No abstract available.
Hepatitis B Vaccines* ; Hepatitis B* ; Hepatitis* ; Humans

The authors report two cases of clozapine-induced acute hepatitis. Two patients developed asymptomatic hepatitis and got better with conservative care. We decreased the dosage of clozapine and added hepatic protectors, resulting in normalized laboratory findings. The authors also reviewed side effects of clozapine in this report. We reviewed the suggested mechanism of either clozapine or chlorpromazine-induced hepatitis. Clozapine influences the liver cell via cytochrome P 450 and chlorpromazine does so via mild cholestasis. There may be a possibility that a patient who has experienced drug-induced hepatitis is vulnerable to clozapine-induced acute hepatitis. In this respect, those who have experienced drug-induced hepatitis must be observed more closely.
Chlorpromazine ; Cholestasis ; Clozapine ; Cytochrome P-450 Enzyme System ; Drug-Induced Liver Injury ; Hepatitis* ; Humans ; Liver

Purpose: To report a case of arteritic anterior ischemic optic neuropathy diagnosed with brain magnetic resonance imaging (MRI) for temporal arteritis instead of temporal artery biopsy.Case summary: An eighty-three years old female visited our clinic for right blurred vision for 2 weeks ago with occipital headache for 4 months and mastication problems. Initial best corrected visual acuity was 0.1 in right eye. She had right inferior altitudinal visual field defect and superior pale optic disc swelling with few cotton wool spots were checked. In serologic tests, erythrocyte sedimentation rate, C reactive peptide, and rheumatoid factor were increased, and fluorescent antinuclear antibody was positive. We performed high resolution brain MRI which could find superficial temporal artery’s luminal signal. In MRI image, we could find loss of intraluminal signal intensity void with total luminal obstruction. We assumed as arteritic anterior ischemic optic neuropathy and high dose intravenous steroid was done. Visual acuity of right eye was 0.9 and central scotoma was improved 1 week after intravenous steroid. We changed to oral steroid with tapering and added oral azathioprine. After 11 months of oral steroid use, her visual acuity was 0.9 in right eye and inferior altitudinal visual field defect was much improved. Conclusions A patient suspected anterior ischemic optic neuropathy was diagnosed by brain MRI with abnormalities in superficial temporal artery. Visual acuity and visual field defect were improved by steroid and immunosuppressive treatment for arteritic anterior ischemic optic neuropathy.

Purpose: The purpose of this study was to examine the level of Person-centered Critical Care Nursing (PCCN) and the factors influencing PCCN for nurses in Intensive Care Units (ICU). Methods: This study was designed by cross-sectional descriptive correlational study. The participants included 147 ICU nurses in two general hospitals in Seoul, Korea. Demographic characteristics, PCCN, communication skills, professionalism, and work environment were measured. The collected data were analyzed using descriptive statistical analysis, independent t-test, One-way ANOVA, Pearson’s correlation coefficient, and stepwise multiple linear regression with the SPSS/Win 25.0 program. Results: The average age of the participants was 29.6±4.7 years and the mean work experience in the ICU was 4.67±3.52 years. The level of PCCN was 3.70±0.41, which was moderate to high, and it significantly showed a positive correlation with therapeutic communication skills (r=.66, p<.001), global interpersonal communication competence (r=.42,p<.001), professionalism (r=.38, p<.001), and work environment (r=.16, p=.048). The factors influencing PCCN were identified as therapeutic communication skill and global interpersonal communication competence (Adj R 2 =.45, p<.001). Conclusion The findings of this study were confirmed that the strategies to promote PCCN are necessary to enhance therapeutic communication skill and global interpersonal communication competence. In addition, they may be particularly meaningful in providing basic data for nursing education and future intervention development research to promote PCCN for the ICU nurses. For improving PCCN for healthcare providers in ICU, further studies should be conducted to develop education and intervention programs.

Purpose: To report a case of arteritic anterior ischemic optic neuropathy diagnosed with brain magnetic resonance imaging (MRI) for temporal arteritis instead of temporal artery biopsy.Case summary: An eighty-three years old female visited our clinic for right blurred vision for 2 weeks ago with occipital headache for 4 months and mastication problems. Initial best corrected visual acuity was 0.1 in right eye. She had right inferior altitudinal visual field defect and superior pale optic disc swelling with few cotton wool spots were checked. In serologic tests, erythrocyte sedimentation rate, C reactive peptide, and rheumatoid factor were increased, and fluorescent antinuclear antibody was positive. We performed high resolution brain MRI which could find superficial temporal artery’s luminal signal. In MRI image, we could find loss of intraluminal signal intensity void with total luminal obstruction. We assumed as arteritic anterior ischemic optic neuropathy and high dose intravenous steroid was done. Visual acuity of right eye was 0.9 and central scotoma was improved 1 week after intravenous steroid. We changed to oral steroid with tapering and added oral azathioprine. After 11 months of oral steroid use, her visual acuity was 0.9 in right eye and inferior altitudinal visual field defect was much improved. Conclusions A patient suspected anterior ischemic optic neuropathy was diagnosed by brain MRI with abnormalities in superficial temporal artery. Visual acuity and visual field defect were improved by steroid and immunosuppressive treatment for arteritic anterior ischemic optic neuropathy.

PURPOSE: Bacille Calmette-Guerin (BCG) vaccination has been reported to be an effective treatment for asthma in several animal models. This study investigated whether the response to BCG treatment in asthma depends on subject clinical characteristics. METHODS: Stable asthma patients were vaccinated with BCG. One month later, alterations in pulmonary function after vaccination and their relationships with subject clinical characteristics were determined. RESULTS: Of 149 patients with asthma, 54 (36.2%) showed a good or fair response to BCG. The DeltaFEV1 after vaccination was significantly related to age (r=-0.348, P<0.001), peripheral blood eosinophil counts (r=0.315, P<0.001) and baseline FEV1, expressed as % personal best value (r=-0.474, P<0.001), but not to FEV1 % predicted value (r=-0.066, P>0.05). A good/fair response was highly prevalent in atopic females compared with atopic males, especially among those aged < or =50 years (90.9% vs. 40.0%, P=0.024). Age (P<0.001, odds ratios (OR)=0.92, confidence interval (CI)=0.88-0.96) and atopy (P<0.01, OR=4.95, CI=1.70-14.44) were significant predictors for a good/fair response in females. However, blood eosinophil counts (P<0.05, OR=1.18, CI=1.01-1.39) and FEV1 % best (P<0.001, OR=0.86, CI=0.79-0.94), but not age or atopy, were significant predictors in males. Approximately three-quarters of the males were smokers. CONCLUSIONS: The therapeutic effect of BCG in asthma may differ according to patient clinical characteristics. The greatest benefit occurred in young atopic females. Asthma activity indices, such as eosinophilia and FEV1 % best, were more predictive of a good/fair response in males; this may have been related to cigarette smoking.
Aged ; Asthma ; Eosinophilia ; Eosinophils ; Female ; Humans ; Male ; Models, Animal ; Mycobacterium bovis ; Odds Ratio ; Smoking ; Vaccination

We had experienced a case of hematogenous brain abscess which occurred at the site of spontaneous intracerebral hemorrhage. The 41-year-old patient was admitted with sponetaneous intracerebral hemorrhage on left basal ganglia and sepsis. Brain abscess was incidentally detected by stereotactic aspiration of intracerebral hemorrhage, followed by the gram staining and culture of aspirated material.
Adult ; Basal Ganglia ; Brain Abscess* ; Brain* ; Cerebral Hemorrhage* ; Humans ; Sepsis

Rupture limited to the lobar bronchus from blunt trauma is especially rare, and the symptoms are light so diagnosis is difficult. In a patient who visited the hospital complaining of shortness of breath after falling down, atelectasis continued in the chest x-ray. Four days after visiting the hospital, a left upper lobar bronchial rupture was diagnosed through a bronchoscopy and 3 dimensional chest computerized tomography. When diagnosis is delayed in the case of a rupture limited to the lobar bronchus, bronchial obstruction can occur from the formation of granulation tissue, so regular monitoring is important. Therefore, when atelectasis continues after blunt trauma, it is important to differentially diagnose a lobar bronchial rupture through tests such as bronchoscopy.
Bronchi ; Bronchoscopy ; Diagnosis ; Dyspnea ; Granulation Tissue ; Humans ; Lung Injury ; Pulmonary Atelectasis* ; Rupture* ; Thorax

In 2015, there was a Middle East respiratory syndrome (MERS) outbreak in Korea. Interestingly, most of the cases were nosocomial infection and significant numbers of healthcare workers (HCWs) were infected. There were various causes, but this study focused on HCWs and their ability to self-protect from infectious materials. HCWs did not receive sufficient instruction or training on biosafety, including how to use personal protection equipment and risk assessment at the beginning of the outbreak. Previous experience from an outbreak of severe acute respiratory syndrome or Ebola showed that HCWs must self-protect from infection sources, but HCW infection occurred again with this MERS outbreak. Therefore, the concept of biosafety self-protection must be emphasized so that HCWs can protect themselves from diseases and avoid spreading them.
Communicable Diseases, Emerging* ; Coronavirus Infections ; Cross Infection ; Delivery of Health Care ; Humans ; Korea ; Risk Assessment ; Severe Acute Respiratory Syndrome