OBJECTIVES: This research was done to identify relationships among job stress, fatigue, job satisfaction, and commitment to organization in customized home health care nurses. METHODS: Research participants were 130 nurses who worked in the customized home health care of 20 county in Gyeongnam province. Data collection for this descriptive correlational study was done at August 2010 using self report questionnaires, and analyzed using descriptive statistics, t-test, ANOVA, and we analyzed a four step approach in which several regression analyses were conducted and significance of the coefficients is examined at each step. RESULTS: The results from step 1 showed that, the effect of each job stress was significantly related to job satisfaction. In step 2, the direct effect of commitment to organization on job satisfactions were all significant too. Step 3 analysis showed that the total effect of each job stress on commitment to organization symptoms was significant. Step 4 showed the results of controlling for mediating factor (job satisfaction): job demand and insecurity were significantly associated with commitment to organization (p<0.001), the finding supports that others were fully mediated by each job satisfaction, and, the job demand and insecurity were partially mediated by job satisfaction. CONCLUSION: Results of this research indicated that job stress in customized home health care nurses was the principal variable affecting job satisfaction and commitment to organization. Appropriate stress management strategies based on assessment of job demand and job security for these nurses lead to development of improved commitment to organization.
Community Health Nursing ; Data Collection ; Delivery of Health Care ; Fatigue ; Job Satisfaction ; Negotiating ; Self Report ; Surveys and Questionnaires

BACKGROUND: Verifying the effect of frailty on health-related quality of life may help us better understand the impact of frailty. The present study explored the relationship between frailty and health-related quality of life in community-dwelling Korean elderly. METHODS: Older adults aged 65 years or older recruited by judgment sampling of the population of Seocho-gu in Seoul were surveyed in 2011. The Korean frailty index measure developed by the Korean Geriatric Society was used as the outcome variable. Proportional odds model was used to evaluate the relationship between health-related quality of life (HRQoL) and frailty. RESULTS: We found that, after adjusting for sociodemographic covariates, being prefrail or frail significantly increased the proportional odds for lowering health-related quality of life than being nonfrail. In addition, of the five components of health-related quality of life, the magnitude of the adverse effects of frailty on HRQoL was largest for pain/discomfort, with anxiety/depression being the second largest. CONCLUSION: Compared to persons who are not frail, older Korean individuals identified as frail and prefrail exhibit significantly lower HRQoL scores. This association between Korean frailty measures and the generic measure of the HRQoL may offer new information to better understand frailty within its broader context.
Adult ; Aged ; Humans ; Judgment ; Quality of Life

BACKGROUND AND OBJECTIVE: The aim of this study was to compare the residual diameter stenosis after PTCA with fractional flow reserve (FFR) and coronary flow reserve (CFR), and investigate the correlation between FFR and CFR in patients with acute myocardial infarction (AMI). MATERIALS AND METHOD: The study population consisted of twenty seven patients with myocardial infarction. Baseline and hyperemic average peak velocity (APV) were measured using Doppler wire 15 minutes after restoration of infarct-related artery (IRA). CFR was obtained by the ratio of distal hyperemic APV to baseline APV. Distal coronary arterial pressure (Pd) was measured with advancing the wire distal to the lesion of IRA. Simultaneous proximal aortic pressure (Pa) was measured using guiding catheter. Myocardial FFR was obtained by the ratio of hyperemic Pd to hyperemic Pa. RESULTS: Post-interventional CFR and FFR were 0.85+/-0.44, 0.91+/-0.09. CFR did not show significant correlation with luminal diameter stenosis (%ST). There was no significant correlation between FFR and CFR with a correlation coefficient of 0.29 (p=.25). But, significant correlation was found between %ST and FFR, %ST and hyperemic PG (hPG) with correlation coefficient of -0.70 (p=.0012) and 0.68 (p=.0018). CONCLUSION: In AMI patients, %ST has a significant correlation with FFR and hPG after PTCA. But, there was no significant correlation between FFR and CFR.
Arterial Pressure ; Arteries ; Catheters ; Constriction, Pathologic ; Humans ; Myocardial Infarction* ; Phenobarbital

Primary hyperparathyroicism is a state of hypersecretion of PTH by the parathyroid. The etiology has not been established. The three possible etiologies of piimary hyperparathyroidism and incidences are adencena(83%), hyperplasia(15%), and carcinoma(1~2%). Parathyroid carcinoma usually presents in the fourth decades. The hallmark preoperative signs are hypercalcemia(serum calcium 15mg/dl). Palpable neck mass and bane and renal disease. Patients may present with multiple signs and syrnptoms, including recurrent nephrolithiasis, peptic ulcers, mental change, less frequently, extensive bone resorption. However, with greater awareness of the disease and wider use of screening tests, including blood calcium determinations, the diagnosis is frequently made in patients who have no symptoms and minimal, if any, signs of the disease ather than hypercalcemia and elevated levels of parathyroid Hormone. An 38-years-old woman was admitted to the hospital due to pain on the left knee joint. We experienced full-brown symptom pertaining to hyperpara- thyroidism. Thus we report a case herein and also discuss clinical anifestation, histologic features and treatment.
Bone Resorption ; Calcium ; Diagnosis ; Female ; Humans ; Hypercalcemia ; Hyperparathyroidism ; Incidence ; Knee Joint ; Mass Screening ; Neck ; Nephrolithiasis ; Parathyroid Hormone ; Parathyroid Neoplasms ; Peptic Ulcer ; Thyroid Gland

PURPOSE: The purpose of this study is to assess the usefulness of magnetic resonance imaging (MRI) in diagnosis, planning of treatment methods for suspected acute septic arthritis in children, and evaluation of the clinical results of the operations with the help of magnetic resonance imaging as a diagnostic modality. MATERIALS AND METHODS: Between March 2003 and May 2007, 20 patients suspected of having acute septic arthritis of the hip underwent MRI. The mean age of the patients was 3 years and 5 months (range: 10 days-14 years). The average follow-up was 2 years and 2 months (range: 1 year-3 years 6 months). Assessment of MRI findings and final results with recurrence of the infection and post-infectious radiographic sequelae was performed retrospectively. RESULTS: Among the 20 cases, 17 cases(85%) showed joint effusion. Among these 17 cases, accompanying signal changes were observed in the meta-epiphyseal region in seven cases, and accompanying signal changes were observed in surrounding soft tissue in three cases. Accompanying abscess formation was observed in one case. The remaining three cases(15%), which had no joint effusion, showed an intramuscular abscess pocket around the joint, which mimicked septic arthritis. At final follow up, two cases showed unsatisfactory results, with limited joint motion and radiographic sequelae. CONCLUSION: In children who are suspected of having acute septic arthritis of the hip, MRI can provide useful information about the location and extent of infection and even the differential diagnosis of acute septic arthritis. MRI was considered to be a useful method for diagnosis of suspected acute septic arthritis in children.
Abscess ; Arthritis, Infectious ; Child ; Diagnosis, Differential ; Follow-Up Studies ; Hip ; Hip Joint ; Humans ; Joints ; Magnetic Resonance Imaging ; Recurrence

PURPOSE: To investigate the clinical manifestations and characteristics of extruded conjunctival melanocytic mass. METHODS: A total of 33 patients who had extruded conjunctival melanocytic mass and who underwent excisional biopsy were retrospectively reviewed. RESULTS: Based on the excisional biopsy results, 13 patients (40%) were diagnosed with compound nevus, nine patients (27%) with subepithelial nevus, eight patients (24%) with primary acquired melanosis without atypia, and three patients (9%) with malignant melanoma. Compound nevus was located on the temporal side of the cornea in 54% of affected cases, bulbar conjunctival in 77%, and was partially pigmented (brown) in 61%. The average size of the melanocytic mass was 24 mm when histological analysis showed melanin nevus cells in the conjunctival epithelial layer and subepithelial stromal layer. Subepithelial nevus was located on the temporal side of the cornea (56%) and in the bulbar conjunctival (78%) and had a brown color (78%). The average size of the melanocytic mass was 28 mm when histological analysis showed melanin nevus cells located only in the subepithelial stromal layer and forming nest shapes. Primary acquired melanosis without atypia was located on the temporal side of the cornea (62.5%) and bulbar conjunctival (75%) and had brown color (75%). The average size of melanin nevus cells located only in the basement membrane of the epithelial layer was 30 mm. Three of these masses were malignant melanoma, and all cases were located on the superior side of the cornea and palpebral conjunctiva. All cases were black and had an average size of 53 mm, with malignant cells observed in all layers of the conjunctiva and connective tissue. CONCLUSIONS: A conjunctival melanocytic mass located on the palpebral conjunctiva, extruding onto the surface, and large in size should be suspected as malignant melanoma. In such cases, early biopsy and aggressive resection are required.
Basement Membrane ; Biopsy ; Conjunctiva ; Connective Tissue ; Cornea ; Humans ; Melanins ; Melanoma ; Melanosis ; Nevus ; Retrospective Studies

Kawasaki disease is an acute febrile vasculitis of childhood and leading cause of acquired heart disease in children. The illness occurs predominantly in young children and only occasionally occurs in teenagers and adults. So we report a case of adolescent-onset Kawasaki disease associated with congestive heart failure and development of coronary dilatation. A 16-year-old girl presented with fever, truncal rash, congestive heart failure due to myocarditis, bilateral conjunctival injection, strawberry tongue, redness of hands and feet, and cervical adenopathy. After Kawasaki disease was diagnosed, intravenous gamma globulin(2 g/kg) and aspirin(70 mg/kg/day) were administered. On the 20th hospital day, echocardiography showed moderate dilatation of right coronary artery. Four months after the discharge, follow up echocardiography showed sustained dilatation of right coronary artery.
Adolescent* ; Adult ; Child ; Coronary Vessels ; Dilatation ; Echocardiography ; Estrogens, Conjugated (USP)* ; Exanthema ; Female* ; Fever ; Follow-Up Studies ; Foot ; Fragaria ; Hand ; Heart Diseases ; Heart Failure* ; Humans ; Mucocutaneous Lymph Node Syndrome* ; Myocarditis ; Tongue ; Vasculitis

Kawasaki disease is an acute febrile vasculitis of childhood and leading cause of acquired heart disease in children. The illness occurs predominantly in young children and only occasionally occurs in teenagers and adults. So we report a case of adolescent-onset Kawasaki disease associated with congestive heart failure and development of coronary dilatation. A 16-year-old girl presented with fever, truncal rash, congestive heart failure due to myocarditis, bilateral conjunctival injection, strawberry tongue, redness of hands and feet, and cervical adenopathy. After Kawasaki disease was diagnosed, intravenous gamma globulin(2 g/kg) and aspirin(70 mg/kg/day) were administered. On the 20th hospital day, echocardiography showed moderate dilatation of right coronary artery. Four months after the discharge, follow up echocardiography showed sustained dilatation of right coronary artery.
Adolescent* ; Adult ; Child ; Coronary Vessels ; Dilatation ; Echocardiography ; Estrogens, Conjugated (USP)* ; Exanthema ; Female* ; Fever ; Follow-Up Studies ; Foot ; Fragaria ; Hand ; Heart Diseases ; Heart Failure* ; Humans ; Mucocutaneous Lymph Node Syndrome* ; Myocarditis ; Tongue ; Vasculitis

OBJECTIVE: Spontaneous intracerebral hemorrhage (ICH) in young adults is rare. The purpose of this study was to investigate causes, sites and other factors affecting the prognosis of ICH in young adults aged < or = 40 years. METHODS: We reviewed 39 consecutive patients diagnosed with spontaneous ICH between January 2001 and June 2012. Patients with primary subarachnoid hemorrhage, previously diagnosed brain tumor bleeding, or vascular malformation were excluded. We analyzed the differences in prognostic factors such as hemorrhage location and vascular structural etiology. The outcome was measured using the Glasgow outcome scale (GOS), and a good outcome was defined as a score of 4 or more. RESULTS: We retrospectively evaluated 39 patients (mean age, 33 years; SD = 6.4, range 17 to 40 years). The most common structural etiology was arteriovenous malformation. A statistically significantly higher proportion of patients with good outcomes had a lower initial systolic blood pressure (SBP < or = 160 mmHg, p = 0.036), a higher initial Glasgow coma scale (GCS) (9 or more, p = 0.034), lower cholesterol levels (< 200 mg/dl, p = 0.036), and smoking history (at discharge, p = 0.008; 6 months after discharge, p = 0.019). CONCLUSION: In this study, cryptogenic ICH was the leading cause of spontaneous ICH. A GCS score of 9 or more on admission, a lower serum cholesterol level (< 200 mg/dl), and a lower SBP (< 160 mmHg) predicted a good outcome.
Aged ; Arteriovenous Malformations ; Blood Pressure ; Brain Neoplasms ; Cerebral Hemorrhage ; Cholesterol ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Hemorrhage ; Humans ; Prognosis ; Retrospective Studies ; Smoke ; Smoking ; Subarachnoid Hemorrhage ; Vascular Malformations ; Young Adult

OBJECTIVE: Spontaneous intracerebral hemorrhage (ICH) in young adults is rare. The purpose of this study was to investigate causes, sites and other factors affecting the prognosis of ICH in young adults aged < or = 40 years. METHODS: We reviewed 39 consecutive patients diagnosed with spontaneous ICH between January 2001 and June 2012. Patients with primary subarachnoid hemorrhage, previously diagnosed brain tumor bleeding, or vascular malformation were excluded. We analyzed the differences in prognostic factors such as hemorrhage location and vascular structural etiology. The outcome was measured using the Glasgow outcome scale (GOS), and a good outcome was defined as a score of 4 or more. RESULTS: We retrospectively evaluated 39 patients (mean age, 33 years; SD = 6.4, range 17 to 40 years). The most common structural etiology was arteriovenous malformation. A statistically significantly higher proportion of patients with good outcomes had a lower initial systolic blood pressure (SBP < or = 160 mmHg, p = 0.036), a higher initial Glasgow coma scale (GCS) (9 or more, p = 0.034), lower cholesterol levels (< 200 mg/dl, p = 0.036), and smoking history (at discharge, p = 0.008; 6 months after discharge, p = 0.019). CONCLUSION: In this study, cryptogenic ICH was the leading cause of spontaneous ICH. A GCS score of 9 or more on admission, a lower serum cholesterol level (< 200 mg/dl), and a lower SBP (< 160 mmHg) predicted a good outcome.
Aged ; Arteriovenous Malformations ; Blood Pressure ; Brain Neoplasms ; Cerebral Hemorrhage ; Cholesterol ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Hemorrhage ; Humans ; Prognosis ; Retrospective Studies ; Smoke ; Smoking ; Subarachnoid Hemorrhage ; Vascular Malformations ; Young Adult