Purpose: This study developed a protocol for nursing care after death for adult patients in hospitals. Methods: This was a methodological study to develop a care after death protocol. The preliminary protocol was developed based on a literature review, guidelines, and practice recommendations from groups of experts and clinical nurses. Content validity was evaluated by a group of experts (n=6) and nurses (n=30) in two hospitals. Results: The preliminary protocol recommendations were modified by validation and the open-question analysis results. The final protocol comprised three general recommendations and 43 recommendations in five steps that are verification and notification of a death, personal care of the body, viewing the patient, patient transfer, and documentation and self-care. Conclusion This study result provides nurses with a consensus information on patient care after death and family support in a hospital setting. This nursing protocol is expected to improve the quality of care after death for adult patients and their families, and can be used for developing educational and emotional support for nurses to accomplish their important role.

PURPOSE: The purpose of the study was to determine effect of incivility, resilience, and social support experienced by nursing students on burnout in clinical practice. METHODS: Subjects were 140 nursing students who agreed to participate in this study. Collected data were analyzed using descriptive statistics, t-test, analysis of variance, Pearson's correlation and stepwise multiple regression with SPSS WIN 23.0 program. RESULTS: Burnout showed significantly positive correlation with incivility but significantly negative correlations with resilience and social support. Factors affecting burnout were satisfaction with major-dissatisfaction, satisfaction with major-average, social support, grade, and relationship with peers. Satisfaction with major (dissatisfaction) had the greatest effect on burnout, explaining 41% of the total variance. CONCLUSION: According to this study, dissatisfaction with major was identified as the most significant factor influencing burnout of nursing students in clinical practice. Therefore, it is important to develop and implement programs that can reduce dissatisfaction with major and increase social support and relationship with peers in order to lower burnout of nursing students. In addition, a systemic management of fourth-grade students with a high level of clinical practice is necessary to reduce the level of clinical practice. The authors declared no conflict of interest.
Conflict of Interest ; Humans ; Nursing ; Resilience, Psychological ; Students, Nursing

Bezafibrate, a fibric acid derivative related to clofibrate, is being used increasingly in the treatment of hypertriglycemia. It is relatively well tolerated at usual dosage, and has a low incidence of adverse reactions. But we had recently observed a reversible deterioration of renal function requiring hemodialysis, presumed to be caused by bezafibrate treatment in a patient with diabetic nephropathy. A 55 year old man was admitted with complaints of general weakness and painful lower extremities. He had taken bezafibrate (200 mg every 12 hours) for the previous 4 months because of hypertriglycemia. After admission, the drug was withdrawn, and he was treated conservatively management with hydration and diuretics for bezafibrate induced rhabdomyolysis. Nevertheless, his symptom was not improved, so he was taken even hemodialysis. These findings suggested that bezafibrate should be admistered with great caution to patient with renal insufficiency. When it is admistered, CK, LDH, aldolase, and sGOT levels have to be checked for early detection of potential side effect.
Aspartate Aminotransferases ; Bezafibrate* ; Clofibrate ; Diabetic Nephropathies ; Diuretics ; Fructose-Bisphosphate Aldolase ; Humans ; Incidence ; Lower Extremity ; Middle Aged ; Renal Dialysis ; Renal Insufficiency ; Rhabdomyolysis*

This study was conducted to identify the attributes constituting Korean social support and to validate the results of the previous study 'Search for the meaning of social support in Korean Society.' The informants were 41 Korean middle-aged women in three cities : Seoul, Dagjun and Daeku. The data were collected through indepth interviews using the interview guide from Jun. 1994 to Jun. 1995. The interview guide was developed in the simulated situations of 'Stroke attack' which expected to be in need of social support. The women were asked to answer what they felt and the appropriated terms representing the situations. Data analysis were conducted by content analysis. consequently, the Koran social support pyramid was modified as follows ; Support is the apex of the pyramid. The four sides of the pyramid are made up of 'Jung'(Bound by ties of affection, regard or shared common experience, Connectedness), Do-oom(both emotional and material help), Mi-dum(Faith or belief in) and Sa-Rang(Love). The base of the pyramid is 'yun'(the basic network of relationships in Korean culture) that connote the meaning of Eunhae(Benevolence), Euimu(duty, responsibility) and Dori(obligation).
Female ; Humans ; Middle Aged* ; Seoul ; Statistics as Topic

The ras, is a G-like protein that controls the mitogen-activated protein kinase (MAPK) pathway involved in control and differentiation of cell growth. MAPK is a key component of its signaling pathway and the aberrant activation may play an important role in the transformation process. To better understand roles of ras in the activation of MAPKs, we have established ras transformed NIH3T3 fibroblast cell line, and analyzed the MAPK module. The ras transformed cells formed numerous spikes at the edges of cells and showed loss of contact inhibition. The levels of ERK1/2 MAPKs as revealed by Western blot analysis were not significantly different between ras transformed and non-transformed cells. However, phosphorylation of ERK MAPKs and the level of MEK were significantly increased although the heavily expressed level of Raf-1, an upstream component of MAPK pathway was unchanged in ras transformed NIH3T3 cells. The sedimentation profile of the MAPK module kinases in a glycerol gradient showed the presence of a rather homogeneous species of multimeric forms of ERK1/2 and MEK as indicated by the narrow distribution peak areas. The broad sedimentation profile of the Raf-1 in a glycerol gradient may suggest possible heterologous protein complexes but the identification of interacting molecules still remains to be identified in order to understand the organization of the MAPK signal transduction pathway.
3T3 Cells ; Animal ; Cell Transformation, Neoplastic* ; Genes, ras* ; Mice ; Mitogen-Activated Protein Kinase Kinases/analysis ; Mitogen-Activated Protein Kinases/analysis ; Phosphorylation ; Protein-Serine-Threonine Kinases/analysis* ; Proto-Oncogene Proteins c-raf/analysis ; p42 MAP Kinase/analysis

Testicular adrenal rest tumors are a well-known complication in male patients with congenital adrenal hyperplasia. Corticosteroid suppressive therapy usually results in the regression of these tumors. We describe a patient with 21-hydroxylase deficiency who developed bilateral testicular masses. Despite steroid suppressive therapy, the tumors did not regress and hormonal control was poor. Consequently, bilateral partial orchiectomies were performed.
Adrenal Hyperplasia, Congenital ; Adrenal Rest Tumor ; Child ; Humans ; Male ; Orchiectomy ; Steroid 21-Hydroxylase ; Testicular Neoplasms

Enterococcus gallinarum carrying both vanA and vanC1 genes were detected from a surveillance culture from a patient staying at the surgical intensive care unit for a few years. E. gallinarum, SI04, was highly resistant to vancomycin (MIC of >or=256ng/mL) and teicoplanin (MIC of >or=256ng/mL). Multiplex PCR for vanA, vanB, vanC1 and vanC2/3 genes revealed SI04 to be positive for both vanA and vanC1 genes. This finding supports the fact that genotyping is needed to classify vancomycin-resistant enterococci (VRE). This is the first report on VanC VRE accompanying vanA gene in Korea.
Enterococcus* ; Humans ; Critical Care ; Korea ; Multiplex Polymerase Chain Reaction ; Teicoplanin ; Vancomycin

OBJECTIVE: The hematopoietic cytokine, erythropoietin (EPO) is known to have neuroprotective effects including promotion of neuronal survival and regeneration after ischemic injury. This study was to investigate the effects of EPO on synaptogenesis and neural restoration in the ischemic condition on neuronal differentiated SH-SY5Y cells and on the behaviors in rat animal model induced by middle cerebral artery occlusion. METHODS: We analyzed the neurite outgrowth and the gene expression of differentiated human neuroblastoma SH-SY5Y cells after the hypoxic stress. Moreover, we performed the motor functional behavior test in EPO treatment of Sprague Dawley rats following cerebral ischemia induced by middle cerebral artery's occlusion (MCAO). RESULTS: Treatment of 2 and 10 units EPO for 1 week showed increase of neurite outgrowth SH-SY5Y cells, compared with non-treatment group (p < 0.05). The results of reverse transcriptase-polymerose chain reaction (RT-PCR) also showed that both synaptophysin (SYP) genes and Growth Associated protein 43 (GAP43) genes in EPO treated cells were significant increased compared with non-treated ischemic group, respectively. The foot fault behavior was recovered in MCAO with EPO treatment group than MCAO group, significantly. CONCLUSION: The elongation of neurite and the increased expressions of SYP and GAP43, and recovered behavioral evidence in the EPO treatment are involved in possible role in neural restoration and synaptogenesis in hypoxic injuried brain. In this study, we suggest that EPO treatment will be may supportive medication to stroke patients to improve the functional brain disturbance.
Animals ; Anoxia ; Brain ; Brain Ischemia ; Erythropoietin ; Foot ; GAP-43 Protein ; Gene Expression ; Humans ; Ischemia ; Middle Cerebral Artery ; Models, Animal ; Neurites ; Neuroblastoma ; Neurons ; Neuroprotective Agents ; Rats ; Rats, Sprague-Dawley ; Regeneration ; Stroke ; Synaptophysin

Yersinia pseudotuberculosis is a relatively infrequent cause of human infections, mostly as intestinal yersinosis. A septicemic form of Y. pseudotuberculosis infection has been reported only rarely. It is usually seen in patients with underlying disorders such as diabetes, hepatic cirrhosis or iron overload. A 63-year-old man with diabetes mellitus and liver fibrosis was admitted to Asan Medical Center via emergency department because of epigastric pain, fever and watery diarrhea; he was septic. The stool culture did not grow Salmonella, Shigella, or Yersinia. But, in the blood culture Y. pseudotuberculosis grew from one anaerobic vial among two sets of aerobic and anaerobic blood cultures. Serotype of Y. pseudotuberculosis strain was could not be determined because it was a rough type. The isolate was positive in the autoagglutination test and polymerase chain reaction for the virF gene. The serum levels of iron, TIBC and ferritin were within normal range. The patient received ceftriaxone therapy for 3 days and was discharged with a clinical improvement.
Ceftriaxone ; Chungcheongnam-do ; Diabetes Mellitus ; Diarrhea ; Emergency Service, Hospital ; Ferritins ; Fever ; Humans ; Iron ; Iron Overload ; Liver Cirrhosis ; Middle Aged ; Polymerase Chain Reaction ; Reference Values ; Salmonella ; Sepsis* ; Shigella ; Yersinia pseudotuberculosis* ; Yersinia*

A 17-year-old girl with 12-year history of systemic lupus erythematosus (SLE) was presented with one month history of diplopia and headache. She had experienced acute cerebral infarction due to multiple cerebral arterial stenosis one year before, and fully recovered except right-side central facial nerve palsy. When she visited pediatric emergency room, ophthalmologic examination showed ophthalmoplegia of the left eye ball; limitation of medial gaze, supra-adduction and infra-adduction. Neurologic examination didn't show any newly developed neurologic defect. There was no newly developed intra-cranial lesion on the brain MRI. But, the brain MRI revealed irregularly enhanced thickened left medial rectus muscle, and that was compatible with orbital myositis. There was no definite evidence of infection or other autoimmune disease. Her condition responded to high dose intravenous methylprednisone therapy (1 g/day for 3 days) and continued oral prednisolone.
Adolescent ; Autoimmune Diseases ; Brain ; Cerebral Infarction ; Constriction, Pathologic ; Diplopia ; Emergency Service, Hospital ; Facial Nerve ; Female ; Headache ; Humans ; Lupus Erythematosus, Systemic* ; Magnetic Resonance Imaging ; Neurologic Examination ; Ophthalmoplegia ; Orbit* ; Orbital Myositis* ; Paralysis ; Prednisolone