Purpose: The research aimed to identify leading factors that affect a nurse’s compliance with safe handling in the use of antineoplastic agents. Methods: Data were collected from 114 nurses working in the university hospital. Data were analyzed through independent t-test, one-way ANOVA, Pearson’s correlation coefficient and multiple regression analysis using SPSS WIN 25.0. Results: The average level of compliance with safe handling of antineoplastic agents was 3.73±0.33 out of 5 points. Workplace safety climate (β=.40, p<.001) and knowledge of safe handling (β=.18, p=.030) had significant influences on nurses’ compliance with safe handling of antineoplastic agents. The explained variance for compliance was 28.3%. Conclusion To enhance the implementation of safety management for antineoplastic agents, each institution should strive to support human and material resources and to enhance specialization in the workplace safety climate through system improvement. Based on the results of this study, we suggest research for the development of an antineoplastic agents safety management training program.

PURPOSE: The out-of-hospital cardiac arrest (OHCA) survival rate of patients in Korea is lower than the global average and it might be caused by an extremely low rate of return of spontaneous circulation in the prehospital field. The authors identified obstacles that disturb on-scene performance of cardiopulmonary resuscitation (CPR) for a certain period from 119 emergency medical technicians (EMTs) through a nation-wide paper survey. METHODS: A total of 1273 first grade EMTs and nurses were surveyed. CPR time performed on the scene (without transfer), CPR experiences, self-assessment of CPR skill performance, and both obstacles to performance of CPR on the scene and solutions to overcoming them for continuous on-scene CPR were investigated using a 28-item questionnaire. RESULTS: The average for work experience and the number of CPR experiences of subjects was 6.8+/-4.5 years and 1.9+/-1.7 times/month, respectively. Survey results for CPR times on the scene showed an average of 4.2+/-2.4 minutes, approximately two periods of CPR (30:2x5 cycles). Obstacles to CPR on the scene were investigated as complaints of family members in 791(62.1%) and fatigue lowering CPR quality due to lack of human resources in 536(41.0%); 627(49.3%) of the subjects answered that they had received complaints due to a long stay on the scene. CONCLUSION: In order to increase the survival rate of OHCA patients, CPR on the scene is needed during a certain period in order to achieve a return of spontaneous circulation. Education, amelioration of guidelines, and support for the EMT administrative system are also needed.
Cardiopulmonary Resuscitation* ; Education ; Emergencies* ; Emergency Medical Technicians* ; Fatigue ; Humans ; Korea ; Out-of-Hospital Cardiac Arrest ; Self-Assessment ; Survival Rate ; Surveys and Questionnaires

PURPOSE: The out-of-hospital cardiac arrest (OHCA) survival rate of patients in Korea is lower than the global average and it might be caused by an extremely low rate of return of spontaneous circulation in the prehospital field. The authors identified obstacles that disturb on-scene performance of cardiopulmonary resuscitation (CPR) for a certain period from 119 emergency medical technicians (EMTs) through a nation-wide paper survey. METHODS: A total of 1273 first grade EMTs and nurses were surveyed. CPR time performed on the scene (without transfer), CPR experiences, self-assessment of CPR skill performance, and both obstacles to performance of CPR on the scene and solutions to overcoming them for continuous on-scene CPR were investigated using a 28-item questionnaire. RESULTS: The average for work experience and the number of CPR experiences of subjects was 6.8+/-4.5 years and 1.9+/-1.7 times/month, respectively. Survey results for CPR times on the scene showed an average of 4.2+/-2.4 minutes, approximately two periods of CPR (30:2x5 cycles). Obstacles to CPR on the scene were investigated as complaints of family members in 791(62.1%) and fatigue lowering CPR quality due to lack of human resources in 536(41.0%); 627(49.3%) of the subjects answered that they had received complaints due to a long stay on the scene. CONCLUSION: In order to increase the survival rate of OHCA patients, CPR on the scene is needed during a certain period in order to achieve a return of spontaneous circulation. Education, amelioration of guidelines, and support for the EMT administrative system are also needed.
Cardiopulmonary Resuscitation* ; Education ; Emergencies* ; Emergency Medical Technicians* ; Fatigue ; Humans ; Korea ; Out-of-Hospital Cardiac Arrest ; Self-Assessment ; Survival Rate ; Surveys and Questionnaires

PURPOSE: This study was done to verify effects of a self-directed feedback practice using smartphone videos on nursing students' basic nursing skills, confidence in performance and learning satisfaction. METHODS: In this study an experimental study with a post-test only control group design was used. Twenty-nine students were assigned to the experimental group and 29 to the control group. Experimental treatment was exchanging feedback on deficiencies through smartphone recorded videos of nursing practice process taken by peers during self-directed practice. RESULTS: Basic nursing skills scores were higher for all items in the experimental group compared to the control group, and differences were statistically significant ["Measuring vital signs" (t= - 2.10, p =.039); "Wearing protective equipment when entering and exiting the quarantine room and the management of waste materials" (t= - 4.74, p <.001) "Gavage tube feeding" (t= - 2.70, p =.009)]. Confidence in performance was higher in the experimental group compared to the control group, but the differences were not statistically significant. However, after the complete practice, there was a statistically significant difference in overall performance confidence (t= - 3.07. p =.003). Learning satisfaction was higher in the experimental group compared to the control group, but the difference was not statistically significant (t= - 1.67, p =.100). CONCLUSION: Results of this study indicate that self-directed feedback practice using smartphone videos can improve basic nursing skills. The significance is that it can help nursing students gain confidence in their nursing skills for the future through improvement of basic nursing skills and performance of quality care, thus providing patients with safer care.
Humans ; Learning* ; Nursing* ; Quarantine ; Students, Nursing

Angelica koreana is an important medicinal plant for some locals in East Asia including Korea. A few reports have shown the efficacy of its phytochemical constituents. We have isolated and purified one compound falcarindiol (FAL) from the methanolic extract of A. koreana roots. At concentrations from to 1 µM to 25 µM, the FAL isolated from the roots of A. koreana exerted no significant cytotoxicity and down-regulated LPS-stimulated pro-inflammatory cytokine IL-8 in colon epithelial cells, while up-regulating anti-inflammatory cytokine IL-10. In addition, the FAL decreased the expression of LPS-induced inducible nitric oxide synthase (iNOS) and cyclooxygenase (COX)-2 protein by Western blot analysis. Colon epithelial cells play pivotal roles in regulating the colon immune system and thus FAL is expected to be candidate agent as therapeutic potential for the treatment of inflammatory bowel disease (IBD) by modulating LPS-induced inflammation in colon epithelial cells.
Angelica* ; Blotting, Western ; Colon* ; Epithelial Cells* ; Far East ; Immune System ; Inflammation ; Inflammatory Bowel Diseases ; Interleukin-10* ; Interleukin-8* ; Korea ; Methanol ; Nitric Oxide Synthase Type II ; Plants, Medicinal ; Prostaglandin-Endoperoxide Synthases

Background and Objectives: Although thyroid hormones affect human cancer progression, the regulatory mechanism of thyroid hormone receptors in carcinogenesis has not been elucidated. This study aimed to evaluate the expression pattern of the thyroid hormone receptor (TR) and its corepressors, and to investigate the clinical and biological functions of TR. Materials and Methods: Transcriptomic and clinical data for thyroid cancer were downloaded from The Cancer Genome Atlas. Paraffin-embedded tissue sections from patients who underwent thyroidectomy were used for immunohistochemistry. BCPAP cells were treated with T3 to investigate the thyroid hormone target genes. Thyroid hormone receptor alpha (THRA) and Thyroid hormone receptor beta (THRB) were knocked down by transient siRNA transfection. Results: THRA and THRB expression was lower in thyroid cancer tissues than in normal tissues. However, strong focal staining of TRβ was observed in the invasive front. High THRB expression was associated with high Silencing Mediator for Retinoid or Thyroid hormone receptor (SMRT) expression, older age, a high MACIS (distant Metastasis, patient Age, Completeness of resection, local Invasion, and tumor Size) score, more aggressive histological subtypes, more frequent extra-thyroidal extension, and advanced TNM stage. THRB expression was positively correlated with Hypoxia Inducible Factor 1 Subunit Alpha (HIF1A), L1 Cell Adhesion Molecule (L1CAM), and Lysyl Oxidase (LOX) expression. Thyroid hormone-induced HIF1A, L1CAM, and LOX upregulation was abolished by siTHRB but not siTHRA in BCPAP cells. High SMRT and high THRB groups (SMRT/THRB) presented more aggressive clinical features and showed an upregulation of HIF1A, L1CAM, and LOX, as well as of epithelial-mesenchymal transition (EMT)-related genes, causing changes in the tumor microenvironment. Conclusion Cooperative subtype switching from NCOR1/THRA to SMRT/THRB was thus related to aggressive clinical and molecular features, possibly related to EMT and EMT-related tumor microenvironment.

BACKGROUND: Laparoscopic gastrectomy requires a reverse-Trendelenburg position and prolonged pneumoperitoneum and it could cause significant changes in cerebral homeostasis and lead to cognitive dysfunction. We compared changes in regional cerebral oxygen saturation (rSO2), early postoperative cognitive function and hemodynamic variables in patients undergoing laparoscopic gastrectomy with those patients that underwent conventional open gastrectomy. METHODS: Sixty patients were enrolled in this study and the patients were distributed to receive either laparoscopic gastrectomy (laparoscopy group, n = 30) or open conventional gastrectomy (open group, n = 30). rSO2, end-tidal carbon dioxide tension, hemodynamic variables and arterial blood gas analysis were monitored during the operation. The enrolled patients underwent the mini-mental state examination 1 day before and 5 days after surgery for evaluation of early postoperative cognitive function. RESULTS: Compared to baseline value, rSO2 and end-tidal carbon dioxide tension increased significantly in the laparoscopy group after pneumoperitoneum, whereas no change was observed in the open group. No patient experienced cerebral oxygen desaturation or postoperative cognitive dysfunction. Changes in mean arterial pressure over time were significantly different between the groups (P < 0.001). CONCLUSIONS: Both laparoscopic and open gastrectomy did not induce cerebral desaturation or early postoperative cognitive dysfunction in patients under desflurane anesthesia. However, rSO2 values during surgery favoured laparoscopic surgery, which was possibly related to increased cerebral blood flow due to increased carbon dioxide tension and the effect of a reverse Trendelenburg position.
Anesthesia ; Arterial Pressure ; Blood Gas Analysis ; Carbon Dioxide ; Gastrectomy* ; Head-Down Tilt ; Hemodynamics ; Homeostasis ; Humans ; Laparoscopy ; Oxygen* ; Pneumoperitoneum

BACKGROUND: We purposed to systemically review studies investigating the prophylactic effect of both pharmacological and non-pharmacological modalities against rocuronium induced withdrawal movement (RIWM) in the Korean population. METHODS: Literature search was performed using MEDLINE, EMBASE, CENTRAL, Koreamed, KMBASE, KISS and RISS up to March 2014. Randomized controlled trials (RCTs) comparing pharmacological and non-pharmacological interventions with placebo aimed for the Korean population were included. Outcome measures were the incidence and severity of RIWM. We conducted subgroup analyses according to each intervention method. RESULTS: Data were analyzed from 41 RCTs totaling 4,742 subjects. The overall incidence of RIWM was about 80% (range 56-100%). Incidence and severity of RIWM were significantly reduced with lidocaine (risk ratio [RR] 0.60, 95% CI 0.49-0.74; standardized mean difference [SMD] -0.74, 95% CI -1.05 to -0.44), opioids (RR 0.28, 95% CI 0.18-0.44; SMD -1.71, 95% CI -2.09 to -1.34) and hypnotics (RR 0.36, 95% CI 0.25-0.52; SMD -2.20, 95% CI -2.62 to -1.79). Regardless of tourniquet use, lidocaine showed a prophylactic effect against incidence and severity of RIWM: tourniquet (RR 0.36, 95% CI 0.21-0.62; SMD -1.51, 95% CI -2.15 to -0.86); non-tourniquet (RR 0.58, 95% CI 0.47-0.71; SMD -0.74, 95% CI -1.05 to -0.44). Dilution and slow injection of rocuronium decreased incidence and severity of RIWM: dilution (RR 0.47, 95% CI 0.39-0.56; SMD -1.64, 95% CI -2.47 to -0.81); slow injection (RR 0.34, 95% CI 0.17-0.70; SMD -2.13, 95% CI -2.74 to -1.51). CONCLUSIONS: The greater part of pharmacological and non-pharmacological interventions showed prophylactic effect against the incidence and severity of RIWM in the Korean population.
Analgesics, Opioid ; Anesthesia ; Hypnotics and Sedatives ; Incidence ; Lidocaine ; Outcome Assessment (Health Care) ; Tourniquets

Child ; Clone Cells ; Drug Resistance, Microbial ; Electronic Health Records ; Humans ; Joints ; Korea ; Leukocidins ; Methicillin-Resistant Staphylococcus aureus ; Molecular Epidemiology ; Molecular Typing ; Polymerase Chain Reaction ; Seoul ; Skin ; Soft Tissue Infections ; Staphylococcus aureus ; Staphylococcus

OBJECTIVE: To evaluate the complication and recurrence rates in patients undergoing trocar-guided mesh implant for pelvic organ prolapse (POP) treatment. METHODS: A retrospective study was performed based on the medical records of patients who had undergone mesh implant by one surgeon from May 2006 to August 2013 at the Presbyterian Medical Center in Korea. We evaluated perioperative complications such as bladder injury, mesh exposure, urinary symptoms, infections, and chronic pelvic pain. Recurrence was defined as a POP-quantification system stage ≥II or any symptomatic prolapse. RESULTS: Sixty-seven patients were evaluated, and the mean age of patients was 65.4±7.2 years. Stage ≥III POP-quantification Ba was noted in 61 patients (91%). Intraoperative complications included three cases of bladder injury (4.5%). The mean follow-up period was 44.1±7.9 months. Postoperative complications occurred in seven women (10.5%): four cases of urinary symptoms (6%), two cases of infections (3%), and one case of chronic pelvic pain (1.5%). Mesh exposure did not occur (0%). Prolapse recurrence was reported in five patients (7.5%). CONCLUSION: Based on our operational result, the trocar-guided mesh implant seems to provide safe and effective outcomes.
Female ; Follow-Up Studies ; Humans ; Intraoperative Complications ; Korea ; Medical Records ; Pelvic Organ Prolapse* ; Pelvic Pain ; Postoperative Complications ; Prolapse ; Protestantism ; Recurrence ; Retrospective Studies ; Surgical Mesh ; Urinary Bladder