Organizational Socialization and Intention to Leave in Operating Room Nurses Working at Secondary General University Hospitals / 간호행정학회지

PURPOSE: To evaluate the relationship between organizational socialization and intention to leave, and to identify factors affecting on intention to leave in operating room nurses. METHODS: This study used a descriptive design. Seventy operating room nurses recruited from three hospitals under the same management style, in-service educational system, and working conditions agreed to participate in this study, and completed self-administered questionnaires of the organizational socialization and the intention to leave questionnaire. Respondents were classified by career as advanced beginner, competent practitioner, proficient practitioner and expert practitioner by Benner's stages of nursing proficiency. Data were analyzed with t-test, ANOVA with multiple comparisons, Spearman correlation, and multiple regression analysis. RESULTS: Nurses unsatisfied with the current in-service continuous education had lower organizational socialization and higher intention to leave. In advanced beginners, job performance was lowest and organizational commitment was highest. In expert practitioners, intention to leave was highest. Organizational commitment, interpersonal relationship, identity and burnout were associated with intention to leave. Mutual trust, burnout, and interpersonal relationship were predictors of intention to leave explained 20.8% of variance. CONCLUSION: The career ladder program to enhance nurses' organizational socialization and intention to stay should be established and expanded for well-experienced operating room nurses.

Neurobiological Mechanism of Nicotine Dependence / 대한정신약물학회지

Nicotine, the primary psychoactive components of tobacco smoke, produce diverse neurophysiological and behavioral effects through several brain regions and neurochemical pathways. It acts as an agonist to activate and desensitize nicotinic acetylcholine receptors. Nicotinic signaling leads to activation of reward centers in the CNS, including the mesoaccumbens dopamine system, which ultimately leads to behavioral reinforcement and addiction. Indeed, the actions of nicotine on many systems, including brainstem cholinergic, GABAergic, glutaminergic, noradrenergic, and serotonergic systems, may help to mediate nicotine effects related to addiction. And many years of smoking induces neuroadaptations in acetylcholine and dopamine systems. Moreover, the long-term synaptic changes results in learned behaviors and memory which are associated with smoking. We reviewed the nicotinic synaptic mechanisms in midbrain dopaminergic areas. In summary, nicotine as obtained from tobacco interacts with multiple nicotinic acetylcholine receptor subtypes on dopamine, GABA, glutaminergic neuron to produce not only the acute positive reinforcement but also the synaptic changes associated with learning and memory.

Understanding Stress by Neuroscience

Stress can be defined generally as reponses to stressors on the body or in a definition more focused on the central nervous system, it can be defined as alterations in neuro-psychological homeostatic processes. There is a psychological aspect to stress, related to issues such as memory, emotion, arousal, and also a biological aspect which included activation of specific brain and endocrine circuits. This article reviews a series of neurobiological mechanisms aimed at understanding what are pathways by which stress is perceived, processed, and transduced into a neuroendocrine response. Multiple brain structures are involved in the organization of responses to stressful stimuli. Among them the hypothalamus, septohippocampal structures, amygdala, cingulate and prefrontal cortices, hindbrain regions such as the brainstem catecholamine cell body group (A2/C2 cell groups in the nucleus of the tractus solitaris; A1/C1 cell groups in the ventrolateral medulla; A6 cell groups in the locus ceruleus), the parabrachial nucleus, cuneiform nucleus, and dorsal raphe nucleus are prominent structures. We reviewed with the focus on the classic stress circuits: the limbic- hypothalamic-pituitary- adrenal axis (LHPA) and locus ceruleus-norepinephrine (LC-NE) system. Our review indicates that the LHPA stress circuit and LC- NE system are the complex systems with multiple control mechanisms and that these mechanisms are altered in pathological states, such as chronic stress and depression. The holistic features described in this reviews can provide insight into the nature and location of brain circuits and neurotransmitter receptors involved in stress and the treatment of stress-related disorders.

The Female Sexual Dysfunction in Overactive Bladder Patients / 대한비뇨기과학회지

Purpose: Female sexual dysfunction is defined as a disorder of sexual desire, arousal, or orgasm, and/or sexual pain, resulting in personal distress that impacts on the quality of life and interpersonal relationships. It is a compilation of problems that has both biological and psychosocial components and is multifactorial in its etiology. In this study, the female sexual dysfunction in overactive bladder (OAB) patients was evaluated. Materials and Methods: The subjects included 63 female who visited our health care center for health medical examinations without voiding symptoms (control group) and 37 female patients with OAB. All patients were asked to complete the Brief index of sexual functioning for women (BISF-W), which had been translated into Korean. The Beck depression inventory (BDI) and State-Trait anxiety inventory (STAI) were also used to assess the relationship between the sexual dysfunction and anxiety or depression. The results were analyzed statistically by ANCOVA using age as a covariant. Results: The mean ages in the OAB and control groups were 35.47+/-6.76 and 42.70+/-9.68 years, respectively. The mean scores of desire in the OAB and control groups were 3.92+/-3.09 and 8.92+/-4.99, for arousal were 6.78+/-3.85 and 11.06+/-5.60, frequency of sexual activity 3.92+/-5.24 and 8.53+/-4.52, receptivity/initiation 10.08+/-3.71 and 11.47+/-4.91, orgasm 13.19+/-6.97 and 19.72+/-7.36, relationship satisfaction 7.12+/-1.68 and 7.11+/-1.88 and physical problems affecting sexual function 12.14+/-6.17, 11.83+/-5.05, respectively. The OAB group shows decreased sexual desire, arousal, frequency of sexual activity and orgasm compared to the control group (p<0.05). However, there were no differences in anxiety or depression between the two groups and there was no sexual dysfunction due to anxiety or depression in either group. Conclusions: Female sexual dysfunction was more common in OAB patients than the controls. OAB is one of the important factor affecting female sexual dysfunction. Consideration should be given with regard to female sexual dysfunction in patients with OAB.

Severe Postoperative Delirium Lasting for Three Weeks: A Case Report / 대한구급학회지

Postoperative delirium in the intensive care unit is a serious problem that has recently attracted much attention. We present a 73-year-old female patient who was admitted by multiple fractures induced by an accident. We started general anesthesia for the operation of open reduction and internal fixation. After the discontinuation of general anesthesia, the patient was transported to the intensive care unit. The symptoms of delirium were developed and controlled with medications including haloperidols, benzodiazepines, and vitamins. The patient was recovered three weeks after the management and received two other operations, but delirium did not be developed again. She was discharged from the hospital without complications.

The Changes of Cytokine Production during the Hangover State Induced by Experimental Alcohol Consumption / 신경정신의학

OBJECT: A hangover is characterized by the constellation of unpleasant physical and mental symptoms that occur 8-16hr after alcohol drinking. We evaluated the effects of experimentally induced alcohol hangover on immune functions by the measurement of cytokine production. METHODS: A total of 13 normal adults males participated in this study. They did not have any previous histories of psychiatric or medical disorder. We defined the experimentally induced hangover condition by 13 hours after drinking high doses of alcohol(1.5g/kg of body weight). Venous blood was taken before the alcohol drinking & during the experimental hangover conditions. Monocyte was separated and stimulated with phytohemagglutinin. Cytokine production was measured by ELISA for IL-1beta, IL-2, IL-4, IL-6, IL-10, IL-12, INF-gamma, TNF-alpha. RESULTS: The production of cytokines IL-10, IL-12 and INF-gamma were increased during hangover conditions. CONCLUSIONS: There is an changes in the production of cytokines IL-10, IL-12 and INF-gamma during hangover conditions. Thus, our results supported the hypothesis that acute alcohol treatment might affect Th1/Th2 immune balance by altering monocyte production of IL-12 and IL-10. These results suggested that elevated monocyte-derived IL-10 can contribute to the cellular immune abnormalities during hangover conditions.

Human Cerebellar Activation during Painful Cold Stimulation:a Functional Magnetic Resonance Imaging Study / 신경정신의학

OBJECTIVES: We report a functional magnetic resonance imaging(fMRI) method for mapping human cerebellar activity during painful cold-stimulation. METHODS: Six healthy volunteers experienced painful thermal stimulation induced by holding an ice bag(0-3C) in their left hand while lying still in 1.5 Tesla MR scanner. In order to capture the hemodynamic BOLD(blood oxygenation level dependent) response associated with the stimuli, a series of susceptibility-weighted MR images were acquired, and a statistical parametric map was generated to visualize and quantify the eloquent areas of brain activation. RESULTS: In addition to cerebral areas including anterior/posterior cingulate gyri, prefrontal cortex, and insula, our results suggested that several cerebellar areas such as quadrangular lobule, bilateral gracile and semilunar lobules were involved in the experience of pain during cold stimulation. CONCLUSIONS: Human cerebellum, in addition to the cerebrum, is involved in the cognition and processing painful sensory stimulation.

Comparison of Risperidone and Olanzapine Use in the Treatment of Inpatients with Schizophrenia / 대한정신약물학회지

OBJECTIVE: This retrospective study was designed to compare the drug usage patterns and clinical outcomes of patients who received either risperidone or olanzapine in a naturalistic setting at a university hospital. METHODS: Inpatients with schizophrenia given either risperidone or olanzapine, as a single oral antipsychotic drug during hospitalization were retrospectively investigated. Data on patients' age, sex, efficacy, duration of hospitalization, dosage, use of antiparkisonian drugs, cost of drugs, weight changes, and hepatotoxicity were collected. RESULTS: Sixty patients, 30 patients for each group, were evaluated. No significant differences were observed between groups for age, sex, the duration of hospitalization, the degree to the improvement of Global Assessment of Functioning and weight gain. The mean daily antiparkinsonian medication use expressed in benztropine equivalents was significantly lower (p<0.001) in the olanzapine group (0.8 mg+/-0.9) than in the risperidone group (2.2 mg+/-0.8). For risperidone, the mean daily dose and associated cost at discharge were 5.6 (+/-1.1)mg and 765.6 (+/-144.9) won per day, whereas those for olanzapine were 15.8 (+/-4.0)mg and 1884.2 (+/-470.9) won per day (p<0.001). A mild increase of liver enzymes was found in both groups. CONCLUSION: It appears from this study that both risperidone and olanzapine are relatively safe and effective in inpatients with schizophrenia. While olanzapine group shows a superior profile in the neurological side effects, risperidone group exhibits better profile in the daily cost of drug. Further controlled studies are recommended to confirm these findings.