Purpose: The purpose of this study was to identify factors influencing job satisfaction among ambulatory care nurses. Methods: Data were collected through a self-evaluation survey of 129 nurses in one tertiary hospital. Data were analyzed using paired t-test, independent t-test, one-way ANOVA, Importance-Performance Analysis, Pearson correlation coefficients, and multiple regression analysis. Results: The mean scores were: for importance, 3.18 out of 4, for performance, 2.24 out of 4, for professional self-concept, 2.92 out of 4, and for job satisfaction 2.77 out of 5. There were statistically significant positive correlations between professional self-concept and job satisfaction (r=.37, p<.001). Stepwise multiple regression analysis showed that satisfaction with professional self-concept, clinical career, and age explained 47.0% of the job satisfaction of ambulatory care nurses (F=37.51, p<.001). Satisfaction with professional self-concept, clinical career, and age were statistically significant predictors of job satisfaction. Conclusion Findings indicate motivation programs according to clinical career would be useful to improve job satisfaction of ambulatory care nurses. Additionally, continuous education should be provided to strengthen the professional self-concept of nursing professionals in both undergraduate curricula and clinical fields.

Objective: To evaluate the signal intensity of the periosteum using ultrashort echo time pulse sequence with threedimensional cone trajectory (3D UTE) with or without fat suppression (FS) to distinguish from artifacts in porcine tibias. Materials and Methods: The periosteum and overlying soft tissue of three porcine lower legs were partially peeled away from the tibial cortex. Another porcine tibia was prepared as three segments: with an intact periosteum outer and inner layer, with an intact periosteum inner layer, and without periosteum. Axial T1 weighted sequence (T1 WI) and 3D UTE (FS) were performed. Another porcine tibia without periosteum was prepared and subjected to 3D UTE (FS) and T1 WI twice, with positional changes. Two radiologists analyzed images to reach a consensus. Results: The three periosteal tissues that were partially peeled away from the cortex showed a high signal in 3D UTE (FS) and low signal on T1 WI. 3D UTE (FS) showed a high signal around the cortical surface with an intact outer and inner periosteum, and subtle high signals, mainly around the upper cortical surfaces with the inner layer of the periosteum and without periosteum. T1 WI showed no signal around the cortical surfaces, regardless of the periosteum state. The porcine tibia without periosteum showed changes in the high signal area around the cortical surface as the position changed in 3D UTE (FS). No signal was detected around the cortical surface in T1 WI, regardless of the position change. Conclusion The periosteum showed a high signal in 3D UTE and 3D UTE FS that overlapped with artifacts around the cortical bone.

Objective: To evaluate the signal intensity of the periosteum using ultrashort echo time pulse sequence with threedimensional cone trajectory (3D UTE) with or without fat suppression (FS) to distinguish from artifacts in porcine tibias. Materials and Methods: The periosteum and overlying soft tissue of three porcine lower legs were partially peeled away from the tibial cortex. Another porcine tibia was prepared as three segments: with an intact periosteum outer and inner layer, with an intact periosteum inner layer, and without periosteum. Axial T1 weighted sequence (T1 WI) and 3D UTE (FS) were performed. Another porcine tibia without periosteum was prepared and subjected to 3D UTE (FS) and T1 WI twice, with positional changes. Two radiologists analyzed images to reach a consensus. Results: The three periosteal tissues that were partially peeled away from the cortex showed a high signal in 3D UTE (FS) and low signal on T1 WI. 3D UTE (FS) showed a high signal around the cortical surface with an intact outer and inner periosteum, and subtle high signals, mainly around the upper cortical surfaces with the inner layer of the periosteum and without periosteum. T1 WI showed no signal around the cortical surfaces, regardless of the periosteum state. The porcine tibia without periosteum showed changes in the high signal area around the cortical surface as the position changed in 3D UTE (FS). No signal was detected around the cortical surface in T1 WI, regardless of the position change. Conclusion The periosteum showed a high signal in 3D UTE and 3D UTE FS that overlapped with artifacts around the cortical bone.

PURPOSE: The aim of the present study was to evaluate the characteristics of electrophysiologic studies (EPS) and radiofrequency ablation (RFA) performed in subjects aged less than 30 years with Wolff-Parkinson-White (WPW) syndrome, particularly pediatric patients under 18 years of age, based on our experience. METHODS: Two hundred and one consecutive patients with WPW syndrome were recruited and divided to 3 groups according to age: group 1, 6 to 17 years; group 2, 18 to 29 years; and group 3, 30 to 60 years. The clinical, electrophysiological, and therapeutic data for these patients were evaluated by a retrospective medical record review. RESULTS: A total of 73 (36%) of these patients were <30 years of age. Although there were more males than females in group 2 (male:female, 31:11), there was no sex difference in group 1 (male:female, 16:15). Left accessory pathway was detected less frequently in group 1 (32%, 10/31) than in group 2 (57%, 24/42) and group 3 (63%, 81/128) (P=0.023 and P=0.002, respectively). CONCLUSION: The present study describes several different electrophysiological characteristics in children and adolescents with WPW syndrome. Therefore, when EPS and RFA are performed in children and adolescence with WPW syndrome, we recommend that these characteristics be considered.
Accessory Atrioventricular Bundle ; Adolescent ; Aged ; Catheter Ablation ; Child ; Electrophysiology ; Female ; Humans ; Male ; Medical Records ; Retrospective Studies ; Sex Characteristics ; Wolff-Parkinson-White Syndrome

Cerebral ischemia exhibits a multiplicity of pathophysiological mechanisms. During ischemic stroke, the reactive oxygen species (ROS) concentration rises to a peak during reperfusion, possibly underlying neuronal death. Recombinant human erythropoietin (EPO) supplementation is one method of treating neurodegenerative disease by reducing the generation of ROS. We investigated the therapeutic effect of PEGylated EPO (P-EPO) on ischemic stroke. Mice were administered P-EPO (5,000 U/kg) via intravenous injection, and middle cerebral artery occlusion (MCAO) followed by reperfusion was performed to induce in vivo ischemic stroke. P-EPO ameliorated MCAO-induced neurological deficit and reduced behavioral disorder and the infarct area. Moreover, lipid peroxidation, expression of inflammatory proteins (cyclooxygenase-2 and inducible nitric oxide synthase), and cytokine levels in blood were reduced by the P-EPO treatment. In addition, higher activation of nuclear factor kappa B (NF-κB) was found in the brain after MCAO, but NF-κB activation was reduced in the P-EPO-injected group. Treatment with the NF-κB inhibitor PS-1145 (5 mg/kg) abolished the P-EPO-induced reduction of infarct volume, neuronal death, neuroinflammation, and oxidative stress. Moreover, P-EPO was more effective than EPO (5,000 U/kg) and similar to a tissue plasminogen activator (10 mg/kg). An in vitro study revealed that P-EPO (25, 50, and 100 U/mL) treatment protected against rotenone (100 nM)-induced neuronal loss, neuroinflammation, oxidative stress, and NF-κB activity. These results indicate that the administration of P-EPO exerted neuroprotective effects on cerebral ischemia damage through anti-oxidant and anti-inflammatory properties by inhibiting NF-κB activation.

PURPOSE: In Korea, emergency department overcrowding in large hospitals have caused social concern. Moreover, patients with low socioeconomic status visit the emergency department more frequently. This kind of visitation also causes a burden on the national budget, but emergent patient should be treated in emergency department regardless of economic state. So, on establishment of policy about the patient with low socioeconomic status, the frequency of emergency visitation alone is difficult to obtain a sufficient basis for policy-making. METHODS: We retrospectively analyzed adult patients with a disease who visited the Pusan Wide-regional Emergency Center in 2015. Korean Triage and Acuity Scale level I, II or III were defined as emergency, and level IV or V was defined as non-emergency. The ratio of emergency and non-emergency was compared in the National Health Insurance and Medicaid database. RESULTS: The number of patients with National Health Insurance was 16,208 (90.3%) and with Medicaid was 1,737 (9.7%). Among those with National Health Insurance, there were 12,720 (78.5%) emergency cases and 3,488 (21.5%) non-emergency cases. Among those with Medicaid, 1,379 (79.4%) emergency cases and 358 (20.6%) non-emergency cases. Between National Health Insurance and Medicaid, there was no statistically significant difference in the ratio of emergency and non-emergency (p=0.380) CONCLUSION: Accessibility of emergency and non-emergency patients with National Health Insurance and Medicaid to Pusan Wide-regional Emergency Center was not different.
Adult ; Budgets ; Busan ; Emergencies* ; Emergency Service, Hospital ; Humans ; Insurance Coverage* ; Insurance* ; Korea ; Medicaid ; National Health Programs ; Retrospective Studies ; Social Class ; Triage

PURPOSE: Chronic low-grade inflammation may induce chronic kidney disease in patients with type 2 diabetes. This study investigated the relation between inflammatory biomarkers and chronic kidney disease in patients with type 2 diabetes, which has not yet been reported in Asian populations. MATERIALS AND METHODS: A cross-sectional study was performed in 543 patients recruited from diabetic clinics for an ongoing, prospective study. Multivariate logistic regression was used to evaluate the association between inflammatory biomarkers and the presence of chronic kidney disease (estimated glomerular filtration rate < 60 mL/min per 1.73 m2 by the simplified Modification of Diet in Renal Disease equation using plasma creatinine). RESULTS: The risk of chronic kidney disease increased in the highest quartiles of C-reactive protein (CRP) [multivariate odds ratio (OR) = 3.73; 95% CI = 1.19-1.70] and tumor necrosis factor-alpha (multivariate OR = 4.45; 95% CI = 1.63-12.11) compared to the lowest quartiles after adjustments for age, sex, zinc intake, and other putative risk factors for chronic kidney disease. CONCLUSION: Our results suggest that CRP and tumor necrosis factor-alpha may be independent risk factors for chronic kidney disease in patients with type 2 diabetes. A causal mechanism of this association should be evaluated in a follow-up study of Korean patients with type 2 diabetes.

Background: This retrospective study was undertaken to assess the effectiveness of the 8-French (Fr) catheter (Pleuracan(R)) for the initial treatment of primary spontaneous pneumothorax. MATERIAL AND METHOD: Between July 2004 and July 2006, 59 patients (72 cases) underwent a closed thoracostomy for primary spontaneous pneumothorax. We divided these patients into two groups: group T (large bore (>20 Fr) chest tube group) and group P (Pleuracan(R) group). RESULT: Initially, the Pleuracan(R) catheters were inserted in 41 cases. There were four catheter malfunctions (9.8%); three cases had a subsequent closed thoracostomy with a large bore chest tube. Ultimately, there were 34 cases in group T and 38 cases in group P. There were no significant differences in indwelling catheter time (T: 2.1+/-1.5 days, P: 2.1+/-1.3 days), hospital stay (T: 6.4+/-5.4 days, P: 5.2+/-2.9 days) and complications (T: 3%, P: 0%) between the two groups. The percentage of cases that needed intravenous analgesics in group P was 60% (23/38); this was significantly lower than the number for group T (90%, 31/34) (p=0.003). In a subgroup of patients that did not undergo bullectomy (T: 17 cases, P: 19 cases), there were no significant differences in the duration of air leakage (T: 0.5+/-0.7 days, P: 0.5+/-1.2 days) and in the percentage of patients with complete lung re-expansion (T: 94%, P: 84%) between the two groups. CONCLUSION: Application of the Pleuracan(R) catheter for the initial treatment of primary spontaneous pneumothorax was as effective as the large bore chest tube.
Analgesics ; Catheters* ; Catheters, Indwelling ; Chest Tubes ; Humans ; Length of Stay ; Lung ; Pneumothorax* ; Retrospective Studies ; Thoracostomy

This study assessed the ability of the Sequential Organ Failure Assessment (SOFA) and Acute Physiology, Chronic Health Evaluation (APACHE) II scoring systems, as well as the Simplified Acute Physiology Score (SAPS) II method to predict group mortality in intensive care unit (ICU) patients who were poisoned with organophosphate. The medical records of 149 organophosphate poisoned patients admitted to the ICU from September 2006 to December 2012 were retrospectively examined. The SOFA, APACHE II, and SAPS II were calculated based on initial laboratory data in the Emergency Department, and during the first 24 hr of ICU admission. The probability of death was calculated for each patient based on the SOFA score, APACHE II score, and SAPS II equations. The ability to predict group mortality by the SOFA score, APACHE II score, and SAPS II method was assessed using two by two decision matrices and receiver operating characteristic (ROC) curve analysis. A total of 131 patients (mean age, 61 yr) were enrolled. The sensitivities, specificities, and accuracies were 86.2%, 82.4%, and 83.2% for the SOFA score, respectively; 65.5%, 68.6%, and 67.9% for the APACHE II scoring system, respectively; and 86.2%, 77.5%, and 79.4% for the SAPS II, respectively. The areas under the curve in the ROC curve analysis for the SOFA score, APACHE II scoring system, and SAPS II were 0.896, 0.716, and 0.852, respectively. In conclusion, the SOFA, APACHE II, and SAPS II have different capability to discriminate and estimate early in-hospital mortality of organophosphate poisoned patients. The SOFA score is more useful in predicting mortality, and easier and simpler than the APACHE II and SAPS II.
*APACHE ; Adult ; Aged ; Aged, 80 and over ; Emergency Service, Hospital ; Female ; Hospital Mortality ; Humans ; *Intensive Care Units ; Male ; Middle Aged ; Organophosphate Poisoning/*diagnosis/mortality ; ROC Curve ; Sensitivity and Specificity ; *Severity of Illness Index

OBJECTIVE: To identify prenatal fetal sex and chromosomal aneuploidies by FISH using isolation of fetal nucleated RBCs. METHODS: peripheral blood samples was collected from 37 women between 11 and 24 weeks of gestation. we tried to enrich nucleated RBCs morphologically by Kleihaur-Betke staining after double gradient centrifugation and magnetic activating cell sorting (MACS) from maternal blood. Fluorescence in situ hybridization (FISH) analyses with CEP X and CEP Y probes for K-B positive nucleated RBCs were performed to detect whether fetal cells were existed among nucleated RBCs by observation of sex chromosomes. RESULTS: The average number of K-B positive nucleated RBCs separated from 10ml of maternal blood was 17.3 (+/-17.2) and the maximum number of nucleated RBCs was 54. We observed FISH signals in nucleated RBCs separated from 18 pregnant women, and Y probe signals were observed in 67.3% of nucleated RBCs separated from 10 pregnant women. CONCLUSION: We confirmed that separated nucleated fetal RBCs can be used to identify fetal sex and chromosomal aneuploidies by FISH. Since nucleated RBCs from maternal origin were not excluded, further studies are needed to overcome this limitation.
Aneuploidy ; Centrifugation ; Female ; Fluorescence ; Humans ; In Situ Hybridization ; Pregnancy ; Pregnant Women ; Prenatal Diagnosis* ; Sex Chromosomes