Purpose: This study was attempted to identify the importance and performance of person-centered care in nurses in intensive care units (ICU) at general hospitals and to derive the priority of practical person-centered care needs and intervention by analysing their needs. Methods: A total of 156 ICU nurses who wrote a written consent participated in a survey questionnaire on person-centered critical care nursing (PCCN). The collected data were analyzed using paired t-test, Borich’s needs assessment, and the Locus for Focus Model. Results: All 15 items of person-centered care in ICU nurses were found to be significantly higher in perception of importance than performance level (t=17.98, p<.001). According to the analysis of Borich's needs and the Locus of Focus Model, person-centered care items with highest priority in ICU were therapeutic contact, comfort words and actions, and efforts to empathize with patients in the compassion category. Conclusion As a strategy to improve the person-centered nursing performance of ICU nurses in the ‘individuality’, it is necessary for ICU nurses to recognize the ICU patients as an individualized person, not as a disease or machine-dependent entity. Also, it is necessary to develop programs to improve the ICU nurses' compassion competence because ‘compassion’ was a top priority according to Borich's needs assessment model and the Locus for Focus Model.

Cantrell's syndrome is a rare congenital anomaly, consists of five malformations. There are the midline abdominal wall defect, the defect of sterna lower part, an agenesis of the anterior part of the diaphragm, an absence of the diaphragmatic pericardium, and the congenital intracardiac problem. We diagnosed Cantrell's syndrome with left ventricular diverticulum in a female neonate with no perinatal problems. She experienced an one-staged operation and discharged with no complications. We report a case with brief review of the literature.
Abdominal Wall ; Diaphragm ; Diverticulum* ; Female ; Humans ; Infant, Newborn* ; Pericardium

The risk factors associated with neonatal scalp abscess include electrode insertion for fetal scalp monitoring, traumatic scalp lacerations, and sepsis or meningitis. We report a case of neonatal scalp abscess with extension to dura mater, although our patient had no known risk factors. A 18-day-old, full-term baby was referred to the our hospital to evaluate a swelling over his left occipital scalp. A full sepsis work-up was performed and all were negative. Cranial sonography revealed echogenic cystic mass with peripheral vascularity consistent with ruptured epidermoid cyst or scalp abscess. The computed tomography (CT) scan of head was performed because of possibility of ruptured epidermoid cyt and revealed 2.0x2.0 cm sized hyperattenuating mass with suspicious intracranial extension. The magnetic resonance imaging (MRI) of head revealed the presence of 1.4x1.1 cm sized peripheral rim enhancing mass at left occipital area consistent with scalp abscess. And also, the lesion was suspicious dural exposure at left temporal area. Clinicians should be aware that scalp abscess may occur without any risk factors and perform diagnostic workup including a complete sepsis evaluation, cerebrospinal fluid analysis (CSF), and cranial imaging study to screen for intracranial extension.
Abscess* ; Cerebrospinal Fluid ; Dura Mater* ; Electrodes ; Epidermal Cyst ; Head ; Humans ; Infant, Newborn* ; Lacerations ; Magnetic Resonance Imaging ; Meningitis ; Risk Factors ; Scalp* ; Sepsis

Galactosemia is a group of inherited enzyme deficiencies characterized by increase in the blood galactose levels. This condition may be associated with deficiencies of galactose-1-phosphate uridyl transferase, galactokinase, or uridine diphosphate galactose-4-epimerase. However, the elevated galactose identified by neonatal screening tests has several other possible etiologies, including hepatic hemangioendothelioma, hepatic hemangioma, and patent ductus venosus with hypoplasia of the portal vein. We report a 13-day-old Korean male with hepatic hemangioendothelioma, which was incidentally detected during the evaluation for suspected galactosemia. Laboratory studies revealed that mildly elevated levels of galactose, galactose-1-phosphate and alpha-fetoprotein, at the time of admission, were gradually decreased to the normal range over the 6 months of observation. Ultrasonography showed a well-defined heterogeneous hypoechoic mass in the liver, and magnetic resonance imaging study showed multiple enhanced mass lesions, which was compatible with the diagnosis of a hepatic hemangioendothelioma. Thus, hepatic imaging, especially ultrasonography, should be performed if neonatal screening suggests galactosemia.
alpha-Fetoproteins ; Galactokinase ; Galactose ; Galactosemias ; Galactosephosphates ; Hemangioendothelioma ; Hemangioma ; Humans ; Infant ; Infant, Newborn ; Liver ; Magnetic Resonance Imaging ; Male ; Neonatal Screening ; Portal Vein ; Reference Values ; UDPglucose-Hexose-1-Phosphate Uridylyltransferase ; Uridine Diphosphate ; Vascular Malformations

BACKGROUND & SIGNIFICANCE: Focal seizures are usually due to an underlying structural lesion of the brain but occasionally caused by metabolic disturbances such as nonketotic hyperglycemia (NKH). Reflex focal seizures associated with NKH have been reported. CASE: The 69 year-old man was admitted in our hospital due to clonic movements of the right leg. His seizures did not occur spontaneously but were provoked by active or passive movements and tactile stimulation of the affected leg. The convulsive movements of the right leg often spread to the left leg without involving any other parts of his body. The seizures regressed with the control of hyperglycemia only. COMMENT: We report a patient presented with reflex focal seizures as the initial manifest-ation of NKH.
Aged ; Brain ; Humans ; Hyperglycemia* ; Leg ; Reflex* ; Seizures*

Idiopathic intracranial hypertension, a syndrome of obscure origin, occurs particularly in fat adolescent girls and young women. The usual symptoms are headache, blurred vision, a vague dizziness, horizontal diplopia and transient visual obscurations etc., and ophthalmoscopic examination reveals papillederma, due to increased ICP. Visual field testing usually shows slight peripheral constrictions with enlargement of the blind sports. CSF pressure is elevated in the range of 250 to 450 mm of water. Radiological or the other laboratory tests show no specific abnormalities. Treatment for idiopathic intracranial hypertension is focused on early detection and prevention of vision loss, the only permanent morbidity. Many different modes of medical treatment, including weight reduction, repeated lumber puncture, corticosteroids, diuretics, glycerol or carbonic anhydrase inhibitors, have successfully been tried up to 90% of the patients. In the remaining patients, particularly in those with measurable impairment of vision that does not respond to conventinal medical therapies, surgical procedure should be considered. We report a case of idiopathic intracranial hypertension successfully treated with optic nerve sheath fenestration.
Adolescent ; Adrenal Cortex Hormones ; Carbonic Anhydrase Inhibitors ; Constriction ; Diplopia ; Diuretics ; Dizziness ; Female ; Glycerol ; Headache ; Humans ; Optic Nerve* ; Pseudotumor Cerebri* ; Punctures ; Sports ; Visual Field Tests ; Water ; Weight Loss

PURPOSE: Parenteral nutrition (PN)-associated cholestasis (PNAC) is one of the most common complications in very low birth weight infants (VLBWIs). The aim of this study is to evaluate the risk factors of PNAC in VBLWIs. METHODS: We retrospectively reviewed the medical records of 322 VLBWIs admitted to the neonatal intensive care unit of our hospital from July 1, 2009 to December 31, 2013. We excluded 72 dead infants; 6 infants were transferred to another hospital, and 57 infants were transferred to our hospital at 2 weeks after birth. The infants were divided into the cholestasis and the non-cholestasis groups. PNAC was defined as a direct bilirubin level of ≥2.0 mg/dL in infants administered with PN for ≥2 weeks. RESULTS: A total of 187 VLBWI were enrolled in this study; of these, 46 infants developed PNAC. Multivariate logistic regression analysis showed that the risk factors of PNAC in VLBWI were longer duration of antimicrobial use (odds ratio [OR] 4.49, 95% confidence interval [95% CI] 4.42-4.58), longer duration of PN (OR 2.68, 95% CI 2.41-3.00), long-term lack of enteral nutrition (OR 2.89, 95% CI 2.43-3.37), occurrence of necrotizing enterocolitis (OR 2.40, 95% CI 2.16-2.83), and gastrointestinal operation (OR 2.19, 95% CI 2.03-2.58). CONCLUSION: The results of this study suggest that shorter PN, aggressive enteral nutrition, and appropriate antimicrobial use are important strategies in preventing PNAC.
Bilirubin ; Cholestasis* ; Enteral Nutrition ; Enterocolitis, Necrotizing ; Humans ; Infant* ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Intensive Care, Neonatal ; Logistic Models ; Medical Records ; Parenteral Nutrition ; Parturition ; Retrospective Studies ; Risk Factors

Protein C exerts anticoagulatory effects by inactivating factor V and VII and stimulating fibrinolysis. Hereditary protein C-deficient individuals have an increased risk of venous thrombosis and thromboembolism at young age. To our knowledge, the deep cerebral venous thrombosis associated with protein C deficiency has not been reported in Korea. A 34-year-old man was admitted to our hospital because of sudden onset of headache with nausea, vomiting and ocular pain. He had suffered from recurrent deep vein thrombosis of the right lower extremity for one year. Brain MRI showed thrombosis of the straight and confluent sinuses and venous infarction of the right thalamus. The result of cerebral angiography corresponded to MRI findings. Protein C antigen concentration was decreased to 65% and its functional activity was 37%. Other coagulation test and routine blood examination was normal. The protein C level of his mother was low in both antigen and activity, but protein C levels of three siblings were normal in functional activity. We speculate that the etiology of the deep cerebral venous thrombosis in this patient is associated with protein C deficiency and suggest it is valuable to measure protein C level in patients with cerebral venous thrombosis.
Adult ; Brain ; Cerebral Angiography ; Factor V ; Fibrinolysis ; Headache ; Humans ; Infarction ; Korea ; Lower Extremity ; Magnetic Resonance Imaging ; Mothers ; Nausea ; Protein C Deficiency* ; Protein C* ; Siblings ; Thalamus ; Thromboembolism ; Thrombosis* ; Venous Thrombosis ; Vomiting

BACKGROUND: To establish effective preventive measures for hepatitis A virus (HAV) infection, a nationwide epidemiologic study on seroprevalence of anti-HAV and the disease prevalence is needed. The aim of this study was to analyze the recent sero-epidemiological changes of hepatitis A markers in Korea. METHODS: The results of 11,068 anti-HAV total and 32,360 anti-HAV IgM tests by electro-chemiluminescence immunoassay (ECLIA) that had been requested in recent four years (2005-2008) to a reference medical laboratory from 1,699 institutions nationwide were retrospectively analyzed according to the distribution of year, sex, and age groups. RESULTS: The overall positive rate of anti-HAV total was 62.8%. The overall positive rate of anti-HAV IgM was 11.0%, showing a significantly increasing trend by year: 7.7%, 10.9%, 8.9%, and 14.3% in 2005, 2006, 2007, and 2008, respectively (P<0.0001). The positive rate of anti-HAV IgM was higher in male than in female subjects (11.8% vs 10.0%, P<0.0001), and 81.8% (2,916/3,566) of the anti-HAV IgM positive results were observed in the age groups of 21-40 yr. The annual positive rates of anti-HAV total and anti-HAV IgM showed significantly decreasing and increasing trends, respectively, in the age groups of > or =21 yr. Conclusion: In accordance with a decreasing sero-positivity of anti-HAV total, the prevalence of acute hepatitis A virus infection has been considerably increased during the recent four years in the age groups of > or =21 yr. The results of this study could be used effectively as a basic data for establishing effective preventive measures for hepatitis A including vaccination in these susceptible age groups.
Adult ; Biological Markers/blood ; Chemiluminescent Measurements ; Enzyme-Linked Immunosorbent Assay ; Female ; Hepatitis A/*epidemiology ; Hepatitis A Antibodies/*blood ; Hepatitis A virus/*immunology ; Humans ; Immunoglobulin M/blood ; Male ; Middle Aged ; Republic of Korea/epidemiology ; Retrospective Studies ; Sex Factors ; Time Factors

The selection of either conventional mechanical ventilation or HFJV depends on the physical status of the patient,potential physioloic advantages and disadvantages, the requirements of the clinical situation and the capability of providing adequate oxygenation and ventilation. We have experienced that HFJV markedly improved the ventilatory status of a 52-year old male patient with severe respiratory failure due to flail chest and ruptured giant bulla refractory to conventional mechanical ventilatory support.
Anoxia* ; Flail Chest ; High-Frequency Jet Ventilation ; Humans ; Male ; Middle Aged ; Oxygen ; Respiration, Artificial* ; Respiratory Insufficiency ; Ventilation