The Effects of a Simulation-Based High Flow Nasal Cannula Oxygen Therapy Training Program on the Knowledge, Clinical Performance and Educational Satisfaction of Clinical Nurses / 임상간호연구

Purpose@#The aim of this study was to develop a simulation-based High Flow Nasal Cannula Oxygen Therapy training program based on NLN/ISF to identify the effect on knowledge, clinical performance, and educational satisfaction compared to a group who had traditional High Flow Nasal Cannula Oxygen Therapy training after applying it to clinical nurses. @*Methods@#31 experimental groups and 33 control groups were conducted from August 2019 to September 2019 for inexperienced nurses over 4 months to 5 years with no experience using high-flow oxygen therapy. Educational programs were developed in scenarios according to Airvo2 and Optiflow, such as facilitator, participant, educational condition, design, characteristics, and educational outcomes. The education application was conducted in advanced for knowledge and clinical performance ability after watching therapy video. Since then, a total of 90 minutes have been conducted for respiratory failure theory training, airvo2 and optiflow simulation training, and debriefing. After applying the education, the medical institution measured nurses’ knowledge, clinical performance, and education satisfaction. Data were analyzed using descriptive statistics, with the SPSS/WIN 22.0 program. @*Results@#Both knowledge and educational satisfaction were higher in the experimental group than in the control group (t=-14.09, p<.001), (t=-12.99, p<.001). The clinical performance for both use of Optiflow and Airvo2 were higher in the experimental group than in the control group (t=-11.39, p<.001), (t=-11.38, p<.001) . @*Conclusion@#Results showed that the simulation-based High Flow Nasal Cannula Oxygen Therapy training was effective with the experimental group having increased scores for every area of this study.

Erratum to: High Seroprevalence and Index of Anti-John-Cunningham Virus Antibodies in Korean Patients with Multiple Sclerosis

High Seroprevalence and Index of Anti-John-Cunningham Virus Antibodies in Korean Patients with Multiple Sclerosis

BACKGROUND AND PURPOSE: The anti-John-Cunningham virus (JCV)-antibody serostatus and index are used in the risk stratification of progressive multifocal leukoencephalopathy (PML) in multiple sclerosis (MS) patients treated with natalizumab. However, little information on these parameters is available for Asian countries. The purpose of this study was to determine the rate of seropositivity, index, and longitudinal index evolution in Korean patients with MS. METHODS: The antibody seroprevalence was analyzed in 355 samples from 187 patients with clinically isolated syndrome or MS using a second-generation, two-step, enzyme-linked immunosorbent assay. A 4-year longitudinal evaluation was applied to 66 patients. RESULTS: The overall antibody seroprevalence was 80% (n=149). Among antibody-positive patients, the index had a median value of 3.27 (interquartile range, 1.52–4.18), with 77% (n=114) and 56% (n=83) of patients having indices >1.5 and >3.0, respectively. The serostatus of 59 (89%) of the 66 patients did not change during the longitudinal analysis, while 3 (6%) of the 53 patients who were initially seropositive reverted to seronegativity, and 2 (15%) of the 13 patients who were initially seronegative converted to seropositivity. All patients with a baseline index >0.9 maintained seropositivity, and 92% of patients with a baseline index >1.5 maintained this index over 4 years. No patients developed PML (median disease duration, 8 years). CONCLUSIONS: The seroprevalence and index of anti-JCV antibodies in Korean patients with MS may be higher than those in Western countries.

Analysis of lawsuit cases in the Department of Surgery in Korea

PURPOSE: The aim of this study is to prepare medical staff in order to prevent medical malpractice litigation through analysis of litigation cases related to the department of surgery in Korea. METHODS: A total of 94 litigation cases related to the department of surgery, where a certain amount of payment was ordered to the defendant between 2005 through 2010, were analyzed. We examined time of occurrence, amount claimed and awarded in damages, plaintiff claims, and court opinion. RESULTS: An average of 3.2 years was spent from the date of the incident occurring to the end of the litigation procedures. The average amount awarded in judgments for damages was 59,708,983 ± 67,307,264 (range, 1,700,000–365,201,482) Korean won. Cases were found involving the following opinion of the court: violation of duty of care (49 cases), violation of informed consent (7 cases), violation of duty of care and informed consent (5 cases), and settlement, reconciliation, and others (32 cases). By analyzing defendants' negligence in court opinions, diagnosis (30.8%) was the most common, followed by post-operation management (27.7%). CONCLUSION: Physicians have to conduct treatment and surgery based on exact diagnosis and be careful to observe patients' conditions and symptoms after surgery. It is essential to identify the current status and characteristics of medical litigation for reducing further litigation and improving patient safety. In order to create a safe medical environment, national efforts should be made not only by individuals but also at the national level.

A Case of Acquired Mucinous Nevus in Nevus Lipomatosus Cutaneous Superficialis

No abstract available.

A Case of Iatrogenic Kaposi's Sarcoma Developed in a Psoriasis Patient after a Long-term Use of Immunosuppressive Agents / 대한피부과학회지

No abstract available.

A Case of Iatrogenic Kaposi's Sarcoma Developed in a Psoriasis Patient after a Long-term Use of Immunosuppressive Agents / 대한피부과학회지

No abstract available.

Comparative Study on Awareness Topical and Oral Steroid Use Awareness / 대한피부과학회지

BACKGROUND: Topical and oral steroids are widely prescribed in dermatology. While interest in steroid use has increased rapidly, people have also acquired misinformation that causes rampant fears. OBJECTIVE: To identify fears and misunderstandings about steroid use by comparing doctors' attitudes and treatment and non-treatment group experiences with steroid use. METHODS: A total of 346 participants including outpatients who visited the Department of Dermatology at Hallym University Sacred Heart Hospital, physicians who work at the hospital, and visitors to its Department of Occupational and Environmental Medicine completed questionnaires. RESULTS: The topical treatment group had a high response rate of 46.7% regarding feeling “somewhat anxious” about using topical steroids, while the oral treatment group had a high response rate of 53.8% regarding feeling “somewhat anxious” about using oral steroids. With respect to information about the adverse effects of steroid use, those in the non-experience group obtained their information mostly from the Internet (67.5%) or the media (47.5%), whereas those in the topical treatment group obtained their information from product guides (48%) and doctors (38.7%). Meanwhile, the oral treatment group acquired information from acquaintances (39.7%) or doctors (32.1%). CONCLUSION: Dermatologists must evaluate the validity of the information that patients have about the adverse effects of topical and oral steroid use as well as the resulting phenomenon of steroid phobia. If the information possessed by patients is inaccurate, clinicians must provide a full understanding and proper education to enhance patient satisfaction and treatment compliance and success rates.

Pulsed Versus Continuous Cyclosporine Regimens for Maintenance Therapy in Psoriasis: A Comparative Study / 대한피부과학회지

BACKGROUND: Psoriasis is a chronic recurrent disease requiring long-term treatment; therefore, special attention is warranted when prescribing cyclosporine A (CsA) for patients diagnosed with psoriasis. Various forms of maintenance therapy have been suggested to reduce the incidence of adverse events associated with CsA use. OBJECTIVE: We aimed to compare the efficacy and safety of the three aforementioned CsA therapies for management of patients with psoriasis. METHODS: Patients fulfilling our selection criteria were selected for the study. CsA therapy (2.5∼5 mg/kg/day) was administered for 12 weeks, and patients who showed remission following this treatment were administered maintenance therapy. Patients with successful induction of response were randomly assigned to three treatment groups. Group A was the continuous regimen group (2∼3 mg/kg/day). Group B was the pulsed regimen group (4 mg/kg/day for 4 days, 3 days of discontinuation). Group C was the weekend regimen group (5 mg/kg/day for 2 days, 5 days of discontinuation). Patients were followed up on an outpatient basis at 4-week intervals to monitor treatment effects. RESULTS: In each group, the Psoriasis Area and Severity Index (PASI) and body surface area (BSA) values decreased in a similar fashion from visit 1 to visit 4 and at the time of the final visit 7. In each group, dermatology life quality index (DLQI) values showed statistically significant differences between pre- and post-treatment states; however, no inter-group differences were observed. Although adverse events such as elevated blood pressure and serum creatinine levels were slightly higher in the intermittent group, there was no significant inter-group difference. CONCLUSION: The pulsed regimen did not show a major difference in treatment effects compared to the everyday use group. We propose that the patient's age, presence of underlying diseases, lifestyle patterns, and convenience of use should be considered while determining the type of regimen administered to a patient.

Primary Cutaneous CD4+ Small/Medium-sized Pleomorphic T-cell Lymphoma with Papillary Thyroid Carcinoma / 대한피부과학회지

No abstract available.

Isolation and molecular identification of Vibrio harveyi from the look down fish (Selene vomer)

Gradual mortality of look down fish (Selene vomer) was observed in a private aquarium in Seoul, showing abnormal swimming behavior and lethargy. A bacterial pathogen from kidney was cultured, identified, and confirmed as Vibrio harveyi using Vitek System 2 and 16S rRNA gene sequencing. A predominant bacterial strain, SNUVh-LW2 was proved to be most closely related to isolates from China by phylogenetic analysis with minimum evolution method. Also, tetracycline was considered as the most sensitive antibiotic agent via antibiotic usceptibility test. The group of fish was treated according to the diagnostic result and no more mortality was observed.

An Unusual Case of Psoriasis Confined to Vitiligo Lesions / 대한피부과학회지

Although the coexistence of vitiligo and psoriasis is well known and considered not unusual, psoriasis localized exactly on vitiliginous lesions has been rarely reported. We report a 13-year-old girl with erythematous scaly plaques localized only on the depigmented vitiliginous patches after narrow-band UVB therapy. Biopsy samples were taken from the areas where the new erythematous plaques occurred. Considering the clinical findings and the biopsy results, our case corresponds to psoriasis co-localized with vitiligo. After the patient discontinued phototherapy and started oral cyclosporine, the psoriatic lesions improved. We report a rare case of psoriasis arising strictly on vitiligo lesions.

Perigastric Abscess as a Complication of Endoscopic Submucosal Dissection for Early Gastric Cancer: First Case Report / 대한소화기학회지

Endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) is a widely accepted and well established procedure because of its curative potential and low invasiveness compared with surgery. Perforation is a potential major complication during ESD, and non-surgical treatments such as endoscopic closure with clips are sufficient in most cases. Here, we report a case of perigastric abscess that occurred as a complication of ESD for EGC. The patient improved with administration of antibiotics without surgical intervention.

Non-Exposed Endoscopic Wall-Inversion Surgery for Gastrointestinal Stromal Tumor of the Stomach: First Case Report in Korea

Laparoscopic wedge resection of the stomach is a widely accepted treatment for primary resectable gastrointestinal stromal tumors (GISTs). However, it is difficult to determine the appropriate incision line from outside of the stomach, and many attempts have been made to avoid unnecessary resection of unaffected gastric tissues. Recently a technique called non-exposed endoscopic wall-inversion surgery (NEWS) was introduced to avoid exposure of GIST to the peritoneum. Here, we describe the first published case of NEWS for GIST of the stomach practiced in Korea.

A Case of Cutaneous Aspergillus flavus Infection in a Immunocompetent Patient / 대한의진균학회지

Fungi of Aspergillus genus are widely distributed in nature, particularly in the soil and in decomposing vegetation. They are frequent opportunistic pathogens in immunocompromised patients, second only to Candida. The most common agent is A. fumigatus, followed by A. flavus, mainly in invasive disease in immunocompromised patients, and in nasal or paranasal sinus lesions. Cutaneous aspergillosis is a rare condition. There are several factors that predispose to Aspergillus infection: the most frequent are granulocytopenia, haematological disorders, diabetes, the neonatal period, local tissue injury, and any primary or acquired diseases that cause immunosuppression. A 25-year-old male was referred to department of dermatology for his skin lesions on the both axillary areas. The skin lesions showed localized erythematous to brownish scaly patches on the both axillary areas. A KOH mount fungal smear showed fungal hyphae, and Aspergillus species was grown in culture. rDNA ITS sequencing result was also consistent with A. flavus. He was treated with itraconazole 200 mg daily for 4 weeks, and showed a good response. This case is thought to be peculiar in that cutaneous aspergillosis is detected in an immunocompetent host.

Isolation and identification of Vibrio harveyi from chub mackerel (Scomber japonicus)

For several days, there was a series of mortalities of chub mackerel (Scomber japonicus) that were reared for public exhibition in a private aquarium in Seoul, Korea. As part of the diagnosis of the dead fish, a bacterial isolate from the kidney was cultured, identified, and confirmed to be Vibrio (V.) harveyi using Vitek System 2 and 16S rRNA gene sequencing. Phylogenetic analysis was also performed by the neighbor-joining method. As a result, the V. harveyi isolated from chub mackerels of a private aquarium in Korea, called as SNUVh-LW1, was clustered in the same group with V. harveyi ATCC33843.

Incidence of and Risk Ractors for Zolpidem-Induced Delirium / 대한내과학회지

BACKGROUND/AIMS: Zolpidem is a safe and effective drug for the treatment of insomnia. However, there are some reports of adverse effects, such as delirium, after administration of zolpidem. The aim of this study was to evaluate the incidence of and risk factors for zolpidem-induced delirium. METHODS: This retrospective study enrolled 481 patients who were admitted to hospital and received zolpidem between January and May 2011. We analyzed the incidence and risk factors associated with zolpidem-induced delirium. RESULTS: Zolpidem-induced delirium occurred in 19 of 481 (4.0%) patients. Zolpidem-induced delirium was significantly associated with old age (> or = 65 years; odds ratio [OR] = 4.35, 95% confidence interval [CI] = 1.52-12.44, p = 0.006) and co-administration of benzodiazepine (OR = 4.30, 95% CI = 1.52-12.12, p = 0.006). When males > 65 years-old took both benzodiazepine and zolpidem simultaneously, the incidence of delirium was notably elevated (OR = 6.04, 95% CI = 1.80-20.20, p = 0.003). Other factors, including dosage, did not influence the occurrence of delirium. CONCLUSIONS: Old age and co-administration of benzodiazepine were independent risk factors for zolpidem-induced delirium. Therefore, a detailed medical history should be taken before prescribing zolpidem to an older person, and zolpidem should be used cautiously, with careful monitoring, in these patients.

A Case of Fulminant Sclerosing Peritonitis Presented Like Acute Culture-Negative Peritonitis and Successfully Treated with Corticosteroid Therapy

Sclerosing peritonitis is an uncommon complication of peritoneal dialysis. It is characterized by peritoneal fibrosis and sclerosis. The most common clinical presentations of sclerosing peritonitis in peritoneal dialysis patients are ultrafiltration failure and small bowel obstruction. The prognosis and response to immunosuppressive therapy of sclerosing peritonitis presenting with ultrafiltration failure or small bowel obstruction are poor. Here, we describe the case of a 28-yr-old man with end-stage renal disease on peritoneal dialysis showing fulminant sclerosing peritonitis presented like acute culture-negative peritonitis and was successfully treated with corticosteroid therapy. It is not well recognized that sclerosing peritonitis may present in this way. The correct diagnosis and corticosteroid therapy may be life-saving in a fulminant form of sclerosing peritonitis.

Everolimus-Induced Interstitial Pneumonitis in a Patient with Metastatic Renal Cell Carcinoma: a Case Report / 대한내과학회지

Everolimus, an inhibitor of the mammalian target of rapamycin, is an active agent against metastatic renal cell carcinoma. Treatment with everolimus prolongs progression-free survival in patients with clear cell-type renal cell carcinoma that has progressed on vascular endothelial growth factor receptor tyrosine kinase inhibitors, such as sunitinib and/or sorafenib. Everolimus-induced interstitial pneumonitis is not rare and is sometimes fatal. Due to the potential for pulmonary toxicity due to everolimus, it is recommended that pulmonary complications be periodically evaluated. We report a case of everolimus-associated interstitial pneumonitis in a patient with metastatic renal cell carcinoma.

Fatigue and Quality of Life in Clinical Nurses / 기본간호학회지

PURPOSE: This study was done to identify correlations between fatigue and quality of life in clinical nurses. METHOD: A sample of 294 nurses working in 3 general hospitals answered a questionnaire containing Yoshitake's fatigue scale and WHOQOL-BREF. Data were analyzed using t-test, ANOVA and Pearson correlation coefficients. The SPSS/WIN 11.0 version program was used. RESULTS: The score for level of fatigue was 2.11 (52.7%) and quality of life, 2.89 (57.8%). The level of fatigue was highest in the physical domain followed by psychical and nervous-sensual domain in that order. There were statistically significant differences in scores of fatigue depending on the nurse's age, marital status, career, position, health status and present illness. Quality of life had the highest score in the social domain followed by physical, overall, psychological, and environmental domain in that order. There were statistically significant differences in scores on quality of life depending on nurse's age, marital status, career, position, health status and present illness. CONCLUSION: The relationship between fatigue and quality of life revealed a significant negative correlation. Based on this study, nursing administrators need to reduce the level of nurse fatigue by providing various programs, which improve quality of life.