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.

BACKGROUND: Factors associated with the prognosis of patients with small cell lung cancer (SCLC) is relatively unknown, than of those with non-small cell lung cancer. This study was undertaken to identify the prognostic factors of SCLC. METHODS: The medical records of 333 patients diagnosed with SCLC at tertiary hospital from January 1, 2008, to December 31, 2012 were retrospectively reviewed. Patients were categorized by age (≤65 years vs. >65 years) and by extent of disease (limited disease [LD] vs extensive disease [ED]). Overall survival and progression free survival rates were determined. Factors associated with prognosis were calculated using Cox's proportional hazard regression model. RESULTS: Most baseline characteristics were similar in the LD and ED groups. Eastern Cooperative Oncology Group (ECOG) performance status (PS), first chemotherapy regimen, and prophylactic cranial irradiation (PCI) differed significantly in patients with LD and ED. Mean ECOG PS was significantly lower (p<0.001), first-line chemotherapy with etoposide-cisplatin was more frequent than with etoposide-carboplatin (p<0.001), and PCI was performed more frequently (p=0.019) in LD-SCLC than in ED-SCLC. Prognosis in the LD group was better in younger (≤65 years) than in older (>65 years) patients, but prognosis in the ED group was unrelated to age. CONCLUSION: This study showed that overall survival (OS) was significantly improved in younger than in older patients with LD-SCLC. Univariate and multivariate analyses showed that age, PCI and the sum of cycles were significant predictors of OS in patients with LD-SCLC. However, prognosis in the ED group was unrelated to age.
Carcinoma, Non-Small-Cell Lung ; Cranial Irradiation ; Disease-Free Survival ; Drug Therapy ; Humans ; Medical Records ; Multivariate Analysis ; Prognosis* ; Retrospective Studies ; Small Cell Lung Carcinoma* ; Tertiary Care Centers

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

PURPOSE: Competency in physical assessment is an important component of nursing practice. However, some physical assessment skills are not being utilized within the current teacher-centered, content-heavy curriculum. This study was conducted to identify the effects of student-centered, self-directed learning in the physical assessment class. METHODS: An experimental study with a post-test only control group design was used to compare an intervention group that was provided self-directed learning classes and a control group that was provided traditional lecture and practice classes. Competency in physical assessment, academic self-confidence, and learning satisfaction were evaluated. Collected data were analyzed using χ²-test (Fisher's exact test) and independent t-test. RESULTS: Competency in physical assessment was significantly higher in the experimental group. However, academic self-confidence and learning satisfaction were not significantly different between the groups. CONCLUSION: The findings in this study indicate that self-directed learning can improve nursing students competency in physical assessment and that self-directed learning is a good education method to improve nursing students' competency in physical assessment during clinical practice and perform quality patient care by making active use of physical assessment skills.
Curriculum ; Education ; Education, Nursing ; Humans ; Learning* ; Methods ; Nursing* ; Patient Care ; Physical Examination ; Students, Nursing*

Aging is one of the risk factors for the development of cardiovascular diseases. During the progression of cellular senescence, cells enter a state of irreversible growth arrest and display resistance to apoptosis. As a flavonoid, quercetin induces apoptosis in various cells. Accordingly, we investigated the relationship between quercetin-induced apoptosis and the inhibition of cellular senescence, and determined the mechanism of oxidative stress-induced vascular smooth muscle cell (VSMC) senescence. In cultured VSMCs, hydrogen peroxide (H₂O₂) dose-dependently induced senescence, which was associated with increased numbers of senescence-associated β-galactosidase-positive cells, decreased expression of SMP30, and activation of p53-p21 and p16 pathways. Along with senescence, expression of the anti-apoptotic protein Bcl-2 was observed to increase and the levels of proteins related to the apoptosis pathway were observed to decrease. Quercetin induced apoptosis through the activation of AMP-activated protein kinase. This action led to the alleviation of oxidative stress-induced VSMC senescence. Furthermore, the inhibition of AMPK activation with compound C and siRNA inhibited apoptosis and aggravated VSMC senescence by reversing p53-p21 and p16 pathways. These results suggest that senescent VSMCs are resistant to apoptosis and quercetin-induced apoptosis attenuated the oxidative stress-induced senescence through activation of AMPK. Therefore, induction of apoptosis by polyphenols such as quercetin may be worthy of attention for its anti-aging effects.
Aging ; AMP-Activated Protein Kinases ; Apoptosis ; Cardiovascular Diseases ; Cell Aging ; Hydrogen Peroxide ; Muscle, Smooth, Vascular ; Polyphenols ; Quercetin ; Risk Factors ; RNA, Small Interfering

OBJECTIVE: Analyses of the status of 119 emergency situation control center (119 ESCC) usage are lacking. Therefore, this study investigated the status of the 119 ESCC usage, including dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) instructions. METHODS: The emergency activity daily reports and emergency instruction sheets of 119 ESCC from January to December 2016 were reviewed. For more accurate status analysis, the computerized data of the 1339 Emergency Medical Information Center from January to December 2011 were also reviewed. RESULTS: In 2016, the total usage of the 119 ESCC was 1,393,876 calls, which was 27.8% lower than the 1,930,977 calls in 2011. Of the 1,393,876 eligible calls, the most common call was hospital guidance (n=743,799, 53.4%), followed by first aid (n=397,620, 28.5%), disease consultation (n=150,128, 10.8%), medical oversight (n=81,174, 5.8%), and interhospital transfer (n=5,123, 0.4%). Regarding the user number per 10,000 persons, Daejeon was the greatest at 57.2, whereas Changwon was the lowest at 11.5. A total number of DA-CPR was 19,439. The time from the call to chest compression were 173±88.6 seconds in the subjects having previous cardiopulmonary resuscitation training and 184.0±88.2 in the subjects having no such training (P < 0.001). CONCLUSION: The ratio of first aid instructions, including DA-CPR, among total usage of the 119 ESCC increased but the overall usage of the 119 ESCC decreased. Therefore, further efforts will be needed to improve the quality and professionality of the information provided through the operation of 119 ESCC.
Cardiopulmonary Resuscitation* ; Emergencies* ; Emergency Medical Services ; First Aid ; Gyeongsangnam-do ; Heart Arrest ; Humans ; Information Centers ; Thorax

Spinal and bulbar muscular atrophy (Kennedy disease) is an X-linked, adult-onset motor neuron disease characterized by slow, progressive weakness of the bulbar and extremity muscles with CAG triplet repeat expansion in the androgen receptor gene. Hirayama disease (HD) is characterized by the juvenile onset of asymmetric weakness and amyotrophy of the hand and is most common in males in Asia. We report a patient with atypical Kennedy disease presenting with asymmetric hand weakness and atrophy typical of HD.

Purpose: This study investigated the clinical and radiologic outcomes of partial trapeziectomy and suspensionplasty with a suture button for thumb carpometacarpal (CMC) joint osteoarthritis over a 2-year follow-up period. Methods: This retrospective study involved 17 patients with thumb CMC joint osteoarthritis (Eaton and Littler stage II or III) treated with partial trapeziectomy and suspensionplasty using a suture button. Clinical outcomes were evaluated using a visual analog scale for pain, the Quick DASH score, pinch and grip strength, and thumb range of motion. The trapezial space ratio (TSR) was used as a radiologic parameter to evaluate radiologic outcomes immediately postoperatively, at 6 months, and at the final follow-up. Results: The study included 17 patients (female, 16 and male, 1) with an average age of 63.2 years (range, 56–70 years). Surgery was performed on the dominant hand in nine cases and the nondominant hand in eight. Significant improvements were observed in clinical outcomes. The TSR significantly decreased up to 6 months postoperatively, but there was no significant change from 6 months onward. Complications included button irritation (n=1), a metacarpal fracture (n=1), and flexor carpi radialis tendon rupture (n=1), which were subsequently treated. At the last follow-up, significant improvements in functional outcomes were observed in comparison to the preoperative status. Conclusion The procedure demonstrated significantly improved clinical outcomes over a 2-year follow-up. This method is less invasive than other surgical techniques because it preserves part of the trapezium, making it a favorable surgical option in patients with early basal thumb arthritis (below Eaton stage III).

Purpose: This study investigated the clinical and radiologic outcomes of partial trapeziectomy and suspensionplasty with a suture button for thumb carpometacarpal (CMC) joint osteoarthritis over a 2-year follow-up period. Methods: This retrospective study involved 17 patients with thumb CMC joint osteoarthritis (Eaton and Littler stage II or III) treated with partial trapeziectomy and suspensionplasty using a suture button. Clinical outcomes were evaluated using a visual analog scale for pain, the Quick DASH score, pinch and grip strength, and thumb range of motion. The trapezial space ratio (TSR) was used as a radiologic parameter to evaluate radiologic outcomes immediately postoperatively, at 6 months, and at the final follow-up. Results: The study included 17 patients (female, 16 and male, 1) with an average age of 63.2 years (range, 56–70 years). Surgery was performed on the dominant hand in nine cases and the nondominant hand in eight. Significant improvements were observed in clinical outcomes. The TSR significantly decreased up to 6 months postoperatively, but there was no significant change from 6 months onward. Complications included button irritation (n=1), a metacarpal fracture (n=1), and flexor carpi radialis tendon rupture (n=1), which were subsequently treated. At the last follow-up, significant improvements in functional outcomes were observed in comparison to the preoperative status. Conclusion The procedure demonstrated significantly improved clinical outcomes over a 2-year follow-up. This method is less invasive than other surgical techniques because it preserves part of the trapezium, making it a favorable surgical option in patients with early basal thumb arthritis (below Eaton stage III).

Purpose: This study investigated the clinical and radiologic outcomes of partial trapeziectomy and suspensionplasty with a suture button for thumb carpometacarpal (CMC) joint osteoarthritis over a 2-year follow-up period. Methods: This retrospective study involved 17 patients with thumb CMC joint osteoarthritis (Eaton and Littler stage II or III) treated with partial trapeziectomy and suspensionplasty using a suture button. Clinical outcomes were evaluated using a visual analog scale for pain, the Quick DASH score, pinch and grip strength, and thumb range of motion. The trapezial space ratio (TSR) was used as a radiologic parameter to evaluate radiologic outcomes immediately postoperatively, at 6 months, and at the final follow-up. Results: The study included 17 patients (female, 16 and male, 1) with an average age of 63.2 years (range, 56–70 years). Surgery was performed on the dominant hand in nine cases and the nondominant hand in eight. Significant improvements were observed in clinical outcomes. The TSR significantly decreased up to 6 months postoperatively, but there was no significant change from 6 months onward. Complications included button irritation (n=1), a metacarpal fracture (n=1), and flexor carpi radialis tendon rupture (n=1), which were subsequently treated. At the last follow-up, significant improvements in functional outcomes were observed in comparison to the preoperative status. Conclusion The procedure demonstrated significantly improved clinical outcomes over a 2-year follow-up. This method is less invasive than other surgical techniques because it preserves part of the trapezium, making it a favorable surgical option in patients with early basal thumb arthritis (below Eaton stage III).