PURPOSE: We report clinical charateristics of percutaneous central venous catheteriza- tion(PCVC) that is performed commonly as a vascular access procedure in the neonatal intensive care unit(NICU) including comparision between the success rate and com- plication rate of groups performed by a doctor and by nurses who were accustomed to the IV procedure. METHODS: We evaluated a total of 158 PCVC cases performed in the NICU of Soonchunhyang Chunan hospital over 2 years 5 rnonths from May, 1995 to September, 1997. The 24 cases of PCVC were performed by doctors and 134 cases of this proce- dures were performed by well trained nurses. We have compared success rates, clinical characteristics, insertion sites, indwelling time, causes of removal of the catheters, and associated complication of both doctor performed group (D) and nurse performed group (N) retrospectively. RESULTS: The mean gestational age, birth weight, weight at the time of insertion were significantly lower in the doctor performed group than in the nurse group(P<0.001). There were significant differences in postnatal age and mean duration per catheter in both groups. The overall success rate of insertions was 89.9%(142/158), the success rate of doctor performed group was 54.2%(13/24) and nurse group was 96.3%(129/134) and there was significant difference(P<0.001). In the doctor performed group, 100% were axillary however in the nurse group 43.4% were axillary, 38.8% were antecubital, 9.4% were temporal, and 5.4% were hand. The most common cause of the removal of the catheter was elective in both groups but there was also substantial spontaneous removal by the patients and mechanical complication. Cultures of catheter tips were done after removal in 110 cases, among then were positive in 36 cases(33.6%), the most common causes were Staphylococcus aureus and Candida albicans. CONCLUSION: In this report, the authors emphasize that percutanous central venous catheterization performed by well trained nurses has a higher success rates than the doctor performed group and can be considered safe. We would also like to emphasize that more attention should be paid to the maintanace of PCVC.
Birth Weight ; Candida albicans ; Catheterization, Central Venous ; Catheters ; Central Venous Catheters ; Chungcheongnam-do ; Gestational Age ; Hand ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Retrospective Studies ; Staphylococcus aureus

BACKGROUND: This study was performed to develop a dietary self-efficacy questionnaire and to determine how dietary self-efficacy is related to selected biochemical markers and health-related quality of life in hemodialysis patients. METHODS: Participants included 172 patients who had been participating in a dialysis program for at least 6 months at two teaching hospitals. A questionnaire was used to assess socio-demographic factors, dialysis-related factors, dietary self-efficacy, and kidney disease quality of life (KDQOL). Serum levels of potassium and phosphorus and interdialytic weight gain were also measured. RESULTS: The internal reliability of dietary self-efficacy was 0.944 (Cronbach's alpha). Principal component analysis resulted in two factors, situational self-efficacy of compliance with dietary guidelines and self-efficacy of food choice. The correlation analysis showed a significant association between situational self-efficacy of compliance with dietary guidelines and serum potassium and KIDQOL. The average scores of situational self-efficacy of compliance with dietary guidelines and self-efficacy of food choice in the participants were 3.52+/-0.72 and 3.61+/-0.71 respectively. Multiple linear regression analysis showed that the situational self-efficacy of compliance with dietary guidelines was significantly associated with serum potassium level and KDQOL and self-efficacy of food choice was significantly associated with KDQOL. CONCLUSIONS: Based on our results, the developed dietary self-efficacy questionnaire may be a suitable survey tool for hemodialysis patients, which can play a role in predicting clinical indicators of patient and health-related quality of life. We recommend further research into clarifying whether the positive effects of increased dietary self-efficacy is maintained in long-term dialysis patients.
Biomarkers ; Compliance ; Dialysis ; Diet ; Hospitals, Teaching ; Humans ; Kidney Diseases ; Linear Models ; Phosphorus ; Potassium ; Principal Component Analysis ; Quality of Life ; Renal Dialysis ; Self Efficacy ; Weight Gain

PURPOSE: The purpose of this study was to compare levels of postpartum fatigue, depression, childcare stress, and maternal identity according to postpartum period between primiparas who used Sanhujori facilities and those who did not. METHODS: The research design was a longitudinal descriptive study using self-report questionnaires. Participants were 55 healthy primiparas who delivered at one of 3 hospitals in Chungnam, 21 using Sanhujori facilities and 34 not using these facilities during the first three weeks after childbirth. Data were collected from October 2008 to April 2009 at three measurement points, 2-4 days after childbirth (T1), 4-6 weeks (T2), and 12-14 weeks (T3). Data were analyzed using the SPSS 17.0 WIN program. RESULTS: There was a significant difference in childcare stress between the two groups at 4-6 weeks after childbirth. Postpartum depression and childcare stress at 4-6 weeks were significantly higher than those of the other postpartum periods, while maternal identity was significantly lower. CONCLUSION: Child care stress is the most important issue among women who use Sanhujori facilities and the 4-6 week period after childbirth is very difficult to primiparas. These results indicate that nursing interventions for primiparas in Sanhujori facilities should focus on reducing childcare stress. Furthermore proper follow-up programs at 4-6 weeks are needed to decrease the difficulties in adjustment by new mothers.
Adaptation, Psychological ; Adult ; Depression, Postpartum ; Fatigue ; Female ; *Health Status ; Humans ; Longitudinal Studies ; Mother-Child Relations ; Mothers/*psychology ; Parenting/psychology ; Postnatal Care/*methods ; Postpartum Period ; Pregnancy ; Questionnaires ; Stress, Psychological

Background: Longitudinal melanonychia (LM) can be caused by a variety of benign and malignant conditions. Nail matrix biopsy is necessary for the diagnosis of LM; however, physicians hesitate to perform the nail matrix biopsy due to the risk of postoperative complications like permanent matrix damage. Therefore, biopsy methods that minimize the risk of postoperative complications are necessary. Objective: To investigate the efficacy and safety of the nail matrix shave biopsy using a razor blade. Methods: We reviewed the medical records, clinical photographs, and histopathologic slides of patients who underwent shave biopsy for the diagnosis of LM from January 2018 to March 2020 at Wonkwang University Hospital. Results: The entire pigmented lesion was removed completely by shaving only a partial thickness of the superficial matrix in all patients. The histopathologic diagnosis was melanocyte activation with no atypia in all cases. Eight patients were followed up for 7∼19 months. Resting pain after the shave biopsy improved in most cases (75%) within 1 week. One patient experienced numbness lasting for 3 months. Abnormal sensations, such as tingling and itching, were temporarily reported by two patients. One patient (12.5%) had temporary postoperative nail plate dystrophy, and three patients (37.5%) had recurrence of pigmentation. Conclusion Our protocol of shave biopsy showed a lower rate of postoperative nail dystrophy than the conventional shave biopsy. We suggest that the shave biopsy using a flexible stainless steel razor blade is a favorable alternative to the conventional shave biopsy.

Necrotizing fasciitis is a rare, but life-threatening infection. Prompt diagnosis and early aggressive intervention is required for survival. However, there has been frequently occurred in delays of diagnosis and treatment due to its non-specific nature. Therefore, a high index of suspicion is needed to ensure timely intervention. We report a case of necrotizing fasciitis in a 7-day-old term healthy neonate.
Dietary Sucrose ; Fasciitis, Necrotizing ; Humans ; Infant, Newborn

PURPOSE: The purpose of this study was to examine the experiences of Sanhujori facility use among the first time mothers in Korea. METHODS: A qualitative study was conducted, using focus group interview. Data were collected from the 24 first time mothers of 4 focus groups, who had given birth within 6 month and had used one of the Sanhujori facilities located in C province, Korea. After obtaining written informed consent from all participants, each session of the focus group was audio-taped and transcribed into verbatim. Data were analyzed using content analysis in order to identify significant themes. RESULTS: Four major themes that emerged from the data were as follows. 1) Promoting postpartum physical recovery through a enough time with only focusing on herself, 2) Promoting postpartum psychological recovery through emotional and informational support with peer mothers, 3) Experiencing breast feeding difficulties and disappointing with unsatisfied help from health professionals, and 4) Lack of the professional education programs regarding parenting. CONCLUSION: Based on these results, it will be suggested that the various support programs by not only the peer mothers co-resided in Sanhujori facilities but also the health care professionals in the Sanhujori facilities should be developed for helping a "becoming a mother" of the first time mother in the Sanhujori facilities. In addition, qualified education and counseling program, especially for the successful breast feeding, should be provided by the health care professionals for improving mothering ability of the first time mother in the Sanhujori facilities.
Breast Feeding ; Counseling ; Delivery of Health Care ; Education ; Education, Professional ; Focus Groups* ; Health Occupations ; Humans ; Informed Consent ; Korea ; Mothers* ; Parenting ; Parents ; Parturition ; Postpartum Period ; Qualitative Research

Tumoral calcinosis is an ectopic calcification syndrome characterized by an irregular soft tissue mass. It has been reported mainly in large joints such as the hip, shoulder, knee, and elbow, but rarely in the hands. When it occurs on the dorsal side of the wrist, there are no specific symptoms except for localized tenderness. Therefore, it is difficult to differentiate the calcification from other common hand tumors, especially ganglions. We report a case of tumoral calcinosis that occurred on the dorsal side of the wrist with magnetic resonance imaging findings.

Tumoral calcinosis is an ectopic calcification syndrome characterized by an irregular soft tissue mass. It has been reported mainly in large joints such as the hip, shoulder, knee, and elbow, but rarely in the hands. When it occurs on the dorsal side of the wrist, there are no specific symptoms except for localized tenderness. Therefore, it is difficult to differentiate the calcification from other common hand tumors, especially ganglions. We report a case of tumoral calcinosis that occurred on the dorsal side of the wrist with magnetic resonance imaging findings.

The problems of foreign body injection such as vaseline, paraffine, mineral oil for penile augmentation done by illegal medical practitioners are tissue inflammation, necrosis, granuloma formation, deformity and erectile dysfunction. The treatment of these complication are composed of foreign body removal and resurfacing of denuded penis. Many resurfacing procedures are introduced such as split thickness skin graft, flap-to-graft conversion method, scrotal flap, groin flap and free flap. Skin graft is the simplest method with minimal donor site morbidity, but there are some complications like scar contracture, hypertrophic scar and difficulty of erection. Thick split thickness skin graft can prevent these complications. We measured the length, circumference and surveyed erectile function with International Index of Erectile Function(IIEF) after long-term follow up. Increase in mean length and circumference at erection are 43% and 36%, respectively, compared to resting, and the survey with IIEF had a better result than that of normal control group. We found preserved erectile function without scar contracture and hypertrophic scar. Thick split thickness skin graft is the good method for treatment of penile vaselinoma with simplicity, minor donor site morbidity and preservation of erectile function.
Cicatrix ; Cicatrix, Hypertrophic ; Congenital Abnormalities ; Contracture ; Erectile Dysfunction ; Follow-Up Studies ; Foreign Bodies ; Free Tissue Flaps ; Granuloma ; Groin ; Humans ; Inflammation ; Male ; Mineral Oil ; Necrosis ; Paraffin ; Penis ; Petrolatum ; Skin* ; Tissue Donors ; Transplants*