Purpose: The purpose of this study was to explore patients’ awareness and treatment experiences with Chronic Obstructive Pulmonary Disease (COPD) through in-depth interviews. The objective was to develop data to support patients in the successful management of their illness. Methods: Purposeful sampling was used to collect information- rich cases and participants were recruited at a university hospital in Daegu, South Korea. Data collection was done through face to face in-depth individual interviews with 10 patients with COPD from November 2016 to December 2018. Interview began with open-ended questions and each interview lasted on average one hour. All interviews were audio-taped and transcribed verbatim and transcripts were analyzed using qualitative thematic analysis. The findings were verified by the participants. Results: Four themes emerged from data analysis: ‘Feeling like the disease is not my disease,’ ‘Terminology spills like a flood,’ ‘Negligent daily disease-management with relief,’ and ‘Relying on health professionals and family members hoping for healing’. Conclusion Participants do not have a clear understanding of their illness nor feel that they are principal agents of their health and illness for treatment and disease management; instead, they depend mainly on their family members and doctors. The findings elucidated the need for increasing patients’ awareness of the illness. Nurses should develop educational support programs to help COPD patients improve their awareness of their illness and successfully manage their treatment.

Rotor syndrome is a rare disease of hereditary hyperbilirubinemia transmitted with autosomal recessive trait. In general, Rotor syndrome shows direct hyperbilirubinemia and there has been several reports since Sons's report in 1966, in Korea. A 34-year-old female was admitted with the chief complaint of intermittent icteric sclera for 24 years. There was no family history of jaundice. Rotor syndrome was diagnosed by oral cholecystogram, BSP retention test, 99mTc-DISIDA scan, liver biopsy and electron microscopy study of liver biopsy specimen. We report this case with brief review of the literature.
Adult ; Biopsy ; Female ; Humans ; Hyperbilirubinemia ; Hyperbilirubinemia, Hereditary* ; Jaundice ; Korea ; Liver ; Microscopy, Electron ; Rare Diseases ; Sclera ; Technetium Tc 99m Disofenin

Rhythm control therapy is used in atrial fibrillation (AF) management to improve AF-related symptoms along with rate control. AF catheter ablation is effective in maintaining sinus rhythm and has an acceptable complication rate. Compared with antiarrhythmic drugs, AF catheter ablation is superior with respect to arrhythmia-free survival and improvement in the quality of life. Therefore, AF ablation is recommended for rhythm control after the failure of antiarrhythmic drugs and is sometimes considered a first-line therapy for AF patients. Radiofrequency and cryoballoon ablation show similar efficacy, with slightly different complication profiles. Surgery for AF is also an effective rhythm control therapy and should be considered in patients undergoing cardiac surgery or in those with failed catheter ablation. For patients undergoing AF catheter ablation, performing ablation under uninterrupted warfarin or non-vitamin K oral anticoagulant treatment is recommended for periprocedural stroke risk management. Here, we review existing data and discuss the general principles of AF catheter and surgical ablation in patients with AF.

Recently, emerging waterborne protozoa, such as microsporidia, Cyclospora, and Cryptosporidium, have become a challenge to human health worldwide. Rapid, simple, and economical detection methods for these major waterborne protozoa in environmental and clinical samples are necessary to control infection and improve public health. In the present study, we developed a multiplex PCR test that is able to detect all these 3 major waterborne protozoa at the same time. Detection limits of the multiplex PCR method ranged from 101 to 102 oocysts or spores. The primers for microsporidia or Cryptosporidium used in this study can detect both Enterocytozoon bieneusi and Encephalitozoon intestinalis, or both Cryptosporidium hominis and Cryptosporidium parvum, respectively. Restriction enzyme digestion of PCR products with BsaBI or BsiEI makes it possible to distinguish the 2 species of microsporidia or Cryptosporidium, respectively. This simple, rapid, and cost-effective multiplex PCR method will be useful for detecting outbreaks or sporadic cases of waterborne protozoa infections.
Cryptosporidium/*isolation & purification ; Cyclospora/*isolation & purification ; DNA Primers/genetics ; DNA Restriction Enzymes/metabolism ; DNA, Protozoan/genetics/metabolism ; Humans ; Microsporidia/*isolation & purification ; Parasitology/*methods ; Polymerase Chain Reaction/*methods ; Polymorphism, Restriction Fragment Length ; Sensitivity and Specificity ; Water/*parasitology

The changes of arterial carbon dioxide partial pressure considerably influence cerebral blood flow and different anesthetic agents have different effects on cerebrovascular physiology. However the importance of these differences in neuroanesthetic practice are unclear. Transcranial Doppler ultrasonography allows the noninvasive direct measurements of cerebral blood flow velocity and direction in the basal brain arteries. The authors performed transcranial Doppler ultrasonography to measure the blood flow velocity of middle cerebral artery in 12 patients who were anesthetized with 10 mcg/kg of fentanyl and 66 % nitrous oxide in oxygen(fentanyl group) and 12 patients with 1.0 vo1% isoflurane and 66 % nitrous oxide in oxygen(isoflurane group) during normocapnia(P(ET)CO(2)=38 mmHg) and hypocapnia(P(ET)CO(2)=28 mmHg)state. The carbon dioxide reactivity was expressed as the changes in mean blood flow velocity per unit changes in endtidal carbon dioxide partial pressure(P(ET)CO(2)). Mean blood flow velocity of middle cerebral artery decreased from 46.6+/-8.9 cm/s to 30.0+/-5.3 cm/s in the fentanyl group and 42.7+/-5.6 cm/s to 32.5+/-4.6 cm/s in the isoflurane group as the P(ET)CO(2) decreased from 38 mmHg to 28 mmHg. There was a significant difference between the CO2 reactivity of fentanyl group(1.7+/-0.7 cm/s/mmHg) and isoflurane group(1,0+/-0,2 cm/s/mmHg) (p<0.05). It is concluded that hyperventilation is more likely to affect cerebral blood flow during fentanyl-nitrous oxide anesthesia than during isoflurane-nitrous oxide anesthesia.
Anesthesia ; Anesthetics ; Arteries ; Blood Flow Velocity ; Brain ; Carbon Dioxide ; Fentanyl* ; Humans ; Hyperventilation ; Isoflurane* ; Middle Cerebral Artery ; Nitrous Oxide ; Partial Pressure ; Physiology ; Ultrasonography, Doppler, Transcranial

This study was conducted to evaluate recipients' perception of service quality, satisfaction, and behavioral intention in home delivered meals program in the US. Out of 398 questionnaires, 265 (66.6%) were collected, and 209 questionnaires (52.5%) were used for the statistical analysis. A Confirmatory Factor Analysis (CFA) with a maximum likelihood was first conducted to estimate the measurement model by verifying the underlying structure of constructs. The level of internal consistency in each construct was acceptable, with Cronbach's alpha estimates ranging from 0.7 to 0.94. All of the composite reliabilities of the constructs were over the cutoff value of 0.50, ensuring adequate internal consistency of multiple items for each construct. As a second step, a Meals-On-Wheels (MOW) recipient perception model was estimated. The model's fit as indicated by these indexes was satisfactory and path coefficients were analyzed. Two paths between (1) volunteer issues and behavioral intention and (2) responsiveness and behavioral intention were not significant. The path for predicting a positive relationship between food quality and satisfaction was supported. The results show that having high food quality may create recipient satisfaction. The findings suggest that food quality and responsiveness are significant predictors of positive satisfaction. Moreover, satisfied recipients have positive behavioral intention toward MOW programs.
Food Quality ; Intention ; Meals ; Surveys and Questionnaires

Childhood granulomatous periorificial dermatitis is a distinctive granulomatous form of perioral dermatitis, characterized by a monomorphous, small papular eruption around the mouth, nose, and eyes. It occurs primarily in prepubertal children. We present a case of a 12-year-old boy with multiple, asymptomatic, erythematous papules on the perioral, perinasal and periorbital areas for 5 months. Histopathological examination revealed upper dermal and perifollicular granulomatous infiltrate. After using oral dapsone 25 mg daily for 7 weeks, the skin lesions were considerably improved. But, 3 months after discontinuence of dapsone, exacerbation of the skin lesions occurred.
Child ; Dapsone ; Dermatitis ; Dermatitis, Perioral ; Eye ; Humans ; Mouth ; Nose ; Skin

Glomus tumors are benign cutaneous neoplasm, occurring in the vascular hamartomatous tubercles of the glomus body, which is a myoarterial apparatus typically found in the reticular dermis of the skin. Histopathologically, glomus tumors are composed of neoplastic cells that resemble normal glomus cells, arranged around a varying number of thin-walled, sometimes branching capillaries. Immunohistochemically, neoplastic cells in glomus tumors clearly exhibit smooth muscle characteristics with expression of muscle-specific actin and alpha-smooth muscle actin; whereas, the expression of CD34 is rare. In this report, we present two cases of benign glomus tumors on the subungual area and palm. Tumor cells of glomus tumor in two patients were both positive for smooth muscle actin (SMA) and CD34 immunohistochemical staining. We thought that coexpression of SMA and CD34 adds support to the interpretation of these lesions as a family of perivascular neoplasms.
Actins ; Capillaries ; Dermis ; Glomus Tumor ; Humans ; Muscle, Smooth ; Muscles ; Skin

Depigmented halos surrounding cutaneous lesions have been the common description of many diseases, including benign melanocytic nevus, acquired blue nevi, malignant melanoma and neurofibromatosis. To the best of our knowledge, a halo around seborrheic keratosis has not been reported in the Korean dermatologic literature, and only two cases have been described abroad. Though vitiligo is known to be frequently associated with this halo phenomenon, the exact etiopathogenesis of vitiligo and the halo phenomenon is still unknown. Herein, we report on a case of halo seborrheic keratosis in a patient with vitiligo.
Humans ; Keratosis, Seborrheic ; Melanoma ; Neurofibromatoses ; Nevus, Blue ; Nevus, Pigmented ; Vitiligo

No abstract available.
Alcoholics* ; Humans ; Liver Cirrhosis* ; Liver*