PURPOSE: Effective literature searching is essential to support evidence-based nursing. The aim of this study was to present our recent systematic search experience to identify guidelines in PubMed for prevention of catheter-associated urinary tract infections. METHODS: Five approaches to the literature search via PubMed were employed. The searches were restricted to items published from 1980 to 2010, for patients admitted to hospital, and in the English language. The search results were compared using the number of records and relevant items, and the sensitivity and precision of each search strategy. RESULTS: The individual approaches retrieved 19-141 of records and 3-6 of relevant items. Sensitivity ranged from 37.5% to 75.0% with the highest values for simple searches and a search combining MeSH terms and free textwords with a methodological search filter. Precision varied from 4.3% to 21.7% and the highest precision was found for MeSH terms with limits feature. CONCLUSION: The simple search in PubMed is an appropriate way for nurses in a busy clinical practice to search the literature for evidence. However, several approaches using MeSH terms, free textwords, limits feature or methodological search filters are also required to have more efficient and better informed search results.
Evidence-Based Nursing ; Humans ; Methods ; Urinary Catheterization ; Urinary Tract Infections* ; Urinary Tract*

PURPOSE: Purpose of this study was to analyze research on the service design process applied to domestic medical service areas. METHODS: A review was made through domestic databases including RISS, KISS, DBpia, and NDSL and for the analysis framework: a medical service classification code which integrated the medical service area and the design fields. RESULTS: In the healthcare service field there were 9 studies (69.2%) in the medical area, 1 study (7.7%) each in nursing and oriental medicine, and 2 studies (15.4%) in healthcare. According to analysis results based on the medical service classification code, there were 5 studies in prevention and management, 6 studies in curative care, 1 each in rehabilitation and ancillary care. Double diamond process was used in 8 studies. CONCLUSION: Service design was applied mainly to the curative care in the domestic medical settings but little research on service design in the long-term nursing care area was identified. As a strategy to improve the quality of nursing service, it is necessary to adopt the service design process for various nursing service areas in Korea.
Classification ; Delivery of Health Care ; Diamond ; Korea ; Medicine, East Asian Traditional ; Nursing ; Nursing Care ; Nursing Services ; Patient-Centered Care ; Quality Improvement ; Rehabilitation

BACKGROUND: Caudal block has proved to be a satisfactory method of providing perioperative analgesia for pediatric surgery in the inguinal and perineal areas. The object of this study was to compare the general (n=55) with caudal anesthesia (n=41) in pediatric inguinal herniorrhaphy during surgery and postoperative 24 hours in their changes of behaviors in the recovery room, and other complications. METHODS: Ninety six children who underwent to inguinal herniorrhaphy were devided into two groups. Group I was given general anesthesia as usual methods using endotracheal intubation. Group II was given caudal block using 1% lidocaine 1 ml/kg or 0.25% bupivacaine 1 ml/kg, or a mixture of both of them at the ratio of 1:1, 1 ml/kg. All caudal blocks were carried out in left lateral position after ketamine 1-1.5 mg/kg intravenous injection. The side effects during and after operation and postoperative behavior in the recovery room, neurologic complications and postoperative fever incidence were observed and compared with the two groups. RESULTS: In group I (n=55), 13 cases (23.6%) showed hoarseness after extubation. 78.2% of 55 patients were irritable and cryng in the recovery room. Postoperative fever incidence was over 69%. In group II (n=41), almost all patients were calm and stayed quiet in the recovery room. However there were 3 cases of bradycardia and 2 cases of hypotension during operation. Postoperative complications were rare and the mumber of patients with fever was 36.6% which was significantly low compared to group I. CONCLUSIONS: As the results of this study, we report that caudal anesthesia is a safe, simple practical method with few complications for inguinal herniorraphy in children compared with general anesthesia. We also recommend that the caudal block can be used safely in pediatric outpatient surgery.
Ambulatory Surgical Procedures ; Analgesia ; Anesthesia, Caudal* ; Anesthesia, General ; Bradycardia ; Bupivacaine ; Child* ; Fever ; Herniorrhaphy* ; Hoarseness ; Humans ; Hypotension ; Incidence ; Injections, Intravenous ; Intubation, Intratracheal ; Ketamine ; Lidocaine ; Postoperative Complications ; Recovery Room

BACKGROUND: Epinephrine-containing epidural test dose is used for obstetric epidural anesthesia to identify the unintentional cannulation of an epidural vessel. This study evaluated the effects of an epinephrine test dose during epidural anesthesia with 0.5% ropivacaine in ceasrean section. METHODS: Seventy healthy pregnant women, scheduled for elective cesarean section were randomly assigned to one of two groups. A lumbar epidural catheter was placed and aspirated. If aspiration was positive for blood or cerebrospinal fluid, the catheter was replaced. All patients received an 3 ml test dose of either 1.5% lidocaine with epinephrine 5microgram/ml (group E) or lidocaine only (group C). After test dose, 50microgram fentanyl and 20 ml of 0.5% ropivacaine were given to the all patients. Applying the pin prick method and a modified Bromage scoring system, senseory block level and motot block intensity were checked at 5 min intervals for the first hour following ropivacaine injection. After then, they were checked at 15 min intervals for the rest of the test period. Heart rate (HR) and blood pressure (BP) were measured as well. RESULTS: No significant difference between the two groups was detected in HR, BP, the profile of sensory block, motor scores and the onset of motor block. However, group C showed significantly shorter span of motor block (102 +/- 31 min.) than group E (134 +/- 32 min.) (P <0.05). There was no significant difference in neonatal outcome, as assessed by Apgar score at delivery. The most common adverse effect in mothers was hypotension. No serious adverse effects were detected in this study. CONCLUSIONS: We conclude that only the span of motor block by the epidural ropivacaine is affected by epinephrine-containing epidural test dose.
Anesthesia, Epidural* ; Apgar Score ; Blood Pressure ; Catheterization ; Catheters ; Cerebrospinal Fluid ; Cesarean Section ; Epinephrine ; Female ; Fentanyl ; Heart Rate ; Humans ; Hypotension ; Lidocaine ; Mothers ; Pregnancy ; Pregnant Women

We investigated the ventilatory changes in healthy patients without cardiopulmonary pathology during elective laparoscopic cholecystectomy in the head-up position. During surgery, intraabdominal pressure was maintained at 15 mmHg by a CO2 insufflator, and minute ventilation was controlled with a constant tidal volume and fixed respiratory rate. PETCO2 was monitored continuously and recorded every minute. Basic hemodynamic and ventilatory parameters were measured before anesthesia; after induction of anesthesia; at 5 min, 10 min and 30 min after peritoneal insufflation; and 5 min and 10 min after exsufflation. Arterial blood samples were obtained 3 times to calculate D(a-A)CO2, VD/VT, and Vco2. The latent period of PETCO2 change was 2.9 min, the ascending period was 12.6 min, and the descending period was 12.2 min. During the 71.5 min of pneumoperitoneum, V(I), VE, peak and plateau Paw increased, while Cdyn decreased significantly. Peritoneal insufflation or exsufflation also resulted in a significant change of D(a-A)CO2, D(a-A)O2, and Vco2. The anesthesiologist must be aware of both hemodynamic and ventilatory changes and must be ready to respond promptly and adequately.
Adolescence ; Adult ; Colectomy* ; Colon/surgery* ; Human ; Intraoperative Period ; Laparoscopy* ; Posture ; Respiration*

BACKGROUND: Shivering is a frequent event during the perioperative period. We performed a prospective, randomized, double-blind study to determine whether intrathecal meperidine (0.2 mg/kg) decreases the incidence and intensity of shivering after spinal anesthesia for transurethral operations. METHODS: Fifty patients scheduled for elective transurethral resection operations under spinal anesthesia were randomly allocated to two groups. Spinal anesthesia consisted of 0.5% hyperbaric bupivacaine 8 mg and, mperidine (0.2 mg/kg) (meperidine group) or, normal saline (saline group). Data collection, including sensory block level (by pinprick), blood pressure, heart rate, sublingual temperature, incidence and intensity of shivering, pruritus, nausea, and vomiting was performed at 10 minute intervals. RESULTS: The incidence and intensity of shivering was significantly less in the meperidine group than saline group (P = 0.012 and P = 0.008, for incidence and intensity, respectively). However, pruritus was more common in the meperidine group compared with the saline group (16% vs. 0%, P < 0.05). CONCLUSIONS: The addition of meperidine 0.2 mg/kg to intrathecal bupivacaine lowers the incidence and severity of shivering during transurethral prostatectomy in elderly patients.
Aged ; Anesthesia ; Anesthesia, Spinal ; Blood Pressure ; Bupivacaine ; Data Collection ; Double-Blind Method ; Heart Rate ; Humans ; Incidence ; Meperidine ; Nausea ; Perioperative Period ; Prospective Studies ; Pruritus ; Shivering ; Transurethral Resection of Prostate ; Vomiting

PURPOSE: Although progenitor cells may contribute to intimal hyperplasia (IH) after arterial injury, positive contribution of IH is variable with type of injury or cells. This study was designed to examine whether differentiated muscle derived stem cells (MDSC) attenuate IH in rat. METHODS: MDSCs were retrieved using preplate techniques from rat calf muscle and MDSCs (preplate 6th culture fraction, pp6) were exposed to VEGF (50 ng/ml) for endothelial differentiation prior to injection. Male rats were divided into two groups (cell treated vs. control) and underwent carotid balloon injury with 2-Fr catheter. The virus containing Green fluorescent protein (GFP) gene was transfected into cells for monitoring. Cells (5x10(6)) were indwelled into carotid artery for 30 minutes after injury and then blood flow was restored. Arteries were harvested at various intervals (1, 2 and 4 weeks) after injury. The intima to media thickness ratio (IMTR) was calculated with morphometric analysis. RESULTS: Endothelial surface markers such as VE-CADHERIN were strongly expressed on differentiated MDSCs. At 4 weeks after injury, IH was predominantly observed in control group compared to cell treated group. The intensity of GFP was strongly observed at 1 week and declined at 4 weeks in carotid artery wall at MDSC group. CD31(+) endothelial cells were observed at MDSC group compared to control. The mean IMTR in cell treated groups were significantly lower than control at 2 weeks (P=0.005) and 4 weeks (P< or =0.001). CONCLUSION: Our study demonstrates that MDSCs therapy promotes re-endothelialization and leads to attenuation of IH after balloon injury in rat.
Animals ; Antigens, CD ; Arteries ; Cadherins ; Carotid Arteries ; Catheters ; Endothelial Cells ; Humans ; Hyperplasia ; Male ; Muscles ; Rats ; Stem Cells ; Vascular Endothelial Growth Factor A ; Viruses

No abstract available.
Nevus, Blue* ; Prurigo*

No abstract available.
Nevus, Blue* ; Prurigo*

In Uremic condition, Secondary Hyperparathyroidism ensues due to phosphate retention, low level of calcitriol, decreased calcium absorption from intestine, skeletal resistance to the Parathyroid Hormone (PTH), hypocalcemia and eventually parathyroid hyperplasia. Theoretically, Reversal of hyperparathyroidism can be expected after successful kidney transplantation. However, Some patients show continuous increase of parathyroid function due to autonomous excretion of PTH, in which case, we could assume a tertiary hyperparathyroidism. There were sporadic reports for the treatment of tertiary hyperparathyroidism after successful kidney transplantation. And in some aspects, there remains a controvesrsy about the timing of parathyroidectomy. The occurrence of a single parathyroid adenoma after kidney transplantation is ever unusual finding. In our hospital, we have experienced a case of parathyroid adenoma who had taken successful kidney transplantation. The patient was 62 year old man who had a long duration of hemodialysis for 10 years. His hypercalcemic findings were managed medically for 1 year. As the patient's hypercalcemic symptom aggrevated, he was admitted and parathyroid adenoma was diagnosed by a CT scan and parathyroid scan. After excsion of the parathyroid adenoma, his general condition and kidney function improved. In our conclusion, there may be a debate for the timing of subtotal parathyroidectomy in the patient with tertiary hyperparathyroidism after kidney transplantation. But when the patient shows a hypercalcemic profile, the parathyroid scan, CT scan, Neck Ultrasonography must be considered to detect single parathyroid adenoma which is so simple to remove surgically.
Absorption ; Calcitriol ; Calcium ; Humans ; Hyperparathyroidism ; Hyperparathyroidism, Secondary ; Hyperplasia ; Hypocalcemia ; Intestines ; Kidney Transplantation* ; Kidney* ; Middle Aged ; Neck ; Parathyroid Hormone ; Parathyroid Neoplasms* ; Parathyroidectomy ; Renal Dialysis ; Tomography, X-Ray Computed ; Ultrasonography