PURPOSE: This study was done to identify the effect of nursing organizational culture on empowerment as perceived by new clinical nurses. METHODS: For the objective a sample of 175 new nurses from secondary/tertiary hospitals having not less than 250 beds located in B city was selected to complete a questionnaire. The collected data were analyzed using descriptive statistics, t-test, One-way ANOVA, Scheffe's test, Pearson correlation coefficients and simultaneous multiple regression with the SPSS 14.0 software program. RESULTS: As for nursing organizational culture as perceived by the respondent, relation-oriented culture had the highest average score (3.60+/-.63) out of a possible 5 points followed by hierarch-oriented culture, innovation-oriented culture and task-oriented culture with 3.45+/-.30, 3.19+/-.53 and 3.05+/-.46, respectively. The respondents' level of perceived empowerment was 3.06+/-.41. The factors influencing empowerment according to nursing organizational culture were innovation-oriented and relation-oriented culture in that order. These 2 variables were statistically significant predictors and explained 48.6% of the variance in empowerment. CONCLUSIONS: The results of this study indicate that emphasis should be given to nursing organizational culture strengthened by innovationoriented and relation-oriented culture, rather than task-oriented and hierarch-oriented culture, in order to foster harmonious empowerment among nurses at all levels.
Surveys and Questionnaires ; Organizational Culture ; Power (Psychology)

BACKGROUND: This study aimed to compare analgesic efficacy and occurance of motor block and other side effects of a 48 hr postoperative continuous epidural infusion of 0.125% bupivacaine or ropivacaine with morphine. METHODS: Forty patients undergoing a Cesarean section were allocated randomly into two groups. Both groups received an epidural injection of 2.0% lidocaine 18 20 ml and 0.5% bupivacaine 2 5 ml with fentanyl 50microgram 20 minutes before surgical incision and received 2 mg of epidural morphine by bolus 40 minutes after surgical incision. For post-operative pain control, a continuous epidural infusion was started using a two day infusor containing 6 mg of morphine in 100 ml of 0.125% bupivacaine (Group 1, n = 20) or 100 ml of 0.125% ropivacaine (Group 2, n = 20). Visual analog scale (VAS) for pain during rest and movement, sensory change and motor blockade were assessed for 48 hrs. after surgery. RESULTS: There were no significant differences in VAS for pain during rest and movement. The incidences of side effect were similar in both groups. CONCLUSIONS: Using 0.125% bupivacaine with morphine via the epidural route provided similar pain relief and side effects as 0.125% ropivacaine with morphine.
Bupivacaine* ; Cesarean Section ; Female ; Fentanyl ; Humans ; Incidence ; Infusion Pumps ; Injections, Epidural ; Lidocaine ; Morphine* ; Pregnancy ; Visual Analog Scale

PURPOSE: To evaluate the ultrasonographic and CT findings of hepatosplenic tuberculosis MATERIALS AND METHODS: We retrospectively reviewed the ultrasonographic and CT findings of confirmed hepatosplenic tuberculosis in 12patients. Six were men and six were women ; their average age was 41, and most were in their twenties. Lesions ofthe liver and spleen, as well as associated findings such as abdominal tuberculosis and other organ involvement oftuberculosis were analyzed. RESULTS: There were three cases of hepatic tuberculosis, seven of splenictuberculosis, and two of hepatosplenic involvement of tuberculosis. On the basis of the ultrasonographic and CTfindings, hepatosplenic tuberculosis was classified as one of two patterns : miliary or micronodular, ormacronodular. The micronodular type was more common (9/12 cases) being characterized by innumerable micronodules,and with easy coalescence in the liver and spleen in five of the nine cases. The macronodular type of low densitymass was noted in the other three patients. Splenomegaly was noted in 12 cases and hepatomegaly in ten. Pulmonarytuberculosis-including the miliary type(n=5)-was noted in eight patients. Associated abdominal tuberculosis suchas lymphadenopathy with central low density and peripheral rim enhancement (n=6), tuberculous peritonitis(n=3),highly attenuated ascites(n=6), adrenal tuberculosis(n=1), renal tuberculosis(n=1), ovarian abscess(n=1), psoasabscess(n=1), and systemic tuberculosis such as central nervous system tuberculoma(n=2), cervicallymphadenopathy(n=4) and tuberculous spondylitis(n=1) were noted. CONCLUSION: Ultrasonography and CT werevaluable in the detection and diagnosis of hepatosplenic tuberculosis
Central Nervous System ; Diagnosis ; Female ; Hepatomegaly ; Humans ; Liver ; Lymphatic Diseases ; Male ; Retrospective Studies ; Spleen ; Splenomegaly ; Tuberculosis* ; Tuberculosis, Gastrointestinal ; Tuberculosis, Hepatic ; Ultrasonography

Purpose: This study aimed to identify the relationship among musculoskeletal problems, sleep problems, and self-rated mental health of home-care workers. Methods: Data were collected from 447 home-care workers spanning three occupation types: life supporters for the elderly, home-visit caregivers, and life supporters for the disabled. Musculoskeletal problems, sleep problems, and self-rated mental health were assessed using structured questionnaires. Factors affecting self-rated mental health were analyzed using multiple regression.SPSS was used to test the mediating effects of sleep problems on musculoskeletal problems and self-rated mental health. Results: Among the general characteristics, the variables that showed significant differences in musculoskeletal problems were monthly income level, caring-related career duration, weekly working hours, and occupation type; and the variable that showed significant differences in self-rated mental health was occupation type. Among the occupation types, supporters for the disabled had the most musculoskeletal problems and the lowest self-rated mental health. Musculoskeletal problems among home-care workers had a direct negative effect on self-rated mental health and indirect negative effects on sleep problems. Conclusion Measures are needed to reduce the differences in working conditions and health status among the occupation types of home-care workers. Considering the relevance between the health issues of home-care workers, the development of a carefully designed health promotion strategy is required.

PURPOSE: We reviewed the treatment results for the patients with locally recurrent rectal carcinoma. The object was to evaluate the treatment outcome and to identify the prognostic factors influencing the survival. METHODS AND MATERIALS: Twenty-eight patients with locally recurrent rectal carcinoma treated principally with external-beam radiation therapy between 1982 to 1996 in the Department of Radiation Oncology at Paik and Hanyang Hospital were reviewed retrospectively. Of these, 17 patients had initially abdominoperineal resection, 9 had low anterior resection, and 2 had local excision. No patients had received adjuvant radiation therapy for the primary disease. There were 14 men and 14 women whose ages ranged from 31 to 72 years (median age:54.5). Median time from initial surgery to the start of radiation therapy for local recurrence was 11 months (4~47 months). Radiation therapy was given with total doses ranging from 27 to 64.8 Gy (median=51.2 Gy). RESULTS: The median survival was 16.7 months. The 2-year and 5-year survival rates were 20.1%, 4.1% respectively. Upon multivariate analysis, overall survival was positively correlated with duration of intervals from initial surgery to local recurrence (P=0.039). Relief of pelvic symptoms was achieved in 17 of 28 patients (60.7%). Pain and bleeding responded in 40% and 100% of patients, respectively. CONCLUSION: Patients with locally recurrent rectal carcinoma treated with radiotherapy have benefited symptomatically, and might have increased survivals with a small chance of cure. But, patient were rarely cured (median survival:10 months, 5-year survival:less than 5%). Overall survival was positively correlated with long intervals from initial surgery to local recurrence. Future efforts should be directed to the use of effective therapy for patients with locally recurrent rectal carcinoma and adjuvant therapy for patients with rectal cancer to reduce the incidence of pelvic recurrence.
Female ; Hemorrhage ; Humans ; Incidence ; Male ; Multivariate Analysis ; Radiation Oncology ; Radiotherapy* ; Rectal Neoplasms ; Recurrence ; Retrospective Studies ; Survival Rate ; Treatment Outcome

PURPOSE: The organ procurement organization (OPO) and transplant coordinator were established in Chonnam National University Hospital in 1993 to promote organ donation and to manage organ procurement. At the same time, the first protocol and planning transplant was performed simultaneously. We performed this study to know the predicting factors and survival rate of cadaveric kidney transplantation. METHODS: First cadaveric donor kidney transplantation was performed at May 1993 in Chonnam National University Hospital. Thereafter 52 cases of cadaveric kidney transplantation were performed using 28 cadaver donors till December 1999. The most frequent cause of brain death was head injury by traffic accident. Male to female donor ratio was 1.8 : 1. 52 recipients (29 males, 23 females), aged 20 to 65 years (median age 36 years) were the subjects of this study. The immunosuppressive regimens consisted of cyclosporin, mycophenolate mofetil, and prednisone. Acute rejection was treated with three consecutive bolus of 1.0 gram methylprednisolone or 5 mg/day for 10 days of OKT3. Three HLA mismatchs were 7 cases (13.5%) and six mismatches were 6 cases (11.5%). There were 2 cases of multiple renal arteries. RESULTS: There was no primary non functioning graft. In the first 7 post operative days, urine amount less than 4,000 mL per day was noted in 29 patients (55.8%) and serum creatinine over 1.5mg/dL was noted in 13 patients (25%). No significant proteinuria and hematuria was observed. Postoperative medical complications were occured in 12 patients (23.1%) and minor surgical complications in 3 patients (5.8 %). One patient was performed reoperation because of urinary leakage. CMV infections were noted in 15 patients (28.8%). Acute rejection episodes were 17 cases (32.7%). We lost 4 grafts within 1 year. The major cause of graft loss was patient death. Recipient age was significant risk variable for graft and patient survival in multivariate analysis (P=0.012). one and five year graft survival rates were 92.15%. CONCLUSION: To achive better results, continued attention should be paid to the cadaveric donor organ procurement.
Accidents, Traffic ; Brain Death ; Cadaver* ; Craniocerebral Trauma ; Creatinine ; Cyclosporine ; Female ; Graft Survival ; Hematuria ; Humans ; Jeollanam-do ; Kidney Transplantation* ; Kidney* ; Male ; Methylprednisolone ; Multivariate Analysis ; Muromonab-CD3 ; Prednisone ; Proteinuria ; Renal Artery ; Reoperation ; Risk Factors ; Survival Rate ; Tissue and Organ Procurement ; Tissue Donors* ; Transplants

Spontaneous renal subcapsular hematoma is a rare, life-threatening condition that is usually caused by benign and malignant renal tumors, vascular diseases, inflammatory disorders, blood dyscrasias, and seldom suspected clinically. The characteristic clinical features are abdominal pain, a mass in the flank and signs of internal bleeding. Severe preeclampsia is also a major contributing factor of the renal hematoma. Because renal function is decreased in spontaneous renal subcapsular hematoma, physicians should be aware of the clinical symptoms and signs, appropriate investigation and management may be life-saving. This case of spontaneous renal subcapsular hematoma and acute renal failure complicated by severe preeclampsia, which occurred after delivery and was treated conservatively.
Abdominal Pain ; Acute Kidney Injury* ; Cesarean Section* ; Female ; Hematoma* ; Hemorrhage ; Pre-Eclampsia* ; Pregnancy ; Vascular Diseases

We have recently managed a case of syringomyelia associated with Chiari I Type malformation. The syrinx was found at C2 level to T10 level. And the patient complained left forearm pain and paresthesia in left shoulder, arm with segmental dissociated sensory loss. The cranio-vertebral decompression(suboccipital craniectomy, cervical laminectomy) and the shunting procedures were performed. Postoperative course was not uneven, the clinical and neurological improvement was observed. M.R.I. permitted rapid, exact diagnosis including localization of syrinx and information of associated anomaly.
Arm ; Diagnosis ; Forearm ; Humans ; Paresthesia ; Shoulder ; Syringomyelia*

PURPOSE: To evaluate the radiologic features of fibrothecoma of the ovary, which is a rare solid tumor originating from the ovarian sex cord-stroma. MATERIALS AND METHODS: The radiologic findings of 29 patients with pathologically-proven fibrothecoma of the ovary were retrospectively evaluated for bilaterality, size, shape, margin, echogenecity, CT attenuation, signal intensity on magnetic resonance imaging, calcification, and amount of ascites. RESULTS: All fibrothecomas were unilateral, and had well defined margins. The diameter of the mass was 4-18(mean, 9.6)cms. Elghteen of 29 tumors were round or oval with a smooth margin, and eleven were lobulated. The internal architecture of the tumor was purely solid in 21 patients, predominantly solid in six, and pre-dominantly cystic in two. A broad spectrum of sonographic features was apparent, including a homogeneously hypoechoic mass (with posterior shadowing in four cases, and without posterior shadowing in ten), a homoge-neously hyperechoic mass in seven cases, an anechoic mass with septatations in two, and a mixed echoic mass in six. On precontrast CT scans, the mass was isodense to the uterine myometrium in eight of nine cases, while on postcontrast scans the lesion was slightly hypodense to the myometrium in seven cases and isodense in one. On T1-weighted MR images, nine of ten cases showed a relatively homogeneous low signal intensity, while on T2-weighted images, signal intensity was homogeneously low in two patients and predominantly low with focal high intensity in seven of the other eight. On gadolinium-enhanced T1-weighted images, most tu-mors showed slight heterogeneous enhancement. Calcifications were present in two cases, and in two others there was a large amount of ascites. CONCLUSION: The characteristic finding of ovarian fibrothecomas is a well-defined, oval or lobulated homoge-neously solid mass, which on CT scans enhances less than uterine myometrium and demonstrates a predomi-nantly low signal intensity on both T1- and T2-weighted images. However, a predominantly solid mass with cystic components or a predominantly cystic mass may also be presented.
Animals ; Ascites ; Female ; Humans ; Magnetic Resonance Imaging ; Mice ; Myometrium ; Ovary ; Retrospective Studies ; Shadowing (Histology) ; Tomography, X-Ray Computed ; Ultrasonography

We studied retrospectively on clinical assessment of treatment in myasthenic patients who visited on our department regularly since 1985. They were divided as a group based on therapeutic modalities such as a thymectomy, steroid therapy. Combined therapy(steroid and thymectomy), plasma exchange. And whole body irradiation. We evluated clinical effectiveness of these therapeutic modalities and come up with following conclusions. Alltherapeutic modalities showed effectiveness. In steroid therapy, thymectomy and the combined therapy. W needed at least 6-24 months for clinical improvement. In thymectomy, rognosis was depend on the number of germinal centers. In whole body irradiation. Effectiveness was shown at 5h week and continued to 6th to 12th months. We also noted that symptomatic improvement was correlated with decreased lymphocyte counts. The effect of plasma exchange was rapid but only short duration.
Germinal Center ; Humans ; Lymphocyte Count ; Myasthenia Gravis* ; Plasma Exchange ; Retrospective Studies ; Thymectomy ; Whole-Body Irradiation