PURPOSE: The purpose of this study was to describe role conflict and job satisfaction of Neurosurgery Clinical Nurse Specialist(NCNS) and to identify associated factors. METHOD: The target populations was 77 NCNSs from 30 general hospitals. Data were collected with self-administered questionnaires and analyzed using t-test and ANOVA. RESULTS: The overall mean scores of role conflict and job satisfaction were 3.60(+/-0.54) and 3.04(+/-0.46) respectively. Significant variables affecting role conflict were the working period as NCNS, the number of colleague NCNSs in working hospital, and assignment of prescription rights. The significant variable affecting job satisfaction was assignment of prescription rights. There was no statistically significant correlation between job and role conflict. CONCLUSION: The variable effecting both role conflict and job satisfaction was the extent of prescription rights. In order to improve the quality of patient care and to protect Neurosurgery Nurse Clinical Specialist, the enactment of law on prescription practice is needed.
Health Services Needs and Demand ; Hospitals, General ; Human Rights ; Humans ; Job Satisfaction* ; Jurisprudence ; Neurosurgery* ; Nurse Clinicians* ; Patient Care ; Prescriptions ; Specialization ; Surveys and Questionnaires

No abstract available.
Inhalation* ; Lung Injury* ; Lung*

Congenital lobar emphysema has the clinical features of an air block' syndrome with- out the evidence of pulmonary infection or intrabronchial foreign body. The hyperinflated lung causes a compression of uninvolved lobes creating respiratory distress, cyanosis within the first weeks of life. We experienced a case of congenital lobar emphysema diagnosed incidentally by chest reontgenogram in an infant with frequent upper respiratory infection within a few weeks of life. Chest X-ray revealed extensive emphysematous changes in the left upper lobe, shifting of heart and medistinum to the right and compression of the right lung. Respiratory distress, cyanosis and chest wall retraction ensued and left upper lobe Lobectomy was performed successfully.
Cyanosis ; Emphysema* ; Foreign Bodies ; Heart ; Humans ; Infant ; Lung ; Thoracic Wall ; Thorax

PURPOSE: A survey was done on knowledge and attitude toward CPR and provision of CPR education to nurses on general wards. METHOD: A survey of 280 nurses on general wards in four university hospitals with 700 beds or more in the city of Pusan was done. The data were collected from September 10, to September 22, 2007. RESULTS: The mean score for knowledge of Basic Life Support was 12.71 (mean converted to 100: 63). About 76% of the nurses believed that they had a responsibility to perform CPR, but 53.3% of the nurses were not confident to perform CPR. About 94% of the nurses had received education on CPR but 32.3% of those took it 6 to 12 years ago. About 41% of the nurses spent 3-4 hours for the education and 73.2% of those took simulation education. CONCLUSION: Although most of the nurses had received CPR education, they were not knowledgeable or confident. Therefore, better CPR education programs including up-dated knowledge are needed. More reinforced education should be offered every six months or on a yearly basis in order to enhance lasting efficiency.
Cardiopulmonary Resuscitation ; Hospitals, University ; Patients' Rooms

No abstract available.

Patients with hyperthyroidism can develop left ventricular dysfunction and heart failure, but severe pulmonary hypertension association with hyperthyroidism is rarely seen. Herein, we describe the case of a 27-year-old female who presented with abdominal distension accompanied by pulmonary arterial hypertension and Graves' disease. Her pulmonary arterial hypertension was improved by treating the hyperthyroidism and pulmonary artery hypertension. Additionally, the patient's symptoms of right-side heart failure improved after pulmonary arterial pressure was reduced. Hyperthyroidism should be regarded as a reversible cause of associated pulmonary arterial hypertension.
Adult ; Arterial Pressure ; Ascites ; Female ; Graves Disease ; Heart Failure ; Humans ; Hypertension ; Hypertension, Pulmonary ; Hyperthyroidism ; Pulmonary Artery ; Ventricular Dysfunction, Left

OBJECTIVE: To evaluate the maternal and fetal outcomes after transvaginal selective fetal reduction(SFR) in multifetal pregnancy. MATERIALS AND METHODS: Transvaginal SFR using fetal intracardiac puncture with KCl injection and aspiration of amniotic fluid was performed in 58 multifetal pregnancies achieved after assisted reproductive technology(ART). After transvaginal SFR, 55 twin and 3 singleton pregnancies were evaluated and analyzed retrospectively with the medical records of mothers and babies. RESULTS: Of 58 cases, abortion within 4 weeks after SFR occurred in 1 case(1.7%). Miscarriage of all fetuses occurred in 8 cases(13.8%) from 4 weeks after SFR until 24 weeks of gestation. Perinatal death occurred in 8 newborns from 5 mothers due to extreme prematurity in 7 cases and anencephaly in 1 case. Take-home baby rate, that is, discharge with at least 1 healthy baby, was 77.6%(45/58). CONCLUSION: Transvaginal SFR is an acceptable and effective management option in the cases of excessive multifetal pregnancy after infertility treatment. The ultimate successful outcomes of reduced multifetal pregnancy may be enhanced by more extensive experience with SFR.
Abortion, Spontaneous ; Amniotic Fluid ; Anencephaly ; Female ; Fetus ; Humans ; Infant, Newborn ; Infertility ; Medical Records ; Mothers ; Pregnancy ; Pregnancy Outcome* ; Pregnancy Reduction, Multifetal* ; Pregnancy* ; Punctures ; Retrospective Studies

Management of chronic wound has been a great problem to many surgeons because the wound is usually associated with an underlying disease of the patient. Without accurate diagnosis and treatment of the disease, the wound can not be healed. Systemic vasculitis is a rare systemic disease which causes inflammation and obstruction of the vessels. This autoimmune disease involves multiple organs and may inflict skin wound spontaneously without traumas. It would improve or aggravate the wound in proportion to the activities of the disease. Our experience is a case of 28-year-old female who has had chronic ulcers on her right foot, especially on the great toe for 1 year. Although she had several operations of sympathectomy, debridement and artificial dermal graft, her wound was not improved. She has been diagnosed as systemic vasculitis during the evaluation for histopathology and cause of fever and pancytopenia. After medical treatments, she had the operation of adipofascial turnover flap coverage and skin graft, and the wound was improved without any complication or relapse. The diagnosis and treatment of the underlying disease should be ahead of the management of chronic wound.
Adult ; Autoimmune Diseases ; Debridement ; Diagnosis ; Female ; Fever ; Foot ; Humans ; Immunoglobulins ; Inflammation ; Pancytopenia ; Recurrence ; Skin ; Sympathectomy ; Systemic Vasculitis* ; Toes ; Transplants ; Ulcer ; Wounds and Injuries*

Primary ovarian ectopic pregnancy has remained a rare event. It is difficult preoperatively to diagnose and differentiate ovarian pregnancy from hemorrhagic ovarian cyst and tubal ectopic pregnancy. However, improved diagnosis of acute hemoperitoneum of ovarian origin may reveal a higher incidence than reported earlier. The diagnostic criteria were described in 1878 by Spiegelberg, which comprise that the pregnancy is in the ovary and does not involve the tube. Ovarian pregnancy occurs within the ovary and on the corpus luteum, usually with rupture of the ovary and a massive hemoperitoneum. We report a relatively intact primary ovarian pregnancy with a brief review of the literatures.
Corpus Luteum ; Diagnosis ; Female ; Hemoperitoneum ; Incidence ; Ovarian Cysts ; Ovary ; Pregnancy ; Pregnancy, Ectopic* ; Rupture

PURPOSE: This study was performed to compare the efficacy and adverse reactions of low dose intravenous immunoglobulin (IVIG) with those of high dose IVIG in childhood acute idiopathic thrombocytopenic purpura (ITP). METHODS: Thirty children who were diagnosed as acute ITP in Seoul National University Children's Hospital from June 2000 to Jan. 2003 were enrolled. IVIG (I.V Globulin S, Green Cross Ltd, Korea) were administered 1 g/kg in low dose group (n=15) and 2 g/kg (400 mg/kg for 5 day or 1 g/kg for 2 days) in high dose group (n=15). RESULTS: 1) The median age of the patients was 4 years (range, 2 months to 13 years) and male to female ratio was 0.5: 1. The median duration of follow-up was 6 months (range, 1 month to 2 year 9 months). 2) The median days to recover the platelet count over 50, 000/muL, 100, 000/muL, 150, 000/muL after IVIG administration were 4, 6, and 7 days in the low dose group and 3, 5, and 5 days in the high dose group. After the initial response, the platelet count decreased below 50, 000/muL in 5 out of 13 patients in the low dose group (the median day, 13) and 6 out of 13 patients in the high dose group (the median day, 21). In 25 patients who were followed over 6 months, 3 out of 13 patients (23.1%) in the low dose group and 4 out of 12 patients (33.3%) in the high dose group were remained as chronic ITP. 3) Adverse reactions related to IVIG administration were observed in 4 out of 15 patients (26.7%) in the low dose group and 5 out of 15 patients (33.3%) in the high dose group. They were fever, headache, nausea and vomiting, and most of them were subsided spontaneously. CONCLUSION: There were no significant difference in the response rate, the relapse rate and the incidence of adverse reactions between the low dose group and the high dose group in childhood acute ITP after IVIG therapy. In respect of the cost and the duration of hospitalization, the low dose IVIG might have some advantages.
Child ; Female ; Fever ; Follow-Up Studies ; Headache ; Hospitalization ; Humans ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Incidence ; Male ; Nausea ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic ; Recurrence ; Seoul ; Vomiting