Caring for a patient dying is a hardship not only for the health care professionals, but also for the direct family members. Everyone wants to die in peace. However, inevitable problems accompanied by pain, dyspnea, moist breathing, nausea and vomiting, restlessness jerking and twitching were commonly noted in the last phase of life. Terminal patients also experience increasing weakness and immobility, loss of interest in food and drink, difficulty in swallowing, and drowsiness during the last hours of life. Control of symptoms and family support are extremely important, and the actual nature of the primary illness takes less importance. This is a time when levels of anxiety, stress, and emotion can be high for patients, families, and other caregivers. Thus, it is important for the healthcare team to adopt sensitive and systematic approach to patients including documentation and communication of end-of-life issues. Hospice is the most ideal program for this purpose.
Anxiety ; Caregivers ; Deglutition ; Delivery of Health Care ; Dyspnea ; Hospices ; Humans ; Nausea ; Patient Care Team ; Psychomotor Agitation ; Respiration ; Sleep Stages ; Vomiting

Caring for a patient dying is a hardship not only for the health care professionals, but also for the direct family members. Everyone wants to die in peace. However, inevitable problems accompanied by pain, dyspnea, moist breathing, nausea and vomiting, restlessness jerking and twitching were commonly noted in the last phase of life. Terminal patients also experience increasing weakness and immobility, loss of interest in food and drink, difficulty in swallowing, and drowsiness during the last hours of life. Control of symptoms and family support are extremely important, and the actual nature of the primary illness takes less importance. This is a time when levels of anxiety, stress, and emotion can be high for patients, families, and other caregivers. Thus, it is important for the healthcare team to adopt sensitive and systematic approach to patients including documentation and communication of end-of-life issues. Hospice is the most ideal program for this purpose.
Anxiety ; Caregivers ; Deglutition ; Delivery of Health Care ; Dyspnea ; Hospices ; Humans ; Nausea ; Patient Care Team ; Psychomotor Agitation ; Respiration ; Sleep Stages ; Vomiting

The treatment application of cultured epithelial autograft (CEA) is the only selected treatment method when performing skin graft for treating massive burns over 70 to 80%. Clinically 2 types of CEA, sheet type and suspension type, are currently available in Korea. The sheet type of CEA, Holoderm(R), was commonly used since no other CEA were available. Since the recent introduction of the suspension type, Keraheal(R), the suspension type is also clinically used. Although 2 types are different in type of forms provided but both types are clinically effective for increasing survival rate of massive burn patients. The early treatment method of massive burn is selected based on the rage of burns using Warden or Parkland Formula. The escharectomy is performed within 3 to 7 days of burn then cadaver skin allograft is applied immediately. At this time, the full thickness skin biopsy in the size of 2x3 cm is obtained from non burned area such as axilla, inguinal or abdomen. Then the skin biopsy is sent to the labs. The length of culturing time is less than 3 weeks for Holoderm(R) and around 2 weeks for Keraheal(R). Holoderm(R) is provided as a sheet type. It is simply applied over 1:3~1:6 meshed skin autograft and fixed with staplers together with skin autograft. In the other hand, the suspension type of CEA, Keraheal(R), is provided in a glass vial and sprayed over 1:3~1:6 meshed skin autograft using Tissomat(R). The fibrin sealant is sprayed after application of Keraheal(R) as a fixation of suspension CEA sprayed. Extra wound care is necessary even after both types of CEA are successfully taken since CEA applied regions are much more fragile than those regions applied skin autograft only. The treatment methods of applying cadaver skin allograft and culture epithelial autograft (CEA) are the most advanced treatments available for increasing survival rate of massive burn patients. The sheet type and suspension type of CEA show difference in type of forms provided but they both show successful take rate that enhance the burn treatment. We suspect that both types of CEA still need ongoing efforts and researches to enhance their advantages and eliminate disadvantages to increase the efficacy that can promote wound healing process of massive burn patients.
Abdomen ; Axilla ; Biopsy ; Burns ; Cadaver ; Fibrin Tissue Adhesive ; Glass ; Hand ; Humans ; Korea ; Rage ; Skin ; Survival Rate ; Transplantation, Homologous ; Transplants ; Wound Healing

PURPOSE: Current treatment of glioblastoma after surgery consists of a combination of fractionated radiotherapy and temozolomide. However, it is difficult to completely remove glioblastoma because it has uncertain boundaries with surrounding tissues. Moreover, combination therapy is not always successful because glioblastoma has diverse resistances. To overcome these limitations, we examined the combined effects of chemotherapy and knockdown of mitogen-activated protein kinase phosphatase-1 (MKP-1). MATERIALS AND METHODS: We used ten different anti-cancer drugs (cisplatin, cyclophosphoamide, doxorubicin, epirubicin, etoposide, 5-fluorouracil, gemcitabine, irinotecan, mitomycin C, and vincristine) to treat glioblastoma multiforme (GBM) cells. Knockdown of MKP-1 was performed using siRNA and lipofectamine. The basal level of MKP-1 in GBM was analyzed based on cDNA microarray data obtained from the Gene Expression Omnibus (GEO) databases. RESULTS: Anti-cancer drug-induced cell death was significantly enhanced by knockdown of MKP-1, and this effect was most prominent in cells treated with irinotecan and etoposide. Treatment with these two drugs led to significantly increased phosphorylation of c-Jun N-terminal kinase (JNK) in a time-dependent manner, while pharmacological inhibition of JNK partially inhibited drug-induced cell death. Knockdown of MKP-1 also enhanced drug-induced phosphorylation of JNK. CONCLUSION: Increased MKP-1 expression levels could be the cause of the high resistance to conventional chemotherapeutics in human GBM. Therefore, MKP-1 is an attractive target for overcoming drug resistance in this highly refractory malignancy.
Apoptosis ; Camptothecin ; Cell Death ; Dacarbazine ; Deoxycytidine ; Doxorubicin ; Drug Resistance ; Drug Resistance, Multiple ; Dual Specificity Phosphatase 1 ; Epirubicin ; Etoposide ; Fluorouracil ; Gene Expression ; Glioblastoma ; Humans ; JNK Mitogen-Activated Protein Kinases ; Lipids ; Mitomycin ; Oligonucleotide Array Sequence Analysis ; Phosphorylation ; Phosphotransferases ; Protein Kinases ; RNA, Small Interfering

A 7 year-old boy visited our hospital with a 2 week history of inflammatory, pustular, tender patches and plaques on the right scalp and face area. He had been treated with topical steroid and antibiotics in a private clinic. In a KOH smear mount, multiple hyphaes and spores appeared on stratum corneum of the outer root sheath layer of his hair. The diagnosis of kerion celsi induced by dermatophytes was made. The patient was treated with oral griseofulvin, and on the 2nd day after starting treatment, multiple erythematous and tendered subcutaneous nodules occurred on his shin. A photosensitive dermatitis like lesion also occurred on his periorbital area. Griseofulvin changed to terbinafine. On the 6th day after treatment, the skin lesions on his face and scalp had improved, as had his shin lesions. The interest of this case lies in the unusual association of kerion and erythema nodosum, of which only eleven cases have been reported in dermatologic literature, and all cases were kerion induced Trichophyton species.
Anti-Bacterial Agents ; Arthrodermataceae ; Child* ; Dermatitis ; Diagnosis ; Erythema Nodosum* ; Erythema* ; Griseofulvin ; Hair ; Humans ; Hyphae ; Male ; Scalp ; Skin ; Spores ; Tinea Capitis* ; Trichophyton

OBJECTIVE: To investigate the stem cell-like characteristics of human periodontal ligament (PDL) stromal cells outgrown from orthodontically extracted premolars and to evaluate the potential for myogenic differentiation. METHODS: PDL stromal cells were obtained from extracted premolars by using the outgrowth method. Cell morphological features, self-replication capability, and the presence of cell-surface markers, along with osteogenic, adipogenic, and chondrogenic differentiation, were confirmed. In addition, myogenic differentiation was induced by the use of 5-aza-2'-deoxycytidine (5-Aza) for DNA demethylation. RESULTS: PDL stromal cells showed growth patterns and morphological features similar to those of fibroblasts. In contrast, the proliferation rates of premolar PDL stromal cells were similar to those of bone marrow and adipogenic stem cells. PDL stromal cells expressed surface markers of human mesenchymal stem cells (i.e., CD90 and CD105), but not those of hematopoietic stem cells (i.e., CD31 and CD34). PDL stromal cells were differentiated into osteogenic, adipogenic, and chondrogenic lineages. Myotube structures were induced in PDL stromal cells after 5-Aza pretreatment, but not in the absence of 5-Aza pretreatment. CONCLUSIONS: PDL stromal cells isolated from extracted premolars can potentially be a good source of postnatal stem cells for oromaxillofacial regeneration in bone and muscle.
Azacitidine ; Bicuspid ; Bone Marrow ; DNA ; Durapatite ; Fibroblasts ; Hematopoietic Stem Cells ; Humans ; Mesenchymal Stromal Cells ; Molecular Biology ; Muscle Fibers, Skeletal ; Muscles ; Periodontal Ligament ; Regeneration ; Stem Cells ; Stromal Cells

In the patient with extensive burn injury, the occult site of infection such as septic arthritis is easy to be overlooked because a painful hip joint may be confused for painful burn wounds around pelvic area. We describe a extensive burned young adult who experienced a septic hip joint with methicillin resistant Staphylococcus aureus bacteremia A 22 year old male who had full thickness burns of whole body (90%) presented with fever, groin pain, and immobility of right hip joint about 3 months after injury. The physical findings, radiographic findings and bone scan were diagnostic for a septic arthritis. Septic arthritis in the extensive burns may be misdiagnosed for painful burn wounds. Hematogenous septic hip arthritis by sustained bacteremia is rare, but clinical examination combined with appropriate laboratory and radiographic studies can lead to prompt diagnosis and treatment.
Arthritis ; Arthritis, Infectious ; Bacteremia ; Burns ; Fever ; Groin ; Hip ; Hip Joint ; Humans ; Male ; Methicillin Resistance ; Staphylococcus aureus ; Young Adult

PURPOSE: The study was undertaken to identify factors affecting perception of the importance and practice of patient safety management (PSM) among hospital employees in Korea. METHODS: This study was conducted using a descriptive design and a self-report questionnaire. Two hundred and eighty employees were recruited from three hospitals using a convenience sampling method. Measures were perception of the importance, practice, and characteristics of PSM. Data were analyzed using descriptive statistics including t test, one-way analysis of variance, Pearson's correlation analysis, and multiple regression. RESULTS: Factors affecting perception of the importance of PSM were whether hospital employees were in contact with patients while on duty, weekly working hours, education on PSM, and perceived adequacy of PSM system construction. Factors affecting the practice of PSM were perceived adequacy of work load, perceived adequacy of PSM system construction and perception of its importance. CONCLUSION: The findings of this study indicate a need for developing strategies to improve perception of the importance and practice of PSM among all hospital employees, and provide a reference for future experimental studies.
Humans ; Korea ; Patient Safety ; Safety Management ; Surveys and Questionnaires

During the second half of the 2000s, the significant impact of human microbiome on human diseases and health conditions was found. Since the Human Microbiome Project, many microbiome studies have been reported in domestic and international references. Gastrointestinal tract microbiome has been most investigated so far, and the association with illness has been demonstrated in many diseases. Recently, the range of study was extended to multiple human organs, such as the respiratory tract, skin, and urogenital tract. Given the scale and speed of research and development in recent years, the role of microbiome in many diseases would be established before long. In this review, we aimed to summarize the current status of microbiome studies in Korea and foreign countries with an emphasis on respiratory tract microbiome. The main concept and analytical methods for microbiome research, associations of microbiome and diseases, and research projects on Korean microbiome are reviewed.
Gastrointestinal Microbiome ; Gastrointestinal Tract ; Humans* ; Korea* ; Metagenomics ; Microbiota* ; Pulmonary Ventilation ; Respiratory System ; Skin

Digital therapeutics is an evidence-based intervention using high-quality software, with the sole purpose of treatment. As many healthcare systems are encountering high demands of quality outcomes, the need for digital therapeutics is gradually increasing in the clinical field. We conducted review of the implications of digital therapeutics in the treatment of neurological deficits for stroke patients. The implications of digital therapeutics have been discussed in four domains: cognition, speech and aphasia, motor, and vision. It was evident that different forms of digital therapeutics such as online platforms, virtual reality trainings, and iPad applications have been investigated in many trials to test its feasibility in clinical use. Although digital therapeutics may deliver high-quality solutions to healthcare services, the medicalization of digital therapeutics is accompanied with many limitations. Clinically validated digital therapeutics should be developed to prove its efficacy in stroke rehabilitation.
Aphasia ; Aphasia, Broca ; Cognition ; Delivery of Health Care ; Hemianopsia ; Hemiplegia ; Humans ; Medicalization ; Neurologic Manifestations ; Rehabilitation ; Stroke