Scale Development of Job Stress for Home Care Nurses / 간호학회지

The purpose of this study was to develop a job stress scale for hospital-based home care nurses in Korea. The process was construction of the conceptual framework, development of the preliminary items, verification of the content validity, item analysis and test of the reliability. The preliminary items were based on literature review and in-depth interviews with home care nurses. As a result, eight categories and sixty items were selected. These were reviewed by seven specialists for content validity and finally fifty one items were chosen. Data was collected from 180 home care nurses who were engaged in 87 hospitals from August to September 2003. The result of item analysis one was excepted. The final item count was 50. Categories were as follows: overload work(8 items), lack of specialized knowledge and technique(5 items), ethical dilemma(4 items), role conflict(5 items), interpersonal relationships(6 items), visiting home environment(9 items), driving conditions(4 items) and lack of administrative support(9 items), The reliability of the scale by Cronbach's alpha was .948 and the domain's reliability ranged from .649 to .841. The result of this study could be used to measure the job stress of home care nurses. However, for further validity and reliability, repeated studies will be necessary.

In vitro Model for Ischemia-Reperfusion Injury of Cultured Kupffer Cells / 대한해부학회지

The aims of this study were to describe a reproducible method for the isolation, purification and primary culture of rat Kupffer cells, and were to develop in vitro system which could provide a tool for the study of ischemia-reperfusion injury. Kupffer cells were isolated following sequential collagenase digestion of the liver by perfusion and enrichment of a nonparenchymal cell fraction by a double-densities gradient centrifugation step using Percoll and were selected by allowing them to adhere to culture vessel for 2 h at 37 degrees C under 5% CO2. The purity of obtained Kupffer cell was about 90% assessed by the phagocytosis of 3 micrometer latex beads. This method for Kupffer cell isolation resulted in yields of 1~5 x10(7) Kupffer cells per liver and Kupffer cells were preserved in maintenance cultures for 10 days. The phagocytic capacity of cultured Kupffer cells was measured according to the amount of latex beads incorporated into the cytoplasm. Larger round Kupffer cells in the culture had higher phagocytic capacity compared with smaller round or irregular shaped Kupffer cells. The different phagocytic capacity of Kupffer cells which was dependent on size and shape in vivo was well preserved during culture. The experimental group of Kupffer cells in culture were sequentially treated with ischemia and reperfusion at 1h and 30 min. The ratio of Kupffer cells having latex beads in their cytoplasm was significantly increased compared with control (p<0.01). This result was able to explain the Kupffer cells' activation after ischemia-reperfusion injury in vivo. In conclusion, Kupffer cells in this culture well resembled the cells in vivo and this in vitro model could provide a valuable tool for the study of Kupffer cells with a key role in pathophysiology of ischemia-reperfusion injury.

Comparison of Predictive Indices of Severity Scorings, Metabolism, and Thyroid Hormones in Systemic Inflammatory Reaction Syndrome / 대한마취과학회지

BACKGROUND: Systemic inflammatory reaction syndrome (SIRS) describes the systemic inflammatory process and can be seen following a wide variety of insults. This is the leading cause of morbidity and mortality for patients admitted to the ICU. The arterial keton body ratio (AKBR), serum lactate level and the thyroid hormones, thyroid stimulation hormone (TSH), thyroxine (T4), free thyroxine (FT4) and triiodothyronine (T3) deteriorate in critically ill patients with a poor prognosis. The APACHE (Acute Physiology, and Chronic Health Evaluation) III and multiple organ failure (MOF) score have been known as good prognostic predictors in the ICU. The object of this study was to compare the AKBR, lactate and thyroid hormone levels, and the APACHE III and MOF score between the survivors (SV) and nonsurvivors (NSV) and the correlation among the above predictors. METHODS: 35 patients with no known thyroid or liver disease who were admitted to the SICU with the criteria of SIRS were selected. Arterial blood was drawn for the AKBR, and the lactate and thyroid hormones studies. The APACHE III and MOF scorings were done in the first 24 hours of SICU admission. RESULTS: There were no significant difference between SV and NSV except APACHE III (SV: 68.7 24.6, NSV; 92.9 27.6). There were significant correlations between the APACHE III and MOF score (R = 0.688, P<0.01), APACHE III and lactate (R = 0.575, P<0.01), and MOF score and lactate (R =0.483, P<0.01). Thyroid hormones had positive correlations among themselves only. CONCLUSIONS: We conclude that APACHE III is the only good predictor of mortality. The APACHE III, MOF score, and lactate level show good correlations indicating the severity in condition of the ICU patients.