PURPOSE: The purpose of this study was to analyze the differences in terms of services and cost between CVA without typical diseases (Group I), and CVA with typical diseases (Group II), in their Hospital-based home health care. METHOD: The subjects of this study were 308 CVA patients who used home care nursing during the second phase demonstration project of their hospital-based home health care. Results: The results of the study was as follows 1. Group II had more home visit (15.3/12.7) (p>0.05), and cases of death when home care (16.8/11.4) (p<0.05). 2. Group II needed more services than Group I such as bladder irrigation, skin care, bed sore care, glycerin enema, finger enema, lung care, urine sugar test, monitoring and surveillance of fluid infusion and R.O.M exercise (p<0.05). 3. The variables that showed statistical significance in the regression analysis were family style, OPD visit, level of consciousness, patient's state on termination of home care, and some extend of home health care services (R2=0.373, 0.205). CONCLUSION: Home nursing care needs to be planned by severity in Hospital-based home health care for CVA patients.
Consciousness ; Delivery of Health Care* ; Enema ; Fingers ; Glycerol ; Home Care Services ; Home Nursing ; House Calls ; Humans ; Lung ; Nursing ; Pressure Ulcer ; Skin Care ; Urinary Bladder

PURPOSE: The purpose of this study was to identify factors affecting prenatal care (PNC) by married immigrant women. METHODS: This study was a secondary analysis of "Reproductive Health Status of Married Immigrant Women and Policy Directions in Korea" by the Korea Institute for Health & Social Affairs. The participants were 727 married immigrant women from Asia. Data were analysed using descriptive statistics, chi2 test and logistic regression with SPSS 14.0. RESULTS: Of the 727 women interviewed, 91.7% visited prenatal clinic. However, first time for PNC was late and total number of PNC was lower (9.07) than the average of Korean women. Timing and number of PNC in rural area were later and fewer than those in urban area. PNC by these women was significantly lower in those who had lived in Korea longer and for those who the employed. However, PNC was significantly higher in those who attended health education during pregnancy and had not experienced premature delivery. Those who attended health education during pregnancy (OR=2.84, CI=1.49~5.40) or were unemployed (OR=0.51, CI=0.26~0.99) were more likely to have PNC. CONCLUSION: These findings illustrate the need to strengthen the public information and provide special services to their demands about PNC for married immigrant women.
Asia ; Emigrants and Immigrants ; Female ; Health Education ; Humans ; Korea ; Logistic Models ; Pregnancy ; Prenatal Care

PURPOSE: The purpose of this study is to identify factors influencing the pregnancy rate among unexplained infertile couples who received treatments of assisted reproductive technology (ART) and intra-uterine inseminations (IUI). METHODS: The medical records of 24,201 cases of unexplained infertility among a total of 31,684 intrauterine insemination treatment cases, (which benefited by 'National Medical-aid Program for ART in 2011') were used for this analysis. RESULTS: Woman's age (OR=0.94), frequency of IUI (OR=0.86), and treatment type (OR=1.54) were significant factors on pregnancy rates in the logistic regression analysis. CONCLUSION: Factors, such as the age of the infertile woman, frequency of IUI, and treatment type used to induce ovulation were shown to positively influence pregnancy rate. However, the age of the spouse was not a significant variable. Infertile couples having unprotected sexual intercourse with unexplained infertility had priority. The results demonstrated that about 70% of infertile Korean couples had unexplained infertility. This was a higher rate of unexplained infertility than that of the clinical standard. Therefore, we should assess for causes through future studies. In addition, affective or emotional factors influencing unexplained infertility need to be researched further.
Coitus ; Family Characteristics* ; Female ; Humans ; Infertility ; Insemination* ; Insemination, Artificial ; Korea* ; Logistic Models ; Medical Records ; Ovulation* ; Pregnancy Rate* ; Pregnancy* ; Reproductive Techniques, Assisted ; Spouses

BACKGROUND: Although enriched broth cultures have been recommended as an adjuvant to the direct plating of tissue and body fluid specimens, the cost-effectiveness of broth cultures has been questioned in regard with the clinical significance of "broth only isolates(BOI)". The purpose of this study was to investigate the usefulness of thioglycollate broth(THIO) cultures. METHODS: We reviewed retrospectively results in the culture specimens of body fluids, tissue biopsies, and puses received during the month of July 1997. All specimens were inoculated into THIO in addition to agar plates. We reviewed the medical records of culture-positive patients to determine the clinical significance and relevance of their isolates. Clinically significant isolates were defined as those for which an appropriate antimicrobial therapy was done except one judged as contaminants by clinicians and clinically relevant isolates as the clinically significant one isolated first. RESULT: Of 2,008 specimens, 512(25.4%) from 365 patients grow 561 isolates 464 plate isolates and 97 BOI. Two hundred eighty nine(62.3%) of the 464 isolates from plate cultures were clinically significant, compared to only 12(12.4%) of 97 BOI (P<0.05). Only four (4.1%) BOI were clinically relevant, including one Pseudomonas aerugiosa from ascites. one Klebsiella pneumoniae and two Staphylococcus aureus from tissue specimens. CONCLUSION: A routine use of enriched broth culture rarely recover clinically relevant isolates. Considering the laboratory and medical costs of the recovery of contaminants and clinically irrelevant isolates, the enrichment broth cultures should be used more selectively.
Agar ; Ascites ; Biopsy ; Body Fluids ; Humans ; Klebsiella pneumoniae ; Medical Records ; Pseudomonas ; Retrospective Studies ; Staphylococcus aureus

The Government of North Korea with WHO proposed the improvement of healthcare for mothers and children as the second-highest priority for North Korea in 2009. The maternal mortality ratio in North Korea was 76 per 100,000 live birth in 2012, almost seven times higher than that of South Korea. The leading cause of maternal death was postpartum hemorrhage, which accounted for 33 percent of all mothers' deaths. Postpartum hemorrhage is indeed a life-threatening crisis that requires a well-established emergency obstetric care (EmOC) system including safe blood. The rate of children under the age of five with chronic malnutrition stood at 27.9 percent in 2012. Infant malnutrition was more prevalent after the first six months of life, with the rate reaching a peak of 36.8 percent at 24 months of age. The proportion of chronic malnutrition was lowest in Pyongyang, at 19.6 percent, and second-lowest in South Phyongan, at 25.8 percent. On the other hand, the proportion was the highest in the three provinces of Ryanggang, Jagang and South Hamgyong at 39.6 percent, 33.4 percent, and 32.9 percent, respectively. Lack of food security has led to a high prevalence of malnutrition. The mortality rate of children under the age of five was 25 per 1,000 live birth in 2014. Of the North Korean children who die under the age of five, 51 percent died within first four weeks of their birth in 2010. Of these, 40 percent was born low birth weight (less than 2,500 grams at birth), indicating the severity of malnutrition in mothers. Therefore this paper suggests strategies approach to improve the quality of the population for the next generation unified the Korean peninsula for future initiatives. First, we need to develop of strategies and actions for reducing geographical disparity in access to maternal and child health services in North Korea. Second, we have to introduce a 'Mother and Child 1,000-Day Project' to reduce undernutrition among mothers and children in the first 1,000 days of a child's life, from conception to two years old. Third, it is desirable to adopt a policy on access to primary health care to build local governance.
Child Health Services ; Child Health* ; Child* ; Delivery of Health Care ; Democratic People's Republic of Korea* ; Emergencies ; Fertilization ; Food Supply ; Hand ; Humans ; Infant ; Infant Mortality ; Infant Nutrition Disorders ; Infant, Low Birth Weight ; Infant, Newborn ; Korea ; Live Birth ; Malnutrition ; Maternal Death ; Maternal Mortality ; Mortality ; Mothers ; Parturition ; Postpartum Hemorrhage ; Prevalence ; Primary Health Care

The autoinfective filariform larva of Strongyloides stercoralis causes hyperinfection in immunosuppressed hosts. Here we report on the case of a male patient who was admitted to the emergency room at Gwangju Veterans Hospital with a complaint of dyspnea, and who was receiving corticosteroid therapy for asthma. Many slender larvae of S. stercoralis with a notched tail were detected in Papanicolaou stained sputum. They measured 269 +/- 21.2 micrometer in length and 11 +/- 0.6 micrometer in width. The esophagus extended nearly half of the body length. The larvae were identified putatively as autoinfective third-stage filariform larvae, and their presence was fatal. The autoinfective filariform larva of S. stercoralis has not been previously reported in Korea.
Aged ; Animals ; Fatal Outcome ; Humans ; Immunocompromised Host ; Larva ; Male ; Sputum ; Strongyloides/growth & development/*isolation & purification ; Strongyloidiasis/*etiology ; Superinfection/*parasitology

PURPOSE: The purpose of this study was to identify the influence of clinical nurse specialists' emotional intelligence on their organizational commitment and turnover intention. METHODS: A descriptive study with second data analysis was conducted with permission. The original data was from the policy research on the status of clinical nurses with extended role hosted by the Hospital Nurses Association in 2007. RESULTS: The mean score of emotional intelligence, organizational commitment, turnover intention were 58.66 (+/-6.63), 46.71 (+/-3.54), 12.87 (+/-3.98) respectively. Emotional intelligence had 40% positive influence on organizational commitment (F=50.58, p<.01, adj.R2=.16) and 24% negative influence on turnover intention (F=16.68, p<.01, adj.R2=.06). CONCLUSION: The results recommend to develop a program that enhances clinical nurse specialists' emotional intelligence. The program could be utilized as an institutional retention strategy to increase clinical nurse specialists' organizational commitment and decrease their turnover intention.
Emotional Intelligence ; Humans ; Intention ; Nurse Clinicians ; Retention (Psychology) ; Statistics as Topic

No abstract available.
Membranes* ; Pregnancy* ; Rupture*

Immune checkpoint inhibitors have dramatically revolutionized the therapeutic landscape for patients with advanced malignancies. Recently, convincing evidence has shown meaningful influence of gut microbiome on human immune system. With the complex link between gut microbiome, host immunity and cancer, the variations in the gut microbiota may influence the efficacy of immune checkpoint inhibitors. Indeed, some bacterial species have been reported to be predictive for cancer outcome in patients treated with immune checkpoint inhibitors. Although immune checkpoint inhibitors are currently proven to be an effective anti-tumor treatment, they can induce a distinct form of toxicity, termed immune-related adverse events. Immune-related colitis is one of the common toxicities from immune checkpoint inhibitors, and it might preclude the cancer therapy in severe or refractory cases. The manipulation of gut microbiome by fecal microbiota transplantation or probiotics administration has been suggested as one of the methods to enhance anti-tumor effects and decrease the risk of immune-related colitis. Here we review the role of gut microbiome on immune checkpoint inhibitor therapy and consequent immune-related colitis to provide a new insight for better anti-cancer therapy.

BACKGROUND: Histological analysis of tuberculosis shows a spectrum of findings, from well formed granulmatous inflammation with few bacilli in patient with normal immune response to M. tuberculosis to poorly formed granulomatous inflammation with many bacilli in patient with defective immune response. To evaluate the degree of immune response to M. tuberculosis, we studied the histologic features, including the presence of acid fast bacilli(AFB) in lymph node of patients with cervical tuberculous lymphadenitis, and compared them with clinical characteristics. METHODS: We reviewed the histologic features of 33 cases of cervical tuberculous lymphadenitis and processed the excised nodes for auramine-rhodamine staining to detect AFB. The AFB positivity in tissue was compared with the histologic features(degree of granuloma formation, presence of caseation necrosis, presence of neutrophilic infiltration) and clinical characteristics (lymph node size, duration of symptom, presence of local symptom or radiologic evidence of pulmonary tuberculosis). RESULTS: 1) The mean age at diagnosis was 42.4 years, and male to female ratio was 1 : 45. 2) Histologically, all cases showed well formed granuloma and variable degrees of caseation necrosis, and 39% of the cases showed neutrophilic infiltration in the granulomatous inflammation. 3) AFB were confirmed in 52% of the cases, and they were found extracellularly and at the periphery of caseation necrosis. 4) There was no association between AFB Positivity and histological features or clinical characteristics. CONCLUSION: Cervical tuberculous lymphadenitis showed well formed granulomatous inflammation with caseation necrosis, and there was no association between AFB positivity in the tissue and histological or clinical characteristics.
Diagnosis ; Female ; Granuloma ; Humans ; Inflammation ; Lymph Nodes ; Lymphadenitis ; Male ; Necrosis ; Neutrophils ; Tuberculosis ; Tuberculosis, Lymph Node*