PURPOSE: This study conducted to identify the effect of learning organization construction and learning orientation on organizational effectiveness among hospital nurses. Method: Data was collected from convenient sample of 296 nurses who worked for the major hospitals in Seoul, Gyeonggi-do and Gangwoen-do. The self-reported questionnaire was used to assess the general characteristics, the level of the learning organization construction, learning orientation and organizational effectiveness. The data were analyzed using descriptive statistics, pearson's correlation coefficient and multiple regression. Result: The mean score of learning organization construction was 3.61(+/-.32), learning orientation got 3.26(+/-.39), and organizational effectiveness obtained 3.38(+/-.42). The learning organization construction affects of organizational effectiveness by 44.18% and learning orientation by 37.43%. CONCLUSION: This finding indicates that learning organization construction and learning orientation affects the nurses' organizational effectiveness in hospital.
Learning ; Orientation ; Surveys and Questionnaires

No abstract available.
Down Syndrome*

BACKGROUND: Current guidelines of advanced trauma life support recommend open thoracotomy when pericardiocentesis reveals bloody pericardial effusion in patients with blunt chest trauma. However, open thoracotomy may not be always required for treating patients alive until arriving emergency department, because rapid accumulation of the blood into pericardial space results in immediate death at scene. We report our experiences of treating traumatic pericardial effusion, and discuss the therapeutic modality in patients with traumatic pericardial effusion. METHODS: The study consisted of 37 patients(20 males and 17 females with the mean age 42) sustaining traumatic pericardial effusion. The patients were divided according to treatment modality into 3 groups(group I : patients receiving conservative management, group II : patients treated with pericardiocentesis, group III : patients required emergency thoracotomy). We compared clinical presentations, hemodynamic profiles and echocardiographic findings among three groups. RESULTS: Cardiac tamponade was present in 14 of 37 patients. Pericardiocentesis was performed in 13 patients, and open thoracotomy in 4 patients. Pericardiocentesis was curative in 9 patients. Thoracotomy was performed in only 3(24%) of 13 patients required pericardiocentesis. 3(75%) of 4 patients having moderate or severe pericardial effusion from penetrating injury were required open thoracotomy. CONCLUSION: In selected patients who have traumatic pericardial effusion by blunt chest injury, pericardiocentesis may be curative, and thoracotomy may not be inquired as long as bleeding via indwelling pericardial catheter is not sustained after pericardiocentesis.
Advanced Trauma Life Support Care ; Cardiac Tamponade ; Catheters ; Echocardiography ; Emergencies ; Emergency Service, Hospital ; Female ; Hemodynamics ; Hemorrhage ; Humans ; Male ; Pericardial Effusion* ; Pericardiocentesis ; Thoracic Injuries ; Thoracotomy ; Thorax

PURPOSE: Dipyridamole stress myocardial perfusion SPECT could predict prognosis, however, long-term follow-up showed change of hazard ratio in patients with suspected coronary artery disease. We investigated how long normal SPECT could predict the benign prognosis on the long-term follow-up. MATERIALS AND METHODS: We followed up 1169 patients and divided these patients into groups in whom coronary angiography were performed and were not. Total cardiac event rate and hard event rate were predicted using clinical, angiographic and SPECT findings. Predictive values of normal and abnormal SPECT were examined using survival analysis with Mantel-Haenszel method, multivariate Cox proportional hazard model analysis and newly developed statistical method to test time-invariance of hazard rate and changing point of this rate. RESULTS: Reversible perfusion decrease on myocardial perfusion SPECT predicted higher total cardiac event rate independently and further to angiographic findings. However, myocardial SPECT showed independent but not incremental prognostic values for hard event rate. Hazard ratio of normal perfusion SPECT was changed significantly (p<0.001) and the changing point of hazard rate was 4.4 years of follow up. However, the ratio of abnormal SPECT was not. CONCLUSION: Dipyridamole stress myocardial perfusion SPECT provided independent prognostic information in patients with known and suspected coronary artery disease. Normal perfusion SPECT predicted least event rate for 4.4 years.
Coronary Angiography ; Coronary Artery Disease ; Dipyridamole* ; Follow-Up Studies ; Humans ; Perfusion ; Prognosis ; Proportional Hazards Models ; Tomography, Emission-Computed, Single-Photon*

BACKGROUND AND OBJECTIVES: Exophthalmos from Graves' disease can result in visual disturbance and cosmetic deformity. Surgical treatment of this disorder is possible through a transnasal endoscopic approach or transantral approach. We aimed to evaluate the efficacy of the transnasal endoscopic orbital decompression and transantral orbital decompression in the management of dysthyroid orbitopathy. MATERIALS AND METHODS: Transnasal endoscopic orbital decompression or transantral orbital decompression was performed on 25 orbits in 14 patients for treatment of progressive exophthalmos or visual loss. Transantral orbital decompression was performed on seven patients simultaneously. RESULTS: Proptosis was reduced an average of 2.8 mm (range 0.5 to 6 mm) by transnasal endoscopic decompression alone and of 3.5 mm (range 0.5 to 8 mm) by transnasal endoscopic decompression and transantral decompression. In five patients who complained of visual disturbance, visual acuity was improved in three of them, and stationary in two of them postoperatively. Four patients who had no diplopia preoperatively developed diplopia after the decompression. Among them the diplopia was only temporary in three patients and the remaining one was referred to an ophthalmologist for correction of persistent diplopia. CONCLUSION: Orbital decomprerssion can be performed successfully via the transantral and transnasal endoscopic approach without significant complications and external scar.
Cicatrix ; Congenital Abnormalities ; Decompression* ; Diplopia ; Exophthalmos ; Graves Disease ; Humans ; Orbit* ; Visual Acuity

No abstract available.

PURPOSE: Colorectal cancer (CRC) has a high risk for postoperative thromboembolic complications such as venous thromboembolism (VTE) compared to other surgical diseases, but the relationship between VTE and CRC in Asian patients remains poorly understood. The present study examined the incidence of symptomatic VTE in Korean patients who underwent surgery for CRC. We also identified risk factors, incidence and survival rate for VTE in these patients. MATERIALS AND METHODS: The patients were identified from the CRC database treated from January 2011 to December 2012 in a single institution. These patients were classified into VTE and non-VTE groups, their demographic features were compared, and the factors which had significant effects on VTE and mortality between the two groups were analyzed. RESULTS: We analyzed retrospectively a total of 840 patients and the incidence of VTE was 3.7% (31 patients) during the follow-up period (mean, 17.2 months). Histologic subtype (mucinous adenocarcinoma) and previous history of VTE affected the incidence of VTE on multivariate analysis. There was a statistically significant difference in survival rate between the VTE and non-VTE group, but VTE wasn't the factor affecting survival rate on multivariate analysis. Comparing differences in survival rate for each pathologic stage, there was only a significant difference in stage II patients. CONCLUSION: Among CRC patients after surgery, the incidence of VTE was approximately 3% within 1 year and development of VTE wasn't a significant risk factor for death in our study but these findings are not conclusive due to our small sample size.
Asian Continental Ancestry Group ; Colorectal Neoplasms* ; Follow-Up Studies ; Humans ; Incidence ; Mortality ; Multivariate Analysis ; Prognosis* ; Retrospective Studies ; Risk Factors ; Sample Size ; Survival Rate ; Venous Thromboembolism*

PURPOSE: The authors evaluate the prevalence of malnutrition and its effect on the postoperative morbidity of patients after surgery for colorectal cancer. METHODS: Three hundred fifty-two patients were enrolled prospectively. Nutritional risk screening 2002 (NRS 2002) score was calculated through interview with patient on admission. Clinical characteristics, tumor status and surgical procedure were recorded. RESULTS: The prevalence of patients at nutritional risk was 28.1 per cent according to the NRS 2002. The rate of postoperative complication was 27%. There was a significant difference in postoperative complication rates between patients at nutritional risk and those not at risk (37.4% vs. 22.9%, P = 0.006). Nutritional risk was identified as an independent predictor of postoperative complications (odds ratio, 3.05; P = 0.045). Nutritional risk increased the rate of anastomotic leakage (P = 0.027) and wound infection (P = 0.01). CONCLUSION: NRS may be a prognostic factor for postoperative complication after surgery for colorectal cancer. A large scaled prospective study is needed to confirm whether supplementing nutritional deficits reduces postoperative complication rates.
Anastomotic Leak ; Colorectal Neoplasms* ; Humans ; Malnutrition ; Mass Screening ; Postoperative Complications ; Prevalence ; Wound Infection

We report a case of vesico-sigmoido-appendiceal fistula from unknown origin in a 29 years old female who was presented with the chief complaints of fecaluria and bladder irritation symptoms The diagnostic procedure such as excretory urography, cystography, barium enema, cystoscopy and proctoscopy were performed, and the vesico-recto-appendiceal or vesico-sigmoido-appendiceal fistula was suspected. On operation, the tip of appendix was communicated with the sigmoid fistulous tract and opened into the bladder in a common pathway. The patient underwent appendectomy, sigmoid fistulectomy, and partial cystectomy and the postoperative course was uneventful.
Adult ; Appendectomy ; Appendix ; Barium ; Colon, Sigmoid ; Cystectomy ; Cystoscopy ; Enema ; Female ; Fistula* ; Humans ; Proctoscopy ; Urinary Bladder ; Urography

PURPOSE: The Niti CAR 27 (ColonRing) uses compression to create an anastomosis. This study aimed to investigate the safety and the effectiveness of the anastomosis created with the Niti CAR 27 in a laparoscopic anterior resection for sigmoid colon cancer. METHODS: In a single-center study, 157 consecutive patients who received an operation between March 2010 and December 2011 were retrospectively assessed. The Niti CAR 27 (CAR group, 63 patients) colorectal anastomoses were compared with the conventional double-stapled (CDS group, 94 patients) colorectal anastomoses. Intraoperative, immediate postoperative and 6-month follow-up data were recorded. RESULTS: There were no statistically significant differences between the two groups in terms of age, gender, tumor location and other clinical characteristics. One patient (1.6%) in the CAR group and 2 patients (2.1%) in the CDS group experienced complications of anastomotic leakage (P = 0.647). These three patients underwent a diverting loop ileostomy. There were 2 cases (2.1%) of bleeding at the anastomosis site in the CDS group. All patients underwent a follow-up colonoscopy (median, 6 months). One patient in the CAR group experienced anastomotic stricture (1.6% vs. 0%; P = 0.401). This complication was solved by using balloon dilatation. CONCLUSION: Anastomosis using the Niti CAR 27 device in a laparoscopic anterior resection for sigmoid colon cancer is safe and feasible. Its use is equivalent to that of the conventional double-stapler.
Anastomotic Leak ; Colonoscopy ; Constriction, Pathologic ; Dilatation ; Follow-Up Studies ; Hemorrhage ; Humans ; Ileostomy ; Retrospective Studies ; Sigmoid Neoplasms*