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Hemodialysis(HD)-associated hypotension is a frequent complication, but it is difficult to manage. Until now, several maneuvers have been tried to prevent the HD-associated hypotension. Of these, the sodium content of dialysate was regarded as an important factor for maintaining blood pressure during HD. In this study, we evaluated the effect of hypertonic dialysate on blood pressure, interdialytic weight gain and the incidence of thirst. The study was done for 6 weeks successively with 3 different groups. Each patient was dialysed with 3 different dialysates for 2 weeks: Group I(Conventional HD: sodium concentration: 137 mEq/L), Group II(Hypertonic HD: 147 mEq/L) and Group III (Sequential HD: from 147 to 140 mEq/L). Hemodynamic parameters(blood pressure, pulse rate and ultrafiltration rate), biochemical parameters(hematocrits, blood urea nitrogen, creatinine, osmolality, sodium, potassium, chloride, fasting blood sugar) and complications (interdialytic weight gain &thirsty sensation) were compared among 3 groups. The results were as follows: 1. Decline of systolic blood pressure and diastolic blood pressure at the time of a 3 hour check during hemodialysis was lower in the Group II than Group I and III (p=0.002; p=0.012). and decline of diastolic blood pressure at the time of a 4 hour check during hemodialysis was lower in the Group II and III than Group I(p=0.04). 2. ncidence of hypotensive episodes during dialysis was significantly lower in Group II than group I (p=0.0287). 3. The ultrafiltration in Group III at the time of 1 hour, 2 hour and 3 hour check during hemodialysis was higher than that in Group I and II at the time of 1 hour, 2 hour and 3 hour check during emodialysis respectively (p=0.0001; p=0.0001; p=0.0004). 4. Interdialytic weight gain was higher in Group II(3.1+/-0.8) than GroupI(2.8+/-0.8) and III (2.9+/-0.9) (p=0.0422). 5. Hematologic and biochemical results were not significantly different among 3 Groups. 6. Frequency of thirst was different in Group I, II and III, 0.05+/-0.12, 0.41+/-0.24 and 0.22+/-0.29 respectively (p=0.0259). The results suggest that hypertonic HD was effective in preventing HD-associated hypotension but interdialytic weight gain and thirst sensations were increased as compared with a conventional method. In this situation, sequential HD seems to be an alternative method to minimizes the side effect of hypertonic HD.
Blood Pressure* ; Blood Urea Nitrogen ; Creatinine ; Dialysis ; Dialysis Solutions ; Fasting ; Hemodynamics* ; Humans ; Hypotension ; Incidence* ; Osmolar Concentration ; Potassium ; Renal Dialysis* ; Sensation ; Sodium ; Thirst* ; Ultrafiltration* ; Weight Gain*

PURPOSE: The purpose of this study was to investigate the effects of major health issues and job stress on presenteeism among clinical nurses. METHODS: The investigator conducted a survey on 226 clinical nurses at a general hospital in Seoul from March 3 to April 15, 2017, and analyzed their responses. RESULTS: The findings showed that job stress did not have a significant effect on the nurses' presenteeism. Fatigue (t=3.55,p < .001) impacted job loss, one of the subcategories of presenteeism, with an explanatory power of 12.1%. Premenstrual syndrome (t=-2.67,p=.008) and fatigue (t=-2.46,p=.015) affected perceived productivity with an explanatory power of 23.6%. CONCLUSION Based on these findings, the study highlighted the need for effective management programs to tackle fatigue and premenstrual syndrome among clinical nurses' major health issues in order to reduce their productivity loss.

PURPOSE: The purpose of this study was to investigate the effects of major health issues and job stress on presenteeism among clinical nurses. METHODS: The investigator conducted a survey on 226 clinical nurses at a general hospital in Seoul from March 3 to April 15, 2017, and analyzed their responses. RESULTS: The findings showed that job stress did not have a significant effect on the nurses' presenteeism. Fatigue (t=3.55,p < .001) impacted job loss, one of the subcategories of presenteeism, with an explanatory power of 12.1%. Premenstrual syndrome (t=-2.67,p=.008) and fatigue (t=-2.46,p=.015) affected perceived productivity with an explanatory power of 23.6%. CONCLUSION: Based on these findings, the study highlighted the need for effective management programs to tackle fatigue and premenstrual syndrome among clinical nurses' major health issues in order to reduce their productivity loss.
Efficiency ; Fatigue ; Hospitals, General ; Humans ; Premenstrual Syndrome ; Presenteeism ; Research Personnel ; Seoul

PURPOSE: A National survey was conducted to assess neonatal intensive care nurses' practice, barriers, knowledge, and belief regarding Kangaroo Care (KC). METHODS: A descriptive survey was conducted. Kangaroo care questionares were sent to nurses in all hospitals in Korea whose were identified as providing neonatal intensive care services(N=263). Descriptive statistics were used to summarized the data. RESULTS: Among 67 neonatal care units, 61.1% adapted KC in their practice. About 60% of nurses in the KC providing hospital actually practiced KC. Major barrier of practicing KC were infant safety concerns, as well as work load of nurses. Respondants who had practiced KC were more knowledgable and were more positive in their belief regarding KC. CONCLUSION: The findings suggest that in order to overcome barriers of practicing KC, educational programs are recommended designed for nurses. In addition, development of KC practice guideline is necessary to facilicate successful and safe KC.
Humans ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Kangaroo-Mother Care Method ; Korea ; Macropodidae ; Practice Patterns, Nurses'

Various treatment modalities are available for mycosis fungoides including topical steroids, topical chemotherapy, phototherapy, and spot radiation therapy. However, these modalities do not always result in optimal effects, with efficacy depending on lesion size, number, and location. Photodynamic therapy (PDT) is a recently introduced therapeutic modality that proved effective in patients with unilesional mycosis fungoides. A 58-year-old woman presented with a seven-year history of a pruritic erythematous scaly patch on her right thigh. Through skin biopsy, we verified the lesion as mycosis fungoides. The lesion did not respond well to a topical steroid. We opted for topical PDT with methyl-aminolevulinate (MAL). MAL cream was applied for 4 hours following irradiation with a red light. Four sessions were administered, separated by five weeks. The lesion clinically improved after treatment without severe side effects. PDT using MAL could be considered an effective and tolerable treatment for mycosis fungoides.
Biopsy ; Drug Therapy ; Female ; Humans ; Middle Aged ; Mycosis Fungoides* ; Photochemotherapy* ; Phototherapy ; Skin ; Steroids ; Thigh

The intubating laryngeal masK airway is a newly available device designed to allow for blind endotracheal intubation and treatment of patients with difficult airways. Emergency tracheostomies are required for oropharyngeal, hypopharyngeal, and laryngeal tumors acutely obstructing the airway. Patients with an airway obstructive tumor maintain their airway by a very active inspiratory effort in a sitting position. In these patients, it may be impossible to position them for a tracheostomy with shoulder extension. We report a case where a patient was tracheostomized successfully under general anesthesia with blind intubation via ILMA insertion in a sitting position.
Anesthesia, General* ; Emergencies ; Equipment Design ; Humans ; Intubation* ; Intubation, Intratracheal ; Laryngeal Masks ; Shoulder ; Tracheostomy*

OBJECTIVES: We conduct this study to investigate the common features between Attention Deficit Hyperactivity Disorder(ADHD) and epileptic patients compared to normal control. METHODS: Epileptic patients were recruited from the department of pediatic in Jesus Hospital. ADHD patients were recruited from the department of neuropsychiatry in Jesus Hospital. We excluded mental retardation or brain organic pathology. We use ADHD Diagnostic System and Korean-Child Behavior Checklist(K-CBCL) to assess features of ADHD. Electroencephalogram(EEG) of ADHD, epileptic patients and normal control were analyzed and compared. RESULTS: Compared to normal control group, inattention, reaction time deviation were increased in both ADHD and epilepsy group. EEG abnormalities(control 13.8%, epilepsy 97.1%, ADHD 40%) in three groups were reported. CONCLUSION: There are common features of ADHD and epileptic patients.
Adolescent ; Attention Deficit Disorder with Hyperactivity ; Brain ; Electroencephalography ; Epilepsy ; Humans ; Intellectual Disability ; Neuropsychiatry ; Reaction Time

Atopic dermatitis (AD) is characterized by disturbances in epidermal barrier functions and the hyperactive immune response. Staphylococcus aureus (S. aureus) can be cultured from 90% of AD skin lesions and can exacerbate or contribute to the persistent skin inflammation in AD by secreting toxins with superantigenic properties. Superantigens can induce mast cell (MC) degranulation after penetrating the epidermal barrier. The role of MCs in AD is suggested by the increase in the MC number and MC activation. MCs are activated for degranulation and mediator release by allergens that cross-link IgE molecules or by microbial products. Therefore, MCs may be critically involved in the pathogenesis of AD. However, the understanding mechanisms of MC degranulation by S. aureus in relation to AD have still not been fully elucidated. In this study, we found that live S. aureus or methicillin-resistant S. aureus (MRSA) but not heat-killed bacteria induced MC degranulation. The heat-treatment partially inhibited MC degranulation by conditioned media (CM) of S. aureus or MRSA. The calcium chelator ethylene glycol tetraacetic acid (EGTA) did not block MC degranulation induced by live S. aureus or MRSA, but EGTA-treatment partially inhibited MC degranulation by CM from S. aureus or MRSA. These results suggest that live S. aureus and MRSA can degranulate MCs via direct interaction which may be important role in AD.
Allergens ; Bacteria ; Calcium ; Culture Media, Conditioned ; Dermatitis, Atopic ; Egtazic Acid ; Humans* ; Immunoglobulin E ; Inflammation ; Mast Cells ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Skin ; Staphylococcus aureus ; Superantigens

Atopic dermatitis (AD) is characterized by disturbances in epidermal barrier functions and the hyperactive immune response. Staphylococcus aureus (S. aureus) can be cultured from 90% of AD skin lesions and can exacerbate or contribute to the persistent skin inflammation in AD by secreting toxins with superantigenic properties. Superantigens can induce mast cell (MC) degranulation after penetrating the epidermal barrier. The role of MCs in AD is suggested by the increase in the MC number and MC activation. MCs are activated for degranulation and mediator release by allergens that cross-link IgE molecules or by microbial products. Therefore, MCs may be critically involved in the pathogenesis of AD. However, the understanding mechanisms of MC degranulation by S. aureus in relation to AD have still not been fully elucidated. In this study, we found that live S. aureus or methicillin-resistant S. aureus (MRSA) but not heat-killed bacteria induced MC degranulation. The heat-treatment partially inhibited MC degranulation by conditioned media (CM) of S. aureus or MRSA. The calcium chelator ethylene glycol tetraacetic acid (EGTA) did not block MC degranulation induced by live S. aureus or MRSA, but EGTA-treatment partially inhibited MC degranulation by CM from S. aureus or MRSA. These results suggest that live S. aureus and MRSA can degranulate MCs via direct interaction which may be important role in AD.
Allergens ; Bacteria ; Calcium ; Culture Media, Conditioned ; Dermatitis, Atopic ; Egtazic Acid ; Humans* ; Immunoglobulin E ; Inflammation ; Mast Cells ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Skin ; Staphylococcus aureus ; Superantigens