Purpose: : This study aimed to comprehensively understand the work experience of the person in charge of the adequacy evaluation of small-and medium-sized hospitals and explore its meaning and essence in-depth. Methods: : This was a descriptive qualitative study. The study participants were 10 nurses who understood the purpose of this study and participated voluntarily. Data collection was conducted via in-depth interviews in January 2021. The interviews were conducted 1-2 times per participant and lasted approximately 40-50 minutes per session. Data analysis was performed using a qualitative content analysis. Results: : The work experience of the person in charge of the adequacy evaluation of small-and medium-sized hospitals included four themes: “difficulty in preparing for evaluation,” “negative views on evaluation,” “lack of a support system,” and “positive improvements and changes due to an evaluation.” Conclusion : Based on the above results, an education program and support system should be developed to strengthen the competence of nurses in charge of the adequacy evaluation of small- and medium-sized hospitals.

PURPOSE: Intravesical instillation of bacillus Calmette-Guerin(BCG) is an established and effective therapy for the superficial bladder carcinoma. The viability of BCG is crucial for the induction of a local immune response as well as effective therapy of recurrent superfical bladder carcinoma. Lubricants are used to facilitate catheterization during intravesical instillation of BCG. Moreover bacteriostatic components contained in them have potential to reduce the viability of the BCG. To verify this assumption, inhibitory effect of four commercially available lubricants on the BCG growth was analyzed. MATERIALS AND METHOD: Four different lubricants and their components were co-incubated with Connaught strain BCG and the resultant growth of BCG was assessed. RESULTS: Significant impairment of BCG viability with lubricants was noted. Chlorhexidine digluconate which is the component of lubricant was considered as responsible for this inhibition. CONCLUSIONS: During intravesical BCG, lubricants might reduce the number of viable BCG in clinical use. For this reason, during intravesical immunotherapy with BCG small amounts of lubricants should be used for urethral catheterization and use of lubricant which does not contain bacteriostatic agent should be considered.
Administration, Intravesical ; Bacillus* ; Catheterization ; Catheters ; Chlorhexidine ; Immunotherapy ; Lubricants ; Mycobacterium bovis ; Thiram ; Urinary Bladder ; Urinary Catheterization ; Urinary Catheters

Purpose: To identify the differences in perception of and adherence to the COVID-19 social distancing behavior guidelines among health care workers, patients, and the general public and to use them to prevent the spread of COVID-19. Methods: From October 16 2020 to November 30, 2020, a survey was conducted among 85 health care workers, 85 patients, and 82 general public regarding the perception of and adherence to the COVID-19 social distancing behavior guidelines. Results: Patients scored significantly higher than the general public in the adherence to the COVID-19 social distancing behavior guideline, and there was no difference between health care workers and general public, and patients and health care workers. In the multivariate analysis, the factors that influence the adherence of the COVID-19 social distancing behavior guide were found in women and the perception of the COVID-19 social distancing behavior guideline. Conclusion In order to promote the implementation of the COVID-19 social distancing behavior guideline, it is necessary to increase the perception of the COVID-19 social distancing behavior guideline and provide additional education in men. It is necessary to investigate the reason behind why men have low adherence to the COVID-19 social distancing behavior guideline.

We aimed to investigate the significance of microalbuminuria and its relationship with subclinical atherosclerosis in nonhypertensive and nondiabetic patients, by using coronary artery computed tomography (CT). A total of 1,318 nonhypertensive and nondiabetic subjects who had taken coronary artery CT and measured spot urine albumin to creatinine ratio (UACR) were evaluated. The atherosclerotic changes of coronary arteries were greater in subjects with microalbuminuria, reflected by coronary artery calcium score (CACS) and significant coronary artery stenosis (CACS > or = 100 in 15.3% vs 7.6% and stenosis > or = 50% in 11.5% vs 4.9% of patients with vs without microalbuminuria, P = 0.008 and P = 0.011, respectively). Among various parameters that are known as a risk factor or possible biomarkers of coronary artery disease, presence of microalbuminuria, age and Framingham risk score were significantly related to coronary artery stenosis. Among them the presence of microalbuminuria showed stronger correlation than others to the coronary artery stenosis detected by CT, even after adjusting confounding factors (OR 3.397, 95% confidence interval 1.138 to 10.140, P = 0.028). The presence of microalbuminuria by UACR was significantly associated with presence of coronary artery stenosis > or = 50% in asymptomatic, nonhypertensive and nondiabetic general population. Our study suggests that the presence of microalbuminuria may imply subclinical coronary artery disease, even in asymptomatic population.
Adult ; Age Factors ; Aged ; Albuminuria/*complications ; Blood Pressure ; Calcium/analysis ; Coronary Artery Disease/complications/*radiography ; Coronary Stenosis/complications ; Coronary Vessels/chemistry ; Creatinine/urine ; Female ; Humans ; Male ; Middle Aged ; Odds Ratio ; Retrospective Studies ; Risk Factors ; Sex Factors ; Tomography, X-Ray Computed

BACKGROUND & SIGNIFICANCE: The neurological manifestations associated with Epstein-Barr viral (EBV) infection includes meningoencephalitis, Guillain Barre syndrome (GBS), Bell's palsy, myelopathy, and radiculopathy. To the best of our knowledge, the neurological manifestation associated with EBV infection has never been reported in Korea. Cases & RESULTS: We have found five patients (3 men, 2 women, mean age 28.4 years ; range 23-42) with EBV-associated neurological illness between August 1994 and July 1995. Serum enzyme immunoassay (EIA) tests for anti- early antigen(EA) IgM and anti-Epstein Barr nucleic acid (EBNA) IgG was positive in all patients, suggestive of reactivated EBV reaction. They showed a wide spectrum of neurological manifestations: 2 meningoecnephalomyelitis, 1 meningoencephalitis and cervical radiculopathy, 1 meningoencephalitis, and 1 GBS. T2-weighted brain magnetic resonance imaging studies showed high signal intensity lesions in three of the four patients who had meningoencephalitis. Outcomes were excellent in all but one patient. CONCLUSIONS: We present five patients with a wide spectrum of neurological manifestations associated with EBV infection. We suggest that one should suspect the EBV infection in a variety of neurological diseases of uncertain etiology.
Bell Palsy ; Brain ; Epstein-Barr Virus Infections ; Female ; Guillain-Barre Syndrome ; Herpesvirus 4, Human ; Humans ; Immunoenzyme Techniques ; Immunoglobulin G ; Immunoglobulin M ; Korea ; Magnetic Resonance Imaging ; Male ; Meningoencephalitis ; Neurologic Manifestations* ; Radiculopathy ; Spinal Cord Diseases

Cystic sebaceous adenomas are rare neoplasms that can arise in salivary glands. Among the salivary glands, the most commonly reported location is the parotid gland where it must be differentiated from other intraparotid masses. Unfortunately, its imaging features are not well-known as a result of its rarity. We report a case of cystic sebaceous adenoma that manifested as a gradually enlarging mass within the parotid gland of a 60-year-old man.
Adenoma* ; Humans ; Middle Aged ; Parotid Gland* ; Salivary Glands

Cystic sebaceous adenomas are rare neoplasms that can arise in salivary glands. Among the salivary glands, the most commonly reported location is the parotid gland where it must be differentiated from other intraparotid masses. Unfortunately, its imaging features are not well-known as a result of its rarity. We report a case of cystic sebaceous adenoma that manifested as a gradually enlarging mass within the parotid gland of a 60-year-old man.
Adenoma* ; Humans ; Middle Aged ; Parotid Gland* ; Salivary Glands

OBJECTIVE: To evaluate the test-retest reliability of supraspinatus cross-sectional area measurement by ultrasonography. METHOD: Both shoulders of 11 normal subjects (22 shoulders in total) were included in this study. The supraspinatus muscle was examined with the arm alongside the body in the coronal oblique and sagittal oblique planes. The occupational ratio of the supraspinatus fossa was measured. To calculate the occupational ratio, the Y view of MRI was reproduced with sonography by locating the suprascapular notch in the coronal oblique plane (in the plane of the scapula) and then rotating the transducer 90degrees to that plane. The cross-sectional area was measured using the tracing and ellipse tool. The second measurement was performed 7 days after the initial measurement. RESULTS: The Pearson correlation coefficient and intraclass correlation coefficient between the first and the second occupational ratio measurements were 0.43 and 0.44, respectively, for the tracing method, and 0.53 and 0.47, respectively, for the ellipsoidal method. The difference between the first and second occupational ratio measurement was 4.1+/-3.9% (0.1-13.2%) for the tracing method, and 4.5+/-3.4% (0.01-10.5%) for the ellipsoidal method. The maximum difference was 13.2%. The occupational ratio was 86.2+/-5.3% (70.6-95.8%) for the tracing method and 85.0+/-5.2% (69.3-96.1%) for the ellipsoidal method. CONCLUSION: Supraspinatus occupational ratio by sonography is a low to moderately reliable intrarater method. However, the maximum difference was not significant. The main reason for its low to moderate reliability was the narrow value range. Therefore, the study method should be re-evaluated in stroke patients and in patients with rotator cuff disease. Knowledge of the anatomy is a prerequisite to attain intrarater reliability.
Arm ; Humans ; Muscles ; Rotator Cuff ; Shoulder ; Stroke ; Transducers

Patients undergoing peritoneal dialysis are at risk for protein-energy malnutrition because of nutrient losses during dialysis. This study determined the nutritional status of patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Forty-four patients receiving CAPD were divided into two groups according to dialysis period. We investigated the nutritional status of the patients by measuring anthropometric and biochemical parameters, as well as food intake, self-appetite, dietary habits, a subjective global assessment, and a total nutritional status assessment. Group I subjects (7 males, 13 females) had received dialysis for < 2 years, whereas the group II subjects (18 males, 6 females) received dialysis for > or = 2 years. Energy intake with added dextrose in the dialysate per kg of body weight was 30.3 +/- 5.8 kcal in group I and 29.0 +/- 8.1 kcal in group II. The average protein intake per kg of weight was 1.0 +/- 0.3 g in group I and 1.0 +/- 0.4 g in group II, which were less than the recommended protein intake for patients undergoing CAPD (1.2-1.5 g/kg). Mean serum albumin level was significantly lower in group II than that in group I (p < 0.05). A recent self-appetite score was significantly higher in group II than that in group I (p < 0.01). The dietary habits score was significantly lower in group II than that in group I (p < 0.05). The subjective global assessment was significantly higher in group I (85.0%) than that in group II (54.2%) under normal nutrition status (p < 0.05). The dialysis period was significantly and negatively correlated with the subjective global assessment (r = -0.502, p < 0.01) and the total nutritional status assessment (r = -0.575, p < 0.01). These results demonstrated that patients undergoing CAPD for > or = 2 years had worse nutritional status than those who had been undergoing dialysis for < 2 years. Good nutritional status can predict the long-term survival of patients undergoing peritoneal dialysis. Additionally, the exact evaluation of nutritional status before 2 years will be important to maintain long-term dialysis therapy in patients undergoing CAPD.
Body Weight ; Dialysis ; Eating ; Energy Intake ; Food Habits ; Glucose ; Humans ; Male ; Nutritional Status ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory ; Protein-Energy Malnutrition ; Serum Albumin

Atlantoaxial subluxation in undifferentiated spondyloarthropathy is extremely rare and has not been reported. We describe a case of 27-year-old man who was diagnosed as undifferentiated spondyloarthropathy with atlantoaxial subluxation with an initial complaint of painful swelling of right 1st metatarsophalangeal joint and posterior neck pain. Roentgenograms showed sclerotic change and increased hazziness in right 1st metatarsophalangeal joint. Magnetic resonance images and roentgenograms of the cervical spine showed inflammation of odontoid process and atlantoaxial subluxation. Bone scan showed hot uptakes in left sacroiliac joint, right 1st & 4th metacarpophalangeal joints and 1st metatarsophalangeal joint. HLA-B27 gene was positive. Spontaneous atlantoaxial subluxation and undifferentiated spondyloarthropathy was diagnosed and conservatively treated with oral medication. Currently, there is no definite neurological sign. Early recognition and awareness of potential clinical complications is important in preventing compressive damage on central nervous system.
Adult ; Central Nervous System ; HLA-B27 Antigen ; Humans ; Inflammation ; Magnetic Resonance Spectroscopy ; Metacarpophalangeal Joint ; Metatarsophalangeal Joint ; Neck Pain ; Odontoid Process ; Sacroiliac Joint ; Spine ; Spondylarthropathies