Objective To summarize the main points of nursing the patients during small incision minimally invasive cardiac surgery.Methods Two hundred and seventy-one patients underwent small incision minimally invasive cardiac surgery during April 2010 and December 2010.The cooperative nursing was performed.Results The patients went well with the operations,with the average extracorporeal circulation time of(117.3±47.1)min and aorta blocking time of(82.6±32.1) min.All of the patients were discharged,without postoperative complications.(6.8±2.6)d.Perioperative and after discharge with no deaths.Postoperative recovery and no postoperative complications,were recovered and discharged without any complications.The postoperative hospital length of stay was(6.8±2.6)d.Conclusions The minimally invasive cardiac surgery is effective and safe.The preoperative health education and intraoperative nursing cooperation are critical for the operative success.

Ground-glass opacity is a frequent but nonspecific finding seen on high-resolution CT scans of lung parenchyma. Histologically, this appearance is observed when thickening of the alveolar wall and septal interstitium is minimal or the alveolar lumen is partially filled with fluid, macrophage, neutrophils, or amorphous material. It has been shown that ground-glass opacity may be caused not only by an active inflammatory process but also by fibrotic processes. When a focal area of ground-glass opacity persists or increases in size, the possibility of neoplasm-bronchioloalveolar carcinoma or adenoma, or lymphoma, for example- should be considered. Diffuse nonsegmental ground-glass opacity in both lung fields was incidentally found on follow up abdominal CT in a stomach cancer patient and signet-ring cell-type metastatic lung cancer was confirmed by transbronchial lung biopsy. We report a case of diffuse ground-glass opacity seen in metastatic lung cancer from adenocarcinoma of the stomach.
Adenocarcinoma* ; Adenoma ; Biopsy ; Follow-Up Studies ; Humans ; Lung Neoplasms ; Lung* ; Lymphoma ; Macrophages ; Neoplasm Metastasis* ; Neutrophils ; Stomach Neoplasms ; Stomach* ; Tomography, X-Ray Computed

Objective To investigate the safety and effect of high intensity focused ultrasound ablation(HIFU) on residual liver cancer in patients after radiotherapy. Methods Twenty liver cancer patients with twenty five residual tumors after three-dimensional conformal radiotherapy or stereotactic radiotherapy received HIFU ablation. Liver function and periphery blood cell counts were performed before HIFU and at 1 week after HIFU in all patients. Enhanced MRI and α-fetoprotein (AFP) level were performed before HIFU and at 2 weeks after HIFU to evaluate the effect of HIFU ablation. The survival of all patients was assessed by the Kaplan-Meier method. Results The mean follow-up time was (12.6 ± 8.0)months. The median survival time and 1-year survival rate were 22 months and 87.5% respectively. No skin burns were observed in all patients. As compared with before HIFU,there were no significant differences in the levels of albumin,alanine transarninase, aspartate transarninase, total bilirubin, direct bilirubin, blood red cell counts,blood white cell counts and blood platelet counts at 1 week after HIFU (paired t test, P =0. 156,0. 356,0. 203,0.659,0. 531,0. 519,0. 310,0. 346, respectively). Significant difference in AFP level of 9 patients with AFP＞20 μg/L was observed before HIFU and 2 weeks after HIFU (paired t test, P =0.030). Among 25 residual liver tumors,sixteen with complete ablation and six with ablation volume of ≥80% were observed by enhanced MRI at 2 weeks after HIFU. Conclusions HIFU may be a safe and effective new method to ablate residual liver cancer after three-dimensional conformal radiotherapy or stereotactic radiotherapy.

Bilateral renal cell carcinoma is very rare. In the past, bilateral renal cell carcinoma indicated a poor prognosis. But recently, aggressive operative intervention with nephron salvaging procedure can improve the survival of bilateral renal cell carcinoma. The conservative treatment of bilatera1 renal cell carcinoma depends on the size, the location and the stage of the tumor. Of several conservative surgical procedures, either enucleation or extracorporeal partial nephrectomy with autotransplantation were performed followed by radical nephrectomy in our cases. The advantages of an extracorporeal approach in such case include an optimum exposure, a bloodless surgical field, an ability to perform a more precise operation with maximum conservation of renal parenchyma, and a greater protection of the kidney from prolonged ischemia. Although this technique involves increased operative time with greater potential morbidity, we performed this procedure without much difficulties with the surgical skills culminated from renal transplantation.
Autografts ; Carcinoma, Renal Cell* ; Ischemia ; Kidney ; Kidney Transplantation ; Nephrectomy ; Nephrons ; Operative Time ; Prognosis

The aim of this study was to investigate the effects of AEG-1 gene silencing on the chemoresistance of human breast cancer cell line MCF-7/ADM and its possible mechanism. MCF-7/ADM cells were incubated in the medium containing adriamycin (ADM). The recombinant pLKO.1-shAEG-1 plasmid was constructed to silence AEG-1 expression in human breast cancer MCF-7/ADM cells. MTT assay was employed to detect the anti-tumor effect of ADM on MCF-7/ADM cells, and IC50 value of ADM was calculated according to MTT. Flow cytometry was used to determine the apoptosis. Western blot was used to analyze the expression levels of AEG-1, p-Akt, p-MDM2, p-Bad, p53 and MDR1. The result showed MCF-7/ADM had a significantly higher expression level of AEG-1 compared with that of MCF-7 (P < 0.05), however, the expression of AEG-1 was decreased after AEG-1 gene silencing. The IC50 value of ADM in shAEG-1 group was significantly lower than that in shcontrol group. AEG-1 gene silencing induced cell apoptosis and enhanced the pro-apoptotic effect of ADM on MCF-7/ADM cells. After AEG-1 gene silencing, the phosphorylation of Akt, MDM2 and Bad was inhibited (P < 0.05), the protein levels of p53 and MDR1 were up-regulated (P < 0.05) and down-regulated (P < 0.05) respectively, compared with control. In conclusion, the results suggest that AEG-1 gene silencing can reverse the ADM resistance in human breast cancer cell line MCF-7/ADM by means of inducing apoptosis and down-regulating the protein level of MDR1.
Apoptosis ; Breast Neoplasms ; genetics ; metabolism ; Cell Adhesion Molecules ; genetics ; metabolism ; Doxorubicin ; pharmacology ; Drug Resistance, Neoplasm ; genetics ; Gene Silencing ; Humans ; MCF-7 Cells

BACKGROUND: Both the Korean Society of Infectious Diseases and The Korean Center for Diseases Control recommended MMR (measles, mumps, rubella) vaccination to health care workers (HCWs) but this had rarely been applied mainly due to economic reasons. In this paper, we report a measles outbreak initiated by two inpatients and then spread to other nine infants and three HCWs. We also report that this outbreak was successfully contained by active infection control measures. METHODS: Measles cases were determined according to CDC clinical criteria and confirmed by the level of the measles-specific IgM antibody. Suspected patients were isolated in aeration-limited areas. After measles cases in HCWs were detected, people in 26 pediatric wards were screened for measles-specific IgG antibody. MMR (measle, rubella, mumps) vaccination was applied to HCWs who were negative for measles-specific antibodies or HCWs who were exposed but not sure of their vaccination status. RESULTS: From April 21 to June 4 in 2007, measles-infected patients consisted of eleven infants (11 months old in median age) and three HCW women. Antibody screening revealed that only 73% (19 out of 26) in pediatric wards were positive for measles-specific IgG. After a medical doctor was confirmed as measles-infected, health care worker exposed to measles patients were all vaccinated without antibody test. CONCLUSION: The precise level of anti-measles antibody in adults has to be revealed by further studies involving multiple organizations. This result could be helpful for establishing a proper health care policy of MMR vaccination.
Adult ; Antibodies ; Centers for Disease Control and Prevention (U.S.) ; Communicable Diseases ; Delivery of Health Care ; Disease Outbreaks ; Female ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Infant ; Infection Control ; Inpatients ; Mass Screening ; Measles ; Mumps ; Rubella ; Tertiary Care Centers ; Vaccination

This study was done to come up with a solution to effectively increase nutrition knowledge and education among nursery school teachers in the Gwang-ju metropolitan city area. The scores of teacher's nutrition knowledge were around the average of 9.4 points on a 15-point scale, which is about 63.1 points on a 100-point scale. When the types of subjects were compared, we recognized that the nursery school teachers with a college degree or those who have any training/education in nutrition had the highest scores in nutrition knowledge. Also, the nursery schools who have more than 101 children or public nursery schools had the highest scores in nutrition knowledge (p < 0.05). We can conclude that the knowledge of nutrition of nursery teachers is very lacking and it is not as high as it should be. In addition, we can also see that the dietary guidance and nutrition education time spent towards the children was very short. The lack of professional knowledge and education seems to be due to shortage of educational materials and because the teachers themselves lack the knowledge to pass on to their predecessors. In fact, even the teachers themselves feel the need to set up more nutrition-related education programs, obtain more guides and materials to teach them, as well as implement more organized and systemized teaching methods.
Child ; Humans ; Nurseries ; Schools, Nursery ; Teaching

PURPOSE: The aim of this study was to synthesize the best available evidence for active warming interventions during cesarean section. METHODS: A database search was done for randomized controlled trials utilizing active warming interventions. Maternal temperature, shivering and neonatal temperature were evaluated as outcome variables. Data were analyzed using Cochrane Review Manager software Version 5.3. RESULTS: Thirteen studies including 1306 patients were reviewed. The degree of lowering of maternal temperature decreased in the warmed fluids (MD 0.51; p=.004) and warming mattress interventions (MD 0.22; p<.001) compared with control groups. Incidence of shivering was also lower in the active warming group (OR 0.55; p=.003). There was no statistically significant difference in maternal temperature with a forced air warming intervention (MD 0.64; p=.15) or in neonatal temperature (MD 0.12; p=.26). CONCLUSION: Findings show that with warmed fluids and warming mattresses applied during cesarean sections maternal temperature decline was reduced and also the incidence of shivering declined, but no significant effect was observed for forced air warming interventions. These findings provide a basis for developing a warming guideline for women having a cesarean section and will help to improve the quality of care for cesarean section patients.
Beds ; Cesarean Section* ; Female ; Humans ; Hypothermia ; Incidence ; Pregnancy ; Shivering

Asbestos exposure may cause asbestosis, pleural plaques and benign pleural disease, and may give a predisposition to malignant mesothelioma in occupationally exposed workers. This case report describes a 50-year-old man, dying from histologically confirmed, diffuse, malignant mesothelioma after asbestos exposure. As a young man, he had been exposed at the workplace to crocidolite for 2 years, but he had no other known history of occupational or environmental asbestos exposure. The patient presented with chest pain and general weakness. Computed tomography showed bilateral irregular pleural thickening along both lower lateral chest walls and a low attenuating mass in the anterior portion of the left lobe. Pathological examinations revealed that it was an epithelial type with tubulopapillary structures and it tested immunohistochemically positive for antibodies against cytokeratin, calretinin and vimentin. The patient was started on chemotherapy but he died to the disease at ten months after the first onset of the symptoms. Mesothelioma is a rare neoplasm in the general population. Nevertheless, the importance of close medical surveillance of the high-risk population is emphasized, because of increased asbestos exposure.
Antibodies ; Asbestos ; Asbestos, Crocidolite* ; Asbestosis ; Calbindin 2 ; Chest Pain ; Drug Therapy ; Humans ; Keratins ; Mesothelioma* ; Middle Aged ; Occupations ; Pleural Diseases ; Thorax ; Vimentin

PURPOSE: Recurrent otitis media (ROM) is usually defined as > or =3 distinct and well-documented episodes within 6 months or > or =4 episodes within 12 months. ROM is sufficiently important to warrant consideration of chemoprophylaxis, tympanostomy tube placement. There also is evidence that children with ROM are at risk for both hearing loss and speech delay. However, studies of ROM have been notably insufficient. In addition, even though environmental, racial, and sociocultural differences can affect risk factors, few studies have been conducted with regard to recurrent otitis media in Korea. METHODS: This study was conducted from July 2009 to January 2010 with infants and children who were younger than 60 months old, who visited the out-patient clinics at Han-Il General Hospital and Kyunghee University Hospital. Data were collected by interview using a pre-formed sheet. Among a total of 892 infants and children, 457 were excluded, and the remaining 435 were allocated to 104 with ROM and 331 as a control group. RESULTS: Attendance at daycare centers (P<0.001, OR=2.85), allergic rhinitis (P=0.026, OR=2.32), past history of bronchiolitis (P=0.003, OR=2.33), and low socioeconomic status (P=0.005, OR=2.00) were found to have a close significant correlation with ROM. Risk factors such as sex, having a sibling, breast-feeding, use of pacifiers, atopy, pneumococcal vaccination, influenza vaccination, smoking of parents, and indoor smoking are not relevant. CONCLUSION: Attendance at daycare centers, allergic rhinitis, past history of bronchiolitis, and low socioeconomic status have been identified as risk factors for ROM.
Bronchiolitis ; Chemoprevention ; Child ; Hearing Loss ; Hospitals, General ; Humans ; Infant ; Influenza, Human ; Language Development Disorders ; Middle Ear Ventilation ; Otitis ; Otitis Media ; Outpatients ; Pacifiers ; Parents ; Rhinitis ; Rhinitis, Allergic, Perennial ; Risk Factors ; Siblings ; Smoke ; Smoking ; Social Class ; Vaccination