Perigraft seroma is uncommon complication of polytetrafluoroethylene(PTFE) grafts applied as an arteriovenous shunt for hemodialysis. It is a collection of clear, sterile fluid confined to nonsecretory fibrous pseudomembrane, most commonly localized around the middle and distal portion of graft. The possible etiologic factors of perigraft seroma include poor graft incorporation, mechanical graft damage caused by alcohol and povidone-iodine, intraoperative streching of the graft, variations in quality control at the time of manufacture and contributing factors such as anemia and coagulopathy in uremia. The best strategy for management of perigraft seroma is not clear. spiration or drainage alone is not effective, and some authors advocate graft removal. We report a case of perigraft seroma around arterial end of PTFE graft along with a brief review of the literatures.
Anemia ; Drainage ; Humans ; Polytetrafluoroethylene ; Povidone-Iodine ; Quality Control ; Renal Dialysis* ; Seroma* ; Transplants ; Uremia

PURPOSE: This study aimed to explore the influence of nurse work environment and patient safety culture in hospital on instances of missed nursing care in South Korea. METHODS: A cross-sectional design was used, in which a structured questionnaire was administered to 186 nurses working at a tertiary university hospital. Data were analyzed using descriptive statistics, t test or analysis of variance, Pearson correlation, and multiple regression analysis. RESULTS: Missed nursing care was found to be correlated with clinical career, nursing work environment, and patient safety culture. The regression model explained approximately 30.3% of missed nursing care. Meanwhile, staffing and resource adequacy (β = −.31, p = .001), nurse manager ability, leadership and support of nurses (β = −.26, p = .004), clinical career (β = −.21, p = .004), and perception on patient safety culture within unit (β = −.19, p = .041) were determined to be influencing factors on missed nursing care. CONCLUSION: This study has significance as it suggested that missed nursing care is affected by work environment factors within unit. This means that missed nursing care is a unit outcome affected by nurse work environment factors and patient safety culture. Therefore, missed nursing care can be managed through the implementation of interventions that promote a positive nursing work environment and patient safety culture.
Humans ; Korea* ; Leadership ; Nurse Administrators ; Nursing Care* ; Nursing* ; Patient Safety* ; Quality of Health Care

PURPOSE: The purpose of this study was to investigate the effects of emergency setting visitors' knowledge and behavior patterns in relation to prevention of respiratory tract infections. METHODS: A descriptive survey was used. The participants were visitors to the emergency service in ‘D’ general hospital in ‘D’ city, and the data were collected from July 1 to September 1, 2016. The collected data were analyzed using frequency analysis, t-test, ANOVA, Scheffé test, Pearson correlation coefficients, and multiple regression analysis. RESULTS: Factors influencing prevention of respiratory tract infections were visitors' education level, methods of dissemination of prevention information, and participants' knowledge with regard to preventive methods. The explanatory power was found to be 35% in the regression model. CONCLUSION: The findings indicate that visitors' education level, knowledge of infection prevention, and the dissemination of information regarding infection prevention by the hospital play an important role in the prevention of respiratory tract infections in emergency services in the hospital. These results highlight the need for a customized education program for prevention of respiratory tract infections in emergency settings. Programs should take into consideration the educational background of visitors, and provide them with appropriate information regarding infection prevention.
Education ; Emergencies* ; Emergency Service, Hospital* ; Hospitals, General ; Respiratory System* ; Respiratory Tract Infections*

Purpose: To compare the contrast sensitivities of type 2 diabetic patients without retinopathy and healthy subjects, and to assess the risk factors associated with a change in contrast sensitivity in diabetes. Methods: A total of 75 (diabetic patients without retinopathy) and 41 (healthy subjects) eyes were reviewed from the medical records. The threshold of contrast sensitivity was measured at 6.3°, 4.0°, 2.5°, 1.6°, 1.0°, and 0.64° under scotopic and photopic states. Optical coherence tomography (OCT) imaging was used to measure the retinal nerve fiber layer (RNFL) thickness and ganglion cell-inner plexiform layer (GC-IPL) thickness in diabetic patients. Results: Diabetic patients showed a lower threshold of contrast sensitivity at all degree measures than did the controls under both scotopic and photopic states. In subgroup analyses, diabetic patients with abnormal contrast sensitivity showed a longer duration of diabetes, decreased total retinal thickness, and decreased average GC-IPL, superior RNFL, superior GC-IPL, and temporal GC-IPL thicknesses. Multivariate logistic regression analyses showed that the duration of diabetes and total retinal thickness were significant predictive factors of decreased contrast sensitivity (odds ratio = 1.117 and 0.942, respectively). Conclusions As the duration of diabetes increased, the contrast sensitivity decreased in type 2 diabetic patients. Neuroretinal degeneration changes both the inner retinal thickness and total retinal thickness and affects contrast sensitivity. Therefore, for longer-term diabetic patients, it is necessary to consider the changes in contrast sensitivity and retinal thickness on OCT evaluation, even if the patient presents with normal fundus findings.

Purpose: To compare the contrast sensitivities of type 2 diabetic patients without retinopathy and healthy subjects, and to assess the risk factors associated with a change in contrast sensitivity in diabetes. Methods: A total of 75 (diabetic patients without retinopathy) and 41 (healthy subjects) eyes were reviewed from the medical records. The threshold of contrast sensitivity was measured at 6.3°, 4.0°, 2.5°, 1.6°, 1.0°, and 0.64° under scotopic and photopic states. Optical coherence tomography (OCT) imaging was used to measure the retinal nerve fiber layer (RNFL) thickness and ganglion cell-inner plexiform layer (GC-IPL) thickness in diabetic patients. Results: Diabetic patients showed a lower threshold of contrast sensitivity at all degree measures than did the controls under both scotopic and photopic states. In subgroup analyses, diabetic patients with abnormal contrast sensitivity showed a longer duration of diabetes, decreased total retinal thickness, and decreased average GC-IPL, superior RNFL, superior GC-IPL, and temporal GC-IPL thicknesses. Multivariate logistic regression analyses showed that the duration of diabetes and total retinal thickness were significant predictive factors of decreased contrast sensitivity (odds ratio = 1.117 and 0.942, respectively). Conclusions As the duration of diabetes increased, the contrast sensitivity decreased in type 2 diabetic patients. Neuroretinal degeneration changes both the inner retinal thickness and total retinal thickness and affects contrast sensitivity. Therefore, for longer-term diabetic patients, it is necessary to consider the changes in contrast sensitivity and retinal thickness on OCT evaluation, even if the patient presents with normal fundus findings.

Diencephalic syndrome is a rare cause of failure to thrive in infancy and early childhood. The syndrome is characterized by profound emaciation with normal appetite, loss of cutaneous adipose tissue, hyperactivity, euphoria, and nystagmus. It commonly occurs in association with chiasmatic and hypothalamic gliomas. It has also been described in association with other histologic types. There is the marked increase of serum growth hormone, which may exhibit an inappropriate, even paradoxical response in stimulation test. A male infant of 12 months of age, showed markedly elevated growth hormone but he had failure to thrive findings. Evenly enhanced round mass was seen at suprasella area in brain CT. Its histological findings was "Desmoplastic infantile ganglioglioma", very rare histologic type. Here we report a case of diencephalic syndrome presented by failure to thrive in association with hypothalamic tumors.
Adipose Tissue ; Appetite ; Brain ; Emaciation ; Euphoria ; Failure to Thrive ; Glioma ; Growth Hormone ; Humans ; Hypothalamic Neoplasms ; Infant ; Male

PURPOSE: This study was done to identify correlations between fatigue and quality of life in clinical nurses. METHOD: A sample of 294 nurses working in 3 general hospitals answered a questionnaire containing Yoshitake's fatigue scale and WHOQOL-BREF. Data were analyzed using t-test, ANOVA and Pearson correlation coefficients. The SPSS/WIN 11.0 version program was used. RESULTS: The score for level of fatigue was 2.11 (52.7%) and quality of life, 2.89 (57.8%). The level of fatigue was highest in the physical domain followed by psychical and nervous-sensual domain in that order. There were statistically significant differences in scores of fatigue depending on the nurse's age, marital status, career, position, health status and present illness. Quality of life had the highest score in the social domain followed by physical, overall, psychological, and environmental domain in that order. There were statistically significant differences in scores on quality of life depending on nurse's age, marital status, career, position, health status and present illness. CONCLUSION: The relationship between fatigue and quality of life revealed a significant negative correlation. Based on this study, nursing administrators need to reduce the level of nurse fatigue by providing various programs, which improve quality of life.
Administrative Personnel ; Fatigue* ; Hospitals, General ; Humans ; Marital Status ; Nursing ; Quality of Life* ; Surveys and Questionnaires

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) has become a one of the most important causes of nosocomial infections, and use of vancomycin for the treatment of MRSA infection has increased. Unfortunately, vancomycin-resistant enterococcus have been reported, as well as vancomycin-resistant S. aureus. Arbekacin is an antibacterial agent and belongs to the aminoglycoside family of antibiotics. It was introduced to treat MRSA infection. We studied the clinical and bacteriological efficacy and safety of arbekacin compared to vancomycin in the treatment of infections caused by MRSA. MATERIALS AND METHODS: This was a retrospective case-control study of patients who were admitted to tertiary Hospital from January 1st, 2009 to December 31st, 2010, and received the antibiotics arbekacin or vancomycin. All the skin and soft tissue MRSA infected patients who received arbekacin or vancomycin were enrolled during the study period. The bacteriological efficacy response (BER) was classified with improved and failure. The improved BER was defined as no growth of MRSA, where failure was defined as growth of MRSA, culture at the end of therapy or during treatment. Clinical efficacy response (CER) was classified as improved and failure. Improved CER was defined as resolution or reduction of the majority of signs and symptoms related to the original infection. Failure was defined as no resolution and no reduction of majority of the signs and symptoms, or worsening of one or more signs and symptoms, or new symptoms or signs associated with the original infection or a new infection. RESULTS: Totally, 122 patients (63/99 in arbekacin, 59/168 in vancomycin group) with skin and soft tissue infection who recieved arbekacin or vancomcyin at least 4 days were enrolled and analysed. The bacteriological efficacy response [improved, arbekacin vs vancomycin; 73.0% (46/63), 95% confidence interval (CI) 60.3 to 83.4% vs 83.1% (49/59), 95% CI 71.0 to 91.6%] and clinical efficacy response [improved, arbekacin vs vancomycin; 67.2% (41/61), 95% CI 52.0 to 76.7% vs 78.0% (46/59), 95% CI 65.3 to 87.7%] were similar between the two groups (P=0.264, 0.265). The complication rate was significantly higher in the vancomycin group [29/59(49.2%), 95% CI 35.9 to 62.5%] than arbekacin [10/63(15.9%), 95% CI 8.4 to 29.0%] (P<0.001). CONCLUSIONS: Arbekacin could be considered as an alternative antibiotics for vancomycin in skin and soft tissue infection with MRSA. However, further prospective randomized trials are needed to confirm this finding.
Anti-Bacterial Agents ; Case-Control Studies ; Cross Infection ; Dibekacin ; Enterococcus ; Humans ; Methicillin-Resistant Staphylococcus aureus ; Retrospective Studies ; Skin ; Soft Tissue Infections ; Tertiary Care Centers ; Vancomycin

BACKGROUND: The demographics of the stroke population consist mainly of elderly patients. Transcranial Doppler is an effective method for intracranial flow detection, but can be limited due to the poor temporal window (PTW), which is frequent in the elderly. Therefore, we investigated whether the low frequency 1.6-MHz probe can be useful to improve flow detection for PTW. METHODS: All 201 participants had a history of transient ischemic attack or minor ischemic stroke. Firstly, we analyzed the success rate of recording intracranial blood flow via temporal window by using 2.0-MHz (high frequency, HF) and 1.6-MHz (low frequency, LF) probes for a maximum of 10 minutes. Secondly, mean flow velocity (MFV) and pulsatile index (PI) of insonated spectrum of 25 patients with good temporal window were compared between the two probes. RESULTS: Seventy-eight patients were female and the mean age was 64.1+/-12.4 years. Among 402 windows, 125 (31.1%) were undetected when using the 2.0-MHz probe. Fifty-five patients were detected for the spectrum by the 1.6-MHz probe. However, 70 (17.4%) still remained as PTW. Between the two probes, there were no significant differences of variables from the middle cerebral arteries: MFVs (HF 61.0+/-14.1 vs. LF 61.3+/-14.8 cm/sec, p=0.403 in the right; HF 59.6+/-13.4 vs. LF 59.3+/-13.3 cm/sec, p=0.232 in the left) and PIs (HF 0.82+/-0.17 vs. LF 0.82+/-0.18, p=0.929 in the right; HF 0.82+/-0.20 vs. LF 0.83+/-0.17, p=0.605 in the left). CONCLUSIONS: Conventional 2.0-MHz probe had relatively high proportion of PTW but 1.6-MHz probe was feasible to improve flow detection for PTW.
Aged ; Cerebral Arteries ; Demography ; Female ; Humans ; Ischemic Attack, Transient ; Middle Cerebral Artery ; Stroke ; Temporal Bone ; Ultrasonography, Doppler, Transcranial

OBJECTIVE: To investigate whether polymorphisms of gene encoding CYP1B1 is associated with the risk of endometriosis in Korean women. METHODS: We investigated 199 patients with histopathologically confirmed endometriosis rAFS stage III/IV and 183 control group women who were surgically proven to have no endometriosis. The genetic distribution of four different CYP1B1 polymorphisms at G119-T, G432-C, T449-C, and A453-G were analyzed by polymerase chain reaction (PCR) and restriction fragment length polymorphism of PCR products. RESULTS: We found no overall association between each individual CYP1B1 genotype and the risk of endometriosis. The odds ratio of genotype GG/GC+GG/TC+TT/AA compared to GG/CC/CC/AA (reference) was calculated as 2.06 with a 95% confidence interval of 1.003~4.216. CONCLUSIONS: This results suggest that CYP1B1 genetic polymorphism may be associated with development of endometriosis in Korean women.
Endometriosis* ; Female ; Genotype ; Humans ; Odds Ratio ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Restriction Fragment Length