The fashion of vascular anastomosis, end-to-end or end-to-side (E-to-S), are depended upon surgeon's preference or surgical situations. In E-to-S anastomosis two different methods of arteriotomy are applicable but it has been suggested the type, either elliptical or slit arteriotomy, play a different role in the flow hemodynamics. We thought that the difference is more considerable in microvascular surgery. This study examines the effects of elliptical versus slit arteriotomy on morphologic vessel patency. Twenty male Sprague-Dawley rats were divided into two groups of ten rats each. Both carotid arteries were selected as a experimental model. During the procedures the rat brain was tolerable to ischemia and all animals were survived after operations. The morphologic analysis of anastomosis site was through resin-casting method with scanning electromicroscopic examination. The results showed notable difference between two groups in three-dimensional morphology at two-month of operation. This difference may affect the flow hemodynamics and long-term vessel patency. In microvascular anastomosis, the mortpologic difference of the elliptical arteriotomy is worse than slit arteriotomy which compromises the vessel circumference.
Animals ; Brain ; Carotid Arteries ; Hemodynamics ; Humans ; Ischemia ; Male ; Models, Theoretical ; Rats ; Rats, Sprague-Dawley

Juvenile dermatomyositis is an uncommon autoimmune disease with classic heliotrope discoloration of eyelids, erythematous skin rash of joints and proximal muscle weakness. Quite different from adults, malignancy is rarely accompanied in juvenile dermatomyositis. However vasculitis, muscle atrophy, calcification and gastrointestinal involvement are often observed in juvenile dermatomyositis. A six year old boy was admitted with chief complaints of general weakness and skin rash. Muscle biopsy was performed which was consistent with dermatomyositis. The patient was treated with intravenous immunoglobulin, steroid, methotrexate and physiotherapy. We report a case of juvenile dermatomyositis.
Adult ; Autoimmune Diseases ; Biopsy ; Dermatomyositis* ; Exanthema ; Eyelids ; Humans ; Immunoglobulins ; Joints ; Male ; Methotrexate ; Muscle Weakness ; Muscular Atrophy ; Vasculitis

Purpose: This study aimed to clarify and analyze the concept of a career plateau among clinical nurses. Methods: Using Walker and Avant’s concept analysis framework, 20 articles on the career plateau of clinical nurses were selected for this study. Results: The attributes of the clinical nurses’ structural career plateau were “unmet need for vertical movement” and “accepting of promotion restrictions”. The attributes of the clinical nurses’ content career plateau were “job repetition”, “involuntary job fixation”, “work lethargy”, “low expectations for nursing professional development,” and “indifference to care recipients”. The antecedent factors for the nurses’ career plateau were “lack of organizational support”, “lack of respect from the organization, bosses, and colleagues”, “personal problems arising or remaining unresolved”, “limited autonomy”, and “absence of role models”. As a consequence of the career plateau, job satisfaction, nursing competency, and nursing quality decreased, while burnout and turnover intention increased. Conclusion This study is significant in that it clarified the concept and attributes of the clinical nurses’ career plateau by reflecting the characteristics and purpose of nursing.

PURPOSE: The purpose of this study was to identify the relationship between self-esteem and sexual attitude in healthcare college students, and also to provide a basis for sexual health education programs to help establish healthy sexual attitudes. METHODS: A survey was conducted with 218 unmarried students attending the healthcare colleges in B and U cities. Data were collected from October 15 to November 10, 2015 and analyzed using Stepwise multiple regression with SPSS PASW 18.0. RESULTS: Mean score for self-esteem was 3.23±0.46 out of 5 and sexual attitude 2.64±0.54 out of 5. Self-esteem and sexual attitude had a negative correlation (r=-.169, p=.012). Among sub-variables of sexual attitude, negative correlations were found between self-esteem and premarital chastity (r=-.207, p=.002), and between self-esteem and homosexual attitudes (r=-.167, p=.013). There were statistically significant differences in sexual attitude according to perceived intimacy with mother (β=-.228, p<.001), year in college (β=.135, p=.047), major (β=.148, p=.023), religion (β=-2.429, p=.016), and homosexual tendencies (β=.139, p=.037). These factors explained 14.6% of the variance in sexual attitude. CONCLUSION: Findings demonstrate the importance of self-esteem for sexual attitudes. This finding should be used in the development of healthcare college students, promotion programs to enhance healthy sexual attitudes.
Delivery of Health Care* ; Education ; Homosexuality ; Humans ; Mothers ; Reproductive Health ; Sexual Behavior ; Single Person

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*

BACKGROUND: This study was conducted to investigate the knowledge, anxiety and compliance with preventive behavior of Middle East respiratory syndrome (MERS) in liver transplant patients. METHODS: The participants in the study were 100 liver transplant patients at an outpatient clinic. The data were collected from May 20, 2016, to June 20, 2016. RESULTS: The knowledge score was 6.37±1.73 (range; 1~10) and the correct answer rate was 63.7%. The state anxiety score was 41.35±10.08 (range; 20~68) and the trait anxiety score was 39.60±8.85 (range; 22~59). The compliance with preventive behavior score was 35.70±5.23 (range; 21~45). Anxiety differed significantly according to education level (P=0.040) and occupation status (P=0.047). Compliance with preventive behavior differed significantly according to period after surgery (P=0.035). Compliance with preventive behavior and state anxiety (P=0.007) and trait anxiety (P<0.001) were negatively related. The factor that had the greatest effect on compliance with preventive behavior was trait anxiety (P=0.003). CONCLUSIONS: The epidemic of the MERS has already been completed and none of the subjects of this study has been infected with the MERS; however, patients with liver transplantation always have a risk of various opportunistic infections. If new infectious diseases such as MERS occur in the future, increased anxiety may decrease the practice of prevention. Therefore, anxiety experienced by liver transplant patients should be managed.
Ambulatory Care Facilities ; Anxiety* ; Communicable Diseases ; Compliance* ; Coronavirus Infections* ; Education ; Humans ; Liver Transplantation ; Liver* ; Middle East* ; Occupations ; Opportunistic Infections

Asphyxia is primarily observed in either suicide or homicide. We encountered two unusual autopsy cases, which were extremely rare and atypical, with respect to the manner or cause of death. The first victim demonstrated external findings of a transverse ligature mark around his neck and foreign material in the form of flour or kneaded flour in the whole airway, including the oral and nasal cavity. Based on the scene investigation images and autopsy findings, we identified that the victim attempted to strangle himself with a necktie first, but failed. He then inhaled flour and suffocated. The second victim, who died while sleeping, had a transverse ligature mark around her neck with marked facial congestion, multiple petechia of the conjunctiva and oral mucosa, and extensive hemorrhage of the neck muscles. Police investigation found the deceased stuck in a massage machine without the protective cover that prevents small objects being sucked into the machine. Her death was ruled to be accidental. We present two unusual cases of asphyxia, discuss the mechanism of asphyxia in each case, and review the literature.

Eosinophilic coronary periarteritis (ECPA) is a new type of coronary arteritis. In most cases, it has showed sudden cardiac death due to vasospastic angina or spontaneous coronary artery dissection. Many studies about ECPA have been conducted, but the cause of ECPA has yet to be clarified. ECPA was diagnosed at autopsy and the patients were mainly 30- to 50-year-old man. We report a case of a 50-year-old woman who died from ECPA without spontaneous coronary artery dissection. The autopsy showed a sudden cardiac death and results of microscopic examiniation related to ECPA.

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

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