No abstract available.
Aged ; Humans

PURPOSE: A meta-analysis was conducted to identify the effectiveness of strategies designed to prevent the incidence and prevalence of pressure ulcers in intensive care units (ICUs).METHOD: The search strategy was designed to retrieve studies both published and unpublished between 2007 and 2017 including studies in English across PubMed and CINAHL, as well as in Korean across RISS, DBPia, NDSL, KISS, and NAL. All adult ICU participants were 18 years or over. Inclusion criteria were randomized controlled trials, quasi-experimental and comparative studies. Two independent reviewers conducted quality assessments of the included studies by Scottish Intercollegiate Guidelines Network. A Review Manager 5 was used to analyze effect sizes and to identify possible sources of heterogeneity among the studies.RESULTS: The odds ratio (OR) effect sizes were all statistically significant. The OR of total effect size was 0.30(95% CI: 0.19, 0.47), care bundle was 0.37(95% CI: 0.24, 0.57), position change was 0.45(95% CI: 0.10, 2.08), and a silicone border foam dressing was 0.14(95% CI: 0.07, 0.29).CONCLUSION: The preventive interventions for patients in the ICUs have positive impacts on reducing the incidence of pressure ulcers.
Adult ; Bandages ; Critical Care ; Humans ; Incidence ; Intensive Care Units ; Methods ; Odds Ratio ; Patient Care Bundles ; Population Characteristics ; Pressure Ulcer ; Prevalence ; Silicon ; Silicones

Purpose: This study aimed to conduct a qualitative synthesis of workplace bullying experiences among nurses in Republic of Korea. Methods: Following the PRISMA guideline, a literature search was conducted using seven domestic and three international databases. Studies published in Korean or English from inception to December 31, 2022 were included. A meta-aggregation approach suggested by the Joanna Briggs Institute was used to synthesize the research findings. Results: Fourteen studies were included in this review. As a result of a data analysis of the selected studies, 199 subthemes and supporting illustrations were identified and grouped into 36 related categories. Based on the subthemes and categories, five synthesized findings were developed: (1) the individual and organizational causes of workplace bullying; (2) the various types of physical violence and psychological harassment; (3) the negative impact of workplace bullying and its effect on self-growth; (4) active and passive coping efforts in dealing with bullying; and (5) strategies for preventing bullying incidents. Conclusion Based on the synthesized findings, four recommendations were made: (1) improving the challenging working conditions for nurses; (2) enhancing educational programs for new nursing graduates; and (3) promoting proactive responses from nursing managers in conjunction with an expansion of resilience training for nursing students. Finally, to address the issue of workplace bullying, (4) multi-center and multi-level research involving nursing organizations needs to be conducted.

Purpose: To determine the incidence of atypical ductal hyperplasia (ADH) in needle biopsy and the upgrade rate to carcinoma, and to evaluate difference in findings between the upgrade and non-upgrade groups. Materials and Methods: Among 9660 needle biopsies performed over 48 months, we reviewed the radiologic and histopathologic findings of ADH and compared the differences in imaging findings (mammography and breast US) and biopsy methods between the upgrade and non-upgrade groups. Results: The incidence of ADH was 1.7% (169/9660). Of 112 resected cases and 30 cases followed-up for over 2 years, 35 were upgraded to carcinoma (24.6%, 35/142). The upgrade rates were significantly different according to biopsy methods: US-guided core needle biopsy (US-CNB) (40.7%, 22/54) vs. stereotactic-vacuum-assisted biopsy (S-VAB) (16.0%, 12/75) vs. US-guided VAB (US-VAB) (7.7%, 1/13) (p = 0.002). Multivariable analysis showed that only US-CNB (odds ratio = 5.19, 95% confidence interval: 2.16–13.95, p < 0.001) was an independent predictor for pathologic upgrade. There was no upgrade when a sonographic mass was biopsied by US-VAB (n = 7) Conclusion The incidence of ADH was relatively low (1.7%) and the upgrade rate was 24.6%. Surgical excision should be considered because of the considerable upgrade rate, except in the case of US-VAB.

PURPOSE: To evaluate the criteria for predicting invasive lesions with preoperative breast MRI in ductal carcinoma in situ (DCIS) histopathologically diagnosed with biopsy. MATERIALS AND METHODS: We retrospectively analyzed the preoperative MRI findings of 80 percutaneous biopsy-proven DCIS. The morphological type, enhancement distribution and kinetics, and extent of the lesions were analyzed. We compared the results of pure DCIS and DCIS with invasive lesions. We evaluated the MRI criteria for predicting DCIS with invasive lesions and assessed its diagnostic performance. RESULTS: Of the 80 DCIS lesions analyzed, 27 contained co-existing invasive lesions and 49 were pure DCIS. No residual lesions after biopsy were seen in 4 cases. DCIS with invasive lesions showed washout kinetics more frequently and to a larger extent than did pure DCIS (p = 0.030 and p = 0.048, respectively). Using enhancement kinetics and the lesion cut-off value of 4 cm yielded the highest diagnostic performance, with 92.6% sensitivity and 93.8% negative predictive value for predicting invasive lesions. CONCLUSION Washout kinetics and the lesion extent of at least 4 cm are useful criteria for the prediction of co-existing invasive lesions in patients with DCIS diagnosed with biopsy.

Purpose: To evaluate the accuracy of magnetic resonance imaging (MRI)-guided breast biopsy. Methods: We retrospectively reviewed the clinical data of 111 consecutive patients referred for MRI-guided breast biopsy after mammography and breast ultrasound between May 2009 and April 2019. After excluding 37 patients without follow-up images (> 2 years), 74 patients (74 lesions) were finally included. We reviewed the histologic results of MRI-guided biopsy and subsequent surgery, post-biopsy management, and breast cancer development during followup. We investigated the false-negative rate, ductal carcinoma in situ (DCIS) underestimation, atypical ductal hyperplasia (ADH) underestimation rate, and technical failure rate of MRIguided biopsy. Results: Among 74 scheduled MRI-guided biopsies, six were canceled because biopsy was deemed unnecessary, while three failed due to technical difficulties (technical failure rate:3/68, 4.4%). MRI-guided biopsy was performed in 65 patients, of which 18 patients were diagnosed with malignant lesions, 46 with benign lesions, and one with ADH bordering on DCIS. Subsequent surgery (n = 27) showed DCIS underestimation in three cases (3/7, 43%), ADH underestimation in two cases (1/2, 50%), as well as seven concordant benign and 11 concordant malignant lesions. The overall false-negative rate was 4.3% (2/46). Thirty-eight out of 48 benign lesions were followed-up (median period, 5.8 years; interquartile range, 4.1 years) without subsequent surgery. Thirty-seven concordant benign lesions were stable (n = 27) or disappeared (n = 10); however, the size of one discordant benign lesion increased on follow-up MRI and it was diagnosed as DCIS after 1 year. Conclusion MRI-guided biopsy is an accurate method for exclusion of malignancy with a very low false-negative rate.

Purpose: To evaluate the accuracy of magnetic resonance imaging (MRI)-guided breast biopsy. Methods: We retrospectively reviewed the clinical data of 111 consecutive patients referred for MRI-guided breast biopsy after mammography and breast ultrasound between May 2009 and April 2019. After excluding 37 patients without follow-up images (> 2 years), 74 patients (74 lesions) were finally included. We reviewed the histologic results of MRI-guided biopsy and subsequent surgery, post-biopsy management, and breast cancer development during followup. We investigated the false-negative rate, ductal carcinoma in situ (DCIS) underestimation, atypical ductal hyperplasia (ADH) underestimation rate, and technical failure rate of MRIguided biopsy. Results: Among 74 scheduled MRI-guided biopsies, six were canceled because biopsy was deemed unnecessary, while three failed due to technical difficulties (technical failure rate:3/68, 4.4%). MRI-guided biopsy was performed in 65 patients, of which 18 patients were diagnosed with malignant lesions, 46 with benign lesions, and one with ADH bordering on DCIS. Subsequent surgery (n = 27) showed DCIS underestimation in three cases (3/7, 43%), ADH underestimation in two cases (1/2, 50%), as well as seven concordant benign and 11 concordant malignant lesions. The overall false-negative rate was 4.3% (2/46). Thirty-eight out of 48 benign lesions were followed-up (median period, 5.8 years; interquartile range, 4.1 years) without subsequent surgery. Thirty-seven concordant benign lesions were stable (n = 27) or disappeared (n = 10); however, the size of one discordant benign lesion increased on follow-up MRI and it was diagnosed as DCIS after 1 year. Conclusion MRI-guided biopsy is an accurate method for exclusion of malignancy with a very low false-negative rate.

BACKGROUND AND OBJECTIVES: To determine the anatomic position of the inferior alveolar nerve (IAN) canal in patients with mandibular prognathism using the cone-beam CT (CBCT). MATERIALS AND METHODS: Fifty rami from 25 patients were evaluated. The images were taken by i-CAT and reconstructed 3-dimensionally using the Simplant 11 program. The linear distances between the IAN canal to the buccal cortex (a, a* and a**), from the IAN canal to the alveolar crest (b and b*) and the anterior margin (b**) and finally the buccal cortical thickness (c, c* and c**) were measured at three reference planes (VP, OP and HP). RESULTS: On the left side, the average distance of a, b and c were 7.12, 15.96 and 3.60 mm on the VP plane, respectively. On the OP, the distance of a*, b* and c* was 6.11, 8.83 and 2.63 mm. For the HP, the distance of a**, b** and c** was 4.84, 10.11 and 2.30 mm. On the right side, the distance of a, b and c, on the VP, was 7.10, 16.13 and 3.42 mm, respectively. On the OP, the distance of a*, b* and c* was 4.77, 8.75 and 2.68 mm. On the HP, the distance of a*, b* and c** was 4.55, 9.84 and 2.38 mm. Regarding the difference between genders, the distance in male's was longer than female's on the VP (p=0.019), and was thicker in males than females on the HP (p=0.002). CONCLUSION: The CBCT data provided accurate information about the location and course of the IAN.
Cone-Beam Computed Tomography ; Female ; Humans ; Male ; Mandibular Nerve ; Prognathism

BACKGROUND AND OBJECTIVES: To determine the anatomic position of the inferior alveolar nerve (IAN) canal in patients with mandibular prognathism using the cone-beam CT (CBCT). MATERIALS AND METHODS: Fifty rami from 25 patients were evaluated. The images were taken by i-CAT and reconstructed 3-dimensionally using the Simplant 11 program. The linear distances between the IAN canal to the buccal cortex (a, a* and a**), from the IAN canal to the alveolar crest (b and b*) and the anterior margin (b**) and finally the buccal cortical thickness (c, c* and c**) were measured at three reference planes (VP, OP and HP). RESULTS: On the left side, the average distance of a, b and c were 7.12, 15.96 and 3.60 mm on the VP plane, respectively. On the OP, the distance of a*, b* and c* was 6.11, 8.83 and 2.63 mm. For the HP, the distance of a**, b** and c** was 4.84, 10.11 and 2.30 mm. On the right side, the distance of a, b and c, on the VP, was 7.10, 16.13 and 3.42 mm, respectively. On the OP, the distance of a*, b* and c* was 4.77, 8.75 and 2.68 mm. On the HP, the distance of a*, b* and c** was 4.55, 9.84 and 2.38 mm. Regarding the difference between genders, the distance in male's was longer than female's on the VP (p=0.019), and was thicker in males than females on the HP (p=0.002). CONCLUSION: The CBCT data provided accurate information about the location and course of the IAN.
Cone-Beam Computed Tomography ; Female ; Humans ; Male ; Mandibular Nerve ; Prognathism