Henoch-Schönlein purpura (HSP) is an acute, systemic immunoglobulin-medicated small-vessel vasculitis. It is the commonest vasculitis of childhood and is typically characterised by a tetrad of abdominal pain, arthritis, palpable purpura, and renal disease. All patients develop palpable purpura, while 84-90% develop arthritis, 57-58% develop abdominal pain, and 20-54% develop renal involvement. Gastrointestinal symptoms can be the first presenting complaint with the absence of initial purpura, leading to a delay in diagnosis.

Child ; Epiphyses, Slipped ; genetics ; Femur Head ; Humans ; Male

PURPOSE: The purposes of this study were to examine the relationships among activities of daily living, self-efficiency, nursing home care quality and nursing home adaptation, and to identify the influencing factors of nursing home adaptation in nursing home residents. METHODS: The study employed a descriptive correlational design. The data were collected from 148 older adults without dementia by interview from six nursing homes in three cities from February 1, 2008 to February 28, 2008. RESULTS: Levels of nursing home adaptation in older adult residents were different by type of decision maker of nursing home admission, reason of nursing home admission, type of payment and length of nursing home stay. The nursing home adaptation was significantly correlated with self-efficiency and nursing home care quality. The strongest predictor of nursing home adaptation was type of decision maker of nursing home admission followed by the self-efficiency. CONCLUSION: The study suggested that during the decision making period of nursing home admission, older adults should have enough time and careful considerations of their families to decide by themselves in positive ways. Nursing home staff should be able to identify reasons of nursing home admission and demands or expectations of older adults and their families.
Activities of Daily Living ; *Adaptation, Psychological ; Aged ; Aged, 80 and over ; Attitude of Health Personnel ; Demography ; Family/psychology ; Female ; Humans ; Interviews as Topic ; *Nursing Homes/organization & administration ; *Patient Admission ; Self Efficacy

PURPOSE: Current increase and complexity of medical tests and surgical procedures at outpatient department (OPD) require OPD nurses to have customer orientation focusing on various customers' interests and needs. The purpose of this study was to identify the factors associated with customer orientation in nurses working at OPD of hospitals. METHODS: The study used a descriptive correlational design with cross-sectional survey. The study settings were four general hospitals in Seoul and its metropolitan area. Data were collected from 138 OPD nurses from general hospitals. Study variables were personal traits, emotional intelligence, internal marketing, service management and customer orientation. RESULTS: Factors associated with customer orientation were identified as conscientiousness from personal traits (β .37, p < .001), emotional intelligence from individual characteristics (β .21, p = .032), and internal marketing from environmental characteristics (β .21, p = .001). CONCLUSIONS: Hospital administrators should support OPD nurses to cultivate sincere and sociable personal traits and emotional intelligence, and to consider employees as internal customers to improve patient-oriented services and satisfaction.
Adult ; Attitude of Health Personnel ; Cross-Sectional Studies ; *Emotional Intelligence ; Female ; Humans ; Male ; Marketing/*methods ; Middle Aged ; *Nurse-Patient Relations ; Nursing Staff, Hospital/*psychology ; Organizational Culture ; Outpatient Clinics, Hospital/*organization & administration ; Outpatients/*psychology ; *Patient-Centered Care ; Seoul ; Surveys and Questionnaires ; Young Adult

PURPOSE: Acute myocardial infarction (AMI) leads to death if the patient does not receive emergency treatment. Thus it is very important to recognize the symptoms in the early stage. The purpose of this study was to identify clusters of symptoms that represent AMI in Koreans. METHODS: The study used a retrospective, descriptive design with secondary data analysis. Data were abstracted from 725 medical records of AMI patients admitted from June 1, 2006 to August 15, 2014 at a university hospital. RESULTS: Analysis of the AMI symptoms revealed five symptom clusters; Cluster 1 (n=140): middle chest pain (100%), shortness of breath, and cold sweating, Cluster 2 (n=256): substernal pain (100%), cold sweating, and shortness of breath, Cluster 3 (n=47): substernal pain (95.7%), left arm pain, shortness of breath, cold sweating, left shoulder pain, right arm pain, and the lower neck pain, Cluster 4 (n=212): shortness of breath (28.3%), left chest pain, and upper abdominal pain, and Cluster 5 (n=70): cold sweating (100%), left chest pain, shortness of breath, left shoulder pain, and upper abdominal pain. Length of hospital stay and mortality rate were significantly different according to symptom clusters (F=2.52, p=.040; F=3.62, p=.006, respectively). CONCLUSION: Symptom clusters of AMI from this study can be used for AMI patients in order to recognize their symptoms at an early stage. The study findings should be considered when developing educational prevention programs for Koreans with AMI.
Acute Disease ; Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Female ; Humans ; Length of Stay ; Magnetic Resonance Angiography ; Male ; Middle Aged ; Myocardial Infarction/mortality/*pathology ; Republic of Korea ; Retrospective Studies ; Survival Rate ; Syndrome

We report two cases of scleredema, which appeared as symmetrically nonpitting wooden-like indurated edema on the nape, shoulder, and upper and mid portion of back in a 49-year-old woman and a 72-year-old man, associated with long standing diabetes mellitus for the past 5 and 14 years respectively. The scleredema showed no tendency to resolve. Acid mucopolysaccharides were demonstrated histochemically between collagen bundles in the dermis, especially in the mid and lower dermis.
Aged ; Collagen ; Dermis ; Diabetes Mellitus ; Edema ; Female ; Glycosaminoglycans ; Humans ; Middle Aged ; Scleredema Adultorum* ; Shoulder

PURPOSE: The purpose of this study was to explore the perspectives of lung cancer patients, their families, physicians and nurses on advance directives. METHODS: The study employed a comparative descriptive design. A total of 124 participants from six general hospitals in Seoul and metropolitan area participated in this study from January 1, 2009 to November 15, 2009. Face-to-face interviews were conducted using a structured questionnaire. RESULTS: The majority of participants were not aware of advance directives. Most participants desired the establishment of a reliable legal system and a specific legal protocol for the design and application of advance directives. The perspectives of patients, their families, physicians and nurses differed regarding end-of-life care decisions. The least preferred treatment by patients with lung cancer was intensive care, followed by cardiopulmonary resuscitation, tracheotomy and artificial ventilation, and radiotherapy. CONCLUSIONS: There were many differences in the perspectives of patients, families, physicians and nurses on advance directives. End-of-life care decisions should take the wishes of patients into account, and that such decisions should therefore be made before the patients lose the capacity to make them. To make well-informed decisions regarding future care, patients and families must be fully educated about advance directives and expected outcomes.
Advance Directives ; Cardiopulmonary Resuscitation ; Hospitals, General ; Humans ; Critical Care ; Lung Neoplasms ; Tracheotomy ; Ventilation

BACKGROUND: Flecainide is an antiarrhythmic agent that is used primarily in the treatment of cardiac arrhythmias. Some evidences also suggest that flecainide can participate in alveolar fluid clearance and inflammatory responses. This experiment was aimed to evaluate the effects of flecainide on sepsis induced acute lung injury in a rat model. METHODS: Rats were treated with subcutaneous infusion of saline or flecainide (0.1 or 0.2 mg/kg/hr) by a mini-osmotic pump. Subcutaneous infusion was started 3 hours before and continued until 8 hours after intraperitoneal injection of saline or endotoxin. Animals were sacrificed for analyses of severity of acute lung injury with wet to dry (W/D) ratio and lung injury score (LIS) in lung and inflammatory responses with level of leukocyte, polymorphonuclear neutrophils (PMNs) and inteleukin-8 (IL-8) in bronchoalveolar lavages fluid (BALF). RESULTS: Flecainide markedly improved dose dependently sepsis induced acute lung injury as analysed by W/D ratio (from 2.24 ± 0.11 to 1.76 ± 0.09, p < 0.05) and LIS (from 3 to 1, p < 0.05), and inflammatory response as determined by leukocyte (from 443 ± 127 to 229 ± 95, p < 0.05), PMNs (from 41.43 ± 17.63 to 2.43 ± 2.61, p < 0.05) and IL-8 (from 95.00 ± 15.28 to 40.00 ± 10.21, p < 0.05) in BALF. CONCLUSIONS: Flecanide improve sepsis induced acute lung injury in rats by controlling inflammatory responses.
Acute Lung Injury* ; Animals ; Arrhythmias, Cardiac ; Bronchoalveolar Lavage ; Flecainide* ; Infusions, Subcutaneous ; Injections, Intraperitoneal ; Interleukin-8 ; Leukocytes ; Lung ; Lung Injury ; Models, Animal ; Neutrophils ; Rats ; Sepsis*

PURPOSE: The purpose of this study was to examine the effects of a face-to-face self-management educational program on knowledge, self-care practice and kidney function in patients with chronic kidney disease (CKD) before kidney replacement therapy. METHODS: This study employed a nonequivalent control group, non-synchronized design. Data were collected from 61 patients with CKD visiting an outpatient department of nephrology in a university hospital in Seoul, South Korea. The experimental group (n=31) took the pre-test, then after 3 weeks, face-to-face education and individualized consultation (1st intervention), after a week of self-practice, the 1st post-test, followed by re-enforcement education and consultation (2nd intervention), and 4 weeks later, the 2nd post-test. The control group (n=30) took the pre-test and post-tests at 4 and 8 weeks. RESULTS: Scores for knowledge of CKD and self-care practice over time improved significantly in the experimental group compared to the control group. Kidney function did not improve significantly in the experimental group. CONCLUSION: Health care providers can identify various and individualized needs, and provide effective education and consultation through face to face self-management for patients with chronic irreversible illnesses. Nurses can coordinate for these program by designing and providing systematic and effective education.
Adult ; Aged ; Blood Urea Nitrogen ; Calcium/blood ; Creatinine/blood ; Female ; Glomerular Filtration Rate ; *Health Knowledge, Attitudes, Practice ; Hemoglobins/analysis ; Humans ; Kidney/*metabolism ; Male ; Middle Aged ; *Patient Education as Topic ; Phosphates/blood ; Potassium/urine ; Program Evaluation ; Renal Insufficiency, Chronic/*psychology ; Renal Replacement Therapy ; *Self Care ; Sodium/urine

PURPOSE: This study was done to examine the effect of an integrated care service which included a combination of oriental and western care on health outcomes in elderly patients with degenerative arthritis. METHODS: A prospective comparative design was used. Data were collected from May 1, 2008 to June 30, 2009 from 85 elderly patients with degenerative arthritis in the lower extremities who were followed in a hospital out-patient department for 8 weeks. The integrated care service group (n=36) received a combination of physical therapy, acupuncture, western medicines or herbal medicines, and the western care group (n=49) received physical therapy or western medicines. Functional independence, walking speed, rotation balance, pain intensity, service satisfaction and total medical costs for the two groups were compared at 8 weeks. RESULTS: Functional independence (t=2.14, p=.036) and walking speed (t=2.51, p=.014) improved significantly in the integrated care group while pain intensity improved significantly in the western care group (t=3.35, p=.002). The integrated care group reported higher scores for service satisfaction (t=2.09, p=.041) and higher medical costs than the western care group (t=2.15, p=.035). CONCLUSION: The results suggest that integrated care services are effective modalities to improve mobility and quality of life for elders with degenerative arthritis.
Acupuncture Therapy ; Aged ; Aged, 80 and over ; Female ; Herbal Medicine ; Humans ; Male ; Middle Aged ; Musculoskeletal Manipulations ; Osteoarthritis/economics/*therapy ; Pain Measurement ; *Patient Care ; Prospective Studies ; Walking