PURPOSE: To develop end-of-life care training programs for nurses who provide in a tertiary hospital, we examined the mediating effects of empathy and resilience on the relationship between their stress and job performance. METHODS: This study was conducted with 218 participants at a hospital in B city in South Korea from August 15 through August 30, 2017. Data collected from the participants were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and multiple regression using the IBM SPSS/WIN 21.0 software. RESULTS: Terminal care stress was found to be negatively correlated with empathy competence (r=−0.345, P < 0.001), resilience (r=−0.223, P=0.001) and terminal care performance (r=−0.260, P < 0.001), whereas empathy (r=0.467, P < 0.001) and resilience (r=0.358, P < 0.001) were positively correlated with terminal care performance. Empathy had a complete mediating effect (β=0.409, P < 0.001) on the relationship between terminal care stress and performance, and resilience a partial mediating effect (β=0.294, P < 0.001). CONCLUSION: Based on the findings of this study, development of training programs with a focus on empathy and resilience are highly recommended to improve job performance of nurses who provide terminal care in a tertiary hospital.
Education ; Empathy* ; Korea ; Mental Competency ; Negotiating* ; Terminal Care* ; Tertiary Care Centers* ; Work Performance

PURPOSE: The purpose of this study was to investigate the experience of uncertainty in cancer patients undergoing chemotherapy in South Korea. METHODS: Data were obtained from in-depth interviews with ten cancer patients conducted from Mar. 21 to Nov. 11, 2017. The data were collected until saturation and analyzed via Colazzi's phenomenological method. RESULTS: In this study, 6 categories were extracted: Four categories contributed to uncertainty including ‘Confusion about cancer and course of treatment’, ‘Inner conflicts’, ‘Being overwhelmed by treatment’, and ‘Unknown future’. Two categories facilitated coping with uncertainty including ‘Seeking knowledge’ and ‘Need for spiritual peace’. CONCLUSION: Uncertainty experiences for cancer patients undergoing chemotherapy in different societies is largely similar. However, some experiences seemed unique to Korean patients. Also, there is a great deal of uncertainty about the treatment outcomes and loss of treatment opportunities in cancer patients undergoing chemotherapy. The results of this study will help oncology professionals develop patient-centered psychological interventions by improving understanding of the uncertainty of cancer patients undergoing chemotherapy.
Drug Therapy* ; Humans ; Korea ; Methods ; Qualitative Research ; Uncertainty*

No abstract available.
Humans ; Pregnancy, Twin*

No abstract available.
Abscess* ; Drainage*

Peripartum cardiomyopathy is defined as a syndrome of cardiac failure occurring in tbe latter part of pregnancy or in the puerperium, without obvious cause and without prior evidence of heart disease. Despite its infrequency, this clinical problem may have devastating consequences upon maternal and fetal outcome. It is important to recognize the association of cardiac failure and pregnancy as a separate syndrome so that, once identified, peripartum cardiomyopathy can be treated promptly and aggressively. We experienced two cases of peripartum cardiomyopathy, and report these cases with a brief review of the literatures.
Cardiomyopathies* ; Heart Diseases ; Heart Failure ; Peripartum Period* ; Postpartum Period ; Pregnancy

OBJECTIVE: This study was conducted to assess the surgical results of one-stage posterior minimal laminectomy and video-assisted thoracoscopic surgery (VATS) for the treatment of thoracic dumbbell tumor and to describe its precise technique. In addition, we investigated the technique's usefulness and limitations. METHODS: Seven cases of thoracic dumbbell tumor (two men and five women, mean age, 43 years) were analyzed retrospectively. Pathological findings included schwannoma in four patients, neurofibroma in two patients, and hemangioma in one patient. The location of tumors varied from T2/3 to T12/L1. Dumbbell tumors were resected by one-stage operation using posterior laminectomy followed by VATS without instrumentation. Clinical data were reviewed. RESULTS: The mean follow-up period was 25 months (range, 3–58 months), and the operative time ranged from 255 to 385 min (mean, 331 min), with estimated blood loss ranging from 110 to 930 mL (mean, 348 mL). The tumor was completely resected without instrumentation and postoperative instability in all cases. Postoperative complications included atelectasis and facial anhydrosis in one case each. CONCLUSION: One-stage posterior minimal laminectomy and VATS may be a safe and less invasive technique for removal of thoracic dumbbell tumor without instability. This method has the advantage of early ambulation and rapid recovery because it reduces blood loss and postoperative pain.
Early Ambulation ; Female ; Follow-Up Studies ; Hemangioma ; Humans ; Laminectomy* ; Male ; Methods ; Neurilemmoma ; Neurofibroma ; Operative Time ; Pain, Postoperative ; Postoperative Complications ; Pulmonary Atelectasis ; Retrospective Studies ; Thoracic Surgery, Video-Assisted*

This study was attempted to observe the rate of fall of arterial oxygen tension and the rate of rise of artetrial carbon dioxide tension after denitrogenation with 100%(Group I, n=10) or 50% oxygen(Group II, n=15) in 25 healthy ASA class I patients scheduled for ear, oromaxillary, head and orthopedic surgery that do not affect respiration or pulmonary function. After 30 minutes of denitrogenation under supine position, apnea was carried out by dis- connecting the endotracheal tube and rebreathing circuit until arterial oxygen saturation decreased to 90-95% by pulse oximetry which was placed at index finger. We calculated the mean rate of decrease of arterial oxygen tension (PaO2(tn)-PaO2(tn+1)) and the mean rate of increase of arterial carbon dioxide tension (PaCO2(tn+1)-PaCO2(tn)) minute by minute by arterial blood gas analysis. The results are as follows. 1) The mean rate of decrease of arterial oxygen tension after apnea was 40.96+/-11.02 in Group I and 43.22+/-5.49 mmHg/min. in Group II 2) The rate of increase of arterial carbon dioxide tension during the first one minute of apnea was 5.94+/-0.85 in Group I and 5.56+0.64 mmHg in Group II 3) The mean rate of increase of arterial carbon dioxide tension after first one minute was 2.46+/-0.78 in Group I and 2.47+/-0.71 mmHg/min. in Group II With the above results, we concluded that healthy human subject who was denitrogenated with 100% oxygen about 30 minutes can withstand apnea as far as 7 minutes, and those who denitrogenated with 50% oxygen can withstand apnea as far as 3 minutes without hypoxic insult.
Anesthesia* ; Anoxia ; Apnea* ; Blood Gas Analysis ; Carbon Dioxide* ; Carbon* ; Ear ; Fingers ; Head ; Humans ; Orthopedics ; Oximetry ; Oxygen* ; Respiration ; Supine Position

PURPOSE: To evaluate the age-related risk factors, clinical manifestations, and prognosis in infectious keratitis. METHODS: Records of patients with infectious keratitis who visited one of the two tertiary medical centers at Jeolla-do from January 2000 to December 2007 were reviewed. Risk factors depending on patient age distribution standardized over and under the age of 60 were reviewed retrospectively by analyzing sex, age, previous history of trauma, systemic disease, previous ocular disease, causative organism and treatment. RESULTS: A total of 757 patients (757 eyes) visited either one of the two tertiary medical centers. The mean age was 58.2+/-18.0 (4 to 93) years, and patients included 437 males (57.7%), and 320 females (42.3%). The most common risk factor among all age groups was trauma, especially due to vegetable matter. The second most frequent risk factor among the younger patients was contact lens use (19.2%), and common risk factors among the elderly were previous ocular disease (20.0%), systemic disease (15.5%), and ocular surgery (9.7%). The most prevalent causative organisms among all age groups were Gram-positive bacteria, in particular Staphylococcus epidermidis. Elderly patients had a higher frequency of corneal perforation than did younger patients. In addition, elderly patients had a worse prognosis and more often required surgical treatment. CONCLUSIONS: Infectious keratitis has more severe clinical manifestations and complications and a worse prognosis in elderly than in younger patients. Elderly patients have more diverse risk factors. Prevention should aim at avoiding ocular trauma, especially by vegetable matter, and at controlling ocular surface diseases, such as exposure keratitis and bullous keratopathy.
Age Distribution ; Aged ; Corneal Perforation ; Female ; Gram-Positive Bacteria ; Humans ; Keratitis ; Male ; Prognosis ; Retrospective Studies ; Risk Factors ; Staphylococcus epidermidis ; Vegetables

BACKGROUND: Cathepsin D, an aspartic lysosomal proteinase, is believed to be involved in local invasion and metastasis of tumor cells by its proteolytic activity and has been described to be associated with tumor progression and prognosis in some human malignancies including breast cancer. But, its prognostic value for human lung cancer remains to be determined. The purpose of this study is to determine clinicopathological and prognostic significance of cathepsin D expression in non-small cell lung cancer. METHOD: Using a polyclonal antibody, immunohistochemical analysis of cathepsin D was performed on paraffin embedded sections of tumors obtained surgically from 54 patients with non-small cell lung cancer (37 squamous cell carcinoma, 14 adenocarcinoma, 2 large cell carcinoma, and 1 undifferentiated carcinoma). RESULTS: Eighteen patients (33.3%) showed positive immunoreactivities of cathepsin D in tumor cells. No significant correlation of cathepsin D expression in tumor cells was found in p-stage (surgical-pathologic stage), tumor size, tumor factor, nodal involvement, and differentiation. Of 54 patients, 29 (53.7%) patients showed moderate to massive cathepsin D-positive stromal cells within the tumor tissues, while the rest (46.3%) showed few cathepsin D-positive stromal cells within the tumor tissues. Cathepsin D expression n stromal cells was significantly associated with p-stage in non-small cell lung cancer (p=0.031). No significant correlation of the degree of cathepsin D-positive stromal cells was found in tumor size, T-factor, nodal involvement, differentiation. Cathepsin D expression status in tumor cells and stromal cells was not significantly associated with prognosis expressed by survival rate. The results of multivariate analyses of variables possibly associated with progonosis showed that nodal involvement was the only independent prognostic factor in all patients. CONCLUSION: Cathepsin D expression in stromal cells was significantly associated with p-stage in non-small cell lung cancer. However, it was not related to other clinicopathologic features and prognosis, and Cathepsin D expression in tumor was not related to p-stage and prognosis.
Adenocarcinoma ; Breast Neoplasms ; Carcinoma, Large Cell ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Cathepsin D* ; Cathepsins* ; Humans ; Lung Neoplasms ; Multivariate Analysis ; Neoplasm Metastasis ; Paraffin ; Prognosis* ; Stromal Cells ; Survival Rate

PURPOSE: This study was undertaken to evaluate the clinical usefulness of Tensilon test, repetitive nerve stimulation test(RNST), single fiber EMG(SFEMG) test and acetylcholine receptor antibody(AchR Ab) assay for making diagnosis of myasthenia gravis(MG). METHOD: These tests were performed in 21 MG patients which were classified into 11 ocular, 5 mild generalized, 4 moderate generalized, and 1 chronic severe MG. RESULT: The overall positivity of Tensilon test, SFEMG and AchR Ab was 95%, 87%, and 76% respectively. The overall positivity of RNST was 67%; 38% on flexor carpi ulnaris, 43% on adductor digiti quinti and 62% on orbicularis oculi muscles. The positivity of each test was higher in generalized MG group than in ocular MG group. But we could observe the statistically significant difference only in the RNST(p<0.05). CONCLUSION: Tensilon test showed the highest positivity in all MG groups. So we would like to recommend the Tensilon test for the diagnosis of MG at first, followed by RNST and AchR Ab assay, and SFEMG would be indicated to MG group which showed relatively low postivity in other tests.
Acetylcholine ; Diagnosis* ; Edrophonium ; Humans ; Muscles ; Myasthenia Gravis*