PURPOSE: This study aimed to test the mediating effect of uncertainty appraisal and coping style in the relation between uncertainty and anxiety in hospitalized pregnant women diagnosed with preterm labor. METHODS: The participants were 105 pregnant women diagnosed with preterm labor in hospitals in Korea. Data were collected from July to October 2017. The measurements included the Uncertainty in Illness Scale, Uncertainty Appraisal Scale, Coping Style Scale, and State Anxiety Inventory. Data were analyzed using descriptive statistics, an independent t-test, correlation, and multiple regression following the Baron and Kenny method and Sobel test for mediation. RESULTS: The mean score for anxiety was 2.29 out of 4.00 points and for uncertainty it was 2.46 out of 5.00 points. There were significant correlations among uncertainty, uncertainty danger appraisal, uncertainty opportunity appraisal, problem-focused coping, emotion-focused coping, and anxiety. Uncertainty danger appraisal (β=.64, p < .001) had a complete mediating effect in the relation between uncertainty and anxiety (Z=4.54, p < .001). Uncertainty opportunity appraisal (β=−.45, p < .001) had a complete mediating effect in the relation between uncertainty and anxiety (Z=3.28, p < .001). Emotion-focused coping (β=−.23, p=.021) had a partial mediating effect in the relation between uncertainty and anxiety (Z=2.02, p=.044). CONCLUSION: Nursing intervention programs focusing on managing uncertainty appraisal and improving emotion-focused coping are highly recommended to decrease anxiety in hospitalized pregnant women diagnosed with preterm labor.
Anxiety* ; Female ; Humans ; Korea ; Methods ; Negotiating* ; Nursing ; Obstetric Labor, Premature* ; Pregnancy ; Pregnant Women* ; Uncertainty*

Non-ketotic hyperglycemia (NKH) is often related to various types of epileptic seizures. However, aphasic seizures associated with NKH have been rarely reported. A 60-year-old diabetic woman was admitted with language disturbance. She presented recurrent motor aphasia and EEG demonstrated ictal rhythmic discharges initiated from left frontal lobe. The seizures disappeared after introduction of carbamazepine and successful control of serum glucose. She remained seizure-free for three months after discharge. We report a case of NKH, manifested by aphasic seizures.
Aphasia, Broca ; Carbamazepine ; Electroencephalography ; Epilepsy ; Female ; Frontal Lobe ; Glucose ; Humans ; Hyperglycemia ; Middle Aged ; Seizures

BACKGROUND: Lung transplantation is a life-saving procedure in patients with end-stage lung disease, and is increasingly performed in Korea. METHODS: We retrospectively evaluated the outcomes of patients who received a lung transplant at Asan Medical Center between January 2008 and December 2016. Thirteen of 54 patients experienced multiorgan transplantation; the remaining 41 who received only lung grafts were included. RESULTS: The mean age of the lung transplant recipients was 44.6 years; 27 were men and 14 were women. The most frequent reasons were idiopathic interstitial pneumonia (21 of 41 patients, 51.2%), interstitial lung disease (9 of 41, 22.0%), and bronchiolitis obliterans after bone marrow transplantation (7 of 41, 17.1%). The median waiting time was 47 days, and many patients received preoperative intensive care (27 of 41, 65.9%), ventilator support (26 of 41, 63.4%), or extracorporeal life support (19 of 41, 46.3%). All 41 patients received bilateral lung grafts. Ten deaths occurred (24.3%), including 5 cases of early mortality (12.2%) and 5 cases of late mortality (12.2%). The 1-, 3-, and 5-year survival rates were 78.9%, 74.2%, and 69.3%, respectively. CONCLUSION: Despite a high percentage of patients who required preoperative intensive care, the transplantation outcomes were acceptable.
Bone Marrow Transplantation ; Bronchiolitis Obliterans ; Chungcheongnam-do ; Critical Care ; Female ; Humans ; Idiopathic Interstitial Pneumonias ; Korea ; Lung Diseases ; Lung Diseases, Interstitial ; Lung Transplantation ; Lung ; Male ; Mortality ; Retrospective Studies ; Survival Rate ; Transplant Recipients ; Transplants ; Ventilators, Mechanical

BACKGROUND: Lung transplantation is a life-saving procedure in patients with end-stage lung disease, and is increasingly performed in Korea. METHODS: We retrospectively evaluated the outcomes of patients who received a lung transplant at Asan Medical Center between January 2008 and December 2016. Thirteen of 54 patients experienced multiorgan transplantation; the remaining 41 who received only lung grafts were included. RESULTS: The mean age of the lung transplant recipients was 44.6 years; 27 were men and 14 were women. The most frequent reasons were idiopathic interstitial pneumonia (21 of 41 patients, 51.2%), interstitial lung disease (9 of 41, 22.0%), and bronchiolitis obliterans after bone marrow transplantation (7 of 41, 17.1%). The median waiting time was 47 days, and many patients received preoperative intensive care (27 of 41, 65.9%), ventilator support (26 of 41, 63.4%), or extracorporeal life support (19 of 41, 46.3%). All 41 patients received bilateral lung grafts. Ten deaths occurred (24.3%), including 5 cases of early mortality (12.2%) and 5 cases of late mortality (12.2%). The 1-, 3-, and 5-year survival rates were 78.9%, 74.2%, and 69.3%, respectively. CONCLUSION Despite a high percentage of patients who required preoperative intensive care, the transplantation outcomes were acceptable.

Background/Aims: Detailed nationwide information regarding the recent status and time trends of kidney transplantation (KT) in South Korea is limited. Methods: We performed a nationwide, population-based cohort study using the national claims database of Korea. We included KT recipients from 2008 to 2016, and their demographic and clinical characteristics were collected. The prognostic outcome was graft failure consisted of patient death and death-censored graft failure (DCGF). Results: We studied 14,601 KT recipients with median follow-up duration of 3.96 years. The median age at the time of transplantation consistently increased from the past, and proportion of underlying diabetes mellitus prominently increased, reaching 35.6% in 2016. The preemptive KT accounted for approximately 30% of the total transplantation cases. The recipients showed a 10-year cumulative graft survival rate of 71.8%, consisting of 10-year DCGF free survival of 77.6% and patient survival of 92.8%. Age ≥ 20 and < 30 years, age ≥ 70 years, underlying history of diabetes, non-preemptive transplantation, and poor compliance on tacrolimus and mycophenolic acid were the significant risk factors associated with worse DCGF outcome. The economic cost of KT showed prominently increasing trends, reaching a total insured fee of > 60,000,000$ in 2016. However, the expansion was mainly burdened by the national insurance service but not by the patients. Conclusions In South Korea, the number of kidney transplantation in elderly or in patients with comorbidities has been increasing. Complex clinical factors were associated with medication compliance and patient prognosis.

BACKGROUND: Continuous renal replacement therapy (CRRT) is an important treatment modality for severe acute kidney injury. As such, the epidemiology of CRRT in Korea needs further investigation. METHODS: We conducted a nationwide, population-based study analyzing the claims data from National Health Insurance Service of Korea. All index intensive care unit admission cases of CRRT in government-designated tertiary referral hospitals in Korea from 2005 to 2016 were included. Patients with a history of renal replacement therapy or who were under 20 years old were not considered. In addition to baseline and treatment characteristics, patient outcomes, including all-cause mortality and renal survival rates, were investigated. We stratified the study patients according to 3-year time periods and major regions of the nation. RESULTS: We included 37,337 patients who received CRRT in Korea. The overall use of CRRT increased over time, and more than 80% of cases of acute renal replacement therapy were CRRT after 2014. Seoul was the region in which the majority of CRRT (45.0%) was performed. The clinical characteristics of CRRT patients were significantly different among time-intervals and regions. Both all-cause mortality and renal survival rates after CRRT were prominently improved in the recent time periods (P < 0.001). CONCLUSION: CRRT is a widely used treatment strategy for severe acute kidney injury in Korea. The prognosis of CRRT patients has improved compared to the past. This epidemiological study of CRRT in Korea revealed notable trends with regard to time period and geographic region.
Acute Kidney Injury ; Critical Care ; Dialysis ; Epidemiologic Studies ; Epidemiology* ; Humans ; Intensive Care Units ; Korea* ; Mortality ; National Health Programs* ; Prognosis ; Renal Replacement Therapy* ; Seoul ; Survival Rate ; Tertiary Care Centers

Infection with carbapenem-resistant Enterobacteriaceae (CRE) and other multidrug resistant bacteria has increased rapidly in Korea. The Korea Centers for Disease Control and Prevention reported 1,609 cases of CRE infection in the country in 2013. The risk factors for CRE infection include history of treatment with antibiotics such as cephalosporins or carbapenem, trauma, diabetes, cancer, and history of ventilator support. Herein, we report four cases of CRE infection seen during a 3-month period in our hospital in 2014. CRE infection is associated with a high mortality rate of 30% to 50%, even with combination antibiotic therapy. Prevention of CRE infection in hospital settings is fundamental to controlling its transmission. Key preventive measures include, contact precautions, hand hygiene, education of healthcare personnel, screening for CRE when indicated, and exercising discretion in prescribing carbapenem or cephalosporins.
Anti-Bacterial Agents ; Bacteria ; Centers for Disease Control and Prevention (U.S.) ; Cephalosporins ; Delivery of Health Care ; Drug Resistance, Bacterial ; Education ; Enterobacter cloacae ; Enterobacteriaceae ; Enterobacteriaceae Infections* ; Hand Hygiene ; Korea ; Mass Screening ; Mortality ; Risk Factors ; Ventilators, Mechanical

BACKGROUND: Over the past few decades, demographics information has changed significantly in patients with surgically resected lung cancer. Herein, we evaluated the recent trends in demographics, surgery, and prognosis of lung cancer surgery in Korea. METHODS: Patients with surgically resected primary lung cancer from 2002 to 2016 were retrospectively analyzed. Multivariable Cox regression analysis was conducted to identify prognostic factors for overall survival. The annual percent change (APC) and statistical significance were calculated using the Joinpoint software. RESULTS: A total of 7,495 patients were enrolled. Over the study period, the number of lung cancer surgeries continued to increase (P < 0.05). The proportion of women to total subjects has also increased (P < 0.05). The proportion of elderly patients (≥ 70 years) as well as those with tumors measuring 1–2 cm and 2–3 cm significantly increased in both genders (all P < 0.05). The proportion of patients with adenocarcinoma, video-assisted thoracic surgery, sublobar resection, and pathological stage I significantly increased (P < 0.05). The 5-year overall survival rate of lung cancer surgery increased from 61.1% in 2002–2006 to 72.1% in 2012–2016 (P < 0.001). The operative period was a significant prognostic factor in multivariable Cox analysis (P < 0.001). CONCLUSION: The mean age of patients with lung cancer surgery increased gradually, whereas tumor size reduced. Prognosis of lung cancer surgery improved with recent increases in the frequency of adenocarcinoma, video-assisted thoracic surgery, sublobar resection, and pathological stage I. The operation period itself was also an independent prognostic factor for overall survival.
Adenocarcinoma ; Aged ; Carcinoma, Non-Small-Cell Lung ; Demography ; Female ; Humans ; Korea ; Lung Neoplasms ; Lung ; Prognosis ; Republic of Korea ; Retrospective Studies ; Survival Rate ; Thoracic Surgery, Video-Assisted

Background: This retrospective study investigated the natural course of synchronous groundglass nodules (GGNs) that remained after curative resection for non-small-cell lung cancer (NSCLC). Methods: Prospectively collected retrospective data were reviewed concerning 2,276 patients who underwent curative resection for NSCLC between 2008 and 2017. High-resolution computed tomography or thin-section computed tomography data of 82 patients were included in the study. Growth in size was considered the most valuable outcome, and patients were grouped according to GGN size change. Patient demographic data (e.g., age, sex, and smoking history), perioperative data (e.g., GGN characteristics, histopathology and pathological stage of the resected tumours), and other medical history were evaluated in a risk factor analysis concerning GGN size change. Results: The median duration of follow-up was 36.0 months (interquartile range, 23.0–59.3 months). GGN size decreased in 6 patients (7.3%), was stationary in 43 patients (52.4%), and increased in 33 patients (40.2%). In univariate analysis, male sex, the GGN size on initial CT, part-solid GGN and smoking history (≥ 10 pack-years) were significant risk factors. Among them, multivariate analysis revealed that lager GGN size, part-solid GGN and smoking history were independent risk factors. Conclusion During follow-up, 40.2% of GGNs increased in size, emphasising that patients with larger GGNs, part-solid GGN or with a smoking history should be observed.

Background: This study aimed to assess the clinical relevance of the parsimonious Eurolung risk scoring system for predicting postoperative morbidity, mortality, and long-term survival in Korean patients with surgically resected non-small cell lung cancer. Methods: This retrospective analysis used the data of patients who underwent anatomical resection for non-small cell lung cancer between 2004 and 2018 at a single institution. The parsimonious aggregate Eurolung score was calculated for each patient. The Cox regression model was used to determine the ability of the Eurolung scoring system for predicting longterm outcomes. Results: Of the 7,278 patients in the study, cardiopulmonary complications and mortality occurred in 687 (9.4%) and 53 (0.7%) patients, respectively. The rate of cardiopulmonary complications and mortality gradually increased with the increase in the Eurolung risk scores (all P < 0.001). When risk scores were grouped into four categories, the Eurolung scoring system showed a stepwise deterioration of overall survival with the increase in risk scores, and this association was statistically significant (P < 0.001). Multivariate Cox analysis showed that the Eurolung scoring system, classified into four categories, was a significant prognostic factor of overall survival even after adjusting for covariates such as tumor histology and pathological stage (P < 0.001). Conclusion Stratification based on the parsimonious Eurolung scoring system showed good discriminatory ability for predicting postoperative morbidity, mortality, and long-term survival in South Korean patients with surgically resected non-small cell lung cancer. This might help clinicians to provide a detailed prognosis and decide the appropriate treatment option for high-risk patients with non-small cell lung cancer.