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

PURPOSE: Delivering bad news is a task that occurs in most medical practices, rendering communication skills essential to competent patient care. The purpose of this study was to identify factors that are associated with scores on an assessment of medical students' communication skills in delivering bad news to help develop more effective curricula to enhance these essential skills. METHODS: One hundred fifty-four fourth-year medical students at Pusan National University were included. Skills for delivering bad news were assessed using the SPIKES protocol in the CPX. The students were categorized into three main groups according to total scores: 'Exceeds expectations (E)', 'Meets expectations (M)', and 'Needs development (N)'. Personal experiences with misfortune and attitudes toward breaking bad news were surveyed, and school records were collected. The differences between the E and N groups were analyzed based on performance test and survey. RESULTS: Compared with students in the N group, E group students acquired significantlyhigher scores on the items of Perception, Invitation, a division of Knowledge, Empathy and Strategy, and Summary but not on Setting and a part of Knowledge. E group students had better records in classes and clerkships. There were no differences in personal experiences and attitudes toward breaking bad news between the groups. CONCLUSION: Personal experience with delivering bad news does not guarantee better communication, and attitudes toward this task do not influence student performance. We expect that deliberate educational programs will have a positive impact on improving communication skills for delivering bad news.
Curriculum ; Empathy ; Humans ; Patient Care ; Personality Inventory ; Professional-Family Relations ; Students, Medical

Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by multiple gas filled cysts in the intestinal wall. The diagnosis of PCI is usually made by colonoscopy, histology, or radiologic findings. We report a case of PCI in a 35-year-old man. The patient initially complained of watery diarrhea and abdominal bloating for 2 weeks. Simple abdominal X-ray demonstrated numerous, small, round, air densities on the right upper abdomen along the ascending and proximal transverse colon. Colonoscopy revealed numerous, 5-20 mm sized, sessile polypoid, balloon-like distended, protruding subepithelial masses covered with normal colonic mucosa from cecum to proximal transverse colon. We performed a CT colonoscopy and confirmed PCI with multiple air-filled cystic masses along the colonic wall from cecum to proximal transverse colon. The patient was treated with antibiotics and oxygen inhalation for 2 weeks. Follow-up CT colonoscopy revealed marked regression in the number and size of the air-filled cystic masses. Herein, we report the first case of the PCI in Korea diagnosed by CT colonoscopy. Follow-up evaluation with CT colonoscopy was performed after the treatment of the PCI. CT colonoscopy is a useful non-invasive diagnostic tool for the diagnosis of pneumatosis cystoides intestinalis.
Adult ; Colonic Diseases/pathology/radiography ; *Colonography, Computed Tomographic ; Humans ; Intestinal Mucosa/pathology ; Male ; Pneumatosis Cystoides Intestinalis/*pathology/radiography