• The Korean Nurse
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• v.36 no.1
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• pp.77-96
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• 1997

The duty shifts of hospital nurses not only affect nurses' physical and mental health but also present various personnel management problems which often result in high turnover rates. In this context a study was carried out from October to November 1995 for a period of two months to find out the status of hospital nurses' duty shift patterns, and preferred duty hours and fixed duty shifts. The study population was 867 RNs working in five general hospitals located in Seoul and its vicinity. The questionnaire developed by the writer was used for data collection. The response rate was 85.9 percent or 745 returns. The SAS program was used for data analysis with the computation of frequencies, percentages and Chi square test. The findings of the study are as follows: 1. General characteristics of the study population: 56 percent of respondents was (25 years group and 76.5 percent were "single": the predominant proportion of respondents was junior nursing college graduates(92.2%) and have less than 5 years nursing experience in hospitals(65.5%). For their future working plan in nursing profession, nearly 50% responded as uncertain The reasons given for their career plan was predominantly 'personal growth and development' rather than financial reasons. 2. The interval for rotations of duty stations was found to be mostly irregular(56.4%) while others reported as weekly(16.1%), monthly(12.9%), and fixed terms(4.6%). 3. The main problems related to duty shifts particularly the evening and night duty nurses reported were "not enough time for the family, " "afraid of security problems after the work when returning home late at night." and "lack of leisure time". "problems in physical and physiological adjustment." "problems in family life." "lack of time for interactions with fellow nurses" etc. 4. The forty percent of respondents reported to have '1-2 times' of duty shift rotations while all others reported that '0 time'. '2-3 times'. 'more than 3 times' etc. which suggest the irregularity in duty shift rotations. 5. The majority(62.8%) of study population found to favor the rotating system of duty stations. The reasons for favoring the rotation system were: the opportunity for "learning new things and personal development." "better human relations are possible. "better understanding in various duty stations." "changes in monotonous routine job" etc. The proportion of those disfavor the rotating 'system was 34.7 percent. giving the reasons of"it impedes development of specialization." "poor job performances." "stress factors" etc. Furthermore. respondents made the following comments in relation to the rotation of duty stations: the nurses should be given the opportunity to participate in the. decision making process: personal interest and aptitudes should be considered: regular intervals for the rotations or it should be planned in advance. etc. 6. For the future career plan. the older. married group with longer nursing experiences appeared to think the nursing as their lifetime career more likely than the younger. single group with shorter nursing experiences ($x^2=61.19.{\;}p=.000;{\;}x^2=41.55.{\;}p=.000$). The reason given for their future career plan regardless of length of future service, was predominantly "personal growth and development" rather than financial reasons. For further analysis, the group those with the shorter career plan appeared to claim "financial reasons" for their future career more readily than the group who consider the nursing job as their lifetime career$(x^2$= 11.73, p=.003) did. This finding suggests the need for careful .considerations in personnel management of nursing administration particularly when dealing with the nurses' career development. The majority of respondents preferred the fixed day shift. However, further analysis of those preferred evening shift by age and civil status, "< 25 years group"(15.1%) and "single group"(13.2) were more likely to favor the fixed evening shift than > 25 years(6.4%) and married(4.8%)groups. This differences were statistically significant ($x^2=14.54, {\;}p=.000;{\;}x^2=8.75, {\;}p=.003$). 7. A great majority of respondents(86.9% or n=647) found to prefer the day shifts. When the four different types of duty shifts(Types A. B. C, D) were presented, 55.0 percent of total respondents preferred the A type or the existing one followed by D type(22.7%). B type(12.4%) and C type(8.2%). 8. When the condition of monetary incentives for the evening(20% of salary) and night shifts(40% of. salary) of the existing duty type was presented. again the day shift appeared to be the most preferred one although the rate was slightly lower(66.4% against 86.9%). In the case of evening shift, with the same incentive, the preference rates for evening and night shifts increased from 11.0 to 22.4 percent and from 0.5 to 3.0 percent respectively. When the age variable was controlled. < 25 yrs group showed higher rates(31.6%. 4.8%) than those of > 25 yrs group(15.5%. 1.3%) respectively preferring the evening and night shifts(p=.000). The civil status also seemed to operate on the preferences of the duty shifts as the single group showed lower rate(69.0%) for day duty against 83. 6% of the married group. and higher rates for evening and night duties(27.2%. 15.1%) respectively against those of the married group(3.8%. 1.8%) while a higher proportion of the married group(83. 6%) preferred the day duties than the single group(69.0%). These differences were found to be statistically all significant(p=.001). 9. The findings on preferences of three different types of fixed duty hours namely, B, C. and D(with additional monetary incentives) are as follows in order of preference: B type(12hrs a day, 3days a wk): day shift(64.1%), evening shift(26.1%). night shift(6.5%) C type(12hrs a day. 4days a wk) : evening shift(49.2%). day shift(32.8%), night shift(11.5%) D type(10hrs a day. 4days a wk): showed the similar trend as B type. The findings of higher preferences on the evening and night duties when the incentives are given. as shown above, suggest the need for the introductions of different patterns of duty hours and incentive measures in order to overcome the difficulties in rostering the nursing duties. However, the interpretation of the above data, particularly the C type, needs cautions as the total number of respondents is very small(n=61). It requires further in-depth study. In conclusion. it seemed to suggest that the patterns of nurses duty hours and shifts in the most hospitals in the country have neither been tried for different duty types nor been flexible. The stereotype rostering system of three shifts and insensitiveness for personal life aspect of nurses seemed to be prevailing. This study seems to support that irregular and frequent rotations of duty shifts may be contributing factors for most nurses' maladjustment problems in physical and mental health. personal and family life which eventually may result in high turnover rates. In order to overcome the increasing problems in personnel management of hospital nurses particularly in rostering of evening and night duty shifts, which may related to eventual high turnover rates, the findings of this study strongly suggest the need for an introduction of new rostering systems including fixed duties and appropriate incentive measures for evenings and nights which the most nurses want to avoid, In considering the nursing care of inpatients is the round-the clock business. the practice of the nursing duty shift system is inevitable. In this context, based on the findings of this study. the following are recommended: 1. The further in-depth studies on duty shifts and hours need to be undertaken for the development of appropriate and effective rostering systems for hospital nurses. 2. An introduction of appropriate incentive measures for evening and night duty shifts along with organizational considerations such as the trials for preferred duty time bands, duty hours, and fixed duty shifts should be considered if good quality of care for the patients be maintained for the round the clock. This may require an initiation of systematic research and development activities in the field of hospital nursing administration as a part of permanent system in the hospital. 3. Planned and regular intervals, orientation and training, and professional and personal growth should be considered for the rotation of different duty stations or units. 4. In considering the higher degree of preferences in the duty type of "10hours a day, 4days a week" shown in this study, it would be worthwhile to undertake the R&D type studies in large hospital settings.

• The Journal of Korean Society for Radiation Therapy
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• v.17 no.1
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• pp.1-8
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• 2005

Purpose : An effect of a packing to uterine treatment of a cervical cancer using a dose-volume histogram for a point dose and a volume dose of the bladder and the rectum was analyzed by establishing a three-dimensional treatment plan using a CT image. Materials and methods : Reference points of the bladder and the rectum were marked, respectively at a treatment plan device (plato brachytherapy V14.2.4) by photographing CT(marconi, USA) when the packing was used and removed under the same condition and a treatment plan was performed to Apoint depending on ICRU38. However, in case of the rectum, a maximum point was looked up and compared with the above point because the point presented from the ICRU is not proper as a representative value of a rectum point dose. Further, the volume dose depending on volume of $50\%,\;80\%,\;and\;100\%$ point doses of the rectum and the bladder was measured. The measured values were used to analyze the effect of the packing through a Wilcoxon Signed Rank Test (a SAS statistical analysis process program). Result : The reference points at the bladder and rectum doses when the packing was removed were $116.94\;35.42\%$ and $117.59\;21.08\%$, respectively. The points when the packing was used were $107.08\;38.12\%$ and $95.19\;21.32\%$, respectively. After the packing was used, the reference points at the bladder and the rectum were decreased by $9.86\%$ and $22.4\%$, respectively. When the packing was removed, the maximum points at the bladder and the rectum were $164.51\;50.89\%,\;128.81\;33.05\%$, respectively. When the packing was used, the maximum points at the bladder and the rectum were $142.31\;44.79,\;110.08\;37.03\%$, respectively. After the packing was used, the maximum points at the bladder and the rectum were decreased by $22.2\%$ and $18.73\%$, respectively. When the packing was removed, the bladder volume at $50\%,\;80\%,\;and\;100\%$ point doses of the rectum and the bladder were $48.62{\pm}18.09\%,\;16.12{\pm}11.15\%,\;and\;7.51{\pm}6.63\%$, respectively and its rectum volume were $23.41{\pm}14.44\%,\;6.27{\pm}4.28\%,\;2.79{\pm}2.27\%$, respectively. When the packing was used, the bladder volume at $50\%,\;80\%,\;and\;100\%$ point doses of the rectum and the bladder were $40.33{\pm}16.72,\;11.63{\pm}8.72,\;and\;4.87{\pm}4.75\%$, respectively and its rectum volume were $18.96{\pm}8.37\%,\;4.75{\pm}2.58\%,\;and\;1.58{\pm}1.06\%$, respectively. After the packing was used, the bladder volume at $50\%,\;80\%,\;and\;100\%$ point doses of the rectum and the bladder were decreased by $8.29\%,\;4.49\%,\;and\;2.64\%$, respectively and its bladder volume were decreased by $4.45\%,\;1.52\%,\;and\;1.21\%$, respectively. Conclusion : Values at Reference point doses of the bladder and the rectum recommended from the ICRU 38 were 0.0781 and 0.0781, respectively and values of their maximum point doses were 0.0156 and 0.0156, respectively, as a result of which an effect of the packing using at the uterine intracavitary treatment of an uterine cervical cancer through the three-dimensional treatment plan used CT were measured. That is, the values at reference point doses and the values at maximum point doses show similar difference. However, P value was 0.15 at over $50\%,\;80\%,\;and\;100\%$ volume doses and the value shows no similar difference. In other words, the effect of the packing looks like having a difference at the point dose, but actually shows no difference at the volume dose. The reason is that the volume of the bladder and the rectum are wide but the volume of the packing is only a portion. Therefore, the effect of decreasing the point dose was not great. Further, the farer the distance is, the more weak the intensity of radiation is because the intensity of radiation is proportional to inverse square of a distance. Therefore, the effort to minimize an obstacle of the bladder and the rectum by using the packing should be made.

• Journal of Gastric Cancer
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• v.6 no.1
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• pp.36-42
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• 2006

Purpose: The $p21^{Waf1/Cip1}$ protein Inhibits the cell cycle by Inhibiting the phosphorylation at the $G1{\rightarrow}S$ check point, and the $p27^{kip1}$ protein similarly performs the suppressor function by controlling the p27-mediated G1 arrest. In this study, we analysed the clinical status and survival rates in correlations with p21 and p27 expression patterns in gastric cancer. Materials and Methods: Between 1993 and 1997, 192 patients who underwent surgeries in Catholic Medical Center were analysed retrospectively in this study. Immunohistochemical staining was performed and if the nuclei of the tumor cells were stained, we assumed those as positive results. Statistical analysis was based on clinicopathological findings and differences in survival rates. Results: The expression rate of p27 was 28.1% and 15.6% in p21 each. The ratio of T1-2(80.0%) was significantly high in p21 (+), but the ratio of T3-4 (50.6%) was slightly high in p21 (-). There was no statistical significance regarding other factors. The results in p27 was not much different from expression rate of p21 in T-stage. In addition, p27 expression in diffuse type (91.3%) was higher than in intestinal type (62.7%) by Lauren's classification (P<0.05). Also, there was no statistical significance in other factors. In the correlation of p21 and p27, p27 was positive when p21 was positive (53.5%). Conversely, p27 was negative when p21 was negative (76.5%, p<0.05). In the p21 and p27 combination test, there was higher rate of T1-2 (87.5%) in p21 (+)/p27 (+), and higher rate of T3-4 (58.1%) in p21 (-)/p27 (-) (P<0.05). Results showed higher rate of intestinal type (100%) in p21 (+)/p27 (+), and diffuse type (87.0%) was dominant in p21 (-)/p27 (-) (P<0.05) by Lauren's classification. Moreover, there was no statistical significance in the 5-year survival rate in the expression of p21 and p27, and the 5-year survival rate was highest in the case of p21 (+)/p27 (+) without statistical significance. Conclusion: In our study, $p21^{Waf1/Cip1}\;and\;p27^{kip1}$ expressed similar patterns. The expression of $p21^{Waf1/Cip1}\;and\;p27^{kip1}$ affected the degree of invasiveness of the tumor, and. Combined examination result revealed the correlation of $p21^{Waf1/Cip1}\;and\;p27^{kip1}$ with Lauren's classification and depth of invasion of the tumor. However, we assumed that little difference between the survival rates depending on expression of $p21^{Waf1/Cip1}\;and\;p27^{kip1}$ has limited their value as predictable prognostic indicators.

• Tuberculosis and Respiratory Diseases
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• v.45 no.1
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• pp.5-19
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• 1998

Introduction: Direct histologic and bacteriologic examination of a representative specimen of lung tissue is the only certain method of providing an accurate diagnosis in various pulmonary diseases including diffuse pulmonary diseases. The purpose of national survey was to define the indication, incidence, effectiveness, safety and complication of open and thoracoscopic lung biopsy in korea. Methods: A multicenter registry of 37 university or general hospitals equipped more than 400 patient's bed were retrospectively collected and analyzed for 3 years from the January 1994 to December 1996 using the same registry protocol. Results: 1) There were 511 cases from the 37 hospitals during 3 years. The mean age was 50.2 years(${\pm}15.1$ years) and men was more prevalent than women(54.9% vs 45.9%). 2) The open lung biopsy was performed in 313 cases(62%) and thoracoscopic lung biopsy was performed in 192 cases(38%). The incidence of lung biopsy was more higher in diffuse lung disease(305 cases, 59.7%) than in localized lung disease(206 cases, 40.3%) 3) The duration after abnormalities was found in chest X-ray until lung biopsy was 82.4 days(open lung biopsy: 72.8 days, thoracoscopic lung biopsy: 99.4 days). The bronchoscopy was performed in 272 cases(53.2%), bronchoalveolar lavage was performed in 123 cases(24.1%) and percutaneous lung biopsy was performed in 72 cases(14.1%) before open or thoracoscopic lung biopsy. 4) There were 230 cases(45.0%) of interstitial lung disease, 133 cases(26.0%) of thoracic malignancies, 118 cases(23.1%) of infectious lung disease including tuberculosis and 30 cases (5.9 %) of other lung diseases including congenital anomalies. No significant differences were noted in diagnostic rate and disease characteristics between open lung biopsy and thoracoscopic lung biopsy. 5) The final diagnosis through an open or thoracoscopic lung biopsy was as same as the presumptive diagnosis before the biopsy in 302 cases(59.2%). The identical diagnostic rate was 66.5% in interstitial lung diseases, 58.7% in thoracic malignancies, 32.7% in lung infections, 55.1 % in pulmonary tuberculosis, 62.5% in other lung diseases including congenital anomalies. 6) One days after lung biopsy, $PaCO_2$ was increased from the prebiopsy level of $38.9{\pm}5.8mmHg$ to the $40.2{\pm}7.1mmHg$(P<0.05) and $PaO_2/FiO_2$ was decreased from the prebiopsy level of $380.3{\pm}109.3mmHg$ to the $339.2{\pm}138.2mmHg$(P=0.01). 7) There was a 10.1 % of complication after lung biopsy. The complication rate in open lung biopsy was much higher than in thoracoscopic lung biopsy(12.4% vs 5.8%, P<0.05). The incidence of complication was pneumothorax(23 cases, 4.6%), hemothorax(7 cases, 1.4%), death(6 cases, 1.2%) and others(15 cases, 2.9%). 8) The 5 cases of death due to lung biopsy were associated with open lung biopsy and one fatal case did not describe the method of lung biopsy. The underlying disease was 3 cases of thoracic malignancies(2 cases of bronchoalveolar cell cancer and one malignant mesothelioma), 2 cases of metastatic lung cancer, and one interstitial lung disease. The duration between open lung biopsy and death was $15.5{\pm}9.9$ days. 9) Despite the lung biopsy, 19 cases (3.7%) could not diagnosed. These findings were caused by biopsy was taken other than target lesion(5 cases), too small size to interpretate(3 cases), pathologic inability(11 cases). 10) The contribution of open or thoracoscopic lung biopsy to the final diagnosis was defininitely helpful(334 cases, 66.5%), moderately helpful(140 cases, 27.9%), not helpful or impossible to judge(28 cases, 5.6%). Overall, open or thoracoscopic lung biopsy were helpful to diagnose the lung lesion in 94.4 % of total cases. Conclusions: The open or thoracoscopic lung biopsy were relatively safe and reliable diagnostic method of lung lesion which could not diagnosed by other diagnostic approaches such as bronchoscopy. We recommend the thoracoscopic lung biopsy when the patients were in critical condition because the thoracoscopic biopsy was more safe and have equal diagnostic results compared with the open lung biopsy.

• Korean Journal of Agricultural Science
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• v.2 no.1
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• pp.199-231
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• 1975

It is well known fact that antibiotic residues in milk of cows create significant problem for the fermented dairy industry and public health because of inhibition of starter activity and of creation of allergic disease. It can be assumed that antibiotic residues in milk of other aniimals also can create some problems for their infants as in the case of humen. For the above mentioned reasons, present studies were undertaken to determine concentration and duration of antibiotic residues in milk of cows, goats and dogs following intramuscular or intravenous injection and intramammary infusion of penicillin, streptomycin and oxytetracycline at usual dosage. The cylinder-plate method was used for their assay. The results obtained were summerized as follows: 1) Following the intramuscular injection of penicillin, the antibiotic was detected in milk of cows up to 72 hours, in milk of goats 48 hours and in milk of dogs 60 hours of postinjection. The mean peak concentrations were recorded at 12 hours as 0.136 I.U./ml in cows. 6 hours as 0.773 I.U./ml in goats and 3 hours as 1.192 I.U./ml in dogs. 2) Following the intramuscular injection of streptomycin, the antibiotic was detected in milk of cows and goats up to 36 hours and in milk of dogs 24 hours of post-injection. The mean peak concentration were recorded at 6 hours as $0.26{\mu}g/ml$ in cows and at 3 hours in goats and dogs $0.45{\mu}g/ml$ and $0.36{\mu}g/ml$ respectively. 3) Following the intra venous injection of oxytetracycline, the antibiotic was detectable in milk of all the test animals up to 48 hours of postinjection. The mean peak concentrations were recorded at 6 hours as $3.5{\mu}g/ml$ in cows $2.4{\mu}g/ml$ in goats and $2.0{\mu}g/ml$ in dogs respectively. 4) Following intrarnammary infusion of penicillin in amounts of 100,000 I.U. for cows, 20.000 I.U. for goats and 10,000 I.U. for dogs, the penicillin residues in milk of the infused quarter perssisted to 72 hours in cows and 84 hours in goats and dogs. 5) Following intramammary infusion of streptomycin in amount of 500mg for cows, 100mg for goats and 25mg for dogs, the streptomycin residues in milk of the infused quarter persisted to 72 hours in cows and goats and 60 hours in dogs. 6) Following intramammary infusion of oxytetracycline in amount of 500mg for cows, 100mg for goats and 25mg for dogs, the oxytetracycline residues in milk of the infused quarter persisted to 72 hours in cows and 60 hours in goats and dogs. 7) A corelation between the residual antibiotic concentration and milk yield in cows and goats was observed; That is, the lower in the milk production showed a higher the concentration of an antibiotic residues and a longer the time in persistance. 8) Intramammary transfer of the antibiotic from an infused to non infused quarters, in dogs, was observed following the intramammary infusion of penicillin. streptomycin and oxytetracyclne in amounts of 10.000 I.U. 25mg and 25mg respectively. However, no transfer by 100.000 I.U. or 20.000 I.U. of penicillin. 500mg of streptomycin and 100mg of oxytetracyline was observed in cows and goats. 9) In dogs, minimum dosage of antibiotics for transfer fro in treated to untreated quarters following intramammary infusion were 2,500 I.U. of penicillin and 5mg each of streptomycin and oxytetracycline.

• Journal of Korean Society of Archives and Records Management
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• v.1 no.1
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• pp.201-230
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• 2001

Conserving the recored cultural inheritance is actually the duty of all of us. Above all, the management and conservation of archives and documents is up to archivists who have technical knowledge about archival science. Archivists have to not only conserve archives and documents but also carry out classifying and appraising them in order to define them as current historic ones. The fundamental education about archival science is made up of history and law. Because Archive is the organisation which manage archives and documents produced by legal and administrative actions. Although there are still arguments about technical knowledge and degree archivists have to acquire, most of them prefer the studies related with history and emphasize legal studies to be the general boundary of archivits' ideology and trust. The training course about conservation of archives is conducted in about 9 National Archives of Torino, Milano, Venezia, Genova, Bologna, Parma, Roma, Napoli, Palermo. The training course in 19th was mostly based on the lectures of Phaleography, Diplomatics. There were not the education about archival science yet. Toward the end of 19th and 20th, people stressed the most basic subject in the training course of National Archive was not Phaleography and Diplomatics but archival science. The goal of archival science is to study the institution and organisation transferring archives and documents to Archive. And also it help archivists not wander about with ignorance of organisational and original procedures and divisions but know exactly theirs works. Like this, the studies on institution and organisation have got in the saddle as a branch of archival science since a few ten years. While archival science didn't evoke sympathy among people and experienced the tedious and difficult path in italy and other countries, Archive was managed by experts of other branches. As a result, there were a lot of faults in Archival Science. Specializing training course for Italian archivists came into being under the backdrop of Social Science Institute of Roma National University in 1925. The archival course of universities accomplished by the studies of history, law and economy. And such as Eugenio Casanova and Giorgio Cencetti were devoted archival science was abled to settle down in national archive. The training course for experts of 'archival science, 'Phaleography and Diplomatics' in National Archive of Bologna(Archivio di Stato di Bologna) is one of courses conducted in 17 National Archives in italy. This course is gratuitous and made up of 8 subjects(Archivistica, Paleografia, Diplomatica, Storia dell' Archivio, Notariato e documenti privati, istituzione medievale, istituzione moderna, istituzione contemporanea) students have to complete for two years. Students can receive the degree through passing twice written exam and once oral test. After department of Culture and education finally puts the marks of students, the chief Nationa Archive of Bologna confer the degree of 'archival science Phaleography and Diplomatics' on students passing the exams. This degree authenticates trainees' qualification which enables him to work at the archive in province, district and administrative capital city and archive of comunity and so on. Italian training course naturally leads archivists to keep in contact with valuable cultural inheritance through training in Archive. And it shows the intention to strengthen the affinity with each documents in the spot of archival management before training archivists. Also this is appraised as one of positive policies to conserve the local cultual inheritante in connection with the original qualitity of national archive with testify the history of each region. Traning course for archivist in Italy shows us the way how we have to prepare and proceed it. First, from producing documents to conserving than forever there has introduced 'original order that is to say a general rule to respect the first order given at the time producing documents'. Management of administrative documents is related consistently with one of historical documents. Second, the traning course for archivist is managing around 17 national archives. because italian national archive lay stress not or rducation of theory bus on train for archivest working in the first time of archival science. Third, diplomatics and phaleography for studies about historical document support archives. Forth, the studies on history id proceeding by cooperation between archivist and historian around archive. How our duties is non continuinf disputer who has to conserve and manage document and archives, but traing experts who having ability, vision and flexible thought, responsibility about archivals.