The purpose of this study is to investigate the effect of job stress and social support on the organizational effectiveness of hospital employees and to examine the role of social support in the experience of job stress among the employees. Previous studies have yielded mixed results regarding the role of social support. Some studies provide supporting evidence for the buffering effect of social support, while others do not. Still others report findings about reverse buffering effects. These inconsistent findings are, in part, accounted for by methodological problems such as poor measurement, small sample size, and the existence of high multicollinearity. To examine more rigorously the role of social support in relation to the negative effects of job stress, this study was carefully designed to overcome methodolgical shortcomings found in the past research. In addition, unlike the previous studies, which were concerned mostly with health-related variables as consequences of job stress, in this study, three work-related variables (job satisfaction, organizational commitment, and intent to stay) which had close relationships with organizational effectiveness were examined as output variables. The sample used in this study consisted of 353 employees from a university hospital in the suburbs of seoul. Data were collected with self-administered questionnaires and analyzed using canonical analysis and hierarchical regression analysis. The results of this study indicate that; (l) job stress has negative main effects on job satisfaction, organizational commitment, and intent to stay; (2) social support has positive main effects on the same three output variables, (3) social support does not moderate the harmful effects of job stress on the three outcome variables, and (4) the three-way interaction effects of (social support * job stress * gender) and of (social support * job stress * education) are not supported The implications of these findings for the management of human resources are discussed.
Humans ; Job Satisfaction ; Surveys and Questionnaires ; Sample Size ; Seoul

The provision of adequate soft tissue cover for a complex hand and forearm wound-dirty, infected and exposed bone can be a challenging problem. Conventionally, a distant flap or free flap have been used, but these have been associated with several problems such as joint stiffness, risk of microsurgical procedures, negligible donor site morbidity, prolonged operation time and economic restriction. As well, fasciocutaneous flap has been the limitation of infection control. In these situations, the ipsilateral muscle flap provides the ideal cover with its rich blood supply and single operative field. Previously described by Lendrum(1980), by Lae et al.(1981), and later by McGeorge(1991), the brachioradilis muscle is the most superficial muscle on the radial side of the forearm. Its flap is based on the radial artery and venae comitantes. From August 1996 to October 1997, we performed branchioradialis muscle flap in seven patients. Despite the sacrifice of the major hand artery, brachioradialis muscle flap has many advantages including the reliability of flap survival, easy dissection, early mobilization and absence of functional and aesthetic problems at the donor site. It is a relatively simple and rapid method for resurfacing soft tissue defect in the hand and forearm. We obtained satisfactory and reliable results.
Arteries ; Early Ambulation ; Forearm* ; Free Tissue Flaps ; Hand* ; Humans ; Infection Control ; Joints ; Radial Artery ; Tissue Donors

No abstract available.
Oropharynx* ; Tongue*

No abstract available.
Urokinase-Type Plasminogen Activator*

Respiratory syncytial virus (RSV) and Influenza virus are the most common pathogen for causing severe upper respiratory infection in all age groups. A multiplex reverse transcription polymerase chain reaction (RT-PCR) has been developed to detect and subtype influenza A (H3N2 and H1N1), B virus and RSV simultaneously in one tube reaction. Amplification with primers derived from conserved sequences within the nucleocapsid for RSV and hemagglutinin subunit for Influenza A (H3N2 and H1N1) and B viruses yielded a 384 bp, a 300 bp, a 236 bp and a 151 bp, respectively. Assay specificity was confirmed by pulse field gel electrophoresis and autosequencing method. Assay sensitivity was 3 PFU/ml of RSV, 22 PFU/ml, 45 PFU/ml of Influenza type A (H3N2 and H1N1) and 6.6 PFU/ml of Influenza B virus by plaque assay. A rapid and sensitive detection method of a one-tube with multiplex RT-PCR capable of identifying more than one viral template as well as synchronizing reverse transcription and PCR had the potential to produce considerable savings of time and cost effectiveness in the diagnostic laboratory.
Conserved Sequence ; Cost-Benefit Analysis ; Electrophoresis ; Hemagglutinins ; Herpesvirus 1, Cercopithecine ; Humans* ; Income ; Influenza B virus ; Influenza, Human* ; Nucleocapsid ; Orthomyxoviridae* ; Polymerase Chain Reaction* ; Respiratory Syncytial Virus, Human* ; Respiratory Syncytial Viruses ; Reverse Transcription* ; Sensitivity and Specificity

PURPOSES: We analysed the five-year outcomes and associated complications of transscleral diode laser photocoagulation (TSDLP), used to treat acute proliferative retinopathy of prematurity (ROP), to evaluate the efficacy and safety of this therapy. METHODS: We performed a retrospective analysis of the records of 163 eyes of 82 infants with acute ROP, who were treated with TSDLP by a single surgeon. Follow-up periods ranged from 15 to 278 weeks. RESULTS: The outcome was favorable in 158 eyes (96.9%) and unfavorable in 5 eyes (3.1%) of the 163 eyes that were treated. Vitreous hemorrhage was found to be an indicator of poor prognosis. Of the complications noted, symblepharon was observed in three eyes, hyphema was observed in four eyes, and a complicated cataract was observed in one eye. CONCLUSIONS: The results suggest that TSDLP is a safe and effective in the treatment of ROP. Vitreous hemorrhage should be regarded as a sign of poor prognosis.
Cataract ; Follow-Up Studies ; Humans ; Hyphema ; Infant ; Lasers, Semiconductor* ; Light Coagulation* ; Prognosis ; Retinopathy of Prematurity* ; Retrospective Studies ; Vitreous Hemorrhage

We performed 70 proceudres of transarterial chemoembolization (TAE) through extrahepatic collateral vessels (n=27) or parasitic feeders (n=18) in 45 hepatocellular carcinoma patients. The collaterals developed after interruption of the hapatic artery due to repeated TAE(n=17), surgical ligation(n=7) and primary celiac occlusion (n=3). Radiologic findings suggesting the existence of parasitic or collateral supply for hepatocellular carcinoma were 1) a focal defect of Lipiodol retention on CT or plain film after TAE via the hepatic artery, 2) dilated and tortuous vessels around the mass on angiography, 3) persistent elevation of the level of serum alpha fetoprotein or continuous clinical symptoms in spite of sufficient devascularization of the tumor via the hepatic artery, and 4) radiological findings of direct invasion into adjacent organ. The sites of the catheter placement were the inferior phrenic artery (n=19), omental branches (n=16), periportal collaterals (n=6), pancreaticodenal arcade (n=3), gastroduodenal artery (n=3), internal mammary artery (n=2), intercostal artery (n=2), lateral thoracic artery (n=1), bronchial artery(n=1), and colic branches(n=1). Masses feeded by the inferior phrenic and chest wall collaterals were usually located at the dome area of the liver, and the omental and gastroduodenal collaterals developed in the masses located at the inferior tip of the liver. After TAE via collateral vessels, 37 patients underwent follow-up study. In 18 cases(48%), the tumor favorably responded to TAE. Specific complications of collateral TAE were epigastric soreness (n=10), severe shoulder pain (n=4), and embolization of the spinal artery during embolization through the intercostal artey (n=1). In conclusion, various extrahepatic collaterals are important alternative or additional routes for effective chemoembolization in patients with advanced hepatoma, and early recognition of the parasitic supply and the effort to perform TAE via collaterals is very important for effective management of the patients with the hepatoma.
alpha-Fetoproteins ; Angiography ; Arteries ; Carcinoma, Hepatocellular* ; Catheters ; Colic ; Ethiodized Oil ; Follow-Up Studies ; Hepatic Artery ; Humans ; Liver ; Mammary Arteries ; Shoulder Pain ; Thoracic Arteries ; Thoracic Wall

PURPOSE: To investigate the levels of radiation exposure of an operator which may be influenced by the wearing an apron, type of procedure, duration of fluoroscopy and operator's skill during various interventional procedures MATERIALS AND METHODS: Radiation doses were measured both inside and outside the apron(0.5mm lead equivalent) of the operator by a film badge monitoring method and the duration of fluoroscopy was measured in 96 procedures prospectively. The procedures were 30 transcatheter arterial embolizations (TAE), 25 percutaneous transhepatic biliary drainages (PTBD), 16 stone removals (SR), 15 percutaneous needle aspirations (PCNA) and 10 percutaneous nephrostomies(PCN). To assess the difference of exposure by the operator's skill, the procedures of TAE and PTBD were done separately by groups of staffs and residents. RESULTS: Average protective effect of the apron was 72.8%. Average radiation exposure(unit:micro Sv/procedure) was 23.3 in PTBD by residents, 10.0 in PTBD by staffs, 10.0 in SR, 8.7 in TAE by residents, 7.3 in TAE by staffs, 9.0 in PCN and 6.0 in PCNA. Average radiation exposure of residents were 1.9 times greater than those of staffs. CONCLUSION: Radiation exposure was not proportionally related to the duration of fiuoroscopy, but influenced by wearing an apron, various types o[procedure and operator's skills.
Aspirations (Psychology) ; Film Dosimetry ; Fluoroscopy ; Needles ; Pregnenolone Carbonitrile ; Proliferating Cell Nuclear Antigen ; Prospective Studies

As a new interventional procedure for the control of variceal bleeding, a portosystemic shunt can be established with the installment of metallic stent through the transjugular approach. In order to evaluate the clinical usefulness of the procedure, transjugular intrahepatic portosystemic chunt procedure were performed in 5 patients with variceal bleeding due to liver cirrhosis. The metallic stents were mainly a self expandable Wallstent(Schneider, Switzerland). An 8 to 10 mm shunt was formed by the insertion of the stent and balloon dilatation after puncture of the proximal portal vein from the right or middle hepatic vein. The patency of the shunt was proven by portography after the procedure. The portal pressure measured in 3 patients before and after the procedure improved with decrease from 31 mmHg to 25 mmHg. The procedure failed in 1 patient due to preexsisting portal vein thrombosis. During the follow-up period from 1 month to 4 months, shunts were patent in all 4 patients. However, hepatic encephalopathy occured in one patient one week following the procedure. Though the follow-up period was not long enough for full evaluation. We found the transjugular intrahepatic portosystemic shunt was a safe and effective procedure for the control of variceal bleeding by lowering the portal pressure. For the appropriate application for this procedure, the optimal size of the shunt and optimal degree of the resultant decompression are yet to be determined in the future.
Decompression ; Dilatation ; Esophageal and Gastric Varices ; Follow-Up Studies ; Hepatic Encephalopathy ; Hepatic Veins ; Humans ; Liver Cirrhosis ; Portal Pressure ; Portal Vein ; Portasystemic Shunt, Surgical ; Portography ; Punctures ; Stents ; Venous Thrombosis

Gastric tuberculosis is a rare disease and the diagnoeis of gastric tuberculosis is based on either positive histological or bacteriological study. We experienced a case of gastric tuberculosis with pleural effuaion in 59 year-old woman, diagnosed by the histological study of the endoscopic biopsy specimen. Follow up endoscopic finding revealed marked improvement of gastric lesion after anti-tubercadoua medication. We reported the case with review of literature.
Biopsy ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Rare Diseases ; Tuberculosis*