Purpose: The aim of this study was to identify the individual, job, and organizational factors affecting the individual innovative behaviors among tertiary care hospitals’ nurses. Methods The participants in this study were 230 nurses who have worked more than one year in tertiary care hospitals. Data were collected using self-administered questionnaires that included individual factors (self efficacy, and empowerment), job factors (knowledge and skills for evidence-based practice, and beliefs for evidence-based practice), organizational factors (perceived organizational support), and individual innovation behavior. The SPSS/WIN 25.0 program was used for data analysis which included descriptive analysis, t-test, ANOVA, Scheffé test, Pearson’s correlation coefficient, and hierarchical regression analysis. Results: Individual innovative behavior had significant positive correlations with all of individual, job, and organizational factors. The results of hierarchical regression analysis showed that knowledge and skills for evidence-based practice (β=.28, p<.001), self efficacy (β=.25, p=.002), gender (female, β=.23, p<.001), and beliefs for evidence-based practice (β=.17, p=.016) were significant factors influencing on individual innovative behavior. Conclusion: These findings suggest that knowledge, skills and beliefs for evidence-based practice, and self efficacy were linked to individual innovative behaviors.Therefore, education and human resource management improving self efficacy, knowledge, skills and beliefs for evidence-based practice are needed to increase nurses’ individual innovative behaviors in tertiary care hospitals.

Purpose: The aim of this study was to identify the individual, job, and organizational factors affecting the individual innovative behaviors among tertiary care hospitals’ nurses. Methods The participants in this study were 230 nurses who have worked more than one year in tertiary care hospitals. Data were collected using self-administered questionnaires that included individual factors (self efficacy, and empowerment), job factors (knowledge and skills for evidence-based practice, and beliefs for evidence-based practice), organizational factors (perceived organizational support), and individual innovation behavior. The SPSS/WIN 25.0 program was used for data analysis which included descriptive analysis, t-test, ANOVA, Scheffé test, Pearson’s correlation coefficient, and hierarchical regression analysis. Results: Individual innovative behavior had significant positive correlations with all of individual, job, and organizational factors. The results of hierarchical regression analysis showed that knowledge and skills for evidence-based practice (β=.28, p<.001), self efficacy (β=.25, p=.002), gender (female, β=.23, p<.001), and beliefs for evidence-based practice (β=.17, p=.016) were significant factors influencing on individual innovative behavior. Conclusion: These findings suggest that knowledge, skills and beliefs for evidence-based practice, and self efficacy were linked to individual innovative behaviors.Therefore, education and human resource management improving self efficacy, knowledge, skills and beliefs for evidence-based practice are needed to increase nurses’ individual innovative behaviors in tertiary care hospitals.

Interprofessional education (IPE) is relatively new in medical schools in South Korea. Since the introduction of IPE in 2022, its effective and sustainable implementation has been of great interest in medical schools. This study analyzed literature on the development of IPE in the United States, Canada, the United Kingdom, Australia, and Japan to explore strategies for successful IPE in Korean medical schools. A systematic literature search focused on institutionalizing IPE yielded 30 papers for review. The findings included the following crucial elements for effective IPE: (1) government or institutional-led support; (2) establishment of networks and partnerships; (3) development of standardized core competency frameworks for IPE; and (4) inclusion of IPE in accreditation standards. These aspects underscore the importance of IPE as an essential component of health professional education that should be effectively and sustainably implemented in academic settings. The study concludes that the successful integration and sustainable development of IPE in Korean health education will necessitate expanded and proactive governmental support. Moreover, promoting collaborations among universities, hospitals, and local healthcare institutions will be vital for creating synergies in implementing IPE programs. Establishing networks to develop and execute joint IPE initiatives and securing initial support for conceptualizing and developing competency frameworks will be critical. Additionally, forming consortia of healthcare accreditation bodies to collaboratively develop and incorporate IPE standards into evaluation criteria will be essential. Efforts to surmount these challenges will contribute to building a structural and institutional support system for the successful introduction and sustainability of IPE in Korea.

Myokymia is a clinical phenomenon characterized by undulating, vermicular, rippling and wavelike movements spreading across the muscle surface. Facial myokymia is an unusual complication of brainstem hemorrhage. It tends to occur in brainstem tumor or multiple sclerosis. We report a 51-year-old man with continuous facial and neck myokymia after brainstem hemorrhage, who revealed focal myokymic discharges in face, neck and pharyngolaryngeal muscles in-nervated by cranial nerve V, VII, X, and XI. After injection of 20-80 units of Botulinum toxin type A (Dysport ) to the left orbicularis oris, mentalis, mylohyoid and posterior belly of digastric muscles, amplitude of continuous myokymic discharges was markedly reduced. We recommend Botulinum toxin injection as a very effective therapeutic method in managing focal movement disorders.
Botulinum Toxins* ; Botulinum Toxins, Type A ; Brain Stem ; Brain Stem Neoplasms ; Facial Nerve Diseases ; Hemorrhage ; Humans ; Middle Aged ; Movement Disorders ; Multiple Sclerosis ; Muscles ; Myokymia* ; Neck* ; Trigeminal Nerve

OBJECTIVE: To investigate the correlation of multifidus muscle atrophy on MRI findings with clinical findings in low back pain patients. METHOD: Medical records of 80 patients presenting with low back pain were retrospectively reviewed. Their MR images were visually analysed to know lumbar multifidus muscle atrophy, disc herniation, disc degeneration, spinal stenosis and nerve root compression. RESULTS: Multifidus muscle atrophy increased from the upper lumbar level to the most caudal intervertebral level. It was bilateral in the majority of the cases. Multifidus muscle atrophy was well correlated with patient's age, referred leg pain, and disc degeneration. However, duration of low back pain, disc herniation, spinal stenosis, nerve root compression, sex, weight, height and BMI had no correlation with multifidus muscle atrophy. CONCLUSION: Examination of multifidus muscle atrophy should be considered when assessing MR images of lumbar spine. It may help for further evaluation and planning the treatment modalities of low back pain.
Atrophy* ; Humans ; Intervertebral Disc Degeneration ; Leg ; Low Back Pain* ; Magnetic Resonance Imaging ; Medical Records ; Muscular Atrophy ; Paraspinal Muscles* ; Radiculopathy ; Retrospective Studies ; Spinal Stenosis ; Spine

Few studies have examined the clinical features and long-term outcomes of isolated pituitary hormone deficiencies after traumatic brain injury (TBI). Such deficiencies typically present at time intervals after TBI, especially after mild injuries such as concussions, which makes their diagnosis difficult without careful history taking. It is necessary to improve diagnosis and prevent life threatening or morbid conditions such as those that may occur in deficiencies of adrenocorticotropic hormone (ACTH) or thyroid-stimulating hormone (as known as thyrotropin, TSH), the two most important pituitary hormones in hypopituitarism treatment. Here, we report two cases of isolated ACTH deficiency and one case of isolated TSH deficiency. These patients presented at different time points after concussion and underwent long-term follow-ups.
Adrenocorticotropic Hormone* ; Brain Injuries* ; Diagnosis ; Follow-Up Studies* ; Humans ; Hypopituitarism ; Pituitary Hormones ; Thyrotropin*

Background: The direct entry of the camera under the epiglottis may provide a better view of the glottis than the indirect lifting of the epiglottis by placing the Macintosh blade tip on the vallecula when using the video laryngoscope. This study aimed to compare the efficiency of two different methods of lifting the epiglottis during the visualization of glottis using video laryngoscopy in the same patient. Methods: This prospective study enrolled 60 patients who underwent general anesthesia with tracheal intubation. In each patient, glottic views were obtained by directly (group DE) and indirectly lifting the epiglottis (group IE). These two methods were compared using the modified Cormack and Lehane grade and the percentage of glottis opening (POGO) score as assessment parameters. Results: Modified Cormack and Lehane grade showed a significant difference between the groups DE and IE (P = 0.004). The difference in the POGO score between the groups DE and IE was also statistically significant (87.5% and 64.4%, respectively; P < 0.001). Conclusions Our results, therefore, revealed that the method of directly lifting epiglottis was better at exposing glottis than the method of indirectly lifting epiglottis using a video laryngoscope.

Background: The direct entry of the camera under the epiglottis may provide a better view of the glottis than the indirect lifting of the epiglottis by placing the Macintosh blade tip on the vallecula when using the video laryngoscope. This study aimed to compare the efficiency of two different methods of lifting the epiglottis during the visualization of glottis using video laryngoscopy in the same patient. Methods: This prospective study enrolled 60 patients who underwent general anesthesia with tracheal intubation. In each patient, glottic views were obtained by directly (group DE) and indirectly lifting the epiglottis (group IE). These two methods were compared using the modified Cormack and Lehane grade and the percentage of glottis opening (POGO) score as assessment parameters. Results: Modified Cormack and Lehane grade showed a significant difference between the groups DE and IE (P = 0.004). The difference in the POGO score between the groups DE and IE was also statistically significant (87.5% and 64.4%, respectively; P < 0.001). Conclusions Our results, therefore, revealed that the method of directly lifting epiglottis was better at exposing glottis than the method of indirectly lifting epiglottis using a video laryngoscope.

PURPOSE: To evaluate the effect of surface conditioning on the shear bond strength of zirconium-oxide ceramic to 4 luting agents. MATERIAL AND METHODS: A total of 120 disk-shaped zirconium-oxide ceramic blocks (3Y-TZP, Kyoritsu, Japan) were treated as follows: (1) Sandblasting with 110 microm aluminum-oxide (Al2O3) particles; (2) tribochemical silica coating (Rocatec) using 110 microm Al2O3 particles modified by silica; (3) no treatment. Then zirconium-oxide ceramic blocks bonded with 4 luting cements (RelyX luting (3M ESPE), Maxcem (Kerr), Nexus3 (Kerr), Rely X Unicem (3M ESPE)). Each group was tested in shear bond strengths by UTM. A 1-way analysis of variance and 2-way analysis of variance was used to analyze the data (alpha = .05). RESULTS: RelyX unicem in combination tribochemical silica-coating produced a highest bond strength (P < .05). Air abrasion group and Rocatec treatment groups resulted in significantly higher than no conditioning group (P < .05). RelyX Luting groups showed lower bond strength than other groups. There were significant differences among groups (P < .05). CONCLUSION: Within the limitation of this study, RelyX Unicem cement provided the highest bond strength and Rocatec treatment enhanced the bond strength.
Ceramics ; Dental Cements ; Dentin-Bonding Agents ; Resin Cements ; Silicon Dioxide ; Zirconium

PURPOSE: The purpose of the present study was to compare the accuracy of four different metal copings fabricated by CAD/CAM technology and to evaluate clinical effectiveness. MATERIALS AND METHODS: Composite resin tooth of the maxillary central incisor was prepared for a metal ceramic crown and duplicated metal die was fabricated. Then scan the metal die for 12 times to obtain STL files using a confocal microscopy type oral scanner. Metal copings with a thickness of 0.5 mm and a cement space of 50 µm were designed on a CAD program. The Co-Cr metal copings were fabricated by the following four methods: Wax pattern milling & Casting (WM), Resin pattern 3D Printing & casting (RP), Milling & Sintering (MS), Selective laser melting (SLM). Silicone replica technique was used to measure marginal and internal discrepancies. The data was statistically analyzed with One-way analysis of variance and appropriate post hoc test (Scheffe test) (α=.05). RESULTS: Mean marginal discrepancy was significantly smaller in the Group WM (27.66 ± 9.85 µm) and Group MS (28.88 ± 10.13 µm) than in the Group RP (38.09 ± 11.14 µm). Mean cervical discrepancy was significantly smaller in the Group MS than in the Group RP. Mean axial discrepancy was significantly smaller in the Group WM and Group MS then in the Group RP and Group SLM. Mean incisal discrepancies was significantly smaller in the Group RP than in all other groups. CONCLUSION: The marginal and axial discrepancies of the Co-Cr coping fabricated by the Wax pattern milling and Milling/Sintering method were better than those of the other groups. The marginal, cervical and axial fit of Co-Cr copings in all groups are within a clinically acceptable range.
Ceramics ; Crowns ; Dental Marginal Adaptation ; Freezing ; Incisor ; Methods ; Microscopy, Confocal ; Printing, Three-Dimensional ; Replica Techniques ; Silicon ; Silicones ; Tooth ; Treatment Outcome