Purpose: This descriptive study investigated the effects of nurses’ knowledge of withdrawalof life-sustaining treatment, death anxiety, and perceptions of hospice care on their attitudes toward withdrawal of life-sustaining treatment. Methods: Data were collected from 262 nurses at tertiary hospitals, general hospitals, or primary hospitals in Busan, Korea, and statistically analyzed using the t-test, analysis of variance, the Scheffé test, Pearson correlation coefficients, and hierarchical regression analysis. Results: The participants’ scores were 3.68±0.45 (out of 5) for attitudes toward withdrawal of life-sustaining treatment, 0.65± 0.15 (out of 1) for knowledge of withdrawal of life-sustaining treatment, 2.61±0.26 (out of 4) for death anxiety, and 4.06±0.43 (out of 5) for perceptions of hospice care. Furthermore, knowledge of withdrawal of life-sustaining treatment and perceptions of hospice care showed positive correlations with attitudes toward withdrawal of life-sustaining treatment, while death anxiety showed a negative correlation. The most significant factors influencing attitudes toward withdrawal of life-sustaining treatment were perceptions of hospice care, followed by having experienced caring for patients who withdrew life-sustaining treatment, death anxiety, having a spouse, and ethical values, and the overall explanatory power was 43.0%. Conclusion This study showed that perceptions of hospice were an important fac-tor influencing nurses’ attitudes toward withdrawal of life-sustaining treatment. Therefore,it is necessary to develop and validate educational intervention programs that can improve perceptions of hospice care.

PURPOSE: Febrile seizures (FSs) are the most common type of seizure in the first 5 years of life and are frequently associated with viral infections. Influenza infection is associated with a variety of neurological conditions, including FSs. The purpose of this study was to evaluate the clinical implications of influenza infection in FSs. METHODS: In total, 388 children with FS were divided into two groups: FS with influenza infection (n=75) and FSs without influenza infection (n=313). Their medical records, including seizure type, frequency, duration, and familial history of FSs or epilepsy, were retrospectively reviewed and the clinical characteristics of the two groups were compared. RESULTS: In total, 75 of the 388 children (19.3%) had FSs associated with influenza infection; such children were significantly older than those with FSs without influenza infection (34.9±22.3 months vs. 24.4±14.2 months; P < 0.001). The children who had more than two febrile seizures episodes were more prevalent in children with FS with influenza infection [40/75 (53.3%) vs. 92/313 (29.4%); P < 0.01]. Children older than 60 months were more likely to have influenza infection compared to those aged less than 60 months [11/22 (50%) vs. 64/366 (17.5%); P=0.001]. CONCLUSION: Influenza infection may be associated with FSs in older children, and with recurrence of FSs. Its role in the development of afebrile seizures or subsequent epilepsy requires further investigation with long-term follow-up.
Child ; Epilepsy ; Follow-Up Studies ; Humans ; Influenza, Human* ; Medical Records ; Recurrence ; Retrospective Studies ; Seizures ; Seizures, Febrile*

Fingertip amputation is a common traumatic injury which can be treated with revascularization therapy or composite grafting. This article reports two case studies showing the successful management of fingertip amputation using hyperbaric oxygen therapy (HBOT) and prostaglandin E1 (PGE1) treatment after composite grafting, where revascularization was not possible. HBOT was used to promote angiogenesis, improve oxygen transfer, and accelerate wound healing. At the same time, PGE1 was administered to control inflammation, stimulate cell proliferation, and promote tissue repair. These case reports offer effective approaches to treating fingertip amputation. The treatment strategy used in this study can be expected to improve patient outcomes and quality of life.

Fingertip amputation is a common traumatic injury which can be treated with revascularization therapy or composite grafting. This article reports two case studies showing the successful management of fingertip amputation using hyperbaric oxygen therapy (HBOT) and prostaglandin E1 (PGE1) treatment after composite grafting, where revascularization was not possible. HBOT was used to promote angiogenesis, improve oxygen transfer, and accelerate wound healing. At the same time, PGE1 was administered to control inflammation, stimulate cell proliferation, and promote tissue repair. These case reports offer effective approaches to treating fingertip amputation. The treatment strategy used in this study can be expected to improve patient outcomes and quality of life.

Fingertip amputation is a common traumatic injury which can be treated with revascularization therapy or composite grafting. This article reports two case studies showing the successful management of fingertip amputation using hyperbaric oxygen therapy (HBOT) and prostaglandin E1 (PGE1) treatment after composite grafting, where revascularization was not possible. HBOT was used to promote angiogenesis, improve oxygen transfer, and accelerate wound healing. At the same time, PGE1 was administered to control inflammation, stimulate cell proliferation, and promote tissue repair. These case reports offer effective approaches to treating fingertip amputation. The treatment strategy used in this study can be expected to improve patient outcomes and quality of life.

Fingertip amputation is a common traumatic injury which can be treated with revascularization therapy or composite grafting. This article reports two case studies showing the successful management of fingertip amputation using hyperbaric oxygen therapy (HBOT) and prostaglandin E1 (PGE1) treatment after composite grafting, where revascularization was not possible. HBOT was used to promote angiogenesis, improve oxygen transfer, and accelerate wound healing. At the same time, PGE1 was administered to control inflammation, stimulate cell proliferation, and promote tissue repair. These case reports offer effective approaches to treating fingertip amputation. The treatment strategy used in this study can be expected to improve patient outcomes and quality of life.

Unmet healthcare is an important indicator to measure accessibility of healthcare services. To examine the latest status of unmet healthcare needs in South Korea, the four different data which is composed of nationally representative sample of South Korean population were used; the Korea Health and Nutrition Examination Survey (KNAHANES, 2007–2019), the Community Health Survey (CHS, 2008–2019), the Korea Health Panel Survey (KHP, 2011–2017), and the Korean Welfare Panel Study (KOWEPS, 2006–2019). The proportion of individuals reporting unmet healthcare needs were 5.8% (KNHANES), 5.3% (CHS), and 11.6% (KHP). Annual percentage change (APC) which identifies trend for the follow-up period was -9.5%, -8.0%, and -6.5%, respectively. The proportion of individuals reporting unmet healthcare needs due to cost were 1.1% (KNAHANES), 0.7% (CHS), 2.4% (KHP), and 0.4% (KOWEPS). The APC was -10.5%, -14.2%, -12.2%, and -19.6%, respectively. Compared to last year, the rate of unmet healthcare needs has declined in general.However, the low-income and the elderly population were reporting the highest rate of unmet health care needs, and the disparity between lowest and highest groups were remained. These results suggest that adequate benefit coverage is needed for low-income and elderly population.

Unmet healthcare is an important indicator to measure accessibility of healthcare services. To examine the latest status of unmet healthcare needs in South Korea, four different data which is composed of nationally representative sample of South Korean population were used; the Korea National Health and Nutrition Examination Survey (KNHANES, 2007–2020), the Community Health Survey (CHS, 2008–2020), the Korea Health Panel Survey (KHP, 2011–2018), and the Korean Welfare Panel Study (KOWEPS, 2006– 2020). The proportion of individuals reporting unmet healthcare needs were 6.4% (KNHANES), 5.4% (CHS), and 12.2% (KHP). Annual percentage change (APC) which identifies trend for the follow-up period was -9.9%, -9.1%, and -5.5%, respectively. The proportion of individuals reporting unmet healthcare needs due to cost were 1.0% (KNHANES), 0.4% (CHS), 2.2% (KHP), and 0.4% (KOWEPS). The APC was -11.3%, -17.0%, -12.2%, and -21.2%, respectively. Overall, the low-income and the elderly population reported a higher rate of unmet health care needs. Although the overall experience rate of unmet medical care due to cost decreased over the past decade, the disparity between the lowest and highest income groups still remained in 2020. Disparity between income levels and age groups is a challenge to address in healthcare system, and these results suggest the need for adequate health coverage for the low-income and the elderly populations.

Granular cell tumor (GCT) of the thyroid is rare and histogenesis of the carcinoma still remains poorly understood. Here in this study, we report a case of perithyroidal granular cell tumor in a 44-year-old woman, diagnosed as medullary carcinoma upon the interoperative frozen diagnosis. The tumor was comprised of white, solid mass with infiltrating margin in isthmus. Microscopically, the tumor revealed abundant eosinophilic cytoplasm, elongated nucleus and eosinophilic amyloid-like materials. It was composed of diffuse sheets of polygonal cells with abundant eosinophilic cytoplasm and cytologically bland nucleus on permanent section. On immunohistochemical staining, S-100 and CD68 are diffusely positive. Determining the progression and the behavior of the tumor is critical for providing long-term management and preventing aggressive treatment.
Adult ; Carcinoma, Medullary ; Carcinoma, Papillary ; Cytoplasm ; Diagnosis ; Eosinophils ; Female ; Granular Cell Tumor* ; Humans ; Thyroid Gland* ; Thyroid Neoplasms*

BACKGROUND: The aims of this study were to compare the efficacy of sevoflurane inhalation alone, intravenous remifentanil alone, and the combination of sevoflurane inhalation and remifentanil as pretreatment for the prevention of rocuronium-induced withdrawal movement in pediatric patients. METHODS: In this prospective, randomized study, 90 American Society of Anesthesiologists physical status I or II pediatric patients aged 3 to 10 years were randomly allocated to one of three treatment groups: The Group S comprising the patients receiving sevoflurane inhalation, the Group R comprising those doing intravenous remifentanil 0.5 microg/kg and the Group C comprising those doing sevoflurane inhalation+intravenous remifentanil 0.5 microg/kg. The response of the patients was graded based on a 4-point scale. RESULTS: The overall incidence of withdrawal movement on rocuronium injection was 54% (16/30) in the Group S, 57% (17/30) in the Group R and 17% (5/30) in the Group C. There was no significant difference in the incidence of withdrawal movements on rocuronium injection between the Group S and Group R. In addition, the incidence of withdrawal movements and generalized movement on rocuronium injection was significantly lower in the Group C as compared with the Group S and R (P < 0.05). CONCLUSIONS: Our results indicate not only that there was no significant difference in the degree of the effect in lowering the incidence of withdrawal movements on rocuronium injection between sevoflurane inhalation and intravenous remifentanil but also that it was significantly higher when combined with intravenous remifentanil as compared with the single use of sevoflurane inhalation or intravenous remifentanil.
Child* ; Humans ; Incidence ; Inhalation* ; Pediatrics ; Prospective Studies