PURPOSE: The purpose of this study was to investigate the welfare status of nurses and the status of fixed night shifts and flexible work arrangements in both general hospitals and advanced general hospitals in Korea. METHODS: A total of 167 hospitals participated in this study, done from April to October 2018. RESULTS: There were 103 hospitals utilizing the fixed night shift system, 22 in the two-shift system, 3 in the fixed holiday shift, 79 in the fixed shift system, and 39 in the short-time working system. The average welfare benefits for nurses increased to 33.02 million won on average. However, welfare services for the nurses were poor: 41.8% of the respondents had a nurses' lounge, 81.7% were given dormitory space at their place of employment, 41.8% had access to welfare facilities, and 56.4% were provided with welfare support countermeasures. CONCLUSION: The results show an increasing trend of hospitals to utilize fixed night shift and flexible work arrangements. An institutional strategy at the national policy level should be established to implement flexible work arrangements including the fixed night shift system, which has a poor level of welfare.
Employment ; Holidays ; Hospitals, General ; Korea ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to compare the working status and Standard Shiftwork Index (SSI) between night shift-fixed nurses and rotating shift nurses. METHODS: Participants were 367 nurses working as registered nurses at 7 different medical institutions. The data were collected from August 8, 2016 to September 30, 2016. RESULTS: Night shift fixed nurses were more satisfied with work schedule than rotating shift nurses. Rotating shift nurses reported higher SSI scores, such as chronic fatigue, musculoskeletal problems, than night shift fixed nurses. In SSI's sub-items, rotating shift nurses reported higher scores, such as the amount of sleep, feeling well after sleep, heartburn or stomach-ache and heartbeat irregularities, than night shift fixed nurses. CONCLUSION: The results indicated that night shift fixed system might be an effective method to improve nurses' work satisfaction. It is necessary to figure out any suitable night shift fixed system based on the characteristics of each nursing organization. The SSImight be an useful tool tomeasure the nurses' satisfaction in reference to their work shift.
Appointments and Schedules ; Fatigue ; Heartburn ; Humans ; Job Satisfaction ; Methods ; Nurses ; Nursing

There are 82 dental hygiene departments and clinical training institutes across the country with a very wide range of clinical practice content and evaluation methods, making standardization difficult. Therefore, there is a need to establish a standard protocol outlining clinical practice content and evaluation methods for systematic and efficient operation of clinical practice. Thus, this study attempted to propose such a protocol for standardization of dental hygiene clinical practice in dental clinics and hospitals to examine the contents of clinical practice by reviewing relevant literature, and relating it to professional practice within the dental hygienic curriculum to facilitate enhancement of expertise. Clinical practice content was extracted from 74 cases, and was consisted of classifying mandatory and optional clinical practice, training time, and activity methods for each component. To standardize effective clinical practice, it is necessary to organize the components acquired in the course of clinical dentistry training in line with their arrangement on each university's curriculum, in order to learn all components step by step. To do this, it is necessary to present a standardized clinical practice protocol and a organic cooperation between educational institutions and clinical training institutions.
Academies and Institutes ; Curriculum ; Dental Clinics ; Dentistry ; Oral Hygiene* ; Professional Practice

Diagnoses of pyelonephritis caused by Staphylococcus aureus should be accompanied by investigations of concomitant bladder obstruction and metastatic infections, especially to the spine or heart. Complicated pyelonephritis due to S. aureus requires more than 2 weeks of antibiotics, which is the typically recommended treatment duration for pyelonephritis. We describe a patient who was diagnosed with complicated epidural and paraspinal abscesses after insufficient evaluation and treatment of acute pyelonephritis due to S. aureus. A 62-year-old man with type 2 diabetes was admitted with fever, increased urinary frequency, and left flank pain. He was diagnosed with acute pyelonephritis caused by S. aureus. His fever and flank pain subsided after 3 days of intravenous antibiotics. Evaluation of bladder obstruction and metastatic infection were not performed, as he declined further evaluation. The patient was discharged with oral antibiotics and was requested to attend weekly appointments but was lost to follow-up. One month later, the patient presented at the outpatient clinic with similar symptoms. Computed tomography showed recurrent pyelonephritis and a distended bladder. His flank pain persisted despite administration of an opioid agent. Therefore, magnetic resonance imaging was performed, revealing epidural and paraspinal abscesses. Ultrasound-guided aspiration of the paraspinal muscle layer was performed, and blood and percutaneous aspirated fluid cultures revealed S. aureus growth. The pattern of antimicrobial sensitivity was identical to that at his first admission. Following more than 4 weeks of antibiotics, magnetic resonance imaging showed the abscesses had decreased in size. The patient was discharged without neurologic sequelae and was provided with oral antibiotics.
Abscess* ; Ambulatory Care Facilities ; Anti-Bacterial Agents ; Appointments and Schedules ; Diagnosis ; Epidural Abscess ; Fever ; Flank Pain ; Heart ; Humans ; Lost to Follow-Up ; Magnetic Resonance Imaging ; Middle Aged ; Paraspinal Muscles ; Pyelonephritis* ; Spine ; Staphylococcus aureus* ; Staphylococcus* ; Urinary Bladder ; Urinary Tract Infections

BACKGROUND: We performed this study to evaluate the potency and time course of rocuronium-induced neuromuscular block following moderate or severe acute normovolemic hemodilution (ANH) in rabbits. METHODS: Forty five rabbits were randomly assigned to the control (C) group, the moderate ANH (M) group, or the severe ANH (S) group. After stabilization of sevoflurane anesthesia, ANH was achieved by drainage of arterial blood and an intravenous infusion of 6% hydroxyethyl starch, during which hematocrit (Hct) decreased to 26.2 ± 2.5% in the M group and 17.6 ± 2.2% in the S group. We determined dose-response relationships of rocuronium in the three groups and created a time course of the action of 0.6 mg/kg rocuronium. RESULTS: The 50% effective dose (ED50) for rocuronium was 45% and 50% lower in the M and S groups, respectively, than in the C group (50.9 ± 6.3 µg/kg) (P < 0.001). The onset time after 0.6 mg/kg rocuronium was faster in the ANH groups compared with the C group (P < 0.001). The duration of neuromuscular block was prolonged by 38% and 43% in the M and S groups, respectively, compared with the C group (49.1 ± 6.9 min) (P < 0.001). CONCLUSIONS: ANH resulted in high potency, rapid onset, and prolonged duration of rocuronium. However, the severity of ANH did not alter the potency and duration of action of rocuronium.
Anesthesia ; Drainage ; Hematocrit ; Hemodilution* ; Infusions, Intravenous ; Neuromuscular Blockade ; Rabbits* ; Starch

BACKGROUND: Nucleophosmin gene (NPM1) mutation may be a good molecular marker for assessing the clinical status and predicting the outcomes in AML patients. We evaluated the applicability of NPM1 type A mutation (NPM1-mutA) quantitation for this purpose. METHODS: Twenty-seven AML patients with normal karyotype but bearing the mutated NPM1 were enrolled in the study, and real-time quantitative PCR of NPM1-mutA was performed on 93 bone marrow (BM) samples (27 samples at diagnosis and 56 at follow-up). The NPM1-mutA allele burdens (represented as the NPM1-mutA/Abelson gene (ABL) ratio) at diagnosis and at follow-up were compared. RESULTS: The median NPM1-mutA/ABL ratio was 1.3287 at diagnosis and 0.092 at 28 days after chemotherapy, corresponding to a median log10 reduction of 1.7061. Significant correlations were observed between BM blast counts and NPM1-mutA quantitation results measured at diagnosis (γ=0.5885, P=0.0012) and after chemotherapy (γ=0.5106, P=0.0065). Total 16 patients achieved morphologic complete remission at 28 days after chemotherapy, and 14 (87.5%) patients showed a >3 log10 reduction of the NPM1-mutA/ABL ratio. The NPM1-mutA allele was detected in each of five patients who had relapsed, giving a median increase of 0.91-fold of the NPM1-mutA/ABL ratio at relapse over that at diagnosis. CONCLUSIONS: The NPM1-mutA quantitation results corresponded to BM assessment results with high stability at relapse, and could predict patient outcomes. Quantitation of the NPM1-mutA burden at follow-up would be useful in the management of AML patients harboring this gene mutation.
Antineoplastic Agents/therapeutic use ; Bone Marrow/metabolism/pathology ; Cytarabine/therapeutic use ; Daunorubicin ; Humans ; Karyotype ; Leukemia, Myeloid, Acute/drug therapy/genetics/*pathology ; Mutation ; Nuclear Proteins/*genetics/metabolism ; Real-Time Polymerase Chain Reaction ; Recurrence ; Remission Induction ; Retrospective Studies ; Sequence Analysis, DNA ; fms-Like Tyrosine Kinase 3/genetics

Crystalline nephropathy is a rare yet well-known condition associated with multiple myeloma and other light chain–secreting disorders. Paraproteins that are resistant to proteolysis crystallize within proximal tubular cells and cause light-chain proximal tubulopathy, which presents clinically as Fanconi syndrome. Podocytes are rarely affected, and the crystalline inclusions within podocytes are typically precipitated, yielding significant glomerular proteinuria. Here we report a case of extensive crystalline inclusions primarily within podocytes and proximal tubules that presented only with Fanconi syndrome and renal insufficiency. Despite the presence of extensive crystalline inclusions in podocytes and diffuse foot process effacement, the patient had no clinical evidence suggestive of podocyte injury.
Crystallins* ; Fanconi Syndrome ; Foot ; Humans ; Multiple Myeloma* ; Paraproteins ; Podocytes ; Proteinuria* ; Proteolysis ; Renal Insufficiency

BACKGROUND: Flow cytometric analysis is the standard method for enumerating CD34+ stem cells in hematopoietic stem cell transplantation. However, it has some limitations such as expensive instrumentation, high reagent costs, and discrepancies between technicians and laboratories. We compared counts of total nucleated cells (TNCs) and CD34+ cells counts obtained from a flow cytometer with a newly-developed image-based microscopic cell counter (ADAM II) to evaluate the possibility of clinical application of the ADAM II.METHODS: We used 18 samples of circulating peripheral blood (PB) and waste tube fractions of peripheral blood stem cells (PBSCs) harvested by apheresis after G-CSF mobilization from adult volunteer donors. We assessed the reproducibility and linearity of the new procedure and compared the numbers of TNCs and viable CD34+ cells determined with the ADAM II and two different flow cytometers (FACSCalibur, FACSCanto II).RESULTS: Numbers of viable CD34+ cells determined with the ADAM II were accurate over the expected range; the intra-assay coefficient of variation was ≤19.8%. Linearity was also satisfactory (R²=0.99). TNC counts obtained with the ADAM II were highly correlated with those obtained with the FACSCalibur (R²>0.9841, P<0.0001) and FACSCanto II (R²>0.9620, P<0.0001), as were the numbers of viable CD34+ cells obtained with the ADAM II and the FACSCalibur and FACSCanto II (R²>0.9911, P<0.0001 and R²>0.9791, P<0.0001), respectively.CONCLUSION: The newly developed image-based microscopic cell counter (ADAM II) appears to be suitable for enumerating TNCs and viable CD34+ cells.
Adult ; Blood Component Removal ; Cell Count ; Granulocyte Colony-Stimulating Factor ; Hematopoietic Stem Cell Transplantation ; Humans ; Methods ; Stem Cells ; Tissue Donors ; Volunteers

BACKGROUND/AIMS: Nasogastric administration of cola for dissolution of phytobezoar was reported but the mechanism is not well understood. We aimed to evaluate the efficacy of cola ingestion for upper gastrointestinal endoscopy in patients who have had distal gastrectomy. MATERIALS AND METHODS: Patients were enrolled from July 2007 to October 2007 and all previously received subtotal gastrectomy. We conducted a randomized case-control study which the patients were randomly assigned to two groups. Group A had preparation with cola and group B had no preparation. Cola preparation group ingested about 1,500 mL of cola between 7 PM to 10 PM in the evening before the procedure. Two examiners who were blinded to the type of preparation performed the endoscopy. We assessed the degree of food residue and bile reflux by Japanese classification. RESULTS: A total of 70 patients were included. The comparison of clinical and laboratory characteristics between the two groups showed no statistically significant difference. During endoscopy, food residue was less found in group A than B, but without statistically significance (group A=12.1%, group B=21.6%, P=0.087). However, bile reflux was significantly less found in group A than B (group A=36.4%, group B=67.6%, P=0.015). Multivariate analysis, cola preparation significantly reduced food residue (OR, 0.032; P=0.001) and bile reflux (OR, 0.102; P=0.001). CONCLUSIONS: Preparation with cola in the evening before endoscopic examination may provide a good quality of preparation in patient with remnant stomach after distal gastrectomy.
Asian Continental Ancestry Group ; Bile Reflux ; Case-Control Studies* ; Classification ; Cola* ; Eating* ; Endoscopy ; Endoscopy, Gastrointestinal ; Gastrectomy ; Gastric Stump* ; Humans ; Multivariate Analysis

PURPOSE: This study was done to explore communication between nurses during preceptorship. METHODS: A qualitative study, using content analysis was conducted. Semistructured interviews were held with 10 nurses working in urban hospitals. RESULTS: A total of 226 significant statements were selected from the data and classified into 4 categories and 23 subcategories. Communication experiences of new nurses' own performance were responses to reproach - acceptance and apology, and unresponsiveness due to feeling small and uncomfortable; responses to questions - misanswer; responses to directions - unconditional acceptance. Communication experiences of new nurses' performance by nurse preceptors were kindness, stigmatization, talking behind one's back, criticism and reproach, impolite words, and emotional expression. Communication experiences of nurse preceptors's own performance were directives, sympathy, reproach, unkindness, authoritative strictness, and nonverbal expression: being cold, and lessening of tension. Communication experiences of nurse preceptors' performance by new nurses were response to criticism - recognition and apology for mistakes, evasion of responsibility, and excuses; responses to explanations-active acceptance, and difficulty with communication due to lack of comprehension. CONCLUSION: These results provide deep understanding of nurses' communication during preceptorship and should help in developing comprehensive education programs for preceptor nurses and new nurses.
Comprehension ; Education ; Hospitals, Urban ; Preceptorship* ; Qualitative Research ; Stereotyping