Purpose: The purpose of this study was to systematically review and conduct meta-analysis on factors affecting career preparation behavior of Korean nursing students. Methods: Related articles published in Korean and English were collected based on search terms and converted into a numerical database. Data extraction, quality assessment and analysis including a systematic review and meta-analysis were completed. Results: The review included 27 studies. There were 25 factors influencing career preparation behavior of Korean nursing students. Factors were categorized into four sub-factors: personal, contextual, cognitive-emotional, and goal-related. In the meta-analysis of 27 articles the total effect size (ESr) was .34. The effect sizes of the four sub-factors were .37 for individual factors, .25 for situation factors, .34 for cognitive and emotional factors, and .41 for target factors. The main factors were .53 for career-related efficacy, .43 for self-leadership, and .43 for career decision level. Conclusion Nursing students with high career-related efficacy and self-leadership are more likely to demonstrate career preparation behavior. Based on these results, educational institutions for nursing students must improve students’ self-leadership and career effectiveness through education so that they can set career goals.

BACKGROUND: Intrathecal (IT) magnesium has antinociceptive effects on animals and has been reported to prolong spinal opioid analgesia in humans. This study examined the effect of IT magnesium on spinal anesthesia and postoperative epidural analgesia. METHODS: Sixty patients undergoing total knee replacement were enrolled in this study. Before the IT injection of 0.5% isobaric tetracaine (10 mg), group C and group M received 0.9% saline or 50% magnesium sulfate 0.1 ml, respectively. The epidural solution for postoperative analgesia contained 0.2% ropivacaine (100 ml) only in group M, and 0.2% ropivacaine plus morphine (50microgram/ml) in group C. The verbal rating scale (VRS) scores for pain, sensory block level, intensity of motor block and side effects were recorded at 5, 60, and 120 minutes after the IT injection and at 1, 12 and 36 hours after surgery in the post-anesthesia care unit (PACU). RESULTS: The VRS score at 120 minutes after the IT injection were lower in group M than in group C (P< 0.05). There were no differences in the VRS scores and the use of supplemental analgesics at the postoperative period. The incidence of PONV, pruritus and urinary retention was significantly lower in group M than in group C at 12 and 36 hours after surgery. CONCLUSIONS: IT magnesium can be used as a local anesthetic adjuvant to strengthen the analgesic effect of spinal local anesthesia and to intensify the analgesic effect of epidural local anesthesia for postoperative pain control to the extent of 5 mg epidural morphine.
Analgesia ; Analgesia, Epidural ; Analgesics ; Anesthesia, Local ; Anesthesia, Spinal ; Animals ; Arthroplasty, Replacement, Knee ; Humans ; Incidence ; Magnesium Sulfate* ; Magnesium* ; Morphine ; Pain, Postoperative ; Postoperative Nausea and Vomiting ; Postoperative Period ; Pruritus ; Tetracaine ; Urinary Retention

BACKGROUND: Patients are most likely to develop severe arterial desaturation during the early postoperative period. Respiratory complications in postanesthesia care unit (PACU) increase the risk of major adverse cardiac outcomes, unanticipated ICU admission or delay in PACU discharges. The increased use of inhalation agents with low blood : gas partition coefficient, intermediate-acting muscle relaxants and continuous pulse oximeter monitoring over the past 10 years may have altered the incidence of immediate postoperative hypoxemia. This study was undertaken to determine the overall incidence of immediate postoperative hypoxemia in PACU. METHODS: Hypoxemia was defined as a pulse oxygen saturation (SpO2) of less than 90% lasting for at least 20 sec. The occurrence of hypoxemia was documented and notified to the anesthesiologist by PACU nurses. The anesthesiologist recorded contributory factors and the management modalities used in patients with hypoxemia. RESULTS: The incidence of hypoxia was 3.5 per 1,000 patients after general anesthesia. Most hypoxemic events (88%) occurred during the first 5 minutes after arrival in PACU. Upper airway obstruction was the major contributory factor for hypoxemia (75.5%) and most of these patients recovered simply after a jaw thrust or the insertion of an oral or nasal airway. CONCLUSIONS: Postoperative hypoxemia does not occur often in PACU, but when it does, it is associated with major morbidity and increased medical costs. Therefore, oxygen supply is recommended in patients with risk factors of hypoxemia during transfer from operating rooms to PACU. Close monitoring of hypoxemia in PACU is needed in all patients after general anesthesia.
Airway Obstruction ; Anesthesia, General ; Anoxia ; Humans ; Incidence* ; Inhalation ; Jaw ; Operating Rooms ; Oximetry* ; Oxygen ; Postoperative Period ; Risk Factors

BACKGROUND: MacFarlane and Rosenthal reported a case of acute quadriplegia after nondepolarizing muscular blocking agents in status asthmaticus patient treated with high doses of corticosteroid. Reports regarding the reactions of glucocorticoid treated muscles to neuromuscular blocking agents are sparse and inconsistent. The aims of this study were to examine the degree of muscle atrophy and its effects on sensitivity to neuromuscular blocking agents in relation to the dose and duration of dexamethasone. METHODS: Sixty Sprague-Dawley rats were divided into six groups. They were treated daily with dexamethasone 0.4 mg/kg and 4 mg/kg daily for 1 week or 3 weeks. The two control groups were treated with normal saline. The day after treatment, the dose-response curves of vecuronium were measured using a phrenic nerve-hemidiaphragm preparation. To classify muscle fiber, the diaphragm was stained for myofibrillar adenosine triphosphatase after alkaline and acid preincubation, and a morphometric examination was carried out. RESULTS: The diaphragmatic muscle in rats treated with long term, high dose dexamethasone showed significant atrophy. For the short term, low dose dexamethasone group, the ED50 and ED95 of vecuronium decreased 41.5% and 26.8% compared to those of the control group, respectively (P<0.05). However, the ED50 of vecuronium in the long term, high dose dexamethasone group increased 22.2% compared to that of the control group (P<0.05). CONCLUSION: This study suggests that sensitiviy to vecuronium was not modulated by dexamethasone-induced muscle atrophy. Quantitative changes of receptors at the neuromuscular junction or some anoother process might be responsible for this change.
Adenosine Triphosphatases ; Animals ; Atrophy ; Dexamethasone* ; Diaphragm ; Humans ; Muscles ; Muscular Atrophy ; Neuromuscular Blocking Agents ; Neuromuscular Junction ; Quadriplegia ; Rats* ; Rats, Sprague-Dawley ; Status Asthmaticus ; Vecuronium Bromide

PURPOSE: Spin-echo (SE) technique is most commonly used pulse sequence for T1-weighted MR imaging. T1-weighted fluid-attenuated inversion recovery (T1FLAIR) is a relatively new pulse sequence and it provides higher tissue contrast between the gray matter (GM) and white matter (WM) of the brain than T1-weighted SE (T1SE) sequence. However, there has been controversy for the evaluation of enhancing brain tumors with T1FLAIR compared to T1SE. The purpose of this study was to compare T1FLAIR and T1SE sequences for the evaluation of enhancing intracranial tumors. MATERIALS AND METHODS: Fifty-two patients with enhancing brain tumors were evaluated with contrast-enhanced (CE) T1SE and T1FLAIR imaging. Eight quantitative criteria were calculated: lesion-to-WM contrast ratio (CR) and contrast-to-noise ratio (CNR), lesion-to-GM CR and CNR, lesion-to-CSF CR and CNR, and WM-to-GM CR and CNR. For qualitative evaluation, two radiologists assessed lesion conspicuity on CE T1SE and T1FLAIR sequences with three-scale: 1, T1SE superior; 2, sequence equal; T1FLAIR superior. RESULTS: Seventy-nine tumors (31 primaries, 48 metastases) were assessed. For quantitative measurement, the T1FLAIR lesion-to-GM, lesion-to-CSF, WM-to-GM CR and CNR values were comparable and statistically superior to those of the T1SE images (p < 0.001 in all). However, lesion-to-WM CR and CNR were similar on both two sequences without statistically significant difference (p = 0.661, 0.662, respectively). For qualitative evaluation, both radiologists assessed that T1FLAIR images were superior to T1SE images for the evaluation of lesion conspicuity. CONCLUSION: For the evaluation of enhancing intracranial tumors, T1FLAIR sequence was superior or comparable to T1SE sequence.
Brain ; Brain Neoplasms* ; Evaluation Studies as Topic ; Humans ; Magnetic Resonance Imaging*

BACKGROUND: Resistant organisms are now a growing and frequent problem in community-acquired infections. There is little information on the etiology and antimicrobial susceptibility patterns of community-acquired urinary tract infection (CA-UTI) at a tertiary-care hospital. METHODS: We evaluated the distribution of etiological organisms with their antimicrobial susceptibility patterns of CA-UTI in the patients visiting a tertiary-care hospital during the period of three years from 2001 through 2003. RESULTS: In total, 1,753 bacterial isolates yielded a significant growth as pathogens of CA-UTI in this study. The most common pathogen was Escherichia coli (38.3%), followed by Pseudomonas aeruginosa (10.8%), Enterococcus faecalis (7.3%), Klebsiella pneumoniae (6.4%), coagulase negative staphylococci (CoNS) (5.4%) and Staphylococcus aureus (5.2%). The prevalence of E. coli was significantly higher in females (P < 0.001), whereas P. aeruginosa, E. faecalis, and S. aureus were significantly more common in male group (P < 0.001). The susceptibility rate of E. coli was 26.0% to ampicillin, 65.8% to gentamicin, 51.3% to co-trimoxazole, and 62.5% to ciprofloxacin. The susceptibility patterns of Enterobacteriaceae other than E. coli were different from those of E. coli. Extended spectrum beta-lactamase was detected in 7.9% of E. coli and 15.6% of K. pneumoniae. CONCLUSION: This study demonstrates a diversity of etiological organisms and a high rate of resistance to commonly used antimicrobials of CA-UTI in patients visiting a tertiary-care hospital.
Ampicillin ; beta-Lactamases ; Ciprofloxacin ; Coagulase ; Community-Acquired Infections ; Drug Resistance, Microbial ; Enterobacteriaceae ; Enterococcus faecalis ; Escherichia coli ; Female ; Gentamicins ; Humans ; Klebsiella pneumoniae ; Male ; Pneumonia ; Prevalence ; Pseudomonas aeruginosa ; Staphylococcus aureus ; Trimethoprim, Sulfamethoxazole Drug Combination ; Urinary Tract Infections* ; Urinary Tract*

OBJECTIVES: This study was conducted to evaluate post-traumatic stress disorder (PTSD), the quality of life and social adjustment of North Korean refugees who consulted psychiatric clinics. METHODS: A total of 66 North Korean refugees who consulted a psychiatric clinic were included in the analysis. A psychiatrist conducted interviews with the subjects, and PTSD was diagnosed using the clinician-administered PTSD Scale. The quality of life of the subjects was evaluated using the World Health Organization Quality of Life Scale. RESULTS: Thirty five (53%) were diagnosed with PTSD. Quality of life was found to show association with understanding the language in South Korea, difficulty interacting with South Koreans, and experience or feeling of neglect. Quality of life of the PTSD group was lower than in the Non-PTSD group. Difficulty adapting to South Korean society was also higher in the PTSD group. Experience or feeling of neglect was negatively correlated with the quality of life in the PTSD group. CONCLUSION: The results of this study may be helpful in providing a specific direction for psychiatric intervention strategies to improve overall quality of life and adaptation to life in South Korea.
Humans ; Korea ; Psychiatry ; Quality of Life ; Refugees ; Social Adjustment ; Stress Disorders, Post-Traumatic* ; World Health Organization

OBJECTIVES: This study was conducted to translate the Impact of Event Scale-Revised (IES-R) into North Korean language and confirm its reliability and validity. METHODS: A total of 207 North Korean defectors recruited from the Call Center for North Korean Defectors participated in this study. Psychiatrists and psychiatric residents interviewed the participants individually and made psychiatric diagnosis. Subsequently, they completed the Brief Psychological State Inventory for North Korean Refugees (BPSI-NKR), the Center for Epidemiologic Studies Depression Scale-North Korea (CES-D-NK), and the Alcohol Use Disorders Identification Test-North Korea (AUDIT-NK) as well as the Impact of Event Scale-Revised-North Korea (IES-R-NK). Of the original participants, 143 subjects participated in test-retest reliability study after one week. RESULTS: The internal consistency using Cronbach's alpha was superior in both male and female from North Korea. In addition, the temporal stability was also satisfactory. A good convergent validity was clearly shown by significant correlations with BPSI-PTSD and CES-D-NK, respectively. On the other hand, IES-R-NK had no or weak correlations with AUDIT-NK and BPSI-NKR-alcohol, demonstrating its satisfactory discriminant validity. CONCLUSION: IES-R-NK might be considered as a short and valid screening tool for identification of PTSD symptoms in North Korean defectors.
Democratic People's Republic of Korea ; Depression ; Epidemiologic Studies ; Female ; Hand ; Humans ; Korea ; Male ; Mass Screening ; Mental Disorders ; Psychiatry ; Refugees ; Reproducibility of Results* ; Stress Disorders, Post-Traumatic

Although coagulase-negative staphylococci (CNS) have been considered part of the resident flora on the human skin, Staphylococcus lugdunensis is an unusually virulent CNS and can cause many types of infection. We report a rare case of acute lymphadenitis with cellulitis in the right infraauricular region caused by S. lugdunensis. A 62-yr-old woman visited the Department of Otolaryngology of Busan Paik university hospital. She had a palpable mass and swelling in the right infraauricular region and complained of aggressive pain and a febrile sensation in the region for 5 days. On the suspicion of abscess with infection, percutaneous aspiration was performed and smooth, flat, white, opaque colonies grew on a blood agar plate as a pure culture. The biochemical test results showed the organism to be catalase positive, tube coagulase negative, ornithine decarboxylase positive, slide coagulase positive, and latex agglutination tests for coagulase positive. The API Staph Kit was used to identify the isolate to the species level as S. lugdunensis with a 64.6% probability (profile 6716152). We confirmed the species identification of this strain by 16S rDNA sequence analysis. The patient's clinical condition improved with appropriate antimicrobial therapy and pus drainage.
Acute Disease ; Cellulitis/*diagnosis/*microbiology ; Drainage ; Ear, External ; Female ; Humans ; Lymphadenitis/*diagnosis/drug therapy/*microbiology ; Microbial Sensitivity Tests ; Middle Aged ; RNA, Ribosomal, 16S/genetics ; Sequence Analysis, DNA ; Staphylococcal Infections/*diagnosis/microbiology

BACKGROUND: We noticed a sudden increase in the isolation of Klebsiella oxytoca from bronchial washing specimens during May to June 2006. An epidemiological investigation was conducted to identify the cause of the outbreak and to implement appropriate infection control measures. METHODS: A total of 18 isolates of K. oxytoca were found. The 14 bronchial washing specimens that yielded K. oxytoca were taken in the outpatient bronchoscopy suite, and the other 4 specimens were obtained by a portable bronchoscopy. The medical records and microbiologic findings of these patients were reviewed. Environmental samples from two bronchoscopes and the bronchoscopy suite were cultured. The relations between the available 10 isolates from bronchial washing fluid were investigated by pulsed-field gel electrophoresis (PFGE). RESULTS: No patients were judged to have had true infections attributable to K. oxytoca either before or after bronchoscopy. Cultures of samples from two bronchoscopes and related environment did not grow K. oxytoca. The PFGE analysis showed that 8 of 10 isolates had a similar pattern of DNA fragments. An infection control strategy was implemented, including adequately cleaning and disinfecting the bronchoscopes, and a sharp reduction in the incidence of K. oxytoca from bronchial washing samples followed. CONCLUSION: The sudden increase of K. oxytoca from bronchial washing specimens was a pseudo-outbreak. We presumed that the bronchoscopes became contaminated during a procedure in a patient colonized with K. oxytoca in the upper-respiratory tract.
Bronchoscopes ; Bronchoscopy ; Colon ; DNA ; Electrophoresis, Gel, Pulsed-Field ; Humans ; Incidence ; Infection Control ; Klebsiella ; Klebsiella oxytoca ; Medical Records ; Outpatients