BACKGROUND: Doxylamine succinate(DS) is an antihistamine commonly used as an over-the-counter medication to relieve insomnia and frequently involved in overdoses. Its overdoses are dominated by anticholinergic effect. Recently it was revealed that DS had a direct effect on muscle, while its exact mechanism is not clear yet. We evaluated the patients with rhabdomyolysis induced by DS overdose for patients disposition based upon clinical decision, especially by creatinine phosphokinase(CPK). METHODS: We reviewed retrospectively the medical records of patients admitted by DS overdose from Jan. 1998 to Oct. 1999. Seventy and nine cases of DS overdose were evaluated with respect to age and sex distribution, amount ingested, clinical symptomatology, time from ingestion to visit, pattern of CPK, amount of bicarbonate used as therapy, complication and prognosis, especially in patients complicated rhabdomyolysis. RESULTS: Rhabdomyolysis, diagnosed as more than 1,000I. U/L of CPK, has been noted in 25(31.6%) of 79 cases of DS overdose visited to our emergency department(ED). In patients diagnosed rhabdomyolysis, the number of man was 10 cases(40%) and the number aged between 20 and 40 years was 22 cases(88%). The average time from DS ingestion to ED visit was 459 minutes. The amount of DS ingested was 500-5,000mg(mean, 1,980mg). 13(52%) cases ingested less than 2,250mg of DS. The initial levels of CPK(range, 48-14900I. U/L; normal range, 26-200I. U/L) after admitting to our emergency department were normal in 15 cases(60%) of rhabdomyolysis patients. The range of peak CPK levels after ingestion was 607 to 412,500I. U/L(mean, 33,550I. U/L). Its peak time was 6 to 96 hours(mean, 28.96 hours). In 14 cases(67%) of 21 visiting within 24 hours after ingestion, peak time of CPK ranged 12 to 24 hours after ingestion. The amount of bicarbonate used as therapy of rhabdomyolysis ranged 100 to 2,740mEq(mean, 656mEq) and all patients was discharged after improvement without other complication including acute renal failure. CONCLUSIONS : Although patients ingested less than 2,250mg of DS, emergency physicians should observe them more than 24 hours after DS ingestion with CPK follow-up after gastric irrigation and charcoal administration.
Acute Kidney Injury ; Charcoal ; Creatinine ; Doxylamine* ; Eating ; Emergencies ; Emergency Service, Hospital ; Follow-Up Studies ; Gastric Lavage ; Humans ; Medical Records ; Prognosis ; Reference Values ; Retrospective Studies ; Rhabdomyolysis* ; Sex Distribution ; Sleep Initiation and Maintenance Disorders ; Succinic Acid*

PURPOSE: The purpose of this study was to identify the relationship between self-leadership and the perception of learning in nursing students. METHODS: A descriptive research design was used in this study. The participants were 378 nursing students in M city and C city who were surveyed between June 1 and June 30, 2014 using self-report questionnaires. The data was analyzed using SPSS WIN 21.0 Program, which determined frequency, percentage, mean, standard deviation; a One-way ANOVA; a Scheffe test; a Pearson correlation coefficient; and a Stepwise multiple regression analysis. RESULTS: There were significant positive correlations between nursing students' self-leadership and their perception of learning. In the multiple regression analysis, self-leadership was the most significant predictor in explaining nursing students' perception of learning. CONCLUSION: Study findings suggest that nursing students' self-leadership is defined as having an important influence on nursing students' perception of learning. In order to strengthen nursing students' self-leadership, there is a need to develop education programs that increase nursing students' self-leadership.
Education ; Humans ; Learning* ; Nursing* ; Research Design ; Students, Nursing

PURPOSE: This study was aimed to examine the gap between predicted cesarean section rate and real cesarean section rate and it's determining factors of 44 tertiary hospitals. METHOD: This study is a cross-sectional analysis using the data of 25,623 deliveries in 2009 drawn from homepage of Health Insurance Review and Assessment Service. Data were analyzed with t-test, F-test, Scheffe? test, and logistic regression. RESULT: There were statistically significant differences in the gap of cesarean section rate (more gap indicates higher quality of delivery) by grade of nurse staffing and delivery cases. Hospitals with nurse staffing grade 1 to 2 had more possibility to be classified into higher grade in quality of delivery (OR 5.67, 95% CI 1.07~30.08). Also hospitals with over 500 delivery cases had more possibility be classified into higher grade in quality of delivery (OR 4.92, 95% CI 1.14~21.23, respectively). CONCLUSION: The finding suggests that grade of nurse staffing may influence the real cesarean section rate because nurses do a vital role to prevent unnecessary cesarean section. Further study is required to provide evidence that nurse staffing influence on patient outcome and cost-effectiveness in order to obtain adequate number of nursing staffs.
Cesarean Section ; Cross-Sectional Studies ; Female ; Humans ; Insurance, Health ; Nursing Staff ; Pregnancy ; Tertiary Care Centers

No abstract available.
Diagnosis* ; Female ; Humans ; Polycystic Kidney Diseases*

BACKGROUND AND OBJECTIVES: It has been reported that various inflammatory and immune reactions are involved in the development and progression of atherosclerosis. We tried to investigate whether the TNF receptor superfamilies are involved in the development and progression of atherosclerosis. MATERIALS AND METHOD: Thirteen carotid atheroma specimens(frozen sections : 10 cases, paraffin section : 5 cases) were obtained from the patients who underwent carotid endarterectomy at Samsung Medical Center and one normal aortic tissue was obtained from a transplantation donor in brain death. In the carotid endarterectomy specimens and a normal aortic tissue , the expressions of R110(TR1), 139(TR2) and DR3(TR3), members of the TNF receptor superfamilies were evaluated by immunohistochemical staining with monoclonal antibodies. Simultaneously, we evaluated the expressions of foam cells, smooth muscle cells, T-lymphocytes and B-lymphocytes. RESULTS: Immunohistochemical analysis identified a strong expressions of foam cells and smooth muscle cells in all atheroma. But, the expression of T-lymphocytes was minimal and that of B-lymphocytes was rare. The expression of DR3(TR3) was seen in all atheroma as strongly positive. The expression of 139(TR2) was observed well in frozen sections, but not in paraffin sections. Whereas, that of R110(TR1) was observed in paraffin sections as weakly positive, but not in frozen section. The areas where the TNF receptor superfamilies were expressed correlated to the area of foam cell presence. The expression of DR3 also correlated with expression of smooth muscle cells. In normal aortic tissue, the expression of inflammatory cells or TNF receptor superfamilies was not observed except smooth muscle cells which were observed in normal artery. CONCLUSION: Foam cells and smooth muscle cells were abundantly present in atheroma. The TNF receptor superfamilies are expressed in the atheroma and the region of expression was coincident with the presence of foam cells.
Antibodies, Monoclonal ; Arteries ; Atherosclerosis ; B-Lymphocytes ; Brain Death ; Endarterectomy, Carotid ; Foam Cells ; Frozen Sections ; Humans ; Myocytes, Smooth Muscle ; Paraffin ; Plaque, Atherosclerotic* ; Receptors, Tumor Necrosis Factor* ; T-Lymphocytes ; Tissue Donors ; Tumor Necrosis Factor-alpha*

No abstract available.
Body Weight* ; Cholesterol*

No abstract available.
Glioblastoma* ; Keratosis, Seborrheic

PURPOSE: This study was done to identify the influence of nursing work environment and social support on multidimensional organizational commitment among nurses. METHODS: The survey was conducted in August 2012 with self-report questionnaire. Participants were 480 registered nurses working in one general hospital. Data were analyzed with descriptive statistics, t-test, ANOVA, Pearson correlation, and multiple regression using SPSS/WIN(16.0). RESULTS: The average scores were; for affective commitment 2.84, for continuance commitment 2.48, and for normative commitment 2.57. There were significant relationships between affective, continuance, normative commitment and sub-factors of nursing work environment and social support. The affective, continuance, and normative commitment were all influenced by 'staffing and resource adequacy' and 'nursing foundations for quality of care', sub-factors of nursing work environment. Distinctively, affective commitment was influenced by 'staffing and resource adequacy', nurses' age, 'nurse-doctor relations', 'supervisor's emotional support', 'nurse participation in hospital affairs', 'nursing foundations for quality of care', and 'supervisor's informational support', which explained 30.9% of variance in affective commitment(F=31.57, p<.001). CONCLUSION: The findings show that programs which promote supervisors' emotional and informational support are important to enhance nurses' affective commitment. Also, it is necessary to improve nursing work environment to improve nurses' organizational commitment.
Foundations ; Hospitals, General* ; Nursing* ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to investigate the relationship among turnover intention, emotional labor, and communication competence in nurses. METHODS: The participants for this study were 297 nurses from three general hospitals in two local cites in Korea. Data were collected by self-administered questionnaires from August 26 to September 10, 2013 and analyzed using descriptive statistics, One-way ANOVA, t-test, Pearson Correlation, Stepwise Multiple Regression with the SPSS/WIN 18.0 program. RESULTS: The average scores for turnover intention, emotional labor, and communication competence respectively, were 3.45, 3.08, and 3.44 out of 5. The novices recognized that their emotional labor and turnover intention were significantly higher, and their communication competence was lower than other nurses. Nurses' turnover intention had a positive relationship with their emotional labor, but no relationship with communication competence. Job satisfaction, frequency of emotional expression, and emotional dissonance had an effect on nurses' turnover intention. CONCLUSION: The results show that emotional labor and job satisfaction are very important factors affecting nurses' turnover intention. So, nurse managers should try to minimize nurses' emotional labor and maximize their job satisfaction by developing various human relationship educational and support programs and using them.
Hospitals, General ; Humans ; Intention* ; Job Satisfaction ; Korea ; Mental Competency* ; Nurse Administrators ; Surveys and Questionnaires

PURPOSE: This study was conducted to identify the factors contributing to sleep disorders in patients on hemodialysis. Methods: A descriptive correlational study design was used. The participants were 135 patients on hemodialysis in hemodialysis clinics. Data were collected from March to May 2007 using structured questionnaires and hematologic sample. Stepwise multiple regression was used to identify factors influencing sleep disorders among the demographic-clinical factors, depression and fatigue. RESULTS: About 69% of the patients had a sleep disorders. There were significant differences in sleep disorders according to marital status, caregiver, religion, economic level, insurance, erythropoietin, somnifacient, and antihypertensive agents. But there were no differences according to age, gender, dialysis period, or antidepressants. Their sleep disorders had significant correlations with depression, and fatigue, and a significant negative correlation with Protein, Albumin, Phosphate and BUN. But there were no correlations with hematocrit, hemoglobin, creatinine, sodium, potassium, or calcium. Depression and fatigue were factors influencing sleep disorders. They accounted for 43.8% of the variance in sleep disorders in these patients. CONCLUSION: Findings provide an understanding of sleep disorders and the factors that are an influence in patients on hemodialysis. To promote sleep in these patients, nursing interventions to manage depression and fatigue are needed.
Antidepressive Agents ; Antihypertensive Agents ; Calcium ; Caregivers ; Creatinine ; Depression ; Dialysis ; Erythropoietin ; Fatigue ; Hematocrit ; Hemoglobins ; Humans ; Insurance ; Marital Status ; Potassium ; Surveys and Questionnaires ; Renal Dialysis ; Sleep Wake Disorders ; Sodium