A Study on Choice Motives and Job Satisfaction about Nurses who Changed Jobs to Public Hospitals / 한국직업건강간호학회지

PURPOSE: This study was performed for the effective management of nursing organization as surveyed choice motives and job satisfaction about nurses who changed to public hospitals. METHODS: This study is a descriptive study. This study surveyed 214 nurses who changed jobs to public hospital in six Gyeonggi-do hospitals from October 23 to November 20, 2015. The collected data were analyzed for descriptive statistics, t-test, one-way ANOVA, sheffe test, multiple linear regression analysis using the SPSS/WIN 21.0 program. RESULTS: Most of the nurses chose public hospitals due to benefits correspond to public officials. They had worked in general hospitals located on provinces and changed jobs due to a heavy workload and low benefits. Of the participants 84.1% were satisfied with changing jobs to public hospitals and the advantages of public hospitals of their choice were job stability and good employee benefits(guaranteed maternity and paternity leave, etc). On the other hand there were complaints about low salaries compared to the workload after changing jobs to public hospitals. CONCLUSION: Hospitals need to enhance job stability and provide nurses with good employee benefits to reduce turnover rate.

The Effect of Violent Experience on Burnout among Some Dental Hygienists / 치위생과학회지

This study investigated the effect of violent experience on burnout among some dental hygienists. The study subjects were 242 dental hygienists working at dental clinics. Data were collected by self-administered questionnaire including information such as demographics, work-related characteristics, working environment, experience of violence, and burnout. The violence was classified as verbal violence, physical threat, or physical violence committed by dentists, patients, or caregivers. Descriptive analysis, t-test, ANOVA, correlation, and multiple linear regression analysis were performed to examine the factors associated with burnout. The levels of verbal violence, physical threat, and physical violence by dentists were 0.53±1.26, 1.12±2.70, and 0.04±0.42, respectively. The levels of verbal violence, physical threat, and physical violence by patients and caregivers were 1.50±1.89, 1.41±2.24, and 0.24±1.38, respectively. The score of burnout was 3.13±0.43. Total violence, verbal violence, and physical violence by dentists were positively correlated with burnout. Total violence, verbal violence, and physical threat by patients and caregivers were positively correlated with burnout. In multiple linear regression analysis, the level of physical violence by dentists was positively associated with burnout of dental hygienists (β=0.95, p=0.032). The levels of total physical violence (β=0.28, p=0.002), verbal violence (β=0.15, p<0.001), and physical threat (β=0.19, p=0.009) by the patients or caregivers were positively associated with burnout of dental hygienists. This study examined the association between violence and burnout among dental hygienists. The level of violence showed positive correlation with burnout. Environment improvement to protect employees from violence and for management of employees who experienced workplace violence are needed to reduce the burnout.

Overexpression of C-reactive Protein as a Poor Prognostic Marker of Resectable Hepatocellular Carcinomas

BACKGROUND: C-reactive protein (CRP) is an acute phase reactant synthesized in the liver. CRP immunoreactivity is a feature of inflammatory hepatocellular adenomas with a higher risk of malignant transformation. A high serum CRP level denotes poor prognosis in hepatocellular carcinoma (HCC) patients. This study was conducted to determine whether CRP is produced in HCC and to assess the clinicopathologic significance of CRP expression in cancer cells. METHODS: CRP immunoreactivity was examined in treatment-naive HCCs (n=224) using tissue microarrays and was correlated with clinicopathologic parameters. The expression of CRP mRNA and protein was also assessed in 12 HCC cases by quantitative real-time polymerase chain reaction and immunoblotting. Hep3B and SNU-449 HCC cell lines were used for the analysis of CRP mRNA regulation by interleukin 6 (IL-6). RESULTS: CRP was expressed in 133 of 224 HCCs (59.4%) with a variable degree of immunoreactivity (grade 1 in 25.9%; grade 2 in 20.1%; grade 3 in 13.4%). There was an inverse relationship between grade 3 CRP immunoreactivity and cancer-specific survival (p=.0047), while no associations were found with other parameters, including recurrence-free survival. The CRP mRNA expression level was significantly higher in CRP immunopositive cases than in immunonegative cases (p<.05). CRP mRNA expression was increased in Hep3B cells, but was not detected in SNU-449 cells even after IL-6 treatment. CONCLUSIONS: We report the expression of CRP in HCC for the first time. CRP expression was associated with poor cancer-specific survival in patients with resectable HCC.

Gastroprotective Effects of Grape Seed Proanthocyanidin Extracts against Nonsteroid Anti-Inflammatory Drug-Induced Gastric Injury in Rats

BACKGROUND/AIMS: To investigate the gastroprotective effects of grape seed proanthocyanidin extracts (GSPEs) against nonsteroid anti-inflammatory drug (NSAID)-induced gastric mucosal injury in rats. METHODS: Sprague-Dawley rats were randomly allocated to the normal control, indomethacin, low-dose GSPE, high-dose GSPE and misoprostol groups. All groups except the normal control group received pretreatment drugs for 6 consecutive days. On the 5th and 6th day, indomethacin was administered orally to all groups except for normal control group. The microscopic features of injury were analyzed. The levels of gastric mucosal glutathione, gastric mucosal prostaglandin E2 (PGE2), and proinflammatory cytokines were investigated. RESULTS: The total areas of ulceration in the GSPE and misoprostol groups were significantly decreased compared with the indomethacin group (p<0.05). However, a difference in ulcer formation among the drug treatment groups was not observed. Meanwhile, the glutathione levels in the high-dose GSPE group were higher than those of both the indomethacin and misoprostol groups (p<0.05) and were similar to those of the normal control group. Additionally, there was no difference among the groups in the levels of gastric mucosal PGE2 and proinflammatory cytokines. CONCLUSIONS: High-dose GSPE has a strong protective effect against NSAID-induced gastric mucosal injury, which may be associated with the antioxidant effects of GSPE.

Levels of Severity in Dry Eye Syndrome According to Delphi Panel Classification

PURPOSE: To investigate levels of severity in dry eye syndrome according to Delphi panel classification. METHODS: Three hundred and twenty-two eyes of 166 patients with dry eye syndrome that did not have coexisting lid margin disease or altered tear distribution and clearance were categorized into 1 of 4 levels of severity, according to the symptoms and signs in the Delphi panel classification. A symptom score was proposed depending on the frequency and impact on the quality of life. Degree of corneal staining using Lissamin green was categorized using the Oxford Scheme. In addition, measurement of the tear film break-up time (BUT) and Schirmer test were performed. RESULTS: According to the levels of severity in the Delphi panel classification, 120 eyes (37.26%) were categorized as level1, 166 eyes (51.55%) as level 2, 30 eyes (9.31%) as level 3, and 6 eyes (1.86%) as level 4. Negative correlations were observed between the levels of severity, BUT, and measurements of the Schirmer test (p<0.001). CONCLUSIONS: Of the 166 eyes with dry eye syndrome that did not have coexisting lid margin disease and altered tear distribution and clearance, 51.55% of eyes were classified as level 2, and 88.81% of eyes were classified as level 1 and level 2.

The Effect of Systemic Steroid Therapy on Dry Eye in Hematopoietic Stem Cell Transplantated Patients

PURPOSE: To evaluate the effects of systemic steroid therapy on the development of dry eye syndrome (DES) in graft-versus-host disease (GVHD) resulting from hematopoietic stem cell transplantation (HSCT) in hematologic malignancy (HM) patients. METHODS: We analyzed 108 HSCT patients. We measured tear film break up time (BUT) and basal tear secretion, and checked for corneal lesions. BUT under 10 seconds and basal tear secretion under 10 mm gave a diagnosis of DES. Significant corneal lesions were also described in this gorup. We compared the clinical aspect and frequency of dry eye according to GVHD and also compared clinical aspects of dry eye in GVHD patients before and after systemic steroid therapy. RESULTS: Fifty-six patients (51.9%) developed GVHD, including 51 patients (91.1%) in the GVHD group and 31 patients (59.6%) in the non-GVHD group. The frequency of DES was statistically significant in the GVHD group (p0.05). CONCLUSIONS: The severity and frequency of DES were high in the GVHD group. At the same time, systemic steroid therapy could relieve DES in GVHD patients. Therefore, proper medical treatment and ocular examinations should be performed for HSCT patients.

Clinical Effect of Cyclosporine 0.05% Eye Drops in Dry Eye Syndrome Patients

PURPOSE: We conducted a study to evaluate the change of tear secretion and symptoms in the patients with dry eye syndrome after using Restasis(R) (Cyclosporine 0.05% ophthalmic emulsion, Allergan Inc., U.S.A.). METHODS: We randomly selected 39 patients from newly or previously diagnosed dry eye syndrome patients and administered Restasis(R) to them. We checked their clinical parameters and symptoms over a period of 3 months. The clinical parameters evaluated were type I and type II Schirmer tests and tear break-up time, and the symptoms of dry eye syndrome were classified into pain, itching, foreign body sensation, blurred vision, and photophobia using a scoring scale for symptoms of 0 to 5. The results were analyzed with a Mann-Whitney test (P-values <0.05 was considered statistically significant). RESULTS: For 26 of 39 patients (52 eyes) on whom all tests were carried out for 3 months, there was a significant improvement after 3 months in the type I Schirmer test, type II Schirmer test, and tear break-up time (P=0.012, 0.009, 0.001, respectively). Only 14 patients completed the questionnaire for scoring of symptoms. After using Restasis(R), foreign body sensation only improved (P=0.010). CONCLUSIONS: In our study, tear secretion was increased by Restasis(R), and a greater increase in tear secretion was seen in patients with systemic disease than in patients without systemic disease. Additional patients need to be evaluated and longer-term studies need to be performed to confirm our results.

Single Blinded, Randomized, Active Drug Comparative, Multi-center Study to Evaluate the Therapeutic Efficacy of Gliptide(R)Tab (Sulglycotide 200 mg) in Gastritis Patients; Phase IV Study / 대한소화기내시경학회지

BACKGROUND/AIMS: Sulglycotide is a sulphoglycopeptide with antiulcer and cytoprotective activity that is derived from the porcine duodenal mucosa. This study carried out a 3-week single blinded, randomized, multicenter, noninferiority trial to compare the efficacy of oral sulglycotide in treating symptomatic erosive gastritis with that of rebamipide. METHODS: Seventy-three patients with symptomatic erosive gastritis were randomized to receive 3 weeks of treatment with either sulglycotide or rebamipide. The primary efficacy parameter was the endoscopic cure rate and the endoscopic improvement rate, and the secondary parameter was the improvement rate in the dyspepsia symptom scores. RESULTS: Of the 73 patients recruited, 36 received sulglycotide and 37 received rebamipide. The endoscopic cure rate in the sulgycotide and rebamipide group was 29.6% and 25.0% according to per protocol (PP) analysis, respectively (p=0.69). The endoscopic improvement rate in the sulglycotide and rebamipide group was 63.0% and 62.5% according to PP analysis, respectively (p=0.97). The symptomatic improvement rate in the sulgycotide and rebamipide group was 51.9% and 53.1% according to PP analysis, respectively (p=0.74). The result of 90% CIs for the difference in endoscopic cure rate, endoscopic improvement rate and symptom improvement rate between the two groups met the criteria for the non-inferiority of sulglycotide to rebamipide. CONCLUSIONS: Sulglycotide was not inferior to rebamipide in both erosion healing and symptom relief in patients with acute and chronic gastritis.

A Case of Zoster Ophthalmicus in a Child

PURPOSE: We report a case of herpes zoster ophthalmicus in a 7-year-old child. METHODS: A 7-year-old boy presented with acute onset of vesiculopapular rash covering his left forehead, upper eyelid, and side of the nose. He was admitted via the pediatrics clinic and was referred to ophthalmology clinic for ophthalmologic examinations. RESULTS: On admission zoster ophthalmicus was limited to his skin and conjunctiva, but the disease progressed to zoster keratitis, uveitis, and meningitis. The patient was treated with topical, oral, and intravenous acyclovir. He had an uneventful recovery and was discharged. CONCLUSIONS: We experienced a case of zoster ophthamicus and meningitis in a patient without an apparent history of chickenpox.

Classification of Microsatellite Alterations Detected in Endoscopic Biopsy Specimens of Gastric Cancers

PURPOSE: Individual gastric cancers demonstrate complicated genetic alterations. The PCR-based analysis of polymorphic microsatellite sequences on cancer-related chromosomes has been used to detect chromosomal loss and microsatellite instability. For the purpose of preoperative usage, we analyzed the correspondance rate of the microsatellite genotype between endoscopic biopsy and surgical specimens. MATERIALS AND METHODS: Seventy-three pairs of biopsy and surgical specimens were examined for loss of heterozygosity and microsatellite instability by using 40 microsatellite markers on eight chromosomes. Microsatellite alterations in tumor DNAs were classified into a high-risk group (baseline- level loss of heterozygosity: 1 chromosomal loss in diffuse type and high-level loss of heterozygosity: 4 or more chromosomal losses) and a low-risk group (microsatellite instability and low-level loss of heterozygosity: 2 or 3 chromosomal losses in diffuse type or 1~3 chromosomal losses in intestinal type) based on the extent of chromosomal loss and microsatellite instability. RESULTS: The chromosomal losses of the biopsy and the surgical specimens were found to be different in 21 of the 73 cases, 19 cases of which were categorized into a genotype group of similar extent. In 100 surgical specimens, the high-risk genotype group showed a high incidence of nodal involvement (19 of 23 cases: 5 cm) irrespective of tumor size while the incidence of nodal involvement for the low-risk genotype group depended on tumor size (5 of 26 cases: 5 cm). Extraserosal invasion was more frequent in large-sized tumor in both the high-risk genotype group (5 cm: 23 of 24 cases) and the low-risk genotype group (5 cm: 16 of 27 cases). The preoperative prediction of tumor invasion and nodal involvement based on tumor size and genotype corresponded closely to the pathologic tumor stage (ROC area>0.7). CONCLUSION: An endoscopic biopsy specimen of gastric cancer can be used to make a preoperative genetic diagnosis that accurately reflect the genotype of the corresponding surgical specimen.

Comparison of Decentration and Tilt of Aquasense(R) with Acrysof(R)

PROPOSE: To compare the decentration and tilt between Aquasense(R) and Acrysof(R). METHODS: The subjects of this study were 48 patients (56 eyes) with Aquasense(R) and 44 patients (49 eyes) with Acrysof(R). Each posterior chamber intraocular lens (PCL) was inserted into the capsular bag after continuous curvilinear capsulorhexis and phacoemulsification. The decentration and tilt of Aquasense(R) and Acrysof(R) were measured 1 day, 30 days and 60 days postoperatively using anterior eye segment analysis system (EAS-1000, Nidek, Japan). RESULTS: The decentration showed no difference between Aquasense(R) and Acrysof(R) on 1st (P=0.19), 30th (P=0.07) and 60th (P=0.06) postoperative day. The tilt showed no difference between Aquasense(R) and Acrysof(R) on 1st (P=0.4), 30th (P=0.47) and 60th (P=0.22) postoperative day. CONCLUSIONS: The decentration and tilt of the two intraocular lenses showed no difference on the 60th postoperative day.

Effect of Corneal Epithelial Flap on the corneal wound healing of canine eyes

PURPOSE: LASEK is a newly developed refractive surgery technique that can make up for the complications from PRK and LASIK. The most unique procedures in LASEK is covering of the cornea with epithelial flap after keratectomy. We examined the effect of corneal epithelial flap on the wound healing of canine cornea. METHODS: Operation was performed in eyes from 12 dogs, and the 12 eyes were recovered with epithelial flap and the remaining 12 eyes were recovered without epithelial flap. Wound healing process was compared using fluorescein staining, light and transmission electron microscopic examination. RESULTS: Fluorescein stained area of the cornea was reduced with time in both groups, and from 9 hours after the operation, it was significantly reduced in the group with epithelial flap compared with those of the group without epithelial flap (p< 0.05). On light microscopic examination of the group with epithelial flap, and normal epithelial structure was found at 24 and 48 hours, respectively. However, in the group without epithelial flap, no complete reepithelialization had occurred on center at 48 hours after the operation. On transmission electron microscopic examination, eyes of the group with epithelial flap showed hemidesmosomes in the area where epithelial flap was closely contacted with the stroma at 24 hours, and they were completely developed at 48 hours. On the other hand, in the group without epithelial flap, hemidesmosomes developed only in the proximal portion but not at the leading edge even at 48 hours. CONCLUSIONS: These results suggest that corneal epithelial flap accelerate the wound healing process of the cornea and the wound healing process depend on the vitality of the epithelial flap.

Clinical Results of Primary Posterior Chamber Intraocular Lens Insertion in the Setting of Penetrating Ocular Trauma: whether PCL insertion or not

PURPOSE: To evaluate the clinical outcome of patients who underwent a lensectomy and IOL implantation at the time of the primary repair due to a penetrating ocular injury. METHODS: We analyzed the records of 25 eyes of 25 perforating injury patients[Group A (13 eyes)-who had undergone simultaneous corneal laceration repair, cataract extraction and IOL implantation, and Group B (12 eyes)-who had undergone corneal laceration repair, cataract extraction and had their refractive error corrected by contact lens or glasses later]. retrospectively from March, 1991 to June,1999. We examined the relationship between their final visual acuity and the influencing factors such as cause of injury, length and feature of the lacerated cornea, initial visual acuity and postoperative complications, etc. RESULTS: The average age of patients was 36.8 and 25.7 years in group A and B, respectively. The major cause of injury was a metallic foreign body. In group A, the wound is relatively short and has a linear shape. In group B, it is a nearly curved line. An anterior vitrectomy was done in 6 patients in both groups, respectively. Nine patients (69%) achieved a final visual acuity of 10/20 or better in group A and only four patients (33%) in group B. The postoperative complications were transient elevation of IOP (1 eye) and corneal ulcer (1 eye) in group A, and vitreous opacity (1 eye) and retinal detachment (1 eye) in group B. CONCLUSIONS: It is recommended for visual rehabilitation and attainment of binocular visual function to implant the IOL at the time of primary repair caused by a penetrating ocular injury.

Clinical Results in 1000 Cases of Acrysof Intraocular Lens Implantations

To evaluate the clinical results of implantation of Acrysof foldable intraocular lens[IOL], we retrospectively analyzed 814 patients who had been implanted with Acrysof IOLs in their eyes and followed-up over 6months postoperatively. Postoperative conditions such as best corrected visual acuity[BCVA], postoperative complications and capsular fibrosis were evaluated. Postoperative BCVA, with measurement above 0.7 was 83%and above 0.5 was 92%.If there was no ocular pathology, BCVA with measurement above 0.7 was 96.5%.Postoperative complications included 9.8%[80 cases]of posterior capsular opacity, 3.2%[28 cases]of microvacuole, and also anterior capsule contracture, haptic damage.7 cases of posterior capsular opacity[totally 80 cases]required Nd;Yag laser posterior capsulotomy.Capsular fibrosis[61.8%]was divided to 4 grades.Most of them were grade I or IIand above grade was 9.8%. In conclusion, the Acrysof IOL implantation showed good visual outcome and few postoperative complications, especially in PCO, it had excellent results.So, it will show excellent longterm visual prognosis including visual quality.

A Case of Orbital Infarction Syndrome in Rhino-Orbitocerebral Mucormycosis

Orbital infarction syndrome is defined as ischemia of all intraorbital and intraocular structures and is a rare disorder due to rich anastomotic vascularization of the orbit. It results in orbital and ocular pain, total ophthalmoplegia, anterior and posterior segment ischemia, and acute bindness. It can occur secondary to different mechanisms such as acute perfusion failure, systemic vasculitis, orbital cellulitis and vasculitis. We experienced a case of orbital infarction syndrome in a 61-year-old nonketotic diabetic woman who had developed paranasal sinusitis by mucormycosis and presented orbital cellulitis, multiple nerve paralysis, chorioretinal ischemia, facial necrosis around orbit and acute blindness. Prompt recognition of clinical pictures and rapid diagnosis is essential for early treatment of orbital infarction due to rhino-orbitocerebral mucormycosis because its progression is very rapid and fatal.

A Case of Orbital Infarction Syndrome in Rhino-Orbitocerebral Mucormycosis

Orbital infarction syndrome is defined as ischemia of all intraorbital and intraocular structures and is a rare disorder due to rich anastomotic vascularization of the orbit. It results in orbital and ocular pain, total ophthalmoplegia, anterior and posterior segment ischemia, and acute bindness. It can occur secondary to different mechanisms such as acute perfusion failure, systemic vasculitis, orbital cellulitis and vasculitis. We experienced a case of orbital infarction syndrome in a 61-year-old nonketotic diabetic woman who had developed paranasal sinusitis by mucormycosis and presented orbital cellulitis, multiple nerve paralysis, chorioretinal ischemia, facial necrosis around orbit and acute blindness. Prompt recognition of clinical pictures and rapid diagnosis is essential for early treatment of orbital infarction due to rhino-orbitocerebral mucormycosis because its progression is very rapid and fatal.

A Clinical Cmparison Silicone and Acrysof IOLs

To evaluate and compare the clinical results of implantation of the Silicone and Acrysof IOLs in early postoperative period(to 3 months), we retrospectively analyzed 30 patients who had taken clear cornea incision and been implanted with Silicone IOL in one eye and Acrysof IOL in the other eye. There were no statistically significant difference in postoperative corrected visual acuity, corneal edema and postoperative astigmatic changes between silicone and acrysof IOLs. But, the rates of postoperative capsular fibrosis and contracture of Silicone IOL was higher than those of Acrysof IOL. In conclusion, in the degree and rate of after-cataract, Acrysof IOLs are more useful than silicone IOLs; therefore, more excellent in longterm visual prognosis. Further studies will be needed for the evaluation of clinical safety and efficacy.