BACKGROUND: Epidermis is directly exposed to various external stimuli and protects internal structures. Most studies about skin tension focused on the dermis, and epidermal tension has not been able to attract interest because dermis much thicker than epidermis and dermal collagen fibers play a predominant role in the skin tension. However, circumstances which involve only the epidermis are often shown, and thus it is necessary to study the mechanical property of the epidermis. OBJECTIVE: The purpose of this study is to quantify the role of the epidermis as a mechanical barrier. METHODS: Human epidermal sheets were obtained from suction blisters in 14 patients with vitiligo during epidermal grafting. Maximal tension, that is the power required to break the epidermal sheets, was measured by tensiometer. RESULTS: The maximal tension of the epidermis ranged from 40.0 g/cm² to 84.5g/cm² with a mean values of 56.1g/cm² and did not differ significantly according to the age or anatomical sites. CONCLUSION: The barrier function of epidermis is important and the results are expected to be used as the basic information for other studies about the mechanical property of the epidermis. In addition, this will be important data in developing an artificial skin whose mechanical property is similar to that of the human skin.
Blister* ; Collagen ; Dermis ; Epidermis* ; Humans* ; Skin ; Skin, Artificial ; Suction* ; Transplants ; Vitiligo

Regardless of the any cause leg ulcers are painful and inconvenient to patients and present clinical and economic problems due to their chronicity. Conventional skin grafts, cultured allogenic epidermis, and cultured autologous epidermis have been used for the treatment of leg ulcers. In a twenty-year-old woman with leg ulcers, autologous pure epidermal sheets were obtained from the lower chest by means of suction blisters and grafted to the leg ulcers. All lesions were healed completely in 20 days after grafting. The donor sites showed slight postinflammatory hyperpigmentations without scars. The autologous epidermal graft using suction blisters appears to be a useful method for the treatment of leg ulcers, with no immunologic rejection, no need for cultivation and anesthesia, no desiccation, and no scars on the donor sites.
Anesthesia ; Blister* ; Cicatrix ; Desiccation ; Epidermis ; Female ; Humans ; Leg Ulcer* ; Leg* ; Methods ; Skin ; Suction* ; Thorax ; Tissue Donors ; Transplants*

Lichen striatus is an uncommon unilateral inflammatory linear papular dermatosis of uncertain etiology. It most commonly affects the extremities and has a self-limiting course. Nail involvement in lichen striatus is a very rare reported finding and is a cause of a deformity of the nail plate. It tends to have a more prolonged course for cutaneous eruptions than disease limited only to the skin. Characteristic histopathological features are important to differentiate this condition from other linear lesions that may interfere with nail growth. Three cases of lichen striatus with onychodystrophy are presented herein.
Congenital Abnormalities ; Extremities ; Lichens* ; Skin ; Skin Diseases

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

PURPOSE: This study was done to investigate the effects of acupressure on pruritus and sleep among patients undergoing hemodialysis. METHODS: The study design was a nonequivalent control group repeat measures quasi-experimental study. Data were collected from June to September 2015 in the kidney center at a hospital located in B city. Participants were 42 patients; 20 in the experimental group and 22 in the control group. For the experimental group, acupressure on the spots of Sameumgyo (SP6), Zoksamli (ST36), Hyolhae (SP10), and Gokji (LI11) was provided at the time of hemodialysis three times a week for 12 weeks. The numeric rating scale (NRS) was used to measure pruritus, and sleep was measured with the sleep scale developed by Jinju Oh et al. RESULTS: There was a significant decrease in pruritus (F=7.80, p=.008) and increase in sleep (F=80.90, p<.001) in the experimental group compared to the control group. CONCLUSION: The findings confirmed in the study show that acupressure is an effective nursing intervention to decrease pruritus felt by patients on hemodialysis and to increase the quality of their sleep.
Acupressure* ; Gyeongsangnam-do ; Humans ; Kidney ; Non-Randomized Controlled Trials as Topic ; Nursing ; Pruritus* ; Renal Dialysis*

No abstract available.
Diagnosis, Differential* ; Fluorodeoxyglucose F18* ; Polyps*

BACKGROUND: Enterococci are a leading cause of nosocomial infection and the emergence of resistant strain to various antibiotics including vancomycin is increasingly serious problems among enterococci. And the risk of spread of glycopeptide genes to other Gram-positive cocci makes the problems more serious. To evaluate the presence of vancomycin-resistant enterococci (VRE) in Ewha Womans University Hospital (EWUH), we screened hospitalized patients for fecal colonization and clinical isolates. METHODS: We screened VRE in 574 stool specimens requested for routine cultures and 91 perirectal swabs or stool specimens from patients who reside in intensive care unit and hemato-oncologic ward in Mookdong and Tongdaemoon EWUH from December 1996 through April 1997. And 295 enterococcal species isolated from various clinical specimens were also included. To detect VRE, specimens were cultured in BHI agar medium including 6 g/mL of vancomycin and to determine the antibiotic susceptibility pattern, broth microdilution test using VITEK GPS-IZ, disk diffusion test and standard agar dilution test were performed. Multiplex PCR was done to determine the genotypes of VRE. RESULTS: Nine enterococci (0.9%) were interpreted as VRE in standard agar dilution method. Two (0.3%) out of 665 were from stool speciemens for surveillence cuture and 7 (2.3%) out of 295 were from various clinical specimens for ordinary cultures including 5 E. casseliflavus, 2 E. gallinarum, 1 E. flavescens and 1 Enterococcus species. All isolates showed low-level resistance against vancomycin (8-16 g/mL) by standard agar dilution. But both disk diffusion method and VITEK system demonstrated difficulties in detecting low-level resistance. The genotypes of VRE were classified as van C-1 in 2 isolates and as van C-2 in 6 isolates except 1 isolates, which was unclassifiable in our study. CONCLUSIONS: Even though VRE with high- or medium-level resistance against glycopeptide was not detected in EWUH from this period of investigation, the possibility of presence of VRE is impanding because several teaching hospitals already reported the presence of VRE in clinical isolates and fecal colonization. So continuous surveillence and strict infection control measures must be implemented to detect and prevent transmission of VRE infection.
Agar ; Anti-Bacterial Agents ; Colon ; Cross Infection ; Diffusion ; Enterococcus ; Female ; Genotype* ; Gram-Positive Cocci ; Hospitals, Teaching ; Humans ; Infection Control ; Intensive Care Units ; Multiplex Polymerase Chain Reaction ; Polymerase Chain Reaction* ; Prevalence* ; Vancomycin

BACKGROUND: This study investigated the characteristic differences of neurocognitive function in patients with subjective memory impairment and in those with mild cognitive impairment. METHODS: Patients with complaints of subjective memory impairment were categorized into subjective memory impairment (SMI, n=42) and mild cognitive impairment (MCI, n=42) based on their scores in the Korean version of Mini-Mental State Examination, Activities of Daily Living (ADL), and Clinical Dementia Rating and the neurologist's diagnosis and evaluation. The neurocognitive function and depression rating between the SMI and the MCI groups were compared using the Seoul Neuropsychological Screening Battery and the Geriatric Depression Scale. RESULTS: The SMI group showed normal concentration, visual-spatial construction ability, and depression and deficits in the processing of memory consolidation through the delay test of verbal learning. The MCI group also showed no deficits in concentration but showed impairments in delayed recall and recognition test of verbal learning, visual memory test, and frontal lobe/executive functions. CONCLUSION: The MCI group showed more distinctive neurocognitive deficits in delayed recall and recognition test of verbal learning; encoding, storage, and retrieval of visual memory; and naming ability compared to the SMI group. The implications and suggestions of this study and further research were discussed.
Activities of Daily Living ; Dementia ; Depression ; Diagnosis ; Humans ; Mass Screening ; Memory* ; Mild Cognitive Impairment* ; Seoul ; Verbal Learning

PURPOSE: This study was designed to assess the level of super-leadership and self-leadership, identify correlations among variables and identify the factors influencing organizational commitment of clinical nurses. METHODS: Participants were 217 nurses working in four hospitals located in Seoul and Gyeonggi Province. Data were analyzed using descriptive statistics, independent t-test, one way ANOVA, Scheffé test, Pearson Correlation, and Multiple Regression. RESULTS: The most influential factor for organizational commitment was super-leadership (β=.28, p<.001), followed by education (β=.16, p=.007), the number of unit nurses (β=-.18, p=.003), self-leadership (β=.17, p=.008), and the number of patients being under 10 (β=.12, p=.046). These factors accounted for 23% of the variance in organizational commitment (F=13.46, p<.001). CONCLUSION: The results of this study suggest a need for strategies to improve organizational commitment of nurses by enhancing nurse' self-leadership through nursing managers' super-leadership.
Education ; Gyeonggi-do ; Humans ; Nursing ; Seoul

We report an annular type of subacute cutaneous lupus erythematosus(SCLE) which is rare in Korea, A 23-year-old female had erythematous annular rashes with a mild itching sensation on the face, trunk and both extremities. She also had painless oral mucosal ulceration, diffuse hair loss and mild arthralgia. Serologic abnormalities of the patient were positive anti-Ro Ab, ANA and Anti-ds-DNA Ab. The histopathologic findings showed vacuolar degenerations in the basal cell layer, mononuclear cell infiltrate in the upper dermis, and dermal edema. Direct IF revealed granular deposition of IgG and IgA at the dermo-epidennal junction.
Arthralgia ; Dermis ; Edema ; Exanthema ; Extremities ; Female ; Hair ; Humans ; Immunoglobulin A ; Immunoglobulin G ; Korea ; Lupus Erythematosus, Cutaneous* ; Pruritus ; Sensation ; Ulcer ; Young Adult