PURPOSE: Recently, vancomycin-resistant enterococci (VRE) have become one of the major nosocomial pathogens in Korea. However, there have been few studies on the epidemiology of VRE colonization among neonates. In this study, we investigated the prevalence of VRE colonization, risk factors for VRE, and how to control the spread of VRE infection in the Neonatal Intensive Care Unit (NICU) of Pusan National University Hospital (PNUH). METHODS: We retrospectively reviewed medical records of 192 neonates who were admitted to the NICU of PNUH from March 2006 to March 2007. Surveillance cultures from rectal swabs for detecting VRE were obtained weekly during the study period. We analyzed the prevalence of VRE and various risk factors. RESULTS: The rate of VRE colonization among NICU patients was 25% (48/192). Thirty five of these VRE colonized patients were transferred to the NICU from other local hospitals. Compared with the non-VRE group, the risk factors associated with VRE colonization were lower birth weight, congenital heart disease, applied mechanical ventilation, use of a central venous catheter, chest tubing, a history of surgery, and use of antibiotics. CONCLUSION: VRE colonization among patients admitted to the NICU is rapidly increasing. Monitoring and managing premature neonates from the beginning of the birth process, avoiding many invasive procedures, avoiding antibiotics such as vancomycin and third generation cephalosporin are important for preventing the emergence and spread of VRE colonization in the NICU.
Anti-Bacterial Agents ; Birth Weight ; Central Venous Catheters ; Colon ; Heart Diseases ; Humans ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Korea ; Medical Records ; Parturition ; Prevalence ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Thorax ; Vancomycin ; Vancomycin Resistance

Pretibial myxedema is a condition in which there is loeal thickening of the skin by a mucin-like deposit; it is nearly always asosciated with ophthalmopathy and thyrotoxicosis, not infrequently becomes more pronounced after treatrnent of thyrotoxicosis. The precise cause of pretibial myxedema is not known, but it appears that IgG LATS represents an autoantibody against a thyroid antigen, retroorbital tiesue and tbe skin, so, pretibial myxedema is presumed to be the result of a local antigen-antibody tissue reaction. A 57-year-old man had the history of diabetes since 1964 and Graves disease since May 1980, he was treated with metimazole for 1 month, with improving thyrotoxicosis but developed the pretibial myxedema. The histologic findings showed considerable amount of mucin, especially hyaluronic acid with toluidin blue stain at PH 3.0. The lesions were improved by local application of 0.01 x fluocinolone acetonide ointment with occlusive dressing technique.
Fluocinolone Acetonide ; Graves Disease ; Humans ; Hyaluronic Acid ; Hydrogen-Ion Concentration ; Immunoglobulin G ; Long-Acting Thyroid Stimulator ; Middle Aged ; Mucins ; Myxedema* ; Occlusive Dressings ; Skin ; Thyroid Gland ; Thyrotoxicosis

Behcet's syndrome has been known as a disease which has the triple symptoms such as recurrent orogenital ulceration and eye inflammation. The syndrome is now recogninized as a multisystem disease involving mucocutaneaous, cardiovascular, central nervous system, renal, articular and gastrointestinal system. The vascular involvement in Behcet's disease has been reported since Mischima first described the case in 1961, four types of vascular lesion are recognized ; arterial occlusion ; aneurysm ; venous occlusion ; and varices. Venous occlusion are frequently observed, most commonly in the inferior or superior vena cava. We report a case of Behcet's disease manifested as superior vena cava syndrome due to thrombus on both brachiocephalic veins.
Aneurysm ; Behcet Syndrome* ; Brachiocephalic Veins ; Central Nervous System ; Inflammation ; Superior Vena Cava Syndrome* ; Thrombosis ; Ulcer ; Varicose Veins ; Vena Cava, Superior*

PURPOSE: To evaluate the imaging findings of endometrial stromal sarcoma (ESS) according to histopathologic grade. MATERIALS AND METHODS: Six patients with pathologically proven ESS were included in this study. The histopathologic diagnosis was low-grade ESS for three patients and high-grade ESS for the three others. Preoperative CT or MR images were evaluated in terms of tumor size, location, growth pattern, the presence of hemorrhage or necrosis, status of the endometrial cavity, and invasion of surrounding structures. The imaging features of ESSs, which varied according to their histopathologic grade, were compared. RESULTS: The mean maximal diameter of low-and high-grade ESSs was 6 cm and 11.2 cm, respectively. All three low-grade ESSs were located mainly in the myometrium, but two high-grade ESSs were situated in the endometrial cavity and associated with focal tumor extension into the myometrium. One high-grade ESS had completely replaced the uterus. Low-grade ESSs were relatively well-defined, but high-grade ESSs had an irregular and lobulated margin. Intratumoral hemorrhage and necrosis were, respectively, found in two and three high-grade ESSs. Widening of the endometrial cavity was noted in all three high-grade ESSs, and lymph node metastasis had occurred in one. CONCLUSION: The imaging findings of ESS vary from a well-defined intramural mass to a bulky infiltrating mass, and depend on their histopathologic grade.
Animals ; Diagnosis ; Female ; Hemorrhage ; Humans ; Lymph Nodes ; Magnetic Resonance Imaging* ; Mice ; Myometrium ; Necrosis ; Neoplasm Metastasis ; Sarcoma ; Sarcoma, Endometrial Stromal* ; Uterine Neoplasms ; Uterus

The current paper reports on a case of subdural empyema secondary to frontal sinusitis in an otherwise healthy child. Sinusitis is a common and benign condition in most pediatric cases. Because of the widespread use of antibiotics, intracranial extension of pediatric sinusitis is rarely seen today; however, complications (e.g., cavernous sinus thrombosis, orbital infection, meningitis, and subdural empyema) are potentially life threatening. A 15-year-old right-handed male presented with a 3-day history of fever, headache, and left-sided palsy. Computed tomography revealed right-sided subdural empyema with right frontal sinusitis and maxillary sinusitis. A postoperative inpatient neurological consultation was requested 2 months post-surgery due to motor function deficits. The results suggested that early and accurate diagnosis of subdural empyema leads to prompt treatment and a favorable outcome for the patient.
Adolescent ; Anti-Bacterial Agents ; Brain Abscess ; Cavernous Sinus Thrombosis ; Central Nervous System ; Child* ; Diagnosis ; Empyema, Subdural* ; Fever ; Frontal Sinus ; Frontal Sinusitis ; Headache ; Humans ; Inpatients ; Male ; Maxillary Sinus ; Maxillary Sinusitis ; Meningitis ; Orbit ; Paralysis ; Sinusitis*

PURPOSE: The purpose of this study is to investigate factors affecting social problem-solving ability of alcohol-dependent patients with a focus on gender differences. METHODS: Participants were 250 alcohol-dependent people(men 140, women 110) who were living in B, G and Y cities. Data were collected from January 10 to March 31, 2017 using self-report questionnaires. Abstinence self-efficacy, alcohol insight, unconditional self-acceptance, and social problem-solving ability were investigated. For data analysis, t-test, one-way ANOVA, Pearson correlation coefficients and multiple regression were employed. RESULTS: Factors influencing social problem-solving ability for men were unconditional self-acceptance and age. The explanatory power was 28%. Factors influencing social problem-solving ability for women were unconditional self-acceptance, stress, religiousness, age, occupation and abstinence self-efficacy and the explanatory power was 72%. Unconditional self-acceptance and age were significant variables of social problem-solving ability in both men and women. Stress, occupation, religiousness and abstinence self-efficacy were significantly associated with social problem-solving ability in women but not in men. CONCLUSION: The results suggest that it is necessary to consider gender characteristics in order to develop effective management programs for social problem-solving ability in alcohol-dependent people.
Alcoholics ; Female ; Humans ; Male ; Occupations ; Problem Solving ; Sex Characteristics ; Statistics as Topic

PURPOSE: After discharge from the hospital, very low birth weight infants require care consultation, information, and interaction and so forth, due to sequelae, different growth and developmental pattern; which increase the burdens and the worries of patients in nurturing them. With the counseling of experts in the related fields, the authors and the Food for the Hungry have run a department of childcare for a year, emphasizing on more family support than extreme early detection of disabilities. This study reports on relieving child care anxiety, promoting growth and development, educating parents on home treatment of sequelae, finding and coping with minor disabilities. METHODS: The subjects were chosen among infants under 1,500 g of birth weight and younger than a corrected age of 6 months. Meetings were held once in a month for a year. Infant care support classes were taught by experts in their fields including a music therapist (with play program), neonatologist, a children's nurse, a child-care director, a clinical psychologist, a rehabilitation therapist, a social worker and, a nutritionist. Within the self-dependent groups, the families were able to share their concerns and experiences on child-caring. Second home visits were carried out to monitor home oxygen therapy, tube feeding, cerebral palsy signs, and to find neglect or abuse in suspected cases. RESULTS: Fifty-one infants participated; the average weight was 1,060 g, the average gestational age was 27 weeks and 2 days. Eighteen were boys and 23 girls. The average age of the mothers was 33.4, and there were 26 appropriate for gestational age, 8 small for gestational age, and, 5 large for gestational age. Twenty three were first-born, 13 were second-born, 1 was third-born, and twins were 4 pairs. Home visits were done in 33 families, and secondary visits were done in 6 families. The depression score of mothers in the attendant group decreased from 10.47+/-5.18 to 8.18+/-5.87 (P=0.080). CONCLUSION: The depression score of mothers in the attendant group decreased after infant care support classes.
Anxiety ; Birth Weight ; Cerebral Palsy ; Child ; Child Care ; Counseling ; Depression ; Enteral Nutrition ; Female ; Follow-Up Studies* ; Gestational Age ; Growth and Development ; House Calls ; Humans ; Infant Care ; Infant* ; Infant, Very Low Birth Weight* ; Mothers ; Music ; Nutritionists ; Oxygen ; Parents ; Psychology ; Rehabilitation ; Social Workers ; Twins

Purpose: This study was conducted to assess public awareness and policy challenges faced by practicing nurses. Methods: After collecting nurse-related news articles published before and after ‘the Thanks to You Challenge’ campaign (between December 31, 2019, and July 15, 2020), keywords were extracted via preprocessing. A three-step method keyword analysis, latent Dirichlet allocation topic modeling, and keyword network analysis was used to examine the text and the structure of the selected news articles. Results: Top 30 keywords with similar occurrences were collected before and after the campaign. The five dominant topics before the campaign were: pandemic, infection of medical staff, local transmission, medical resources, and return of overseas Koreans. After the campaign, the topics ‘infection of medical staff’ and ‘return of overseas Koreans’ disappeared, but ‘the Thanks to You Challenge’ emerged as a dominant topic. A keyword network analysis revealed that the word of nurse was linked with keywords like thanks and campaign, through the word of sacrifice. These words formed interrelated domains of ‘the Thanks to You Challenge’ topic. Conclusion The findings of this study can provide useful information for understanding various issues and social perspectives on COVID-19 nursing. The major themes of news reports lagged behind the real problems faced by nurses in COVID-19 crisis. While the press tends to focus on heroism and whole society, issues and policies mutually beneficial to public and nursing need to be further explored and enhanced by nurses.

Purpose: This study was conducted to assess public awareness and policy challenges faced by practicing nurses. Methods: After collecting nurse-related news articles published before and after ‘the Thanks to You Challenge’ campaign (between December 31, 2019, and July 15, 2020), keywords were extracted via preprocessing. A three-step method keyword analysis, latent Dirichlet allocation topic modeling, and keyword network analysis was used to examine the text and the structure of the selected news articles. Results: Top 30 keywords with similar occurrences were collected before and after the campaign. The five dominant topics before the campaign were: pandemic, infection of medical staff, local transmission, medical resources, and return of overseas Koreans. After the campaign, the topics ‘infection of medical staff’ and ‘return of overseas Koreans’ disappeared, but ‘the Thanks to You Challenge’ emerged as a dominant topic. A keyword network analysis revealed that the word of nurse was linked with keywords like thanks and campaign, through the word of sacrifice. These words formed interrelated domains of ‘the Thanks to You Challenge’ topic. Conclusion The findings of this study can provide useful information for understanding various issues and social perspectives on COVID-19 nursing. The major themes of news reports lagged behind the real problems faced by nurses in COVID-19 crisis. While the press tends to focus on heroism and whole society, issues and policies mutually beneficial to public and nursing need to be further explored and enhanced by nurses.

PURPOSE: This study reviewed articles related to breast cancer, cognitive function and chemotherapy available in 4 databases. METHODS: The researcher reviewed 32 pieces of literature that were published between January 2001 and November 2011. RESULTS: Within the last decade, several studies have investigated whether adjuvant treatment of breast cancer affects cognitive function. A number of prospective studies have reported inconsistent results regarding whether chemotherapy affects cognitive function. Approximately half of the studies reported subtle cognitive decline in a wide range of domains among some breast cancer patients following chemotherapy, and others did not. CONCLUSION: Breast cancer patients receiving adjuvant chemotherapy showed the most deterioration and the most persistent decline in cognitive function. Since cognitive impairment is subtle, if evident at all, discrepant findings are due to hormonal, physiological, psychological or temporal confounding variables and differences in study design. Especially, that chemotherapy may impair memory, executive function, attention and visuospatial function in women with breast cancer.
Breast ; Breast Neoplasms ; Chemotherapy, Adjuvant ; Cognition ; Confounding Factors (Epidemiology) ; Executive Function ; Female ; Humans ; Memory