PURPOSE: The aim of this study was to identify the relationships between the difficulty of end-of-life care and moral distress, burnout and job satisfaction of nurses working in intensive care units (ICUs). METHODS: This descriptive study was conducted using self-report questionnaires. Participants were nurses who had more than one year of ICU experience and were recruited from three university hospitals (N=168). RESULTS: The mean scores for ICU nurses' difficulty in end-of-life care, moral distress, burnout and job satisfaction were 3.42, 113.88, 3.16 and 2.58 points, respectively. Difficulty in end-of-life care was positively correlated with moral distress (r=.48, p < .001) and burnout (r=.26, p=.001) and was negatively correlated with job satisfaction (r=−.17, p=.024). Difficulties in end-of-life was identified as a predictor of moral distress (β=.44, p < .001), burnout (β=.26, p=.001) and job satisfaction (β=−.18, p=.024). CONCLUSION: The results of this study suggest the following: it is important to have a deep understanding of ICU nurses who experience various difficulties in end-of-life care and to provide realist support for these nurses. And practical efforts by nursing organizations are needed, including support systems and education programs to alleviate ICU nurses' difficulties in end-of-life care.
Education ; Hospitals, University ; Intensive Care Units ; Job Satisfaction ; Nursing ; Terminal Care

PURPOSE: This study was to determine the impacts of traumatic events and resilience on the professional quality of life (ProQoL) among clinical nurses. METHODS: In this cross-sectional correlational descriptive study, 325 nurses completed questionnaires of traumatic events, resilience, and ProQoL consisted of compassion satisfaction (CS) and compassion fatigue (CF). Data were analyzed by Spearman correlation analysis and hierarchical regression. RESULTS: Traumatic events positively correlated with CF. Resilience positively correlated with CS and negatively correlated with CF. In this study, multivariate analysis showed that traumatic events and resilience explained 24% of the variance in CS and 7% of the variance in CF. CONCLUSION: A nursing education to enhance resilience and recognition of CS and CF from stressful work-related traumatic events may benefit to improve the professional quality of life for clinical nurses.
Compassion Fatigue ; Education, Nursing ; Empathy ; Multivariate Analysis ; Quality of Life

No abstract available.
Ductus Arteriosus, Patent* ; Endarteritis*

Syndesmotic injuries are found frequently in clinical practice, and they remain controversial because of the variety of diagnostic techniques and management options. Bony avulsions or malleolar fractures are commonly associated with syndesmotic disruptions. Even unstable isolated syndesmosis injuries are associated with a latent or frank tibiofibular diastasis and should not be ignored in the early phase. A relevant instability of the syndesmosis with diastasis results from collateral ligaments tears and requires operative stabilization.The treatment involves an anatomic reduction of the distal tibiofibular articulations followed by stable fixation. Syndesmotic transfixation screws or suture button implants are being proposed as a means of fixation. Recently, suture button fixation has shown more favorable outcomes, but the outcomes can still be controversial. Syndesmotic malreduction can lead to hardware failure, adhesions, heterotopic ossification, tibiofibular synostosis, chronic instability, and posttraumatic arthritis. In particular, the correct diagnosis and evidencebased treatment options for unstable syndesmotic injury should be considered.

Background: Tea tree oil has antiviral, antimicrobial and antifungal effects and Mastic oil has antifungal and anticancer effects. For synergistic effects of oils, blending oil containing a mixture of two to three oils is recommended. This study aimed to determine the antibacterial effects of Tea tree oil, Mastic oil, and Blending oil containing the two oils in a mixture, to verify and suggest the potential use of these oils as a substance to prevent dental caries. Methods: Tea tree oil, Mastic oil, and Blending oil with a 1:1 blend of the two oils were diluted in liquid medium to 0% (negative control), 0.5%, 1.0%, and 2.0%. Streptococcus mutans was applied to each experimental group of the three diluted oils and after 8 h culture, the optical density (OD) was measured and the growth inhibition rate for S. mutans was estimated. Results: Tea tree oil had significantly low OD values across all concentrations (p<0.05) without significant variation among different concentrations (p>0.05). Mastic oil did not significantly vary in OD compared to the negative control across all concentrations (p>0.05) without significant variation among different concentrations (p>0.05). Blending oil, compared to the negative control, did not significantly vary in OD at 0.5% (p>0.05) but significant variation was found as the concentration increased (p<0.05). Additionally, for Tea tree oil and Mastic oil, the growth inhibition rate showed no significant variation according to concentration (p>0.05), whereas for Blending oil, the growth inhibition rate for S. mutans showed a significant difference at 1.0% (p<0.05) and at higher concentrations. Conclusion Blending oil containing a Tea tree oil and Mastic oil demonstrated a significant growth inhibition effect on S. mutans from the concentration of 1.0%, which suggested its potential use as an effective antibacterial agent for dental caries.

BACKGROUND: Rescently, the immunotherapy against infectious disease and cancer is being actively studied, and high yield of pure CD14+ monocytes is a key of concern. In this study, we optimized the percoll gradient method to increase the purity and yield of monocytes from peripheral mononuclear cells. METHODS: We separated mononuclear cells (MNC) from healthy donors, and monocytes from MNC were separated with the various density of percoll gradient. After centrifugation, we determined the most efficient density of the percoll gradient to get the highest yield and purity of monocytes. We also obtained monocytes by the plastic absorption method. Monocytes were differentiated into dendritic cells (DC) and the efficacy of differentiation to DC is confirmed and compared by morphological characteristics and using a flowcytometer. RESULTS: The purity of monocytes was 51.3+/-8.3% by the 35% percoll gradient method and the purity was improved to 82.9+/-4.2% with 100% of yield by repeating the same method. Therefore, the yield of mature dendritic cells was 3.6+/-0.9% of the total input MNC by the 35% percoll repetition method, which was 1.7 times higher than the plastic adherent method (2.1+/-0.5%). CONCLUSION: This study shows a cost-effective method to isolate CD14+ monocytes and these cells demonstrate high differentiation rate to DC. This process will be valuable for obtaining a sufficient number of DC.
Absorption ; Centrifugation ; Communicable Diseases ; Dendritic Cells ; Humans ; Immunotherapy ; Monocytes ; Plastics ; Povidone ; Silicon Dioxide ; Tissue Donors

PURPOSE: Cyclooxygenase-2 (COX-2) expression is up-regulated in several types of human cancers and it has been suggested that COX-2 is closely inked to carcinogenesis. The objectives of this study were to investigate COX-2 expression in periampullary cancer and to evaluate the association of the clinicopathological factors with its expression. METHODS: Thirty specimens which were resected from patients with periampullary cancers (13 pancreatic adenocarcinomas, 8 common bile duct cancers, 9 ampulla of vater cancers) were investigated by immunohistochemical staining using Anti COX-2 monoclonal Ab. The 30 specimens were divided into stain-positive and stain-negative groups. The correlation between COX-2 expression and the various clinicopathological factors including the tumor size, nodal metastasis, differentiation, perineural and vascular invasion, were studied. RESULTS: COX-2 was expressed in 69% of pancreatic adenocarcinomas, 100% of common bile duct cancers and 78% of ampulla of vater cancers. However there was no significant correlation between COX-2 expression and the clinicopathological factors. CONCLUSION: COX-2 is highly expressed in periampullary cancer. Even though there was no correlation with the clinicopathological factors, the utility of the COX-2 inhibitors in preventing or treating periampullary cancer remains undetermined but warronts further investigation.
Adenocarcinoma ; Ampulla of Vater ; Carcinogenesis ; Common Bile Duct ; Cyclooxygenase 2 Inhibitors ; Cyclooxygenase 2* ; Humans ; Ink ; Neoplasm Metastasis

To investigate effect of fatigue and anticipation on lower extremity joint load during a side-cutting maneuver in female collegiate soccer players, thirteen female collegiate soccer players whose right leg dominant participated in this study. Three dimensional motion analysis system and a force plate were used to record the 45degrees side cutting maneuver. In the first, anticipated and unanticipated cutting were measured in the pre-fatigue condition. Second, participations performed the fatigue protocol by the squat exercise with weight lifting. And then, two different type of cutting task were measured again after fatigue condition. The cutting direction let known before start their running in case of the anticipated cutting, the random signal of cutting direction were presented in the unanticipated condition. In the results, the most influential variable was anticipation factor. Lower limb angles represented significantly flexed posture during unanticipated cutting than anticipated condition. Maximum knee flexion moment represented significantly higher in unanticipated cutting than anticipated cutting. Adduction and internal rotation moment of lower limb joint decreased in unanticipated cutting. Fatigue factor was influenced by the initial contact angles of the ankle joint. Lower limb angles at the initial ground contact indicated more erect posture in post-fatigue condition. The unanticipation factor had more effect on locomotors ability of lower limb in this study. Therefore, the sensory-motor training to adapt to unanticipated situation should be considered for the injury prevention training program.
Ankle Joint ; Anterior Cruciate Ligament ; Fatigue ; Female ; Humans ; Joints ; Knee ; Leg ; Linear Energy Transfer ; Lower Extremity ; Posture ; Running ; Soccer ; Weight Lifting

PURPOSE: Cyclooxygenase (COX) enzymes catalyze the ratelimiting step in arachidonate metabolism. COX-1 is expressed constitutively in many cell types. However COX-2 is an inducible enzyme responsible for prostaglandin production at site of inflammation. Recently, there has been increasing evidence that COX-2 involves in development and progression of human tumors. The aim of the present investigation is to evaluate the antiproliferative effect of NS-398, a selective COX-2 inhibitor, and its mechanism in a papillary thyroid cancer cell line, TPC-1. METHODS: We used TPC-1 cell line, NS-398 and EGF. COX-2 expression was detected by RT-PCR and western blot. We used MTT assay to evaluate antiproliferative effect of NS- 398. The mechanisms of growth inhibition were evaluated by apoptosis assay and cell cycle analysis using flow cytometry. RESULTS: COX-2 expression was identified by both RT-PCR and western blot in TPC-1 cells and it was upregulated by serum, EGF (10 ng/ml), and NS-398 (50 mM). NS-398 induced a dose-dependent inhibition of cell proliferation but did not increases apoptotic cell population significantly in the TPC-1 cell line. EGF treatment (10 ng/ml) for 72 hours did not seem to change the antiproliferative effect of NS-398. The proportion of G0/G1 cell cycle was increased by 10% compared with control after 36 hours of treatment with NS-398. CONCLUSION: TPC-1 cells expressed COX-2 constitutively and its expression was upregulated by serum, EGF, and NS-398. The selective COX-2 inhibitor, NS-398 inhibited cell proliferation in TPC-1 cell line rather by cell cycle arrest at G₀/G₁ phase than by inducing apoptosis.
Apoptosis ; Blotting, Western ; Cell Cycle ; Cell Cycle Checkpoints ; Cell Line* ; Cell Proliferation ; Cyclooxygenase 2 ; Epidermal Growth Factor ; Flow Cytometry ; Humans ; Inflammation ; Metabolism ; Prostaglandin-Endoperoxide Synthases ; Thyroid Gland* ; Thyroid Neoplasms*

PURPOSE: The purpose of this study was to evaluate the clinical and radiologic results of open arthrodesis with using variable pitch tapered screws (Acutrak(R) screw) for treating ankle arthritis. MATERIALS AND METHODS: The subjects were 14 patients with 16 cases of performing ankle arthrodesis with using variable pitch tapered screws. Clinical evaluation was performed with using the American Orthopaedic Foot and Ankle Society ankle-hindfoot functional scale and the visual analogue scale pain score, and we assessed the postoperative complications and the patient's satisfaction. Radiological evaluation was performed by the assessing the time to union, the position of union, and the degenerative changes of the adjacent joints of the foot. RESULTS: The average follow-up period was 15 months. The ankle-hindfoot functional scale was improved from an average of 38.9 points (range: 27-57 points) preoperatively to an average of 77.3 points (range: 66-89 points) at the last follow up. The visual analogue scale pain score was decreased from an average of 7.9 (range: 3-10) to 2.9 (range: 0-5), and 13 cases (81%) were satisfied with the outcome of surgery. For all the cases, radiological union was obtained at an average of 11.2 weeks (range: 6-16 weeks). CONCLUSION: We performed arthrodesis with using variable pitch tapered screws for treating ankle arthritis, and satisfactory short term results were obtained both clinically and radiologically.
Animals ; Ankle ; Ankle Joint ; Arthritis ; Arthrodesis ; Follow-Up Studies ; Foot ; Humans ; Joints ; Postoperative Complications