BACKGROUND: Core hypothermia after induction of anesthesia results from an core-to-peripheral redistribution of body heat and a loss of body heat to environment. The purpose of this study is finding body temperatures during operation by either general of epidural anesthesia and evaluates content of total body heat. METHODS: We measured tympanic membrane temperature, 4 point skin temperature (mid calf, mid thigh, upper extremity, nipple). And we calculate mean skin temperature, mean body temperature, total body heat content changes based on tympanic membrane temperature and 4 point skin temperature. RESULTS: Tympanic membrane temperature of the first group decreased significantly after 10 minutes of induction (p<0.005), the second group decreased after 45 minutes of induction. Although upper extremity temperature has continuously increased as time passed, there was no significant difference in both group. Lower extremity temperature has significantly increased after 30 minutes of induction in the first group, and the second group has significantly increased after 10 minutes of induction (p<0.05). Mean skin temperature hasdecreasd temperaturily in both group after 10 minutes of induction and increased as time passed. Mean body temperature of the first group has significantly decreased after 10 minutes of induction (p<0.05) and second group has no significant changes. Total body heat content has continuously decreased after induction with no significance. CONCLUSIONS: General anesthesia reveals more significant decrease than epidural anesthesia. Both groups show significant decrease of body temperature after induction. We think that we need to close attention to temperature changes after induction for preventing possible side effects due to core hypothermia.
Anesthesia ; Anesthesia, Epidural* ; Anesthesia, General* ; Body Temperature Changes* ; Body Temperature* ; Hot Temperature ; Hypothermia ; Lower Extremity ; Skin Temperature ; Thigh ; Tympanic Membrane ; Upper Extremity

Fungi have been recognized as a significant cause of external otitis and it may be the primary pathogen or be part of a mixed infection. In the immunocompromised host, fungus is capable of producing infection in inner ear or middle ear. Otomycoses are most frequently caused by Aspergillus spp. and Candida sap. There are few reports that Aspergillus species other than A. fumigatus, A. niger and f. flavus have caused chronic otitis media. We report two cases of chronic otitis media caused by Aspergillus ferrous in Korea. One case is a 7-year-old girl who had recurrent serous otorrhea and otalgia for 4 years, was reattended otolaryngology clinics with otorrhea of 3 days durations and another is a 6-year-old girl who had serous otorrhea for 2 months and 3 day fever, was attended otolaryngology clinics with them. Microscopic appearance and colony morphology from ear discharge cultures revealed A. ferrous. The infection responded well to topical ketoconazole therapy. This report should help to raise medical personnel's awareness of such human opportunistic fungal ear infections.
Aspergillus* ; Candida ; Child ; Coinfection ; Ear ; Ear, Inner ; Ear, Middle ; Earache ; Female ; Fever ; Fungi ; Humans ; Immunocompromised Host ; Ketoconazole ; Korea ; Niger ; Otitis Externa ; Otitis Media* ; Otitis* ; Otolaryngology ; Otomycosis

BACKGROUND: Various molecular methods such as polymerase chain reaction (PCR) and DNA hybridization have been introduced to diagnose the hepatitis B more accurately. Recently, Hybrid Capture Assay (HCA) was developed, which uses the signal amplification solution hybridization capture assay with chemiluminescent detector. So we evaluated the sensitivity and clinical utility of the HCA and PCRs for the detection of hepatitis B virus DNA (HBV DNA) and compared these results with serologic markers. METHODS: We analysed the 50 samples from the hepatitis B patients using enzyme immunoassay, HCA and nested PCRs with two different primer sets. The primers of PCR I and PCR II were targeted to pol and core region respectively. RESULTS: In 18 cases, HBV DNA were detected by HCA in which the positive rates by PCR I and PCR II were 55.6%, and 88.9%, respectively. And in 32 cases in which HBV DNA by HCA was negative, the positive rates by PCR I and PCR II were 6.2% and 31.3%, respectively. In 44 cases which were positive for HBsAg, the positive rates for HBV DNA were 38.6% by HCA, 27.3% by PCR I, and 56.8% by PCR II. In cases positive for HBeAg, the positive rates were 93.3% by HCA, 60.0% by PCR I and 80.0% by PCR II. In cases positive for anti-HBe and negative for HBeAg, the positive rates were 10.3% by HCA, 10.3% by PCR I, and 44.8% by PCR II. CONCLUSIONS: Both HCA and PCR compensated each other yet as to the accurate investigation of the viral replication in patients with hepatitis B and the sensitivity was better in HBV PCR with primers to core region than to pol region.
DNA ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans ; Immunoenzyme Techniques ; Polymerase Chain Reaction*

PURPOSE: Effective transitional care is needed to improve the quality of life in older adult patients with chronic illness and avoid discontinuity of care and adverse events. The aim of this article is to provide an overview of the key features, broader implications, and the utility of Meleis' transition theory intended for the transitional care of older adults with chronic illnesses. We present the role of nurse in the context of transitional care and propose future directions to increase the quality of nursing care. METHODS: The online databases Cumulative Index of Nursing and Allied Health Literature, MEDLINE, and Science Direct were searched for relevant literature published since 1970 along with textbooks regarding nursing theory. RESULTS: An evaluation of the usefulness of transition theory based on transitional care in older adult patients with chronic illnesses is provided. Healthy transition should be the expected standard of nursing care for older adults across all healthcare settings. CONCLUSION: Nurses need to contribute to the development of transitional care for vulnerable populations; however, transition theory needs to be enhanced through additional theoretical work and repeated evaluations of the applicability in areas of transitional care.
Aged ; Chronic Disease ; Databases, Factual ; Education, Nursing ; Humans ; Models, Theoretical ; Nurse's Role ; *Quality of Life ; *Transitional Care

BACKGROUND: The genetic basis of isoniazid (INH) resistance in Mycobacterium tuberculosis has been attributed to at least four genes. Mutations of the katG gene encoding catalase-eroxidase have been shown to cause resistance to INH. Among these mutations, the point mutation of codons 315 and 463 are frequently found. To determine whether simple screening method could potentially be useful for the detection of INH-esistant strains, we investigated the presence of mutation of codons 315 and 463 of katG gene in INH-esistant M. tuberculosis from Korea. METHODS: We used the polymerase chain reaction (PCR) and direct sequencing analysis to detect the point mutation of codons 315 and 463 of katG gene in 48 strains of INH-esistant and 10 strains of INH-usceptible M. tuberculosis. RESULTS: No amplification product was generated from 2 of 48 INH-esistant strains. Among the remaining 46 isolates, point mutations at codons 315 and 463 were identified in 19 isolates (41.3%) and 40 isolates (87.0%), respectively. Among the 10 INH-usceptible strains, the codon 463 point mutation was identified in 7 isolates, however, no point mutation of the codon 315 was found. CONCLUSIONS: These results suggest that the point mutation of codon 463 of katG gene of M. tuberculosis may be a polymorphism not related with INH resistance. Although the mutation of codon 315 of katG gene was limited to 41.3% of INH-esistant isolates, further investigation of the codon 315 of katG gene should lead to increased understanding of resistance genes and the deveolpment of rapid molecular detection methods.
Codon ; Isoniazid ; Korea* ; Mass Screening ; Mycobacterium tuberculosis* ; Mycobacterium* ; Point Mutation ; Polymerase Chain Reaction ; Tuberculosis

BACKGROUND: The genetic basis of isoniazid (INH) resistance in Mycobacterium tuberculosis has been attributed to at least four genes. Mutations of the katG gene encoding catalase-eroxidase have been shown to cause resistance to INH. Among these mutations, the point mutation of codons 315 and 463 are frequently found. To determine whether simple screening method could potentially be useful for the detection of INH-esistant strains, we investigated the presence of mutation of codons 315 and 463 of katG gene in INH-esistant M. tuberculosis from Korea. METHODS: We used the polymerase chain reaction (PCR) and direct sequencing analysis to detect the point mutation of codons 315 and 463 of katG gene in 48 strains of INH-esistant and 10 strains of INH-usceptible M. tuberculosis. RESULTS: No amplification product was generated from 2 of 48 INH-esistant strains. Among the remaining 46 isolates, point mutations at codons 315 and 463 were identified in 19 isolates (41.3%) and 40 isolates (87.0%), respectively. Among the 10 INH-usceptible strains, the codon 463 point mutation was identified in 7 isolates, however, no point mutation of the codon 315 was found. CONCLUSIONS: These results suggest that the point mutation of codon 463 of katG gene of M. tuberculosis may be a polymorphism not related with INH resistance. Although the mutation of codon 315 of katG gene was limited to 41.3% of INH-esistant isolates, further investigation of the codon 315 of katG gene should lead to increased understanding of resistance genes and the deveolpment of rapid molecular detection methods.
Codon ; Isoniazid ; Korea* ; Mass Screening ; Mycobacterium tuberculosis* ; Mycobacterium* ; Point Mutation ; Polymerase Chain Reaction ; Tuberculosis

BACKGROUND: Currently, several different apolipoprotein E (apo E) genotyping methods have been developed. The Amplification Refractory Mutation System (ARMS) apo E genotyping, as previously described, requires four separate PCR reactions. The purpose of this study is to determine the clinical usefulness of the multiplex ARMS apo E genotyping with the use of only two PCR reactions. METHODS: We used five primers and two separate PCR reactions to detect the apo E polymorphism by using the multiplex ARMS technique. Apo E genotyping was performed with both the multiplex ARMS and INNO-LiPATM Apo E kit (INNOGENETICS) in 122 random samples. We investigated the effect of dimethyl sulfoxide (DMSO) in the multiplex ARMS PCR with various DMSO concentrations (0-15%). RESULTS: All six possible genotypes for apo E were clearly discernible with the multiplex ARMS. The apo E genotypes determined by the two methods were in complete agreement with all 122 samples. We found that DMSO is essential for the successful amplification of the multiplex ARMS and DMSO at concentrations of 3%-7% to be the optimal concentration. CONCLUSIONS: ARMS analysis involves two stages: PCR and agarose gel electrophoresis. Apo E genotyping using the multiplex ARMS requires only two PCR reactions. Thus, because of its simplicity, speed, accuracy, and cost-effectiveness, this method may be appropriate for determining the apo E genotypes in routine clinical laboratories.
Apolipoproteins E ; Apolipoproteins* ; Arm ; Dimethyl Sulfoxide ; Electrophoresis, Agar Gel ; Genotype ; Polymerase Chain Reaction

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) continues to be a major cause of nosocomial infection and a molecular typing is necessary for proper epidemiologic investigations of sources and moles of spread in an outbreak. An nosocomial outbreak of MRSA in a neonatal intensive care unit at Ewha Womans University Mokdong Hospital was suspected. To investigate the clonality of isolates and control the spread of nosocomial outbreak, we performed plasmid restriction analysis of MRSA isolates from patients and medical staffs. METHODS: We studied 7 MRSA strains (umbilicus 4, blood 1, urine 1 and pus 1) from patients in a neonatal intensive care unit and the MRSA strains from nares and hands surveillance cultures of 26 medical staffs (4 medical doctors and 22 nurses). All MRSA strains were tested for antimicrobial susceptibility and plasmic analysis after EcoRI restriction. We analyzed the plasmid patterns of MRSA isolated from patients and compared with those from medical staffs. RESULTS: Ten MRSA strains (from 7 nares and 3 hands) were isolated from surveillance cultures of 26 medical staffs. Seven out of 10 MRSA strains from medical staffs revealed identical pattern of antibiogram which was the same pattern in all 7 MRSA strains from seven patients. Plasmid restriction patterns were classified 6 groups from A to F showing 2-10 bands. Six out of 7 MRSA strains from the patients showed group A(A1 5, A31) and 5 out of 10 MRSA strains from the medical staffs showed group A(A1 1, A21, A32, A41) and remainders showed different plasmid restriction analysis patterns. CONCLUSIONS: These results suggest that plasmid restriction analysis is a rapid, inexpensive, and good discriminating molecular typing of MRSA outbreak and is useful for the epidemiologic investigation of MRSA outbreaks in the clinical laboratory.
Cross Infection ; Disease Outbreaks ; Female ; Hand ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Medical Staff ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Microbial Sensitivity Tests ; Molecular Epidemiology* ; Molecular Typing ; Plasmids* ; Suppuration

BACKGROUND: Pelviscopic techniques have rapidly increased in therapeutic procedures as well as diagnostic procedures because of the many benefits associated with much smaller incisions than traditional open techniques. But the deliberate pneumoperitoneum with carbon dioxide during pelviscopic surgery may cause some problems-hypercarbia, pneumomentum, subcutaneous or mediastinal emphysema, pneumothorax, hypoxemia, hypotension, cardiovascular collapse and cardiac dysrhythmia. METHOD: We observed the changes of blood pressure (systolic, mean, diastolic), pulse rate, PaCO2, PaO2, peak inspiratory airway pressure and expired tidal volume at 10 minute after induction of general anesthesia (control value), 30 minutes and 60 minutes after insufflation of CO2 and Trendelenburg position. RESULTS: The blood pressure, PaCO2 and peak inspiratory airway pressure were increased significantly than control values (p<0.05). The changes of pulse rate and expired tidal volume were not statistically significant in comparison to control values. The PaO2 was decreased significantly (p<0.05). CONCLUSION: To minimize the risk of CO2 retension and unstability of cardiovascular system during pelviscopy under the Trendelenburg position, we must monitor the vital signs and the arterial blood gas status continuously and carefully.
Anesthesia, General* ; Anoxia ; Arrhythmias, Cardiac ; Blood Pressure ; Carbon Dioxide ; Cardiovascular System ; Head-Down Tilt* ; Heart Rate ; Hypotension ; Insufflation* ; Mediastinal Emphysema ; Pneumoperitoneum ; Pneumothorax ; Tidal Volume ; Vital Signs

Purpose: This study aimed to investigate factors affecting prevention performance of catheter-associated urinary tract infection (CAUTI) among long-term care hospital nurses. Methods: The participants were 162 nurses in 11 long-term care hospitals. Data were collected from May 21 to June 4, 2021, using structured questionnaires. The collected data were analyzed with an independent t-test, Mann-Whitney U test, a one-way ANOVA, Pearson’s correlation, and multiple regression analysis. All analyses were performed using SPSS/WIN 26.0. Results: The factors influencing the prevention performance of CAUTI were formal learning (β=.22, p=.003) and prevention knowledge on CAUTI (β=.17, p=.029). These variables explained 13% of the prevention performance of CAUTI. Conclusion In this study, it is necessary for long-term care hospitals to develop infection prevention educational programs for CAUTI based on nursing evidence and ensure that nurses apply the knowledge obtained through these educational programs.