PURPOSE: This study was to verify the effects of spiritual care module education programs by applying it to nurses. METHOD: The study employed a non-equivalent control group pretest-posttest design in a quasi-experimental basis. Subjects were 93 nurses (46 in an experimental group and 47 in a control group) with more than two years clinic experience, attending a bachelor program of K University, in I city, Korea. The program consists of courses with 2.5 hours per week for seven weeks. RESULT: Scores of spiritual needs and spiritual nursing competence increased significantly in the experimental group. The score of spirituality and spiritual well-being also increased in the experimental group, but not significantly. CONCLUSION: The spiritual care module education program was considered to be an effective nursing intervention education course. Nurses educated with this program seemed to perform better nursing interventions for subjects facing difficulties or confusion by helping them restore and cope with those problems by themselves. Therefore, it is recommended that spiritual care module education should be settled as a regular course of nursing college with consideration to the corrections and supplements mentioned in this study.
Education* ; Korea ; Mental Competency ; Nursing ; Spirituality

Desmoplastic trichilemmoma is a rare variant of trichilemmoma characterized by typical features of trichilemmoma with abundant desmoplastic stroma. We report herein a 54-year-old man presented with 2-year history of a solitary bean sized verrucous nodule on the occipital scalp. Histologically, the tumor showed a well-defined lobular growth extending from the epidermis into the dermis with abundant central desmoplastic stroma. Epithelial lobules at the margins of the neoplasm showed the typical features of trichilemmoma composed of glycogen-rich clear cells and peripheral palisading columnar cells. In contrast, at the center the cells assume a more random pattern of cords and strands traversed by the hyaline stroma, mimicking invasive carcinoma. It was diagnosed desmoplastic trichilemmoma by the distinctive histologic appearance and totally excised.
Dermis ; Epidermis ; Humans ; Hyalin ; Middle Aged ; Scalp

No abstract available.
Humans* ; Ovarian Neoplasms* ; Tamoxifen*

BACKGROUND: There has been no clinical study of skin problems of the amputee in Korea and at Veterans Hospital, we have experienced so many skin problems of amputees. OBJECTIVE: We tried to observe skin problems of amputees and to relate them with sweating, poor hygiene, poor fit of socket, mechanical trauma, and duration of wearing prosthesis. METHODS: 125 extremity amputees who visited the Seoul Veterans Hospital during the period of 5 years from Jan. 1994 to Dec. 1998 were analyzed clinically. RESULTS: The study results are summarized as follows: 1. Among the 125 extremity amputees, the number of male patients was 124(99.2%) and that of female patients was 1(0.8%). The age distribution showed a peak incidence in the 7th decade(30.4%), followed by the 5th decade(28.8%), 6th decade(24.8%), and the mean age was 56.4 years. 2. The most common type of amputation was below the knee amputation(74 cases), the second was above the knee amputation(37 cases). 3. The duration of wearing prosthesis was above 20 years in 88 patients(70.4%), 16-20 years in 15(12%), 11-15 years in 11(8.8%), and 1-5 years in 6(4.8%). 4. The skin problems of the amputees were superficial fungal infection, chronic ulcer, intertriginous dermatitis, callus, corn, verrucous hyperplasia, verruca which were 63 cases(50.4%), 26 cases(20.80%), 17 cases(13.6%), 6 cases(4.8%), 5 cases(4%), 5 cases(4%), 3 cases(2.4%) respectively. 5. The predisposing factors of the dermatoses were mechanical trauma(84 cases) which acted as a cause of the chronic ulcer, intertriginous dermatitis, corn and callus, sweating(80 cases) and poor hygiene(11 cases) as those of superficial fungal infection, and poor fitting(6 cases) as that of verrucous hyperplasia. CONCLUSION: Superficial fungal infection and chronic ulcer were the main skin problems of the amputee. The longer the duration of wearing prosthesis, the more skin problems developed. The mechanical trauma and sweating were the major predisposing factors of stump dermatoses, especially of chronic ulcer and superficial fungal infection. Amputation is only the beginning of a long period of rehabilitation, and the treatment of the patient and the affected skin goes on for the rest of the patient's life. This clinical study suggests that the dermatologist must be concerned of the care of amputee's skin problems.
Age Distribution ; Amputation ; Amputees* ; Bony Callus ; Causality ; Dermatitis ; Extremities ; Female ; Hospitals, Veterans ; Humans ; Hygiene ; Hyperplasia ; Incidence ; Knee ; Korea ; Male ; Prostheses and Implants ; Rehabilitation ; Seoul ; Skin Diseases ; Skin* ; Sweat ; Sweating ; Ulcer ; Warts ; Zea mays

OBJECTIVE: To determine the effect of the addition of Vit. D3 (1,25-Dihydroxychole calciferol D3) to the conventional postmenopausal hormone replacement therapy on bone mineral density(BMD) DESIGN: A 2-year retrospective , randomized study Setting : Department of Obstetrics and Gynecology of Catholic university hospital Patients : 388 postmenopausal women were recruited and divided into 5 groups according to treatment regimen; A: conjugated estrogens only treated group(n=146), B : conjugated estrogens and progesterone treated group(n=103), C : conjugated estrogens and Vit.D3 treated group (n=36), D : conjugated estrogens, progesterone and Vit.D3 treated group (n=41), E : control group (n=60). METHODS: The bone mineral density of the lumbar spines and femoral neck were determined by dual-energy X-ray absorptiometry(DEXA) every 2 years. STATISTICS: The difference between before and after treatment was determined by paired t-test. The comparison among the groups were determined by one way ANOVA test and student's t-test. RESULTS: The addition of progesterone to estrogen showed insignificant increase in the lumbar and femoral neck BMD. The addition of Vit. D3 compared with conventional hormone replacement therapy insignificantly influened bone density in women with initially normal BMD, but definitely increase in women with initially osteopenic and osteoporotic BMD of femoral neck rather than lumar spine(p<0.05). CONCLUSIONS: The use of Vit. D3 combined with postmenopausal estrogen replacement effects the increase of BMD in low bone density than normal bone density, especially femoral neck.
Bone Density* ; Estrogen Replacement Therapy ; Estrogens ; Estrogens, Conjugated (USP) ; Female ; Femur Neck ; Gynecology ; Hormone Replacement Therapy ; Humans ; Obstetrics ; Progesterone ; Retrospective Studies ; Spine ; Vitamins*

OBJECTIVE: To evaluate the effects of isoflavone intake on estrogen deprivated symptoms in surgically menopaused women. METHODS: Premenopausal women who took total hysterectomy with both adnexectomy were randomized into three groups. One group took conjugated equine estrogen 0.625 mg daily for 12 weeks after surgery, the second group took isoflavone 100 mg #3 daily for 12 weeks after surgery, and the third group took no medication for controlled group. Questionnaires about the acute menopausal symptoms, incontinence score, blood lipid profile, bone turnover marker were checked before and 12 weeks after surgery. RESULTS: Kupperman's index and insentience score were showed less increased rate than control group. Total cholesterol and triglyceride were increased in all groups and HDL cholesterol was increased in estrogen and isoflavone groups. Osteocalcin was decreased in estrogen and isoflavone groups, ICTP was decreased in estrogen group, and increased in the other groups. CONCLUSION: Isoflavone was effective to acute postmenopusal symptoms, urogenital atrophy and bone turnover.
Atrophy ; Cholesterol ; Cholesterol, HDL ; Estrogens ; Female ; Humans ; Hysterectomy ; Osteocalcin ; Surveys and Questionnaire ; Triglycerides

PURPOSE: In this research, a definition of overcrowding in emergency department (ED) was proposed, and the actual state of overcrowding in ED was measured by surveys and extensive statistical analysis of data using objective variables. METHODS: The emergency physicians (EP) of 10 arbitrarily selected hospitals were questioned about the definition and cause of overcrowding in ED. The hospitals were divided into two groups (high-feeling and low-feeling) in accordance with the survey results. Admission/discharge records of the patients including arrival/departure date and time, were also collected for the duration of 4 weeks with consideration of seasonal variations, from March 2002 to March 2003. Four parameters, the bed ratio (BR), the provider ratio (PR), the acuity ratio (AR), and the demand value (DV), which were used for the evaluation of overcrowding, were calculated for each hospital. A statistical analysis was carried out to see whether any difference existed in the BR, the PR, the AR and the DV between weekends and weekdays. Also, a similar statistical method was used to analyze the differences between the high-feeling group and the low feeling group. RESULTS: In the survey, 83 physicians were asked to answer the questions. The most preferred answers (>70%) for the definition of overcrowding were "saturation of the beds in the ED for more than 6 hours a day."For the cause of overcrowding, the popular answers were "delay in the consultation and the disposition decision" (74.7%), "use of the ED by non-urgent patients"(74.7%), and "lack of inhospital beds"(65.1%). Among the 10 hospitals, 5 hospitals were categorized the high-feeling group, and the rest fell into the low-feeling group. The average BR and AR were higher in high-feeling group than those of low-feeling group (p<0.01, p<0.01). However, average PR of low-feeling group was higher than that of high-feeling group (p<0.01). Average DV did not exhibit any difference between the two groups (p=0.31). CONCLUSION: The definition of overcrowding in the ED should include not only the lack of beds in the ED but also patient's acuity and the lack of providers. Certain aspects of overcrowding are clearly different between the high-feeling and the low-feeling groups.
Crowding ; Emergencies* ; Emergency Medicine ; Emergency Service, Hospital* ; Humans ; Seasons ; Tertiary Care Centers*

BACKGROUND: With the development of bioengineering techniques for noninvasive characterization of skin pathophysiology, the induction of irritant dermatitis by surfactants has been extensively studied. OBJECTIVE: We performed this study to compare the skin responses in terms of transepidermal water loss (TEWL) and erythema induced by benzalkonium chloride (BAC), a well-known non-corrosive irritant, in comparison with sodium lauryl sulfate (SLS), a representative corrosive irritant. METHOD: We applied 0.1, 0.2, 0.5, 1, and 2% solutions of BAC and SLS on volar forearm skin for 24 hours using a large Finn chamber with filter paper disc on 19 normal healthy subjects. TEWL and erythema index (E-index) were measured prior to testing, then at 30 minutes, one day, two days, three days, one week, and two weeks after the removal of the patches. RESULTS: TEWL values of BAC and SLS patch areas increased with concentration. However, BAC induced a significantly lower TEWL increase than SLS did at the corresponding concentrations. TEWL induced by BAC was highest at 30 minutes after the removal of the patch, whereas TEWL induced by SLS was highest at one day. TEWL values had recovered with the passage of time to baseline values at 2 weeks after removal of the patch at lower concentrations (0.1, 0.2, 0.5%) of SLS, but still showed significantly high TEWL values at 1% and 2% concentration SLS patch areas. TEWL values of BAC in 0.1, 0.2, 0.5 and 1% concentrations had recovered to the baseline values at 2 weeks after the removal of the patch, but not in 2% concentration BAC patch areas. E-indices of BAC and SLS increased with concentration in a similar reaction pattern. E-index induced by BAC was highest at 30 minutes after the removal of the patch, and E-index induced by SLS was highest at 30 minutes or 1 day after the removal of the patch. E-index of each concentration, except 2%, had recovered with the passage of time to baseline values on both BAC and SLS patch areas at 2 weeks, but E-indices of both 2% BAC and SLS did not recover at 2 weeks. CONCLUSION: Benzalkonium chloride showed much less damage to the skin barrier function compared to the corresponding concentration of SLS, whilst they showed a similar degree of erythema. Skin barrier function affected by the corrosive irritant SLS would need a more prolonged recovery time than skin barrier disruption by non-corrosive irritant BAC.
Benzalkonium Compounds* ; Bioengineering ; Dermatitis, Irritant ; Erythema ; Forearm ; Skin* ; Sodium Dodecyl Sulfate* ; Sodium* ; Surface-Active Agents

OBJECTIVE: This study aimed to examine whether educational stressors and relational stressors are associated with burnout in medical students and to test social support as a moderator between stressors and burnout. METHODS: A total of 263 medical students attending Gyeongsang National University composed the study sample. A standardized questionnaire was used to investigate educational and relational stressors, three dimensions of burnout, and social support of medical students. RESULTS: The findings showed that overall burnout is very high among Korean medical students, with 9.9% totally burned out. Educational and relational stressors were significantly associated with the risk of burnout in medical students after controlling for socio-demographics and health behaviors. Social support moderated educational and relational stressors on personal accomplishment, but did not moderate stressors on emotional exhaustion and depersonalization. CONCLUSION: Burnout level is substantially high among Korean medical students. Educational and relational stressors are significantly associated with burnout risk in Korean medical students. Social support had moderated educational and relational stressors on personal accomplishment. The results suggest that more social support for medical students is needed to buffer stressors on and burnout.
Burns ; Depersonalization ; Health Behavior ; Humans ; Students, Medical*

No abstract available.
Endoderm* ; Endodermal Sinus Tumor*