No Abstract Available.
Hepacivirus* ; Hepatitis C* ; Hepatitis*

This study aimed to examine factors and the correlations of burnout and job satisfaction in hospital dietitians. Burnout was classified into three sub-concepts: emotional exhaustion, depersonalization, and reduced personal accomplishment. Job satisfaction was also classified into three sub-concepts, including relationships, self-realization, and advancement opportunities. A survey was conducted with dietitians working in general hospitals of over 400 beds, in the Seoul metropolitan area. The factors that significantly influenced emotional exhaustion were health, work hours, number of intern dietitians, self-esteem, level of responsibility, while the factors that influenced depersonalization were relationships with coworkers, and role ambiguity. Personal accomplishment was influenced by age, the number of staff dietitians, the general number of managed workers, and self-esteem. In terms of job satisfaction, relationship was affected by age and relationships with supervisors, while self-realization was influenced by work hours, health, the number of patient meals, and role ambiguity. Age, job regularity, business management, role ambiguity, and relationships with supervisors also affected advancement opportunities. Emotional exhaustion, depersonalization, and reduced personal accomplishments, which represented burnout, had negative relationships with satisfaction with relationships, self-realization and advancement opportunities. Dietitians with low job satisfaction were likely to experience burnout. These results suggest that burnout and job satisfaction are influenced by internal and external factors that are individual or organizational problems encountered by hospital dietitians. Therefore, managers as well as dietitians need to understand these factors and overcome them through communication and mutual support.
Commerce ; Depersonalization ; Hospitals, General ; Humans ; Job Satisfaction ; Meals

A Radical gastrectomy can affect the dumping syndrome, reflux gastritis, injury of the autonomic nervous system and the small capacity syndrome and can cause some problems in the quality of life for post-gastrectomy patients. To minimize these complications in the treatment of early gastric cancer (EGC), various gastric-reduced operations have been discussed by gastric surgeons. A pylorus preserving gastrectomy (PPG) is a kind of reduced-gastric operation which preserves the distal portion (1.5 cm) of the gastric antrum and reduces postoperative complications such as the dumping syndrome and reflux esophagitis. However, a limitation of this operation is that complete lymph node dissection of the suprapyloric lymph node is undesirable for preservation of the pyloric branch of the vagus nerve. Nowadays, some reports state that this operation may be applicable in EGC confined to the mucosa and located at the gastric mid-body. (Purpose) This study was designed to evaluate the gastric function after PPG by using solid foods to obtain the gastric emptying time. (Materials and Method) From June 1995 to December 1995, we performed PPGs on 7 patients (4 patients with mucosal cancer, 2 patients with gastric ulcer and 1 patient with a leiomyoma) and Billroth I reconstruction in 7 patients (5 patients with mucosal cancer, 1 patient with advanced gastric cancer and 1 patient with gastric ulcer). To compare the gastric function between these two subgroups, we analyzed the lag time, T1/2 and the residual food after 100 min using 99mTc-tin-colloid-steamed eggs to obtain the gastric emptying time for the PPG group (n=7), the Billroth I reconstruction group (n=7), and the normal control group (n=7). A statistical analysis was done by using the Kruskal-Wallis test (Chi-square approximation). (Results) There were no differences in the amount of transfusion, the hospital stay, the operation time, and the body weight loss after operation between the PPG group and the Billroth I reconstruction group. The severe dumping syndrome and reflux esophagitis were found in one of the patients after Billroth I reconstruction, but were not found in PPG group. Statistically, there was no difference in T1/2 between the Billroth I reconstruction group and the PPG group; however, both lag times were longer than that of the normal control group. We also found that the residual food 100 min after oral intake was greater in both the Billroth I reconstruction and the PPG groups than in the normal control group. (Conclusion) Though both PPG and Billroth I reconstruction showed delayed gastric emptying, we found that PPG is superior to Billroth I reconstruction in lag time and in the amount of residual food after 100 min. We conclude that PPG is superior to Billroth I reconstruction in gastric motility, and if this operation is applied in indicated gastric cancer patients, post-operative complications, such as the dumping syndrome and reflux esophagitis can be reduced and the quality of life in post-gastrectomy patients can be increased.
Autonomic Nervous System ; Body Weight ; Dumping Syndrome ; Eggs ; Esophagitis, Peptic ; Gastrectomy ; Gastric Emptying ; Gastritis ; Gastroenterostomy ; Humans ; Length of Stay ; Lymph Node Excision ; Lymph Nodes ; Mucous Membrane ; Ovum ; Postgastrectomy Syndromes* ; Postoperative Complications ; Pyloric Antrum ; Pylorus ; Quality of Life ; Stomach Neoplasms ; Stomach Ulcer ; Vagus Nerve

This research aims to examine the experiences of hospital dietitians' burnout and the factors of their burnout, such as demographic factors, unique characteristics of hospitals, their self-respect, and organizational factors. In order for this, a questionnaire survey was conducted with hospital dietitians working in general hospitals of over 400 beds in the Seoul Metropolitan area. The average point of self-respect of dietitians is 3.67 out of 5.00. Their experience of burnout turned out to be 3.17 out of 7, the extent of job satisfaction is high, that is 3.35 out of 5.00. The decrease of personal accomplishment is shown to be closely related to the burnout of dietitians. The emotional exhaustion in burnout at the significant level 0.001 is increasing as the annual gross salary is low, their age is young, extra-working hours are long, and is high to the dietitians serving meals and working at entrusted companies. The factors affected by burnout experience vary with individual circumstances. So, to prevent the emotional exhaustion, depersonalization, and reduced personal accomplishment, hospital dietitians' spiritual and physical health needs to be kept up by their self-development and investment.
Demography ; Depersonalization ; Hospitals, General ; Humans ; Investments ; Job Satisfaction ; Meals ; Salaries and Fringe Benefits ; Surveys and Questionnaires

No abstract available.
Down Syndrome* ; Heart Defects, Congenital*

No abstract available.
Adenoma* ; Hyperaldosteronism*

BACKGROUND: Although being associated with an elevated plasma atrial natriuretic peptide(ANP), its precise role in the postobstructive diuresis has not been fully understood. Evidence has been provided suggesting that the locally-synthesized ANP in the kidney contributes to the regulation of urinary sodium excretion. The present study was aimed to investigate whether an altered regulation of local ANP system is involved in the postobstructive diuresis. METHODS: Male Sprague-Dawley rats were used. Both proximal ureters were ligated for 48 hours, after which the kidneys were taken without releasing the ligature, being designated as bilateral ureteral obstruction(BUO) group; or the ligature was released and 4 or 24 hr later, urinary data were collected, being designated as BUR-4 or BUR-24, respectively. Sham operated rats were used as control. Plasma ANP levels were determined by radioimmunoassay. The expression of ANP and natriuretic peptide receptor(NPR)-A mRNAs was determined by reverse transcription-polymerase chain reaction(RT-PCR). To further examine whether the altered renal ANP system, if any, was associated with an altered biological effects of guanylyl cyclase, ANP-stimulated cGMP accumulation was determined in membrane preparations of the glomeruli and papillae by radioimmunoassay. RESULTS: The plasma ANP level was increased in BUO group compared with that in the control(260.5+/-32.5 vs. 133.3+/-23.5pg/mL, p<0.05), decreased in BUR-4 group(3.6+/-0.5 vs. 143.5+/-42.8pg/mL, p<0.01), while not significantly different in BUR-24 group. In BUR-4. the urinary flow rate increased compared with that in the control(1598+/-370 vs. 215+/-34 microL/hr, p<0.01), along with increases of FENa(11.5+/-4.1 vs. 0.25+/-0.02%, p<0.05) and UNaV (153.7+/-23.7 vs. 36.5+/-9.3microEq/hr, p<0.01). In BUR-24, the urinary parameters were normalized. Renal tissue expression of ANP mRNA was increased in BUO as well as in BUR-4, while not changed in BUR-24. NPR-A mRNA expression was decreased in the kidney of BUO. The ANP-stimulated accumulation of cGMP in the isolated glomeruli and papillae in BUO was significantly reduced. The guanylyl cyclase activities were partly recovered in BUR-4 and completely in BUR-24. CONCLUSION: An enhanced local activity of ANP in the kidney may be causally related to the postobstructive diuresis.
Animals ; Atrial Natriuretic Factor ; Diuresis ; Guanylate Cyclase ; Humans ; Kidney* ; Ligation ; Male ; Membranes ; Plasma ; Radioimmunoassay ; Rats* ; Rats, Sprague-Dawley ; RNA, Messenger ; Sodium ; Ureter

BACKGROUND: Extracorporeal membrane oxygenation (ECMO) strategy is proposed to reduce the ventilator-induced lung injury in acute respiratory distress syndrome (ARDS). As ECMO use has increased, a number of studies on prognostic factors have been published. Age is estimated to be an important prognostic factor. However, clinical evidences about ECMO use in elderly patients are limited. Therefore, we investigated clinical courses and outcomes of ECMO in elderly patients with ARDS. METHODS: We reviewed medical records of patients with severe ARDS who required ECMO support. Study patients were classified into an elderly group (> or = 65 years) and a non-elderly group (< 65 years). Baseline characteristics, ECMO related outcomes and associated factors were retrospectively analyzed according to group. RESULTS: From February 2011 to June 2013, a total of 31 patients with severe ARDS were treated with ECMO. Overall, 14 (45.2%) were weaned from ECMO, 9 (29.0%) survived to the general ward and 7 (22.6%) survived to discharge. Among the 18 elderly group patients, 7 (38.9%) were weaned from ECMO, 4 (22.2%) were survived to the general ward and 2 (11.1%) were survived to discharge. Overall intensive care unit survival was inversely correlated with concomitant acute kidney injury or septic shock. CONCLUSIONS: In this study, ECMO outcome was poor in severe ARDS patients aged over 65 years. Therefore, the routine use of ECMO in elderly patients with severe ARDS is not warranted except in highly selective cases.
Acute Kidney Injury ; Aged* ; Extracorporeal Membrane Oxygenation ; Humans ; Intensive Care Units ; Medical Records ; Patients' Rooms ; Respiratory Distress Syndrome, Adult* ; Retrospective Studies ; Shock, Septic ; Ventilator-Induced Lung Injury

Acalculous cholecystitis is an inflammation of the gallbladder in the absence of gallstones. Diagnosing this condition is often difficult because of the patient's debilitated medical condition and because of the limitation of biliary imaging technique. Nonetheless, its recognition and therapy are critically important, for if left untreated, many patients will die. During 10 years and 6 months from January 1986 to June 1996, 52 patients underwent assessment and treatment for acalculous cholecystitis at the Department of Surgery, Kyungpook National University Hospital. A clinical analysis of those patients was done and the following results were obtained: The incidence rate was 3.5%. The most prevalent age group was the seventh decade (13cases), and the male-to-female ratio was 1.4 : 1. Possible etiologic factors were found in 25 cases (48.1%). These factors were surgery in 5 cases (9.6%), trauma in 5 cases (9.6%), sepsis in 5 cases (9.6%), clonorchiasis in 5 cases (9.6%), and others in 5 cases(9.6%). Neither Ascariasis nor Salmonellosis was found as a predisposing factor in this study.The main cardinal symptoms and physical signs were similar to those of calculous cholecystitis. The sensitivities of diagnostic imaging by ultrasonography and computed tomography were 88.4% and 100%, respectively. Of the 52 patients, 46 cases underwent cholecystectomy, and 6 cases were initially treated by percutaneous transhepatic cholecystostomy. Of these 6 cases, two patients had cholecystostomies during subsequent abdominal operations for other conditions. Two patients had the cholecystostomy tube removed 2 months after an uneventful recovery and have had no further biliary problems. The other two patients died. The operative findings were cholecystitis only in 26 cases (56.5%), cholecystitis with localized peritonitis in 18 cases (39.1%), and cholecystitis with generalized peritonitis in 2 cases (4.3%). Postoperative complications occurred in 16 cases (34.8%), and wound infection was the most common complication (62.5% of all complications).The overall mortality was 9.6%. Conclusively, acalculous cholecystitis had high morbidity and mortality in this study. Once the diagnosis of acalculous cholecystitis is made, the gallbladder should be drained or removed. A decision as to the best approach depends on the specific situation and will require close cooperation between the internist, the surgeon, and the radiologist.
Acalculous Cholecystitis* ; Ascariasis ; Causality ; Cholecystectomy ; Cholecystitis ; Cholecystostomy ; Clonorchiasis ; Diagnosis ; Diagnostic Imaging ; Gallbladder ; Gallstones ; Gyeongsangbuk-do ; Humans ; Incidence ; Inflammation ; Mortality ; Peritonitis ; Postoperative Complications ; Salmonella Infections ; Sepsis ; Ultrasonography ; Wound Infection

The present study was aimed at investigating whether an altered role of nitric oxide (NO) is involved in chronic renal failure (CRF). Rats were subjected to 5/6 nephrectomy and kept for 6 weeks to induce CRF. On the experimental day, after measurement of arterial pressure under anesthesia, the arterial blood was collected, and thoracic aorta and kidney were rapidly taken. NO metabolites (NOx) were determined in the plasma, urine, aorta and kidney. The expression of NO synthase (NOS) isozymes was determined in the kidney and aorta by Western blot analysis. The expression of NOS mRNA in the glomeruli was also determined by RT-PCR. There were significant increases in arterial pressure and serum creatinine levels in CRF. Urine NOx levels were decreased in CRF, whereas plasma NOx levels were not altered. Aorta and kidney tissue NOx levels were also decreased in CRF. The expression of endothelial constitutive (ec) and inducible (i) isoforms of NOS proteins was decreased in the kidney and aorta in CRF. Accordingly, the expression of ecNOS and iNOS mRNA was decreased in the glomeruli in CRF. In conclusion, NO synthesis is decreased in the kidney and vasculature of CRF rats.
Animal ; Aorta, Thoracic/metabolism ; Comparative Study ; Enzyme Induction ; Isoenzymes/metabolism+ACo- ; Isoenzymes/genetics ; Kidney/metabolism ; Kidney Failure, Chronic/metabolism+ACo- ; Male ; Nephrectomy ; Nitrates/urine ; Nitrates/blood ; Nitric Oxide/deficiency+ACo- ; Nitric Oxide/biosynthesis ; Nitric-Oxide Synthase/metabolism+ACo- ; Nitric-Oxide Synthase/genetics ; Nitrites/urine ; Nitrites/blood ; Organ Specificity ; RNA, Messenger/biosynthesis ; Rats ; Rats, Sprague-Dawley