PURPOSE: This study was conducted to provide basic data for quality improvement among oncology advanced practice nurses (oncology APNs) through increasing job satisfaction by determining their job satisfaction level and analyzing the influencing factors. METHODS: The subjects were 114 certified oncology APNs working at general hospitals in metropolitan areas. Data were collected using a structured questionnaire from August 4 to October 29, 2018. The instruments were the Role Conflict Scale, Self-Efficacy Scale, Professional Self-Concept Scale, and the Level of Job Satisfaction. The data were analyzed using descriptive statistics, t-tests, chi-square tests, ANOVA, Pearson’s correlation coefficients and multiple regression in SPSS version 23.0, IBM. RESULTS: Factors that significantly affected job satisfaction were number of years since being certified as an oncology APN (β=-.20, p=.031), oncology advanced practice (β=.38, p<.001), and professional self-concept (β=.44, p<.001). The explanatory power was 39.4%. CONCLUSION: These results showed that factors significantly affecting job satisfaction were number of years since being certified as an oncology APN, advanced practice in oncology, and professional self-concept. Job satisfaction was found to be higher when the number of years since being certified as an oncology APN was shorter and professional self-concept was higher.
Advanced Practice Nursing ; Hospitals, General ; Job Satisfaction ; Oncology Nursing ; Quality Improvement

OBJECTIVES: Studies investigating problematic internet use have increased rapidly and have been focused on its causes, psychopathology, prevalence, characteristics and so on. However, there are few studies concerning the correlation between problematic internet use and youth health risk behavior. Therefore, the purpose of this study was to examine the relationship between problematic internet use and youth health risk behavior. METHODS: A community sample of 632 high school students in grades 10 and 11 was collected for the survey. The sample was assessed using the Youth Risk Behavior Surveillance System(YRBSS) and Young's Diagnostic Questionnaire of Internet Addiction(YDQ). The subjects were classified into two groups: normal and problematic internet use, and the problematic internet use group was further divided into at-risk use and addiction groups. RESULTS: There were 56 subjects(8.9%) in the internet addiction group and 56 subjects(8.9%) in the at-risk internet use group. The other 507 subjects were classified as normal. The subjects in the internet addiction group kissed more frequently and ate less fruit than those in the normal group. They also showed a relatively higher tendency to watch TV, ride in a car driven by a drunk driver and to carry a weapon than those in the normal group. There were no differences in health risk behaviors between the subjects in the internet addiction group and those in the at-risk internet use group, except for the possibility of riding in a car driven by a drunk driver. CONCLUSION: Unlike the normal group, there was very little difference in health risk behavior between the internet addiction group and the at-risk internet use group, which indicates that the addiction group and the at-risk internet use groups are homogenous. It is important to focus on the behavior of individuals in the at-risk group, and preventive measures should be taken in order to reduce the possibility of at-risk adolescents becoming addicted.
Adolescent ; Fruit ; Humans ; Internet* ; Prevalence ; Psychopathology ; Risk-Taking* ; Weapons ; Surveys and Questionnaires

PURPOSE: The present research was done to examine the fundamental significance and structure of conflict experience of nurses in hospital nursing organizations.METHODS: This qualitative research was conducted by analyzing data collected through in-depth interviews based on Colaizzi's (1978) method of analysis, one of the phenomenological methods of analysis.RESULTS: Statements from the 12 study participants demonstrate two key topics “accumulation of conflicts” and “manifestation of new conflicts” as well as seven sub-topics including “being forced to comply”, “Lack of respect and consideration”, “unsatisfactory conflict management by the leaders”, “continuous and overwhelming vicious cycle”, “prevalence of self-defensive egotism”, “difficult to accept differences”, and “incapable of responding to the structural changes of nursing workforce”.CONCLUSION: Resolving the dysfunctional conflicts in hospital nursing organizations requires not only improvement in the organizational culture of individuals and nursing organizations, but also legal and institutional measures in addition to new attempts to integrate education and research findings from relevant fields of studies.
Education ; Methods ; Nursing ; Organizational Culture ; Qualitative Research

BACKGROUND: Initial symptoms for esophageal perforation have not been clarified, but when there is no early diagnosis and proper treatment to follow immediately after the diagnosis, it is fatal for the patients. Therefore, this study attempted to discover the factors that influence the prognosis of esophageal perforation to contribute to the improvement of the treatment result. MATERIAL AND METHOD: The subjects of this study are 32 patients who came to the hospital with esophageal perforation from October, 1984 to June, 2000. This study examined the items for clinical observation such as patients' sex, age, cause of the perforation, perforation site, the time spent until the beginning of the treatment, symptoms caused by the perforation and its complication, and treatment methods. This study tried to find out the relationship between the survival of patients and each item. RESULT: There were 24 male and 8 female patients and their mean age was 49.7 +/- 16.4. For the causes of perforation, there were 14 cases(43%) of iatrogenic perforation, which ranked first, caused by the medical instrument operation and surgical damage. As for the perforation sites, thoracic esophagus was the most common site(26 cases of 81.2%) and chest pain was the most frequent symptom. The complication caused by esophageal perforation showed the highest cases in the order of mediastinitis, empyema, sepsis and peritonitis. After the treatment, there were 23 cases of survival and 9 cases of mortality. The total mortality rate was 28.1% and the main causes of mortality were sepsis and acute respiratory distress syndrome(ARDS). As for the treatment, 8 cases(25.0%) treated the perforation successfully using conservative treatment only. As for the surgical treatment, there were 5 cases(15.6%) of cervical drainage, 7 cases (21.8%) of primary repair and 12 cases(37.5%) of esophageal reconstruction after performing an exclusion-diversion. There were 18 cases(56.2%) of complete treatment of esophageal perforation at its initial treatment and in 14 cases(43.8%) of treatment failure at its initial treatment, patients were completely cured in the next treatment stage or died during the treatment. The cases of perforation in thoracic esophagus, complication into severe mediastinitis or sepsis and the cases of failure at initial treatment showed a statistically significant mortality rate (p<0.05). CONCLUSION: Based on the above results, it is thought that a proper choice for initial treatment choice depending on the perforation site and the prevention of serious complication such as mediastinitis or sepsis can shorten the treatment period for the patients with esophageal perforation and improve the convalescence.
Chest Pain ; Convalescence ; Diagnosis ; Drainage ; Early Diagnosis ; Empyema ; Esophageal Perforation* ; Esophagus ; Female ; Humans ; Male ; Mediastinitis ; Mortality ; Peritonitis ; Prognosis ; Sepsis ; Treatment Failure

Intraosseous arteriovenous malformation (AVM) in the craniofacial region is rare. When it occurs, it is predominantly located in the mandible and maxilla. We encountered a 43-year-old woman with Klippel-Trenaunay syndrome affecting the right lower extremity who presented with a left orbital chemosis and proptosis mimicking the cavernous sinus dural arteriovenous fistula. Computed tomography angiography revealed an intraosseous AVM of the sphenoid bone. The patient's symptoms were completely relieved after embolization with Onyx. We report an extremely rare case of intraosseous AVM involving the sphenoid bone, associated with Klippel-Trenaunay syndrome.
Adult ; Angiography ; Arteriovenous Malformations ; Cavernous Sinus ; Caves ; Central Nervous System Vascular Malformations ; Exophthalmos ; Female ; Hemangioma ; Humans ; Klippel-Trenaunay-Weber Syndrome ; Lower Extremity ; Mandible ; Maxilla ; Orbit ; Sphenoid Bone

PURPOSE: To report a case of recurred iris cyst 11 years after treatment with endodiathermy, which was treated with laser photocoagulation and cystotomy followed by intraocular pressure elevation and underwent anterior chamber irrigation. CASE SUMMARY: A 46-year-old female presented to our department with decreased vision in her left eye that had persisted for several months. The patient had a history of surgical removal of an iris cyst with endodiathermy 11 years ago. Slit lamp examination showed an iris cyst adjacent to the nasal corneal limbus. The cyst was filled with turbid fluid. It distorted the pupil and threatened visual axis. Iris cystotomy (diameter larger than 500 microm) was done with diode laser photocoagulation and a neodymiumdoped yttrium aluminium garnet laser. At the same day, the patient's intraocular pressure elevated to 50 mm Hg in spite of maximal conservative treatment and went through anterior chamber irrigation. After six months, the iris cyst was adhered to corneal endothelium and disappeared. Visual acuity and intraocular pressure was within normal range. CONCLUSIONS: An iris cyst can recur after treatment with endodiathermy. Recurred iris cyst can be successfully treated with laser photocoagulation and cystotomy. However, turbid fluid inside the cyst may outflow to the anterior chamber and cause secondary ocular hypertension after treatment, so careful observation is needed.
Anterior Chamber ; Axis, Cervical Vertebra ; Cystotomy* ; Endothelium, Corneal ; Female ; Humans ; Intraocular Pressure ; Iris* ; Lasers, Semiconductor ; Light Coagulation* ; Limbus Corneae ; Middle Aged ; Ocular Hypertension ; Pupil ; Reference Values ; Visual Acuity ; Yttrium

BACKGROUND AND OBJECTIVES: The aim of this study was to investigate the relationship between inhalation anesthetics and hearing in mice. MATERIALS AND METHODS: As inhalation anesthetics, isoflurane was used. Auditory brainstem response and distortion product otoacoustic emission were used as measurement of hearing. Mice were divided into 2 groups. 'Isoflurane group' consisted of mice that were anesthetized with an inspired concentration of 2.0 vol% isoflurane with 2 L/min of oxygen (n=10). 'Control group' consisted of mice that were anesthetized with ketamine and xylazine (n=10). RESULTS: Auditory brainstem response thresholds in mice anesthetized with ketamine and xylazine was not different from those in mice anesthetized with isoflurane. Threshold of DPOAE was higher in mice with isolurane than with ketamine and xylazine. Changes of efferent control may be induced by isoflurane and consequently change the threshold of DPOAE in mice. CONCLUSIONS: These results infer that, there was a change of central nervous system induced by inhalation anesthetics, this change also can be applied to the strategies for prevention of hearing loss.
Anesthetics ; Anesthetics, Inhalation ; Animals ; Central Nervous System ; Evoked Potentials, Auditory, Brain Stem ; Hearing ; Hearing Loss ; Isoflurane ; Ketamine ; Mice ; Oxygen ; Xylazine

A petrous apex cholesterol granuloma (PACG) is the most common lesion of the petrous apex mass. Affected patients present with various symptoms such as hearing loss, vertigo, headache, tinnitus, facial spasms, and diplopia. We report the case of a 32-yr-old man with a PACG, who was first misdiagnosed with Meniere's disease. He was placed on a low-salt diet, and prescribed medication from another hospital, for several months, but the symptoms persisted and worsened. The patient presented to the emergency room complaining of left facial twitching and numbness. To rule out a central neurological lesion, temporal bone magnetic resonance imaging was carried out and a 2.5 cm mass with high signal intensity on T1- and T2-weighted imaging, without gadolinium enhancement, was found. Because of the hearing and facial problems, we drained cholesterol-bearing material via an infralabyrinthine approach using a computer aided image-guided surgical device, the BrainLAB(R). After the operation, the vertigo and hearing loss were no longer present. It is likely that the patent's Meniere's disease-like symptoms were due to the compression of the endolymphatic sac by a PACG.
Cholesterol ; Diet, Sodium-Restricted ; Diplopia ; Emergencies ; Endolymphatic Hydrops ; Endolymphatic Sac ; Gadolinium ; Granuloma ; Headache ; Hearing ; Hearing Loss ; Humans ; Hypesthesia ; Magnetic Resonance Imaging ; Meniere Disease ; Spasm ; Temporal Bone ; Tinnitus ; Vertigo

PURPOSE: To report some early experiences of ultrasonography-guided mammotome biopsy for solid breast lesions. MATERIALS AND METHODS: Sixty seven solid breast lesions in 59 patients aged 25 -77 (mean, 44.5) years were biopsied under ultrasound-guidance using an 11 gauge mammotome. The size and depth of the lesions, diagnostic accuracy achieved, complications, and merits and demerits of the device were evaluated. RESULTS: The lesions ranged in size from 0.5 to 8 (mean, 1.6)cm, and at their center the mean depth was 1.4 cm. For every lesion at least seven biopsies were performed, and the mean weight of extracted tissue was 0.44 gm. The lesions were located mainly at the at 12 o'clock area and upper inner quadrant of the left breast (n=10 for each area); they were also found in other regions fo both breasts, including subareolar areas. The histopathologic diagnosis was malignant in 26 lesions and benign in 39, and in one case, atypical ductal hyperplasia was diagnosed. One lesion contained no tumor cells. Twenty-four malignant lesions were surgically excised, and in 21 invasive ductal/lobular carcinomas and one ductal carcinoma in situ (DCIS) (91.7%) the initial and subsequent diagnosis correlated. One lesion diagnosed as DCIS and one whose invasiveness could not be initially determined were confirmed as invasive ductal carcinomas (8.3%). Follow-up ultrasonography involved six benign lesions and showed that five of these had become smaller. The complications noted were severe pain in three patients and a moderate amount of bleeding in two, but in all cases good control was achieved by interrupting the procedure or applying compression. The merits of the mammotome biopsy compared with the conventional core biopsy technique are higher diagnostic accuracy due to the larger amount of tissue extracted by suction and the large caliber of the needle, multiple biopsies achieved by one needle insertion, and less possibility of severe complications such as pneumothorax. Drytapping was a demerit of the device. Very small lesions could be extracted completely, and this may be a merit for benign lesions and a demerit for malignant lesions. For the latter, clips could be used. CONCLUSION: Ultrasonography-guided mammotome biopsy is a very accurate and safe method for the diagnosis of various breast lesions.
Biopsy* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Diagnosis ; Follow-Up Studies ; Hemorrhage ; Humans ; Hyperplasia ; Needles ; Pneumothorax ; Suction ; Ultrasonography

PURPOSE: To evaluate the surgical results of Ahmed valve implant surgery with adjunctive mitomycin C and selective postoperative 5-fluorouracil (5-FU) subconjunctival injection with a needling procedure. METHODS: In this retrospective study, 40 eyes of 40 patients who had undergone Ahmed valve implant surgery with adjunctive mitomycin C were observed for at least 1 year. The Ahmed valve was implanted after 5-minute application of 0.04% mitomycin C. Selective 5-FU injection with a needling procedure was performed during the follow- up period based on intraocular pressure (IOP). Hypertensive phase was defined as IOP higher than 21 mm Hg within 3 months after operation. IOP higher than 18 mm Hg regardless of IOP-lowering medications at 2 consecutive visits was considered to be a surgical failure. RESULTS: The mean follow-up period was 35.5 ± 12.4 months. Preoperative intraocular pressure was 32.8 ± 7.5 mm Hg, which decreased to 14.0 ± 4.2 mm Hg post-operatively. The number of glaucoma medications decreased significantly from 3.8 ± 0.5 to 2.0 ± 1.0. Eleven of 40 eyes (27.5%) experienced hypertensive phase at 6.0 ± 3.1 weeks after surgery. Kaplan-Meier survival analysis showed cumulative probability of surgical success rates of 82.5%, 79.6%, 72.7%, and 58.8% at 1, 2, 3, and 4 postoperative years respectively. There were no risk factors that affecting surgical failure except age (hazard ratio = 0.17, p = 0.02). CONCLUSIONS: Ahmed valve implant surgery with adjunctive mitomycin C and selective 5-FU injection with a needling procedure showed good success in refractory glaucoma.
Fluorouracil* ; Follow-Up Studies ; Glaucoma ; Humans ; Intraocular Pressure ; Mitomycin* ; Retrospective Studies ; Risk Factors