BACKGROUND: This study was performed to develop a dietary self-efficacy questionnaire and to determine how dietary self-efficacy is related to selected biochemical markers and health-related quality of life in hemodialysis patients. METHODS: Participants included 172 patients who had been participating in a dialysis program for at least 6 months at two teaching hospitals. A questionnaire was used to assess socio-demographic factors, dialysis-related factors, dietary self-efficacy, and kidney disease quality of life (KDQOL). Serum levels of potassium and phosphorus and interdialytic weight gain were also measured. RESULTS: The internal reliability of dietary self-efficacy was 0.944 (Cronbach's alpha). Principal component analysis resulted in two factors, situational self-efficacy of compliance with dietary guidelines and self-efficacy of food choice. The correlation analysis showed a significant association between situational self-efficacy of compliance with dietary guidelines and serum potassium and KIDQOL. The average scores of situational self-efficacy of compliance with dietary guidelines and self-efficacy of food choice in the participants were 3.52+/-0.72 and 3.61+/-0.71 respectively. Multiple linear regression analysis showed that the situational self-efficacy of compliance with dietary guidelines was significantly associated with serum potassium level and KDQOL and self-efficacy of food choice was significantly associated with KDQOL. CONCLUSIONS: Based on our results, the developed dietary self-efficacy questionnaire may be a suitable survey tool for hemodialysis patients, which can play a role in predicting clinical indicators of patient and health-related quality of life. We recommend further research into clarifying whether the positive effects of increased dietary self-efficacy is maintained in long-term dialysis patients.
Biomarkers ; Compliance ; Dialysis ; Diet ; Hospitals, Teaching ; Humans ; Kidney Diseases ; Linear Models ; Phosphorus ; Potassium ; Principal Component Analysis ; Quality of Life ; Renal Dialysis ; Self Efficacy ; Weight Gain

BACKGROUND: Discrepancies exist in the existing researches regarding the association between social capital and self-efficacy, and most of these researches have been done in developed countries. The aims of this study were to assess the independent association between individual social capital and self-efficacy and to assess the associations between individual social capital, self-efficacy and self-rated health. METHODS: Data were obtained from the Gyeongnam health survey (6,500 persons) conducted in 2008. A self-administered questionnaire was additionally administered to gather information on demographic variables, health behaviors, chronic diseases, self-efficacy, social capital, and self-rated health status. Total study population was 3,843 as those with chronic diseases were excluded. RESULTS: In males, trust was positively associated with confidence and preference to task difficulty, and participation was negatively associated with confidence and positively associated with regulation and preference to task difficulty. In females, trust was positively associated with confidence and preference to task difficulty and negatively associated with regulation. Participation was positively associated with preference to task difficulty. In males, the odds for self-rated health status was better for persons with confidence (95% confidence interval, CI 1.088-1.705), trust (95% CI 1.172-1.821) and participation (95% CI 1.268-2.117). In females, the odds for self-rated health status was better for those with confidence (95% CI 1.250-1.803), preference of task difficulty (95% CI 1.019-1.683) and participation (95% CI 1.024-1.555). CONCLUSIONS: High social capital measured at an individual level may promote self-efficacy and health status.
Chronic Disease ; Developed Countries ; Female ; Health Behavior ; Health Surveys ; Humans ; Male ; Self Efficacy ; Surveys and Questionnaires

A 70 years old female patient with thyroid cancer received palliative radiation therapy for neck swelling and hemoptysis. She had a cardiac pacemaker under her chest due to complete AV block since 8 years ago. We present clinical detail and review previously reported articles.
Aged ; Atrioventricular Block ; Female ; Hemoptysis ; Humans ; Neck ; Radiotherapy* ; Thorax ; Thyroid Neoplasms

PURPOSE: For early stage non-small-cell lung cancer, surgical resection is the treatment of choice. But when the patients are not able to tolerate it because of medical problem and when refuse surgery, radiation therapy is considered an acceptable alternative. We report on the treatment results and the effect of achieving local control of primary tumors on survival end points, and analyze factors that may influence survival and local control. MATERIALS AND METHOD: We reviewed the medical records of 32 patients with medically inoperable non-small cell lung cancer treated at our institution from June, 1987 through June, 1997. All patients had a pathologic diagnosis of non-small cell lung cancer and were not candidate for surgical resection because of either patients refusal (4), old age (2), lung problem (21), chest wall invasion (3) and heart problems (3). In 8 patients, there were more than 2 problems. The median age of the patients was 68 years (ranging from 60 to 86 years). Histologic cell type included squamous (24), adenocarcinoma (6) and unclassified squamous cell (2). The clinical stages of the patients were T1 in 5, T2 in 25, T3 in 2 patients. Initial tumor size was < or =3.0 cm in 11, between 3.0 cm and 5.0 cm in 13 and more than 5.0 cm in 8 patients. All patients had taken chest x-rays, chest CT, abdomen USG and bone scan. Radiotherapy was delivered using 6 MV or 10 MV linear accelerators. The doses of primary tumor were the ranging from 54.0 Gy to 68.8 Gy (median; 61.2 Gy). The duration of treatment was from 37 days through 64 days (median; 48.5 days) and there was no treatment interruption except 1 patient due to poor general status. In 12 patients, concomitant boost technique was used. There were no neoadjuvant or adjuvant treatments such as surgery or chemotherapy. The period of follow-up was ranging from 2 months through 93 months (median; 23 months). Survival was measured from the date radiation therapy was initiated. RESULTS: The overall survival rate was 44.6% at 2 years and 24.5% at 5 years, with the median survival time of 23 months. Of the 25 deaths, 7 patients died of intercurrent illness, and cause-specific survival rate was 61.0% at 2 years and 33.5% at 5 years. The disease-free survival rate was 38.9% at 2 years and 28.3 % at 5 years. The local-relapse-free survival rate was 35.1%, 28.1%, respectively. On univariate analysis, tumor size was significant variable of overall survival ( p=0.0015, 95% C.I.; 1.4814-5.2815), disease-free survival ( p=0.0022, 95% C.I.; 1.4707-5.7780) and local-relapse-free survival ( p=0.0048, 95% C.I.; 1.2910- 4.1197). T stage was significant variable of overall survival ( p=0.0395, 95% C.I.; 1.1084-65.9112) and had borderline significance on disease-free survival ( p=0.0649, 95% C.I.; 0.8888-50.7123) and local-relapse-free survival ( p= 0.0582, 95% C.I.; 0.9342-52.7755). On multivariate analysis, tumor size had borderline significance on overall survival ( p=0.6919, 955 C.I.; 0.9610-5.1277) and local-relapse-free survival ( p=0.0585, 95% C.I.; 0.9720- 4.9657). Tumor size was also significant variable of disease-free survival ( p=0.0317, 95% C.I.; 1.1028-8.4968). CONCLUSION: Radical radiotherapy is an effective treatment for small (T1 or < or =3 cm) tumors and can be offered as alternative to surgery in elderly or infirmed patients. But when the size of tumor is larger than 5 cm, there were few long-term survivors treated with radiotherapy alone. The use of hyperfractionated radiotherapy, endobronchial boost, radisensitizer and conformal or IMRT should be consider to improve the local control rate and disease-specific survival rate.
Abdomen ; Adenocarcinoma ; Aged ; Carcinoma, Non-Small-Cell Lung* ; Diagnosis ; Disease-Free Survival ; Disulfiram ; Drug Therapy ; Follow-Up Studies ; Heart ; Humans ; Lung ; Lung Neoplasms ; Medical Records ; Multivariate Analysis ; Particle Accelerators ; Radiotherapy* ; Survival Rate ; Survivors ; Thoracic Wall ; Thorax ; Tomography, X-Ray Computed

Purpose: The purpose of our study was to assess the clinical and radiological results of isolated acetabular revision and the differences in the results between monoblock and modular femoral stems. Materials and Methods: Between October 1991 and June 2002, 39 patients (39 hips) underwent isolated acetabular revisions with use of uncemented cups and bone grafts. The mean period of follow-up was 5 years 3 months (range, 2 years 1 month to 9 years 8 months). The mean age of the patients at the time of the surgery was 51 years old (range, 26 to 75 years old). The monoblock femoral stems were used in 19 hips and the modular femoral stems were used in 20 hips. The monoblock stems were retained without exchange provided that there was no gross scratch on the femoral head and the femoral stem was confirmed to be stable and fixed intraoperatively. In the modular stems, the femoral heads were always exchanged with new ones. Results: The mean Harris hip score improved from 57 to 87 points. Radiologically, all the stems retained at surgery remained well osseointegrated without osteolysis. Re-revisions of the acetabular components were performed in 5 hips using monoblock stems due to periacetabular osteolysis caused by excessive wear of polyethylene and subsequent loosening of the cups in 3 hips and mechanically unstable acetabular cups without osteolysis in 2 hips. The mean wear rate of polyethylene coupled with the monoblock stem was 0.27 mm/year which was greater than the 0.11 mm/year in the cases with modular stems. Conclusion: To prevent failure of acetabular cups that may occur later by excessive wear of polyethylene, we recommend revision of the well-fixed monoblock femoral stems even though there is no gross scratch on the femoral heads of the monoblock stems.
Acetabulum* ; Follow-Up Studies ; Head ; Hip ; Humans ; Osteolysis ; Polyethylene ; Transplants

PURPOSE: The purpose of this study was to identify the effects of job stress, emotional labor, and positive psychological capital on the job satisfaction of physician assistants (PAs). METHODS: The sample consisted of 166 PAs working in general hospitals in B city, Y city, and C city. Data were analyzed through the SPSS/WIN 18.0 program using t-test, ANOVA, Scheffé test, Pearson's correlation coefficients, and multiple regression. RESULTS: The factors of job stress (β=−.488, p<.001), positive psychological capital (β=.188, p=.004), and total clinical career (β=−.147, p=.014) had the greatest influence on the level of job satisfaction experienced by the PAs. The total explanatory power was 49.9%. CONCLUSION: It was found that job stress, positive psychological capital, and total clinical career were influencing factors in the job satisfaction of PAs. Therefore, to improve their job satisfaction, it is necessary to develop strategies to manage the job stress experienced by PAs, and to strengthen and develop positive psychological capital.
Hospitals, General ; Humans ; Job Satisfaction ; Physician Assistants ; Stress, Psychological

PURPOSE: The purpose of this study was to identify the effects of job stress, emotional labor, and positive psychological capital on the job satisfaction of physician assistants (PAs). METHODS: The sample consisted of 166 PAs working in general hospitals in B city, Y city, and C city. Data were analyzed through the SPSS/WIN 18.0 program using t-test, ANOVA, Scheffé test, Pearson's correlation coefficients, and multiple regression. RESULTS: The factors of job stress (β=−.488, p<.001), positive psychological capital (β=.188, p=.004), and total clinical career (β=−.147, p=.014) had the greatest influence on the level of job satisfaction experienced by the PAs. The total explanatory power was 49.9%. CONCLUSION It was found that job stress, positive psychological capital, and total clinical career were influencing factors in the job satisfaction of PAs. Therefore, to improve their job satisfaction, it is necessary to develop strategies to manage the job stress experienced by PAs, and to strengthen and develop positive psychological capital.

OBJECTIVE: A number of studies to improve in vitro culture conditions have been tried over past ten years by using co-culture system with helper somatic cells. However, the mechanism of coculture is poorly understood. This study was designed to understand the mechanism for the mode of actual action of co-culture system of ICR strain's 1-cell embryos with human oviduct epithelial cells by examining the effect of conditioned medium and contactless coculture using a cell culture insert on the embryo development and by measuring the level of superoxide anion from conditioned medium after co-culture. METHODS: ICR strain's zygote embryos were cultured in medium alone (control), coculture, conditioned medium, or contactless coculture system for 6 days. Conditioned media (CM) were prepared as following 5 groups. All CM were collected after culturing oviduct cells for 2 days. CM-1 was stored at -20degrees C until use, and CM-2 was prepared just before use as a culture medium. CM-3 was cocultured with embryos and retrieved just before use. CM-4 and CM-5 were derives from the microfilteration of CM-2 and CM-3, respectively, using Microcon-10 (10 kDa molecular weight cut-off). The percentage of the embryos developed to hatched blastocyst stage and the level of superoxide anion in supernatant from medium alone culture (control), coculture, and contactless coculture were measured. RESULTS: The rates of embryo development to the hatched blastocyst stage were significantly higher in coculture (43%) than in control (0%) (p<0.05). The CM-1 group had no embryo development since 2-cell embryonic stage, whereas the CM-2, CM-3, CM-4 and CM-5 groups had the improved development to 4 or 8 cell embryo stage, but the similar rate of development to hatched blastocyst compared to control. The effect of coculture on embryo develpment was disappeared in the contactless coculture group. The level of superoxide anion was significantly reduced in coculture group compared to control. CONCLUSION: It is concluded that the present coculture system overcomes the 2-cell block in vitro and improves the embryo development. This beneficial effect may be due to the direct cell-cell contact between embryo and helper cells or the removal of deleterious components from medium rather than the embryotrophic factors.
Animals ; Blastocyst ; Cell Culture Techniques ; Coculture Techniques* ; Culture Media, Conditioned ; Embryonic Development ; Embryonic Structures ; Epithelial Cells ; Female ; Humans ; Molecular Weight ; Oviducts ; Pregnancy ; Superoxides ; T-Lymphocytes, Helper-Inducer ; Zygote

Purpose: The aim of this research was to identify, appraise and synthesize available evidence exploring new nurses' experiences of turnover. Methods: The qualitative meta-synthesis method suggested by Thomas and Harden was used. Qualitative research articles considered for inclusion in the review were identified through an extensive search of relevant literature in scientific databases. Data were extracted from the aforementioned articles, and qualitative research findings were pooled according to Thomas and Harden's review process. This process involved the categorization of findings according to similarity of meaning and aggregation of these sub-themes to produce a comprehensive set of synthesized themes. Results: A total of 4 research articles met the inclusion criteria and were included in the review. The review process resulted in 30 sub-themes that were aggregated into 10 themes: ineffective education; overwhelming work; personal maltreatment by doctors, career nurses, patients and caregivers; lack of professional vision; suffering; fear; loss of confidence; isolation; cynical reaction to turnover; new beginning and growth. Conclusion These findings illuminated the necessity of educational, organizational, emotional and social support for new nurses to help them accomplish their developmental tasks during their transition, as well as the need for this support to continue even after the turnover.

Uterine papillary serous carcinoma (UPSC) behave more aggressively than other endometrial carcinomas and have a propensity for intraabdominal spread, simulating the behavior of ovarian carcinoma. Because of high relapsing rate, and high mortality rate of UPSC, many gynecologist studied about its treatment regimen and recommended many treatment method. Many investigators recommended that patients with UPSC should undergo a staging laparotomy and they suggested the surgery should include at least total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, pelvic lymphadenectomy, paraaortic lymphadenectomy, peritoneal washing and peritoneal cytology, By and large, adjuvant systemic Platinum based chemotherapy or, paclitaxel based chemotherapy and adjuvant whole abdominal irradiation or pelvic irradiation was prescribed. We experienced two cases of the UPSC stage IIIc and stage IV diagnosed after explolaparotomy. We present these cases and review the literatures about the optimal treatment regimen of UPSC.
Drug Therapy ; Endometrial Neoplasms ; Female ; Humans ; Hysterectomy ; Laparotomy ; Lymph Node Excision ; Mortality ; Paclitaxel ; Platinum ; Research Personnel