To stydy the parameters of preload, afterload, and contractility of the heart, we evaluated 10 mitral stenosis, 5 mitral stenoinsufficiency, and 5 mitral stenosis with aortic insufficiency by measuring the external energy potential, external mechaical work, and external energy potential to PVa(Pressure-volume Area) ratio with non-invasive method, echocardiography and carotid pulse tracting. The results are summarized as follows; 1) External energy potential of mitral stenosis was significantly higher than that of MSI or MS with AI. 2) External mechanical work of MSI or MS with AI was significantly higher than that of Ms. 3) External energy potential to PVA ratio was signifiantly higher in the MS, but there was no significantly difference between the MSI and MS with AI. According to the above results, external energy potential to PVA ratio with echocardiogram and carotid pulse tracting was good parameters of preload, afterload, and contractility. And this method may used bed-side monitoring in the clinical area.
Echocardiography ; Heart ; Heart Valve Diseases* ; Mitral Valve Stenosis

No abstract available.
Radionuclide Imaging*

No abstract available.
Cardiomyopathy, Hypertrophic*

PURPOSE: This study was conducted to investigate the influence of emotional labor, emotional dissonance, and burnout on nurse's turnover intention and examine the effect of job satisfaction on the relationships among emotional labor, emotional dissonance, burnout, and turnover intention. METHODS: The sample consisted of 350 nurses recruited from 6 general hospitals in 2 cities in Korea. A multiple-group analysis was utilized. Data were analyzed using SPSS statistics 23 and AMOS 20. RESULTS: In the path analysis, turnover intention was directly related to burnout in clinical nurses who had a high job satisfaction (β=.24, p=.003), while it was indirectly related to emotional dissonance (β=.13, p=.002). In the multiple-group path analysis, turnover intention was directly related to emotional dissonance (β=.18, p=.033) and burnout (β=.26, p=.002) for nurses with low job satisfaction. CONCLUSION: These results indicate that manuals and guidelines to alleviate the negative effects of emotional labor, emotional dissonance, and burnout, and to increase job satisfaction are strongly required to reduce turnover intention in nurses at the organizational level as well as at the individual level.
Hospitals, General ; Intention* ; Job Satisfaction* ; Korea ; Personnel Turnover

BACKGROUND: Electromagnetic fields (EMF) are ubiquitous in modern society including medical field. As the technology of medical instruments and telecommunications has developed rapidly, it has influenced on our lives in many ways. Modern medical practice requires high quality medical equipments, which have a great deal of electromagnetic interference and susceptibility. The purpose of this study were to evaluate electromagnetic condition under usual clinical condition and to suggest a practical guideline in general hospital. MATERIALS AND METHODS: The actual state of the electromagnetic interference in the medical field was studied under usual clinical conditions including operating rooms, intensive care units, magnetic resonance imaging unit, and hyperthermia unit. RESULTS: There was considerable noise as a result of electromagnetic fields from medical equipments including electrosurgical units and hyperthermia unit, and cellular phones, which could induce serious functional derangements of functioning medical devices. CONCLUSION: It will be necessary to evaluate the individual electromagnetic situations under various medical conditions and to define a limited zone for cellular phone as well as reposition medical equipments to secure a safer medical practice and to minimize electromagnetic interference.
Cellular Phone ; Electromagnetic Fields* ; Fever ; Hospitals, General* ; Intensive Care Units ; Magnetic Resonance Imaging ; Magnets* ; Noise ; Operating Rooms ; Telecommunications

Background: This study investigated the relationship between trauma exposure and suicidal ideation. Moreover, this study examines the moderating roles of organizational climate on the association between trauma exposure and suicidal ideation in Korean male firefighters. Methods: A total of 15,104 male firefighters who completed a questionnaire were analyzed. The data were obtained using an online self-administered questionnaire from the Firefighter Research on Enhancement of Safety and Health Study. Poisson regression analysis was performed to determine the effects of trauma exposure on suicidal ideation and the moderating effect of organizational climate. Results: The results showed that 389 firefighters (2.6%) responded that they had experienced suicidal ideation. In the final model, trauma exposure was positively related to suicidal ideation (adjusted risk ratio [aRR], 1.076; 95% confidence interval [CI]: 1.051–1.103), and organizational climate was negatively associated with suicidal ideation (aRR, 0.772; 95% CI: 0.739–0.806). Additionally, the interaction term (trauma exposure × organizational climate) was related to suicidal ideation (aRR, 1.016; 95% CI: 1.009–1.023). Conclusions This study suggests that trauma exposure might play a significant role in developing suicidal ideation and that positive organizational climate moderates the negative effects of trauma exposure on suicidal ideation among firefighters. It is necessary to perform a follow-up study of various intervention strategies to maintain a healthy organizational climate or work environment. Such interventions should promote lasting trust within teams, provide social support and belonging, and nurture job value.

Background: The current lack of the number of nurses and high nurse turnover rate leads to major problems for the health-care system in terms of cost, patient care ability, and quality of care. Theoretically, burnout may help link emotional labor with turnover intention. The purpose of this study was to investigate the mediating effect of burnout in the association between emotional labor and turnover intention in Korean clinical nurses. Methods: Using data collected from a sample of 606 nurses from six Korean hospitals, we conducted a multiple regression analysis to determine the relationships among clinical nurses' emotional labor, burnout, and turnover intention, looking at burnout as a mediator. Results: The results fully and partially support the mediating role of burnout in the relationship between the subfactors of emotional labor and turnover intention. In particular, burnout partially mediated the relationship between emotional disharmony and hurt, organizational surveillance and monitoring, and lack of a supportive and protective system in the organization. In addition, we found that burnout has a significant full mediation effect on the relationship between overload and conflicts in customer service and turnover intention. Although the mediating effect of burnout was significantly associated with the demands and regulation of emotions, no significant effects on turnover intention were found. Conclusion To reduce nurses' turnover, we recommend developing strategies that target both burnout and emotional labor, given that burnout fully and partially mediated the effects of emotional labor on turnover intention, and emotional labor was directly associated with turnover intention.

BACKGROUND: Since the introduction of atrial switch operation, the outlook for patients with complete transposition of the great arteries (TGA) has improved dramatically. However, many survivors are afflicted with postoperative complications and continue to demand medical attention. We therefore performed the study for the evaluation of the clinical course in the patients with complete TGA after atrial switch operation. METHODS: We analyzed the data of 51 patients who underwent the atrial switch operation for complete TGA at Seoul National University Hospital between January 1981 and June 1993 retrospectively. RESULTS: The patients were composed of 36 males and 15 females (mean age at operation, 15+/-30 months, range 2 months-18 years). Senning operation was undertaken in 43 and Mustard operation in 8. Among these, 27 had simple and 24 complex complete TGA. The early mortality rate within 1 month postoperatively was 39% and the late mortality rate 16%. The actuarial survival rate after 10 years was 78%. Of these, 17 cases have been followed up so far. Although the significant tricuspid regurgitation was noted in 9, right ventricular systolic function was maintained in all of them. Preoperative sinus node dysfunction was noted in 1 case. Postoperatively, premature ventricular contractions were found in 8 cases, atrial flutter in 4, and sinus node dysfunction in 7. Subclinical pulmonary venous obstruction was found in 2 and systemic venous obstruction in 1. At present, one takes digoxin for prevention of atrial flutter and 7 take digoxin, furosemide, and/or angiotensin-converting enzyme inhibitors for prevention of ventricular functional deterioration. Twelve cases were in New York Heart Association functional class I at the latest follow-up and 5 were in class II. CONCLUSION: This study revealed that morbidity and mortality were not low after atrial switch operation. However, considering the good long-term functional status in the survivors, atrial switch operation could be an alternative to arterial switch operation in complicated cases of TGA.
Angiotensin-Converting Enzyme Inhibitors ; Arteries* ; Atrial Flutter ; Digoxin ; Female ; Follow-Up Studies* ; Furosemide ; Heart ; Humans ; Male ; Mortality ; Mustard Plant ; Postoperative Complications ; Retrospective Studies ; Seoul ; Sick Sinus Syndrome ; Survival Rate ; Survivors ; Tricuspid Valve Insufficiency ; Ventricular Premature Complexes

BACKGROUND: Since the introduction of atrial switch operation, the outlook for patients with complete transposition of the great arteries (TGA) has improved dramatically. However, many survivors are afflicted with postoperative complications and continue to demand medical attention. We therefore performed the study for the evaluation of the clinical course in the patients with complete TGA after atrial switch operation. METHODS: We analyzed the data of 51 patients who underwent the atrial switch operation for complete TGA at Seoul National University Hospital between January 1981 and June 1993 retrospectively. RESULTS: The patients were composed of 36 males and 15 females (mean age at operation, 15+/-30 months, range 2 months-18 years). Senning operation was undertaken in 43 and Mustard operation in 8. Among these, 27 had simple and 24 complex complete TGA. The early mortality rate within 1 month postoperatively was 39% and the late mortality rate 16%. The actuarial survival rate after 10 years was 78%. Of these, 17 cases have been followed up so far. Although the significant tricuspid regurgitation was noted in 9, right ventricular systolic function was maintained in all of them. Preoperative sinus node dysfunction was noted in 1 case. Postoperatively, premature ventricular contractions were found in 8 cases, atrial flutter in 4, and sinus node dysfunction in 7. Subclinical pulmonary venous obstruction was found in 2 and systemic venous obstruction in 1. At present, one takes digoxin for prevention of atrial flutter and 7 take digoxin, furosemide, and/or angiotensin-converting enzyme inhibitors for prevention of ventricular functional deterioration. Twelve cases were in New York Heart Association functional class I at the latest follow-up and 5 were in class II. CONCLUSION: This study revealed that morbidity and mortality were not low after atrial switch operation. However, considering the good long-term functional status in the survivors, atrial switch operation could be an alternative to arterial switch operation in complicated cases of TGA.
Angiotensin-Converting Enzyme Inhibitors ; Arteries* ; Atrial Flutter ; Digoxin ; Female ; Follow-Up Studies* ; Furosemide ; Heart ; Humans ; Male ; Mortality ; Mustard Plant ; Postoperative Complications ; Retrospective Studies ; Seoul ; Sick Sinus Syndrome ; Survival Rate ; Survivors ; Tricuspid Valve Insufficiency ; Ventricular Premature Complexes

Minimally invasive surgery is being widely accepted in various fields of surgery. Although several appendectomy techniques have been reported but, there is no standardization. We report here the experiences of transumbilical endoscopic appendectomy in humans. Between July 2008 and September 2010, ten patients with appendicitis successfully underwent transumbilical endoscopic appendectomies. There were 7 cases of suppurative, 2 cases of gangrenous and 1 case of perforated in operative findings. The ages of the patients were 13-56 years (mean age, 32.7 +/- 15.4 years). Under general anesthesia, a 15-mm port was inserted through the umbilicus and then a two-channel endoscope was inserted in the peritoneal cavity. After appendix identification, counter-traction of the appendix with a direct abdominal wall puncture using a straight round needle prolene was performed to achieve good visualization of the operative field. Tissue dissection was performed using an endoscopic needle knife. Tissue grasping and resected appendix retrieval were done with endoscopic forceps. The average operation time was 79.5 +/- 23.6 minutes (range, 45 to 110 minutes). No procedures were converted to laparoscopic or open appendectomy. Hospital stay was 4-6 days. All patients completely recovered without complications. As it is highly maneuverable, we believe transumbilical endoscopic appendectomy can be a feasible method. And, as surgeons want to proceed from laparoscopic surgery to natural orifice transluminal endoscopic surgery, this procedure could be a triable method.
Abdominal Wall ; Anesthesia, General ; Appendectomy* ; Appendicitis ; Appendix ; Endoscopes ; Endoscopy ; Hand Strength ; Humans ; Laparoscopy ; Length of Stay ; Natural Orifice Endoscopic Surgery ; Needles ; Peritoneal Cavity ; Polypropylenes ; Punctures ; Surgical Instruments ; Surgical Procedures, Minimally Invasive ; Umbilicus