Factors Associated with Person-Centered Care among Hospice Nurses / 한국호스피스완화의료학회지

Purpose@#The purpose of this study was to examine person-centered care, nursing professionalism, the nursing work environment, and empathy capacity among hospice ward nurses and to identify the factors affecting person-centered care. @*Methods@#Data were collected using a self-report questionnaire completed by 120 nurses at 30 inpatient hospice institutions in South Korea from August 24, 2020 to September 8, 2020. The independent t-test, one-way analysis of variance, and Pearson correlation analysis were conducted using SPSS version 26.0. @*Results@#The scores were 3.76±0.45 for person-centered care, 3.58± 0.47 for nursing professionalism, 3.24±0.57 for the nursing work environment, and 4.00± 0.46 for empathy capacity. There were positive correlations between the variables. Factors that influenced the person-centered care of hospice nurses were being a manager (β=0.20, P=0.002), high nursing professionalism (β=0.20, P=0.012), a better nursing work environ-ment (β=0.15, P=0.033), and high empathy capacity (β=0.51, P＜0.001). The explanatorypower was 65.3%. @*Conclusion@#To reinforce the person-centered care competency of hospice nurses, it is necessary to improve nursing professionalism, the nursing work environment, and empathy competency. Opportunities for nurses to practice independently must be expanded for nurses to develop nursing professionalism. Sufficient nursing personnel and material resources must be provided to nurses to cultivate a positive work environment.Empathy should be improved by implementing integrated education programs that include nursing practice situations.

A Concept Analysis of Posttraumatic Growth in Family Caregivers of Cancer Patients

PURPOSE: The purpose of this article was to identify and define concepts of post-traumatic growth of family caregivers of cancer patients. METHODS: This study was conducted according to the method of Walker and Avant (2005)'s, focusing on research articles and books published from 2000 to 2017. RESULTS: There were five attributes of the concept: personal growth, reinforcing relationships with others, understanding of others, finding meaning of care, and gratitude for life. Furthermore, antecedents were as follows: cancer diagnosis of a family member, cancer severity, role acceptance of caregiver, caregiving related burden, self-esteem, and hope. The consequences, therefore, were promoting patient' s posttraumatic growth and psychological well-being, increased the quality of life, health related habits change, balance of life, satisfaction of life, and continuation of care. CONCLUSION: Knowing the factors of posttraumatic growth in nursing can be used to devise an intervention to enhance the posttraumatic growth of family caregivers of cancer patient, which can then be applied to a variety of nursing areas.

All-on-4 implant restoration with full-digital system preserving existing occlusion: A case report / 대한치과보철학회지

In edentulous patients, implant - supported fixed prosthesis treatment has been proved to be useful, but involves complex treatment process. On the other hand, in the modern dentistry, digital technology has been developed day by day and it has expanded its range to the implant restoration of edentulous patients. In this case, a digital system was used for all stages of diagnosis, surgery, design and fabrication of provisional implants fixed prosthesis restoration in 66-year-old mandibular edentulous patients. In the preoperative diagnosis stage, a provisional restoration was designed based on the mucosal scan using the intraoral scanner and the stable occlusion of prefabricated complete denture of the patient. After flapless implant surgery using the surgical guide, the prefabricated interim restoration was connected to the implant and used as immediate provisional restoration. The final restoration was designed and fabricated by transferring the vertical dimension and the centric relation of the provisional restoration with stable occlusion using digital technology. We report a simple protocol of implant treatment in edentulous patients by using digital techniques to preserve the patient's vertical dimension and occlusion.

The Consideration about Usefulness of Mass Screening for Dementia

BACKGROUND: With the increasing elderly population in Korea, the number of dementia patients is estimated to reach nearly a million by 2027. To resolve this problem, centers for dementia were established in Korea since 2007 and mass screening for dementia proceeded in these center. This research was the analysis of the results of mass screening in Seongdong-gu center for dementia. METHODS: From July 2007 to December 2013, we registered 23,186 persons at Seongdong-gu center for dementia and all individuals were aged 60 and older. They classified the subjects into cognitive impairment group and normal group by Korean version Mini-Mental State Examination (K-MMSE). Next, the cognitive impairment group was assorted by Consortium to Establish a Registry for Alzheimer's Disease Korean version (CERAD-K) and the examination of two neurologists. We investigated the prevalence of dementia and the usefulness mass screening of dementia among that data. RESULTS: A total of 23,186 subjects were enrolled, of which 3,286 were cognitive impairment group, and 1,856 were diagnosed with dementia finally. The mean age was 77.1 years, 67% were female and the mean education level was 6.3 years. Disease incidence of dementia was lower year by year, but this went up when we focused the group who has high risk of dementia. Especially, the sharp decline was observed in complete enumeration dementia screening test about the specific age group. CONCLUSIONS: These results could suggest that we should focus on the group who has high risk of dementia in screening for dementia and it requires a more judicious approach.

GC/MS analysis of high-performance liquid chromatography fractions from Sophora flavescens and Torilis japonica extracts and their in vitro anti-neosporal effects on Neospora caninum

We analyzed alcoholic extracts of herbs possessing anti-neosporal activity against Neospora (N.) caninum. To identify the chemical components of Sophora (S.) flavescens and Torilis (T.) japonica associated with anti-neosporal activity, specific fractions were isolated by high-performance liquid chromatography (HPLC). In vitro activity of the fractions against N. caninum was then assessed. Gas chromatography/mass spectrometry (GC/MS) was used to identify and quantify specific anti-neosporal molecules in the herbal extracts. Almost all HPLC fractions of S. flavescens and T. japonica had higher levels of anti-neosporal activity compared to the not treated control. Active constituents of the extracts were sophoridane, furosardonin A, and tetraisopropylidene-cyclobutane in S. flavescens; 5,17-beta-dihydroxy-de-A-estra-5,7,9,14-tetraene, furanodiene, and 9,12-octadecadienoic acid (Z,Z)-(CAS,1) in T. japonica.

Clinical Features of Patients on Home Oxygen Therapy Due to Chronic Respiratory Failure at One University Hospital

BACKGROUND/AIMS: Home oxygen therapy (HOT) costs a great deal every year and demand for the service is growing. In Korea, health insurance has covered HOT since November 1, 2006. The objective of this study was to evaluate clinical features of patients who used long-term HOT due to chronic respiratory failure and to determine the appropriateness of oxygen prescriptions. METHODS: Between November 2006 and April 2010, patients prescribed long-term HOT were enrolled in the study at a tertiary university referral hospital and their medical records and telephone survey information were evaluated. In total, 340 patients were evaluated retrospectively. RESULTS: Regarding the initial indications for HOT, their mean PaO2 was 49.8 mmHg and mean SpO2 was 82.2%. Underlying diseases included chronic obstructive pulmonary disease (COPD, 19.8%), lung cancer (12.6%), and interstitial lung disease (11.2%). The admission rate within 1 year was 53.4% and the average number of admissions was 1.64/patient. Other underlying diseases for which oxygen was prescribed, despite not meeting the insurance coverage criteria, were lung cancer (36.6%) and interstitial pneumonia (16.6%). CONCLUSIONS: Home oxygen prescriptions have increased since health insurance coverage was extended. However, cases of oxygen prescriptions frequently do not meet the coverage criteria. It is important to discuss extending the coverage criteria to other disease groups, such as interstitial lung disease and lung cancer, in terms of cost-effectiveness. Further, physicians prescribing oxygen therapy should be educated regarding the criteria.

The prevalence of feline parasites in Suwon, Korea / 대한수의학회지

Feline parasites were investigated in the area of Suwon in Korea from September to October, 2003. Wild cat had spread to zoonotic parasites, these parasites could cause infection with a person. People have a lot of interest in parasite infection of wild cat. This article reviews rate of infection of a parasites and kind of a parasite of wild cats. We will report the critical characteristic features of parasites to a better understanding of the disease. The incidence rates of Toxocara cati, Trichuris felis, Ancylostoma braziliense and Capillaria sp were 37.0, 4.3, 1.1 and 1.1% in nematodes. Those of Taenia taeniaformis and Opisthorchis sp were 2.2 and 1.1% in cestode and trematode. Those of Isospora felis, Toxoplasma gondii, and Sarcocystis sp were 8.7, 9.8, and 2.2% in protozoa. Almost of these were zoonotic parasites without Isospora felis.

A Case of Respiratory Syncytial Virus Related Acute Respiratory Distress Syndrome: A Case Report / 대한구급학회지

Respiratory syncytial virus (RSV) is a common cause of respiratory tract infection in children. Although previously considered as children's virus, the increasing number of patients who receive immunosuppression after transplantation of bone marrow and solid organs highlighted the role of RSV as a pathogen for opportunistic infection. We report a case of community-acquired respiratory syncytial virus pneumonia in a patient with newly diagnosed leukemia, resulting in acute respiratory distress syndrome (ARDS).

The number of resident physicians and the mortality rate in a medical intensive care unit / 대한내과학회지

BACKGROUND/AIMS: The treatment outcome of patients hospitalized in intensive care units (ICUs) can be influenced by physician factors, including both intensivists and resident physicians. We evaluated the association between the number of residents who are exclusively responsible for the ICU and the mortality rate in a medical ICU. METHODS: The data obtained from an open medical ICU in a teaching hospital from Jan. 2005 to Dec. 2009 were analyzed retrospectively. We evaluated the associations between the ICU mortality rate and both the number of resident physicians and the number of patient-days per resident physician using multivariate Poisson regression analysis adjusted for year and month. RESULTS: The months with fewer than two residents tended to have a higher ICU mortality rate, although this difference was not significant in the univariate analyses. Multivariate Poisson regression analysis showed that months with fewer than two residents had a significantly higher ICU mortality rate compared with months with two residents (incidence risk ratio (IRR) 1.59, 95% confidence interval (CI) 1.05-2.41; p=0.029). The number of ICU patient-days per resident physician was not associated with the ICU mortality rate (IRR; 1.00, 95% CI, 0.99-1.01; p=0.649). CONCLUSIONS: The presence of fewer than two residents exclusively responsible for the medical ICU was an independent risk factor of a higher ICU mortality rate. However, no association was found between the number of ICU patient-days per resident physician and the ICU mortality rate.

A case of malignant pericardial mesothelioma misdiagnosed as tuberculosis pericarditis / 대한내과학회지

Primary pericardial mesothelioma is an extremely rare neoplasm with a bleak prognosis. It is often misdiagnosed as constrictive pericarditis initially, especially as tuberculosis pericarditis in Korea due to the high incidence of active tuberculosis. A targeted pericardial biopsy and noninvasive imaging modalities, such as delayed phase contrast chest computed tomography (CT) images and magnetic resonance imaging (MRI), can play an important role in the differential diagnosis of pericardial disease. We present the case of a 37-year-old man with a 3-week history of exertional dyspnea. A large pericardial effusion with pericardial thickening was noted, but its etiology was not revealed after conventional diagnostic procedures, including a closed pericardial biopsy. Empirical antituberculosis treatment was started, but the dyspnea recurred 5 months later. A malignant pericardial mesothelioma was diagnosed through a pericardiectomy and biopsy under direct visualization

A Case of Poststreptococcal Glomerulonephritis Representing Rapidly Progressive Glomerulonephritis in an Elderly Patient / 대한신장학회잡지

Postinfectious streptococcal glomerulonephritis (PSGN) presenting as a rapidly progressive glomerulonephritis (RPGN) and nephrotic syndrome (NS) is a rare disease in elderly patients. Here we report a case of PSGN with RPGN and NS in an elderly male patient with a complete recovery from his illness. A 73-year-old man was admitted for dyspnea, oliguria and generalized edema appearing after acute upper respiratory infection. On admission, he presented nephrotic range of proteinuria, decreased renal function with elevated ASO, and decreased C3 and CH50 concentrations. The renal biopsy showed marked cellular crescents in the glomeruli with collapsed glomerular tufts and inflammatory cell infiltration. There were prominent and various sizes of "humps" in subepithelial areas in electron microscopy. Under the diagnosis of PSGN with RPGN, we successfully treated the patient with steroid pulse therapy and hemodialysis. We would suggest that early diagnosis and aggressive steroid therapy should be indicated in the treatment of PSGN with RPGN.

Acute Myocardial Infarction Associated with Secondary Hypertension by Renal Juxtaglomerular Cell Tumor

Most patients with hypertension and no definable cause are said to primary or essential hypertension, while other patients with hypertension and specific causes are siad to secondary hypertension. Approximately 5% fo patients with hypertension have specific causes. The patients of secondary hypertension should not be ignored for the reason: The elimination of cause for hypertension can normalize the blood pressure. Juxtaglomerular cell tumor is a rare condition of secondary hypertension, with only approximately 70 cases reported to date. The higher the level of blood pressure, the most likely that various cardiovascular diseases will develop prematurely through acceleration of atherosclerosis. But Acute myocardial infarction in young hypertensives has been reported rarely. We describe the rare case of a young patient with acute myocardial infarction associated with secondary hypertension by renal juxtaglomerular cell tumor.

A Study on Levels of Awareness of Nosocomial Infection and Management Practices by Operating Room Nurses / 기본간호학회지

PURPOSE: This study was done to examine the awareness and management practice of operating room nurses, to prevent nosocomial infection, to identify problems and to propose solutions. METHOD: The research tools used were the hospital infection control guideline and a modified version of the measurment tools used in the study of Cho (1998). The questionnaire consisted of questions on hand washing, personal hygiene and clothes control, cleaning and environment control, sterilizing supplies and disposal of contaminated materials. The collected data were analysed with the SPSS program. RESULTS: The mean score for domain-specific awareness of nosocomial infection control was 4.81 out of a possible 5 points. The highest score was for sterilizing supplies and disposal of contaminated materials. The mean score for domain-specific practices of nosocomial infection control was 4.40, out of a possible 5 points. Sterilizing supplies and disposal of contaminated materials had the highest scores. The mean score for awareness in all domains was higher than mean score for practice. Among the general characteristics of the nurses, high awareness was found only in the provision of infection control guidelines and it had shown statistically significant difference. Examination of relation of general characteristics to practice showed that for age, career, the provision of infection control guidelines, and experience in infection control education there were statistically significant differences in the scores. For the relation between awareness of nosocomial infection control and practice, positive correlation was found in all domains, thus high awareness leads to high practice. CONCLUSION: Considering the result of this research, plans are needed that promote virtual practice of hospital infection control.

Factors Associated with Renal Scar in Children with Vesicoureteral Reflux

PURPOSE : The urinary tract infection associated with vesicoureteral reflux(VUR) in children may result in serious complications such as renal scarring, hypertension, proteinuria and end stage renal disease. The purpose of this study was to evaluate the factors affecting renal scar such as age, gender, grade of VUR, and ACE gene polymorphism, and body growth in the patients with and those without renal scar associated with VUR METHODS : During the period from January 1994 to July 2000, We had 93 children with urinary tract infection associated with VUR who were admitted to the Department of pediatrics of Chonbuk National University Hospital. The patients were divided into two groups according to follow up 99mTc-DMSA renal scan; patients with renal scar group and those with non-scar group. We analyzed and compared the factors associated with renal scarring between the two groups. RESULTS : There were no significant difference in gender, causative organism, ACE gene polymorphism, height and weight at diagnosis between renal scar group and non-scar group. Fifty four patients were in renal scar group and forty seven of them had VUR. The age at diagnosis was significantly higher in renal scar group (2.48 +/-2.64yr) than in non renal scar group (1.26+/-1.83yr). Especially, the infants who were less than 1 year of age with VUR developed relatively more renal scar compared with infants older than 1 year of age. The incidence of renal scarring showed a direct correlation with the severity of VUR. CONCLUSION : The factors affecting renal scar formation were age at diagnosis, presence and grade of VUR, but the other factors such as gender, causative organism, ACE gene polymorphism were not associated with renal scarring. Therefore, further evaluation about uropathogenic E. coli and follow up study about body growth associated with severity of renal scar would be necessary.

A Case of Constrictive Pericarditis with Purulent Effusion in an Infant

Constrictive pericarditis is a rare disease of infancy and childhood, and is almost always caused by a tuberculosis or other infection. It is usually fatal, if untreated in acute phase. Early diagnosis of this condition is now facilitated by echocardiography and computerized tomography. Favorable outcome seems to depend on early diagnosis assured by echocardiography, early surgical treatment such as pericardiocentesis or pericardiectomy, and appropriate antibiotic treatment according to culture and sensitivity test. We report a case of constrictive pericarditis with severe purulent effusion in a 11-month-old female who presented with fever, irritability and hepatomegaly, and was treated with pericardiectomy and antibiotics.

A Case of Small Duodenal Carcinoid Tumor Treated by Strip Biopsy Technique / 대한소화기내시경학회지

Carcinoid tumors of the duodenum are infrequent, represent 2.0-3.0% of all gastrointestinal carcinoid tumors in western countries and 14.8% of those in Japan. Small carcinoid tumors of the duodenum are often asymptomatic, discovered endoscopically, Duodenal carcinoid tumors have been treated by surgical resection or endoscopic resection with strip biopsy or polypectomy. We experience a case of carcinoid tumor of duodenum in 49 years woman. Endoscopic examination, 0.7 cm sized polypoid mass with central depression was noted on duodenal bulb area. We present a case of a small duodenal carcinoid treated with strip biopsy technique.

A Case of the HELLP Syndrome treated with Postpartum Plasmapheresis / 대한산부인과학회잡지

Plasmapheresis has been used for some conditions during pregnancy and puerperium, such as hemolysis, elevated liver enzymes, and low platelet (HELLP) syndrome. We present one case of the HELLP syndrome which was treated with plasmapheresis and also review the indications, complications and guidelines for repetitive plasma exchange.

Mediastinal Hemangioma: Report of a case

Benign hemangioma of the mediastinum is rare. This slowly growing tumor is described as well circumscribed, cystic, hemorrhagic tumor. Histologically it can be differentiated into capillary or cavernous form. We present a case of mediastinal hemangioma. A 20-year-old-man was presented with a slowly growing posterior mediastinal mass of 6 years duration, 8x6 cm in size. The mass was relatively well defined but focally invasive. Microscopically, it was differentiated into vessels of capillary, cavernous, and venous patterns. A solid cellular proliferation with inconspicuous capillary lumens was focally seen. The stroma between variable-sized vessels showed marked myxoid change associated with some smooth muscle bundles and adipose tissue. Ultrastructurally, areas of solid cellular proliferation showed formation of lumens. These lumens were lined by active endothelial cells showing plasmalemmal vesicles and Weibel-Palade bodies on the abluminal surface.

Comparison of Cine Magnetic Resonance Imaging with Doppler Echocardiography for the Quantative Evaluation of Tricuspid Regurgitation in Newborn

BACKGROUND: Cine MR imaging has been found to bo a non-invasive technique in evaluation cardiac anatomy and cardiovascular function in a variety of cardiac diseases. The capability of this technique for quantatively estimating the severity of regurgitation has not been tested in newborns. The purpose of this study is to compare the degees of tricuspid regurgitation by echorcardiography with those by cine MRI, and verify the utility of MRi in evaluating tricuspid regurgitation. METHODS: Fifty-one newborns with tricuspid regurgitation were evaluated on the same day by echocardiography and cine MRI. Area and regurgitant fraction of area were estimated at four chamber view by two techniques. RESULTS: The area of tricuspid regurgitation was similar by two techniques. The correlation for the area(r=0.66, p<0.025) and the regurgitant area fraction(r=0.647, p<0.025) of tricuspid regurgitation obained by cine MRI with echocardiographic data was good. CONCLUSION: Cine MR imaging can provide quantative data estimating for evaluation of tricuspid regurgitation in newborns.

Reaction of the sera of the Korean children free from Hib invasive diseases against H. influenzae type B capsular polysaccharide antigen

The purpose of our experiment is to examine the level of anti-Haemophilus influenza polysaccharide antibody titer in the Korean population. Using ELISA, the level of Hib-PS antibodies in 384 infants and children who were all free from Hib invasive diseases, was tested. And the blood of 50 mothers within 24 hours of delivery and cord blood from their respective full-term neonates was also tested. The transport of Hib-PS IgG and IgG subclasses in paired sera from mothers and neonates was also measured. The titer of Hib-PS IgG varies with age. At birth the mean optical density of cord blood was 1.028; however, it declined to 0.609 up to 6 months and further decline was noted up to 2 years to 0.488. Then the mean O.D. remained around 0.5 from 3 to 14 years of age. The mean O.D. of Hib-PS IgG in the mothers blood was 0.856. The ratio of mean O.D. of anti-Hib PS IgG antibody in the cord blood to that in the maternal blood was 1.20. The mean optical densities of IgG subclasses were: 1.18 for anti-Hib PS IgG1, 1.07 for anti-Hib PS IgG2, 1.01 for anti-Hib PS IgG3, and 1.09 for anti-Hib PS IgG4. The sera from Korean children of almost all age groups reacted to Hib-PS antigen on ELISA. Also the active transport of anti-Hib PS IgG antibody through placenta was observed. Among four IgG subclasses, only IgG1 transport had significant experimental meaning.