Purpose: The purpose of this study was to identify factors that can affect transition shock in newly-graduated nurses. Methods: The first descriptive written survey was conducted on 450 graduate students from five nursing colleges. After their employment, the second survey was conducted on 316 participants who had responded to the first survey. A total of 158 respondents were used for the final analysis. Data were analyzed using an independent t-test, ANOVA, Tukey test, Pearson’s correlation coefficient, and hierarchical multiple regression analysis with the SPSS Win 25.0 Program. Results: The average age of the participants was 24.25±4.47. Of the participants, 126 (79.8%) were satisfied that they had majored in nursing. The average score for transition shock was 2.61±0.55 points. Factors influencing the transition shock of newly-graduated nurses were the working department, working period, and working environment. The more positively the newly-graduated nurses perceived the nursing work environment, the less of a transition shock they experienced. Grade point average, clinical competence, confidence in performing core nursing skills, and nursing professionalism did not affect their transition shock. It could be confirmed that there is a gap between college nursing education and the clinical field. Conclusion In order to reduce the transition shock of newly-graduated nurses, it is necessary to improve the nursing work environment and apply educational and emotional support strategies according to the characteristics of each work department and the period of work.

OBJECTIVE: We report an evaluation of incidence of the traumatic disc herniation and an effect of early closed reduction without prior magnetic resonance(MR) imaging in cervical spine fracture-dislocation injury. METHODS: The medical records and radiologic images of twenty consecutive traumatic cervical spine injury from the C2-3 to C7-T1 were reviewed. The disc injury on MR images was divided into two category: a herniation defined as deforming the thecal sac or nerve root and a disruption defined as a disc with high T2-weighted signal characteristics. Closed reduction was attempted in all patients and neurologic status was measured on admission and following reduction. MR image was obtainted within three days after early closed reduction. RESULTS: Early closed reduction by Gardner-Wells skeletal traction and serial plain radiography was achieved in 90% of patients and there was no associated neurological deterioration after reduction. The incidence of disc injury at the level of the fracture subluxation on the postreduction MR images was 60%(herniation-30%, disruption-30%), but the presence of disc herniation or disruption did not affect the degree of neurological recovery, as measured by American Spinal Injury Association(ASIA) motor score and the Frankel scale following early closed reduction. The average ASIA motor score prior reduction was 48.4 compared with 62.5 following reduction. CONCLUSION: Although disc herniation and disruption can occur following traumatic cervical fracture-dislocation, the actual incidence of neurological deterioration following early closed reduction is rare. Therefore, immediate closed reduction using traction in patients with any neurological deficit can be safe and effective before MR imaging.
Asia ; Humans ; Incidence ; Magnetic Resonance Imaging* ; Medical Records ; Radiography ; Spinal Injuries ; Spine ; Traction

OBJECTIVE: To characterize perioperative biomechanical changes after thoracic spine surgery. METHODS: Fifty-eight patients underwent spinal instrumented fusions and simple laminectomies on the thoracolumbar spine from April 2003 to October 2008. Patients were allocated to three groups; namely, the laminectomy without fusion group (group I, n = 17), the thoracolumbar fusion group (group II, n = 27), and the thoracic spine fusion group (group III, n = 14). Sagittal (ADS) and coronal (ADC) angles for adjacent segments were measured from two disc spaces above lesions at the upper margins, to two disc spaces below lesions at the lower margins. Sagittal (TLS) and coronal (TLC) angles of the thoracolumbar junction were measured from the lower margin of the 11th thoracic vertebra body to the upper margin of the 2nd lumbar vertebra body on plane radiographs. Adjacent segment disc heights and disc signal changes were determined using simple spinal examinations and by magnetic resonance imaging. Clinical outcome indices were determined using a visual analog scale. RESULTS: The three groups demonstrated statistically significant differences in terms of angle changes by ANOVA (p < 0.05). All angles in group I showed significantly smaller angles changes than in groups II and III by Turkey's multiple comparison analysis. Coronal Cobb's angles of the thoracolumbar spine (TLC) were not significantly different in the three groups. CONCLUSION: Postoperative sagittal balance is expected to change in the adjacent and thoracolumbar areas after thoracic spine fusion. However, its prevalence seems to be higher when the thoracolumbar spine is included in instrumented fusion.
Humans ; Laminectomy ; Magnetic Resonance Imaging ; Prevalence ; Spine

Atlantoaxial rotatory fixation (AARF) in adult is a rare disorder that occurs followed by a trauma. The patients were presented with painful torticollis and a typical 'cock robin' position of the head. The clinical diagnosis is generally difficult and often made in the late stage. In some cases, an irreducible or chronic fixation develops. We reported a case of AARF in adult patient which was treated by immobilization with conservative treatment. A 25-year-old female was presented with a posterior neck pain and limitation of motion of cervical spine after a traffic accident. She had no neurological deficit but suffered from severe defect on the scalp and multiple thoracic compression fractures. Plain radiographs demonstrated torticollis, lateral shift of odontoid process to one side and widening of one side of C1-C2 joint space. Immobilization with a Holter traction were performed and analgesics and muscle relaxants were given. Posterior neck pain and limitation of the cervical spine's motion were resolved. Plain cervical radiographs taken at one month after the injury showed that torticollis disappeared and the dens were in the midline position. The authors reported a case of type I post-traumatic AARF that was successfully treated by immobilization alone.
Accidents, Traffic ; Adult ; Analgesics ; Female ; Fractures, Compression ; Head ; Humans ; Immobilization ; Joints ; Muscles ; Neck Pain ; Odontoid Process ; Scalp ; Spine ; Torticollis ; Traction

Infiltrating lipoma is a rare mesenchymal neoplasm that, in spite of benign nature, characteristically infiltrates adjacent tissues and tends to recur after surgery. It has a predilection for the extremities and the trunk and is extremely rare in the head and neck region. We present a case of congenital infiltrating lipoma of the face, describing the intrabony invasion and osseous dystrophy as well as the soft tissue changes seen on plain radiographs and magnetic resonance imaging.
Extremities ; Head ; Lipoma* ; Magnetic Resonance Imaging ; Maxilla* ; Neck

Infiltrating lipoma is a rare mesenchymal neoplasm that, in spite of benign nature, characteristically infiltrates adjacent tissues and tends to recur after surgery. It has a predilection for the extremities and the trunk and is extremely rare in the head and neck region. We present a case of congenital infiltrating lipoma of the face, describing the intrabony invasion and osseous dystrophy as well as the soft tissue changes seen on plain radiographs and magnetic resonance imaging.
Extremities ; Head ; Lipoma* ; Magnetic Resonance Imaging ; Maxilla* ; Neck

Kissing aneurysms are very rare with only a few cases having been previously reported in the literature. We report a case of aneurysms arising from bilateral distal anterior cerebral arteries. A 56-year-old man was admitted to our hospital with subarachnoid hemorrhage. CT angiogrms and cerebral angiograms showed mirror image aneurysms touching each other were located at bilateral distal anterior cerebral arteries. During operation we confirmed the aneurysms were in contact.
Aneurysm* ; Anterior Cerebral Artery* ; Humans ; Middle Aged ; Subarachnoid Hemorrhage

OBJECTIVE: 6R-Tetrahydrobiopterin(BH4) is a cofactor for the aromatic amino acid hydroxylases which is essential for the biosynthesis of catecholamines and serotonin. It also acts as a cofactor for nitric oxide synthase, and stimulates the release of some neurotransmitters such as dopamine, serotonin, acetylcholine and glutamate. Recently, it has been reported that BH4 could induce cellular proliferation and enhance neuronal survival. This study was performed to investigate the antioxidative effect of BH4 on the various oxidative insults in mouse cerebral cortical cell cultures. METHODS: Iron ion(FeCl2), zinc ion(ZnCl2), sodium nitroprusside(SNP) and buthionine sulfoximine(BSO, a glutathione depletor) were used as oxidants. Cell death was assessed by measurement of lactate dehydrogenase efflux to bathing media at the end of exposure. RESULT: All 4 oxidants induced neuronal cell death associated with cell body swelling, which was markedly inhibited by trolox(100nM), a vitamin E analog. BH4(10-100nM) markedly inhibited the neuronal cell death induced by all 4 oxidants(20nM Cu2+, 20nM Zn2+, 1nM SNP or 1mM BSO). However, BH4 failed to inhibit the neuronal cell death induced by 24hr exposure to 20nM NMDA. CONCLUSION: These results suggest that BH4 has antioxidative action independently of any actions of enzyme cofactor.
Acetylcholine ; Amino Acids, Aromatic ; Animals ; Baths ; Catecholamines ; Cell Culture Techniques ; Cell Death ; Cell Proliferation ; Dopamine ; Glutamic Acid ; Glutathione ; Iron ; L-Lactate Dehydrogenase ; Mice* ; Mixed Function Oxygenases ; N-Methylaspartate ; Neurons* ; Neurotransmitter Agents ; Nitric Oxide Synthase ; Oxidants ; Serotonin ; Sodium ; Vitamin E ; Vitamins ; Zinc

Colorectal cancer is the third most common cancer in Korea and the third leading cause of death from cancer. Treatment outcomes for colon cancer are steadily improving due to national health screening programs with advances in diagnostic methods, surgical techniques, and therapeutic agents.. The Korea Colon Cancer Multidisciplinary (KCCM) Committee intends to provide professionals who treat colon cancer with the most up-to-date, evidence-based practice guidelines to improve outcomes and help them make decisions that reflect their patients’ values and preferences. These guidelines have been established by consensus reached by the KCCM Guideline Committee based on a systematic literature review and evidence synthesis and by considering the national health insurance system in real clinical practice settings. Each recommendation is presented with a recommendation strength and level of evidence based on the consensus of the committee.