PURPOSE: The purpose of this study was to figure out influences of supervisor's and colleague's supports, nursing work environment, ego-resilience, organizational commitment and burnout on turnover intention of nurses working in general hospitals. METHODS: The data were collected from 379 nurses working in general hospitals with more than 500 beds in S city from July 1 to August 31, 2012. The collected data were analyzed with independent t-test, one-way ANOVA, Pearson's correlation and Hierarchial regression analysis by using SPSS 19.0. RESULTS: In case the subject was young, with work experience of 1~5 years, single, female and position of general nurse, turnover intention was statistically significantly higher. Turnover intention, supervisor's support, nursing work environment, organizational commitment and ego-resilience showed significantly negative correlations, but burnout showed significantly positive correlations. In case of controlling general characteristics, higher correlational variables with turnover intention accounted for 30.2%. CONCLUSION: In order to reduce turnover intention of general nurses who showed higher intention with 1~5 years' work experience, situational variables such as organizational commitment and nursing work environment and interpersonal relation variables such as supervisor's support as well as personal variables such as ego-resilience should all be considered.
Female ; Hospitals, General ; Humans ; Intention* ; Interpersonal Relations* ; Nursing ; Regression Analysis

BACKGROUND AND PURPOSE: Cheyne-Stokes respiration (CSR) is frequently observed in patients with acute stroke. There have been conflicting opinions about the associations of CSR with the location and size of the lesion. We aimed to better define the clinical relevance and pathogenesis of CSR in acute stroke. METHODS: We investigated patients who had been admitted with acute ischemic stroke and received an overnight sleep apnea test. We collected data on demographics, risk factors, etiologic subtypes, initial vital signs, clinical course of the stroke, and parameters associated with respiratory events during the sleep apnea test. We performed a multivariate logistic regression analysis to determine the factors associated with CSR. RESULTS: Among 182 patients, 35 patients showed CSR in sleep apnea testing. Large-artery atherosclerosis or cardioembolism, bilateral hemispheric involvement, atrial fibrillation, low left-ventricle ejection fraction (LVEF), and left atrium (LA) enlargement were all associated with the presence of CSR. Multivariate analysis revealed that the previous modified Rankin Scale (mRS) score, bilateral hemispheric involvement, low LVEF, and LA enlargement were significantly associated with CSR. Subgroup analysis with large-artery atherosclerosis without cardiac disease revealed that the previous mRS score is the only independent factor associated with CSR. CONCLUSIONS: CSR frequently occurs in strokes involving large arteries or due to cardioembolism, regardless of the location and severity of the stroke. Predisposing conditions such as preexisting neurologic disability, low LVEF, and LA enlargement are associated with CSR in acute stroke.
Arteries ; Atherosclerosis ; Atrial Fibrillation ; Cheyne-Stokes Respiration* ; Demography ; Heart Atria ; Heart Diseases ; Humans ; Logistic Models ; Multivariate Analysis ; Risk Factors ; Sleep Apnea Syndromes ; Stroke* ; Vital Signs

PURPOSE: The purpose of this study was to figure out influences of supervisor's and colleague's supports, nursing work environment, ego-resilience, organizational commitment and burnout on turnover intention of nurses working in general hospitals. METHODS: The data were collected from 379 nurses working in general hospitals with more than 500 beds in S city from July 1 to August 31, 2012. The collected data were analyzed with independent t-test, one-way ANOVA, Pearson's correlation and Hierarchial regression analysis by using SPSS 19.0. RESULTS: In case the subject was young, with work experience of 1~5 years, single, female and position of general nurse, turnover intention was statistically significantly higher. Turnover intention, supervisor's support, nursing work environment, organizational commitment and ego-resilience showed significantly negative correlations, but burnout showed significantly positive correlations. In case of controlling general characteristics, higher correlational variables with turnover intention accounted for 30.2%. CONCLUSION: In order to reduce turnover intention of general nurses who showed higher intention with 1~5 years' work experience, situational variables such as organizational commitment and nursing work environment and interpersonal relation variables such as supervisor's support as well as personal variables such as ego-resilience should all be considered.
Female ; Hospitals, General ; Humans ; Intention ; Interpersonal Relations ; Nursing ; Regression Analysis

Coronavirus disease 2019 (COVID-19) is associated with a variety of neurologic manifestations. Acute necrotizing encephalopathy (ANE) is a rare, life-threatening complication characterized by rapid deterioration of neurologic status following viral infection, such as influenza or human herpesvirus 6. Since the COVID-19 pandemic, a rise in ANE cases associated with the infectious disease has been reported in adult patients. We present a case of COVID-19-associated ANE in a 9-year-old boy. The patient experienced 3 days of fever and mild respiratory symptoms, followed by lethargy. Magnetic resonance imaging on day 4 showed hyperintensity in the bilateral thalami, midbrain, pons, hypothalamus, and cerebellum, along with some areas of hemorrhage. From the imaging findings, ANE was strongly suspected, leading to the initiation treatment involving a 5-day course of remdesivir and multiple immunomodulator therapies, including high-dose corticosteroids, intravenous immunoglobulin, tocilizumab, and 10 cycles of therapeutic plasma exchange. Subsequently, the patient gradually improved, experiencing only minor neurological sequelae and showing favorable radiologic improvement. In COVID-19-infected patients presenting neurologic symptoms, it is crucial to promptly suspect and investigate unexplained encephalopathy using neuroimaging. Early administration of immunomodulator therapy is vital for the diagnosis and optimizing clinical outcomes.

Escherichia (E.) coli is commensal bacteria found in the intestine; however, some pathogenic strains cause diseases in animals and humans. Although E. coli does not typically produce hydrogen sulfide (H2S), H2S-producing strains of E. coli have been identified worldwide. The relationship between virulence and H2S production has not yet been determined. Therefore, characteristics of H2S-producing isolates obtained from swine feces were evaluated including antibiotic resistance patterns, virulence gene expression, and genetic relatedness. Rates of antibiotic resistance of the H2Sproducing E. coli varied according to antibiotic. Only the EAST1 gene was detected as a virulence gene in five H2S-producing E. coli strains. Genes conferring H2S production were not transmissible although the seeA gene encoding 3-mercaptopyruvate sulfurtransferase was detected in all H2S-producing E. coli strains. Sequences of the seeA gene motif CGSVTA around Cys238 were also identical in all H2S-producing E. coli strains. Diverse genetic relatedness among the isolates was observed by pulsed-field gel electrophoresis analysis. These results suggested that H2S-producing E. coli strains were not derived from a specific clone and H2S production in E. coli is not associated with virulence genes.
Animals ; Bacteria ; Clone Cells ; Drug Resistance, Microbial ; Electrophoresis, Gel, Pulsed-Field ; Escherichia coli* ; Escherichia* ; Feces ; Gene Expression ; Humans ; Hydrogen Sulfide ; Hydrogen* ; Intestines ; Swine* ; Virulence Factors* ; Virulence*

Primary carcinoid tumor of the urinary bladder is extremely rare. We report a case of primary carcinoid tumor of the urinary bladder in a 45-year-old man who presented with frequency, dysuria and urinary tenesmus for 6 months with clinicopathologic, immunohistochemical and ultrastructural findings.
Carcinoid Tumor* ; Dysuria ; Humans ; Middle Aged ; Urinary Bladder*

BACKGROUND: Aquaporins (AQPs) are a family of water transporting proteins present in many mammalian epithelial and endothelial cell types. Among the AQPs, AQP3 is known to be a water/glycerol transporter expressed in human skin. OBJECTIVE: The relationship between the expression level of AQP3 and transpidermal water loss (TEWL) in the lesional and peri-lesional skin of psoriasis-affected patients, and skin hydration in the lesional and peri-lesional skin of psoriasis patients, was investigated. METHODS: The expression of AQP3 in psoriasis-affected and healthy control skin was determined using immunohistochemical and immunofluroscence staining. TEWL and skin hydration were measured using a Tewameter(R) TM210 (Courage & Khazaka, Cologne, Germany) and a Corneometer(R) CM 820 (Courage & Khazaka), respectively. RESULTS: AQP3 was mainly expressed in the plasma membrane of stratum corneum and the stratum spinosum in normal epidermis. Unlike the normal epidermis, AQP3 showed decreased expression in the lesional and peri-lesional epidermis of psoriasis. TEWL was increased, and skin hydration was decreased, in the lesional and peri-lesional skin of psoriasis patients, compared with the healthy control sample. CONCLUSION: Although various factors contribute to reduced skin hydration in the lesional and peri-lesional skin of psoriasis, AQP3 appears to be a key factor in the skin dehydration of psoriasis-affected skin.
Aquaporin 3 ; Aquaporins ; Cell Membrane ; Dehydration ; Endothelial Cells ; Epidermis ; Humans ; Proteins ; Psoriasis ; Skin ; Water Loss, Insensible

BACKGROUND AND PURPOSE: The literature indicates that obstructive sleep apnea (OSA) increases the risk of ischemic stroke. However, the causal relationship between OSA and ischemic stroke is not well established. This study examined whether preexisting OSA symptoms affect the onset of acute ischemic stroke. METHODS: We investigated consecutive patients who were admitted with acute ischemic stroke, using a standardized protocol including the Berlin Questionnaire on symptoms of OSA prior to stroke. The collected stroke data included the time of the stroke onset, risk factors, and etiologic subtypes. The association between preceding OSA symptoms and wake-up stroke (WUS) was assessed using multivariate logistic regression analysis. RESULTS: We identified 260 subjects with acute ischemic strokes with a definite onset time, of which 25.8% were WUS. The presence of preexisting witnessed or self-recognized sleep apnea was the only risk factor for WUS (adjusted odds ratio=2.055, 95% confidence interval=1.035–4.083, p=0.040). CONCLUSIONS: Preexisting symptoms suggestive of OSA were associated with the occurrence of WUS. This suggests that OSA contributes to ischemic stroke not only as a predisposing risk factor but also as a triggering factor. Treating OSA might therefore be beneficial in preventing stroke, particularly that occurring during sleep.
Berlin ; Humans ; Logistic Models ; Risk Factors ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Stroke*

BACKGROUND/AIMS: There is no consensus as to the best treatment for non-variceal, non-ulcer gastrointestinal hemorrhage. Endoscopic band ligation is an inexpensive, readily available, and easily learned technique in contrast to conventional thermal methods of endoscopic hemostasis. The purpose of this study is to define the effectiveness of endoscopic band ligation for non-variceal, non-ulcer gastrointestinal hemorrhage and post-polypectomy hemorrhage. METHODS: Twenty eight patients were treated by band ligation between July 1996 and October 2000. The lesions treated were: Dieulafoy's lesion in 13, Mallory-Weiss tear in 7, angiodysplasia in 1, post-polypectomy bleeding in 4, post-endoscopic mucosal resection bleeding in 2, post-endoscopic biopsy bleeding in 1. RESULTS: Endoscopic band ligation was successful in 25 of 28 cases. Additional sclerotherapy was necessary in two cases of Dieulafoy's lesion. The remaining case was early band detachment. CONCLUSIONS: Endoscopic band ligation is effective for non-variceal, non-ulcer bleeding. It has the advantage of ease of use and is relatively inexpensive.
Angiodysplasia ; Biopsy ; Consensus ; Gastrointestinal Hemorrhage* ; Hemorrhage* ; Hemostasis, Endoscopic ; Humans ; Ligation* ; Mallory-Weiss Syndrome ; Sclerotherapy

Background and Objectives: Outcomes of deferring percutaneous coronary intervention (PCI) without invasive physiologic assessment for intermediate coronary lesions is uncertain.We sought to compare long-term outcomes between medical treatment and PCI of intermediate lesions without invasive physiologic assessment. Methods: A total of 899 patients with intermediate coronary lesions between 50% and 70% diameter-stenosis were randomized to the conservative group (n=449) or the aggressive group (n=450). For intermediate lesions, PCI was performed in the aggressive group, but was deferred in the conservative group. The primary endpoint was major adverse cardiac events (MACE, a composite of all-cause death, myocardial infarction [MI], or ischemia-driven any revascularization) at 3 years. Results: The number of treated lesions per patient was 0.8±0.9 in the conservative group and 1.7±0.9 in the aggressive group (p=0.001). At 3 years, the conservative group had a significantly higher incidence of MACE than the aggressive group (13.8% vs. 9.3%; hazard ratio [HR], 1.49; 95% confidence interval [CI], 1.00–2.21; p=0.049), mainly driven by revascularization of target intermediate lesion (6.5% vs. 1.1%; HR, 5.69; 95% CI, 2.20–14.73;p<0.001). Between 1 and 3 years after the index procedure, compared to the aggressive group, the conservative group had significantly higher incidence of cardiac death or MI (3.2% vs.0.7%; HR, 4.34; 95% CI, 1.24–15.22; p=0.022) and ischemia-driven any revascularization. Conclusions For intermediate lesions, medical therapy alone, guided only by angiography, was associated with a higher risk of MACE at 3 years compared with performing PCI, mainly due to increased revascularization.