Purpose: The purpose of this study was to develop and test the validity and reliability of the Ethical Sensitivity Scale for Clinical Nurses (ESSCN). Methods: 40 items for the preliminary instrument of ESSCN were developed through a literature review and deep interviews with 8 clinical nurses. The scale validation was conducted with a convenience sample of 344 nurses recruited from four general hospitals in Busan and the Gyeongnam area. Content validity, construct validity, criterion validity, convergent validity and discriminative validity were used to evaluate the validity. Cronbach’s ⍺ and test-retest were used to evaluate the reliability of ESSCN. Results: The 36-item ESSCN was found to have eight subscales- patient respect, professional ethics, nursing practice responsibilities, willingness to do good, ethical contemplation, ethical burden, perception of ethical situation and empathy- explaining 61.4% of the total variance. The correlation coefficient between ESSCN and the Korean Moral Sensitivity Questionnaire was .52 (p<.001). Criterion-related validity was supported by known-group comparison. The Cronbach's ⍺ reliability coefficient was .92 and test-retest reliability coefficient was .89 (p<.001). Conclusion The results of this study suggest that the ethical sensitivity scale is a reliable and valid instrument for measuring ethical sensitivity by clinical nurses.

PURPOSE: Renal vascular clamping during a laparoscopic partial nephrectomy is a time-consuming procedure with a risk of renal ischemia. To study the feasibility of laparoscopic partial nephrectomy without renal arterial clamping, we compared the procedure with laparoscopic partial nephrectomy with vascular clamping. MATERIALS AND METHODS: Seventeen patients underwent laparoscopic partial nephrectomy without renal arterial clamping (group 1) from February 2004 to June 2008. The operative results were reviewed retrospectively and compared with those of 16 patients who underwent laparoscopic partial nephrectomy with arterial clamping (group 2). Patient characteristics did not differ significantly between the 2 groups. However, exophytic tumors were detected in 13 patients in group 1 and 3 patients in group 2 (p=0.001). Scores on the preoperative aspects and dimensions used for an anatomical (PADUA) classification were 6.9 in group 1 and 7.7 in group 2 (p=0.037). All surgeries by the transperitoneal approach were performed by a single surgeon. RESULTS: The mean operative times were 103 and 130 minutes in groups 1 and 2, respectively (p=0.312). The mean renal arterial clamping time of group 2 was 27.6 minutes (range, 20-42 minutes). The mean estimated blood loss was 327 ml in group 1 and 315 ml in group 2 (p=0.971). The mean postoperative change in the glomerular filtration rate was 20.11 ml/min/1.73 m2 in group 1 and 18.95 ml/min/1.73 m2 in group 2 (p=0.748). The mean times to postoperative initiation of ambulation and of oral intake were 1.6 and 1.7 days (p=0.486) and 1.3 and 1.6 days (p=0.811) in groups 1 and 2, respectively. The mean length of hospital stay was 7.4 and 7.9 days in groups 1 and 2, respectively (p=0.9). The mean tumor size was 2.1 cm (range, 1-7 cm) in group 1 and 3.3 cm (range, 1.5-9 cm) in group 2. CONCLUSIONS: Laparoscopic partial nephrectomy without renal arterial clamping is feasible for a localized renal tumor. However, patients should be selected carefully, such as those with an exophytic tumor.
Constriction ; Glomerular Filtration Rate ; Humans ; Ischemia ; Kidney Neoplasms ; Laparoscopy ; Length of Stay ; Nephrectomy ; Operative Time ; Retrospective Studies ; Walking

No abstract available.
Breast ; Carcinoma, Ductal ; Neoplasm Metastasis

Background: Verruca vulgaris is a common cutaneous viral infectious disease caused by human papilloma virus (HPV). The main treatment modalities are cryotherapy, immunotherapy, laser therapy, intralesional injection of bleomycin, and salicylic acid therapy. However, there is no definitive tool for predicting clinical improvement or treatment response. Objective: This study was designed to evaluate clinical treatment response according to the hardness of verruca vulgaris skin lesions. We developed a new prediction tool called the “hardening sign” that divides the course of treatment into four categories based on inspection and palpation. Methods: We conducted a retrospective medical chart review of patients who visited Hanyang University Guri Hospital between January 2016 and January 2017 and were clinically diagnosed with verruca vulgaris. We divided the patients into four groups according to the grade of rigidity of their lesions. Results: Forty-seven patients (24 male and 23 female) were identified. The mean age at diagnosis was 17.2±8.5 years, and the mean duration of treatment was 28.8±27.7 weeks. The mean number of hospital visits was 16.5±12.4. Eleven patients underwent only cryotherapy, while 36 patients underwent combined cryotherapy and immunotherapy. We observed significantly shorter durations of treatment for patients with higher grades of hardening. There was no correlation between the hardening grade and the number of treatments required for patients to be completely cured. Conclusion This study suggests that the therapeutic response of verruca vulgaris warts to cryotherapy can be easily predicted by careful consideration of the “hardening sign”.

The contagious skin infestation scabies, is caused by the mite Sarcoptes scabiei var. hominis. These microscopic organisms navigate under the skin surface to lay eggs, creating burrows that cause notable discomfort and itching and enable the maturation and subsequent proliferation of the mites. Spread to other hosts can occur through direct, often prolonged, skin-to-skin contact or indirectly through shared items such as clothing, bedding, or towels.Current Concepts: Management of a scabies outbreak encompasses several pivotal steps: accurate diagnosis, comprehensive treatment with topical scabicides to kill the mites, rigorous environmental control (including washing all possibly infested materials in hot water), meticulous contact tracing of all close contacts, administration of symptomatic relief through antihistamines and corticosteroids, and meticulous follow-up to verify successful treatment outcomes.Discussion and Conclusion: The prevention of further infestation and recurrent outbreaks is crucial, necessitating a holistic, integrative public health management approach. This approach involves consistent communication and public education about preventive measures and prompt treatment strategies to curtail widespread infestation, thereby safeguarding community health.

BACKGROUND: Condyloma acuminatum is a sexually transmitted disease (STD) associated with the human papillomavirus (HPV). Although it is a relatively common disease, there has been no epidemiological and clinical study of condyloma acuminatum performed in Korea since 1978. OBJECTIVE: We aimed to evaluate the clinical features of condyloma acuminatum in Korean patients, to identify the genotypes of HPV, as well as determine factors associated with recurrence of condyloma acuminatum. METHODS: We studied 80 patients (60 men and 20 women) diagnosed with condyloma acuminatum. We analyzed age, sex, duration of the disease, number and locations of lesions, underlying diseases and co-infection with STDs, treatment modalities, and number of relapses. Additionally, 26 patients were analyzed for HPV subtypes. We also evaluated factors affecting recurrence of condyloma. RESULTS: Mean age at the time of diagnosis was 36.9±17.7 years and mean duration of disease was 7.2±16.5 months. The most common sites of involvement were found to be the penile shaft in men and the labia majora in women. We observed that 28 patients showed relapse with a mean duration of 1.5±4.5 months. HPV genotyping revealed that type 6, 11, and 44 genotypes that are associated with a low risk of malignancy were detected in 76.9% of cases, and type 16, 18, 51, 52, and 66 genotypes associated with a high risk of malignancy were detected in 15.3% cases. A significant relationship was observed between the recurrence rates of condyloma acuminatum and the rates of co-infection with STDs and the number of lesions. CONCLUSION: We report a recent epidemiological and clinical review analyzing genotypes of HPV in Korean patients presenting with condyloma acuminatum.
Clinical Study ; Coinfection ; Diagnosis ; Female ; Genotype* ; Humans* ; Korea ; Male ; Recurrence ; Sexually Transmitted Diseases

STATEMENT OF PROBLEM: Because dental impression can be a cross-infection source, disinfection, such as immersion disinfection is nessecary. However, the disinfection process may change the volume of the impression cast. PURPOSE: The purpose of this study is to find out the effects on dimensional change of different storage times and methods, of agar-alginate impression when immersed in a 5% idophor disinfectant. MATERIAL AND METHODS: An agar-alginate impression was made from a mandible model and then was disinfected and stored according the experimental conditions and a stone model was produced. Measurements were taken between reference points on the original mandible model and they were compared to measurements taken between reference points on the stone model. The study was divided into 4 groups. In group 1, the impression was stored in a 100% humidor for 30 minutes, 1 hour, 2 hours, 3 hours, 4 hours, 6 hours, 12 hours and 24 hours and stone models were made at each time. In group 2, the impression was immersed in 5% idophor disinfectant and then stored in a 100% humidor for the same length of times as group 1, and stone models were made at each time. In group 3, the impression was stored in extend-A-pourR, a special storage solution for 30 minutes, 1 hour, 2 hours, 3 hours, 4 hours, 6 hours, 12 hours, 24 hours 3 days, and 7 days and stone models were made at each time. In group 4, the impression was immersed in 5% idophor disinfectant and then stored in stored in extend-A-pourR, a special storage solution for the same length of times as group 3, and stone models were made at each time. 5 impressions and stone models were made at each time to make a total of 180. The Student-t test (P < .05) was used to do a statistical analysis of the measurements of the mandible model and stone models. The repeated-measure 2-way analysis of variance (P < .05) was used to do a statistical analysis of the difference in the 4 groups. RESULTS: The percent liner dimensional change was from 0.25+/-0.03% (group 1, 30 minutes) to 0.34+/-0.06% (group 4, 7 days). No significant change was noticed between the 4 groups. CONCLUSION: According to the above study, in both methods, least dimensional change was recorded when the storage times were short and in both methods, immersion in 5% idophor disinfectant did not effect dimensional change in the agar-alginate impression.
Disinfection* ; Immersion ; Mandible

PURPOSE: We evaluated the feasibility of a laparoendoscopic single-site (LESS) nephroureterectomy for an upper urinary tract tumor. MATERIALS AND METHODS: Between March 2009 and September 2009, 4 patients with upper urinary tract tumors underwent LESS nephroureterectomy. The mean age of the 2 female and 2 male patients was 69 years old, and their mean body mass index was 23.0. We used a homemade single-port device made with a surgical glove and a wound retractor, which were put into a 4 cm periumbilical incision. Operations with articulating and rigid laparoscopic instruments were performed transperitoneally. An open technique with a 4 cm additional midline incision and laparoscopic technique with an endoscopic stapler were used for the treatment of the distal ureter and bladder cuff. RESULTS: All cases were completed successfully, without conversion to conventional laparoscopy or open surgery. The mean operative time was 169.5 minutes. The mean estimated blood loss was 361.4 ml. One patient had transfusion and wound infection. The mean hospital stay was 7.8 days. The mean specimen weight and tumor size were 271.8 g and 2.9 cm. Pathologic results of all cases showed urothelial carcinoma with a negative surgical margin. Three patients were in stage T3N0M0 and 1 was in stage T2N0M0. CONCLUSIONS: Our initial experience shows that LESS nephroureterectomy with a homemade single-port device is technically feasible. However, long term follow-up for the effect on cancer control and technical development for comfortable surgery are needed.
Body Mass Index ; Female ; Gloves, Surgical ; Humans ; Kidney Neoplasms ; Laparoscopy ; Length of Stay ; Male ; Nephrectomy ; Operative Time ; Ureter ; Ureteral Neoplasms ; Urinary Bladder ; Urinary Tract* ; Wound Infection ; Wounds and Injuries

PURPOSE: We evaluated the feasibility of a laparoendoscopic single-site (LESS) nephroureterectomy for an upper urinary tract tumor. MATERIALS AND METHODS: Between March 2009 and September 2009, 4 patients with upper urinary tract tumors underwent LESS nephroureterectomy. The mean age of the 2 female and 2 male patients was 69 years old, and their mean body mass index was 23.0. We used a homemade single-port device made with a surgical glove and a wound retractor, which were put into a 4 cm periumbilical incision. Operations with articulating and rigid laparoscopic instruments were performed transperitoneally. An open technique with a 4 cm additional midline incision and laparoscopic technique with an endoscopic stapler were used for the treatment of the distal ureter and bladder cuff. RESULTS: All cases were completed successfully, without conversion to conventional laparoscopy or open surgery. The mean operative time was 169.5 minutes. The mean estimated blood loss was 361.4 ml. One patient had transfusion and wound infection. The mean hospital stay was 7.8 days. The mean specimen weight and tumor size were 271.8 g and 2.9 cm. Pathologic results of all cases showed urothelial carcinoma with a negative surgical margin. Three patients were in stage T3N0M0 and 1 was in stage T2N0M0. CONCLUSIONS: Our initial experience shows that LESS nephroureterectomy with a homemade single-port device is technically feasible. However, long term follow-up for the effect on cancer control and technical development for comfortable surgery are needed.
Body Mass Index ; Female ; Gloves, Surgical ; Humans ; Kidney Neoplasms ; Laparoscopy ; Length of Stay ; Male ; Nephrectomy ; Operative Time ; Ureter ; Ureteral Neoplasms ; Urinary Bladder ; Urinary Tract* ; Wound Infection ; Wounds and Injuries

PURPOSE: Several studies have suggested that many children have no symptoms before hospitalization with asthma exacerbations. The purpose of this study was to evaluate how many asymptomatic children were hospitalized for asthma exacerbation, and to analyze their prior symptoms. METHODS: Children over 3 years old, hospitalized for acute asthma exacerbation in the Pediatric Allergy and Respiratory Centers in the Kangnam St. Mary's Hospital from January 2003 to December 2006 were enrolled, and their medical records reviewed retrospectively. RESULTS: Among 142 identified patients (median age 5+/-2.5 yr), the group who developed asthmatic symptoms within four weeks before admission occupied about 18.5%. And the group who developed asthmatic symptoms in four weeks or acute exacerbation in six weeks before admission occupied about 23.2%. And group who had asthmatic symptoms in four weeks or acute exacerbation in six weeks or acute exacerbation one year before admission occupied about 31.6%. In September, the group who had no symptom before admission was larger than the group who had asthmatic symptom. The baseline characteristics of each group were not significantly different with respect to age, sex, past history or family history of allergic disease, UniCAP, total IgE and eosinophil count. CONCLUSION: Many children had no symptoms before admission for acute asthma exacerbation. Therefore, we suggest considering that a large number of patients with no previous symptoms are at great risk of acute exacerbation in September, when maintenance therapy is determined.
Asthma* ; Child* ; Child, Preschool ; Eosinophils ; Hospitalization ; Humans ; Hypersensitivity ; Immunoglobulin E ; Medical Records ; Respiratory Center ; Retrospective Studies