To compare the differences between hemodialysis and essential hypertension patients and its affecting factors of left ventricular hypertrophy and left ventricular systolic dysfucntion in patients with hemodialysis, M-mode and two dimensional echocardiography were performed in 77 essential hypertension without azotemia and 78 chronic renal failure patients receiving maintenance hemodialysis. M-mode measurement including LV mass (192.56+/-63.6g vs 300.01+/-95.99g, P=0.000), r/th (radius/LV thickness, 4.41+/-0.97 vs 4.74+/-1.0, P=0.039), LV dimemsion and fractional shortening (4.68+/-0.6 vs 5.63+/-0.97, P=0.000, 30.0+/-19.7% vs 36.6+/-97%, P=0.000 respectively) showed more severe eccentric LV hypertrophy and LV dysfunction in patients with hemodialysis than those of essential hypertension. Using Pearson correlation in hemodialysis patients, Interdialytic weight gain was positively correlated with LVEDD (r=0.318, P=0.005). In addition to the determinant, serum PTH level was negatively (r=-0.344, P=0.002) and Kt/V (r= 0.0487, P=0.003) was positively correalated with systolic function. The hypertension and dialysis duration, patient's age, had no relationship with LV function and mass in this study. In Conclusion, LV hypertrophy and LV systolic dysfunction occur more frequently in hemodialysis patients than in essential hypertension patients. And the LV systolic dysfunction, which is acutally related with the patient's quality of life, was partially explained by serum parathyroid level and Kt/V. But additional laboratory and prospective clinical studies are needed to further elucidate the mechanisms involved in the development of LVH and LV impairment in hemodialysis patients.
Azotemia ; Dialysis ; Echocardiography* ; Humans ; Hypertension* ; Hypertrophy ; Hypertrophy, Left Ventricular ; Kidney Failure, Chronic ; Quality of Life ; Renal Dialysis* ; Ventricular Dysfunction, Left ; Weight Gain

Aggregatibacter aphrophilus is a facultatively anaerobic gram-negative coccobacillus or bacillus that grows with no dependence on X factor and variable requirement for V factor. The organism is normal flora in the human oral cavity and upper respiratory tract and, rarely, causes invasive infections such as bacteremia, endocarditis, brain abscess, or osteomyelitis. We report a case of septic peripheral embolism in left leg from A. aphrophilus endocarditis. A 49-year-old man with known hypertension presented with acute muscle pain in the left leg. On physical examination, a regular heartbeat with a pansystolic murmur was heard. There were decreased pulses in the left popliteal and dorsalis pedis arteries and coldness of the left foot, although sensory and motor functions were intact. Angiography revealed an embolus in a branch of the left femoral artery. He underwent emergency embolectomy, and gram-negative bacilli grew in the embolus cultures. The same microorganism was isolated in two pairs of blood culturs and subsequently identified as A. aphrophilus. Transthoracic echocardiography revealed mitral regurgitation and multiple vegetations on the mitral valve. The patient was treated with a third-generation cephalosporin for 4 weeks and mitral valve replacement in view of the diagnosis of infective endocarditis and septic peripheral embolism.
Angiography ; Arteries ; Bacillus ; Bacteremia ; Brain Abscess ; Cold Temperature ; Echocardiography ; Embolectomy ; Embolism ; Embolism and Thrombosis ; Emergencies ; Endocarditis ; Femoral Artery ; Foot ; Humans ; Hypertension ; Leg ; Middle Aged ; Mitral Valve ; Mitral Valve Insufficiency ; Mouth ; Muscles ; Osteomyelitis ; Physical Examination ; Respiratory System

The purpose of this study was to analyse the current adult nursing curriculum content in diploma and baccaleurate level nursing schools. The Study was initiated by the Korean Academic Society of Adult Nursing and data were collected from these institutions from March 1997 to April 1998. The questionnaire was constructed after several meetings of researchers which included course description, objectives, conceptual framework, credits(theory and practicum), number of teaching staffs, content and hours for each content. The questionnaire was sent to all of the nursing schools(41 baccalaureate and 62 diploma) in the nation and the response rate were 53.7% in baccalaureate and 25.8% in diploma schools. Primary analysis was took place during summer workship of 1997 Korean Academic Society of Adult Nursing. The second analysis was carried out after additional data of detailed content and hours in adult nursing course were obtained from the schools. The result of primary analysis were as below : 1) The consensus in philosophy of adult nursing was drawn. The client of adult nursing was defined as individual over 18 years who has psychological, physical, social and spiritual aspects and interacting with environment. The client is a member of family and community. The students who finished the course should be able to adapt nursing process to their clients, and improve quality of life. The client, nursing process and nursing were common concepts which included in their conceptual framework. 2) Theory credits ranged 9-18(mean 14.1), practicum credits ranged 5-12(mean 8.1). The number of teaching staffs ranged from 2-6(mean 3.2). 3) The content which most hours assigned to were neuro/endocrine(mean 30.8 hours) gastrointestinal(mean 28.4 hours), cardiovascular(mean 28.6 hours) and respiratory(mean 22.7 hours) systems. 4) Areas taught by other profession(mostly physician) were eye, ear, nose, throat integumentary, radiation therapy, neuromuscular, rehabilitation, respiratory physiology, male genitourinary, pathology and anesthesiology. 5) Contents overlap with other course content should be rearranged in each school curriculums. Improvement of RN national board examination is prerequsite in order to improve adult nursing education in Korea. The result of second analysis were as below : 1) Credits required for graduation were 130-175 in baccalaureate, 93-134 in diploma. Thirteen to Twenty-eight percent of total credits required for nursing major were credits of adult nursing. 2) Mean hours of total adult nursing lecture were 217 in baccalareuate and 212 in diploma. 3) Disease process occupied more hours than nursing process in adult nursing theory. It is suggested to include all nursing educational institutions in order to complete the survey, to delineate the core contents of adult nursing and rate of hours between theory and practise by Korean Academic Society of Adult Nursing.
Adult* ; Anesthesiology ; Consensus ; Curriculum* ; Ear ; Education, Nursing ; Humans ; Korea ; Male ; Nose ; Nursing Process ; Nursing Theory ; Nursing* ; Pathology ; Pharynx ; Philosophy ; Quality of Life ; Rehabilitation ; Respiratory Physiological Phenomena ; Schools, Nursing ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to identify the symptoms and interference of activities of daily living (ADL) of chemotherapy induced peripheral neuropathy (CIPN) in patients receiving taxane and platinums. METHODS: 141 cancer patients were recruited in the cross-sectional survey design. The instruments used in the study was the Chemotherapy-induced Peripheral Neuropathy Assessment Tool (CIPNAT) developed by Tofthagen and colleagues. RESULTS: The patients experienced the symptom and interference of ADL of CIPN moderately. The most common symptom was nerve pain (70.2%) and the patients with high cumulative doses showed a significant of tingling sensation in the feet. Symptom severity increased substantially with cumulative dose of chemotherapeutic agents. CONCLUSION: The results of this study suggest that chemotherapy-induced peripheral neuropathy increase due to repeated chemotherapy and nursing intervention is necessary to reduce symptom severity and interference of ADL of CIPN.
Activities of Daily Living* ; Bridged Compounds ; Cross-Sectional Studies ; Drug Therapy ; Foot ; Humans ; Neuralgia ; Nursing ; Peripheral Nervous System Diseases* ; Platinum* ; Sensation ; Taxoids*

The large animal model with benign biliary stricture (BBS) is essential to undergo experiment on developing new devices and endoscopic treatment. This study conducted to establish a clinically relevant porcine BBS model by means of endobiliary radiofrequency ablation (RFA). Endoscopic retrograde cholangiography (ERC) was performed on 12 swine. The animals were allocated to three groups (60, 80, and 100 W) according to the electrical power level of RFA electrode. Endobiliary RFA was applied to the common bile duct for 60 seconds using an RFA catheter that was endoscopically inserted. ERC was repeated two and four weeks, respectively, after the RFA to identify BBS. After the strictures were identified, histologic evaluations were performed. On the follow-up ERC two weeks after the procedure, a segmental bile duct stricture was observed in all animals. On microscopic examination, severe periductal fibrosis and luminal obliteration with transmural inflammation were demonstrated. Bile duct perforations occurred in two pigs (100 W, n = 1; 80 W, n = 1) but there were no major complications in the 60 W group. The application of endobiliary RFA with 60 W electrical power resulted in a safe and reproducible swine model of BBS.
Animal Experimentation ; Animals ; Bile Ducts ; Catheter Ablation* ; Catheters ; Cholangiography ; Common Bile Duct ; Constriction, Pathologic* ; Electrodes ; Endoscopes ; Fibrosis ; Follow-Up Studies ; Inflammation ; Models, Animal ; Phenobarbital ; Swine*

BACKGROUND/AIMS: Common bile duct stones are associated with the extent of dilation of the common bile duct as well as its angulation. Multidetector computed tomography (MD CT) has a good resolution for the definition of the anatomical features of the common bile duct. METHODS: The multiplanar reformation images of 398 patients that underwent multidetector CT for the diagnosis of disorders not related to the bile duct were examined. The diameter and angulation were categorized by gender and age. RESULTS: The average diameter and angulation of the common bile duct was 6.7 mm and 132.6degrees. There was a statistically significant correlation between age and the common bile duct diameter. The Pearson correlation analysis for age and diameter resulted in a value of 0.415 (p<0.001). And the common bile duct (CBD) diameter in people older than 51 years of age showed a significant difference compared to the subjects younger than 50 years of age (p<0.01). However, the degree of angulation has no correlation with age. CONCLUSIONS: We suggest that CBD diameters in patients more than 50 years of age can be more than 7 mm and be within normal limits.
Bile Ducts ; Common Bile Duct ; Humans ; Multidetector Computed Tomography

PURPOSE: This study was conducted to develop a nurse-learning program for the pain management of cancer patients. METHODS: In this methodological study, a learning program was developed between January and June 2011, following the methodological procedure based on the ADDIE Instructional System Design. RESULTS: The learning program consists of 4 parts: learning goal, learning outcomes, learning method, and evaluation method. Learner-centered learning goal and learning outcomes were established, and lecture-based group learning and self-directed study were combined as the learning method. For the evaluation, we developed a written test, a nursing skill checklist, and a case report evaluation tool. After a pilot test, the learning program was assessed by an expert group for its construct validity and content-related conformance. Moreover, the effectiveness of the program was validated by the results of the learning outcomes evaluation and the achievement levels of 40 trainees who participated in the program. CONCLUSION: On the basis of the results of this study, we suggest that this unit-based core nursing practice learning program, comprising 202 nursing units developed by a research institute nursing department since 2010, be shared by all nurses in clinical nursing care settings to improve their practical performance and ensure necessary specialization.
Academies and Institutes ; Checklist ; Humans ; Learning* ; Methods ; Nursing Care ; Nursing* ; Oncologic Nursing ; Pain Management* ; Programmed Instruction as Topic

Damages on the recurrent laryngeal nerve (RLN) during thyroid surgery is the most common iatrogenic cause of vocal cord paralysis. Identification of the recurrent laryngeal nerve and meticulous surgical techniques can significantly decrease the incidence of this complication. The nonrecurrent inferior laryngeal nerve is an exceedingly rare anomaly of the recurrent laryngeal nerve. The nonrecurrent inferior laryngeal nerve is associated with abnormal development of the aortic arch, where the innominate (brachiorephalic) artery is not found and the right common carotid artery rises directly from the aortic arch. The aberrant right subclavian artery can always be felt against the vertebral column behind the esophagus. Surgeons need to be aware of the positions of these arteries to avoid damaging them. We experienced a case of nonrecurrent inferior laryngeal nerve in the right side with the aberrant right subclavian artery. The patient received a total thyroidectomy with neck dissection for thyroid carcinoma with nodal metastasis. Incidentally, we also found nonrecurrent inferior laryngeal nerve, and also found an aberrant right subclavian artery by the computed tomography scan. The patient presented transient vocal cord paralysis but gained complete recovery of vocal cord mobility after one and a half month later.
Aorta, Thoracic ; Arteries ; Carotid Artery, Common ; Esophagus ; Humans ; Incidence ; Neck Dissection ; Neoplasm Metastasis ; Recurrent Laryngeal Nerve* ; Spine ; Subclavian Artery ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy ; Vocal Cord Paralysis ; Vocal Cords

BACKGROUND: There is no guideline for the appropriate wavelength at which to measure the optical density (OD) value in broth microdilution antifungal susceptibility testing, although a spectrophotometric reading method is commonly used. The present study aimed to analyze the difference in the OD values over the range of visible light and to ascertain the optimal wavelength for the spectrophotometric method of microdilution testing. METHODS: We measured the OD of background blank controls of broth medium, antifungal agents, and inocula of five type strains using a Synergy HT multi-detection microplate reader at 5-nm intervals from 380 nm to 760 nm. We also estimated the OD differences between the 50% of growth control and blank control. RESULTS: The OD of the blank control showed a parabola shape with two peaks and steadily decreased at longer wavelengths. The curves of the antifungal agent were similar to those of blank controls, and the influence of each antifungal agent on the OD was minimal. For the difference in OD between 50% of growth control and the blank control, the curve was the opposite of the blank control, and the OD increased steadily at the wavelengths above 600 nm. CONCLUSIONS: The range between 600 nm and 700 nm was the optimal wavelength for broth microdilution antifungal susceptibility testing, although any wavelength within the visible light spectrum can be used.
Antifungal Agents/*chemistry ; Azoles/*chemistry ; Culture Media/*chemistry ; Flucytosine/*chemistry ; Microbial Sensitivity Tests ; Spectrophotometry/*methods

To determine the characteristics of seroprevalence of herpes simplex virus type 2 (HSV-2) infection among Korean people, a cross-sectional study was conducted on three groups in 2004. The three groups consisted of the general public who visited public health centers, commercial sex workers (CSWs), and human immunodeficiency virus (HIV)-infected persons. Among the general public, HSV-2 seroprevalence rates for age under the 20s, in the 20s, 30s, 40s and the above 22.6%, 32.7% and 32.3%, respectively, which showed rapid increase of the rate in the 30s (p<0.0001). In case of the above of 19 yr old, women (28.0%) was higher than men (21.7%) (p<0.0001). The rate of CSWs (81.6%) was about 10 times higher than that of general women. In case of HIV-infected men (47.6%), the figure was about 2-3 times higher than that of general men. The low rate in the teens and the 20s proved that it is essential to develop sexually transmitted infections (STIs) prevention programs of education and publicity for them as a precaution measure. This study is the first major study of its kind on HSV-2 and would provide basic data for prevention of STIs including information about target groups subject to vaccination program.
Adult ; Age Factors ; Aged ; Antibodies, Viral/*blood ; Female ; HIV Infections/complications ; Herpes Genitalis ; Herpesvirus 2, Human/*immunology ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Seroepidemiologic Studies