Purpose: This study aimed to understand the meaning of the nurses’experiences of patients’ safety accident. Methods: This study is qualitative research using Giorgi’s phenomenological methodology to identify themes of the nurses’experiences of patients’safety accident. The research question was “What is the essential meaning of the nurses’experiences of patients’self-extubating?” Data were collected from the individual in-depth interview from November to December 2017. Seven clinical nurses working in intensive care units were purposely selected. Results: The results showed that 6 essential themes and 13 theme clusters were derived. The essential themes of nurses’ experiences were as follows: ‘Fear of unexpected situations’, ‘Guilt for having a safety accident’, ‘Regret about the cause of the accident’, ‘The conflict between patient human rights and adherence to patient safety principles’, ‘Daunted by the blame of others and feelings of guilt’, ‘Attention is paid to accident prevention practices’. Conclusion It is necessary to manage post-processing management of incidents and nurses’trauma.

This study aimed to investigate the correlation between the inclinations of the incisors and lips in mixed dentition aged 7 – 11 years. Lateral cephalometric radiographs of 353 children were analyzed to measure the upper incisor inclination, lower incisor inclination, lower-nasolabial angle, and mentolabial angle in relation to the skeletal malocclusion classification. The measurements were then assessed using the Kruskal-Wallis test, Pearson correlation, and multiple regression analysis.There were significant negative correlations between the inclination of the upper incisors and lower-nasolabial angle in all classes of skeletal malocclusion. There was a negative correlation between the inclination of the lower incisors and mentolabial angle; however, class Ⅱ malocclusion had a significant positive correlation.This study identified the factors that affect lip inclination and verified their associations.
Child ; Classification ; Dentition, Mixed ; Humans ; Incisor ; Lip ; Malocclusion

This study was to investigate clinical characteristics and any differential trends in survival among renal replacement therapy (hemodialysis [HD], peritoneal dialysis [PD], and kidney transplantation [KT]) in Korean end-stage renal disease (ESRD) population. We tried to analyze retrospectively the survival rate adjusted by risk factors and the relative risk stratified by key risk factors among 447 ESRD patients who began dialysis or had a kidney transplant at Ajou University Hospital from 1994 to 2004. In adjusted Cox survival curves, the KT patients had the best survival rate, and the HD patients had better survival than PD patients. The consistent trends in different subgroups stratified by age and diabetes were as following: 1) The risk of death for PD and HD was not proportional over time, 2) The relative risk of PD was similar or lower than that of HD for the first 12 months, but it became higher at later period. The significant predictors for mortality were age (over 55 yr), presence of diabetes, cerebrovascular accident at ESRD onset, and more than one time of hospitalization caused by malnutrition. Further large-scaled, multicenter-based comparative study is needed in Korean ESRD patients and more meticulous attention is required in high-risk patients.
Survival Analysis ; Renal Replacement Therapy/*mortality ; Morbidity ; Middle Aged ; Male ; Kidney Transplantation ; Kidney Failure, Chronic/*mortality ; Humans ; Follow-Up Studies ; Female ; Aged ; Adult

Disseminated herpes zoster commonly occurs in patients with decreased immunity, but rarely in patients without any evidence of immunosuppression. We reported a case of disseminated herpes zoster with visceral organ involvement in a non-immunocompromised patient. An 83-year-old man visited our pain center, with chief complaints of painful rashes on the L3–L4 and S2–S4 due to acute herpes zoster. Even though intravenous antiviral therapy was initiated immediately upon hospitalization, his lesion deteriorated and systemic cluster formed. Urinary retention and hyponatremia occurred, and he was diagnosed with zoster cystitis and severe inappropriate antidiuretic hormone syndrome. Conservative treatment, including Foley catheter insertion and correction of hyponatremia with antiviral therapy, was initiated, and he was discharged without any complications at the 33rd day of hospitalization. Old age can be a risk factor of disseminated herpes zoster, and visceral organ involvement should also be considered.
Aged ; Aged, 80 and over ; Catheters ; Cystitis ; Exanthema ; Herpes Zoster ; Hospitalization ; Humans ; Hyponatremia ; Immunocompetence ; Immunosuppression ; Inappropriate ADH Syndrome ; Pain Clinics ; Risk Factors ; Urinary Bladder ; Urinary Retention

Background: Propofol is a short-acting intravenous sedative widely used for procedural sedation and general anesthesia. However, pain during propofol injection is a distressing adverse effect. This study was designed to investigate whether transcutaneous electrical nerve stimulation (TENS) could reduce pain during propofol injection compared to sham TENS. Methods: In a randomized controlled trial, 80 patients were allocated to two groups: the active TENS group received electrical stimulation via two electrodes on the venous cannulation site, whereas the sham TENS group received no stimulus. After 20 min following TENS, propofol 0.5 mg/kg pain was injected intravenously and pain was evaluated using a four-point score (0 = none, 1 = mild, 2 = moderate, 3 = severe). Adverse effects associated with TENS were also recorded. Results: The overall incidence of pain during propofol injection was 47.5% in the TENS group and 87.5% in the sham group (P < 0.001). The incidence of moderate pain was significantly lower in the TENS group (7.5%) than in the sham TENS group (42.5%) (P < 0.001). There were no complications associated with TENS. Conclusion Pre-treatment with TENS significantly reduced the incidence and intensity of pain during propofol injection.

Episodic ataxia type 2 (EA-2) is a rare disorder presenting with paroxysmal vertigo and cerebellar dysfunction. EA-2 is known to be caused by mutations of the CACNA1A gene on chromosome 19q13. We examined a family of EA-2 with a novel mutation of the CACNA1A gene showing characteristic ocular symptoms. A-36-year woman visited our hospital with paroxysmal vertigo. When she experienced vertigo attack, she also suffered from gait disturbance, dysarthria, and ataxia. She complained that she could not ride in a car or a train that moved fast, because she could not visually follow the moving objects. Her mother, grandmother, and uncle also complained of similar symptoms. Video nystagmographic findings showed loss of optokinetic nystagmus. We found a novel missense mutation, R279C (c.835C>T), on exon 6 in the CACNAIA gene. This is the first report of a family with new mutation of EA-2 in Korea.

The organic anion transporters (OATs) are expressed in various tissues, primarily in the kidney and liver, but they are also expressed in the placenta, small intestine, and the choroid plexus, which are all epithelial tissues that transport xenobiotics. Six isoforms of OATs are currently known. Considering the variety of organic anionic compounds, other OATs isoforms can be assumed. In this connection, we have searched for a new isoform in the expressed sequence tag (EST) database. We found the new candidate clone AK052752 in the mouse kidney cDNA library and we named it mouse organic anion transporter like protein 1 (mOATLP1). The mOATLP1 cDNA consisted of 2221 base pairs that encoded a 552 amino acid residue protein with 12 putative transmembrane domains. The deduced amino acid sequence of mOATLP1 showed 37 to 63% identity to other members of the OAT family. According to the tissue distribution based on Northern blot analysis, 2.7 kb and 2.9 kb mOATLP1 transcripts (approximate sizes) were observed in the kidney and liver. An 85-kDa band (approximate) was detected using Western blot analysis of mouse kidney performed with a synthesized oligopeptide-induced mOATLP1 antibody. Immunohistochemical results showed mOATLP1 was stained in the blood vessels, glomeruli (the parietal epithelial cells and podocytes), distal convoluted tubules, connecting tubules, and inner medullary collecting tubules. mOATLP1 appears to be a novel candidate for an organic anion transporter isoform identified in the kidney.
Tissue Distribution ; Sequence Homology, Amino Acid ; Rabbits ; Protein Structure, Tertiary ; Protein Isoforms/isolation & purification ; Phylogeny ; Organic Anion Transporters/*isolation & purification/*metabolism ; Oligopeptides/immunology ; Multigene Family ; Molecular Sequence Data ; Mice ; Kidney/*metabolism ; Immunohistochemistry ; Cloning, Molecular ; Blotting, Western ; Animals ; Amino Acid Sequence

Cryptococcal pneumonia usually occurs in immunocompromised patients with malignancy, acquired immune deficiency syndrome, organ transplantations, immunosuppressive chemotherapies, catheter insertion, or dialysis. It can be diagnosed by gaining tissues in lung parenchyma or detecting antigen in blood or bronchoalveolar lavage fluid. Here we report an immunocompetent 32-year-old male patient with diabetes mellitus diagnosed with cryptococcal pneumonia after a ultrasound-guided percutaneous supraclavicular lymph node core needle biopsy. We treated him with fluconazole at 400 mg/day for 9 months according to the guideline. This is the first case that cryptococcal pneumonia was diagnosed from a percutaneous lymph node biopsy in South Korea.
Acquired Immunodeficiency Syndrome ; Adult ; Biopsy* ; Biopsy, Fine-Needle ; Biopsy, Large-Core Needle ; Bronchoalveolar Lavage Fluid ; Catheters ; Cryptococcosis* ; Diabetes Mellitus ; Dialysis ; Drug Therapy ; Fluconazole ; Humans ; Immunocompromised Host ; Korea ; Lung ; Lymph Nodes* ; Male ; Organ Transplantation ; Pneumonia ; Transplants