Purpose: The purpose of this study was to examine the influence of empowerment, infection control organizational culture, and infection control awareness on infection control performance among nurses in long-term care hospitals. Methods: A descriptive survey study was conducted with 125 nurses as subjects who had been working for at least six months in four long-term care hospitals located in Busan metropolitan city and Gyeongsangnam-do Province. Data were collected from September 30 to October 28, 2021 and analyzed using t-test, one-way ANOVA, Pearson’s correlation coefficients, and stepwise multiple regression with SPSS/WIN 26.0. Results: The results showed that infection control performance had significant correlations with empowerment (r=.36, p<.001), infection control organizational culture (r=.51, p<.001), and infection control awareness (r=.75, p<.001). Multiple regression analysis for infection control performance revealed that the most powerful predictor was infection control awareness (β=.70, p<.001). Empowerment, infection control awareness and awareness of infection control guidelines explained approximately 60.0% of the variance in infection control performance. Conclusion Findings indicated that various factors are related to the infection control performance among nurses in long-term care hospital. Based on the results of this study, further development and application of the programs to enhance empowerment and infection control awareness are needed in order to improve the infection control performance of nurses in long-term care hospitals.

Thyrotoxic periodic paralysis (TPP) is a rare manifestation of hyperthyroidism characterized by muscle weakness and hypokalemia. All ethnicities can be affected, but TPP typically presents in men of Asian descent. The most common cause of TPP in thyrotoxicosis is Graves' disease. However, TPP can occur with any form of thyrotoxicosis. Up to our knowledge, very few cases ever reported the relationship between TPP and painless thyroiditis. We herein report a 25-yr-old Korean man who suffered from flaccid paralysis of the lower extremities and numbness of hands. The patient was subsequently diagnosed as having TPP associated with transient thyrotoxicosis due to painless thyroiditis. The paralytic attack did not recur after improving the thyroid function. Therefore, it is necessary that early diagnosis of TPP due to transient thyrotoxicosis is made to administer definite treatment and prevent recurrent paralysis.
Administration, Oral ; Adult ; Anti-Arrhythmia Agents/therapeutic use ; Humans ; Hypokalemic Periodic Paralysis/*diagnosis/drug therapy/etiology ; Male ; Organotechnetium Compounds/chemistry/diagnostic use ; Potassium Chloride/therapeutic use ; Propranolol/therapeutic use ; Radiopharmaceuticals/diagnostic use ; Thyroiditis/*complications/radiography/ultrasonography ; Thyrotoxicosis/*diagnosis/etiology

BACKGROUND: Leptin, produced in the adipose tissue, is involved in the regulation of body weight. The release of the leptin is increased in obese adults even in children. This study investigated whether the serum leptin in cord blood was related to babys birth weight and metabolic parameters. METHODS: 71 pairs of singleton pregnancy babies and their mother were studied. Babies are classified in LGA (large for gestational age), AGA (appropriate for gestational age), SGA (small for gestational age) three groups. After delivery, cord blood and maternal venous blood samples were drawn. We measured the plasma leptin, insulin-like growth factor (IGF)-1, insulin and proinsulin in cord and maternal serum. RESULTS: The concentration of leptin from cord blood was increased in LGA babies and decreased in SGA babies compued with the level in AGA babies. There was positive correlatian (r=0.55, p<0.01) between the plasma leptin level in cord and birth weight. There were positive correlatian between both the plasma proinsulin (r=0.37, p<0.01) and IGF-1 (r=0.32, p<0.01) and birth weight, too. But there was no difference between female and male baby's cord blood leptin level. In multiple regression analysis, cord blood leptin level was found independent factor related to birth weight ( p=0.001) CONCLUDION : The plasma leptin, proinsulin and IGF-1 is correlates to the birth weight. These data provide evidence that leptin and proinsulin are highly related to the nutritional status already during the fetal periods, and effect on the intrauterine fetal growth.
Adipose Tissue ; Adult ; Birth Weight* ; Body Weight ; Child ; Female ; Fetal Blood* ; Fetal Development ; Humans ; Insulin ; Insulin-Like Growth Factor I ; Leptin* ; Male ; Mothers ; Nutritional Status ; Parturition* ; Plasma ; Pregnancy ; Proinsulin

Background: This study was performed to evaluate etiologies and secular trends in primary amenorrhea in South Korea. Methods: This retrospective multi-center study analyzed 856 women who were diagnosed with primary amenorrhea between 2000 and 2016. Clinical characteristics were compared according to categories of amenorrhea (hypergonadotropic/hypogonadotropic hypogonadism, eugonadism, disorders of sex development) or specific causes of primary amenorrhea. In addition, we assessed secular trends of etiology and developmental status based on the year of diagnosis. Results: The most frequent etiology was eugonadism (39.8%). Among specific causes, Müllerian agenesis was most common (26.2%), followed by gonadal dysgenesis (22.4%). Women with hypergonadotropic hypogonadism were more likely to have lower height and weight, compared to other categories. In addition, the proportion of cases with iatrogenic or unknown causes increased significantly in hypergonadotropic hypogonadism category, but overall, no significant secular trends were detected according to etiology. The proportion of anovulation including polycystic ovarian syndrome increased with time, but the change did not reach statistical significance. Conclusion The results of this study provide useful clinical insight on the etiology and secular trends of primary amenorrhea. Further large-scale, prospective studies are necessary.

Although tumor necrosis factor (TNF)-alpha antagonist is a successful treatment modality for various autoimmune diseases, including rheumatoid arthritis (RA), ankylosing spondylitis and psoriatic arthritis, many adverse effects have been reported. Cutaneous adverse reactions of TNF-alpha antagonist include skin rash, urticaria, lupus like rash, seborrheic dermatitis and different kinds of psoriasiform dermatitis. We report a case of psoriasiform dermatitis during TNF-alpha antagonist treatment in a 50-year-old woman with RA. The patient has been treated with adalimumab. After 2 months, she developed pruritic erythematous eruption and desquamative lesions on the head and limbs, which were defined as psoriasiform change by a skin biopsy. These skin lesions are successfully treated with combination therapy, including cessation of adalimumab, corticosteroid and phototherapy.
Antibodies, Monoclonal, Humanized ; Arthritis, Rheumatoid ; Autoimmune Diseases ; Biopsy ; Dermatitis ; Dermatitis, Seborrheic ; Exanthema ; Extremities ; Female ; Head ; Humans ; Middle Aged ; Phototherapy ; Skin ; Tumor Necrosis Factor-alpha ; Urticaria ; Adalimumab

The diagnosis of acute inflammation of the placenta, represented as acute chorioamnionitis, is important in that it is associated with a poor clinical outcome for both the mother and the fetus, including major perinatal morbidities such as sepsis, respiratory distress syndrome, and CNS damage. However, current medical trends in Korea seem to overlook the significance of a histopathological diagnosis of acute placental inflammation, mainly due to the indifferences of clinicians and pathologists. Since late 1993, histopathological examinations have been performed on preterm placentas at Seoul National University. These examinations have demonstrated acute placental inflammation in a significant number of cases. In the present study the incidence of acute placental inflammation was analyzed in 521 placentas which were submitted for pathological examinations in 1995. Examinations were performed to provide basic information on the incidence and profile of acute placental inflammation in this hospital and, thereby, to emphasize the significance of histopathological examinations of the placenta in the routine surgical pathology service. Among the 521 placentas, acute inflammation was found in 194 cases (37.2%). In preterm placentas acute inflammation was found in 39.6% of the cases (67/169), while 36.1% (127/352) of term placentas showed acute inflammation. Taking the delivery mode into account, 26.3% (49/186) of the placentas delivered by cesarean section showed acute inflammation, while 43.3% (145/335) of the transvaginally delivered placentas showed inflammation. The present analysis demonstrates the existence of acute inflammation in a significant proportion of placentas with different clinical settings. The importance of a histopathological examination in routine hospital practice should be emphasized.
Incidence

PURPOSE: To measure the level of compliance to conservative treatment of epicondylitis and to identify factors affecting compliance. METHODS: This study included 104 patients who were treated non-operatively for epicondylitis of the elbow from 2009 to 2011. At the time of initial visit, all patients had thorough explanation about diagnosis, cause and pathophysiology of the disease, and were recommended to wait-and-see or to have steroid injection. At minimum of 6 month's follow-up, we performed telephone survey including patient's level of perception about the disease, maintenance of initial treatment method, and final symptom relief. Statistical analysis was performed using chi-square test, Fisher's exact test and logistic regression analysis. RESULTS: Of the 104 patients, 82 (78.8%) patients maintained initial treatment methods. 23 (22.1%) remembered exact diagnosis and mechanism of the disease, 49 (47.1%) remembered cause or mechanism but not about the diagnosis, and 32 (30.8%) didn't know about the diagnosis nor mechanism. Compliances of those groups were 73.9% (17/23), 79.6% (39/49), and 81.3% (26/32), respectively, and the differences were not statistically significant (p=0.7934). Initial pain (odds ratio=0.7, p=0.0293) and the compliance (odds ratio=6.13, p=0.0015) were significant predictors of final symptom relief. CONCLUSION: There were no factors including perception level that proved to affect the compliance. Since higher compliance led to more successful outcome, further research on factors that increase compliance may be needed.
Compliance ; Elbow ; Follow-Up Studies ; Humans ; Logistic Models ; Telephone

BACKGROUND AND OBJECTIVES: Accumulation of keratin debris in the middle ear is one of the characteristics of the cholesteatoma. It is related to increased rate of cell death and differentiation of keratinocytes compare to normal skin. This kind of cell death is known as apoptosis. In this study, we plan to investigate the apoptotic cell death and expression of Fas in both normal and cholesteatoma epithelia. MATERIALS AND METHODS: Seven cholesteatomas and retroauricular skins were obtained from patients undergoing middle ear operations. Detection of the fragmented DNA in apoptosis was done by in situ TUNEL methods and agarose gel electrophoresis. For the morphologic confirmation of apoptosis, transmission electron microscopy (TEM) was done. Immunohistochemistry was also performed for detection of Fas expression on the tissue. RESULTS: In TUNEL staining, many positive staining nuclei were observed in upper layers of cholesteatoma epithelium whereas a few positive cells were found on the granular layer of retroauricular skin. Typical "ladder pattern" was seen on the gel electrophoresis of the genomic DNA of cholesteatoma. On TEM study, we observed condensation of chromatin in the keratinocytes of the cholesteatoma epithelium. Immunohistochemical studies revealed that Fas protein was expressed in all layers of cholesteatoma epithelium, while retroauricular skin showed weak reactions only in the granular layer. CONCLUSION: We confirmed that increased apoptosis and up-regulated expression of Fas in cholesteatoma epithelium. Since Fas is known as apoptosis triggering protein, the authors suggest that accumulation of keratin debris is due to increased apoptotic cell death and further investigation should be needed about the mechanism of cell death in cholesteatoma.
Apoptosis ; Cell Death* ; Cholesteatoma* ; Chromatin ; DNA ; Ear, Middle ; Electrophoresis ; Electrophoresis, Agar Gel ; Epithelium* ; Humans ; Immunohistochemistry ; In Situ Nick-End Labeling ; Keratinocytes ; Microscopy, Electron, Transmission ; Skin

No abstract available.

Gastropleural fistula is a very rare disorder, caused by various conditions, such as trauma and postoperative complication, subphrenic abscess, malignancy, hiatal hernia. The major causes of the gastropleural fistula have changed from trauma and subphrenic abscess to postoperative complication of malignant disorders. We report a case of empyema that developed respiratory failure caused by gastropleural fistula in a middle age woman with review of related articles.
Empyema ; Female ; Fistula* ; Hernia, Hiatal ; Humans ; Middle Aged ; Postoperative Complications ; Respiratory Insufficiency* ; Subphrenic Abscess