Purpose: This study was done to analyze the experience of nurses working in comprehensive nursing care unit, which is an essential task for developing job instructions and guidelines for nurses. Methods: In total, 161 nurses from comprehensive nursing care units in Seoul, Korea were surveyed from October to November 2018. Differences in work experience according to general characteristics were analyzed by independent t-test. The work experience of the nurses was analyzed by ranking the average by category and item, and the correlation between variables was obtained using Pearson correlation coefficients. Results: Among the sub-categories of work experience, ‘Advance for Better Nursing’ had the highest rank, while the highest item was ‘Patient classification criteria suitable for the use in comprehensive nursing care units are needed’ (4.39±0.78). ‘Advance for Better Nursing’ was significantly correlated with ‘Distributed Difficulties of Nursing’ (r=.48, p<.001). Conclusion To improve the quality of comprehensive nursing care units in small and medium sized hospitals, job instructions and guidelines for comprehensive nursing care should be developed. Furthermore, a system should be implemented along with policies supporting comprehensive nursing care.

BACKGROUND: Atherosclerosis is a diffuse disease process that produce thickening of the vascular wall because of intimal deposition of lipid, fibrous tissue, and calcific material. Nowadays it is possible to evaluate atherosclerotic changes of carotid arteries accurately by developed noninvasive techniques such as ultrasonography. Left ventricular hypertrophy (LVH) is known to be an important risk factor for cardiovascular events in hypertension. The purpose of this study was to establish whether the carotid intimal - medial thickness (IMT) correlates with the severity of LVH. METHOD: We measured intimal-medial thickness (IMT) for 12 sites in carotid arteries (near and far walls in common carotid, bifurcation, and internal carotid arteries of both sides) by B-mode ultrasonography in both 38 normotensive and 72 hypertensive patients. Left ventricular measurements were made according to the recommendations of the American Society of Echocardiography. Left ventricular mass was derived from the formula described by Devereux et al. and each left ventricular mass value was indexed to body surface area. And then we have investigated whether hypertensive patients have significant changes of carotid IMT and IMT correlates with left ventricular mass index (LVMI). RESULTS: (1) Most hypertensive patients had diffuse thickening of the carotid artery and some had focal or multiple plaques. (2) In general, mean IMT was widest in the carotid bifurcation. (3) The mean IMT of all 12 segments increased about 40% in hypertensive patients compared with normal control group. (4) LVMI significantly correlates with IMT of carotid artery, especially bifurcation site and mean all 12 segments. CONCLUSION: The mean IMT may serve as a useful marker of the severity of atherosclerosis in hypertensive patients. The significant association between carotid IMT and LVMI suggests a simultaneous correlation of carotid atherosclerosis with left ventricular hypertrophy in hypertension.
Atherosclerosis ; Body Surface Area ; Carotid Arteries* ; Carotid Artery Diseases ; Carotid Artery, Internal ; Echocardiography ; Humans ; Hypertension ; Hypertrophy, Left Ventricular* ; Risk Factors ; Ultrasonography

BACKGROUND: Vascular lesions are the major cause of morbidity and mortality in hypertensive patients. However, the pathologic characteristics of gradually evolving, chronic hypertension have not been adequately studied and the mechanism by which hypertension accelerates atherosclerosis is still uncertain. This study was undertaken to invertigate the ultrastructural changes of the aorta and the effect of high cholesterol diet in spontaneously hypertensive rats(SHR). METHODS: Spontaneously hypertensive rats (n=80, male, 5 weeks old) and Wistar rats (n=40, male, 5 week old) were used. Forty SHR were fed with 2% cholestrol diete, while the remainder with control diet. Systolic blood pressure was measured weekly until 16 weeks after birth, and then biweekly until 40 weeks after birth. Transmission and scanning electron microscopy were used to evaluate ultrastrucural changes of the aorta. RESULTS: 1) The blood pressure of SHR rose stedily and progressively from the 5 weeks after birth and reached nearly 190mmHG at the 16 weeks after birth. 2) In SHR, the subendothelial component contained finely granular substances, abundant fibrillar collagen and elastin. Infiltration of the mononuclear blood leukocytes into the intima was frequently seen. 3) Endothelium from cholestrol-fed SHR did exhibit numerous pinocytotic vesicles and contained many cytoplasmic filaments. There were a number of large mononuclear lipid-filled cells in the intimal lesions. Blistering of the endothelial plasma membrane was also observed in high cholesterol diet-fed SHR. Later on, adhesion of platelets, febrin, and white blood cells as well as damage of intima shown as multiple small holes were more marked. 4) There was no significant difference in systoloic blood pressure between high cholesterol diet-fed and control diet-fed SHR. CONCLUSION: In the aorta of SHR, the most prominent change was an expansion of the subendothelial space and infiltration of the mononuclear leukocytes into the intima. The present study showed that the SHR was indeed a reliable model for the essential hypertension. In some SHR, high cholesterol diet could induce more pronounced vascular lesions, which were enhanced by hypertension.
Aorta* ; Atherosclerosis ; Blister ; Blood Pressure ; Cell Membrane ; Cholesterol* ; Cytoskeleton ; Diet* ; Elastin ; Endothelium ; Fibrillar Collagens ; Humans ; Hypertension ; Leukocytes ; Leukocytes, Mononuclear ; Male ; Microscopy, Electron ; Microscopy, Electron, Scanning ; Mortality ; Parturition ; Rats, Inbred SHR* ; Rats, Wistar

BACKGROUND/AIMS: Rapid urease tests are used commonly for the detection of H. pylori. These tests are inexpensive and can be done easily and rapidly in the endoscopy room. A new rapid urease test, Hp Kit test, was developed for the first time in Korea. The test kit has two wells for two biopsies taken from each gastric antrum and corpus. We performed this study to estimate the diagnostic usefulness of Hp Kit test for the detection of H. pylori. METHODS: In one hundred patients undergoing gastroscopy, biopsy specimens were taken for Hp Kit test, polymerase chain reaction, culture, and histologic examination (Warthin-Starry stain). The 13C-urea breath test was also performed. The results of Hp Kit test were read after 2 hours. RESULTS: The sensitivity, specificity, positive and negative predictive value of Hp Kit test to diagnose H. pylori infection were 90.0%, 97.5%, 98.2%, and 86.7%, respectively. The positive reactions in only one well were observed in 12.9% of true positives with Hp Kit test. The reaction times of the Hp Kit test were 35.2+/-21.4, 26.6+/-15.3, and 17.8+/-15.8 minutes (mean+/-S.D.) at grade 1, 2, and 3, respectively (r=-0.3, p<0.05), therefore the results were usually observed within 1 hour. CONCLUSIONS: Hp Kit test has a high sensitivity and specificity, and may be used as an alternative rapid urease test to diagnose H. pylori infection.
Biopsy ; Breath Tests ; Endoscopy ; Gastroscopy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Korea ; Polymerase Chain Reaction ; Pyloric Antrum ; Reaction Time ; Sensitivity and Specificity ; Urease

BACKGROUND: The glomerular filtration rate (GFR) is considered the best overall index for the level of renal function and is estimated commonly by the creatinine-based, Cockcroft-Gault (CG) equation or the Modification of Diet Disease Study (MDRD) equation indirectly. Recently, cystatin C has been reported as a new endogenous marker of GFR. To predict the decrease of renal function in the elderly, we measured standard GFR (EDTA-GFR) by (51)Cr- EDTA and attempted to compare the result with CG, MDRD, and cystatin C equation for accuracy. METHODS: Sixty-three elderly persons (28 men, 35 women:mean age 70, range 65-78) who underwent health screening, were measured for plasma creatinine, cystatin C and EDTA-GFR. RESULTS: The CG and MDRD equations performed better than the cystatin C equation with an accuracy of within 30% (68 and 67%, respectively, versus 37%) and 50% (98 and 94%, respectively, versus 72%) of EDTA-GFR. The coefficient of determination (R2) of each estimated equation was 0.08 (p=0.03) in CG, 0.06 (p=0.04) in MDRD, and 0.07 (p=0.04) in cystatin C equation. Analysis of ROC curves with EDTA-GFR 60 mL/min/1.73m2 showed that each estimated equation was inadequate for the diagnosis of chronic kidney disease (sensitivity and specificity, 73% and 65% in CG, and 68% and 65% in MDRD, respectively). CONCLUSION: In the elderly, CG or MDRD equation was more accurate than cystatin C equation. Nevertheless, problems remain in the assessment of GFR using these equations and caution is particularly necessary in the diagnosis of chronic kidney disease with calculated estimates of GFR<60 mL/ min/1.73m2 in the elderly.
Female ; Male ; Humans ; Sensitivity and Specificity

BACKGROUND: The glomerular filtration rate (GFR) is considered the best overall index for the level of renal function and is estimated commonly by the creatinine-based, Cockcroft-Gault (CG) equation or the Modification of Diet Disease Study (MDRD) equation indirectly. Recently, cystatin C has been reported as a new endogenous marker of GFR. To predict the decrease of renal function in the elderly, we measured standard GFR (EDTA-GFR) by (51)Cr- EDTA and attempted to compare the result with CG, MDRD, and cystatin C equation for accuracy. METHODS: Sixty-three elderly persons (28 men, 35 women:mean age 70, range 65-78) who underwent health screening, were measured for plasma creatinine, cystatin C and EDTA-GFR. RESULTS: The CG and MDRD equations performed better than the cystatin C equation with an accuracy of within 30% (68 and 67%, respectively, versus 37%) and 50% (98 and 94%, respectively, versus 72%) of EDTA-GFR. The coefficient of determination (R2) of each estimated equation was 0.08 (p=0.03) in CG, 0.06 (p=0.04) in MDRD, and 0.07 (p=0.04) in cystatin C equation. Analysis of ROC curves with EDTA-GFR 60 mL/min/1.73m2 showed that each estimated equation was inadequate for the diagnosis of chronic kidney disease (sensitivity and specificity, 73% and 65% in CG, and 68% and 65% in MDRD, respectively). CONCLUSION: In the elderly, CG or MDRD equation was more accurate than cystatin C equation. Nevertheless, problems remain in the assessment of GFR using these equations and caution is particularly necessary in the diagnosis of chronic kidney disease with calculated estimates of GFR<60 mL/ min/1.73m2 in the elderly.
Female ; Male ; Humans ; Sensitivity and Specificity

BACKGROUND/AIMS: Pronto Dry test, a new rapid urease test, is consisted of a dry filter paper containing urea and has been reported to have a more rapid reaction time than others. We performed this study to compare the accuracy of Pronto Dry test with the other conventional tests for detection of H. pylori. METHODS: One hundred patients underwent gastroscopy in our hospital for gastrointestinal symptoms. Biopsy specimens were taken for Pronto Dry test, polymerase chain reaction, culture, and histologic examination (Warthin-Starry stain). 13C-urea breath test was also performed. The results of Pronto Dry test were read after 1 hour. RESULTS: The sensitivity, specificity, positive and negative predictive value of Pronto Dry test to diagnose H. pylori infection were 90.0%, 100%, 100%, and 90.9%, respectively. The kappa statistic between H. pylori status and Pronto Dry test was 0.90, demonstrating an acceptable level of reliability. CONCLUSIONS: Pronto Dry test has a high sensitivity and specificity, and can be used as a rapid test to diagnose H. pylori infection.
Biopsy ; Breath Tests ; Diagnosis* ; Gastroscopy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Polymerase Chain Reaction ; Reaction Time ; Sensitivity and Specificity ; Urea ; Urease

BACKGROUND/AIMS: Pronto Dry test, a new rapid urease test, is consisted of a dry filter paper containing urea and has been reported to have a more rapid reaction time than others. We performed this study to compare the accuracy of Pronto Dry test with the other conventional tests for detection of H. pylori. METHODS: One hundred patients underwent gastroscopy in our hospital for gastrointestinal symptoms. Biopsy specimens were taken for Pronto Dry test, polymerase chain reaction, culture, and histologic examination (Warthin-Starry stain). 13C-urea breath test was also performed. The results of Pronto Dry test were read after 1 hour. RESULTS: The sensitivity, specificity, positive and negative predictive value of Pronto Dry test to diagnose H. pylori infection were 90.0%, 100%, 100%, and 90.9%, respectively. The kappa statistic between H. pylori status and Pronto Dry test was 0.90, demonstrating an acceptable level of reliability. CONCLUSIONS: Pronto Dry test has a high sensitivity and specificity, and can be used as a rapid test to diagnose H. pylori infection.
Biopsy ; Breath Tests ; Diagnosis* ; Gastroscopy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Polymerase Chain Reaction ; Reaction Time ; Sensitivity and Specificity ; Urea ; Urease

Hepatocellular carcinoma is one of the most common causes of death in Koreans. Most cases of hepatocellular carcinoma are beyond the stage of curative resection at the time of diagnosis due to extrahepatic metastasis as well as wide distribution of tumor in the liver. The lung is the most common site of extrahepatic metastasis but metastasis to gingiva is very rare in hepatocellular carcinoma. We report a case hepatecellular carcinoma with gingival methststasis in a 59 year old male patient.
Carcinoma, Hepatocellular/*secondary ; English Abstract ; Gingival Neoplasms/*secondary ; Human ; Liver Neoplasms/*pathology ; Male ; Middle Aged

Colonic lipomas represent mesenchymal origin tumors that are second most common benign colonic tumor after hyperplastic polyps and adenomatous polyps. The patho-genesis of them is not clear. Most patients are asymptomatic and the lesion is often detected incidentally at colonoscopy, operation, and autopsy. According to the size and the location of lipoma, it may cause intestinal obstruction, perforation, intussusception, and life-threatening bleeding. There have been many reports of small colonic lipomas removed by endoscopic resection. Giant lipoma which is greater than 2 cm in size has been associated with higher risk of perforation, thus it has been removed by surgery until now. We report a case of colonic giant lipoma inducing intussusception which could be removed by endoscopic resection.
Adenomatous Polyps ; Autopsy ; Colon* ; Colonoscopy ; Hemorrhage ; Humans ; Intestinal Obstruction ; Intussusception ; Lipoma* ; Polyps