PURPOSE: This study aimed to understand the degree of clinical nurses' emotional labor that they perceive in the relationships with people related to their work. METHODS: This study was a descriptive research, and its subjects were 167 nurses in five university hospitals located in B and Y city. The degree of emotional labor was measured with Visual Analogue Scale (VAS). Data were collected from April to May in 2015, and analyzed by descriptive statistics, t-test, ANOVA, Scheffé and Games-Howell examination. RESULTS: The score of the emotional labor of health care providers and visitors were higher than non-health care providers. Among health care providers, doctors had the highest emotional scores, and fellow nurse and nurses other departments were followed after that. Among visitors in hospital, patients and their family had the higher emotional labor scores than care givers. There was statistically significant difference in the emotional labor, according to the subjects' educational level, age, wages, job position, and working departments. CONCLUSION: Clinical nurses perceived emotional labor not only from the interaction with patients, but also from the interaction with the various other persons concerned such as health care providers, non-health care providers and visitors.
Caregivers ; Health Personnel ; Hospitals, University ; Humans ; Salaries and Fringe Benefits

Background: In Korea, laws for many medical technicians were revised in the Enforcement Decree of the Medical Technicians Act (MTA), which was announced on December 2018, whereas those related to dental hygienists remained unchanged. This study aimed to determine the awareness and opinions of dental hygienists regarding MTA. Methods: Dental hygienist were recruited as participants via convenient sampling in Seoul, Gyeonggi-do, and Chungcheong-do; data from 291 self-reported questionnaire responses were used for the final analysis. We investigated the participants’ general characteristics, awareness, and request for the amendment of the MTA. The compliance with the work scope specified in the MTA and level of demand for revision of the MTA were analyzed by independent t-test and one-way analysis of variance. For all statistical analyses, the significance level was set at 0.05. Results: For the 2018 MTA revision, 99 (34.02%) knew that dental treatment assistance and surgery assistance were excluded, whereas 192 (65.98%) did not know. The item “The current medical technician law must be revised” was scored 4.13±0.80 out of 5 points, and significant differences were identified according to the education level, career, and position (p＜0.05). The item “It is necessary to institutionalize the expanded work scope beyond the work scope of dental hygienists specified in the MTA” was scored 4.02±1.04 out of 5 points, and significant differences were identified according to age (p＜0.05). Conclusion The participants wanted the MTA to be revised to reflect the real-world work performed by dental hygienists in the dental clinical field. The legal system must ensure the legal protection of the work area of the dental hygienist as an oral health professional, and recognize the legal work scope of the dental hygienist.

No abstract available.
Bone Marrow* ; Waldenstrom Macroglobulinemia*

PURPOSE: Bony resection of the proximal medial tibia, an alternative technique for soft tissue balancing in total knee arthroplasty (TKA), was compared to the conventional medial soft tissue release technique. MATERIALS AND METHODS: From June 2005 to June 2007, we performed 40 TKA in 27 patients with > or =10degrees tibio-femoral varus deformity. The conventional, medial soft tissue release technique was applied in 20 cases and bony resection of proximal medial tibia in the other 20 cases (vertical osteotomy group). Total operation time, knee range of motion (ROM), hospital for special surgery (HSS) scores, and tibio-femoral medial-lateral gap ratio in 0degrees, 90degrees, and 130degrees flexion at postoperative 6 months were compared between the groups. RESULTS: The total operation time was shorter in the vertical osteotomy group. Tibio-femoral medial-lateral gap ratio in 130degrees flexion was closer to 1 in the vertical osteotomy group (p=0.000). There was no significant difference in the ROM, HSS score, or tibio-femoral medial-lateral gap ratio in 0degrees and 90degrees flexion at postoperative 6 months. CONCLUSIONS: In severe varus knees, bony resection of proximal medial tibia can be considered as an alternative technique, in order to decrease total operation time and to obtain medial-lateral, soft-tissue balance in deep flexion.
Arthroplasty ; Congenital Abnormalities ; Humans ; Knee ; Ligaments ; Osteotomy ; Range of Motion, Articular ; Tibia

The relationship between thyroid disease and rheumatic disorders has been the subject of considerable debate. Autoimmune thyroid disease (ATD), such as Graves' disease, Hashimoto's thyroiditis are occasionally associated with systemic lupus erythematosus, Sj gren syndrome, and rheumatoid arthritis (RA). Although the exact mechanism of this association is not well documented, genetic factor, immunologic defect, hormonal factor, drugs for treatment might contribute for it. There is a question of whether common factors are involved in the etiology of RA and thyroid disease, and controversy over whether an association between RA and ATD exists. The possibility of coexistent thyroid disease in patients with RA should be carefully considered throughout the course of follow-up. Recently, we experienced a 39-year-old male patient with RA during treatment of Graves' disease, and present the case here with brief review of literatures.
Adult ; Arthritis ; Arthritis, Rheumatoid* ; Autoimmunity ; Follow-Up Studies ; Graves Disease* ; Humans ; Lupus Erythematosus, Systemic ; Male ; Thyroid Diseases ; Thyroid Gland ; Thyroiditis

PURPOSE: The purpose of this study was to examine the possible direction of critical care nursing research in the future by analyzing the trends of recent Korean studies.METHOD: Using a database search, we selected 263 articles on critical care nursing that were published in Korean journals between 2008 and 2017. Then, we conducted an integrative review of the contents of the selected articles and analyzed the English abstracts using the relevant packages and functions of the R program.RESULTS: The number of studies concerning critical care nursing has increased over the 10-year period, and the specific topic of each study has diversified according to the time at which it was conducted. In terms of quality, the majority of the research was published in high-level academic journals. The key words regularly studied over the past decade were: knowledge, delirium, education, restraint, stress, and infection. Studies related to vancomycin-resistant enterococci infection, compliance, and standards have decreased, while studies related to death, communication, and safety have increased.CONCLUSION: Randomized controlled trials and protocol research for evidence-based critical care need to be conducted, as does research on family involvement. The key word analysis of unstructured text used in this study is a relatively new method; it is suggested that this method be applied to various critical care nursing research and develop it methodologically.
Compliance ; Critical Care Nursing ; Critical Care ; Data Mining ; Delirium ; Education ; Humans ; Korea ; Methods ; Nursing Research ; Nursing ; Vancomycin-Resistant Enterococci

Purpose: The purpose of this study was to describe changes in positive psychological capital, organizational commitment and burnout according to work periods for new nurses. Methods: A longitudinal study was done using surveys of 91 nurses from a tertiary hospital located in Seoul, South Korea. Data were collected from these newly graduated nurses during the period from July 2018 to September 2019, three times (2 months, 4 months and 6 months after starting to work). Results: Hope of positive psychological capital decreased after 6 months of work (F=7.11, p=.001) and organizational commitment decreased after 4 months of work (F=15.30, p<.001). Factors influencing participants' burnout included the optimism of positive psychological capital and continuance of organizational commitment. These factors explained 51.3% of the variance in burnout (F=48.47, p<.001). Conclusion Organizational support for new nurses is urgently needed. It is necessary to develop programs to strengthen the positive psychological capital of newly graduated nurses to reduce their burnout and to help their job adaptation.

Moyamoya disease (MMD) is a cerebrovascular disorder characterized by bilateral stenosis or occlusion of the terminal portions of the internal carotid arteries. MMD is also accompanied by typical net-like collateral vessels in the basal ganglia. Although the etiology of MMD remains unknown, hereditary, immunogenic, and hemodynamic factors have been implicated as underlying mechanisms of MMD. Here, the authors report on one patient with a rare combination of Graves' disease-associated thyrotoxicosis, myasthenia gravis, and MMD, where cerebrovascular ischemic events occurred during a thyrotoxic state.
Basal Ganglia ; Brain Ischemia ; Carotid Artery, Internal ; Cerebrovascular Disorders ; Constriction, Pathologic ; Graves Disease ; Hemodynamics ; Humans ; Moyamoya Disease ; Myasthenia Gravis ; Thyrotoxicosis

BACKGROUND: Elevated serum levels of growth differentiation factor-15 (GDF-15) are associated with type 2 diabetes. Therefore, the effects of atorvastatin on metabolic parameters and GDF-15 levels in patients with type 2 diabetes and dyslipidemia were evaluated. METHODS: In this prospective randomized trial from February 2013 to March 2014, 50 consecutive type 2 diabetic patients with a low density lipoprotein cholesterol (LDL-C) levels > or =100 mg/dL were enrolled. The patients were divided into two groups based on the amount of atorvastatin prescribed, 10 mg/day (n=23) or 40 mg/day (n=27). The effect of atorvastatin on metabolic parameters, including lipid profiles and GDF-15 levels, at baseline and after 8 weeks of treatment were compared. RESULTS: The baseline metabolic parameters and GDF-15 levels were not significantly different between the two groups. After 8 weeks of treatment, the total cholesterol (TC) and LDL-C levels were significantly decreased in both groups. The mean changes in TC and LDL-C levels were more significant in the 40 mg atorvastatin group. The GDF-15 level was decreased in the 10 mg atorvastatin group, from 1,460.6+/-874.8 to 1,451.0+/-770.8 pg/mL, and was increased in the 40 mg atorvastatin group, from 1,271.6+/-801.0 to 1,341.4+/-855.2 pg/mL. However, the change in the GDF-15 level was not statistically significant in the 10 or 40 mg atorvastatin group (P=0.665 and P=0.745, respectively). CONCLUSION: The GDF-15 levels were not significantly changed after an 8-week treatment with atorvastatin in type 2 diabetic patients.
Cholesterol ; Cholesterol, LDL ; Diabetes Mellitus, Type 2* ; Dyslipidemias* ; Growth Differentiation Factor 15 ; Humans ; Prospective Studies ; Atorvastatin Calcium

PURPOSE: To assess the diagnostic value of Mn-DPDP for the detection of focal hepatic tumors on MR images and to determine the optimal pulse sequence to maximize its effect. MATERIALS AND METHODS: Twenty-three patients with 32 focal hepatic tumors were examined by means of 1.5-T MRI. Before and after the intravenous administration of Mn-DPDP, five pulse sequences were used to obtain T1-weighted images: two-dimensional fast low-angle shot (2D FLASH) with/without fat saturation (FS), spinecho (SE), and three-dimensional fast low angle shot reconstruction (3D FLASH) with/without FS. Quantitative assessment involved determination of the signal-to-noise ratio (SNR) of the liver and the tumor, the percentage signal enhancement ratio (PSER) of the liver, and tumor-to-liver contrast to noise ratio (CNR). Pulse sequences were also evaluated subjectively for tumor conspicuity, delineation, and image artifact. In addition, two experienced radiologists compared tumor detection rates between precontrast and postcontrast images. RESULTS: Mn-DPDP had a marked effect on liver SNR and absolute CNR at all pulse sequences (p<0.05). On postcontrast images, PSER and absolute CNR of the liver were highest at 3D FLASH and 2D FLASH FS, respectively, and significantly higher at GRE than at SE (p<0.05). On postcontrast images, the CNR of focal nodular hyperplasia and hepatocellular carcinoma was positive, while that of hemangioma, metastasis and cholangiocarcinoma was negative. The postcontrast CNR of all tumors except hepatocellular carcinoma increased more than 100%. Qualitative studies showed that tumor conspicuity increased significantly at all sequences except SE, and delineation increased significantly except at SE and postcontrast 2D GRE FS. After Mn-DPDP, GRE more effectively demonstrated tumor conspicuity and image artifact than did SE, and GRE other than 2D FLASH FS was also better than SE for tumor dilineation (p<0.05). The sensitivity of all postcontrast images increased and the tumor detection rate at GRE was significantly higher than at SE. CONCLUSION: Mn-DPDP favorably affects tumor-to-liver contrast, and may be useful in the imaging of focal hepatic tumors, more so with 2D or 3D FLASH pulse sequences than with SE.
Administration, Intravenous ; Artifacts ; Carcinoma, Hepatocellular ; Cholangiocarcinoma ; Dyphylline ; Focal Nodular Hyperplasia ; Hemangioma ; Humans ; Liver ; Magnetic Resonance Imaging* ; Manganese ; Neoplasm Metastasis ; Noise ; Signal-To-Noise Ratio