PURPOSE: This study was conducted to identify emotional labor, nursing work environment, self-efficacy and happiness index and address factors associated with happiness index to provide basic resources for national psychiatric hospital nurses' happiness at work. METHODS: Participants were 249 nurses working in 5 national psychiatric hospitals. They participated in the survey and data were collected from May 16 to July 30, 2016. Data were analysed using SPSS/WIN 22.0. RESULTS: Mean scores were nurses' emotional labor, 3.89, nursing work environment, 2.77, self-efficacy, 3.77, and happiness index, 3.52. There were significant differences on the happiness index for: department, type of work, career length, position and payment. Happiness index was influenced by self-efficacy, work environment and emotional labor. Explanatory power of these variables was 36.9%. CONCLUSION: These results show that self-efficacy and work environment are important factors related to the happiness of the national psychiatric hospital nurses. Additionally, developing an effective program to facilitate self-efficacy of nurses and research studies to identify effects of such a program are required.
Happiness* ; Hospitals, Psychiatric* ; Korea* ; Nursing*

PURPOSE: This study was conducted to investigate and analyze the association between stress from shift and non-shift work as well as the effects living habits have on eating habits in order to identify why and how workers can improve their health and form proper eating habits for higher working efficiency. METHODS: The subjects of this study were 361 workers from K manufacturing company from April 7 to 11, 2014 and they were surveyed using a questionnaire. The subjects were divided into two groups according to working pattern: shift workers (n = 216) and non-shift workers (n = 110). RESULTS: In the general characteristics, there were significant differences in age, work career, work time, marriage, monthly income, and education levels between the two groups. For healthy behaviors, significant differences in subjective health status, moderate physical activity, drinking, smoking, and sleep time were observed between shift workers and non-shift workers. For eating habits, scores of non-shift workers having a regular mealtime, balanced meal composition, and vegetable and seaweed intakes were significantly higher than those of shift workers. The sum score of dietary habits in non-shift workers was also significantly lower than that in shift workers (p < 0.05). Total job stress score did not significantly differ between the two groups. CONCLUSION: The sum of eating habit scores according to work types was 16.1 ± 0.6 in non-shift workers and 14.0 ± 0.3 in shift workers. These results suggest that it is necessary to provide food suitable to characteristics of different workers according to work type which should be provided along with daily nutrition counseling to help subjects recognize their status.
Counseling ; Diagnostic Self Evaluation ; Drinking ; Eating* ; Education ; Food Habits ; Gwangju* ; Marriage ; Meals ; Motor Activity ; Seaweed ; Smoke ; Smoking ; Vegetables

BACKGROUND/AIMS: The Dieulafoy lesion is an important cause of gastrointestinal bleeding. The bleedings from caliber- persistent vessel or abnormally large and tortuous submucosal artery are usually located on proximal stomach. Endoscopic band ligation (EBL) is currently regarded as the treatment of choice of Dieulafoy lesions. This study reports on the clinical features, the efficacy and safety of EBL. METHODS: 10 patients with Dieulafoy-like lesion (median age: 47 yr range: 22~71, M:F 8:2 ) were treated using EBL. EBL was performed as the primary hemostatic tratment as follows in 8 cases of urgency and 2 cases of emergency. RESULTS: The location of all lesions (n=10) were in stomach, 8 in body (4 in posterior wall), 2 in fundus. The bleeding focuses were identified during the first endoscopy. Five lesions were bleeding, 5 had adherent clots or protruding vessels without active bleeding. Hemostasis were achieved with first session of EBL in 9 patients successfully, one case in the fundus was failed due to early band release. CONCLUSION: EBL is a simple, effective, and safe endoscopic method of Dieulafoy-like lesions and, it should be proposed as a primary option.
Arteries ; Emergencies ; Endoscopy ; Hemorrhage ; Hemostasis ; Humans ; Ligation* ; Stomach

Streptococcus pneumoniae is a major human pathogen that is involved in community-acquired pneumonia. Tumor necrosis factor-alpha (TNF-alpha) is a pro-inflammatory cytokine that activates immune responses against infection, invasion, injury, or inflammation. To study the role of TNF-alpha during S. pneumoniae infection, a murine pneumococcal pneumonia model was used. We intranasally infected C57BL/6J wild-type (WT) and TNF-alpha knockout (KO) mice with S. pneumoniae D39 serotype 2. In TNF-alpha KO mice, continuous and distinct loss of body weight, and low survival rates were observed. Bacterial counts in the lungs and blood of TNF-alpha KO mice were significantly higher than those in WT mice. Histopathological lesions in the spleen of TNF-alpha KO mice were more severe than those in WT mice. In TNF-alpha KO mice, severe depletion of white pulp was observed and the number of apoptotic cells was significantly increased. Interferon-gamma (IFN-gamma), IL-12p70 and IL-10 levels in serum were significantly increased in TNF-alpha KO mice. TNF-alpha is clearly involved in the regulation of S. pneumoniae infections. Early death and low survival rates of TNF-alpha KO mice were likely caused by a combination of impaired bacterial clearance and damage to the spleen. Our findings suggest that TNF-alpha plays a critical role in protecting the host from systemic S. pneumoniae infection.
Animals ; Bacterial Load ; Body Weight ; Humans ; Inflammation ; Interferon-gamma ; Interleukin-10 ; Lung ; Mice ; Pneumonia ; Pneumonia, Pneumococcal ; Spleen ; Streptococcus pneumoniae* ; Survival Rate ; Tumor Necrosis Factor-alpha*

BACKGROUND: To decide the optimal antibiotics and application of chest tube, examination of pleural fluid is fundamental in the management of empyema. Some criteria for drainage of pleural fluid have been recommended but some controversies have been suggested. Recently, newer radiologic methods including ultrasound and computed tomography scanning, have been applied to the diagnosis and management of pleural effusions. We undertook a retrospective analysis of 30 patients with pleural effusion who had CT scans of the chest in order to apply the criteria of Light et at retrospectively to patients with loculation and to correlate the radiologic appearance of pleural effusions with pleural fluid chemistry. METHOD: We analyzed the records of 30 out of 147 patients with pleural effusion undergoing chest CT scans. RESULTS: 1) Six of the pleural fluid cultures yielded gram negative organisms and three anaerobic bacterias and one Staphylococcus aureus and one non-hemolytic Streptococci. No organism was cultured in nineteen cases(63.0%). 2) The reasons for taking chest CT scans were to rule out malignancy or parenchymal lung disease(46.7%), Poor response to antibiotics(40.0%), hard to aspirate pleural fluid(10.0%) and to decide the site for chest tube insertion(3.3%). 3) There was no significant correlations between ATS stages and loculation but there was a tendency to Inoculate in stage III. 4) There was a significant inverse relationship between the level of pH and loculation(P<0.05) but there appeared to be no relationship between pleural fluid, LDH, glucose, protein, loculation and pleural thickening. 5) In 12 out of 30, therapeutic measures were changed according to the chest CT scan findings. CONCLUSION: We were unable to identify any correlations between the plerual fluid chemistry, ATS stages and loculations except pH, and we suggest that tube thoracotomy should be individualized according to the clinical judgement arid serial observation. All patients with empyema do not need a chest CT scan but a CT scan can provide determination of loculation, guiding and assessing therapy which should decrease morbidity and hospital stay.
Anti-Bacterial Agents ; Bacteria, Anaerobic ; Chemistry ; Chest Tubes ; Diagnosis ; Drainage ; Empyema* ; Glucose ; Humans ; Hydrogen-Ion Concentration ; Length of Stay ; Lung ; Pleural Effusion ; Retrospective Studies ; Staphylococcus aureus ; Thoracotomy ; Thorax* ; Tomography, X-Ray Computed* ; Ultrasonography

BACKGROUND/AIMS: Serum HBV DNA levels are correlated with hepatic histologic activity in chronic HBV infection based on HBeAg. Liver injury may persist, even though HBV DNA are not detected by hybridization assay. This study was to investigate whether serum HBV DNA levels determined by more sensitive quantitative method are correlated with histologic activities in chronic HBV infections. METHODS: This study included 66 chronic HBV infected patients. HBV DNA level was quantified by Cobas Amplicor HBV Monitor(TM). RESULTS: Serum HBV DNA levels in HBeAg-positive patients were significantly higher than HBeAg-negative patients. In HBeAg-positive patients, serum HBV DNA levels showed a significant negative correlation with portal-periportal activity and fibrosis (r=-0.451, -0.446 respectively). AST levels were correlated with lobular, portal-periportal activity and fibrosis (r=0.432, 0.365, 0.301 respectively), whereas ALT levels were related to lobular activity (r=0.294). Elevated AST levels predicted lobular activity, portal-periportal activity, and fibrosis with moderate to severe degree (OR 1.733, 95% CI 1.083-2.775; OR 1.518, 95% 1.028-2.243, p=0.336; OR 17.897, 95% CI 1.517-211.208, p=0.022, respectively). CONCLUSIONS: In HBeAg-positive patients, serum HBV DNA level correlates inversely with histologic activity. On the other hands AST level correlates with histologic activity and the stage of moderate or severe degree.
Adolescent ; Adult ; Child ; Child, Preschool ; DNA, Viral/*blood ; Female ; Hepatitis B e Antigens/analysis ; Hepatitis B virus/genetics/*isolation & purification ; Hepatitis B, Chronic/pathology/*virology ; Humans ; Liver/*pathology ; Male ; Middle Aged

Our objective is to describe the characteristic CT findings of gastrointestinal (GI) tract perforations at various levels of the gastrointestinal system. It is beneficial to localize the perforation site as well as to diagnose the presence of bowel perforation for planning the correct surgery. CT has been established as the most valuable imaging technique for identifying the presence, site and cause of the GI tract perforation. The amount and location of extraluminal free air usually differ among various perforation sites. Further, CT findings such as discontinuity of the bowel wall and concentrated free air bubbles in close proximity to the bowel wall can help predict the perforation site. Multidetector CT with the multiplanar reformation images has improved the accuracy of CT for predicting the perforation sites.
Gastrointestinal Tract/*radiography ; Humans ; Intestinal Perforation/etiology/*radiography ; Peptic Ulcer Perforation/*radiography ; Tomography, X-Ray Computed

PURPOSE: In Asian countries, laser iridotomy for the treatment of angle-closure glaucoma is a common cause of bullous keratopathy, which may be associated with a shallow anterior chamber and dark iris pigmentation in Asians. Several cases of corneal decompensation after argon laser iridotomy have been reported. In the present study, we evaluated the harmful effects of argon laser iridotomy on the corneal endothelium. METHODS: Argon laser iridotomy was performed on the right eyes of pigmented rabbits. Changes in corneal thickness and endothelial cell density after laser iridotomy were evaluated. Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) was performed for assessment of corneal endothelial cell apoptosis. Combined staining with alizarin red and trypan blue, as well as a live/dead cell assay, were performed for evaluation of damage to the corneal endothelium induced by laser iridotomy. RESULTS: Corneal thickness did not change immediately after laser iridotomy; however, a significant increase was observed 24 hours after iridotomy (p = 0.001). The endothelial cell density of laser-treated eyes four days after laser iridotomy was significantly decreased compared with control eyes (p < 0.001). TUNEL staining showed many TUNEL-positive cells in the corneal endothelium and corneal stroma. No endothelial trypan blue-stained cell nuclei were observed after laser iridotomy; however, several large endothelial cells with damaged membrane integrity were observed. The live/dead cell assay clearly showed a large number of dead cells stained red in several areas throughout the entire corneal button 24 hours after iridotomy. CONCLUSIONS: Argon laser iridotomy induces corneal endothelial cell apoptosis in pigmented rabbit eyes, resulting in decreased endothelial cell density.
Animals ; Apoptosis ; Corneal Diseases/pathology/*surgery ; Disease Models, Animal ; Endothelium, Corneal/*pathology ; In Situ Nick-End Labeling ; Iris/*surgery ; Laser Therapy/*methods ; Lasers, Gas/*therapeutic use ; Ophthalmologic Surgical Procedures/*methods ; Rabbits

Pyogenic granuloma is a overzealous proliferation of a vascular type connective tissue as a result of some minor trauma and is a well circumscribed elevated, pedunculated or sessile benign inflammatory lesion of skin and mucous membrane. The clinical features of pyogenic granuloma are indicative but not specific and nearly all cases of pyogenic granulomas are superficial in nature, and there is little if any mention in the literature of these lesions producing alveolar bone even jaw bone loss. This case is somewhat unique in that the lesion was an obvious histologic pyogenic granuloma; however, it appeared to invade the mandibular bone which resulted in the loss of the adjacent teeth. A 12-year-old boy came to Seoul National University Dental Hospital with chief complaints of left facial swelling. The features obtained were as follows ; Plain radiograms showed a large well-circumscribed radiolucent lesion on left mandibular ramus area, which made severe expansion of lingual cortex and displacement of lower left 3rd molar tooth germ. Computed tomograms showed large soft tissue mass involving left masticator space with destruction of left mandibular ramus. Histologically, sections revealed loose edematous stroma with intense infiltration of inflammatory cells and proliferation of vascular channels. Also, there were focal areas of extensive capillary proliferation, bone destruction and peripheral new bone formation.
Capillaries ; Child ; Connective Tissue ; Granuloma, Pyogenic* ; Humans ; Jaw ; Male ; Mandible ; Molar ; Mucous Membrane ; Osteogenesis ; Seoul ; Skin ; Tooth ; Tooth Germ

PURPOSE: To compare the clinical results of BRTO in the gastric varices with those of TIPS. MATERIALS AND METHODS: From January 2004 to March 2006, eight patients who had been followed up for more than 1 month after BRTO were enrolled in this study. This study compared the clinical efficacy of BRTO with that of TIPS in 13 patients who had undergone TIPS from January 2000 to March 2006. The change in laboratory parameters before and after each procedure and the incidence of rebleeding, encephalopathy, asictes and varices were analyzed after each procedure. Results:In the BRTO group, the level of albumin increased, and the levels of ammonia and the Child-Pugh score decreased. The TIPS group showed no improvement in the liver function. In the BRTO group, the gastric varices were eradicated in 7 patients. Gastric variceal rebleeding and encephalopathy did not occur. However, the esophageal varices worsened in 6 patients. In the TIPS group, rebleeding (n=4), encephalopathy (n=7) and a worsening of the gastric (n=5) or esophageal varices (n=2) occurred. CONCLUSION: BRTO improves the metabolic activity of the liver and has a lower incidence of encephalopathy. Hence, BRTO is a good alternative to TIPS in the gastric varices accompanied by a gastrorenal shunt although a treatment for a worsening of the esophageal varices may be needed after BRTO.
Ammonia ; Esophageal and Gastric Varices* ; Humans ; Incidence ; Liver ; Portasystemic Shunt, Surgical* ; Varicose Veins