The purpose of this study was to assess how job stiess affects the nursing performance of emergerncy room nurses. Data were collected from 210 emergency room nurses at 20 general hospitals, with more than 200 beds, in Pusan, Taegu and Kungbuk province, between October 5 and October 15, 1998. The instruments used for this study were the job stress scale which was developed by Mae Ja, Kim and Mi Ok, Gu(1984), and nursing performance of nurses scale developed by Kwi Ae, Chung(1989). Data Analysis was done using t-test, ANOVA, Tukey test, and Pearson Correlation. The results were as follows : 1. The highest rank of job stress items, emergency room nursing were as follows with lessening order when physicians delegate their clinical responsibilities to nurses(M=3.12+/-0.69). The most stressed factor among the nursing works was reported as night duty(M =2.99+/-0.87). 2. The mean score of nursing performance items, to prevent patient from falling or other injury(M = 3.69+/-0.50). 3. Our study reveals that there was statistically significant negative correlation relationship between stress level and emergency room nursing performance(r= -0.14, p=0.0454), in other words, the more stress the nurses experienced, the weaker their nursing performance became. Two factors, heavy work load(r=0.30, p=0.0001), and poor compensation(r =0.15, p =0.031). were negativly related to nursing performance. 4. The study revealed that the group with monthly income experienced less stress(F=2.71, p= 0.0461). Also, the degree of stress was significantly lower in the group with work experience (F=3.01, p=0.0313). Stress varied according to position superintendent nurse showed a lower level of stress than lay nurses and change nurses (F=2.93, p=0.0349). 5. There was significant difference in the degree of nursing perfnrm~nre according to religion (F= 3.97, p=0.0088). In conclusion, there was statistically significant negative correlations between job stress and nursing performance, so there is need for special consideration in nursing administration in terms of reducing the job stress in emergency nursing. Suggestions based on this study as follows. 1. Further study is necessary to examine variables that influence job stress and nursing performance. 2. The expem~ntaI study is needed for an effectiveness of systerrntic and in-lividual effort in order to reduce or manage nurses'stress in the emergency room.
Busan ; Daegu ; Emergencies* ; Emergency Nursing ; Emergency Service, Hospital* ; Hospitals, General ; Humans ; Nursing* ; Statistics as Topic

PURPOSE: The purpose of this study was to examine the effects of preceptor nurses' self-leadership on role recognition and job satisfaction. METHOD: The participants were 171 preceptor nurses worked in one of three general hospitals in Seoul. The data were collected from April 12 to May 12, 2011 and analyzed using descriptive statistics, t-test, ANOVA, pearson correlation, Scheffe, and regression with SPSS Win 19.0 program. RESULT: The results of the study were as followed. The average score for preceptor nurses' self-leadership was 3.55, for role recognition, 3.81 and for job satisfaction, 3.28. The factors of the preceptors' self-leadership affecting role recognition were self-expectation (beta=260, p=.002) and goal setting (beta=199, p=.030), and those factors accounted for 18.9% of explanatory power. The factors of self-leadership influencing job satisfaction were self-expectation (beta=18.3, p=.021), and rehearsal (beta=-168, p=.030), and those factors accounted for 31.3% of explanatory power. Among the factors of self-leadership, self-expectation influenced both role recognition and job satisfaction. CONCLUSIONS: The results of the study indicate that to improve preceptor's role recognition and job satisfaction, there should be special training programs to enhance preceptor's self leadership.
Hospitals, General ; Job Satisfaction ; Leadership

Trichogenic tumors are very rare and described as cutaneous neoplasms probably derived from hair germ which develops into hair follicles. We report a case of trichoblastic fibroma on the left parietal scalp of a 45-year-old man. The lesion was a solitary, firm, non-tender, 2×2cm subcutaneous nodule. The histopathological study showed a well circumscribed dermal tumor composed of abundant basophilic palisading basaloid lobules with some keratinous cysts, hair follicle differentiation and fibroblastic stroma.
Basophils ; Fibroblasts ; Fibroma* ; Hair ; Hair Follicle ; Humans ; Middle Aged ; Rabeprazole ; Scalp

Tumor-draining lymph node (TDLN) lymphocytes contain immunologically sensitized to tumor but functionally deficient T cells. The 30 kDa protein antigen, a major secreted protein antigen of Mycobacterium tuberculosis, exhibits strong T cell stimulatory effect. In this study, it examined that the feasibility of using M tuberculosis 30 kDa antigen to stimulate tumor-draining lymph node cells for the generation of specific immune effector cells. Freshly isolated TDLN lymphocytes could directly respond to the 30 kDa antigen alone and their proliferative responses were markedly augmented by stimulation with rIL-2. TDLN cells were stimulated with the 30 kDa antigen for various time intervals and examined for the induction of IFN-r and IL-4 mRNA using RT-PCR. The expression of IFN-r mRNA was greatly augmented after 1 wk, whereas IL-4 mRNA is markedly decreased after 1 wk. Cytotoxic T cell activities induced by the 30 kDa antigen was also evaluated. TDLN cells stimulated with the 30 kDa antigen alone were able to generate remarkable cytotoxic response to K562 or Daudi cell lines after 6 days of culture. And their cytotoxic effects were highly augmented by stirnulation with rIL-2. These results suggest that the 30 kDa antigen of M. tuberculosis may selectively activate Thl cells of TDLN lymhocytes and induce the cytotoxic T cell activities. In conclusion, the 30 kDa antigen can be used as a biologic response modifier in tumor immunology.
Allergy and Immunology ; Cell Line ; Interleukin-4 ; Lymph Nodes* ; Lymphocytes* ; Mycobacterium tuberculosis* ; Mycobacterium* ; RNA, Messenger ; T-Lymphocytes ; Th1 Cells* ; Tuberculosis

BACKGROUND: There are two kinds of mechanism for laser therapy according to selectie photothermolysis. Selective photothermolysis means that a chromophore can be selectively dei, stroyed with a laser of n appropriate wavelength and of a short pulse duration that is shortor than the thermal relaxation time of the chromophore. It is supposed that the side effects of the continuous wave laser, in which selective photothermolysis does not exist occur more often than when a pulsed wave laser is used. OBJECTIVE: We compar.d the side effects of flashlamp-pumped pulsed tunable dye laser(SPTL), whose treatment is baseal on selective photothermolysis, with those of copper vapor laser(CVL , which is a quasi-continuous thermal laser. METHODS: The laser cl arts of 498 patients with SPTL treatment and 485 patients with CVL, treatment in Asan Medical Center from 1989 to 1994 were examined, retrospectively. RESULTS: 1) Among 498 patients, with SPTL treatment, we observed various side effects in 47(9.4%). The incidences of individial side effects are as follows, hyperpigmentation in 6.2%(31), vesicl formation in 1.6% (8), surface texture change in 0.8% (4), Hypopigmentation in 0.6% (3), scar format,ion in 0.2% (1). 2) After CVL treatment, side effects occurred in 30(6.2%) among 485 patient.. Hyperpigmentation in 3.1%(15), vesicle formation in 2.5%(12), surface texture change in 0.2%(1), hypopigmentation in 0.2%(1), and scar formation in 0.1%(1) were observed. CONCLUSION: The total incidence of side effect.s after CVL treatment is not statistically different, from that after SPTL treatment, which contradicts the previous theory.
Chungcheongnam-do ; Cicatrix ; Copper* ; Humans ; Hyperpigmentation ; Hypopigmentation ; Incidence ; Laser Therapy ; Lasers, Dye* ; Lasers, Gas* ; Relaxation ; Retrospective Studies

Pulmonary thromboembolism (PTE) is a serious postoperative complication. Prompt diagnosis of PTE is important but it is difficult because clinical manifestations of PTE are not obvious in most cases. A 59 year-old woman received cholecystectomy and choledocholithotomy under general anesthesia. At the 9th postoperative day, syncope, hypoxemia and hypotension were developed suddenly and the patient was transfered to intensive care unit. PTE was suspected with hemodynamic monitoring from pulmonary arterial catheter and echocardiography and diagnosed with lung perfusion scan and venogram of lower extremities. Proper cardiopulmonary support was done and the patient was recovered and discharged in improved condition. In conclusion, if a patient have syncopal attack with shock in postoperative period, PTE must be thought to be an one of possible causes of syncope and thoroughly investigated.
Anesthesia, General ; Anoxia ; Catheters ; Cholecystectomy ; Diagnosis ; Echocardiography ; Female ; Hemodynamics ; Humans ; Hypotension ; Intensive Care Units ; Lower Extremity ; Lung ; Middle Aged ; Perfusion ; Postoperative Complications ; Postoperative Period ; Pulmonary Embolism* ; Shock ; Syncope

Neurocutaneous melanosis is a very rare congenital syndrome characterized by the presence of large or multiple congenital melanocytic nevi and benign or malignant melanotic tumors of the central nervous system. We report herein a case of neurocutaneous melanosis with leptomeningeal melanosis and a malignant melanoma of the right temporal lobe in a 46-year old man. The case is exceptional as regards the late onset of symptoms and death. Even without a malignant melanoma, the symptomatic neurocutaneous melanosis has a fatal course. The syndrome is rare but lethal, so the dermatologist should be aware of this syndrome when evaluating the patients with large or numerous congenital melanocytic nevi so as to watch for the usual signs of increased intracranial pressure and to take prompt palliative measures.
Central Nervous System ; Humans ; Intracranial Pressure ; Melanoma ; Melanosis* ; Nevus, Pigmented ; Temporal Lobe

We describe a 38-year-old woman with an adenoma of anogenital mammary-like glands on the left labium major. Adenomas of anogenital mammary-like glands have been rarely reported with various nomenclatures in the English literature. The knowledge of this rare disease entity may be important to diagnose and treat the lesions arising on the anogenital areas.
Adenoma* ; Adult ; Female ; Humans ; Rare Diseases

Exercise is one of the most ubiquitous triggers of acute bouts of asthma. Late asthmatic responses(LARs) have been described following strenuous exercise, as in allergen-induced asthma. However, most studies have reported that airway responsiveness is not increased after exercise, even in subjects with LAR to exercise. This suggests that LAR after exercise may not be associated with inflammatory changes in the airways. We have frequently seen asthmatic children whose complaint is that symptoms are exacerbated at night after strenuous daytime exercise. Furthermore, airway responsiveness to allergen was reported to increase after LAR to exercise. Therefore, it is crucial to know whether exercise can induce airway inflammation, as in allergen-induced asthma. As an indirect measure to investigate it, we measured the activation status of eosinophil granulocyte in the peripheral blood during the early and late phase of exercise- or allergen-induced asthma. Eight subjects who showed early asthmatic response(EAR) and LAR(group 1), or EAR only (group 2) to allergen (Dermatophagoides pteronyssinus) challenge were selected. Similarly eight subjects who showed EAR and LAR(group 3), or EAR only (group 4) to exercise were selected. Blood samples were drawn at baseline, the early phase, the late phase, and 24 hours after each stimuli. Eosinofphil cationic protein (ECP) was measured in the serum. Eosinophil granulocytes were separated and the production of leukotriene C4 (LTC4) from purified eosinophfis was measured after stimulation with the calciumionophore. Serum levels of ECP were unchanged at EAR after allergen or exercise challenge. In the dual responder to allergen (group 1), serum ECP level was elevated at LAR and 24 hours after allergen challenge, as compared with the baseline level. On the other hand, in the dual responder to exercise (group 3), it remained unaltered up to 24 hours after exercise challenge. Eosinophils at EAR after allergen or exercise challenge in each group generated the similar amounts of LTC4 as baseline values. In group 1, the production of LTC4 was slightly increased though not significantly at LAR, and significantly increased 24 hours after allergen challenge. In group 3, it was increased significantly at LAR, but restored to the baseline values at 24 hours after exercise challenge. These results indicate that not only allergen but also exercise can activate eosinophils in accordance with LAR. The present findings suggest that LAR to exercise may also have the potential to induce airway eosinophilic inflammation although its duration may be shorter than that of LAR to allergen. Therefore exercise should be understood not only as a triggering factor of bronchoconstriction but also as one that incites or deteriorates airway inflammation.
Asthma* ; Bronchoconstriction ; Child ; Ear ; Eosinophils* ; Granulocytes ; Hand ; Humans ; Inflammation ; Leukotriene C4

BACKGROUND: Neuropeptides are biologically active polypeptides in sensory afferent nerve fibers and autonomic afferent nerve fibers, where they coexist with neurotransmitters. In additian to the neurotransmitter or neuroendocrine role, neuropeptides play a role in mitogenic action in tissues and modulation in immure response. The cutaneous diseases which may be related to neuropeptides are psoiriasis, atopic dermatitis, chronic urticaria, postherpetic neuralgia, hemodialysis related pruritus, and scleorderma. OBJECTIVES: We carried out two kinds of experiments to study the role of neuropeptides in postherpetic neuralgia. Firstly, we investigated the occurrence and distribution of substance P (SP), calcitonin gene relating peptide(CGRP), vasoactive intestinal peptide(VIP), neuropeptide Y (NY), neurokinin A(NA), and somatostatin in normal human skin, provided the principal information needed to identify the neuropeptide role in several cutaneous diseases. Secondly, we compared the distribution of neuropeptides in normal skin and those in the skin of patients with postherpetic neuralgia. METHODS: We used the indirect immunofluorescence staining method to achieve two objectives mentioned above. RESULTS: In almost all regions of normal human skin and the skin of patients with postherpetic neuralgia, significant amounts of SP, CGRP, VIP, NY, NA, and somatostatin immunoreactive nerve fibers(IRNF) were found. CGRP, VIP, and NY IRNF were more frequently observed around sweat glands and blood vessels. Only VIP IRNF were found occasionally in the epidermis. CONCLUSION: There was no difference between the neuropeptides IRNF of the skin from patients with postherpetic neuralgia and those of the normal skin except the absence of VIP IRNF in patients with postherpetic neuralgia.
Blood Vessels ; Calcitonin ; Dermatitis, Atopic ; Epidermis ; Fluorescent Antibody Technique ; Fluorescent Antibody Technique, Indirect ; Humans ; Nerve Fibers* ; Neuralgia, Postherpetic* ; Neuropeptide Y ; Neuropeptides* ; Neurotransmitter Agents ; Peptides ; Pruritus ; Renal Dialysis ; Skin* ; Somatostatin ; Substance P ; Sweat Glands ; Urticaria