No abstract available.
Coronary Artery Bypass* ; Coronary Vessels* ; Echocardiography*

OBJECTIVE: We developed a biosignal telemonitoring system which is based on HL7 and MFER standard. METHODS: For the communication of waveform data (ECG, EEG etc.) we adopted MFER(Medical waveform description Format Encoding Rules) standard and HL7(Health Level 7). MFER is a standard for encoding waveform biosignal such as ECG, EEG and so on. HL7 is a standard for electronic data communication between two different information systems. RESULTS: The telemornitoring system consists of an HL7 interface gateway and a central repository. The HL7 interface gateway has three modules of an MFER analyzer, an HL7 message generator, and a file sender. The central repository is a central database combined with an HL7 archiver. CONCLUSION: Through this study we might conclude that the proposed system can be a promising model for telemonitoring system in healthcare environment.
Delivery of Health Care ; Electrocardiography ; Electroencephalography ; Information Systems

PURPOSE: We designed this study to find out the risk factors affecting the patency rate after creation of arteriovenous fistula (AVF) for maintenance hemodialysis. METHODS: From March 1997 to April 1999, a total of 206 AVF creation operations [126 of radiocephalic fistula (RCF), 59 of brachiocephalic fistula (BCF), and 21 of grafted fistula] in 165 patients were undertaken by single surgeon under the same surgical technique and principles. In 128 cases (62.1%), operation was performed for the first time and in 42 cases (20.4%), the trial was second time. However in remaining 36 cases (17.5%), the operation was three or more than three times. RESULTS: After a mean follow-up of 9 months, 27 patient death and 53 fistula failure were identified. The overall patency rate at 1- and 2-year were 72.6% and 61.1%. The success patency rate, excluding the early failure cases, at 1-and 2-year were 78.4% and 65.9%. In multivariate analysis, the presence of 2 or more than 2 times failed AVF episodes was the significant risk factor forecasting the poor fistula patency (p<0.05, odd ratio=2.72). Although the odd ratio in patients with grafted fistula or in diabetic patients was 1.39 or 1.48 in multivariate analysis, these factors did not reach the statistical significance in multivariate analysis (P>0.05). In univariate analysis, the 1- and 2 year patency rate of more than third AVF trial group were 53.2% and 25.3%, which showed significant poor patency rate comparing with the ones of first or second AVF trial group (76.73% in 1- and 67.9% in 2-year) (p=0.0197). CONCLUSION: In conclusion, repeated trial of AVF creation (= or >3) in itself was the most powerful significant risk factor affecting the patency rate after AVF creation. The successful first or second trial is very important to expect a long-term patency. Well designed surgery under delicate surgical technique in early referred patient should promise the long-term patency even in patients with diabetes or patients requiring grafted fistula.
Arteriovenous Fistula* ; Fistula ; Follow-Up Studies ; Forecasting ; Humans ; Multivariate Analysis ; Renal Dialysis* ; Risk Factors* ; Transplants

OBJECTIVE: To evaluate the usefulness of percutaneous umbilical blood sampling (PUBS) and prevalence of fetal infection in the pregnant women with suspicious fetal rubella infection. METHODS: Between June 1996 and May 2002 in Chonnam National University Hospital, the rubella specific IgG, IgM antibody and RT-PCR were checked in fetal blood obtained from 31 pregnant women with high risk of rubella infection. Eighteen women (58.1%) had rubella specific IgM, 11 women (35.5%) high titer of rubella specific IgG, and 2 women had a history of recent rubella vaccination within 3 months. RESULTS: PUBS was performed in all cases, successful in 27 cases (87.1%) and failed in 4 cases (12.9%). Cardiocentesis was performed in failed cases. Performing the PUBS, fetal bradycardia was observed in 7 cases (25.9%), fetal tachycardia in 1 case (14.8%), and preterm labor in 2 cases (7.4%). Performing cardiocentesis, fetal bradycardia was observed in 1 case (25.0%), fetal tachycardia in 2 cases (50.0%), and preterm labor in 1 case (25.0%). There was no fetal death. All samples of fetal blood were positive for rubella specific IgG but rubella specific IgM was detected in only 1 case. RT-PCR was negative in all cases. CONCLUSION: Fetal blood sampling is relatively safe and a great precaution is necessary before termination of pregnancy with suspicious fetal rubella infection and without typical maternal rash to reduce unnecessary termination of pregnancy. Several tests such as rubella specific IgM and PCR from placental villi, amniotic fluid, and fetal blood should be considered before termination of pregnancy.
Amniotic Fluid ; Bradycardia ; Chorionic Villi ; Cordocentesis* ; Exanthema ; Female ; Fetal Blood ; Fetal Death ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Jeollanam-do ; Obstetric Labor, Premature ; Polymerase Chain Reaction ; Pregnancy ; Pregnant Women* ; Prenatal Diagnosis* ; Prevalence ; Rubella* ; Tachycardia ; Vaccination

OBJECTIVE: We aimed to introduce our method involving prepuncture ultrasound scan for cannulation of the common femoral artery (CFA) during transfemoral cerebral angiography (TFCA), and to assess the clinical and radiological outcomes. MATERIAL AND METHODS: Our study included 90 patients who underwent prepuncture ultrasound examination of the inguinal area for TFCA between April 2015 and June 2015. Prior to skin preparation and draping of the inguinal area, we identified the CFA and its bifurcation using ultrasound. Based on the ultrasound findings, we marked cruciate lines in the inguinal area. Thereafter, we inserted a puncture needle at the interface between the horizontal and vertical lines at a 30–45° angle, simultaneously palpating the pulsation of the femoral artery. After TFCA was completed, femoral artery angiography was performed in the anteroposterior and oblique directions. Clinical and radiological parameters, including CFA cannulation, the ultrasound scan time, the first pass success rate, the time required for the passage of the wire, and complications, were evaluated. RESULTS: The mean ultrasound scan time of the CFA and its bifurcation was 72.6 seconds, and the mean time between administration of local anesthesia and wire passage was 67.44 seconds. The first pass success rate was 77.8% (70/90 patients), and the CFA puncture rate was 98.8% (89/90 patients). Although minor complications were noted in 7 patients, no patient reported serious complications (a large hematoma [≥ 5 cm], pseudoaneurysms, dissection, and/or a retroperitoneal hematoma.) CONCLUSION: Prepuncture ultrasound examination might be a simple, safe, and accurate technique for cannulation of the CFA during TFCA.
Anesthesia, Local ; Aneurysm, False ; Angiography ; Catheterization ; Cerebral Angiography* ; Femoral Artery* ; Hematoma ; Humans ; Methods ; Needles ; Punctures ; Skin ; Ultrasonography*

Malignant mixed Mullerian tumor(MMMT) of the ovary is very uncommon neoplasm consisting of both a sarcomatous and carcinomatous component. These tumors usually present in an advanced stage and are characterized by rapid growth and poor survival and appropriate treatment remained controversial. The patients with advanced stage ovarian cancer could only benefit from an optimal surgical debulking. However, the optimal cytoreductive surgery may often be difficult to achieve due to the initial extent of the disease. Thus primary surgery for this subset of patients may be questionable. So, we tried neoadjuvant Taxol and/or cis-platinum combined chemotherapy as primary treatment. At the end of neoadjuvant chemotherapy, the patient showed markedly decrease of serum CA 125 level(from 210 U/ml to 59 U/ml) and optimal cytoreductive surgery was performed. After surgery, adjuvant chemotherapy was administered and the serum CA 125 level decreased to the normal range. This case shows our experience of neoadjuvant chemotherapy followed by cytoreductive surgery and adjuvant chemotherapy in patient with primarily unresectable ovarian malignant mixed Mullerian tumor(MMMT).
Chemotherapy, Adjuvant ; Cisplatin ; Drug Therapy* ; Female ; Humans ; Ovarian Neoplasms ; Ovary ; Paclitaxel ; Reference Values

Malignant mixed Mullerian tumor(MMMT) of the ovary is very uncommon neoplasm consisting of both a sarcomatous and carcinomatous component. These tumors usually present in an advanced stage and are characterized by rapid growth and poor survival and appropriate treatment remained controversial. The patients with advanced stage ovarian cancer could only benefit from an optimal surgical debulking. However, the optimal cytoreductive surgery may often be difficult to achieve due to the initial extent of the disease. Thus primary surgery for this subset of patients may be questionable. So, we tried neoadjuvant Taxol and/or cis-platinum combined chemotherapy as primary treatment. At the end of neoadjuvant chemotherapy, the patient showed markedly decrease of serum CA 125 level(from 210 U/ml to 59 U/ml) and optimal cytoreductive surgery was performed. After surgery, adjuvant chemotherapy was administered and the serum CA 125 level decreased to the normal range. This case shows our experience of neoadjuvant chemotherapy followed by cytoreductive surgery and adjuvant chemotherapy in patient with primarily unresectable ovarian malignant mixed Mullerian tumor(MMMT).
Chemotherapy, Adjuvant ; Cisplatin ; Drug Therapy* ; Female ; Humans ; Ovarian Neoplasms ; Ovary ; Paclitaxel ; Reference Values

No abstract available.
Pregnancy*

This study aimed to analyze the experiences of new nurses during their first year of hospital employment to gather data for the development of an evidence-based new nurse residency program focused on adaptability. Methods: This study was conducted at a tertiary hospital in Korea between March and August 2021 with 80 new nurses who wrote in critical reflective journals during their first year of work. NetMiner 4.5.0 was used to conduct a text network analysis of the critical reflective journals to uncover core keywords and topics across three periods. Results: In the journals, over time, degree centrality emerged as “study” and “patient understanding” for 1 to 3 months, “insufficient” and “stress” for 4 to 6 months, and “handover” and “preparation” for 7 to 12 months. Major sub-themes at 1 to 3 months were: “rounds,” “intravenous-cannulation,” “medical device,” and “patient understanding”; at 4 to 6 months they were “admission,” “discharge,” “oxygen therapy,” and “disease”; and at 7 to 12 months they were “burden,” “independence,” and “solution.” Conclusion:These results provide valuable insights into the challenges and experiences encountered by new nurses during different stages of their field adaptation process. This information may highlight the best nurse leadership methods for improving institutional education and supporting new nurses’ transitions to the hospital work environment.

This study aimed to analyze the experiences of new nurses during their first year of hospital employment to gather data for the development of an evidence-based new nurse residency program focused on adaptability. Methods: This study was conducted at a tertiary hospital in Korea between March and August 2021 with 80 new nurses who wrote in critical reflective journals during their first year of work. NetMiner 4.5.0 was used to conduct a text network analysis of the critical reflective journals to uncover core keywords and topics across three periods. Results: In the journals, over time, degree centrality emerged as “study” and “patient understanding” for 1 to 3 months, “insufficient” and “stress” for 4 to 6 months, and “handover” and “preparation” for 7 to 12 months. Major sub-themes at 1 to 3 months were: “rounds,” “intravenous-cannulation,” “medical device,” and “patient understanding”; at 4 to 6 months they were “admission,” “discharge,” “oxygen therapy,” and “disease”; and at 7 to 12 months they were “burden,” “independence,” and “solution.” Conclusion:These results provide valuable insights into the challenges and experiences encountered by new nurses during different stages of their field adaptation process. This information may highlight the best nurse leadership methods for improving institutional education and supporting new nurses’ transitions to the hospital work environment.