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: The study was conducted to investigate correlations between self-management and physiological measurements of patients on hemodialysis according to their age. METHODS: The subjects were 120 patients on hemodialysis at three hospitals in S and G cities. Data were collected using a structured questionnaire and medical records. The collected data were analyzed using descriptive statistics including t-test, ANOVA, and Pearson's correlation analysis with the SPSS 23.0 program. RESULTS: The levels of compliance with self-management were highest in the middle-aged group. There was no significant difference in physiological measurements between the different age groups. CONCLUSION: The results suggest that nurses should consider characteristics of different age groups to improve the levels of self-management and physiological measurements.
Compliance ; Humans ; Medical Records ; Renal Dialysis ; Self Care

A case of extrapulmonary silicosis involving abdominal lymph nodes in a 62-year-old man is presented. The patient underwent subtotal gastrectomy and regional lymph nodes dissection for gastric adenocarcinoma of clinical stage III. On gross examination, two separate gastric adenocarcinomas and multiple enlarged lymph nodes mimicking metastatic lesion were noted. Microscopic examination of the enlaged lymph nodes revealed characteristic sclerohyaline silicotic nodules without metastatic adenocarcinoma. Chest roentgenogram showed diffusely scattered multiple tiny nodular lesions in the entire lung fields, particularly the posterior side of both upper lung fields. He had worked in a mine for 18 years and had been exposed to silica for 5 of those years. We report incidentally found, unusual case of extrapulmonary silicosis.
Adenocarcinoma ; Gastrectomy ; Humans ; Lung ; Lymph Nodes ; Middle Aged ; Silicon Dioxide ; Silicosis* ; Thorax

No abstract available.
Body Weight* ; Cholesterol*

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.
Stevens-Johnson Syndrome*

PURPOSE: This study was done to examine interpersonal relations, hope, professional self-concept and turnover intention according to adult attachment styles in early stage nurses. METHODS: A survey using a structured questionnaire was conducted with 245 nurses who work in one of six general hospitals. Additionally, a qualitative method was used to obtain data on experiences in interpersonal relations. Data were analyzed using SPSS/WINdows 14.0 and qualitative data from open question in the survey questionnaire were analyzed using content analysis. RESULTS: There was a significant difference in interpersonal relations, hope, and professional self-concept according to adult attachment styles. In the interpersonal relation of early stage nurses, 8 themes were identified, of which the most frequent were: a comfortable relationship with my co-workers (43%) and stress from the relationship (34%). CONCLUSION: Findings from this study should be useful in the development of programs to promote adult attachment and professional self-concept for early stage nurses.
Adult ; Hospitals, General ; Humans ; Intention ; Interpersonal Relations ; Object Attachment ; Personnel Turnover ; 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

OBJECTIVE: The purpose of this study was to find out the effect of job stress, and the coping strategy of hospital workers on job satisfaction. METHODS: 468 self-administered questionnaires, were obtained from 120 doctors, 194 nurses, 45pharmacists and 109 administrators at a university hospital located in Seoul. The sociodemographic characteristics, personality types, degree of social support, job stresses, coping strategies, and job satisfaction were all assessed from the questionnaires. RESULTS: The analysis of job stress, according to occupation, showed that the most important job-related stress-inducing factors were: for doctors, role overload, and poor advancement opportunity; for nurses, role overload, and career development and wages; for pharmacists, role overload and lack of recognition from other health professionals; and for administrators, career development and wages, and organizational inefficiency. Job satisfaction had a significant positive correlation with control strategy, and a negative correlation with role ambiguity, career development and wages, personal relationship, role overload, and symptom management strategy. Job satisfaction was significantly influenced by control strategy, occupation, role ambiguity, person with an 'A' type personality and gender, from a multiple regression analysis. CONCLUSION: The results of this study suggested that to increase the job satisfaction for hospital workers, they need to be encouraged to use control strategies; create a supportive hospital atmospheres for social supports; re-evaluation, structuring and a new job design are all required to reduce role ambiguity.
Administrative Personnel ; Atmosphere ; Health Occupations ; Humans ; Job Satisfaction* ; Occupations ; Pharmacists ; Questionnaires ; Salaries and Fringe Benefits ; Seoul