Development and Effectiveness of Emotional Intelligence Promotion Program for Schizophrenia / 정신간호학회지

Purpose@#The emotional problem of schizophrenia is an important factor that directly affects interpersonal relations and social behavior and can put them at risk of worsening symptoms and recurrence. This study attempted to develop an emotional intelligence promotion program for schizophrenia and verify its effectiveness based on Moon's emotional intelligence component and Leventhal and Cameron's self-regulation model. @*Methods@#The design of this study is the experimental design before and after the non-equivalence control group. The participants were 32 patients with schizophrenia (experimental group:16, control group:16). There were 16 schizophrenias in the experimental group and 16 schizophrenia in the control group. The emotional intelligence promotion program was conducted in 12 session for 6 weeks. Collected data was analyzed with SPSS/WIN by using descriptive statistics, normality test, x2-test, Fisher's Exact test, paired t-test, Repeated measure ANOVA and Independent t-test. @*Results@#There were statistically significant differences in emotional intelligence, interpersonal relations, and social behavior between the experimental group and the control group. @*Conclusion@#Since the program developed in this study has been tested to improve emotional intelligence, interpersonal relations, and social behavior of schizophrenia, it is expected to be widely used in clinical and community practice.

Hand Hygiene Compliance among Visitors at a Long-term Care Hospital in Korea: A Covert Observation Study

PURPOSE: This study aimed to assess hand hygiene (HH) compliance among visitors at a long-term care hospital in South Korea. METHODS: The study was conducted at a 502-bed long-term care hospital located in Gyeonggi-do Province. From July 1 to August 15, 2017, including more than 6 weekends and one holiday, a trained observer covertly assessed visitors' HH at all five units (360 beds in total) of the study hospital building until the completion of 1,000 HH opportunities (i.e., 200 opportunities per unit). The modified World Health Organization (WHO) HH observation form was used. Instead of professional categories and the “before clean/aseptic procedure” moment, the estimated age range for each visitor were recorded in four categories: children (<14 years old), adolescents (14~18), adults (19~64), and the elderly (≥65). The collected data were analyzed using SPSS 22.0. RESULTS: A total of 1,000 HH opportunities were observed from 766 visitors (an average of 1.31 per visitor) and the overall HH compliance rate was 20.3%. Overall, 53.7% of the HH cases were performed with soap and water. Among the 4 HH moments, the “after body fluid exposure risk” moment showed the highest compliance rate (83.5%); 93.9% used soap and water. The most commonly exposed potential body fluid among visitors was saliva (48.1%). CONCLUSION: For hospital visitors in long-term care hospitals, HH education programs including HH moments need to be developed and implemented. Further studies are necessary to evaluate visitors' HH compliance in various hospital settings and find the related variables influencing visitors' HH.

Educational Needs of Communication among Nursing Students / 정신간호학회지

PURPOSE: The purpose of this study was to explore educational needs of communication, focusing on how nursing students evaluate their current communication skills and what students think is most crucial in communication competency. METHODS: This cross-sectional descriptive study collected data from 276 nursing students at multiple universities from September to November 2016. Main analyses included descriptive statistics, independent t-tests, and one-way ANOVA with SPSS/WIN and R 3.2.3, as well as importance-performance analysis by Martilla and James. RESULTS: There was a difference in the perceived importance of communication depending on field experience. Students who reported excellent communication skills compared to their peers had higher perceived communication importance than those who reported similar or inferior skills. The perceived need for dominant communication of goal setting skills was the highest. After confirming the list of priorities for Borich's needs assessment, the education need for goal setting skills was the highest with 1.79. CONCLUSION: Our study findings emphasize that the highest need for education of nursing students was the dominant communication of goal setting skills. This is needed to develop an education program that can strengthen goal setting communication for nursing students with a special focus on dominant communication.

Safety and Usability Guidelines of Clinical Information Systems Integrating Clinical Workflow: A Systematic Review / 대한의료정보학회지

OBJECTIVES: The usability of clinical information systems (CISs) is known to be an essential consideration in ensuring patient safety as well as integrating clinical flow. This study aimed to determine how usability and safety guidelines of CIS consider clinical workflow through a systematic review in terms of the target systems, methodology, and guideline components of relevant articles. METHODS: A literature search was conducted for articles published from 2000 to 2015 in PubMed, Cochrane, EMBASE, Web of Science, and CINAHL. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement method was employed. Articles containing recommendations, principles, and evaluation items for CIS usability and safety were included. The selected articles were classified according to article type, methodology, and target systems. Taking clinical workflow into consideration, the components of guidelines were extracted and classified. RESULTS: A total of 7,401 articles were identified by keyword search. From the 76 articles remaining after abstract screening, 15 were selected through full-text review. Literature review (n = 7) was the most common methodology, followed by expert opinions (n = 6). Computerized physician order entry (n = 6) was the most frequent system. Four articles considered the entire process of clinical tasks, and two articles considered the principles of the entire process of user interface affecting clinical workflow. Only two articles performed heuristic evaluations of CISs. CONCLUSIONS: The usability and safety guidelines of CISs need improvement in guideline development methodology and with consideration of clinical workflow.

Ultrasonographic Assessment in Crystal-induced Arthritis / 대한내과학회지

The latest recommendations for the diagnosis and management of crystal-induced arthritis, such as gout and calcium pyrophosphate dihydrate (CPPD) deposition disease, recognize the diagnostic potential of musculoskeletal ultrasonography (MSUS). MSUS allows rapid, highly sensitive, non-invasive detection of microcrystal aggregates in multiple anatomic areas, and can be used as a safe, reliable guide for aspiration of articular and periarticular specimens suitable for microscopic analysis. MSUS can also be used to monitor disease after treatment. Ultrasonographic differentiation between gout and CPPD deposition disease is based on the characteristics of crystal aggregates and their preferential localization in different anatomical areas. This rapid assessment may profoundly affect the clinical process, avoiding expensive, time-consuming diagnostic procedures. This article reviews the current status of and recent advances in MSUS imaging in crystal-induced arthritis.

Clinical Characteristics Associated with Blood Culture Contamination in Neonates

PURPOSE: This study was aimed to investigate the contamination rates of blood culture in a neonatal intensive care unit (NICU) and to examine the clinical characteristics related to the contamination. METHODS: Eight hundred thirty cases of blood culture performed from March 2013 to February 2014 were analyzed. We evaluated the contamination rates of blood culture by blood sampling sites and compared the clinical characteristics such as real name system and body weights of the contaminated cases and those of non-contaminated ones. The clinical characteristics were retrospectively reviewed by medical records. RESULTS: The overall contamination rate was 3.6% (30/830). The contamination rates by blood sampling sites were as follows: peripheral vein 15.6% (10/64), peripheral artery 2.6% (20/759), and umbilical arterial catheter 0% (0/7). There was no difference in the contamination rates between cases with and without real name system (P =0.484). However, there were significant differences in the contamination rates by the physicians who performed the culture (P =0.038) and body weight ( or =1,000 g) at the time of blood culture (P<0.001). CONCLUSIONS: These results suggest that neonates with a body weight less than 1,000 g have more risks of the contamination of blood culture. Furthermore, there is a necessity to provide blood culture performers with active feedbacks and individualized education plans that can help diminish blood culture contamination rates. Prospective studies in a systematic manner that can be applied in actual clinical settings are needed in order to figure out factors that can diminish the contamination rates of blood culture in NICU.

Preterm Ovarian Hyperstimulation Syndrome

Preterm ovarian hyperstimulation syndrome (POHS) is characterized by swelling of the vulva and hypogastrium, elevated estradiol and gonadotropin levels, and multiple ovarian follicular cysts in premature baby girls. We report a case of POHS with a review of the literature. The patient presented with swelling of the clitoral hood, and the labia majora and minora. We confirmed multiple ovarian cysts, as well as elevated estradiol and lutenizing hormone levels by performing pelvic ultrasound and laboratory tests. The symptoms resolved gradually and spontaneously.

Intractable Hiccup as the Presenting Symptom of Cavernous Hemangioma in the Medulla Oblongata: A Case Report and Literature Review

A case of intractable hiccup developed by cavernous hemangioma in the medulla oblongata is reported. There have been only five previously reported cases of medullary cavernoma that triggered intractable hiccup. The patient was a 28-year-old man who was presented with intractable hiccup for 15 days. It developed suddenly, then aggravated progressively and did not respond to any types of medication. On magnetic resonance images, a well-demarcated and non-enhancing mass with hemorrhagic changes was noted in the left medulla oblongata. Intraoperative findings showed that the lesion was fully embedded within the brain stem and pathology confirmed the diagnosis of cavernous hemangioma. The hiccup resolved completely after the operation. Based on the presumption that the medullary cavernoma may trigger intractable hiccup by displacing or compression the hiccup arc of the dorsolateral medulla, surgical excision can eliminate the symptoms, even in the case totally buried in brainstem.

Cerebral Aspergillosis with Multiple Enhancing Nodules in the Right Cerebral Hemisphere in the Immune-Competent Patient

Aspergillosis in the central nervous system (CNS) is a very rare disease in immune-competent patients. There was a case of a healthy man without a history of immune-compromised disease who had invasive aspergillosis with unusual radiologic findings. A 48-year-old healthy man with diabetes mellitus, presented with complaints of blurred vision that persisted for one month. Brain magnetic resonance imaging (MRI) showed multiple nodular enhancing lesions on the right cerebral hemisphere. The diffusion image appeared in a high-signal intensity in these areas. Cerebrospinal fluid examination did not show any infection signs. An open biopsy was done and intraoperative findings showed grayish inflammatory and necrotic tissue without a definitive mass lesion. The pathologic result was a brain abscess caused by fungal infection, morphologically aspergillus. Antifungal agents (Amphotericin B, Ambisome and Voriconazole) were used for treatment for 3 months. The visual symptoms improved. There was no recurrence or abscess pocket, but the remaining focal enhanced lesions were visible in the right temporal and occipital area at a one year follow-up MRI. This immune-competent patient showed multiple enhancing CNS aspergillosis in the cerebral hemisphere, which had a good outcome with antifungal agents.

Pulmonary Hypertension Associated with Acute Hypoxic Pulmonary Vasoconstriction in a Patient with Acute Myeloid Leukemia / 대한내과학회지

Hypoxic pulmonary vasoconstriction is a unique response of the pulmonary circulation to hypoxia. It constitutes part of the self-regulatory mechanism by which pulmonary capillary blood flow is adjusted to alveolar ventilation for maintaining the optimal balance of ventilation and perfusion. In pathological conditions, hypoxic pulmonary vasoconstriction may occur as an acute episode or as a sustained response with pulmonary hypertension and vascular remodeling. We report a case of reversible pulmonary hypertension induced by acute hypoxic pulmonary vasoconstriction in an 18-year-old man with relapsed acute myeloid leukemia, complicated with severe anemia and pneumonia.

A Case of Septic Shock by Prevotella Species associated with Acute Periapical Abscess / 감염과화학요법

A healthy 34-year-old man was admitted to the intensive care unit through the emergency room with a drowsy mentality and severe chilling. Following a diagnosis of septic shock of unknown origin, the patient was treated with broad spectrum antibiotics and massive hydration. After recovery of consciousness, he complained of a severe toothache that originated from the right lower teeth. Under dental consultation, he was diagnosed as having an acute periapical abscess of the right mandibular first molar. The patient underwent extraction and cyst enucleation. Gram negative bacilli isolated from blood culture on day 5 after admission were identified as Prevotella species. After receiving antibiotic treatment and undergoing dental procedures, the patient made a full recovery. We report on a case of septic shock due to infection by Prevotella species in association with an acute periapical abscess.

Adrenal Metastasis from Hepatocellular Carcinoma without Intrahepatic Recurrence after Hepatic Resection / 대한소화기학회지

Although the adrenal gland is a common site of metastasis from hepatocellular carcinoma (HCC), adrenal metastases are rarely seen in clinical practice because of its lower metastatic potential compared to the other malignancies. Adrenal metastases usually were detected at the time of diagnosis of primary HCC or simultaneously with intrahepatic recurrence after curative management of HCC. It is very rare that only metastatic HCC is detected without evidence of intrahepatic recurrence. Hereby, we report two cases of adrenal metastasis from HCC without intrahepatic recurrence after hepatic resection.

Comparison of the BACTEC Blood Culture and Conventional Culture Methods for Isolation of Microorganisms Causing Peritonitis in CAPD Patients / 대한내과학회지

BACKGROUND/AIMS: Peritonitis is the most frequent complication of continuous ambulatory peritoneal dialysis (CAPD). Prompt recognition and treatment of peritonitis is important. The purpose of this study was to compare the effectiveness of isolation of the microorganisms causing CAPD peritonitis by the BACTEC blood culture and conventional methods. METHODS: We retrospectively reviewed 38 episodes of peritonitis in 34 CAPD patients between September 2007 and February 2010. Two methods of processing dialysate from patients on CAPD were used. Blood culture was performed using two 10-mL effluents, which were inoculated into a pair of BACTEC culture bottles. The conventional method was performed using 50 mL of centrifuged dialysate. The sedimented dialysate was inoculated onto blood agar and MacConkey agar plates or into thioglycollate broth. To evaluate effectiveness, we compared the rate of positive culture results and the time to identify the causative organism of the two culture methods. RESULTS: Use of the BACTEC bottle method resulted in more positive culture results than did conventional culture (86.8 vs. 57.9% p = 0.003). The time taken to identify the causative organism from culture-positive peritonitis was more rapid using the blood culture compared with the conventional culture method (90 vs. 109 hr, p = 0.03). CONCLUSIONS: Blood culture using the BACTEC bottle is more effective than the conventional culture technique for detection of causative microorganisms in CAPD peritonitis.

The Comparison between 6th and 7th International Union Against Cancer/American Joint Committee on Cancer Classification for Survival Prognosis of Gastric Cancer / 대한소화기학회지

BACKGROUND/AIMS: The tumor-node-metastasis (TNM) staging is an useful system to assess the prognosis of any solid cancer. As new TNM staging classification of 7th stomach cancer was revised in 2009, we evaluated the prognostic predictability of the 7th International Union Against Cancer/American Joint Committee on Cancer (UICC/AJCC) TNM classification compared to 6th UICC/AJCC TNM classification in gastric cancer. METHODS: From January 2000 to December 2009, 5-year survival rates of 266 patients with gastric cancer were calculated by the 6th and 7th UICC/AJCC TNM classification. RESULTS: Using the 7th UICC/AJCC TNM classification, there was no significant difference in the 5-year cumulative survival rates (5 YSR) between stage IIA and IIB, IIB and IIIA, and IIIA and IIIB (70% vs. 71%, p=0.530; 71% vs. 80%, p=0.703; 80% vs. 75%, p=0.576, respectively) though significant differences of the survival rates were observed among stages of 6th edition. Using T stage of 7th edition, 5 YSR was not different between T2 and T3 (86% vs. 82%, p=0.655). Using N stage of 7th edition, 5 YSR were not different between N1 and N2, N3a and N3b (79% vs. 81%, p=0.506; 41% vs. 17%, p=0.895, respectively). CONCLUSIONS: The 7th UICC/AJCC TNM classification had poor prognostic predictability in gastric cancer compared to the 6th edition.

Two Cases of Wernicke's Encephalopathy with Hyperemesis Gravidarum / 대한산부인과학회잡지

We have experienced two cases of Wernicke's encephalopathy associated with hypere-mesis gravidarum. Delay in it's diagnosis caused a protracted illness and persisting neurol-ogic deficits. Because of its association with chronic alcoholism, possibility of Wernicke's encephalopathy may not be considered in early stage of disease. The clinical feature, the principle of management and the prevention of Wernicke's encephalopathy are discussed.

A Case Using Misoprostol When Surgical Abortion Failed / 대한산부인과학회잡지

Suction curettage is a relatively safe procedure to induce abortion of first trimester pregnancy with a very low complication rate. But, in order to do that, cervix should be dilated enough to pass operating devices. We experienced a case of first trimester pregnancy terminated successfully using transvaginal misoprostol when suction curettage was failed due to severely cervical stenosis after LEEP conization.

Subperiosteal Ganglion: A Case Report / 대한정형외과학회잡지

Ganglia are ubiquitous but periosteal ganglion is rare. This case is presented showing an unusual radiological picture. The radiological picture with honey combed appearance is striking. Previaus reports have stressed the concavity in the cortex. Histologically the structure is identical to that of soft tissue ganglia.

The Treatment of Scaphoid Nonunion / 대한정형외과학회잡지

Fracture of the scaphoid constitute 60% to 70% of all diagnosed carpal injury. The acute fracture will heal approximately 90% of the time if recognized early and properly immobilized. But nonunion are common since the symtoms do not alert patients to seek early medical treatment and the diagnosis is easily missed. Authors have experienced 19 cases of scaphoid nonunion and accomplished good result in all case by Russe procedure. The results were summerized as follow: 1 The cause of fratures was mainly due to fall down dinjury (36.8%). 2. The most common mechanism of the fracture was fall on the outstretched hand (52.7%). 3. Fractures were shown on the anterior-posterior, lateral and billiards view in all cases. 4. In ten cases, the fractures were found on the waist of scaphoid. 5. The cases of nonunion were probably inadequate intial treatment and delayed diagnosis. 6. The good results were obtained by bone graft according to Russe procedure.