BACKGROUND: One of the problem in emergency room(ER) of university hospital is over-crowdedness that causes exhaustion of medical resources (personnel, device, space) and disturbes optimal treatment. METHODS: This is an evaluative research for the purpose of promoting efficient operation system in ER of university hospital. RESULTS: 1) In 387 visitors, mean age was 47.5 years, and male to female ratio 1.21:1. As the specialty in charge, 28.9%f them were internal medicine, 26.6%mergency medicine, 9.9%eurology, and 8.5%eurosurgery. 24%f visitors have come by ambulances. The patients stayed for average 16.1 hours. The admission rate of ER visitors was 33.4 %60.3 %returned home after some management. 2) The visitors had various causes without correlation between the severity of conditions and the choice of high level hospital ER. They perceived their situations emergent in 78.4% but after triage only 25.6%were classified emergent. 48.6%of the visitors were the patients of out-patient department of this hospital due to chronic diseases. 3) The patients were assessed within 9.5 minutes after arrival at ER by nurse and within 34 minutes by doctor. If they were in need of consultation to second/third department, they waited for 141.5/460 minutes respectively to see the doctor. They waited for 59.9/52.7 minutes to get routine laboratory sampling/radiologic examination respectively. 4) Every 2.3 new patients visited this ER per hour. Average 63.2 patients were taken over to next shirt of nurse duty, and 60%of them had chronic degenerative diseases. CONCLUSION: The causes of overcrowding in ER of the university hospital were (1) huge number of patients at out-patient department of the hospital, (2) shortage of beds compared to the number of patients waiting admission, (3) too many kinds of procedures performed in ER, (4) cooperation failure among doctors of different specialty, and (5) no definite criteria of admission/discharge into/from ER. To solve these problems, conversion of ER management policy from complete examination and treatment to more simple and rapid one is necessary.
Ambulances ; Chronic Disease ; Emergencies* ; Emergency Service, Hospital* ; Female ; Hospitals ; Humans ; Internal Medicine ; Male ; Outpatients ; Triage

No abstract available.
Family Practice* ; Humans

No abstract available.
Humans ; Male ; Nursing* ; Urinary Incontinence*

PURPOSE: This study was aimed at exploring the current status of graduate programs for an advanced practice nurse(APN) to recommend future directions of APN education. METHODS: A total of 142 students enrolled in seven APN specialty programs, 67 professors who were involved in APN education, and nine nurse administrators participated in the study. Data was collected by questionnaires and focus group interviews. RESULTS: The current definition of APN was found not to be specific enough to represent expected roles of APN in regards to knowledge, attitudes, roles, and skills. Standard curricula employed regardless of the area of APN specialty, lack of qualified clinical practice settings, as well as prepared instructors were found to be problematic. CONCLUSION: The following needs to be addressed: 1. redefining of APN roles, 2. tailoring specialty areas of APN, 3. consolidating educational programs, and 4. ensuring APN role models and faculty. Suggesting a CNS role in Korean APN, areas of APN should be rearranged toclarify their roles and educational programs need to be further developed to meet the expectations and quality of APNs. It is necessary to ensure APN's employment in the health care system by laws and policies to perform advanced nursing roles.
Adult ; Curriculum ; Education, Nursing, Continuing ; Education, Nursing, Graduate ; Educational Measurement ; Focus Groups ; Humans ; Interviews as Topic ; Middle Aged ; Nurse Clinicians/*education ; Nurse Practitioners/*education ; Nursing Evaluation Research ; Questionnaires ; Societies, Nursing ; Specialties, Nursing/*education

Renal artery stenosis is a rare cause of acute pulmonary edema. So-called flash pulmonary edema is associated with bilateral renal artery stenosis or stenosis in a single functioning kidney. Flash pulmonary edema has been recognized as an absolute indication for vascular intervention. A 33-year old man was admitted with acute shortness of breath. Renal angiography showed occlusion of the right renal artery. He underwent a right renal artery bypass graft. However, after the renal artery bypass graft, episodes of pulmonary edema recurred. A renal angiography showed complete obstruction of the right renal artery and bypass graft. The left renal angiography showed an intact renal artery and decreased kidney size.
Adult ; Angiography ; Constriction, Pathologic ; Dyspnea ; Humans ; Kidney ; Pulmonary Edema* ; Renal Artery Obstruction* ; Renal Artery* ; Transplants*

PURPOSE: This study was to analyze the trend of research on intervention for patients with metabolic syndrome. METHOD: Using Pubmed, Medline, and CINAHL search engines, a randomized controlled trial(RCT) researching titles such as "metabolic syndrome", "intervention", "lifestyle modification", or "community-based" were collected. A total of 16 researches were analyzed based on the guidelines of the National Cholesterol Education Program-Adult Treatment Panel(NCEP-ATP III). RESULTS: 1) The total period of the intervention was from 12 to 24 weeks, the frequency was 3 to 5 times per week, and the duration of each session was from 45 to 60 minutes. The types of intervention included exercise, diet, and medication. Among these types, diet was performed most frequently. 2) The outcomes of the intervention was measured with physical aspects such as anthropometric measures, body composition, or biological markers. No studies have evaluated psychosocial outcomes such as quality of life. 3) In terms of effectiveness of the intervention, anthropometric indicators, body composition, or serological markers showed positive effects, whereas results on endothelial or urine indicators were inconsistent. CONCLUSION: Methodological research developing comprehensive therapeutic lifestyle modification programs and intervention studies are needed for patients with metabolic syndrome. In addition, effects should be evaluated with multidimensional perspectives.
Humans ; Life Style ; Metabolic Syndrome X/*nursing ; *Nursing Methodology Research ; Randomized Controlled Trials as Topic ; Statistics, Nonparametric

Purpose: This study aims to describe and identify in-depth the breastfeeding experience of primiparas for more than one year using a phenomenological research method and to raise the understanding of the primiparas’ subjective experiences during the breastfeeding process to contribute to the improving and maintaining maternal and child health. Methods: This research was a phenomenological and qualitative study conducted on 5 primiparas who continued breastfeeding for more than 12 months. Data was collected through individual in-depth interviews from November 1, 2021 to March 20, 2022, and it was analyzed through the sixth stage of phenomenological research analysis presented by Colaizzi. Results: The study consisted of 10 theme clusters and 26 themes from meaningful statements about the breastfeeding success experiences of primiparas for more than one year. The 10 theme collections were "Planning breastfeeding during pregnancy," "Commitment to breastfeeding through information and education," "Challenges faced during breastfeeding," "Continuous hard work," "Continued conflict over breastfeeding amid confusion," "Connects with experts who lead the way," "Establishes one's own standards and direction," "Peace after hard work," "Solid and firm confidence," and "Deep-rooted beliefs brestfeeding serve as reminders." Conclusion It is expected that this study will help to understand the individual difficulties and problems experienced by primiparas during breastfeeding, the importance of breastfeeding education, the role of medical personnel in the early stage of childbirth, social and environmental support, and the importance of an active window for information exchange. By identifying these factors, this study can serve as basic data for nursing practice to promote successful breastfeeding.

BACKGROUND: The aim of this study was to evaluate antibiotic consumption by adult patients at a single university hospital in Korea between 2001 and 2012. METHODS: We used the 2004 World Health Organization Anatomical Therapeutic Chemical Classification System definition of defined daily doses (DDD) per 1,000 patient-days to calculate the annual antibiotic consumption for 18 antibiotic groups. Chi-square linear-by-linear analysis was performed to evaluate antibiotic consumption trends for each group. RESULTS: Average annual antibiotic consumption during 2001-2012 was 644.6 DDD/1,000 patient-days (standard deviation, 33.3 DDD/1,000 patient-days). Although no statistically significant change was observed during the study period, consumption of first- and second-generation cephalosporins, and aminoglycosides was significantly decreased, while that of beta-lactam/beta-lactamase inhibitors, fourth-generation cephalosporins, carbapenem, glycopeptide, linezolid, colistin, and quinolone increased significantly. CONCLUSION: The total amount of prescribed antibiotics did not change, but the use of broad-spectrum antibiotics increased during the study period.
Adult ; Aminoglycosides ; Anti-Bacterial Agents ; Cephalosporins ; Classification ; Colistin ; Hospitals, University ; Humans ; Korea ; World Health Organization ; Linezolid

BACKGROUND/OBJECTIVES: The root of Vitis amurensis Ruprecht, a sort of wild-growing grape, has been used in oriental medicine for treatment of skin ailments; however, its dermatological activity is not sufficiently understood. The aim of this study was to investigate tyrosinase inhibitory and anti-melanogenic activities of V. amurensis Ruprecht root methanol extract (VARM) in B16F10 mouse melanoma cells and to attempt to isolate and identify the active compound issued from VARM. MATERIALS/METHODS: Anti-melanogenic activity of VARM was analyzed in alpha-melanocyte stimulating hormone (MSH)-stimulated B16F10 cells through evaluation of antioxidative activity as well as inhibited tyrosinase activity and melanin contents compared with those of kojic acid and arbutin. After anti-melanogenic analysis of VARM, serial fractionation, nuclear magnetic resonance (NMR), and thin layer chromatorgraphy (TLC) were applied for identification of active compounds contained in VARM. RESULTS: VARM significantly inhibited oxidative stress and tyrosinase activity and attenuated alpha-MSH-induced melanin production in B16F10 cells. For isolation of active compounds, VARM was fractionated using a series of organic solvents, including dichloromethane (CH2Cl2), ethyl acetate (EtOAc), and n-butanol (n-BuOH). Among fractions showing anti-melanogenic activity, the CH2Cl2 fraction induced the most potent attenuation of melanogenesis without cytotoxicity and the major compound in the CH2Cl2 fraction was identified as betulinic acid. Betulinic acid isolated from the CH2Cl2 fraction of VARM significantly attenuated alpha-MSH-induced melanogenesis in a dose dependent manner, which was stronger than that of arbutin used as a positive control. CONCLUSIONS: These results indicate that VARM inhibits oxidative stress, tyrosinase activity, and alpha-MSH-induced melanogenesis in B16F10 cells, due primarily to the active compound, betulinic acid, in the CH2Cl2 fraction.
1-Butanol ; Animals ; Arbutin ; Magnetic Resonance Spectroscopy ; Medicine, East Asian Traditional ; Melanins ; Melanoma ; Methanol ; Methylene Chloride ; Mice ; Monophenol Monooxygenase ; Oxidative Stress ; Skin ; Solvents ; Vitis*

The association between aplastic crisis and human parvovirus (HPV) B19 infection is well described in patients with sickle cell anemia. This association has also been described, although much less frequently, in patients with hereditary spherocytosis (HS). However, most cases of aplastic crises in patients with HS and induced by HPV B19 have been reported in children or adolescents. In this paper, we describe an aplastic crisis induced by HPV B19 in an adult with HS. A 34-year-old female presented with presyncope, febrile sensation, and myalgia. The complete blood counts showed severe anemia. The peripheral blood smear revealed spherocytosis with reticulocytopenia and pancytopenia. The direct Coombs' test was negative; the osmotic fragility test was positive. In the bone marrow aspirates, a few giant pronormoblasts with deep blue cytoplasm, pseudopods, and intracellular inclusion bodies were observed. The patient was given eight units of packed red blood cells. HPV B19 infection was proven by the presence of IgM antibodies to HPV B19 and the detection of viral DNA using the PCR technique. To the best of our knowledge, this is the first report in Korea that describes an adult with aplastic crisis presenting initially with HS.
Adult ; Anemia, Aplastic/*etiology ; Female ; Humans ; Parvoviridae Infections/*complications/diagnosis ; Parvovirus B19, Human ; Spherocytosis, Hereditary/*diagnosis