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

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

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

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.

Granular cell tumors (GCTs) can be divided into neural type with S-100 reactivity and non-neural type without that. The latter has not been widely recognized and there are only fewer reports available when compared to conventional GCT. A 65-year-old man was presented with the presence of a painless mass on his back. The mass had developed into a small nodule on the scar developed because of previous surgery carried out 2 years ago. The tumor consisted of large, polygonal cells comprising of an enormous number of faintly eosinophilic small granules in the cytoplasm. The cytoplasmic granules were stained positively for periodic acid-Schiff stain. Immunohistochemical stains for S-100 protein and neuron-specific enolase were found to be negative. Herein, we report the appearance of a very rare case of non neural GCT developed on the surgical scar in support with relevant literature reviews.
Aged ; Cicatrix ; Coloring Agents ; Cytoplasm ; Cytoplasmic Granules ; Eosinophils ; Granular Cell Tumor ; Humans ; Phosphopyruvate Hydratase ; S100 Proteins

Darier's disease is a genetic disorder of keratinization with autosomal dominant inheritance. Its appearance is usually in the form of greasy, crusted, keratotic yellow-brown papules and plaques found particularly on seborrheic areas of the body. However, there are some clinical variants showing atypical skin lesions. Here we report an unusual case of Darier's disease, which mainly showed prominent comedonal papules over the face.
Darier Disease ; Keratins ; Skin ; Wills

Extramammary Paget's disease (EMPD) is an uncommon intraepithelial adenocarcinoma, primarily affecting the apocrine-bearing skin. Bowen disease is an intraepithelial squamous cell carcinoma having the potential to become invasive carcinoma. The histopathological concomitant features between EMPD and Bowen disease have been described. One theory is that primary EMPD arises multicentrically, within the epidermis from the pluripotent stem cells. Herein, we describe a case of EMPD that had bowenoid features, and review the previous cases associated with the origin of EMPD.
Adenocarcinoma ; Bowen's Disease ; Carcinoma, Squamous Cell ; Epidermis ; Genitalia ; Genitalia, Male ; Male ; Paget Disease, Extramammary ; Pluripotent Stem Cells ; Skin