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Percutaneous dilatational tracheostomy (PDT) is preferred over conventional surgical tracheostomy for prolonged airway protection and mechanical ventilation. However, despite its advantages, severe PDT-related complications have been reported, including catastrophic hemorrhage from common carotid artery laceration and innominate artery pseudo-aneurysm. PDT can typically be applied to the trachea, which is the focal point for the transverse course of great vessels (e.g., the anomalous brachiocephalic trunk, which overlaps with the targeted lesion anteriorly); therefore, to improve patient outcomes, an alternative method using aortic debranching may be considered.
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BACKGROUND@#Polarization sensitive-optical coherence tomography (PS-OCT) provides the unique advantage of being able to measure the optical characteristics of tissues by using polarized light. Although the well-organized fibers of healthy muscle can change the polarization states of passing light, damaged tissue has different behaviors. There are studies on optical imaging methods applied to the respiratory organs; however, they are restricted to structural imaging. In particular, the intercostal muscle situated under the pleura is very challenging to visualize due to the difficulty of access.METHOD: In this study, PS-OCT was used to identify subpleural cancer in male New Zealand white rabbits (3.2–3.4 kg) and to assess the phase retardation changes in normal and cancerous chest walls. VX2 cell suspension was injected between the intercostal muscle and parietal pleura and a tented area was observed by thoracic scope. A group of rabbits (n = 3) were sacrificed at day 7 after injection and another group (n = 3) at day 14. @*RESULTS@#In the PS-OCT images, pleura thickness changes and muscle damage were criteria to understand the stages of the disease. The results of image and phase retardation analysis matched well with the pathologic examinations. @*CONCLUSION@#We were able to visualize and analyze subpleural cancer by PS-OCT, which provided structural and functional information. The measured phase retardation could help to identify the margin of the tumor. For further studies, various approaches into other diseases using polarization light are expected to have positive results.
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BACKGROUND@#Polarization sensitive-optical coherence tomography (PS-OCT) provides the unique advantage of being able to measure the optical characteristics of tissues by using polarized light. Although the well-organized fibers of healthy muscle can change the polarization states of passing light, damaged tissue has different behaviors. There are studies on optical imaging methods applied to the respiratory organs; however, they are restricted to structural imaging. In particular, the intercostal muscle situated under the pleura is very challenging to visualize due to the difficulty of access.METHOD: In this study, PS-OCT was used to identify subpleural cancer in male New Zealand white rabbits (3.2–3.4 kg) and to assess the phase retardation changes in normal and cancerous chest walls. VX2 cell suspension was injected between the intercostal muscle and parietal pleura and a tented area was observed by thoracic scope. A group of rabbits (n = 3) were sacrificed at day 7 after injection and another group (n = 3) at day 14. @*RESULTS@#In the PS-OCT images, pleura thickness changes and muscle damage were criteria to understand the stages of the disease. The results of image and phase retardation analysis matched well with the pathologic examinations. @*CONCLUSION@#We were able to visualize and analyze subpleural cancer by PS-OCT, which provided structural and functional information. The measured phase retardation could help to identify the margin of the tumor. For further studies, various approaches into other diseases using polarization light are expected to have positive results.
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BACKGROUND@#We aimed to validate a pilot study of photodiagnosis using near infrared (NIR) transillumination and assess the clinical efficacy of hypericin-mediated photodynamic therapy (HYP-PDT) in a rabbit laryngeal cancer model in order to develop a novel therapeutic modality with complete remission and preservation of the functional organ. @*METHODS@#(1) In vitro study: VX tumor cells were subcultured and subjected to HYP-PDT. (2) In vivo study: A laryngeal cancer model was developed in which 12 rabbits were inoculated with a VX tumor suspension in the submucosal area of the left vocal fold using a transoral approach. All rabbits underwent NIR transillumination using light with a wavelength of 780 nm. The survival periods of the three treatment groups (6 rabbits in Group A: HYP-PDT, 3 each in Groups B and C: laser irradiation or HYP administration only) were analyzed. @*RESULTS@#The higher the HYP concentration, the lower the VX cell viability in response to HYP-PDT using 590 nm LED. Following HYP-PDT, small tumors in Group A-1 rabbits healed completely and the animals demonstrated a long survival period, and larger tumors in Group A-2 healed partially with a survival period that extended over 3 weeks after inoculation. The survival of Groups B and C were not different over the first 3 weeks of the study, and were shorter than in Group A. @*CONCLUSION@#We found HYP-PDT could be a curative therapy for early-stage cancers that may also preserve organ function, and may inhibit tumor progression and metastasis during advanced stages of laryngeal cancer.
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Objectives@#：This study evaluated the medical communication skills of trainee doctors and analyzed the relationship between medical communication skills, self-efficacy on clinical performance (SECP) and empathy. @*Methods@#：A total of 106 trainee doctors from a university hospital participated. The questionnaire comprised self-evaluated medical communication skills, modified SECP and the Korean version of the Jefferson Scale of Empathy-Health Professionals version. The mean difference in medical communication skills scores according to gender, age, division (intern, internal medicine group or surgery group) and position (intern, first-/second- and third-/fourth-year residents) were analyzed. Pearson correlation coefficients were determined between medical communication skills, modified SECP and empathy. The effects of each variable on medical communication skills were verified using the structural equation model. @*Results@#：There were no statistically significant mean differences in self-evaluated medical communication skills according to gender, age, division or position. Medical communication skills had a significant positive correlation with modified SECP (r=0.782, p<0.001) and empathy (r=0.210, p=0.038). Empathy had a direct effect on modified SECP (β=0.30, p<0.01) and modified SECP had a direct effect on medical communication skills (β=0.80, p<0.001). Empathy indirectly influenced medical communication skills, mediating modified SECP (β=0.26, p<0.05). @*Conclusions@#：Medical communication skills are an important core curriculum of residency programs, as they have a direct correlation with SECP, which is needed for successful treatment. Moreover, the medical communication needs a new understanding that is out of empathy.
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Anti-N-methyl-D-aspartate receptor (Anti-NMDAR) encephalitis is a neuroinflammatory disease mediated by autoantibodies to NMDAR. In the initial clinical stages of anti-NMDAR encephalitis, psychiatric symptoms like delusions, perceptual disturbances, and disorganized speech or behaviors are pronounced even without obvious neurological symptoms. Early treatments like immunotherapy and/or tumor removal are central to good clinical outcomes. Hence, it is important to diagnose early anti-NMDAR encephalitis, distinguishing it from mental disorder. In the present case study, the authors described psychiatric symptoms assessed with Positive and Negative Syndrome Scale (PANSS) of Ms. A, a 26-year-old woman, in the early phase of anti-NMDAR encephalitis. We will discuss the characteristic psychopathology of anti-NMDAR encephalitis toward prompt diagnosis and treatment. Ms. A showed a higher negative subscale score than positive one on the PANSS. Compared with mental disorder, negative symptoms and cognitive impairment would be more prominent in the early stage of anti-NMDAR encephalitis. Rituximab and teratoma removal were effective, and quetiapine showed good tolerability. It is recommended to evaluate anti-NMDAR encephalitis when negative symptoms, cognitive impairment, catatonia, changes in consciousness level, and neurological symptoms are observed, especially in young women.
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PURPOSE: This study aimed to examine the association among sexual double standard, dating violence recognition, and sexual assertiveness among Korean university students. METHODS: Using a cross-sectional survey study in January 2018, Korean university students (N = 322, years; 54.3% female) completed structured questionnaires with the double standard scale, dating violence recognition index, and sexual assertiveness index. The relationship among the variables was analyzed with Pearson's correlations and multiple regression analyses. RESULTS: There were significant correlations among sexual double standard, dating violence recognition, and sexual assertiveness. Sexual double standard (β = .12, p = .043) was determined to influence dating violence recognition. In addition, gender (β = .63, p < .001) and sexual double standard (β = .11, p = .015) were determined to influence dating violence recognition; the explanatory power was 43%. CONCLUSION: These findings will serve as a basis for the development of education programs that help university students to establish appropriate sexual values and enjoy a healthy sex life.
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Humans , Young Adult , Assertiveness , Cross-Sectional Studies , Education , Intimate Partner Violence , Korea , Reproductive Health , Sexual BehaviorABSTRACT
PURPOSE: This is a descriptive study to investigate the relevance between biological nursing science subjects (structure and function of the human body (SFHB), mechanism and effects of drugs (MED), clinical microbiology) and examination workbook items for Registered Nurse Licensure Examination (RNLE) in Republic of Korea (ROK) and the United States of America (USA). METHODS: RNLE 8 workbooks which were published by the Korean Nurses Association were utilized for analysis of Korean RNLE. Saunders comprehensive review for the NCLEX-RN® examination was used for analysis of US RNLE. The relevance between items in the standard syllabuses of biological nursing science subjects (SFHB, MED, clinical microbiology) and the RNLE items of these workbooks in ROK and the USA was analyzed. RESULTS: The relevance rates of ROK and the USA were 3.6% vs 0.4% in SFHB, 8.9% vs 23.0% in MED, and 4.5% vs 5.8% in clinical microbiology. CONCLUSION: In SFHB, the relevance of the RNLE in ROK was higher than that of the USA. However in MED the relevance of the RNLE in USA was higher than that of the ROK. Since medications are one of major tasks of nurses, it is necessary to increase the number of related items in the RNLE in ROK.
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Humans , Americas , Human Body , Licensure , Nurses , Nursing , Republic of Korea , United StatesABSTRACT
PURPOSE: This study aimed to synthesize the caring experiences of Korean family members of patients with dementia through a qualitative meta-synthesis method. METHODS: By searching through nine Korean and English databases, we compared 37 qualitative studies on caring experiences of family members of patients with dementia. The selected studies were synthesized through meta-synthesis, proposed by Sandelowski and Barroso (2007). RESULTS: The meta-synthesis elicited four themes: tough life due to care for patients, changes in relationships, adaptation to caregiver's roles, and new perspectives of life through personal growth. Caregivers were shocked when a sudden diagnosis of dementia was made prior to any preparation on their part. They were tied to their patients all the time and their mind and body got exhausted. Their relationship with patients began to change and they looked at them differently. They experienced conflicts with the other non-caring family members and were alienated from them. They were also socially isolated. However, by building their own care strategies and utilizing social resources, they gradually adapted to their caregiver roles. Finally, they experienced personal growth and acquired a new perspective toward life by accepting their roles and finding meaning in their lives. Shifting the caregiver's centricity from themselves to the patient was the process of becoming human beings who actively constructed their realities while giving meaning to their painful lives and interacting with the environment. CONCLUSION: The results of the study can be useful for nurses in understanding the experiences of caregivers of the patients with dementia and in providing them with practical interventions.
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Humans , Caregivers , Dementia , Diagnosis , Emigrants and Immigrants , Methods , Qualitative Research , ShockABSTRACT
PURPOSE: The purpose of this study was to investigate the effects of the Korean Dietary Approaches to Stop Hypertension (DASH) education program on oxidative stress, antioxidant capacity, and serum homocysteine (Hcy) level in elderly Korean women. METHODS: This was a quasi-experimental study employing non-equivalent control group pretest-posttest design. The DASH group (n=27) underwent the DASH education program for 12 weeks, whereas the control group (n=21) was provided one education session. The survey was conducted before and after the intervention period. RESULTS: In DASH group, monounsaturated fatty acid (MUFA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) intakes significantly increased after the intervention as compared to prior to the intervention. No significant differences were found in the control group. After the intervention, thiobarbituric acid reactive substance (TBARS) and Hcy levels significantly decreased in the DASH group but not in the control group. CONCLUSION: The DASH education program was effective in reducing oxidative stress and Hcy levels in elderly Korean women.
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Aged , Female , Humans , Antioxidants , Diet , Education , Eicosapentaenoic Acid , Homocysteine , Hypertension , Non-Randomized Controlled Trials as Topic , Oxidative StressABSTRACT
PURPOSE: The purpose of this study was to determine subjective happiness related factors in Korean nursing students. METHODS: A purposive sample of 200 nursing students was recruited for the cross-sectional survey design. The instruments were perceived stress scale, major satisfaction scale, resilience scale, and subjective happiness scale. Data were analyzed using descriptive statistics, hierarchical linear regression, and the Sobel test for testing mediating effects. RESULTS: The mean score of stress, major satisfaction, resilience and subjective happiness was 2.21, 3.95, 3.60 and 5.03, respectively. Perceived health status, stress_positive perception, stress_negative perception, resilience_self confidence, resilience_positivity, resilience_social support had significant effects on subjective happiness. Explained variance for the subjective happiness was 53.4%. Resilience had a partial mediating effect in the relationship between stress and subjective happiness (Sobel test: Z=-5.67, p<.001). Also, resilience had a mediating effect in the relationship between major satisfaction and subjective happiness (Sobel test: Z=5.65, p<.001). CONCLUSION: Based on the findings of this study, nursing intervention programs focusing on improving resilience are recommended to improve subjective happiness in nursing students.
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Humans , Cross-Sectional Studies , Happiness , Linear Models , Negotiating , Nursing , Students, NursingABSTRACT
PURPOSE: This study is a descriptive study to investigate the relevance between pathophysiological subject and examination workbook items for national nurse licensure examination in South Korea and the United States. METHODS: Eight registered nurse licensure examination workbooks published by the Korean nurses association were used for the analysis. Saunders comprehensive review for the national council licensure examination (NCLEX-RN) was used for analysis of those in the United States. The relevance between the subjects in the standard syllabuses of pathophysiology and the registered nurse licensure exam items of these workbooks in South Korea and the United States respectively was analyzed. RESULTS: The Relevance rates in South Korea and the United States were : fundamentals of nursing 6.34% vs 32.12%, adult nursing 25.5% vs 25.92% child health nursing 7.81% vs 21.7%, woman health nursing 5.1% vs 17.07% psychiatric mental health nursing 2.7% vs 7.32%, and community health nursing 0.9% vs 0%. CONCLUSION: the relevance in pathophysiology between the registered nurse licensure exam in South Korea and the United States was high in adult nursing and fundamentals of nursing (especially in the United States). In developing integrated registered nurse licensure exam questions, we should consider pathophysiology as an important subject.
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Adult , Female , Humans , Child Health , Community Health Nursing , Korea , Licensure , Nurses , Nursing , Psychiatric Nursing , United StatesABSTRACT
PURPOSE: This study was done to assess nursing students' practice of patient safety management (PSM), identify factors affecting PSM and provide basic data to develop education programs to strengthen students' competencies for patient safety. METHODS: In this descriptive research the practice of PSM by nursing students was examined and predictive factors were identified. Participants were junior and senior nursing students from 7 universities in 7 cities. Self-report questionnaires were used for data collection. RESULTS: Significant positive correlations were found between knowledge of PSM, perception of the importance of PSM and practice of PSM. In multivariate analysis, women students, participation in patient safety education in school, knowledge of PSM, and practice of PSM predicted high perception of the importance of PSM. In multivariate analysis, senior year and participation in patient safety education in school predicted higher knowledge of PSM. In multivariate analysis, perception of the importance of PSM predicted high practice of PSM. CONCLUSION: In this study, knowledge was not found to directly affect PSM practice, but was found to affect the perception of the importance of PSM, a significant predictive variable. Thus, the importance of PSM should be strongly emphasized during education.
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Female , Humans , Data Collection , Education , Multivariate Analysis , Nursing , Patient Safety , Surveys and Questionnaires , Students, NursingABSTRACT
PURPOSE: In this study factors affecting job satisfaction and turnover intention of nurses were explored in the context of organizational culture, self-leadership, and empowerment. METHODS: Participants were 286 nurses drawn from 3 general hospitals. Data were analyzed using t-test, one-way ANOVA, Pearson correlation, and hierarchial multiple regression with the SPSS/WIN 18.0 program. RESULTS: Significant differences in job satisfaction and turnover intention were found according to organizational culture types. Significant positive correlations were found between self-leadership, empowerment, task oriented organizational culture, relationship oriented organizational culture, innovation oriented organizational culture and job satisfaction. On the other hand, significant negative relationships were found between empowerment, relationship oriented organizational culture, innovation oriented organizational culture and turnover intention. The factors that enhance job satisfaction were found to be higher innovation-oriented organizational culture. Lower turnover intention was shown to be positively associated with relationship- or innovation oriented organization culture. CONCLUSION: Innovation oriented organizational culture is needed in order to raise job satisfaction and reduce turnover intention of nurses.
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Hand , Hospitals, General , Intention , Job Satisfaction , Organizational Culture , Power, PsychologicalABSTRACT
PURPOSE: The study was undertaken to investigate effects of decision making competency, nursing professionalism and job satisfaction on turnover impulse, and identify factors contributing to turnover impulse among nurses. METHODS: The study was a descriptive study with 231 nurses from 4 general tertiary hospitals participating. Data were collected during March, 2013 using a structured self-report questionnaire. Decision making competency, nursing professionalism, and job satisfaction were measured with validated instruments, and turnover impulse was measured with one question using a 5-point Likert scale. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson correlation coefficients and multiple regression. RESULTS: The significant predictors of turnover impulse among nurses were professionalism (beta=-0.18, p=.015) and job satisfaction (beta=-0.18, p=.009). These variables explained 12% of the variance in turnover impulse among nurses. CONCLUSION: The results indicate that nursing managers need to put efforts in improving nurses' job satisfaction and to develop plans to increase nursing professionalism in order to reduce nurses' turnover impulse.
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Decision Making , Job Satisfaction , Nursing , Surveys and Questionnaires , Tertiary Care CentersABSTRACT
A 70-year-old man was transferred to our center due to severe epigastric and back pain with the impression of a ruptured thoracic aortic aneurysm. Six months previously, he had undergone insertion of stent graft into the descending thoracic aorta at another hospital. The findings of the computed tomographic scan suggested a rapidly growing malignant mediastinal tumor rather than a ruptured aneurysm. Exploratory thoracotomy confirmed the diagnosis and the tumor was resected along with the portion of the aorta contained in it. This exemplary case should raise the concern against overzealous application of endovascular aortic repair.