PURPOSE: This study investigated the preemptive analgesic effects of Morphine and Ketorolac on postoperative pain, cortisol, O2 saturation and heart rate for the first 24 hr after abdominal surgery. METHODS: Data collection was performed from April 1 to September 30, 2006. Forty patients undergoing a gastrectomy under general anesthesia were randomly allocated to the experimental or control group. The experimental group (20 patients) was administered Morphine and Ketorolac approximately 1 hr prior to skin incision, but the control group (20 patients) was administered Morphine and Ketorolac at peritoneum closure through a patient-controlled analgesia (PCA) pump. Postoperative pain, blood pressure, heart rate, cortisol, O2 saturation, frequency of the PCA button pressed and doses of additional analgesics were observed through post operative 24 hr. Collected data was analyzed using t-test, chi-square test, repeated measures ANOVA, and Bonferroni methods. RESULTS: Postoperative pain, cortisol, the frequency of PCA button pressed, and dose of additional analgesics of the experimental group were significantly lower than the control group. There were no statistical differences in blood pressure, heart rate and O2 saturation between the experimental group and control group. CONCLUSIONS: We concluded that administration of morphine and ketorolac at 1 hr prior to skin incision resulted in decreasing postoperative pain, but it didn't affect blood pressure, heart rate or O2 saturation for 24 hr after abdominal surgery.
Aged ; Analgesics/*administration & dosage ; Blood Pressure ; Female ; Heart Rate ; Humans ; Hydrocortisone/analysis ; Injections, Intravenous ; Ketorolac/*administration & dosage ; Male ; Middle Aged ; Morphine/*administration & dosage ; Oximetry ; Pain Measurement ; Pain, Postoperative/*prevention & control

PURPOSE: To develop outcome indicators of urinary incontinence to measure quality of care in long term care hospitals in Korea. METHODS: The draft indicators of urinary incontinence were developed from a literature review and clinical expert panel. A survey of medical records of 280 patients in 20 hospitals was conducted to test inter-rater reliability. Statistical analysis was done to test risk adjustment criteria, variation between hospitals, and stability of indicators, using assessment data from 77,918 patients in 623 hospitals. RESULTS: The inter-rater reliability of items was high (Kappa range: 0.66-0.92). Severe cognitive impairment (odds ratio [OR]: 3.15, confidence interval [CI]: 3.03-3.26) and total mobility activities of daily living (ADLs) dependency (OR: 4.85, CI: 4.72-4.98) increased the prevalence of urinary incontinence, thus they proved to be significant criteria to stratify high and low risk groups. The prevalence for low risk showed more substantial variation than the high risk group. The indicators were stable over one month. CONCLUSION: This study demonstrated the feasibility of outcome indicators of urinary incontinence. Improving the reliability of the patient assessment tool and refining the indicators through validation study is a must for future study.
Activities of Daily Living ; Aged ; Aged, 80 and over ; Female ; Health Services for the Aged/standards ; Hospitals ; Humans ; Long-Term Care/*standards ; Male ; Outcome Assessment (Health Care) ; Prevalence ; *Quality of Health Care ; Urinary Incontinence/*therapy

Nasal lymphoma is an uncommon neoplasm in the sinonasal tract. The NK/T-cell type of lymphoma is more commonly found in Asian populations. However, B-cell lymphoma is more common in the western countries whereas it is rare in Asia. Recently, we experienced two cases of sinonasal B-cell lymphoma, which are rare cases in Korea, one in an advanced stage and one in an early stage. Both patients had no specific nasal symptoms or systemic B symptoms (fever, night sweat, weight loss). As our cases demonstrate, diagnosis of B cell lymphoma is often delayed in many cases because B-cell lymphoma does not show any specific symptoms. Thus, careful physical examination and biopsy under suspicion of malignancy are important for early diagnosis of nasal lymphoma.
Asia ; Asian Continental Ancestry Group ; B-Lymphocytes ; Biopsy ; Humans ; Korea ; Lymphoma ; Lymphoma, B-Cell ; Physical Examination ; Sweat

OBJECTIVES: To develop dedicated markup language for clinical contents models (CCM) to facilitate the active use of CCM in electronic health record systems. METHODS: Based on analysis of the structure and characteristics of CCM in the clinical domain, we designed extensible markup language (XML) based CCM markup language (CCML) schema manually. RESULTS: CCML faithfully reflects CCM in both the syntactic and semantic aspects. As this language is based on XML, it can be expressed and processed in computer systems and can be used in a technology-neutral way. CONCLUSIONS: CCML has the following strengths: it is machine-readable and highly human-readable, it does not require a dedicated parser, and it can be applied for existing electronic health record systems.
Computer Systems ; Electronic Health Records ; Electronics ; Electrons ; Semantics

BACKGROUND: The risk of bleeding during extracorporeal membrane oxygenation (ECMO) is a potential deterrent in performing tracheostomy at many centers. To evaluate the safety of surgical tracheostomy (ST) in critically ill patients supported by ECMO, we reviewed the clinical correlation between preoperative coagulation status and bleeding complication-related ST during ECMO. METHODS: From April 1, 2012 to March 31, 2016, ST was performed on 38 patients supported by ECMO. We retrospectively reviewed and analyzed the medical records including complications related to ST. RESULTS: Heparin was administered to 23 patients (60.5%) for anticoagulation during ECMO, but 15 patients (39.5%) underwent ECMO without anticoagulation. Of the 23 patients administered anticoagulation therapy, heparin infusion was briefly paused in 13 prior to ST. The median platelet count, international normalized ratio, and activated partial thromboplastin time before ST were 126 ×109/L (range, 46 to 434 ×109/L), 1.2 (range, 1 to 2.3) and 62 seconds (27 to 114.2 seconds), respectively. No peri-procedural clotting complications related to ECMO were observed. Two patients (5.3%) suffering from ST-related major bleeding required surgical hemostasis. Minor bleeding after ST occurred in two cases (5.3%). No significant difference was found according to anticoagulation management (P = 0.723). No fatality was attributable to ST. CONCLUSIONS: The complication rates of ST in the patients supported by ECMO were low. Therefore, ST performed by an experienced operator, and with careful optimization of coagulation status, is a relatively safe procedure; the use of ST with ECMO should thus not be dismissed on account of the potential for bleeding caused by the administration of anticoagulants.
Anticoagulants ; Critical Illness ; Extracorporeal Membrane Oxygenation* ; Hemorrhage ; Hemostasis, Surgical ; Heparin ; Humans ; International Normalized Ratio ; Medical Records ; Partial Thromboplastin Time ; Platelet Count ; Retrospective Studies ; Tracheostomy*

Purpose: Incontinence-associated dermatitis (IAD) is widespread and a common problem in healthcare settings, It is defined as irritation of the perineal skin due to contact with urine, feces, or both. It is one of the major risk factors for the development of pressure injuries are regarded as a quality indicator of nursing care.It is important to understand the knowledge and attitudes of nurses who are primarily responsible for providing appropriate nursing care that includes differentiation of IAD from other skin breakdowns, and appropriate management. Therefore, the purpose of this study was to determine the knowledge, attitudes, and performance of IAD among clinical nurses in Korea. Methods: Data about IAD knowledge, attitudes, and performance were collected from August to November 2022. 656 nurses from six hospitals participated in the study. Results: The mean scores of nurses’ knowledge, attitudes, and performance were 17.98±2.91, 76.34±7.85, and 91.53±16.18, respectively. Nurses' knowledge showed a positive correlation in both attitudes (r=0.27, p<.001) and performance (r=0.09, p=.02), and attitudes and performance (r=0.34, p<.001) also showed a positive correlation. Conclusion To improve the knowledge and performance of nurses, an educational program consisting only of incontinence-related dermatitis is needed, and case-based education and clinical skills education are needed to enhance the ability to differentiate from pressure injury.

Purpose: Incontinence-associated dermatitis (IAD) is widespread and a common problem in healthcare settings, It is defined as irritation of the perineal skin due to contact with urine, feces, or both. It is one of the major risk factors for the development of pressure injuries are regarded as a quality indicator of nursing care.It is important to understand the knowledge and attitudes of nurses who are primarily responsible for providing appropriate nursing care that includes differentiation of IAD from other skin breakdowns, and appropriate management. Therefore, the purpose of this study was to determine the knowledge, attitudes, and performance of IAD among clinical nurses in Korea. Methods: Data about IAD knowledge, attitudes, and performance were collected from August to November 2022. 656 nurses from six hospitals participated in the study. Results: The mean scores of nurses’ knowledge, attitudes, and performance were 17.98±2.91, 76.34±7.85, and 91.53±16.18, respectively. Nurses' knowledge showed a positive correlation in both attitudes (r=0.27, p<.001) and performance (r=0.09, p=.02), and attitudes and performance (r=0.34, p<.001) also showed a positive correlation. Conclusion To improve the knowledge and performance of nurses, an educational program consisting only of incontinence-related dermatitis is needed, and case-based education and clinical skills education are needed to enhance the ability to differentiate from pressure injury.

Purpose: Incontinence-associated dermatitis (IAD) is widespread and a common problem in healthcare settings, It is defined as irritation of the perineal skin due to contact with urine, feces, or both. It is one of the major risk factors for the development of pressure injuries are regarded as a quality indicator of nursing care.It is important to understand the knowledge and attitudes of nurses who are primarily responsible for providing appropriate nursing care that includes differentiation of IAD from other skin breakdowns, and appropriate management. Therefore, the purpose of this study was to determine the knowledge, attitudes, and performance of IAD among clinical nurses in Korea. Methods: Data about IAD knowledge, attitudes, and performance were collected from August to November 2022. 656 nurses from six hospitals participated in the study. Results: The mean scores of nurses’ knowledge, attitudes, and performance were 17.98±2.91, 76.34±7.85, and 91.53±16.18, respectively. Nurses' knowledge showed a positive correlation in both attitudes (r=0.27, p<.001) and performance (r=0.09, p=.02), and attitudes and performance (r=0.34, p<.001) also showed a positive correlation. Conclusion To improve the knowledge and performance of nurses, an educational program consisting only of incontinence-related dermatitis is needed, and case-based education and clinical skills education are needed to enhance the ability to differentiate from pressure injury.

Purpose: Incontinence-associated dermatitis (IAD) is widespread and a common problem in healthcare settings, It is defined as irritation of the perineal skin due to contact with urine, feces, or both. It is one of the major risk factors for the development of pressure injuries are regarded as a quality indicator of nursing care.It is important to understand the knowledge and attitudes of nurses who are primarily responsible for providing appropriate nursing care that includes differentiation of IAD from other skin breakdowns, and appropriate management. Therefore, the purpose of this study was to determine the knowledge, attitudes, and performance of IAD among clinical nurses in Korea. Methods: Data about IAD knowledge, attitudes, and performance were collected from August to November 2022. 656 nurses from six hospitals participated in the study. Results: The mean scores of nurses’ knowledge, attitudes, and performance were 17.98±2.91, 76.34±7.85, and 91.53±16.18, respectively. Nurses' knowledge showed a positive correlation in both attitudes (r=0.27, p<.001) and performance (r=0.09, p=.02), and attitudes and performance (r=0.34, p<.001) also showed a positive correlation. Conclusion To improve the knowledge and performance of nurses, an educational program consisting only of incontinence-related dermatitis is needed, and case-based education and clinical skills education are needed to enhance the ability to differentiate from pressure injury.

BACKGROUND: Liver transplantation (LT) is a complicated procedure with a high incidence of postoperative acute kidney injury (AKI). Previous studies indicate that even transient or mild post-LT AKI can result in critical conditions, including prolonged stays in hospitals and intensive care units and increased morbidity and mortality. The aim of this study was to investigate the association between body mass index (BMI) and occurrence of AKI in LT recipients. METHODS: Medical data from 203 patients who received LT surgery from January 2010 to August 2016 in a single university hospital setting were retrospectively collected and analyzed. Patients were classified as either underweight (BMI <20 kg/m²) or normal weight (20 ≤ BMI < 30 kg/m²). Demographic data, anesthetic methods, complications, and perioperative laboratory test values of each patient were assessed. Propensity analyses and logistic regression were performed to evaluate the association between BMI and post-LT AKI. RESULTS: There was no significant difference in occurrence of post-LT AKI between underweight and normal weight patients. The underweight patient group had significantly longer hospital stay compared with the normal weight patient group (P = 0.023). CONCLUSIONS: BMI classification was neither a positive nor negative predictor of postoperative AKI occurrence. However, patients with lower BMI had significantly longer hospital stay compared with their counterparts. Although our study was limited by its retrospective design, our observations suggest that lower BMI might play a role in post-LT AKI.
Acute Kidney Injury* ; Body Mass Index* ; Classification ; Humans ; Incidence ; Intensive Care Units ; Length of Stay ; Liver Transplantation* ; Liver* ; Logistic Models ; Mortality ; Retrospective Studies* ; Thinness