PURPOSE: This study was designed to assess the degree of psychological well-being, perceived health status, and health promoting behavior of clinical nurses, and to identify correlations between variables. METHODS: Participants were 194 nurses working at S hospital, Seoul and data were analyzed using descriptive statistics, ANOVA, Duncan's test, Pearson correlation coefficient, and multiple regressions. RESULTS: Mean scores were 3.45 (5 point scale) for psychological well-being, 2.82(4 point scale) for perceived health status, and 2.30(4 point scale) for health promoting behavior. Psychological well-being correlated positively with perceived health status (r=.34, p<.001). Perceived health status showed a positive correlation with health promoting behavior (r=.30, p<.001). There was a positive correlation between psychological well-being and health promoting behavior (r=.52, p<.001). Personal growth(t=2.85, p=.005), purpose in life (t=2.30, p=.023) among subscales of psychological well-being, and perceived health status (t=2.13, p=.034) had a significant influence on health promoting behavior. These combinations explained 32.1% of health promoting behavior (F=12.58, p<.001). CONCLUSION: The results of this study suggest strategies to improve health promoting behavior by enhancing psychological well-being of nurses. Furthermore, a study to identify the effects of developed and applied psychological well-being promotion program should be conducted.
Humans ; Seoul

Sixty patients anesthetized with nitrous oxide-oxygen-halothane, who received pancuronium for the maintenance of muscular relaxation were divided into three group of twenty each. Ath the end of anesthesia, the patients of Group l received in 1.0mg atropine travenously and neostigmine 2.0mg: those in Group ll glycopyrrolate 0.4mg and neostigmine 2.0mg. and those in Group lll atropine 0.5mg, glycopyrrolate 0.2mg and neostigmine 2.0mg. After that the changes in heart rate, arrhythmsia, blood pressure and oropharyngeal secretions were observed and evaluated. The results are as follows: 1) The safety and effectiveness of all groups in antagonizing the muscarinic actions of neostigmine were demonstrated. 2) Glycopyrrolate produced a significantly smaller change in heart rate than atropine. 3) There were no significant difference in the indicence of severe tachycardia in all groups respectively. 4) Glycopyrrolate is superior to atropine in the antisalivary action. 5) There were no more advantages in combined use of atropine and glycopyrrolate than that of atropine or glycopyrrolate separotely.
Anesthesia ; Atropine* ; Blood Pressure ; Cholinergic Agents* ; Glycopyrrolate* ; Heart Rate ; Humans ; Neostigmine* ; Pancuronium ; Relaxation ; Tachycardia

Immunoglobulin G4-related disease (IgG4-RD) is a systemic inflammatory disease found in many organs including biliary tract, salivary gland, kidney, and lung. Tubulointerstitial nephritis is the most common renal manifestation, but hematologic involvement of IgG4-RD is rare. Here, we report on a case of a 57-year-old male with IgG4-related interstitial nephritis with bicytopenia, which was initially thought to be systemic lupus erythematosus. He presented with proteinuria, anemia, thrombocytopenia, and low complement levels. Histological findings showed an increased number of IgG4-positive plasma cells (>200/high power field), and an elevated IgG4/IgG ratio (>90%). Serum levels of IgG and IgG4 were also increased. This case emphasized the importance of differential diagnosis of IgG4-RD and immune complex glomerulonephritis.
Anemia ; Antigen-Antibody Complex ; Biliary Tract ; Complement System Proteins ; Diagnosis, Differential ; Glomerulonephritis ; Humans ; Immunoglobulin G ; Immunoglobulins* ; Kidney ; Lung ; Lupus Erythematosus, Systemic ; Male ; Middle Aged ; Nephritis, Interstitial* ; Plasma Cells ; Proteinuria ; Salivary Glands ; Thrombocytopenia

Pyogenic granulomas (PGs) are rare benign lobular capillary hemangiomas that occur on the skin or mucosa. The most common sites of PG occurrence are the skin, lip, face and finger. This entity is extremely rare in the alimentary tract, with the exception of the oral cavity. We describe here a 72-year-old man who presented with dysphagia due to the presence of a pyogenic granuloma. The tumor was located in the mid-esophagus and it was treated with endoscopic submucosal dissection. PG is considered a lesion of reactive origin that may develop in response to trauma, infection, pregnancy, angiogenic factors or hormones. Gastrointestinal PG need to be treated because it is a rare cause of gastrointestinal hemorrhage, and it is hard to differentiate from tumorous conditions such as Kaposi's sarcoma.
Aged ; Angiogenesis Inducing Agents ; Deglutition Disorders ; Fingers ; Gastrointestinal Hemorrhage ; Granuloma ; Granuloma, Pyogenic ; Hemangioma ; Humans ; Lip ; Mouth ; Mucous Membrane ; Pregnancy ; Skin

Churg-Strauss syndrome (CSS) is a rare systemic vasculitis. It is characterized by peripheral eosinophilia, asthma, neuropathy, skin manifestation, and less frequently gastrointestinal tract symptoms. Here we report a case of CSS which is initially manifested as acute acalculous cholecystitis. A 67-year-old asthmatic woman visited Emergency Room because of acute abdominal pain. Computed tomography showed acalculous cholecystitis and laparoscopic cholecystectomy was done. Pathology of gallbladder showed marked eosinophilic infiltration with necrotizing vasculitis and granuloma. On the basis of asthma, sinusitis, lung infiltration, combined peripheral eosinophilia and neuropathy, the patient was diagnosed as CSS. To our knowledge, this is the first case of pathologically proven eosinophilic cholecystitis in Korea.
Abdominal Pain ; Acalculous Cholecystitis* ; Aged ; Asthma ; Cholecystectomy, Laparoscopic ; Cholecystitis ; Churg-Strauss Syndrome* ; Emergencies ; Eosinophilia ; Eosinophils ; Female ; Gallbladder ; Gastrointestinal Tract ; Granuloma ; Humans ; Korea ; Lung ; Pathology ; Sinusitis ; Skin Manifestations ; Systemic Vasculitis ; Vasculitis

PURPOSE: Toxocariasis is the most common cause of peripheral blood eosinophilia in Korea and produces eosinophilic infiltration in various organs, including the lung. However, the prevalence of toxocariasis in the general population is rarely reported. METHODS: We investigated the seroprevalence of Toxocara larval antibody among asymptomatic people who attended Samsung Medical Center for a health checkup, including low-dose chest computed tomography (CT) between March 2012 and December 2013. A total of 633 people (400 men and 233 women) were prospectively recruited. RESULTS: The Toxocara-seropositive rate was 51.2% using the current cutoff value based on Toxocara enzyme-linked immunosorbent assay (ELISA) (67.0% for men and 24.0% for women). In the multivariate-adjusted model, age (odds ratio [OR], 1.08; 95% confidence intervals [CI], 1.04-1.11), male sex (OR, 3.47; 95% CI, 2.26-5.33), rural residence (OR, 1.55; 95% CI, 1.05-2.30), and history of raw liver intake (OR, 8.52; 95% CI, 3.61-20.11) were significantly associated with Toxocara seropositivity. When subjects were divided into 3 groups using cutoff values base on weak positive and strong positive control optical densities (ODs), the ORs for peripheral blood eosinophilia and serum hyperIgEaemia were 0.31 (95% CI, 0.02-2.89) in the weakpositive group and 36.64 (95% CI, 11.73-111.42) in the strong positive group compared to the seronegative group. Similarly, ORs for the solid nodule with surrounding halo were 2.54 (95% CI, 0.60-10.84) in the weak positive group and 15.08 (95 CI 4.09-55.56) in the strong positive group compared to the seronegative group. CONCLUSIONS: The study indicated that the Toxocara-seropositive rate obtained by using the current cutoff value based on ELISA was high in the asymptomatic population in Korea. The results of this study suggest that active toxocariasis may be more frequently seen in the Toxocara-strong positive group than in the Toxocara-weak positive group.
Adult* ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Eosinophilia ; Eosinophils ; Humans ; Korea ; Liver ; Lung ; Male ; Prevalence* ; Prospective Studies ; Seroepidemiologic Studies ; Serologic Tests* ; Thorax ; Toxocara ; Toxocara canis ; Toxocariasis*

PURPOSE: The purpose of this study is to investigate differences in organ-specific cancer incidence according to the region and population size in Korea. MATERIALS AND METHODS: We reviewed the data of the cancer registration program of Gyeongnam Regional Cancer Center between 2008 and 2011. Age-standardized rates of cancer incidence were analyzed according to population size of the region and administrative zone. RESULTS: Incidence of thyroid cancer has been increasing rapidly in both urban and rural areas. However, the thyroid cancer incidence was much lower in rural areas than in urban areas and megalopolis such as Seoul. Gastric cancer was relatively more common in rural areas, in megalopolis near the sea (Ulsan, Busan, and Incheon), and other southern provinces (Chungcheongnam-do, Gyeongsangbuk-do, and Gyeongsangnam-do). A detailed analysis in Gyeongsangnam-do revealed that rural areas have relatively low incidence of thyroid and colorectal cancer, and relatively high incidence of gastric and lung cancer compared to urban areas. CONCLUSION: This study suggests that there are some differences in cancer incidence by population size. Thyroid and colorectal cancer incidence was increasing, and gastric and lung cancer was slightly decreasing in urban areas, whereas gastric and lung cancer incidence still remains high in rural areas.
Busan ; Colorectal Neoplasms ; Epidemiology ; Gyeongsangbuk-do ; Gyeongsangnam-do ; Incidence* ; Korea* ; Lung Neoplasms ; Population Density ; Rural Population ; Seoul ; Stomach Neoplasms ; Thyroid Gland ; Thyroid Neoplasms ; Urbanization

BACKGROUND AND OBJECTIVES: Venous malformations are one of the most common vascular anomalies, and are more frequently found in head and neck region. Various treatment options are available, and intralesional injection of sclerosant is the commonest primary treatment modality. We reviewed 20 cases of venous malformation treated with sclerotherapy at Seoul National University Hospital. MATERIALS AND METHODS: Twenty cases of venous malformation in head and neck were reviewed retrospectively, which had been managed with sclerotherapy from January 1991 to July 2001. The patients were treated at the department of otolaryngology-Head and Neck Surgery or plastic surgery of Seoul National University Hospital. Emulsion of Ethamolin and Lipiodol was used as a sclerosing agent. Some patients received surgical treatment after sclerotherapy. All of the patients received direct-puncture venography(Digital subtraction angiography) before sclerotherapy. Treatment results were evaluated by using MRI, angiography, or CT. If the reduction of volume of mass was more than 50 percent after sclerotherapy, we regarded the result as effective, if less than 50 percents, non-effective. Statistical analysis was done using SPSS10.0 for windows. RESULTS: Among twenty patients, there were eight males(40%), and twelve females(60%). Ages at the beginning of treatment ranged from six to thirty-eight years(mean age:20.6 years). The most common site of lesions was cheek(in 12 cases). Mass sizes(largest diameter) ranged from 2 cm to 20 cm. Nine cases were managed with both sclerotherapy and surgical excision, and eleven cases, only with sclerotherapy. Thirteen cases(65%) responded well to sclerotherapy(volume reduction>or=50%). There was no major complication. Tenderness, induration, swelling, and pain were reported as post-sclerotherapy complaints. Mild dyspnea occurred in one case, and the patient was managed at ICU shortly without fatal event. CONCLUSION: Sclerotherapy with or without surgical excision was an effective treatment modality for venous malformation, with minimal risk of major complications. There were no significant differences in the treatment results according to the initial size of the lesions.
Angiography ; Dyspnea ; Ethiodized Oil ; Head ; Humans ; Injections, Intralesional ; Magnetic Resonance Imaging ; Neck ; Retrospective Studies ; Sclerotherapy* ; Seoul ; Surgery, Plastic

BACKGROUND/AIMS: MELD-Na (model for end-stage liver disease with incorporation of serum sodium) was suggested to provide better survival prediction than MELD alone for patients with end stage liver disease. However, there is no data verifying the usefulness of MELD-Na for predicting short term mortality of cirrhotic patients in Korea. This study was aimed to determine whether MELD-Na would be more accurate in predicting short term mortality than other scoring systems such as Child-Turcotte-Pugh (CTP) or MELD. METHODS: Data from 355 patients admitted due to liver cirrhosis were retrospectively reviewed. The cumulative survival rates were obtained. Prediction of mortality rate for three months and one year were analyzed using the area under the receiver's operating characteristics curve (AUC). RESULTS: One hundred patients (28%) died during the study period. All of the three systems showed significant differences in the cumulative survival rate according to the scores on admission (p<0.001). The AUC of CTP, MELD, and MELD-Na in predicting three-months mortality were 0.828, 0.845, and 0.862 (p>0.05), and the AUC of each score system for death within one year were 0.792, 0.800, and 0.831, respectively (p>0.05). The AUC of MELD-Na in predicting short term death were the highest, although it was not statistically significant. Multivariate analysis showed that only MELD-Na was significantly related to three-month mortality (p=0.012). CONCLUSIONS: MELD-Na is more appropriate in predicting short term mortality, but larger scale studies are needed to confirm the superiority of MELD-Na to MELD and CTP in patients with liver cirrhosis.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Liver Cirrhosis/*mortality ; Male ; Middle Aged ; Multivariate Analysis ; Predictive Value of Tests ; ROC Curve ; Retrospective Studies ; *Severity of Illness Index ; Survival Analysis ; Time Factors

BACKGROUND/AIMS: Our clinical experience and recent published literatures suggest that Clostridium difficile colitis (CDC) has become more common and potentially more pathogenic in recent years. The aim of study was to evaluate changes in the epidemiological features of CDC in hospitalized patients in Korea. METHODS: We retrospectively reviewed all patients of CDC diagnosed at Kangnam St. Mary Hospital from 1998 to 2007. CDC was defined as having a positive C. difficile cytotoxicity assay, or endoscopic or pathologic evidence of CDC. RESULTS: A total of 189 cases (male 73, female 116, mean age 63.3 years) of CDC were diagnosed during the study period. The prevalence of CDC increased from 1.9/10,000 patient admissions in 1998-1999 to 8.82/10,000 patient admissions in 2006-2007. One hundred sixty three indication for cases (86.2%) of patients identified a prior use of antibiotics in the 2 months preceding diagnosis. The most common antibiotic use was prophylactic use during perioperational period (33.3%) followed by pneumonia (23.3%). The overall response rate to initial antibiotics was 82.7%. One hundred seventy two (91%) patients were initially treated with metronidazole. The response rate was 84.3%. All patients with initial failure to metronidazole were successfully treated by vancomycin. The response rate of vancomycin as first treatment was 80%. Three deaths were associated with CDC despite the use of combination of metronidazole and vancomycin. CONCLUSIONS: The prevalence of CDC in hospitalized patients in Korea significantly increased from 1998 to 2007.
Aged ; Anti-Bacterial Agents/therapeutic use ; *Clostridium difficile ; Enterocolitis, Pseudomembranous/diagnosis/drug therapy/*epidemiology ; Female ; Humans ; Male ; Metronidazole/therapeutic use ; Middle Aged ; Republic of Korea ; Retrospective Studies ; Vancomycin/therapeutic use