Community-based health management policies are needed considering societal aging. We aimed to develop a transitional care model (TCM) program for patients with pneumonia, asthma, and chronic obstructive pulmonary disease. First, we conducted in-depth interviews with patients who were hospitalized, released, and readmitted for those three conditions to identify issues with the current hospitalization/discharge system and post-discharge processes. Next, we developed a new TCM program suited to the realities of the current medical environment. Interviews revealed problems including inadequate awareness of disease and health management; insufficient information exchange between patients, caregivers, and primary medical institutions; and absence/low usage of community-based care services. The investigation applying the new TCM program to patients and following up on readmission rates and life satisfaction after discharge is ongoing. Reviewing these results and conducting further studies in the future will allow improvements to the model.

Pulmonary Fibrosis*

PURPOSE: The purpose of this study was to identify the death orientation of college student nurses and to evaluate the effectiveness in death orientation of a class on 'hospice care'. this was done by investigating the difference between the death orientation before and after the class. METHOD: The instrument used in this investigation was the death orientation scale developed by Thorson and Powell (1988). The subjects of the study were the 47 college student nurses in a 'hospice care' class. The research was carried out between March 2, 2001, when the class began, and June 21, 2001 when the class ended. The collected data were examined using arithmetic mean, percentage, t-test, ANOVA. RESULT: The results of the study are as follows: 1. The average death orientation score of the subjects before the class was 2.80. 2. There were a significant difference in the death orientation scores before and after the class (p<0.001). Before the class, 'hospice care', the students had an average score of 2,80. Their average score decreased to 2.55 after the class. Of 25 death orientation items on the scale, 14 items decreased significantly after the class as compared to before the class. 3. According to personal attributes (religion, the existence of religion, the experience of a death in recently) of subjects, there were no significant statistical differences in death orientation (p>0.05). CONCLUSION: This study showed that a class on hospice care was effective in changing the death orientation of student nurses.
Hospice Care* ; Hospices* ; Humans

One hundred and twenty-two strains of E. coli isolated from urinary tract infection were examined for antibiogram, transferability of trimethoprim (Tp) resistance, incompatibility with F group plasmid and southem hybridization with DHFR I, II, and III probe of Tp-resistant R plasmids. 1. Among 172 Gram negative bacilli isolated from urinary tract infection, 122 (70.9%) were E. coli and 75 strains of them were resistant to trimethoprim (Tp). Most of Tp-resistant isolates were also resistant to penicillins (ampicillin, carbenicillin, and ticarcillin), aminoglycosides (kanamycin and gentamicin), and sulfisoxazole but almost all strains were susceptible to cephalosporins. 2. Most of Tp-resistant strains and E. coli transconjugant derived from them showed multiple drug resistance and various antimicrobial resistance patterns. 3. Thirty-three Tp-resistant strains (45.2%) transferred 35 Tp-resistant plasmids to E. coli recipients but among them 6 transconjugants did not show retransfer of resistance and plasmid DNA were not detected in 2 transconjugants after resistance transfer. 4. Tp-resistant R plasmids ranged from 157 to 67 kb and 8 R plasmids were classified to incompatibilty group IncFI or IncFII ranging from 120 to 83 kb. Three and two R plasmids belonged to IncFII showed similar molecular weight, resistance pattern, and reaction site by southern hybridization with DHFR I probe. Twenty-five plasmids specifically responded on various EcoRI endonuclease fragments to DHFR I probe but not to DHFR II or DHFR III probe. These findings suggest that most of Tp- resistant R plasmids from urine isolates of E. coli were derived from various sources but some plasmids including IncFII R plasmids were probably originated from same or similar sources.
Aminoglycosides ; Carbenicillin ; Cephalosporins ; Deoxyribonuclease EcoRI ; DNA ; Drug Resistance, Multiple ; Escherichia coli* ; Escherichia* ; Microbial Sensitivity Tests ; Molecular Weight ; Penicillins ; Plasmids ; R Factors ; Sulfisoxazole ; Trimethoprim Resistance* ; Trimethoprim* ; Urinary Tract Infections

The purpose of this study was to propose a method for the effective management of toothbrush contamination. Toothbrush microbial contamination was analyzed according to the duration of toothbrush use, frequency of toothbrush use per day, and toothbrush storage location. We also analyzed the microbial reduction effect of vinegar, antimicrobial mouth rinse, bamboo salt, and baking soda, which are sterilization materials that can be easily used every day. We collected 45 toothbrushes from university dormitories from May to June 2018. To determine the degree of microbiological contamination with general bacteria, coliform bacteria, and Staphylococcus aureus, bristle samples were cultured at 36oC for 24 hours using 3M™ Petrifilm plates and then measured based on Petrifilm evaluation criteria. Toothbrush microorganisms were analyzed according to the duration of use, frequency of use per day, storage location, and effect of each sterilization material. General bacteria, coliforms, and S. aureus contamination increased with frequency and duration of use (p <0.05). In particular, S. aureus showed a statistically significant increase to 36.15 CFU/ml after 1 month, 504.23 CFU/ml after 2 months, and 2,386.67 CFU/ml after 3 months (p <0.05). We found that 1% vinegar was the most effective substance for reducing general bacteria, coliforms, and S. aureus. In addition, 1% antimicrobial mouth rinse solution applied for 5 minutes was the most effective in reducing S. aureus. It is crucial to recognize the importance of toothbrush care and store toothbrushes in a dry place and replace them periodically. We recommend use of vinegar and antimicrobial mouth rinse solution to disinfect toothbrushes. These should be applied as a 1% solution for at least 1 minute. Proper care of toothbrushes is important in maintaining oral health as well as overall health. Instructions on toothbrush care should be given when teaching children or adults how to brush teeth.
Acetic Acid ; Adult ; Bacteria ; Child ; Humans ; Methods ; Mouth ; Oral Health ; Oral Hygiene ; Sodium Bicarbonate ; Staphylococcus aureus ; Sterilization ; Tooth ; Toothbrushing

BACKGROUND/AIMS: Abdominal ultrasonography is useful for the detection and diagnosis of nonalcoholic fatty liver disease (NAFLD). The aims of this study were to establish a predictive model for the selection of subjects for abdominal ultrasonography for the diagnosis of NAFLD and to assess validity of the model. METHODS: The subjects included 901 people who visited the health examination center of the Busan Medical Center. We conducted multiple logistic regression analyses of potential risk factors to identify independent risk factors for NAFLD, and developed an index system. RESULTS: Four independent risk factors were identified. The index system was developed by assigning 1 clinical scoring point to approximately 0.7 logistic regression coefficients to each factor as follows: alanine aminotransferase/aspartate aminotransferase ratio >1.5 (odds ratio [OR], 2.22; 95% confidence interval [CI], 1.21-4.07; P=0.010), 1 point; gamma-glutamyl transpeptidase >50 (OR, 2.15; 95% CI, 1.13-4.07; P=0.019), 1 point; triglyceride >150 mg/dL (OR, 1.92; 95% CI, 1.14-3.24; P=0.015), 1 point; 23 kg/m2< or =BMI<25 kg/m2 (OR, 3.68; 95% CI, 2.05-6.63; P<0.001), 2 points; and BMI 25 kg/m2 (OR, 7.65; 95% CI, 4.29-13.62; P<0.001), 3 points. The area under the receiver operating characteristics curve was 0.797 (95% CI, 0.751-0.842), and when 3 points was used as a cut-off value, the sensitivity and specificity were 71.7% and 75.9%, respectively. CONCLUSIONS: NAFLD can be predicted through the clinical application of the index system established herein. If abdominal ultrasonography is used for high-risk patients, NAFLD will be diagnosed and managed in its early stage.
Adult ; Aged ; Alanine Transaminase/blood ; Area Under Curve ; Aspartate Aminotransferases/blood ; Body Mass Index ; Fatty Liver/*diagnosis/ultrasonography ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Predictive Value of Tests ; Risk Factors ; Sensitivity and Specificity ; Severity of Illness Index ; gamma-Glutamyltransferase/blood

Objective: Advanced cervical cancer is still difficult to treat and in the case of recurrent cancer, it is desirable to utilize personalized treatment rather than uniform treatment because the type of recurrence is different for each individual. Therefore, this study aimed to establish a patient-derived organoid (PDO) platform to determine the effects of chemotherapy, radiation therapy, and targeted therapy in cervical cancer. Methods: We established organoids from 4 patients with various types of cervical cancer. The histopathological and gene profiles of these organoid models were compared to determine their characteristics and the maintenance of the patient phenotype. Each type of organoid was also subjected to anticancer drug screening and radiation therapy to evaluate its sensitivity. Results: We established PDOs to recapitulate the main elements of the original patient tumors, including the DNA copy number and mutational profile. We selected 7 drugs that showed growth inhibition in cervical cancer organoids out of 171 using an Food and Drug Administration -approved drug library. Moreover, adenocarcinoma and large-cell neuroendocrine carcinoma showed resistance to radiation therapy. whereas squamous cell carcinoma and villoglandular carcinoma showed a significant response to radiotherapy. Conclusion Our results showed that patient-derived cervical cancer organoids can be used as a platform for drug and radiation sensitivity testing. These findings suggest that patient-derived cervical cancer organoids could be used as a personalized medicine platform and may provide the best treatment options for patients with various subtypes of cervical cancer.

Mesothelioma is a rare aggressive tumor arising from the mesothelial cell and regarded as universally fatal disease with average survival around 1 year. The incidence rate is varied from one to forty per million in different countries and increasing by the year. The most common site of tumor origin is the pleura and only 20% to 33% of mesothelioma arise from the peritoneum. There are increasing reports of malignant mesothelioma with forty to fifty fatal cases per year in Korea. Histological studies with immunohistochemical stain is helpful for the diagnosis of peritoneal mesothelioma and imaging modality alone is not sufficient for diagnosis, so it is difficult to confirm diagnosis. A 64-year-old male patient was admitted to the hospital with a palpable mass on abdomen. The 6x6 cm sized huge mass was seen on the body of stomach adjacent to the peritoneum. We report a case of malignant peritoneal mesothelioma without evident exposure to asbestos, of which direct invasion to the gastric mucosa was confirmed by endoscopic biopsy and immunohistochemical stain.
Gastric Mucosa/*pathology ; Humans ; Male ; Mesothelioma/*diagnosis/pathology ; Middle Aged ; Neoplasm Invasiveness ; Peritoneal Neoplasms/*diagnosis/pathology ; Stomach Neoplasms/*pathology/secondary ; Tomography, X-Ray Computed

BACKGROUND AND OBJECTIVES: Increased central arterial stiffness is an emerging risk factor for cardiovascular disease. Acute aerobic exercise reduces arterial stiffness, while acute resistance exercise may increase arterial stiffness, but this is not a universal finding. We tested whether an acute resistance exercise program was associated with an increase in arterial stiffness in healthy young men. SUBJECTS AND METHODS: Thirteen healthy subjects were studied under parallel experimental conditions on 2 separate days. The order of experiments was randomized between resistance exercise (8 resistance exercises at 60% of 1 repeated maximal) and sham control (seated rest in the exercise room). Carotid-femoral pulse wave velocity (PWV) and aortic augmentation index as indices of aortic stiffness were measured using applanation tonometry. Measurements were made at baseline before treatments, 20 minutes, and 40 minutes after treatments (resistance exercise and sham control). RESULTS: There was no difference in resting heart rate or in arterial stiffness between the two experimental conditions at baseline. At 20 minutes after resistance exercise, heart rate, carotid-femoral PWV and augmentation index@75(%) were significantly increased in the resistance exercise group compared with the sham control (p<0.05). Brachial blood pressure, central blood pressure and pulse pressure were not significantly increased after resistance exercise. CONCLUSION: An acute resistance exercise program can increase arterial stiffness in young healthy men. Further studies are needed to clarify the effects of long-term resistance training on arterial stiffness.
Blood Pressure ; Cardiovascular Diseases ; Collodion ; Exercise ; Heart Rate ; Humans ; Male ; Manometry ; Pulse Wave Analysis ; Resistance Training ; Risk Factors ; Salicylamides ; Vascular Stiffness

No abstract available.
Alzheimer Disease*