PURPOSE: This study examined the factors influencing posttraumatic and conflict management styles for nursing performance in intensive care units (ICUs).METHOD: In this study, 250 nurses from eight general hospitals in three cities participated. Structured self-report questionnaires were used to collect data on posttraumatic, conflict management styles, and nursing performance. Finally, the data were analyzed by SAS 9.3 program.RESULTS: The mean of total sum scores was 31.29, and the high risk of posttraumatic symptoms was 61.2%. It was noted that nursing performance is significantly correlated with collaboration, compromise, accommodation styles, and intrusion. Collaboration styles (β=0.39, p < .001) and hyperarousal (β=−0.22, p=.050), ICU experience below 1 year (β=−0.21, p=.027) and that of 5–10 years (β=−0.19, p=.049), and compromise style (β=0.16, p=.049) were found to be the factors influencing nursing performance with 35.9% explanatory power value of regression model.CONCLUSION: The results of the study reveal that conflict management styles, hyperarousal, and ICU experience are factors predicting the successful performance of ICUs. These findings emphasize the need of developing interventions to reduce stress symptoms and conflicts in ICUs.
Cooperative Behavior ; Critical Care ; Hospitals, General ; Intensive Care Units ; Methods ; Nursing ; Work Performance

No abstract available.

Iatrogenic fracture is not popular and might be recognized as a malpractice. Surgical error related to iatrogenic fracture which has occurred after an operation can be detected only by a surgeon. Stress riser fracture is another form of iatrogenic fracture also known as a Young's modulus fracture. As the majority of surgical related stress riser fractures can be preventive, the accurate prevalence is not known. The majority of fractures occurred in the weight bearing bones such as femur and tibia. The subtrochanter area is the most stress concentrated area in the human body, thus it is a common area for occurrence of stress riser iatrogenic fractures. We experienced 2 cases of stress riser iatrogenic fractures, which are related to technical errors, thus we report cases with literature review.
Elastic Modulus ; Femur ; Hip Fractures* ; Human Body ; Iatrogenic Disease ; Malpractice ; Medical Errors* ; Prevalence ; Tibia ; Weight-Bearing

Rotavirus is a major cause of acute gastroenteritis in infancy and early childhood. Febrile seizures can occur in some infants or children exhibiting rotavirus gastroenteritis even without severe electrolyte imbalance, hypoglycemia or abnormal cerebrospinal fluid (CSF) finding. Some reports have described diffuse cerebral white matter lesions on diffusion-weighted magnetic resonance imaging (DW-MRI) in neonates with rotavirus-associated encephalopathy/encephalitis. In this case study, a 6-day-old male neonate was transferred to the neonatal intensive care unit after having a fever lasting 24 hours. On hospital day two, the seventh day after birth, the patient had his first seizure. The pregnancy and delivery were uneventful. The lab findings, including a CSF exam, were normal, but a stool antigen test for rotavirus was positive. The electroencephalography (EEG) examination result was normal. DW-MRI of the brain showed bilateral symmetric diffusion restriction in the genu and splenium of the corpus callosum as well as in the periventricular white matter of the lateral ventricles. Multiple scattered high-signal-intensit foci on T1-weighted image/fluid-attenuated inversion recovery (FLAIR) in the periventricular white matter were also seen bilaterally. He is now 17 months old, and there were no further seizures. He did not show any neurodevelopmental delay. This case reports that the patient with rotavirus-induced neonatal seizures with cerebral white matter abnormalities on magnetic resonance imaging (MRI) showed a normal neurodevelopmental outcome on the follow-up.
Brain ; Cerebrospinal Fluid ; Child ; Corpus Callosum ; Diffusion ; Diffusion Magnetic Resonance Imaging ; Electroencephalography ; Fever ; Follow-Up Studies ; Gastroenteritis ; Humans ; Hypoglycemia ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Lateral Ventricles ; Magnetic Resonance Imaging* ; Male ; Parturition ; Pregnancy ; Rotavirus ; Seizures* ; Seizures, Febrile ; White Matter*

PURPOSE: Dendropanax morifera Leveille(DML) exhibits diverse biological and pharmacological activities, including anti-oxidative effect, anti-cancer activity, hepatoprotection, immunological stimulation, and bone regeneration. As part of the identification for novel functions of DML, we investigated the therapeutic effects of DML on diabetes induced by streptozotocine (STZ) treatment. METHODS: First, the four extracts including the water extract of leaf (DLW), the ethanol extract of leaf (DLE), the water extract of stem (DSW), and the ethanol extract of stem (DSE) were collected from the leaf and stem of DML using a hot water and ethanol solvent. Alterations in body weight, glucose concentration, insulin level, and pancreatic islet structure were investigated in diabetic mice after treatment with extracts of DML for 2 weeks. RESULTS: Among four extracts, the highest level of total polyphenols and total flavonoids was detected in DLW, while the lowest level of these was measured in DSE. The radical scavenging activity was also higher in DLW than in the other three extracts at the concentration of 25-100 microg/mL, although this activity was maintained at a constant level in all groups at the concentration of 500 microg/mL. Based on the results of anti-oxidant activity, DLW and DLE were selected for examination of anti-diabetic effects in a diabetes model. Body weight was gradually decreased in all STZ treated groups compared with the No treated group. However, four STZ/DML treated groups maintained a high level of body weight during 7-14 days, while the STZ/vehicle treated group showed a gradual decrease of body weight during the same period. Also, a significant decrease or increase in the concentration of glucose and insulin in the blood of the diabetes model was detected in a subset of groups, although the highest increase was detected in the STZ/DLE-200 treated group. In addition, the histological structure of pancreatic islet was significantly recovered after treatment with DLW and DLE. CONCLUSION: These results suggest that DLW and DLE may contribute to attenuation of clinical symptoms of diabetes as well as prevent the destruction of pancreatic beta-cells in STZ-induced diabetes mice.
Animals ; Body Weight ; Bone Regeneration ; Ethanol* ; Flavonoids ; Glucose ; Immunization ; Insulin ; Islets of Langerhans ; Mice ; Polyphenols ; Streptozocin ; Water

BACKGROUND: Although ablative fractional resurfacing is known to be effective against photoaging and acne scars, studies on its efficacy, safety and changes in the skin characteristics of Asians are limited. OBJECTIVE: The aim of this study is to assess the efficacy and safety of carbon dioxide fractional laser (CO2FL) in Koreans treated for wrinkles and acne scars, and to define the changes in skin characteristics during recovery period. METHODS: We administered one session of CO2FL on 10 acne scar patients and 14 wrinkles patients with skin types IV and V. The surveillance of efficacy and side effects along with the measurement of biophysical properties was carried out before 1 day, 1 week, 1 month and 3 months after treatment. RESULTS: Using a non-invasive method, skin barrier damage, erythema and bronzing of skin during the recovery period were assessed, and all of the items eventually returned to the pre-treatment level. Skin elasticity was measured in the wrinkle group, and the statistically significant effect was sustained throughout the next three months. The outcome of treatment was found to be better than 'moderate improvement' in both the acne scar and wrinkle groups. Further, there were no serious side effects three months post-procedure. CONCLUSION: CO2 FL is thought to be an effective and safe method for treating moderate to severe acne scars and wrinkles in Asians.
Acne Vulgaris* ; Asian Continental Ancestry Group* ; Carbon Dioxide ; Cicatrix* ; Elasticity ; Erythema ; Humans ; Skin*

PURPOSE: Pseudomembranous colitis (PMC) occurs rarely in children, but its incidences are increasing due to frequent antibiotic use. We investigated the incidence and clinical characteristics of PMC accompanied by bacterial enteritis-like symptoms in children. METHODS: Between November 2003 and July 2007 at the Department of Pediatrics, Dongsan Medical Center, we analyzed the medical records of consecutive patients who received antibiotics in the past 1 month, developed bacterial enteritis-like symptoms, and were diagnosed with PMC based on sigmoidoscopy examination and histological findings. RESULTS: Among 22 patients who underwent sigmoidoscopy and biopsy examinations, 11 (50%) were diagnosed with PMC. These 11 patients were aged 2 months-12 years, among whom 5 patients (45.5%) were less than 1 year old. The clinical symptoms were bloody diarrhea (28.6%), abdominal pain or colic (28.6%), watery or mucoid diarrhea (23.8%), vomiting (9.5%), and fever (9.5%). The antibiotics used were penicillins (55.6%), macrolides (27.8%), cephalosporins (11.1%), and aminoglycosides (5.6%). The period of antibiotic use was 3-14 days. The interval between the initial antibiotic exposure and the onset of symptoms was 5-21 days. The results of stool examination of all patients were negative for Clostridium difficile toxin A. Patient distribution according to the degree of PMC was as follows: grade I, 18.2% (2 cases); grade II, 27.3% (3); grade III, 36.4% (4); and grade IV, 18.2% (2). PMC did not recur in any case. CONCLUSION: PMC is not a rare disease in children. If pediatric patients receiving antibiotics manifest symptoms like bacterial enteritis, PMC should be suspected. Endoscopy and biopsy should be applied as aggressive diagnostic approaches to detect this condition.
Abdominal Pain ; Aged ; Aminoglycosides ; Anti-Bacterial Agents ; Bacterial Toxins ; Biopsy ; Cephalosporins ; Child ; Clostridium difficile ; Colic ; Diarrhea ; Endoscopy ; Enteritis ; Enterocolitis, Pseudomembranous ; Enterotoxins ; Fever ; Humans ; Incidence ; Korea ; Macrolides ; Medical Records ; Pediatrics ; Penicillins ; Rare Diseases ; Sigmoidoscopy ; Vomiting

BACKGROUND: Microalbuminuria and obesity markers are known risk factors for cardiovascular or renal disease. This study aimed to evaluate the prevalence of microalbuminuria according to body mass index (BMI) and abdominal obesity criteria. METHODS: The study subjects included 3,979 individuals aged 30 years or older who did not have diabetes, hypertension, renal failure, or overt proteinuria, from among those who participated in The Korean National Health and Nutrition Examination Survey in 2013, a cross-sectional, nationally representative, stratified survey. Microalbuminuria was defined as a urinary albumin to creatinine ratio of 30 to 300 mg/g. BMI and waist circumference were classified according to the Asia-Pacific criteria. RESULTS: The prevalence of microalbuminuria was found to be 5.1%. In the normoalbuminuria group, 3.4%, 41.7%, 24%, 27.6%, and 3.2% of participants were included in the underweight, normal, overweight, obesity 1, and obesity 2 groups, respectively. These percentages in the microalbuminuria group were 7.1%, 34.5%, 19.2%, 28.6%, and 10.6%, respectively (P<0.001). The waist circumference in men was 21.4% in the normoalbuminuria group and 36.5% in the microalbuminuria group (P=0.004). Logistic regression analyses were performed to evaluate the relationship between the presence of microalbuminuria and BMI or waist circumference groups. The risk of microalbuminuria was significant only in the underweight group (odds ratio, 13.22; 95% confidence interval, 2.55-68.63; P=0.002) after adjusting for confounding factors, abdominal obesity was not significantly associated with microalbuminuria. CONCLUSION: The prevalence of microalbuminuria in a general population in Korea was associated with underweight in men and was not associated with waist circumference in either men or women.
Adult* ; Body Mass Index* ; Creatinine ; Female ; Humans ; Hypertension* ; Hypertension, Renal* ; Korea ; Logistic Models ; Male ; Malnutrition ; Nutrition Surveys* ; Obesity ; Obesity, Abdominal ; Overweight ; Prevalence* ; Proteinuria* ; Risk Factors ; Thinness ; Waist Circumference*

Cowden's syndrome is a harmatomatous polyposis syndrome with characteristic mucocutaneous lesions and among the spectra of clinical disorders that has been attributed to germline mutations in the PTEN gene. Although Cowden's syndrome has rarely been reported, immunologic studies have revealed that patients with this syndrome have humoral and/or cellular immune abnormalities. We recently identified a 21-year-old woman with Cowden's syndrome who was diagnosed with candida esophagitis without a history of diabetes, carcinoma, or steroid therapy. We report the immunologic status of this patient and the relationship with candida esophagitis on the basis of a literature review.
Candida ; Esophagitis ; Female ; Germ-Line Mutation ; Hamartoma Syndrome, Multiple ; Humans ; Young Adult

When a patient represents pain in foot, physician can easily overlook compression neuropathy of peripheral nerve as it is uncommon. Among nerve entrapment syndrome encountered in the foot, selective compression in lateral branch of deep peroneal nerve (DPN) is rare. We report a case of a patient with pain and dysesthesia in dorsolateral foot which turned out as lateral branch of deep peroneal nerve entrapment syndrome caused by talonavicular joint effusion. We would like to share diagnostic work up flow and conservative treatment courses. This case manifests the importance of the deep peroneal nerve and its branches in clinical setting of pain and ankle instability.