PURPOSE: To develop end-of-life care training programs for nurses who provide in a tertiary hospital, we examined the mediating effects of empathy and resilience on the relationship between their stress and job performance. METHODS: This study was conducted with 218 participants at a hospital in B city in South Korea from August 15 through August 30, 2017. Data collected from the participants were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and multiple regression using the IBM SPSS/WIN 21.0 software. RESULTS: Terminal care stress was found to be negatively correlated with empathy competence (r=−0.345, P < 0.001), resilience (r=−0.223, P=0.001) and terminal care performance (r=−0.260, P < 0.001), whereas empathy (r=0.467, P < 0.001) and resilience (r=0.358, P < 0.001) were positively correlated with terminal care performance. Empathy had a complete mediating effect (β=0.409, P < 0.001) on the relationship between terminal care stress and performance, and resilience a partial mediating effect (β=0.294, P < 0.001). CONCLUSION: Based on the findings of this study, development of training programs with a focus on empathy and resilience are highly recommended to improve job performance of nurses who provide terminal care in a tertiary hospital.
Education ; Empathy* ; Korea ; Mental Competency ; Negotiating* ; Terminal Care* ; Tertiary Care Centers* ; Work Performance

Gangweon-do is known to be highly endemic area of sparganosis more than other provinces in Korea. A seroepidmiologic examination for the detection of anti-Spirometra erinacei plerocercoid IgG in serum was carried out in normal inhabitants in Hongcheon-gun, Gangweon-do. Sere were tested by enzyme-linked immunosrobent assay (ELISA) for the anti-sparganum antibodies. Positive rate for anti-sparganum antibody in 719 adults was 3.3%. Data of the questionnaire for 24 ELISA positive inhabitants revealed that 20 had a history of eating raw meat of snakes, 24 had a history of eating frogs, and 24 had a history of drinking stream water. Two positive cases had a past history of sparganosis. Two positive cases showed current symptoms of sparganosis. The data revealed that ELISA would be useful to find infected cases among normal inhabitants at sparganosis-endemic areas.
Adult ; Aged ; Aged, 80 and over ; Animals ; Antibodies, Helminth/*blood ; Enzyme-Linked Immunosorbent Assay ; Female ; Human ; Immunoglobulin G/*blood ; Korea/epidemiology ; Male ; Middle Aged ; Seroepidemiologic Studies ; Sparganosis/*epidemiology ; Spirometra/*immunology

The antimicrobial agents reduced infectious diseases significantly. However, antibiotic resistance has followed for almost every antimicrobial agent. Especially, Staphylococcus aureus was one of the most notorious for the multidrug resistance. Streptomyces sp. 681 has been selected for antibiotic-producing strain against methicillin-resistant Staphylococcus aureus (MRSA) from 1,000 strains of Actinomycetales which had been isolated from soil. In antimicrobial susceptibility test, all of the test strains were susceptible to vancomycin. However, most strains of Staphylococcus aureus were found to be resistant to methicillin. Ninety eight (75%) strains out of 129 strains showed multiple resistance pattern to more than 5 antimicrobial agents. The MIC values of the purified antibiotic (K-681) were 1-32 ug/ml against Gram-positive bacteria compared to >128 ug/ml against Grarn-negative bacteria or fungi. The MIC was 8 ug/ml for 90% of the 129 clinical isolates of S. aureus. The antibiotic showed no cytotoxicity against P 388, HeLa, and S180 at the concentration of 500 ug/ml.
Actinomycetales ; Anti-Infective Agents ; Bacteria ; Communicable Diseases ; Drug Resistance, Microbial ; Drug Resistance, Multiple ; Fungi ; Gram-Positive Bacteria ; Methicillin ; Methicillin-Resistant Staphylococcus aureus ; Soil ; Staphylococcus aureus* ; Staphylococcus* ; Streptomyces* ; Vancomycin

Minoxidil is a potent direct-acting peripheral vasodilator indicated in the management of severe or refractory hypertension. Well-known adverse effects include reflex tachycardia, fluid retention and hypertrichosis. This drug has also been reported to cause pericardial effusion in about three percent of nondialyzed patients with compromised renal function and to cause cardiac tamponade less frequently. Many studies have reported that the mean duration of therapy that caused pericardial effusion was about 8 months (range 1 month-53 months). We report a case of cardiac tamponade in nondialyzed patient with chronic renal failure receiving minoxidil for 10 years. A 58-year-old female was admitted to our hospital with dyspnea of NYHA III. She was a chronic renal failure patient without dialysis treatment and received kidney transplantation from cadaver donor and was dignosed chronic rejection in 1994. Minoxidil 10mg has been used for past 10 years. Lasix has been used for past 2 years, with dosage of 40mg to 240mg. On admission, blood pressure was 90/60mm Hg. Cardiomegaly was seen on chest radiograph. The two-dimensional echocardiogram showed a large amount of pericardial effusion. Emergency treatment with pericardiocentesis removed 2500ml of straw- colored pericardial fluid and resulted in marked improvement of dyspnea and stabilized blood pressure. The minoxidil was discontinued. The evidence of pericardial effusion was not seen for 12 months after minoxidil had been discontinued.
Blood Pressure ; Cadaver ; Cardiac Tamponade* ; Cardiomegaly ; Dialysis ; Dyspnea ; Emergency Treatment ; Female ; Furosemide ; Humans ; Hypertension ; Hypertrichosis ; Kidney Failure, Chronic* ; Kidney Transplantation ; Middle Aged ; Minoxidil* ; Pericardial Effusion ; Pericardiocentesis ; Radiography, Thoracic ; Reflex ; Tachycardia ; Tissue Donors

Lovastatin is a potent inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A reductase, which catalyzes the conversion of hydroxymethylglutaryl-coenzyme A to mevalonate, anearly and rate-limiting step in the synthesis of cholesterol. We studied the therapeutic effect and safety of lovastatin in 18 patients with nonfamilial primary hypercholesterolemia. Patients received 20mg/day lovastatin therapy as a single evening dose. If the total cholesterol level exceeded 200mg/dl after 2weeks of lovastatin therapy, the dosage of lovastatin was doubled. Mean percent total cholesterol level reductions from baseline were 26.4% and 31.9% after 4, and 8 weeks of lovastatin therapy respectively. Mean percent HDL-cholesterol level increase from baseline were 12% and 13% after 4, and 8 weeks of lovastatin therapy respectively. Adverse effects attributable to lovastatin were mild and temporary and no patient was withdrawn from therapy. We concluded that lovastatin was a well tolerated and effective agent for the treatment of nonfamilial primary hypercholesterolemia. Further studies are needed to establish the long-term safety and effectiveness of this drug.
Cholesterol ; Coenzyme A ; Humans ; Hypercholesterolemia* ; Lovastatin ; Mevalonic Acid ; Oxidoreductases

By November 2013, a total of 125 clinical practice guidelines (CPGs) have been developed in Korea. However, despite the high burden of diseases and the clinical importance of CPGs, most chronic diseases do not have available CPGs. Merely 83 CPGs are related to chronic diseases, and only 40 guidelines had been developed in the last 5 yr. Considering the rate of the production of new evidence in medicine and the worsening burden from chronic diseases, the need for developing CPGs for more chronic diseases is becoming increasingly pressing. Since 2011, the Korean Academy of Medical Sciences and the Korea Centers for Disease Control and Prevention have been jointly developing CPGs for chronic diseases. However, priorities have to be set and resources need to be allocated within the constraint of a limited funding. This study identifies the chronic diseases that should be prioritized for the development of CPGs in Korea. Through an objective assessment by using the analytic hierarchy process and a subjective assessment with a survey of expert opinion, high priorities were placed on ischemic heart disease, cerebrovascular diseases, Alzheimer's disease and other dementias, osteoarthritis, neck pain, chronic kidney disease, and cirrhosis of the liver.
Chronic Disease ; *Disease Management ; Expert Testimony ; Female ; Health Priorities ; Humans ; Male ; *Practice Guidelines as Topic ; Primary Health Care ; Republic of Korea ; Surveys and Questionnaires

BACKGROUND: As the rupture of chordae and/or papillary muscle became the main cause of mitral valve regurgitation, mitral reconstructive surgery has a very important role. In this regard, we analyzed the clinical result and postoperative early result of operative treatment performed in our hospital. MATERIAL ANDMETHOD: For this analysis, forty nine patients (male 26, female 23, mean age 49.0+/-16.5) who underwent mitral valve operation caused by the rupture of chordae and/or papillary muscle from August 1991 to April 2002 were reviewed. Among forty nine patients, twenty two (44.9%) received mital valve reconstruction and twenty seven (59.2%) received mitral valve replacement. RESULT: As to the pathological etiology of rupture of mitral and papillary muscle, twenty five cases (51.0%) were nonspecific degeneration, eleven cases (22.4%) were myxomatous degeneration, seven cases (14.3%) were subacute bacterial endocarditis. Three patients suffered mortality after operation (6.1%) and valve replacement was performed again on one patient because of remnant mitral insufficiency after valve reconstruction. The 5-year survival rate after operation for the entire mitral valve regurgitation patients was 81.4%. We have also compared and analyzed the operation results of a group of patients who underwent valve reconstruction and the other group of patients who underwent valve replacement from thirty six patients who had suffered from mitral valve regurgitation caused by degenerative disease. The mortalities were 0% and 14.3%, respectively and the 5-year survival rates were 90.2% and 64.3%, respectively, but there were no statistical significance. CONCLUSION: The most common pathological etiology of mitral valve regurgitation caused by rupture of chordae and/or papillary muscle was nonspecific degeneration. In case of degenerative disease is the cause of mitral valve regurgitation, valve reconstruction showed better long-term effects in many respects and better operation results compared to valve replacement.
Endocarditis, Subacute Bacterial ; Female ; Humans ; Mitral Valve Insufficiency* ; Mitral Valve* ; Mortality ; Papillary Muscles* ; Rupture* ; Survival Rate

POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal M protein, and skin lesion) is a rare multisystemic disease of unknown cause with varying clinical manifestations. Amyloidosis-associated POEMS Syndrome is also rare condition. We experienced a 63-year-old female who had been suffered from edema and tingling sensation of low extremities. She also had a marked demyelination, axonal degeneration and regeneration of the nerve, hypoaldosteronism, hyperprolactinemia, decreased sexual hormone, monoclonal gammopathy (IgG lambda type), skin change and ascites. The renal biopsy revealed homogenous mesangial widening with a few cell nuclei at the glomerular capillary, and it showed positive apple-green birefringence in Congo-red stain. It's the first report that shows the deposition of amyloid in patients with POEMS syndrome in Korea. Edema and M-spike were improved by use of prednisolone, melphalan, fludrocortisone and colchicine.
Amyloid ; Amyloidosis* ; Ascites ; Axons ; Biopsy ; Birefringence ; Capillaries ; Cell Nucleus ; Colchicine ; Demyelinating Diseases ; Edema ; Extremities ; Female ; Fludrocortisone ; Humans ; Hyperprolactinemia ; Hypoaldosteronism ; Korea ; Melphalan ; Middle Aged ; Paraproteinemias ; POEMS Syndrome* ; Prednisolone ; Regeneration ; Sensation ; Skin

STUDY DESIGN: Cross-cultural adaptation of the Korean version of the Oswestry Disability Index (KODI). OBJECTIVES: To conduct the cross-cultural adaptation for translating the original version of Oswestry Disability Index (ODI) (English version) SUMMARY OF LITERATURE REVIEW: Society is multicultural populations income. (This makes no sense?) Since languages and cultures are highly related, any cross-cultural assessment must be addressed in the outcome of the measurements. (I have made this into a proper sentence, but the meaning is still unclear, please confirm?) The Oswestry Disability Index (ODI) has not been translated into Korean, but is the most widely used tool in the world for measuring the intensity of back pain. MATERIAL AND METHOD: We used the guideline for the translation and cultural adaptation process, (Where were these guidelines from?) including forward translation, synthesis of translation, backward translation, committee review, pre-testing, test of the pro-final version, and finally, submission of the documentation to the developers. The Korean version of the Oswestry Disability Index (KODI) was tested on 116 patients with chronic low back pain. RESULTS: The reliability for the KODI, as measured by the Cronbach's alpha value, was 0.9168, and the reliability of the testretest was 0.9331. The process results were reported to the developer (Dr. Jeremy Fairbank), who appraised the KODI. CONCLUSIONS: The KODI was found to have satisfactory reliability. Therefore, the KODI can be recommended as a tool for the measurement of lower back pain in Korea.
Back Pain ; Humans ; Korea ; Low Back Pain ; Translating

BACKGROUND: The macrophages activated by lipopolisaccharide produce numerous molecules and proteins, such as tumor necrotic factor-alpha (TNF-alpha), interleukin-6 (IL-6), IL-1beta, inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), and free radicals, associated with inflammation. The response was occurred by intracellular cascaded, NF-kappaB pathway. So, the regulation of this pathway is very important in control of inflammation. OBJECTIVE: In this study, the anti-inflammatory and anti-oxidant effects of Sophora flavescens that is used empirically in oriental medicine and folk remedy were evaluated and the mechanism of the effects was studied. METHODS: By using the root extracts of Sophora flavescens, we performed experiment in LPS and interferon-gamma (IFN-gamma)-activated Raw 264.7 cells. We measured the production of NO, PGE2 and expression of iNOS and COX-2 in activated Raw 264.7 cells with Sophora flavescens root extract. Also, we tested anti-oxidant effect of Sophora flavescens root extracts by ELISA kit in activated Raw 264.7 cells, and the free radical scavenging effect of material itself by DPPH assay. RESULTS: The Sophora flavescens root extracts decreased the production of NO (p<0.001) and PGE2 (p<0.01) in Raw 264.7 cells activated by LPS and IFN-gamma. The expression of proteins, iNOS and COX-2, suppressed along with the elevated concentration of Sophora flavescens root extracts. The result of DPPH assay was that the test material itself had scavenging effect for free radical (p<0.001). And the antioxidant activity in activated Raw 264.7 cells was increased with the level of the Sophora flavescens root extracts (p<0.05). CONCLUSION: The Sophora flavescens root extracts suppressed the production of NO and PGE2 through the decreased expression of iNOS and COX-2. And the Sophora flavescens root extracts had the scavenging effect about free radicals itself and increased the antioxidant activity in activated macrophages.
Antioxidants ; Cyclooxygenase 2 ; Dinoprostone ; Enzyme-Linked Immunosorbent Assay ; Free Radicals ; Inflammation ; Interferon-gamma ; Interleukin-6 ; Macrophages ; Medicine, East Asian Traditional ; Medicine, Traditional ; NF-kappa B ; Nitric Oxide Synthase Type II ; Proteins ; Sophora