Purpose: The purpose of this study was to develop a novel mouth contactless breathing exercise solution based on virtual reality (VR), and to test its feasibility. Methods: We developed the Virtual Reality-based Breathing Exercise System (VR-BRES), a self-regulating biofeedback breathing exercise with gaming characteristics and a soft stretch sensor. The feasibility and efficacy of the VR-BRES prototype were investigated through a randomized crossover trial. Fifty healthy adults participated in the trial, and their respiratory parameters and user evaluation of the VR-BRES were compared with conventional deep breathing (CDB) exercises. Results: The respiratory parameters, forced vital capacity (Z = 4.82, 4.95, p < .001), forced expiratory volume in one second (t = 6.02, 6.26, p < .001), and peak expiratory flow (t = 5.35, 5.68, p < .001) were significantly higher during breathing exercises using the VR-BRES. User evaluation was also significantly higher for the VR-BRES in terms of efficiency (Z = 3.86, p < .001), entertainingness (Z = 5.00, p < .001), and intention to use (Z = 3.22, p = .001) compared to CDB. However, there was no difference in convenience between the two methods (Z = −0.90, p = .369). Conclusion The VR-BRES has the potential to be an efficient breathing exercise solution. We recommend a clinical study that evaluates the effects of the VR-BRES for a certain period of time for people who need breathing exercises.

Purpose: This study aimed to assign weights for subscales and items of the Post-Intensive Care Syndrome questionnaire and suggest optimal cut-off values for screening unplanned hospital readmissions of critical care survivors. Methods: Seventeen experts participated in an analytic hierarchy process for weight assignment. Participants for cut-off analysis were 240 survivors who had been admitted to intensive care units for more than 48 hours in three cities in Korea. We assessed participants using the 18-item Post-Intensive Care Syndrome questionnaire, generated receiver operating characteristic curves, and analysed cut-off values for unplanned readmission based on sensitivity, specificity, and positive likelihood ratios. Results: Cognitive, physical, and mental subscale weights were 1.13, 0.95, and 0.92, respectively.Incidence of unplanned readmission was 25.4%. Optimal cut-off values were 23.00 for raw scores and 23.73 for weighted scores (total score 54.00), with an area of under the curve (AUC) of .933 and .929, respectively. There was no significant difference in accuracy for original and weighted scores. Conclusion The optimal cut-off value accuracy is excellent for screening of unplanned readmissions. We recommend that nurses use the Post-Intensive Care Syndrome Questionnaire to screen for readmission risk or evaluating relevant interventions for critical care survivors.

Purpose: : In this study, we aimed to identify factors influencing the inpatient satisfaction in integrated nursing care service wards. Methods: : Using data from the 2020 and 2021 healthcare service experience surveys conducted by the Ministry of Health and Welfare, this study analyzed a weighted sample of 416,020 participants using descriptive statistics, pairedt-test, Pearson’s correlation, and multiple linear regression analyses. Results: : Inpatient satisfaction in integrated nursing care service wards was most significantly affected by the experiences with nursing services and perceived health status, followed by experiences with doctor services, length of hospitalization, age, experiences with medical institution services, education level, gender, presence of chronic diseases, type of hospital, and occupation. Most significant positive impacts were associated with experiences with nursing and doctor services, especially in general hospitals and high-level facilities, among males and elderly patients ＞ 60 years old. In contrast, high education level, presence of chronic diseases, and unemployment were associated with low inpatient satisfaction. Conclusion : Effective programs and guidelines must be developed and implemented to expand and promote the integrated nursing care and medical services and overall utilization of healthcare institutions, with a special focus on person-centered care.

No abstract available.
Alopecia ; Humans ; Male

No abstract available.
Child* ; Giant Cell Tumors* ; Giant Cells* ; Humans ; Tendons*

BACKGROUND: As the number of dermatologic surgical procedures increases, home care wound management is growing in frequency. OBJECTIVE: The aim of this study was to evaluate the efficacy and surgical site infection rate of home care wound management according to the use of oral antibiotics and the characteristics of the wound and of the patient. METHODS: Our study included 207 patients that had undergone a dermatologic surgical procedure and the subsequent management of their wounds in the home. We checked overall infection rate of home care wound management and compared the result according to the use of oral antibiotics. We evaluated surgical site infection rate after we classified each surgical wound based on age, sex, surgical method, site, size, and depth. In addition, we surveyed efficacy of home care wound management. RESULTS: Overall surgical site infection rate was 1.86%, and the infection rate was not significantly different between the group that utilized home care wound management without oral antibiotics and the group with oral antibiotics (p>0.05). There was no statistically significant difference of surgical site infection rate according to sex, age, wound's size and depth (p>0.05). However, patients with younger age, male sex, greater size, and depth of wounds showed a numerical increase in surgical site infection rate. Staged partial excision for nevus sebaceous in scalp showed significantly higher rate of surgical site infection (p<0.05). In our survey, most patients preferred home care wound management after dermatologic surgical procedures and patients were able to perform the wound care well. CONCLUSION: We expect to utilize home care wound management after dermatologic surgical procedures, provided that physicians appropriately educate patients and their caretakers on proper dressings.
Anti-Bacterial Agents ; Bandages ; Dermatologic Surgical Procedures ; Home Care Services ; Humans ; Male ; Nevus ; Scalp

Extraskeletal Ewing sarcoma is a rare and aggressive tumor, often presenting diagnostic challenges because of its nonspecific radiologic and clinical features. This case report highlights a unique instance of a primary extraskeletal spinal Ewing sarcoma (PESES), initially misdiagnosed as a neurogenic tumor. The report discusses the imaging characteristics that led to the initial misdiagnosis and reviews the distinguishing features of PESES on advanced imaging modalities. This case emphasizes the necessity of a comprehensive diagnostic approach for an accurate diagnosis of PESES, including a high degree of suspicion, advanced imaging techniques, and histopathological correlation.

Pseudoxanthoma elasticum is a multiorgan disorder, characterized by ectopic mineralization of elastic fibers of skin, eyes, and cardiovascular system. The dermatologic manifestations include laxity of skin, as well as cutis laxa-like wrinkling especially on both axillae. The classic forms of pseudoxanthoma elasticum are due to mutations in the ATP-binding cassette subfamily C member 6 (ABCC6) gene, a presumed transmembrane transporter expressed primarily in the liver and the kidneys. Recent case reports of mutations of gamma-glutamyl carboxylase (GGCX) gene describe associations with vitamin K-dependent coagulation factor deficiency and pseudoxanthoma elasticum as well. A 23-year old woman presented with laxity on both axillae and trunk and a history of vitamin K-dependent coagulation factor deficiency, diagnosed 2 years ago. Fragmented and markedly degenerated elastic fibers with calcium deposition were identified on biopsy specimens. Herein, we report a case of autosomal recessive pseudoxanthoma elasticum combined with vitamin K-dependent coagulation factor deficiency.
Axilla ; Biopsy ; Blood Coagulation Factors ; Calcium ; Carbon-Carbon Ligases ; Cardiovascular System ; Elastic Tissue ; Eye ; Female ; Genes, vif ; Humans ; Kidney ; Liver ; Pseudoxanthoma Elasticum ; Skin ; Vitamins

Primary cutaneous adenoid cystic carcinoma is a rare, slow-growing malignancy that consists of basaloid cells. It characteristically follows an indolent course but has a high tendency to recur locally after excision. We experienced a recurrent primary adenoid cystic carcinoma of the abdomen in a 69-year-old female. It had recurred locally three times over 13 years despite repeated excisions. Wide spreading and perineural invasion of tumor cells were identified during Mohs micrographic surgery, and it seemed to be related to the repeated recurrences. Herein, we report this rare case with clinical and histological features of a recurrent nature.
Abdomen ; Adenoids ; Aged ; Carcinoma, Adenoid Cystic ; Cicatrix ; Female ; Humans ; Mohs Surgery ; Recurrence

BACKGROUND: This study was done to evaluate the sole effect of norepinephrine on the regional myocardial perfusion during displacement of the porcine beating heart using thermal diffusion method. METHODS: Thermal diffusion probe was inserted into the anterior myocardial wall during 20 procedures in 10 male pigs (30-35 kg). The measurements of regional myocardial perfusion and hemodynamic parameters were performed after complete instrumentation (baseline), after displacement of the beating heart anteriorly, and 5 and 15 minutes after norepinephrine infusion, titrated to restore baseline mean arterial pressure (MAP). RESULTS: Norepinephrine infusion reversed the decrease in MAP and myocardial perfusion, caused by displacement of the beating heart (62 +/- 3% to 115 +/- 4% of baseline, P < 0.01; 41 +/- 5% to 125 +/- 4% of baseline, P < 0.05, respectively). CONCLUSIONS: Restoration of MAP with norepinephrine infusion without any preload augmentation reversed deterioration in regional myocardial perfusion during displacement of the porcine beating heart.
Arterial Pressure ; Displacement (Psychology) ; Heart ; Hemodynamics ; Humans ; Male ; Norepinephrine ; ortho-Aminobenzoates ; Perfusion ; Swine ; Thermal Diffusion