PURPOSE: The purpose of this study was to investigate differences in professionalism, organizational citizenship behavior and psychological ownership between nurses and nurse officers. METHODS: A cross-sectional survey was conducted with 1017 hospital nurses and military nurse officers. The instruments used were the Korean Version of Hall's Professionalism Inventory' modified by Baek (2007), Organizational Citizenship Behavior Qquestionnaire(OCBQ) modified by Lee (2006), and the Psychological Ownership Inventory' developed by Van Dyne and Pierce (2004). RESULTS: The average score for military nurse officers professionalism was 3.15, for organizational citizenship behavior, was 3.43 and for psychological ownership, 3.64. These scores were higher than the scores for hospital nurses. There were significant positive correlations between the variables(r=.47~.581, p<.001). CONCLUSION: The results of this study indicate an affirmable outcome and that the significant variables affected levels of Professionalism, Organizational citizenship behavior, and Psychological ownership. So in order to improve the level of variables, there is a need to consider strategies related to organization, work environment and conceptualization as related to the variables.
Cross-Sectional Studies ; Humans ; Military Personnel ; Ownership

No abstract available.
Carcinoma, Small Cell* ; Prognosis*

PURPOSE: We report a case of systemic cystinosis who showed cystine crystal depositions within cornea. METHODS: A 13-year-old boy with systemic cystinosis who had chronic renal failure, growth retardation, rickets for 9 years was consulted for ophthalmic examination for photophobia. We performed complete ophthalmic examinations including slit lamp examination, corneal pachymetry, corneal sensitivity test, specular microscopy, corneal topography, and fundoscopic examination. RESULTS: There were needle-like cystine crystal depositions within the entire corneal stroma. Other findings were within normal. CONCLUSIONS: We report a case of sytemic cystinosis that had cystine crystal depositions within cornea. It is the first case report in Korea.
Adolescent ; Cornea* ; Corneal Pachymetry ; Corneal Stroma ; Corneal Topography ; Cystine* ; Cystinosis* ; Humans ; Kidney Failure, Chronic ; Korea ; Male ; Microscopy ; Photophobia ; Rickets

No abstract available.
Enterovirus* ; Humans ; Meningitis, Aseptic*

PURPOSE: An accurate assessment of body fluid status is a significant challenge during every clinical examination. In many disorders, the therapy and its effectiveness depend on appropriate evaluation of body fluid state, especially in the trauma patient. The purpose of this study was to evaluate the clinical significance of the IVC/aorta diameter index on abdominal CT scans and to determine whether? The IVC/aorta diameter index was useful for predicting the outcome of trauma patients in the emergency department. METHODS: This study was a retrospective analysis of data acquired between December 2008 and April 2009. We included 108 trauma patients who received abdominal CT in the emergency department. Persons who had a major medical problem such as liver cirrhosis, or who were transferred from other hospitals for ICU care, or who were younger than 15 years, were excluded. IVC and aorta were measured below the infrarenal vein in the abdominal CT in an axial view. Clinical assessment included the patient's final diagnosis, blood pressure, heart rate, weight and whether he was dead or not. Receiver operating characteristic (ROC) curves were used to find the value of the IVC/aorta diameter index that maximized the sum of the sensitivity and specificity. Statistical analysis was performed using SPSS 17.0. RESULTS: We studied 135 patients (trauma 108 and non trauma 27). The mean IVC/aorta diameter index of nontrauma patients was 1.26+/-0.17; for trauma patients it was 0.80+/-0.33. The average IVC/aorta index in the shock group at arrival were significantly smaller than in the non shock group (0.57+/-0.27 versus 0.89+/-0.3). CONCLUSION: The inferior vena cava/aorta diameter index in trauma patients is useful in assessment of injury severity and prognosis.
Aorta ; Blood Pressure ; Body Fluids ; Emergencies ; Heart Rate ; Humans ; Liver Cirrhosis ; Prognosis ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity ; Shock ; Veins ; Vena Cava, Inferior

The occurrence of CRPS after a snake bite was very rare, only two cases were reported worldwide. Here we report a case that the 44-year-old female patient bitten by snakes CRPS type 1 was treated consecutive intravenous regional block, lumbar sympathectomy and antiepileptic drug therapy, also discuss the possible pathophysiology.
Adult ; Drug Therapy ; Female ; Humans ; Snake Bites* ; Snakes* ; Sympathectomy

PURPOSE: Procalcitonin (PCT) is a newly introduced marker of systemic bacterial infection. The MEDS (Mortality in Emergency Department Sepsis) scoring system has proven to be the most useful and appropriate clinical prediction tool in cases of systemic bacterial infection in the emergency department. There have been no studies comparing the PCT assay with the abbreviated MEDS scoring system (without neutrophil bands). This study aimed to determine the efficacy of quantitative PCT assay and the abbreviated MEDS score in predicting the 28-day mortality and intensive care unit (ICU) admission in emergency department patients with systemic inflammatory response syndrome (SIRS). METHODS: This study was carried out prospectively on 212 patients >18-years-of-age with the criteria of SIRS who had visited to the emergency department. They were included if they had an emergency department diagnosis of sepsis, two or more SIRS criteria. We checked the initial PCT concentration and calculated abbreviated MEDS score. The primary outcome was 28-day mortality and ICU admission. We evaluated the predictive abilities of the initial PCT assay and abbreviated MEDS score. Receiver operating characteristic (ROC) curves were used to identify the value of PCT and abbreviated MEDS scoring system that maximized the sum sensitivity and specificity. RESULTS: Among the 212 patients included in this study, the mortality rate was 21%(45 of 212 patients) and the ICU admission rate was 33%(70 of 212 patients). Non-survivor group had a significantly higher PCT concentration (median, interquartile range (IQR), 12.23 ng/mL, 2.33-39.77 vs. 0.58 ng/mL, 0.10-3.60, p=0.05) and a higher abbreviated MEDS score (12.62+/-4.33 vs. 5.53+/-3.57, p<0.05) than the survival group. ICU admission patients had a significantly higher PCT concentration (median, IQR, 7.75 ng/mL, 1.43-36.85 vs. 0.55 ng/mL, 0.08-3.03 p<0.05) and a higher abbreviated MEDS score (10.90+/-4.60 vs. 5.13+/-3.48, p<0.05) than general ward admission patients. ROC analysis showed the discriminative power of the abbreviated MEDS score and PCT assay in predicting ICU admission and 28-day mortality. For ICU admission, areas of under the curves (AUC) of abbreviated MEDS score and PCT were 0.842 and 0.749, respectively (p<0.05). For PCT, AUC of abbreviated MEDS and PCT were 0.888 and 0.784, respectively (p<0.05). The optimal PCT threshold in predicting ICU admission was 1.22 ng/mL (odds ratio (OR), 6.92; 95% confidence interval (CI), 3.51-13.63; p<0.05) and 1.90 ng/mL in predicting 28-day mortality (OR, 11.90; 95% CI, 4.76-29.74). The optimal threshold of abbreviated MEDS score in predicting ICU admission was 8 (OR, 10.95; 95% CI, 5.47-21.90; p<0.05) and 9 in predicting 28 day mortality (OR, 19.03; 95% CI, 8.28-43.78; p<0.05). CONCLUSION: Both abbreviated MEDS scoring system and single plasma PCT assays can be used as a useful marker in rapidly and accurately predicting poor prognosis in emergency department patients with sepsis.
Area Under Curve ; Bacterial Infections ; Calcitonin ; Emergencies ; Humans ; Intensive Care Units ; Neutrophils ; Patients' Rooms ; Plasma ; Prognosis ; Prospective Studies ; Protein Precursors ; ROC Curve ; Sepsis ; Systemic Inflammatory Response Syndrome

PURPOSE: Procalcitonin (PCT) is a newly introduced marker of systemic bacterial infection. The MEDS (Mortality in Emergency Department Sepsis) scoring system has proven to be the most useful and appropriate clinical prediction tool in cases of systemic bacterial infection in the emergency department. There have been no studies comparing the PCT assay with the abbreviated MEDS scoring system (without neutrophil bands). This study aimed to determine the efficacy of quantitative PCT assay and the abbreviated MEDS score in predicting the 28-day mortality and intensive care unit (ICU) admission in emergency department patients with systemic inflammatory response syndrome (SIRS). METHODS: This study was carried out prospectively on 212 patients >18-years-of-age with the criteria of SIRS who had visited to the emergency department. They were included if they had an emergency department diagnosis of sepsis, two or more SIRS criteria. We checked the initial PCT concentration and calculated abbreviated MEDS score. The primary outcome was 28-day mortality and ICU admission. We evaluated the predictive abilities of the initial PCT assay and abbreviated MEDS score. Receiver operating characteristic (ROC) curves were used to identify the value of PCT and abbreviated MEDS scoring system that maximized the sum sensitivity and specificity. RESULTS: Among the 212 patients included in this study, the mortality rate was 21%(45 of 212 patients) and the ICU admission rate was 33%(70 of 212 patients). Non-survivor group had a significantly higher PCT concentration (median, interquartile range (IQR), 12.23 ng/mL, 2.33-39.77 vs. 0.58 ng/mL, 0.10-3.60, p=0.05) and a higher abbreviated MEDS score (12.62+/-4.33 vs. 5.53+/-3.57, p<0.05) than the survival group. ICU admission patients had a significantly higher PCT concentration (median, IQR, 7.75 ng/mL, 1.43-36.85 vs. 0.55 ng/mL, 0.08-3.03 p<0.05) and a higher abbreviated MEDS score (10.90+/-4.60 vs. 5.13+/-3.48, p<0.05) than general ward admission patients. ROC analysis showed the discriminative power of the abbreviated MEDS score and PCT assay in predicting ICU admission and 28-day mortality. For ICU admission, areas of under the curves (AUC) of abbreviated MEDS score and PCT were 0.842 and 0.749, respectively (p<0.05). For PCT, AUC of abbreviated MEDS and PCT were 0.888 and 0.784, respectively (p<0.05). The optimal PCT threshold in predicting ICU admission was 1.22 ng/mL (odds ratio (OR), 6.92; 95% confidence interval (CI), 3.51-13.63; p<0.05) and 1.90 ng/mL in predicting 28-day mortality (OR, 11.90; 95% CI, 4.76-29.74). The optimal threshold of abbreviated MEDS score in predicting ICU admission was 8 (OR, 10.95; 95% CI, 5.47-21.90; p<0.05) and 9 in predicting 28 day mortality (OR, 19.03; 95% CI, 8.28-43.78; p<0.05). CONCLUSION: Both abbreviated MEDS scoring system and single plasma PCT assays can be used as a useful marker in rapidly and accurately predicting poor prognosis in emergency department patients with sepsis.
Area Under Curve ; Bacterial Infections ; Calcitonin ; Emergencies ; Humans ; Intensive Care Units ; Neutrophils ; Patients' Rooms ; Plasma ; Prognosis ; Prospective Studies ; Protein Precursors ; ROC Curve ; Sepsis ; Systemic Inflammatory Response Syndrome

PURPOSE: Urethral catheterization is a commonly done, painful procedure, but few studies have evaluated the use of topical anesthesia prior to catheterization. This study was designed to assess the effect of topical anesthetics (2% lidocaine gel) prior to uretheral catheterization. METHODS: This study was a prospective, randomized, case-controlled trial conducted in an emergency department of a university teaching hospital. The 54 subjects were alert, cooperative male adults. Patients in the experimental group were catheterized after injection of topical lidocaine gel in their urethras, and a wait of 3 minutes. Patients in the control group were catheterized with a urethral catheter that was coated by plain lubricant. After each procedure, the patients indicated their subjective assessment of pain on a 100 mm visual analog scale (VAS). We assessed VAS at 4 times: during the procedure, at the end of the procedure, and at 3 and 6 hours after the procedure. SPSS 17.0 was used for statistical analysis. RESULTS: The 54 patients were evenly distributed between the 2 study groups. Mean age was 50 years (range 28-71) in the control group, and 54 years (range 27-70) in the experimental group. The mean reduction in VAS values in the experimental group was 27 mm during the procedure, and 23 mm at 6 hours after the procedure. CONCLUSION: Use of a topical lidocaine gel during urethral catheterization results in significant reduction in pain compared to topical lubricants. This benefit is provided both during the procedure as well as up to 6 hours after the procedure.
Adult ; Anesthesia ; Anesthesia, Local ; Anesthetics ; Case-Control Studies ; Catheterization ; Catheters ; Emergencies ; Hospitals, Teaching ; Humans ; Lidocaine ; Lubricants ; Male ; Prospective Studies ; Urethra ; Urinary Catheterization ; Urinary Catheters

Phytolacca americana poisoning is a benign plant intoxication that causes gastrointestinal symptoms, including abdominal cramps, vomiting, diarrhea, and gastrointestinal bleeding. Other signs and symptoms include diaphoresis, salivation, visual disturbance, and seizures or mental changes. We report two cases of patients who experienced confusion and abdominal pain, vomiting, and hematemesis after oral ingestion of pokeweed. A 60-year-old female with confusion and a 67-year-old female with abdominal pain, vomiting, and diarrhea were admitted to the emergency department after pokeweed poisoning. After supportive treatment of hydration and gastrointestinal medication, the two patients showed full recovery within 24 h and were discharged from the hospital.
Abdominal Pain ; Aged ; Colic ; Diarrhea ; Eating ; Emergencies ; Female ; Hematemesis ; Hemorrhage ; Humans ; Middle Aged ; Phytolacca ; Phytolacca americana ; Plant Poisoning ; Plants ; Salivation ; Seizures ; Vomiting