PURPOSE: The aim of this study was to analyze relationships between perfectionism, burnout, and emotional intelligence in APN and to identify the mediating effect of emotional intelligence on the relationship between perfectionism and burnout. METHODS: A structured self-report questionnaire was used to measure perfectionism, burnout, and emotional intelligence. Data were collected from 121 APN working in five advanced general hospitals and two general hospitals. Data were analyzed using descriptive statistics, Independent t-test, One-way ANOVA, Mann-Whitney U test, Pearson correlation and Hierarchical multiple regression with the SPSS/WIN 22.0 program. RESULTS: Mean scores for each variable were: perfectionism 3.57 (on a 5-point scale), burnout 3.32 (on a 7-point scale), and emotional intelligence 5.00 (on a 7-point scale). Self-oriented perfectionism had a positive correlation with burnout, as did socially prescribed perfectionism. Emotional intelligence was a significant variable reducing burnout, as it also had a reverse buffering effect on the relationship between self-oriented perfectionism and burnout. Explanatory power of the final model based on variables was 34%. CONCLUSION: The results of this study suggest a mediating direction regarding burnout by demonstrating that emotional intelligence plays a direct and reverse buffering role to self-oriented perfectionism, which can be used to reduce burnout in APN.
Emotional Intelligence* ; Hospitals, General ; Negotiating*

PURPOSE: The purpose of this study was to investigate the relationships among hope, self-care agency and quality of life of female oncology patients with lymphedema. METHODS: From May 2014 to April 2016, questionnaire responses of 102 patients diagnosed with secondary lymphedema were collected. The data of 100 patients were analysed using the IBM SPSS Statistics 21.0 program. RESULTS: There was a statistically significant correlation between hope and self-care agency. Self-care agency increased when participants had higher hope (r=.44, p < .001). Moreover, participants with higher Physical Component Summary (PCS) scores also had higher Mental Component Summary (MCS) scores (r=.77, p < .001). CONCLUSION: Educational programs and organized support for improving hope and PCS are needed to increase self-care agency and MCS of female cancer patients with secondary lymphedema.
Female* ; Hope* ; Humans ; Lymphedema* ; Quality of Life* ; Self Care*

PURPOSE: The purpose of this study were to investigate the self-reported quality of life and family burden and to examine the factors associated with the quality of life in patients with cancer. METHODS: 216 patients participated in the cross-sectional study. The European Group of Research and Treatment of Cancer Quality of life Questionnaire (EORTC QLQ-C30) and the Family Burden Scale were sent by mail to 2,000 cancer patients. Two hundred and sixteen patients answered the questionnaire. The stepwise multiple regression was conducted to analyze predictors of overall quality of life. RESULTS: All subscales of EORTC QLQ-C30 were significantly correlated with family burden. The regression analysis of patients with cancer revealed some variables as significant predictors; performance, perceived severity, family burden, time since diagnosis, and sex. CONCLUSION: The results offer a number of recommendations for future research and nursing practice focused on primary care for patients with cancer and their family for improving quality of life.
Cross-Sectional Studies ; Diagnosis ; Humans ; Nursing ; Postal Service ; Primary Health Care ; Quality of Life* ; Surveys and Questionnaires

BACKGROUND: Aquafol, a microemulsion propofol, causes more severe and frequent pain on injection than propofol. The purpose of this study was to compare a combination of lidocaine and ketamine on aquafol-induced pain with lidocaine or ketamine alone during the induction of anesthesia. METHODS: In this prospective, randomized, double-blinded study, 130 healthy patients who were undergoing elective surgery under general anesthesia were enrolled. The patients received IV lidocaine 40 mg plus ketamine 25 mg (Group LK, n = 43), lidocaine 40 mg (Group L, n = 42), or ketamine 25 mg (Group K, n = 45) with a rubber tourniquet on the forearm 1 min before the injection of microemulsion propofol. The pain score was assessed by a 4-point verbal rating scale (VRS) at 10 seconds after injection of microemulsion propofol 30 mg and during the injection of the remaining total dose. RESULTS: The incidence and severity of pain was significantly lower in Group LK than Group L or Group K at 10 seconds after the injection of microemulsion propofol 30 mg (P < 0.05). And the incidence and severity of pain was significantly lower in Group LK and Group K than Group L during the injection of the remaining total dose (P < 0.05). CONCLUSIONS: Pretreatment with IV lidocaine 40 mg plus ketamine 25 mg with a rubber tourniquet on the forearm 1 min before the injection of microemulsion propofol is more effective than lidocaine 40 mg or ketamine 25 mg alone in preventing pain from the injection of microemulsion propofol.
Anesthesia ; Anesthesia, General ; Forearm ; Humans ; Incidence ; Ketamine ; Lidocaine ; Propofol ; Prospective Studies ; Rubber ; Tourniquets

X-linked agammaglobulinemia is a common type of primary immunodeficiency disorder that's caused by mutation of the BTK gene. The absence of B lymphocytes and plasma cells causes recurrent infections. Patients with X-linked agammaglobulinemia also have a high risk for developing hematological malignancies and, to a lesser degree, carcinoma. We report here on a 26-years-old male patient who suffered with X-linked agammaglobulinemia that was caused by BTK gene mutation, and he developed a gastric cancer in the antrum. He was noted to have chronic atrophic gastritis and diffuse intestinal metaplasia on the endoscopic examination that was done 7 years previously. We recommend regular esophagogastroduodenoscopic evaluation for a patient with X-linked agammaglobulinemia in order to make an early diagnosis of stomach carcinoma.
Adenocarcinoma ; Agammaglobulinemia ; B-Lymphocytes ; Early Diagnosis ; Gastritis, Atrophic ; Genetic Diseases, X-Linked ; Hematologic Neoplasms ; Humans ; Male ; Metaplasia ; Plasma Cells ; Stomach ; Stomach Neoplasms

Pulmonary alveolar proteinosis (PAP) is a rare condition that is treated using whole lung lavage. A recent study suggested that granulocyte-macrophage colony stimulating factor (GM-CSF) plays roles in both the pathogenesis and treatment of PAP. We present a 69-year-old man with PAP who deteriorated despite bilateral whole lung lavage; that said, his symptoms, chest X-ray findings, and pulmonary function test improved after GM-CSF inhalation therapy over 12 months. GM-CSF therapy is an effective treatment modality for PAP.
Aged ; Bronchoalveolar Lavage ; Colony-Stimulating Factors ; Granulocyte-Macrophage Colony-Stimulating Factor ; Humans ; Inhalation ; Lung ; Pulmonary Alveolar Proteinosis ; Respiratory Function Tests ; Respiratory Therapy ; Thorax

BACKGROUND: This study was performed to evaluate the effectiveness of intravenous low dose ketamine for reducing the incidence and severity of postoperative sore throat (POST). METHODS: This was a prospective, randomized, double-blind clinical trial. The study population consisted of 70 patients between 20 and 70 years old who were classified as American Society of Anesthesiologists I-II and were scheduled for elective laparoscopic cholecystectomy. The patients were divided randomly into two groups. Patients in the ketamine group received an intravenous injection of 0.5 mg/kg of ketamine just before induction, followed by 10 microgram/kg/min throughout the operation. Patients in the control group received intravenous saline instead of ketamine. The patients were interviewed 1, 6, and 24 h after the operation. The incidence and severity of POST were recorded. RESULTS: No significant differences in the incidence and severity of POST during the 24 h after the operation were found between the two groups (21/31 in the ketamine group vs. 26/34 in the control group, P = 0.398). CONCLUSIONS: Intravenous injection of low dose ketamine was not effective for reducing POST.
Cholecystectomy, Laparoscopic ; Humans ; Incidence ; Injections, Intravenous ; Intubation ; Ketamine ; Pharyngitis ; Prospective Studies

To elucidate the clinical significance of phenotypic alterations of Lewis antigen in gastric cancer patients, we investigated Lewis antigens by analyzing the genotypes of the Le and Se genes and by comparing the results obtained with the phenotypic expression of Lewis antigen in gastric cancer tissue and blood cells. One hundred and twenty gastric cancer patients were examined and compared with respect to Lewis blood phenotype and genotype. The expression of Lea, Leb, sialylated Lea, and sialylated Lex antigens was immunohistochemically examined in uninvolved gastric mucosa, intestinal metaplasia, and cancerous tissue. We also analyzed the significance of Lewis antigen expression by analyzing patient survival. The frequencies of the Lewis phenotypes of RBCs corresponding to Le(a+b-), Le(a-b+), and Le(a-b-) were 16%, 58%, and 26%, respectively. The Le and le allele gene frequencies calculated from genotyping in gastric cancer patients were 0.623 and 0.377, respectively. The frequency for Le(a-b-) of the RBC phenotype had a tendency to be higher in cancer patients than in normal healthy Koreans. However, no difference in the Lewis gene frequency was found between these gastric cancer patients and healthy persons. The phenotype of Le(a-b+) was most prevalent in uninvolved gastric mucosal tissue, whereas the most prevalent form in tumor tissue was Le(a-b-). Sialyl-Lea and sialyl-Lex antigens were hardly detectable in uninvolved gastric mucosa, whereas the two antigens were expressed highly in intestinal metaplastic mucosa and tumor cells. In conclusion, the loss of Lewis antigen expression in tissue and on RBCs in gastric cancer patients is not a result of genetic influences, but rather a result of sialylation in tissue. We also confirm that poor prognosis is associated with dimeric sialyl-Lex and vascular spread.
Adult ; Aged ; Alleles ; Erythrocytes/*chemistry ; Female ; Fucosyltransferases/*analysis/genetics ; Gangliosides/analysis ; Genotype ; Human ; Immunohistochemistry ; Male ; Metaplasia ; Middle Age ; Oligosaccharides/analysis ; Phenotype ; Stomach Neoplasms/*blood/genetics/mortality

BACKGROUND: The opioid sparing effect of low dose ketamine is influenced by bolus dose, infusion rate, duration of infusion, and differences in the intensity of postoperative pain. In this study, we investigated the opioid sparing effect of low dose ketamine in patients with intravenous patient-controlled analgesia (PCA) using fentanyl after lumbar spinal fusion surgery, which can cause severe postoperative pain. METHODS: Sixty patients scheduled for elective lumbar spinal fusion surgery were randomly assigned to receive one of three study medications (K1 group: ketamine infusion of 1 microg/kg/min following bolus 0.5 mg/kg, K2 group: ketamine infusion of 2 microg/kg/min following bolus 0.5 mg/kg, Control group: saline infusion following bolus of saline). Continuous infusion of ketamine began before skin incision intraoperatively, and continued until 48 h postoperatively. For postoperative pain control, patients were administered fentanyl using IV-PCA (bolus dose 15 microg of fentanyl, lockout interval of 5 min, no basal infusion). For 48 h postoperatively, the total amount of fentanyl consumption, postoperative pain score, adverse effects and patients' satisfaction were evaluated. RESULTS: The total amount of fentanyl consumption was significantly lower in the K2 group (474 microg) compared to the control group (826 microg) and the K1 group (756 microg) during the 48 h after surgery. Pain scores at rest or with movement, the incidence of adverse events and patient satisfaction were not significantly different among the groups. CONCLUSIONS: Low-dose ketamine at 2 microg/kg/min following bolus 0.5 mg/kg significantly reduced the total amount of fentanyl consumption during the 48 h after lumbar spinal fusion surgery without increasing adverse effects.
Analgesia, Patient-Controlled ; Fentanyl ; Humans ; Incidence ; Ketamine ; Pain, Postoperative ; Patient Satisfaction ; Skin ; Spinal Fusion

Methanol poisoning is a medical emergency that requires rapid elimination of the toxin and its metabolites for recovery. The danger of methanol results from the accumulation of its toxic metabolite formic acid. This accumulation may result in the development of metabolic acidosis, visual impairment, and damage to the basal ganglia. Extracorporeal treatment is recommended in severe cases of methanol poisoning with coma, seizure, new vision deficits, metabolic acidosis, high serum anion gap, elevated methanol concentrations or impaired kidney function. Although the serum methanol concentration is helpful in determining the use of extracorporeal treatment, methanol assays are not standard laboratory tests in Korea. Herein, we report a case of methanol poisoning in which the patient's clinical improvement was confirmed using serum and urine methanol levels.
Acid-Base Equilibrium ; Acidosis ; Basal Ganglia ; Coma ; Emergencies ; Extracorporeal Circulation ; Kidney ; Korea ; Methanol* ; Osmolar Concentration ; Poisoning* ; Renal Replacement Therapy* ; Seizures ; Vision Disorders