consecutive patients received an operation due to AMI between January 2001 and June 2009. The hospital medical charts and clinical records were retrospectively reviewed. Clinical features, laboratory findings, operative findings, surgical procedure, and prognostic scoring system were collected and assessed as possible the prognostic factors for in-hospital mortality. RESULTS: The overall hospital mortality rate was 32.5% (13/40). In a univariate analysis, significant predictors of in-hospital mortality were decreased mentality (P=0.029), shock at admission (P=0.006), symptom duration (P=0.011), blood urea nitrogen (P=0.029), serum creatinine (P<0.001), glucose (P=0.004), total bilirubin (P=0.044), aspartate aminotransferase (P=0.001), lipase (P=0.039), pH (P=0.014), bicarbonate (P=0.027), prothrombin time-international normalized ratio (P=0.006), activated partial thromboplastin time (P=0.004), length of remnant bowel (P=0.008), postoperative inotropics (P=0.007), Acute Physiology and Chronic Health Evaluation II (P=0.009), and American Society of Anesthesiologists (ASA) grading (P=0.005). In a multivariate analysis, the variables hyperglycemia (P=0.013) and higher ASA (>II) (P=0.02) were identified as independent prognostic factors of in-hospital mortality. CONCLUSION: In conclusion, the prognostic factors in AMI who have hyperglycemia (>200 mg/dL) and high ASA grading (>II) are truly associated with very high in-hospital mortality.
APACHE ; Aspartate Aminotransferases ; Bilirubin ; Blood Urea Nitrogen ; Creatinine ; Glucose ; Hospital Mortality ; Humans ; Hydrogen-Ion Concentration ; Hyperglycemia ; Ischemia ; Lipase ; Multivariate Analysis ; Partial Thromboplastin Time ; Prognosis ; Prothrombin ; Retrospective Studies ; Shock ; Vascular Diseases