PURPOSE: The aim of this study was to identify Russian inpatients' expectation and satisfaction with nursing service, and further, to analyze the relationship between these variables. METHODS: A structured questionnaire was used to survey for 81 Russian inpatients. The survey was conducted from January to June, 2014. RESULTS: Empathy and assurance significantly influenced nursing service expectation and satisfaction. Nursing service expectation was statistically significant for the number of visit to Korea, and nursing service satisfaction was statistically significant for gender, monthly income and primary care giver during hospitalization. Revisit intention was significantly different according to religion, medical department and primary care giver during hospitalization. There were positive correlations between nursing service expectation and satisfaction, and between nursing service satisfaction and intention to revisit the hospital. CONCLUSION: The results of this study show that the level satisfaction with nursing service influences Russian inpatients' intention continue using the hospital. Therefore, in order to increase the intention to revisit the hospital Korea hospital employees, especially nurses, need to develop nursing service strategies according to general characteristics, culture and nationality of foreign patients.
Empathy ; Ethnic Groups ; Hospitalization ; Humans ; Inpatients ; Intention* ; Korea ; Medical Tourism ; Nursing Services* ; Nursing* ; Patient Satisfaction ; Primary Health Care

STUDY DESIGN: Experimental investigation in vitro. OBJECTIVES: To evaluate the relationship between the degeneration of intervertebral disc cells, and low back pain induced by degeneration of intervertebral disc cells and increases in use of proinflammatory mediators via nicotine stimulation. SUMMARY OF LITERATURE REVIEW: Smoking is a leading cause of degeneration of intervertebral disc cells and low back pain. According to the existing literature, nicotine, one of the main ingredients in cigarettes, causes the degeneration of intervertebral disk cells including decrease of glycoprotein through generation of carboxy-hemoglobin, vasoconstriction, and disability of fibrinolysis and changes of metabolism of nucleus pulposus cells. MATERIALS AND METHODS: Annulus fibrosus of intervertebral disc and knee joint cartilage were collected from pigs; these cells were acquired by gradual enzyme decomposition. Using Trypan blue, concentration and survival rate of cells were examined; cells were inserted on alginate beads for tertiary cultivation. Nicotine was then applied at 0, 50, 100, 200 and 300 nM, respectively, and the samples were cultivated for three, six and nine days, respectively. After collecting culture fluid, it was measured for interleukin(IL)-1beta, IL-6 and IL-8 with the ELISA Test. DNA of cells used for cultivation was quantitated and the amount of the resulting proinflammatory mediator was normalized. The results were then compared with the result of same study on cartilage of porcine knee joints. RESULTS: For changes of the inflammatory mediator based on the concentration of nicotine, in nicotine stimulation with low concentration of 50 nM and the control group, there was no significant change, while transient increases of inflammatory mediator showed in nicotine stimulation with concentrations of 100, 200 nM, respectively. There was not a significant increase of IL-1beta observed in all nicotine stimulation groups; these were the same results in porcine cartilage study. The level of IL-6 in 200, 300 nM nicotine concentration showed significant increases, respectively. The level of IL-8 in high dose nicotine stimulation groups also showed significant increases of DNA on the sixth day. And in porcine cartilage study group, significant changes were observed in 200, 300 nM, but the absolute value was lower than that of annulus fibrous cells group. CONCLUSION: Inflammatory mediators such as IL-6 and IL-8 increased as the result of tertiary cultivation of annulus fibrosus cells of porcine intervertebral disk and nicotine stimulation. It is believed that the cells of the disc annulus are more sensitive than articular chondrocytes to nicotine stimulation. This may be the focus of future long-term studies effects of nicotine other inflammatory cytokines.
Cartilage ; Chondrocytes ; Cytokines ; DNA ; Enzyme-Linked Immunosorbent Assay ; Fibrinolysis ; Glycoproteins ; Interleukin-6 ; Interleukin-8 ; Intervertebral Disc* ; Knee Joint ; Low Back Pain ; Metabolism ; Nicotine* ; Smoke ; Smoking ; Survival Rate ; Swine ; Tobacco Products ; Trypan Blue ; Vasoconstriction

Purpose: The purpose of this study was to identify the factors relating to commitment to a plan for exercise in the breast cancer patient following a mastectomy and to examine the relationship between these factors. Methods: This study was a correlational research and the participants were 152 patients with breast cancer. Data were collected using a structured questionnaire from June to October, 2015. Results: The final regression model showed that income, experience of exercise and current exercise were significant predictors related to commitment to a plan for exercise in patients with breast cancer and explained for 65.9% of the variance in commitment to a plan for exercise. Conclusion The findings indicate that patients in breast cancer-oriented intervention programs have an enhancing experience of exercise. Current exercise should be provided for patients with breast cancer in order to promote health and quality of life.

OBJECTIVE: Whereas fusion with pedicle screw fixation has shown satisfactory clinical results, solid fusion has been reported to accelerate degenerative changes in adjacent unfused levels. The purpose of this study was to evaluate the effect of bone/ligament/bone integrity after subtotal or total laminectomies on the development of adjacent segment instability (ASI). The hypothesis that total laminectomy would increase ASI more than would subtotal laminectomy was analyzed. Material and METHODS: This is a retrospective study of 316 patients who were treated with posterior fusion and pedicle screw fixation between 1996 and 2001. After attempts to review all 316 patients and radiologic files, 36 patients who were diagnosed with ASI were carefully reviewed, including follow-up periods of 2-8 years. The medical records were carefully reviewed for recurrence of low back pain or neurologic symptoms after a period of postoperative relief, and the radiologic files were evaluated to determine instability. All patients had undergone single-level or multilevel instrumented posterior lumbar interbody fusion for intractable pain related to degenerative conditions of the spine. RESULTS: Patients over the age of 60 were at a higher risk of developing clinical ASI however,fusion length, level and gender were not associated with ASI. The ASI was noted to occur most commonly in the cranial segment prior to fusion. CONCLUSIONS: This study revealed more frequent ASI after total laminectomy than after subtotal laminectomy, especially in elderly patients. The ideal procedure will be one combining maximal canal and foraminal decompressions with minimal resection of bony structures and supporting ligaments.
Aged ; Follow-Up Studies ; Humans ; Laminectomy ; Ligaments ; Low Back Pain ; Medical Records ; Neurologic Manifestations ; Pain, Intractable ; Recurrence ; Retrospective Studies ; Spine

PURPOSE: To report a successful case of corneal ulcer caused by multidrug-resistant Pseudomonas aeruginosa using topical colistin in an immobilized patient who was hospitalized for a long period. CASE SUMMARY: An immobilized 58-year-old female who was admitted for a long stay due to cerebral aneurysm hemorrhage presented with left ocular discharge and hyperemia, and was referred to our clinic. The patient was treated at a local clinic with topical antibiotics, but showed no improvement. At initial visit, she had difficulty communicating with the medical team and taking ophthalmic examination, and she had severe chemosis and corneal infiltration, corneal opacity, and hypopyon on her left eye with a portable slit lamp. Gram staining, bacterial and fungal cultures, and an antibiotic sensitivity test were performed from a corneal scrape. The cultures revealed growth of Pseudomonas aeruginosa, which is resistant to all antibiotics except colistin. As soon as we were aware of the results of the antibiotic sensitivity test, she was treated with topical colistin 0.19% every 1 hour on her left eye, starting immediately. After 28 days of treatment, the infection was resolved except for the remaining corneal opacity. She had a persisted stable corneal lesion at 1-year-follow up after colistin treatment, which indicated no recurrence. CONCLUSIONS: Due to gait disturbance, the patient almost missed appropriate ophthalmic examination or treatment. However, as we started immediate topical colistin treatment, we report a successful therapy of corneal ulcer induced by multidrug-resistant Pseudomonas aeruginosa without severe complications, such as perforation.
Anti-Bacterial Agents ; Colistin* ; Corneal Opacity ; Corneal Ulcer ; Female ; Gait ; Hemorrhage ; Humans ; Hyperemia ; Intracranial Aneurysm ; Middle Aged ; Pseudomonas aeruginosa* ; Pseudomonas* ; Recurrence ; Slit Lamp ; Ulcer*

PURPOSE: This study analyzed the difference in survival time of patients with delirium according to sedative medication. METHODS: From January 2012 through December 2013, a retrospective cohort study was performed using the electronic medical records (EMR) of Pusan National University Hospital. Among 900 patients who died from cancer, we selected 240 who suffered delirium based on the EMR. The Nu-DESC delirium screening test was used to diagnose delirium. RESULTS: The median length of delirium period was five days. Delirium characteristics were dominated by inappropriate behaviors (35.0%). Sedatives were administered in 72.1% of the cases. The most frequently used sedative was haloperidol which was used in 59.6% of cases. The delirium period significantly differed by patients' age (F=3.96, P=0.021), cancer type (F=3.31, P=0.010), chemotherapy (t=−3.44 P=0.001). The average survival time was 16.85 days for the sedative medication group and 9.37 days for the non-medication group, which, however, was not significant (t=1.766, P=0.079). CONCLUSION: In this study, the use of sedatives did not affect patients' survival time. Thus, appropriate sedative medication can be positively recommended to comfort terminal cancer patients and their families.
Busan ; Cohort Studies* ; Delirium* ; Drug Therapy ; Electronic Health Records ; Haloperidol ; Humans ; Hypnotics and Sedatives ; Mass Screening ; Retrospective Studies* ; Survival Rate ; Terminally Ill*

Carcinoid tumors are low-grade malignant tumors arising from neuroendocrine cells. Primary renal carcinoid tumors are extremely rare, and only 56 cases have been reported in the literature. Because of the rarity of the lesion, its histogenesis and prognosis are unclear. Here we report a case of a primary renal carcinoid tumor in a 51-year-old man that was found incidentally in a medical examination and was treated by transperitoneal radical nephrectomy.
Carcinoid Tumor ; Humans ; Kidney ; Middle Aged ; Nephrectomy ; Neuroendocrine Cells ; Prognosis

Nesidioblastosis is a term that describes multifocal hyperplasia of all panereatic cell components and is characterized primarily by their disorganization and proliferation throughout the entire panaeas. Adult onset nesidioblastosis is an extremely rare entity associated with hypersecretion of insulin. The authors have recently experieneed a case of nesidioblastosis in an adult. A 41-year old man was admitted due to interrnittenr hypoglycemic symptoms, that had been relieved by carbohydrate ingestion. Hyperinsulinemic hypoglycemia was documented during prolonged fast. Under the presumptive diagnosis of insulinoma, abdominal CT, celiac angiogram and percutaneous transhepatic portal venous sampling were done but we could not find any definitive mass. Eight-five percent of the panacas was removed. Pathologic examination of the resected pancreas revealed irregularly sized islets and scattering of small endocrine cell clusters throughout the acinar tissue and ductuloinsular complex.
Adult ; Cellular Structures ; Congenital Hyperinsulinism ; Diagnosis ; Eating ; Endocrine Cells ; Humans ; Hyperplasia ; Hypoglycemia ; Insulin ; Insulinoma ; Nesidioblastosis ; Pancreas ; Tomography, X-Ray Computed

Aim of this study was to investigate if pancreatic polypeptide (PP) reduced the insulin action via the intra-pancreatic cholinergic nerves in the isolated rat pancreas. The pancreas was isolated from rats and perfused with intra-arterial infusion of modified Krebs-Henseleit solution containing 2.5 mM glucose at a flow rate of 1.2 ml/min. Simultaneous intra-arterial infusion of insulin (100 nM) resulted in potentiation of the pancreatic flow rate and amylase output which were stimulated by cholecystokinin (CCK, 14 pM). These potentiating actions of insulin on the CCK-stimulated pancreatic exocrine secretion were completely abolished by administration of rat PP. Vesamicol, a potent inhibitor of vesicular acetylcholine storage, and tetrodotoxin (TTX) also significantly reduced the combined actions of insulin and CCK. Administration of carbamylcholine, an acetylcholine agonist, completely restored the vesamicol-or TTX-induced inhibition of the potentiation between insulin and CCK. Also rat PP failed to attenuate the restoring effect of carbamylcholine. Electrical field stimulation (15-30 V, 2 msec and 8 Hz) resulted in a significant increase in the pancreatic flow rate and amylase output in voltage-dependent manner. Effects of electrical field stimulation were augmented by endogenous insulin. Rat PP also suppressed the pancreatic exocrine secretion stimulated by electrical field stimulation. These observations strongly suggest that PP inhibits the potentiating actions of insulin on CCK-stimulated pancreatic exocrine secretion by suppression of the intra-pancreatic cholinergic activity in the isolated rat pancreas.
Acetylcholine ; Amylases ; Animals ; Carbachol ; Cholecystokinin ; Cholinergic Agonists ; Glucose ; Infusions, Intra-Arterial ; Insulin ; Pancreas* ; Pancreatic Polypeptide* ; Rats* ; Tetrodotoxin