PURPOSE: The purposes of this study were to explore knowledge, barriers, and self-efficacy in relation to pain management practice, and to identify factors influencing pain management practice in pediatric nurses. METHODS: A descriptive correlational study was conducted. The participants were 237 pediatric nurses from a metropolitan city. Data were analyzed using t-test or analysis of variance and Pearson correlation and multiple regression analyses. RESULTS: The mean percentage of correct answers on the children's pain management knowledge scale was 58.8%. Child and parent related factors were the main barriers for pain management. Self-efficacy to assess children's pain across developmental stages was particularly low. Pain management practices for assessing pain and non-pharmacological interventions were relatively low. Factors significantly affecting children's pain management practice were current conditions of work department and self-efficacy in pain management, and these factors accounted for 37.5% of the variance in pain management practice. CONCLUSION: The results suggest that an integrative education program needs to be developed to improve self-efficacy in children's pain management practice. Moreover, good communication, building cooperative relationships with children and parents, and a more active role by pediatric nurses are required to carry out more effective pain management.
Child ; Education ; Humans ; Pain Management* ; Parents

PURPOSE: The aim of this research was to identify the mediating effect of sleep quality on the relationship between job stress and stress response of shift-working nurses.METHODS: The participants in this study were 150 nurses who had more than 6 months of shift-working experience. A survey was conducted from May to June 2017 in a hospital in Gyeonggi-do, South Korea. The data were collected through self-report questionnaires. The collected data were analyzed using SAS 9.4 program. The analysis was based on Baron and Kenny's model to examine the mediating effects of sleep quality on the relationship between job stress and stress response of shift-working nurses.RESULTS: In the first and second steps, job stress was identified as a significant predictor of sleep quality (β=.29, p=.001) and stress response (β=.24, p=.004). In the third step, sleep (β=.55, p < .001) was observed as a significant predictor of stress response, and the direct relationship between job stress and stress response was not significant (β=.07, p=.291). Sleep quality was found to exhibit complete mediating effect on the relationship between job stress and stress response.CONCLUSION: The results of this study suggest that strategies for managing the stress of shift-working nurses should include effective ways to ensure sleep quality.
Gyeonggi-do ; Korea ; Negotiating

PURPOSE: The benefits of thrombolytic treatment are time-dependent. We developed a smartphone application that aids stroke patient self-screening and hospital selection, and may also decrease hospital arrival time. MATERIALS AND METHODS: The application was developed for iPhone and Android smartphones. Map data for the application were adopted from the open map. For hospital registration, a web page (http://stroke119.org) was developed using PHP and MySQL. RESULTS: The Stroke 119 application includes a stroke screening tool and real-time information on nearby hospitals that provide thrombolytic treatment. It also provides information on stroke symptoms, thrombolytic treatment, and prescribed actions when stroke is suspected. The stroke screening tool was adopted from the Cincinnati Prehospital Stroke Scale and is displayed in a cartoon format. If the user taps a cartoon image that represents abnormal findings, a pop-up window shows that the user may be having a stroke, informs the user what to do, and directs the user to call emergency services. Information on nearby hospitals is provided in map and list views, incorporating proximity to the user's location using a Global Positioning System (a built-in function of smartphones). Users can search for a hospital according to specialty and treatment levels. We also developed a web page for hospitals to register in the system. Neurology training hospitals and hospitals that provide acute stroke care in Korea were invited to register. Seventy-seven hospitals had completed registration. CONCLUSION: This application may be useful for reducing hospital arrival times for thrombolytic candidates.
*Cellular Phone ; Geographic Information Systems ; Hospitals ; Humans ; Republic of Korea ; Stroke/*diagnosis

PURPOSE: This study was to investigate the age and sex differences of the fractal dimension of the normal parotid glands in the digitized CT images. MATERIALS AND METHODS: The six groups, which were composed of 42 men and women from 20`s, 40`s and 60`s and over were picked. Each group contained seven people of the same sex. The normal parotid CT images were digitized, and their fractal dimensions were calculated using Scion ImagePC program. RESULTS: The mean of fractal dimensions in males was 1.7292(+/-0.0588) and 1.6329(+/-0.0425) in females. The mean of fractal dimensions in young males was 1.7617, 1.7328 in middle males, and 1.6933 in old males. The mean of fractal dimensions in young females was 1.6318, 1.6365 in middle females, and 1.6303 in old females. There was no statistical difference in fractal dimension between left and right parotid gland of the same subject(p>0.05). Fractal dimensions in male were decreased in older group(p<0.05) and larger than female in same age group(p<0.05). But fractal dimensions in female had a tendency to decrease in older group but no statistical difference between ages(p>0.05). CONCLUSIONS: The fractal dimension of parotid glands in the digitized CT images will be useful to evaluate the age and sex differences.
Female ; Fractals* ; Humans ; Male ; Parotid Gland* ; Sex Characteristics

Radiotherapy in the treatment of head and neck cancers is often used either alone or in addition to surgery. Radiation disrupts the proliferative capacity of the cancer while doing as little damage as possible to the normal tissue. Nevertheless, conventional radiotherapy of advanced head and neck tumors is frequently associated with severe oropharyngeal mucositis. The fungiform papillae are found on the dorsal surface of the anterior 2/3 of the tongue and have one taste bud which always located on the superior side. In recent years, many study have demonstrated the location of neuropeptides in the intragemmal cells of the taste buds. We used neural cell adhesion molecule (NCAM) in this study. NCAM is a membrane surface glycoprotein found in neural tissue that functions in cell -cell interactions such as adhesion and recognition and may contribute to neuronal and receptoneural synaptogenesis. However, to the best of our knowledge, there is no study about NCAM in relation to dysgeusia, especially after radiotherapy. Therefore, we studied the change of the expression of NCAM in the fungiform papilla of the young rat tongue following single dose radiation. Twenty days old 18 Sprague -Dawley rats were used. Twelve rats were irradiated with a single dose of 17 Gy gamma radiation. We sacrificed rats 1, 7, 20 days after radiation. The anterior part of tongues were removed and cut into at 30 micro gram on a cryocut. Using the free floating method, we immunostained sections. In control group, NCAM is expressed on some intragemmal cells which were located in the center of the bud and intragemmal nerve fibers. NCAM -immunoreactive (ir) perigemmal nerve fibers were rare, however basal plexus fibers and subpapillary nerve bundle showed strong immunoreactivity. One day after radiation, taste buds had no detectable changes of the expression of NCAM. However, seven days after radiation, the number of NCAM -ir intragemmal cells was reduced and the shape of ir cells was deformed. Immunoreactivity of basal plexus fibers and subpapillary nerve bundle was also decreased. The surface of the papilla was transformed into dome shape. Twenty days after radiation, overall forms of buds were recovered except a few deformed NCAM -ir intragemmal cells. NCAM was expressed in the intragemmal cells which are thought to be related with taste sensation, and we speculate that NCAM participate synaptogenesis. However, more studies using immunoelectron microscopic method are required.
Animals ; Dysgeusia ; Gamma Rays ; Head ; Immunohistochemistry ; Membrane Glycoproteins ; Membranes ; Mucositis ; Neck ; Nerve Fibers ; Neural Cell Adhesion Molecules* ; Neurons ; Neuropeptides ; Radiotherapy ; Rats* ; Sensation ; Taste Buds ; Tongue*

Forensic autopsy is performed to investigate a death. However, this is difficult in some cases, particularly in putrefied bodies. Pulmonary ossification is a rare pathological process, characterized by progressive and metaplastic ossification, which leads to the formation of small bony fragments in the pulmonary tissue. This condition can develop within the pulmonary tissues that are injured due to various causes. Metastatic and dystrophic calcification occur in normal tissues in conditions of deranged calcium metabolism and dead or degenerative tissue, respectively. Here, we describe the case of a 54-year-old man who lived alone and whose putrefied body was discovered by his landlord. A forensic pathologist identified needle-like sharp materials in both the lower lobes of the lungs during autopsy. Microscopic examination revealed dendriform pulmonary ossification with calcification. After autopsy, his medical history, including chronic kidney disease, was recorded by forensic pathologist. A review of his past medical history and comprehensive postmortem examination findings of the gross dissection, microscopic examination, and postmortem laboratory tests led to the determination of the cause of death as renal problems.

This study was carried out to investigate the development rates of human embryos co-cultured with cumulus cells to each blastocyst stage. Human zygotes were co-cultured on cumulus cell monolayer in YS medium supplemented with 20% hFF. On day 2, if patient had four or more 'good' embryos(regular blastomeres without fragmentation), embryos were further cultured for 72hrs. Blastocysts on day 5 were classified into early blastocyst (ErB), early expanding blastocyst (EEB), middle expanding Blastocyst (MEB), and expanded blastocyst (EdB) on the basis of their morphological aspects of trophectoderm cells and blastocoele. Subsequently, maximum 3 of best blastocysts were transferred in 486 cycles. The results in this study were as follows: Patients who had four or more 'good' embryos on day 2 were 498 persons, but patients whose embryos could not be transferred due to failure in development to the blastocyst stage on day 5 were 12 persons (2.4%). The development rate of embryos to the blastocyst stage was 58.2% (2,885/4,957) on day 5, and the rates that developed to the ErB, EEB, MEB, and EdB stage were 15.0% (743/4,957), 14.9% (739/4,957), 14.4% (714/4,957), and 13.9% (689/4,957), respectively. Total 1366 blastocysts were transferred in 486 cycles (mean number=2.81). The implantation rate and the ongoing implantation rate obtained by observing the number of G-sac and FHB were 29.9% (409/1,366) and 22.5% (308/1,366), respectively. The clinical pregnancy rate was 51.2% (249/486), and the ongoing pregnancy rate was 39.1% (190/486). Among women showing ongoing pregnancy, women with singleton were 50% (95/190), women with twin were 37.9% (72/190), and women with triplet were 12.1% (23/190). Although triplet pregnancy rate in this study was high such as 12.1%, because many blastocysts with high viability were produced in our co-culture system using cumulus cells on day 5, we really believe that a multiple pregnancy except twin should not occur by selecting good embryos for maximum two blastocyst transfer. These results demonstrate that autologous cumulus cells may be used for the production of blastocysts with high developmental competence, and the use of autologous cumulus cells to be collected easily, and to be treated conveniently at OPU must be an effective means for obtaining high implantation and pregnancy rate.
Blastocyst* ; Blastomeres ; Coculture Techniques* ; Cumulus Cells* ; Embryo Transfer ; Embryonic Structures* ; Female ; Humans* ; Mental Competency ; Pregnancy ; Pregnancy Rate ; Pregnancy, Multiple ; Pregnancy, Triplet ; Triplets ; Zygote

BACKGROUND: We postulate that a delay in the implementation of hepatic arterial embolization for traumatic liver injury patients will negatively affect patient prognosis. Our work also seeks to identify factors related to the mortality rate among traumatic liver injury patients. METHODS: From January 2008 to April 2014, patients who had been admitted to the emergency room, were subsequently diagnosed with traumatic liver injury, and later underwent hepatic arterial embolization were included in this retrospective study. RESULTS: Of the 149 patients that underwent hepatic arterial embolization, 86 had the procedure due to traumatic liver injury. Excluding the 3 patients that were admitted to the hospital before procedure, the remaining 83 patients were used as subjects for the study. The average time between emergency room arrival and incidence of procedure was 164 min for the survival group and 132 min for the non-survival group; this was not statistically significant (p = 0.170). The average time to intervention was 182 min for the hemodynamically stable group, and 149 min for the hemodynamically unstable group, the latter having a significantly shorter wait time (p = 0.047). Of the factors related to the mortality rate, the odds ratio of the Glasgow Coma Score (GCS) was 18.48 (p < 0.001), and that of albumin level was 0.368 (p = 0.006). CONCLUSIONS: In analyzing the correlation between mortality rate and the time from patient admission to arrival for hepatic arterial embolization, there was no statistical significance observed. Of the factors related to the mortality rate, GCS and albumin level may be used as prognostic factors in traumatic liver injury.
Coma ; Embolization, Therapeutic ; Emergency Service, Hospital ; Humans ; Incidence ; Liver* ; Mortality* ; Odds Ratio ; Patient Admission ; Prognosis ; Retrospective Studies ; Time Factors

This study investigates the relationship between smoking and periodontal disease through quantitative analysis of intra-buccal oral pathogenic bacteria detected in smokers and aims to yield objective baseline data for applications in anti-smoking and dental health education programs. From April to May 2016, participants in an oral health management program within an intensive dental hygiene training course at Choonhae College of Health Sciences received an explanation of the study purposes and methods, after which male smokers aged 18~30 years agreed to participate voluntarily. Real-time polymerase chain reaction (PCR) analysis of oral pathogenic bacteria was performed after collecting gingival sulcus fluid samples from 67 smokers. The intra-buccal oral pathogenic bacteria distributions were analyzed based on the subjects' general characteristics, smoking behaviors, and oral care behaviors. The distribution results show that pathogens in the anterior teeth are affected (in this order) by age, toothbrush size, and smoking status; older people had fewer pathogens, those who used larger toothbrushes had more pathogens, and smokers had more pathogens, compared to non-smokers ((adj)R²=19.1). In the posterior teeth, pathogens were influenced (in this order) by smoking status, smoking duration, and the number of tooth brushings per day; smokers had more pathogens than non-smokers, and those who brushed their teeth more often had fewer pathogens ((adj)R²=25.1). The overall pathogen distribution was affected only by smoking status: smokers generally had more pathogens, compared to non-smokers. Therefore, it is necessary to provide information about the risk of periodontal disease due to smoking during anti-smoking or dental health education sessions; particularly, the use of smaller toothbrushes for anterior teeth and the need for smokers in their early twenties to quit smoking for dental health should be highly emphasized.
Bacteria ; Health Education, Dental ; Humans ; Male ; Oral Health ; Oral Hygiene ; Periodontal Diseases ; Real-Time Polymerase Chain Reaction ; Smoke ; Smoking ; Tooth