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

PURPOSE: The present study assessed the diagnostic significance of digital infrared thermal imaging (DITI) in determining the inflammatory state of patients with nonspecific orbital inflammation. METHODS: The present study included 11 patients diagnosed with nonspecific orbital inflammation between December 2009 and March 2011 and who were followed-up for more than 6 months. All patients were all diagnosed based on computed tomography (CT), magnetic resonance image (MRI) and tissue biopsy. The grade of eyelid swelling was classified as 5 and severe compared with the temperature of location. The temperature of the upper eyelid, caruncle, medial conjunctiva, lateral conjunctiva, lower eyelid, cornea and lateral orbit were measured with DITI. RESULTS: When comparing the normal eye with the diseased eye in patients with nonspecific orbital inflammation, the temperature of the upper eyelid and cornea were statistically significant (p = 0.003, p = 0.038, respectively, Mann-Whitney test). The correlation between the grade of eyelid swelling and the temperature of location was most highly related in the temperature of the upper eyelid (Spearman's correlation coefficient, r = 0.55, p = 0.008) and cornea (Spearman's correlation coefficient, r = 0.45, p = 0.037). CONCLUSIONS: DITI may aid in evaluating the inflammatory state of nonspecific orbital inflammation. In particular, the temperature of the upper eyelid and cornea can be very useful indicator. Future studies, including larger study population are necessary in order to confirm DITI as a diagnostic tool which can assess the results of medical treatment by comparing temperature before and after treatment.
Biopsy ; Conjunctiva ; Cornea ; Eye ; Eyelids ; Humans ; Inflammation ; Magnetic Resonance Spectroscopy ; Orbit

PURPOSE: The lateralization of cognitive functions in crossed aphasia in dextrals (CAD) has been explored and compared mainly with cases of aphasia with left hemisphere damage. However, comparing the neuropsychological aspects of CAD and aphasia after right brain damage in left-handers (ARL) could potentially provide more insights into the effect of a shift in the laterality of handedness or language on other cognitive organization. Thus, this case study compared two cases of CAD and one case of ARL. MATERIALS AND METHODS: The following neuropsychological measures were obtained from three aphasic patients with right brain damage (two cases of CAD and one case of ARL); language, oral and limb praxis, and nonverbal cognitive functions (visuospatial neglect and visuospatial construction). RESULTS: All three patients showed impaired visuoconstructional abilities, whereas each patient showed a different level of performances for oral and limb praxis, and visuospatial neglect. CONCLUSION: Based on the analysis of these three aphasic patients' performances, we highlighted the lateralization of language, handedness, oral and limb praxis, visuospatial neglect and visuospatial constructive ability in aphasic patients with right brain damage.
Aged ; Aphasia/*etiology/*physiopathology ; Brain Injuries/*complications ; Cognition/*physiology ; Female ; Functional Laterality/*physiology ; Humans ; Male ; Middle Aged

Background: This study examined the effect of housing affordability on the incidence of depression in Korean adults aged 45 years and above usingthe Korean Longitudinal Study of Aging (KLoSA). Methods: Five-year data from wave two to wave six of the KLoSA provided by the Ministry of Labor were used. In the first year of KLoSA in 2006, amongthose who did not suffer from depression, ones who had one or more of the survey data from the second to the sixth were analyzed. generalizedestimating equation (GEE) regression analysis and chi-square test were used as data processing methods. Results: According to the 2010 data, out of 4,606 people, 3,558 (77.3%) were in the affordable group, and 1,048 (22.8%) in the experienced overburdengroup. The result of regression analysis with controlling general characteristics as covariates showed that the experienced overburden group had ahigher incidence of depression than the affordable group. A longitudinal analysis of housing affordability and incidence of depression for five yearsrevealed no significant difference in the incidence of depression. However, the overall share of overburden experience increased steadily. Acomparison of the incidence of depression between the affordable and experienced overburden groups in each year showed that the incidence ofdepression was statistically higher each year. Conclusion Housing affordability increases the incidence of depression, and eight years of data indicated depression in the experienced overburdengroup to be higher than the affordable group.

Relapsing polychondritis (RP) is a rare inflammatory disorder of unknown etiology, causing recurrent inflammatory and degenerative reactions involving the cartilaginous structures throughout the body. Generally, RP is known as multiorgan disease presented as auricular chondritis, arthritis, nasal chondritis, ocular inflammation, audiovestibular damage and respiratory tract inflammation. Major airway involvement occurs in more than 50% of the patient and has been reported to be the primary cause of death. Rarely, it may be presented with only respiratory symptoms without typical clinical manifestation of RP. We experienced a 64-year-old male patient with RP involving diffuse airway tract without other characteristic clinical manifestation and present here with a review of literatures.
Arthritis ; Cause of Death ; Humans ; Inflammation ; Male ; Middle Aged ; Polychondritis, Relapsing* ; Respiratory System

BACKGROUND: Osteoradionecrosis is the most dreadful complication after head and neck irradiation. Orocutaneous fistula makes patients difficult to eat food. Fibular free flap is the choice of the flap for mandibular reconstruction. Osteocutaneous flap can reconstruct both hard and soft tissues simultaneously. This study was to investigate the success rate and results of the free fibular flap for osteoradionecrosis of the mandible and which side of the flap should be harvested for better reconstruction. METHODS: A total of eight consecutive patients who underwent fibula reconstruction due to jaw necrosis from March 2008 to December 2015 were included in this study. Patients were classified according to stages, primary sites, radiation dose, survival, and quality of life. RESULTS: Five male and three female patients underwent operation. The mean age of the patients was 60.1 years old. Two male patients died of recurred disease of oral squamous cell carcinoma. The mean dose of radiation was 70.5 Gy. All fibular free flaps were survived. Five patients could eat normal diet after operation; however, three patients could eat only soft diet due to loss of teeth. Five patients reported no change of speech after operation, two reported worse speech ability, and one patient reported improved speech after operation. The ipsilateral side of the fibular flap was used when intraoral soft tissue defect with proximal side of the vascular pedicle is required. The contralateral side of the fibular flap was used when extraoral skin defect with proximal side of the vascular pedicle is required. CONCLUSIONS: Osteonecrosis of the jaw is hard to treat because of poor healing process and lack of vascularity. Free fibular flap is the choice of the surgery for jaw bone reconstruction and soft tissue fistula repair. The design and selection of the right or left fibular is dependent on the available vascular pedicle and soft tissue defect sites.
Carcinoma, Squamous Cell ; Diet ; Female ; Fibula* ; Fistula ; Free Tissue Flaps ; Head ; Humans ; Jaw* ; Male ; Mandible* ; Mandibular Reconstruction ; Mouth Neoplasms ; Neck ; Necrosis ; Osteonecrosis ; Osteoradionecrosis* ; Patient Selection* ; Quality of Life ; Skin ; Tooth

Pericardial tamponade can lead to significant hemodynamic derangement including cardiac arrest. We experienced a case of pericardial tamponade in a patient with end-stage renal disease. Hemodynamic changes occurred by unexpectedly aggravated pericardial effusion during surgery for iatrogenic hemothorax. We quickly administered a large amount of fluids and blood products for massive bleeding and fluid deficit due to hemothorax. Pericardial effusion was worsened by massive fluid resuscitation, and thereby resulted in pericardial tamponade. Hemodynamic parameters improved just after pericardiocentesis, and the patient was transferred to the intensive care unit.
Cardiac Tamponade ; Heart Arrest ; Hemodynamics ; Hemorrhage ; Hemothorax ; Humans ; Intensive Care Units ; Kidney Failure, Chronic ; Pericardial Effusion ; Pericardiocentesis ; Resuscitation

BACKGROUND: Implant surgery has become popular with the advance of surgical techniques such as sinus lifting, guided bone regeneration, and block bone graft. However, there were no data about the frequency of bone graft during implant surgery. The purpose of this study was to report the frequency and types of bone graft depending on dental implant patients' profile to complement the database regarding implant surgery. METHODS: The implant operations had been performed from January 2006 to October 2014. The upper and lower jaws were divided into six sextants. A total of 792 sextants were included in this study. Patient information including sex, age, sites, bone graft, and types of bone were investigated. RESULTS: A total of 1512 implants had been placed. Male and female sextants were 421 and 371, respectively (M:F = 1:0.88). Average age was 54.3 (ranging from 20 to 88 years old). Implants were placed in the posterior maxilla (322 sextants, 40.7 %), posterior mandible (286 sextants, 36.1 %), anterior maxilla (127 sextants, 16.1 %), and anterior mandible (57 sextants, 7.2 %). Bone graft was performed in 50.3 % of the sextants. Among the bone grafted sites, sinus lifting with lateral approach (22.1 %) and guided bone regeneration (22.7 %) were performed most frequently. CONCLUSIONS: Bone graft in implant surgery was necessary to augment defects. More than half of the sextants needed bone graft for implant installation.
Bone Regeneration ; Complement System Proteins ; Dental Implants ; Female ; Humans ; Jaw ; Lifting ; Male ; Mandible ; Maxilla ; Transplants*

Background: The angular stable locking system (ASLS) was developed to provide additional stability to the distal interlocking screw of the intramedullary (IM) nail. Effects of ASLS on the treatment of femoral diaphyseal fractures in the elderly remain unknown. The aim of this study was to compare radiological outcomes of IM nailing using ASLS screws to IM nails with conventional interlocking screws in elderly patients with femoral shaft fractures. Methods: A multicenter retrospective review of 129 patients (average age, 73.5 years; 98 women and 31 men) aged 65 years or older who underwent IM nail fixation for femoral diaphyseal fractures (AO/Orthopaedic Trauma Association [OTA] classification 32) was conducted. Demographic information of patients, fracture site (subtrochanteric or shaft), fracture type (traumatic or atypical), and AO/OTA fracture classification were investigated. Reduction status was evaluated by postoperative plain radiography. Presence of union and time to union were evaluated through serial plain radiograph follow-up. Reoperation due to nonunion or implant failure was also evaluated. Results: ASLS was used in 65 patients (50.3%). A total of 118 patients (91.5%) achieved union without additional surgery and the mean union time was 31.8 ± 13.0 weeks. In terms of reduction status, angulation was greater in the group using ASLS. There were no statistically significant differences of union rate, time to union, and reoperation rate according to the use of ASLS (p > 0.05). There was no difference in the outcomes according to the use of ASLS even when the analysis was divided in terms of fracture site or fracture type (p > 0.05). In further subgroup analysis, only the traumatic subtrochanteric area group showed statistically significantly shorter time to union when ASLS was used (p = 0.038). Conclusions In geriatric patients with femoral diaphyseal fractures, the use of ASLS was not considered to have a significant effect on fracture healing. Fracture healing seemed to be more affected by surgical techniques such as minimizing the gap and fracture characteristics such as atypical femoral fractures, rather than implants.

OBJECTIVE: To develop Korean version of Frenchay Aphasia Screening Test (K-FAST) and to standardize K-FAST in normal adult population in Korea. METHOD: The 'river scene' of stimulus set in original version of FAST was adapted for K-FAST. English version of the test instructions and scoring methods were translated into Korean and reverse-translation was performed by English- Korean bilinguals. The test structures and language domains (comprehension, expression, reading, and writing) were unchanged and possible maximum score was 30 points. We standardized K-FAST in 240 normal adult populations (male 102, female 138) whose ages were above 44. Basic personal information was collected through an interview and we performed Edinburgh handedness inventory (EHI), K- MMSE and K-FAST. Subjects who had history of brain disease, cognitive communicative disorders, or K-MMSE scores less than 2 percentile of same age group were excluded. K-FAST scores were analyzed according to the age and education groups. RESULTS: Mean EHI, K-MMSE, and K-FAST scores in total subjects were 9.4+/-1.2, 25.9+/-2.8, 25.4+/-3.3 points, respectively. Post-hoc analysis of K-FAST scores according to age groups classified into 3 age groups, 45~64, 65~74, and > or =74 years and education groups into 0, 1~9, > or =10 years of total education. K-FAST scores decreased significantly as increase of age (r=-0.441, p=0.000) and decrease of total years of education (r=0.580, p=0.000). CONCLUSION: Newly adapted K-FAST can be used for screening of aphasia in Korea and the standardized data according to age and education levels may provide useful reference values for interpretation of the results of K-FAST.
Adult ; Aphasia ; Brain Diseases ; Communication Disorders ; Female ; Functional Laterality ; Humans ; Korea ; Mass Screening ; Reference Values ; Research Design ; Stroke