PURPOSE: This study investigated the preemptive analgesic effects of Morphine and Ketorolac on postoperative pain, cortisol, O2 saturation and heart rate for the first 24 hr after abdominal surgery. METHODS: Data collection was performed from April 1 to September 30, 2006. Forty patients undergoing a gastrectomy under general anesthesia were randomly allocated to the experimental or control group. The experimental group (20 patients) was administered Morphine and Ketorolac approximately 1 hr prior to skin incision, but the control group (20 patients) was administered Morphine and Ketorolac at peritoneum closure through a patient-controlled analgesia (PCA) pump. Postoperative pain, blood pressure, heart rate, cortisol, O2 saturation, frequency of the PCA button pressed and doses of additional analgesics were observed through post operative 24 hr. Collected data was analyzed using t-test, chi-square test, repeated measures ANOVA, and Bonferroni methods. RESULTS: Postoperative pain, cortisol, the frequency of PCA button pressed, and dose of additional analgesics of the experimental group were significantly lower than the control group. There were no statistical differences in blood pressure, heart rate and O2 saturation between the experimental group and control group. CONCLUSIONS: We concluded that administration of morphine and ketorolac at 1 hr prior to skin incision resulted in decreasing postoperative pain, but it didn't affect blood pressure, heart rate or O2 saturation for 24 hr after abdominal surgery.
Aged ; Analgesics/*administration & dosage ; Blood Pressure ; Female ; Heart Rate ; Humans ; Hydrocortisone/analysis ; Injections, Intravenous ; Ketorolac/*administration & dosage ; Male ; Middle Aged ; Morphine/*administration & dosage ; Oximetry ; Pain Measurement ; Pain, Postoperative/*prevention & control

Purpose: The purpose of this study is to investigate new nurses’ needs for intravenous infusion therapy training by analyzing the current training status. Methods: This study examined the needs for intravenous infusion therapy training with 159 new nurses. The measurement tool consisted of 93 items developed based on intravenous therapy-related studies, and was evaluated on a 4-point Likert scale. For data analysis, SPSS/WIN 25.0 was used, and frequency, percentage, average, standard deviation, paired t-test, were performed. Results: The demand for intravenous therapy education was analyzed using a questionnaire composed of 8 areas, 16 sub-areas, and 93 items. According to the findings, post-ward placement intravenous therapy education(83.7%) is conducted more often than in preliminary education (72.2%). The demand for intravenous infusion therapy education did not differ significantly in preliminary and post-ward placement education (t=-.89, p=.376). While therapy skills were preferred in preliminary education, there were high demands for education content related to blood transfusion, central venous catheter, and drug use in continuing education. As for preferred teaching methods, lecture (38.2%) and simulation (26.7%) were most answered for preliminary education, while a range of methods were preferred for continuing education including lecture (31.1%), clinical practice (20.6%), preceptor training (19.8%), simulation (16.8%), and self-study (11.6%). Conclusion For efficient training, it is required to provide different education contents and methods for each stage.

PURPOSE: This study was aimed to explore the work experience of nurses who transitioned from the patient nursing department to administrative departments.METHODS: The participants were 11 nurses who had worked in departments of human resources, education and training, medical insurance review, information technology, and quality improvement. Data were collected through in-depth individual interviews done between December 2017 and July 2018 and were analyzed in terms of Giorgi's phenomenological methodology. The research question was ‘What kind of experience did you have as you transition to a new role from a nurse to a hospital administrative nurse? What are the challenges in carrying out a new role? How do you overcome obstacles and adjust to being a hospital administrative nurse?’RESULTS: The main essence of the administrative nurses' work adjustment experience is represented by six components; 1) Beginning of a new challenge in conflict, 2) Running into barriers, 3) Struggling to take root, 4) Recognizing changes in the hospital, 5) Gradually adjusting to change, 6) Becoming a proficient hospital administrative nurse.CONCLUSION: Based on these findings, it is essential to create systems that enable administrative nurses to adjust to their work without confusion, and continuously develop programs to enhance their competence.
Education ; Humans ; Insurance ; Mental Competency ; Nursing ; Qualitative Research ; Quality Improvement ; Running

STUDY DESIGN: Experimental investigation in vitro. OBJECTIVES: To evaluate the relationship between the degeneration of intervertebral disc cells, and low back pain induced by degeneration of intervertebral disc cells and increases in use of proinflammatory mediators via nicotine stimulation. SUMMARY OF LITERATURE REVIEW: Smoking is a leading cause of degeneration of intervertebral disc cells and low back pain. According to the existing literature, nicotine, one of the main ingredients in cigarettes, causes the degeneration of intervertebral disk cells including decrease of glycoprotein through generation of carboxy-hemoglobin, vasoconstriction, and disability of fibrinolysis and changes of metabolism of nucleus pulposus cells. MATERIALS AND METHODS: Annulus fibrosus of intervertebral disc and knee joint cartilage were collected from pigs; these cells were acquired by gradual enzyme decomposition. Using Trypan blue, concentration and survival rate of cells were examined; cells were inserted on alginate beads for tertiary cultivation. Nicotine was then applied at 0, 50, 100, 200 and 300 nM, respectively, and the samples were cultivated for three, six and nine days, respectively. After collecting culture fluid, it was measured for interleukin(IL)-1beta, IL-6 and IL-8 with the ELISA Test. DNA of cells used for cultivation was quantitated and the amount of the resulting proinflammatory mediator was normalized. The results were then compared with the result of same study on cartilage of porcine knee joints. RESULTS: For changes of the inflammatory mediator based on the concentration of nicotine, in nicotine stimulation with low concentration of 50 nM and the control group, there was no significant change, while transient increases of inflammatory mediator showed in nicotine stimulation with concentrations of 100, 200 nM, respectively. There was not a significant increase of IL-1beta observed in all nicotine stimulation groups; these were the same results in porcine cartilage study. The level of IL-6 in 200, 300 nM nicotine concentration showed significant increases, respectively. The level of IL-8 in high dose nicotine stimulation groups also showed significant increases of DNA on the sixth day. And in porcine cartilage study group, significant changes were observed in 200, 300 nM, but the absolute value was lower than that of annulus fibrous cells group. CONCLUSION: Inflammatory mediators such as IL-6 and IL-8 increased as the result of tertiary cultivation of annulus fibrosus cells of porcine intervertebral disk and nicotine stimulation. It is believed that the cells of the disc annulus are more sensitive than articular chondrocytes to nicotine stimulation. This may be the focus of future long-term studies effects of nicotine other inflammatory cytokines.
Cartilage ; Chondrocytes ; Cytokines ; DNA ; Enzyme-Linked Immunosorbent Assay ; Fibrinolysis ; Glycoproteins ; Interleukin-6 ; Interleukin-8 ; Intervertebral Disc* ; Knee Joint ; Low Back Pain ; Metabolism ; Nicotine* ; Smoke ; Smoking ; Survival Rate ; Swine ; Tobacco Products ; Trypan Blue ; Vasoconstriction

PURPOSE: The aim of this study was to evaluate the mediating role of psychological capital (PCP) in the relationship between occupational stress and turnover intention in nurses. METHODS: Data were collected from a sample of 447 nurses working at four Veterans Administration Hospitals throughout South Korea from July 1 to July 31, 2014. We collected data from the nurses using the following surveys: the Short Form Korean-Occupational Stress Scale, the Korean version of the Turnover Intention Scale, and the Korean version of the Psychological Capital Questionnaire. Multiple linear regression analysis was performed to examine the mediating role of PCP. RESULTS: The level of occupational stress was 1.81 ± 0.23, the level of turnover intention was 3.29 ± 0.86, and the PCP level was 3.95 ± 0.52. There were significant correlations among the three variables (occupational stress, turnover intention, and PCP). PCP played a partial mediating role (β=−0.22, p = .008) in the relationship between occupational stress and turnover intention (p < .001) among nurses working at the Veterans Administration Hospitals. CONCLUSION: Based on the findings of this study, we recommend that South Korean hospitals offer occupational stress management programs that incorporate relevant programs in efforts to strengthen the overall components of PCP among nurses to reduce turnover intentions. Further studies are required to determine the most effective intervention programs for hospital settings.
Humans ; Intention* ; Korea* ; Linear Models ; Negotiating* ; Nursing Care ; Personnel Turnover ; United States Department of Veterans Affairs* ; Veterans*

The purpose of this study is to provide a fundamental basis for defining measures to prevent suicide by specifically examining the relationship between suicide and alcohol consumption, which is thought to be a key factor in suicide. This study reviewed 426 suicide autopsies diagnosed by the department of forensic medicine, National Forensic Service (2007-2009) and analyzed the preliminary data on variables such as gender, age, and cause of death, with particular focus on the relationship between these variables and blood alcohol concentration. The relationship between each variable and alcohol consumption was as follows. First, alcohol was present in 48.4% of suicides. Second, blood alcohol concentration wrere twice as high in women as in men. Third, the relationship between suicide and alcohol consumption was greater in people in their 30s and 40s. The correlation between suicide and alcohol intake was evident this age group. These results are more specific and practical than the results of previous studies on the correlation between suicide and alcohol intake. The results of this study will help define measures to facilitate suicide prevention as an important reference and may eventually help lower the suicide rate in Korea.
Alcohol Drinking ; Autopsy ; Cause of Death ; Drinking ; Female ; Forensic Medicine ; Humans ; Korea ; Male ; Suicide

Parathyroid carcinoma is an uncommon cause of PTH-related hypercalcemia with a reported incidence of 0.4% to 5% of all cases of primary hyperparathyroidism. Even though the clinical manifestations of hyperparathyroidism are more severe in patients with parathyroid carcinoma than in those with parathyroid adenoma, it is difficult to differentiate carcinoma from adenoma preoperatively. Parathyroid carcinomas are usually larger and firmer than parathyroid adenomas and patients with parathyroid carcinoma have a higher incidence of renal dysfunction, bone disease and gastrointestinal symptoms. Anemia is an uncommon clinical feature of parathyroid carcinoma. There have been no prior cases of ectopic parathyroid carcinomas reported to date. In this article, we report the case of a 26-year-old man who developed severe anemia and acute renal failure due to an ectopic parathyroid tumor and was diagnosed with parathyroid carcinoma postoperatively. His serum calcium levels returned to normal and the anemia resolved postoperatively.
Acute Kidney Injury ; Adenoma ; Adult ; Anemia* ; Bone Diseases ; Calcium ; Humans ; Hypercalcemia ; Hyperparathyroidism ; Hyperparathyroidism, Primary ; Incidence ; Parathyroid Neoplasms* ; Renal Insufficiency*

PURPOSE: To evaluate characteristic MR findings of craniocerebral anomaly and its relationship with neurologic manifestations. MATERIALS AND METHODS: We retrospectively reviewed MR images of 36 patients with craniocerebral anomaly diagnosed by MRI and clinical courses. We correlated the characteristic MR findings in 41 lesions with neurologic manifestastions focusing on seizures and developmental delay. RESULTS: Twenty-three patients with seizures consisted of 14 patients(60%) with neuronal migration disorders and seven(30%) with phakomatosis, among which 18 patients(78%) had generalized type of seizures. Locations of the lesions were the parietal lobes in 11 patients(52%) and the subependymal or periventricular regions in seven(33%). Two patients with tuberous sclerosis had the lesions in both parietal and subependymal areas. Nine patients had the signs of developmental delay that were seen in the four(44%) with schizencephaly, two (22%) with tuberous sclerosis, two(22%) with heterotopia, and one(ll %) with pachygyria. CONCLUSION: Neuronal migration anomaly was relatively common lesion that presented neurologic manifestations such as seizures and developmental delay. Generalized type of seizures was common. We were able to diagnose these anomalies using the MRI that helped establish therapeutic plans.
Humans ; Lissencephaly ; Magnetic Resonance Imaging ; Malformations of Cortical Development ; Neurocutaneous Syndromes ; Neurologic Manifestations ; Neuronal Migration Disorders ; Neurons ; Parietal Lobe ; Rabeprazole ; Retrospective Studies ; Seizures* ; Tuberous Sclerosis

BACKGROUND: Post-Herpetic Neuralgia(PHN) is the most common and serious complication of herpes zoster(H-Z). Especially in the elderly, intractable chronic pain is caused by PHN and it affects the quality of life severely. The study examined the predictive factors of PHN for its prevention and treatment. METHODS: 691 cases of patients with herpes zoster who visited department of dermatology were studied of Kwang Ju Christian Hospital during the five years from Jan. 1991 to Dec. 1995 Retrospective chart review was used to compare occurrence of PHN according to age, sex, residential area of patients, inpatients or outpatients status, nerve dermatome, interval of treatment, methods of treatment associated conditions and duration of PHN. The authors compared the incidence of patients with PHN and patients with H-Z according to above variables. For statistical analysis, we used Chi-square and t-test through SPSS/PC+ (P<0.05). RESULTS: The incidence of PHN was 22.9% (159/691) and increased with age. The incidence of patients under 60 years of age was 16.5%, more than 60 was 30.7% (P<0.05). There was no statistical significance concerning sex, residential area of patients, dermatome, method of treatment, associated conditions in the incidence of PHN compared to patients with H-Z. The significant difference In the incidence of PHN was shown between inpatients and outpatients status(20.5%, 27.3% respectively) (P<0.05). Anatomical site of PHN of the highest incidence was the opthalmic branch of trigeminal nerve(27.1%), followed by cervical(26.0%), thoracic(24.4%) and sacral(22.2%) in order of sequence. Associated conditions or diseases of PHN were observed in 80 patients(24.7%) including hypertension(39.5%), tuberculosis(39.3%), malignancy (34.5%), COPD(33.3%), Chronic hepatitis(22.7%), DM(15.4%). The interval between the onset of H-Z and the initiation of treatment showed that significant difference in the incidence of PHN was on the fourth day with less than and more than 4 days showing 18.5% : 25.1% respectively(P<0.05). CONCLUSIONS: The important factors affecting the incidence of PHN were interval between the onset of H-Z and the initiation of treatment age and inpatients or outpatients status. The methods of treatment(acyclovir or steroid), sex, residential area of patients, associated conditions and nerve distribution were not significant factors.
Aged ; Chronic Pain ; Dermatology ; Gwangju ; Herpes Zoster* ; Humans ; Incidence ; Inpatients ; Neuralgia* ; Outpatients ; Quality of Life ; Retrospective Studies

Malignant mixed mullerian tumor of the ovary are very aggressive tumors that were usually diagnosed at an older age. They are usually at an advanced stage at the time of diagnosis, and survival after diagnosis varies by stage of disease and histological type. Despite aggressive treatment that includes surgery and chemotherapy, women with these tumors have a significantly increased risk of death giving them a very poor prognosis. The poor prognosis associated with this rare disease represents a need to new therapeutic regimens to improve patients' survival. We experienced two cases of primary malignant mixed mullerian tumor of the ovary.
Diagnosis ; Drug Therapy ; Female ; Humans ; Ovary* ; Prognosis ; Rare Diseases