Bone metastasis is the third most common extrahepatic metastasis from hepatocellular carcinoma (HCC), following lung and lymph node metastasis. Although transcatheter arterial chemoembolization (TACE) is widely used for the treatment for unresectable HCC in the liver, its effects on bone metastasis from HCC have not been well described in past literature. We report a case of a patient with a metastatic bone lesion from an HCC treated with TACE. After the procedure, the patient's pain and narcotic requirement significantly decreased without major complications.

OBJECTIVES: The aim of this study is to evaluate the polysomnographic characteristics and prescription status of restless legs syndrome (RLS) patients in naturalistic setting. METHODS: We reviewed medical record of the patients over 18 years olds who (i) satisfied the clinical RLS diagnostic criteria and (ii) had the polysomnography and got treatment related thereto. As a baseline, we evaluated the four diagnostic criteria of the International Restless Legs Syndrome Study Group (IRLSSG) and the International Restless Legs Scale (IRLS) of the subjects. Then the polysomnography and the suggested immobilization test (SIT) were conducted and, after one month of pharmacotherapy using dopamine agonist, the IRLS was evaluated again. RESULTS: A total of 211 subjects participated in this analysis and 94 (44.5%) of them were male and the other 117 (55.5%) were female and the average age of the 211 subjects was 46.9+/-14.2. Out of such 211 subjects, 136 subjects (64.5%) also had the obstructive sleep apnea (OSA), and 53 subjects (25.1%) also had the periodic limb movement disorder (PLMD). 185 subjects (87.7%) out of the 211 subjects had some other sleep disorders except RLS. The results of the polysomnography were as follows : 78.0% of sleep efficiency, 86.8 min of wake after sleep onset, and 3.4% of N3. More specifically, 12.4/h of the average apnea hypopnea index, 14.8/h of the periodic limb movement during sleep (PLMS), 41.2/h of the periodic limb movement during wake during SIT and 21.6/h of total arousal index during sleep. Out of the total subjects, 149 (70.6%) of them took the ropinirole and 47 (22.3%) of them took the pramipexole, and the average dosage of ropinirole was 0.9mg(dosage range 0.125-5 mg) while the average dosage of pramipexole was 0.5 mg (dosage range 0.125-4 mg). The dosage of the ropinirole showed a significant positive correlation with the age (r=0.25, p=0.002) and also with the IRLS (r=0.23, p=0.038). The IRLS at the baseline was 24.9 while the same was decreased down to 13.4 after one month. CONCLUSIONS: Analyzing the result of this study, a majority of clinical RLS subjects demonstrated comorbidity with some other sleep disorder such as the OSA or PLMD. 25.1% of the subjects showed a PLMD, which was less than in previous researches and the average PLMS was not very high as 14.8/h. The dosage of dopamine agonist taken was often a bit more than the amount recommended in Korea. A prospective research using a large scale controlled subjects will be necessary with respect to this topic.
Apnea ; Arousal ; Benzothiazoles ; Comorbidity ; Dopamine Agonists ; Extremities ; Female ; Humans ; Immobilization ; Indoles ; Isothiocyanates ; Korea ; Male ; Medical Records ; Nocturnal Myoclonus Syndrome ; Polysomnography ; Prescriptions ; Restless Legs Syndrome ; Sleep Apnea, Obstructive ; Sleep Wake Disorders

PURPOSE: The purpose of this study was to investigate the relationship among work environment of nursing, nursing organizational culture, demands at work and the emotional labor in clinical nurses. METHODS: A convenience sample of 241 registered nurses was obtained from two hospitals. Data were collected by a self-administered questionnaire during December, 2014. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson correlations and multiple regression with SPSS/WIN 21.0. RESULTS: The mean score for emotional labor was 3.36±0.48, for work environment of nursing, 2.44±0.36, and for innovational-orientation, 2.95±0.56: Relation-orientation, 3.34±0.62, Task-orientation, 2.95±0.53, and hierarchy-orientation, 3.41±0.49, The score for quantitative demands was 3.02±0.56, and for work pace, 3.76±0.76. In multivariate analysis, factors related to emotional labor were work environment of nursing, innovational-orientation and work pace. CONCLUSION: Findings from this study indicate the need to evaluate and improve the work environment for nurses to decrease emotional labor.
Multivariate Analysis ; Nursing ; Organizational Culture*

PURPOSE: The purpose of this study was to identify factors associated with the intention of the prostate cancer screening (PCS). To achieve this purpose, a structural equation model was established based on the health belief model and the theory of planned behavior.METHODS: The subjects of this study were 260 male participants who were between 40 and 74 years old and had not taken the PCS. Data were collected using a structured self-report questionnaire (i.e., perceived benefits, perceived barriers, attitude, subjective norms, perceived behavior control, and intention of the PCS). Descriptive statistics, reliability analysis, correlation analysis, confirmatory factor analysis, and fitness test were used to test hypotheses.RESULTS: The intention of the PCS was directly affected by the perceived behavior control and indirectly influenced by the perceived benefits. The structural equation model also showed that the perceived behavior control explained 78% of the intention.CONCLUSION: To raise the intention to take the PCS, it is necessary to increase the confidence of a subject that may control its difficulties and inform the perceived benefits of the PCS to a subject.

PURPOSE: The study was done to analyze attributes of emotional labor experienced by clinical nurses working in domestic hospitals and to develop tools for measurement. METHODS: The concept of nurse emotional labor was verified through concept analysis based on Hybrid model. The preliminary Nurse Emotional Labor Scale were examined for content validity, reliability and validity. The scale was verified with 500 nurses working in general hospitals located in Kangwon-do. RESULTS: Attributes of the nurse emotional labor concept were derived from three types: surface type, internalize type and control behaviors and identified as having six constitutive factors: conscious surface behaviors, casual behaviors, empathy effort, repress, solve and endure. The results of the construct validity test of the tool showed 8 factors. The Nurse Emotional Labor Measurement Tool had a significant correlation (r=.35, p < .001) with the Scale of Morris & Felman in result of criterion-related validity. And the internal consistency reliability Cronbach's α coefficient was .93. CONCLUSION: The development process showed that to accurately describe emotional labor of nurses, it is necessary to consider not only quantitative aspects but also qualitative aspects and content aspects.
Empathy ; Factor Analysis, Statistical ; Gangwon-do ; Hospitals, General ; Reproducibility of Results

Endotracheal intubation has many advantage such as airway protection, maintenance of patent airway, pulmonary toilet, application of positive pressure ventilation, and maintenance of adequate oxygenation. But risks that develop complications related to endotracheal tube always present, when we insert a tube into the trachea. We have experienced an armored tube obstruction with bulged inner wall after EO gas sterilization. So, it is important that we have to pretest a tube and check pateney of the inside of a tube, before endotracheal intubation.
Airway Obstruction* ; Intubation, Intratracheal ; Oxygen ; Positive-Pressure Respiration ; Sterilization ; Trachea

OBJECTIVES: To determine the effectiveness and clinical utility of antenatal corticosteroids in the reduction of neonatal morbidity and mortality on preterm birth Material and method: Neonatal outcomes of 312 preterm babies were evaluated retrospectively. One hundred and two preterm babies(study group) were given dexamethasone more than 1 dose antenatally and 210 preterm babies(control group) were not given dexamethasone antenatally. Antenatal steroids were administered in the form of four 5mg intramuscular doses of dexamethasone 12 hours apart. Maternal and neonatal outcomes of study group were compared with those of control group. Student t- test, x2 test, Fisher's exact test, and logistic regression analysis were used where appropriate. p-value< 0.05 was considered significant. RESULTS: Antentenatal corticosteroid significantly decreased the incidence of RDS(OR:0.47, 95% CI:0.25-0.86), IVH/PVL(OR : 0.32, 95% CI : 0.12-0.86), necrotizing enterocolitis(OR : 0.49, 95% CI : 0.25-0.98), and neonatal death(OR: 0.30, 95% CI: 0.10 - 0.89) in preterm delivery. In the presence of PROM, antenatal corticosteoid seemed to have no protective effect on the neonatal complications such as RDS, IVH/PVL, NEC, PDA, and neonatal death. CONCLUSIONS: Antenatal administration of corticosteroids was effective to decrease the incidence of neonatal morbidity and neonatal mortality in the preterm neonates with no apparent maternal complications.
Adrenal Cortex Hormones ; Dexamethasone ; Humans ; Incidence ; Infant ; Infant Mortality ; Infant, Newborn ; Logistic Models ; Mortality ; Premature Birth* ; Retrospective Studies ; Steroids

Advances in endoscopic instruments and techniques have enabled increased detection and removal of early colorectal cancer (ECC), which is defined as a tumor whose invasion is limited to the mucosa or submucosa. Some cases can be treated by endoscopic mucosal resection (EMR). However, local recurrence frequently occurs after an EMR for ECC. The recurrence pattern is usually intramural recurrence with a mucosal lesion at the EMR's site. We report the cases of two patients with intramural recurrence without mucosal lesions after an EMR for ECC. These cases indicate that a local recurrence after an EMR for ECC can appear as an intramural recurrence without mucosal lesions at a previous EMR site or another site, although this presentation is very unusual.
Colorectal Neoplasms ; Humans ; Mucous Membrane ; Neoplasm Recurrence, Local ; Recurrence

Advances in endoscopic instruments and techniques have enabled increased detection and removal of early colorectal cancer (ECC), which is defined as a tumor whose invasion is limited to the mucosa or submucosa. Some cases can be treated by endoscopic mucosal resection (EMR). However, local recurrence frequently occurs after an EMR for ECC. The recurrence pattern is usually intramural recurrence with a mucosal lesion at the EMR's site. We report the cases of two patients with intramural recurrence without mucosal lesions after an EMR for ECC. These cases indicate that a local recurrence after an EMR for ECC can appear as an intramural recurrence without mucosal lesions at a previous EMR site or another site, although this presentation is very unusual.
Colorectal Neoplasms ; Humans ; Mucous Membrane ; Neoplasm Recurrence, Local ; Recurrence

An acquired tracheoesophageal fistula (TEF) is a rare complication that can occur in the treatment of laryngeal cancer. Explosive coughing from the tracheostomy-opening site after swallowing is a warning sign of the TEF. A 68-year old male laryngeal cancer patient showed delayed TEF after chemoradiotherapy with a total laryngectomy.The clinicians carrying out a videofluoroscopic swallowing study should be familiar with the total laryngectomy state, as well as the findings and initial general management of TEF. This report discusses the pathophysiology and management of TEF and the needs for dysphagia care team after chemoradiation in laryngeal cancer patients.