PURPOSE: This study was performed to explore the effect of senior simulation on nurses' attitudes toward the elderly. METHOD: Twenty-seven nurses working in various settings such as acute hospitals, community health centers, geriatric hospitals, and clinics were recruited. Among them, 25 subjects completed the whole experimental protocol. Aging Semantic Differential Scaling was utilized to evaluate attitudes toward the elderly and 'Suit for Experiencing Being Aged' from the Sakamoto Model was provided for the experiment. Before and after the experiment subjects filled out questionnaires. RESULT: Attitude score before experiment was 4.36, which indicates neutral attitude. Objective attitude scores were not different significantly after experiment. However subjective statements indicated attitude changes in a positive way. CONCLUSION: Senior simulation can affect nurses' attitude toward elderly in subjective way. That is, nurses became more empathetic and understanding to elderly's physical limitations and felt more initiative nursing approach were needed in caring elderly.
Adult ; *Aged ; *Attitude of Health Personnel ; Female ; Humans ; Nurse-Patient Relations ; Nurses/*psychology ; *Patient Simulation

PURPOSE: To compare results between in femtosecond laser and microkeratome LASIK correction of myopia METHODS: We retrospectively analyzed the result of 94 eyes of 47 patients in the femtosecond group (F) and 103 eyes of 52 patients in the microkeratome group (M). All patients had undergone LASIK using either a femtosecond laser or a microkeratome for making of flap. Patients were divided into groups I (6D< or =) and II (> or =6D) according to preoperative myopia. Each patient was followed up for over 6 months with measurements of uncorrected visual acuity and manifest refraction at 1 week and 1, 3, and 6 months after operation. Complications during and after the operation were reviewed retrospectively in two groups 6month after the operation. RESULTS: In groups F-I, F-II, M-I, and M-II, postoperative 6-month uncorrected visual acuity was 0.98+/-0.08, 0.96+/-0.09, 0.97+/-0.03, 0.98+/-0.09. At the 6-month follow-up, there were no significant differences between the two groups in uncorrected visual acuity and mean spherical equivalent. Corneal opacity was found in 3 eyes in group M and complication related with flap was found 1 eye in group F and 4 eyes in group M. CONCLUSIONS: During a 6-month follow up, LASIK using either a femtosecond laser or a microkeratome has an similar effect in uncorrected visual acuity and mean spherical equivalent. Thus LASIK for using femtosecond laser can be used as an alternative procedure to correct myopia.
Corneal Opacity ; Follow-Up Studies ; Humans ; Keratomileusis, Laser In Situ* ; Myopia* ; Retrospective Studies ; Visual Acuity

PURPOSE: Recently, vancomycin-resistant enterococci (VRE) have become one of the major nosocomial pathogens in Korea. However, there have been few studies on the epidemiology of VRE colonization among neonates. In this study, we investigated the prevalence of VRE colonization, risk factors for VRE, and how to control the spread of VRE infection in the Neonatal Intensive Care Unit (NICU) of Pusan National University Hospital (PNUH). METHODS: We retrospectively reviewed medical records of 192 neonates who were admitted to the NICU of PNUH from March 2006 to March 2007. Surveillance cultures from rectal swabs for detecting VRE were obtained weekly during the study period. We analyzed the prevalence of VRE and various risk factors. RESULTS: The rate of VRE colonization among NICU patients was 25% (48/192). Thirty five of these VRE colonized patients were transferred to the NICU from other local hospitals. Compared with the non-VRE group, the risk factors associated with VRE colonization were lower birth weight, congenital heart disease, applied mechanical ventilation, use of a central venous catheter, chest tubing, a history of surgery, and use of antibiotics. CONCLUSION: VRE colonization among patients admitted to the NICU is rapidly increasing. Monitoring and managing premature neonates from the beginning of the birth process, avoiding many invasive procedures, avoiding antibiotics such as vancomycin and third generation cephalosporin are important for preventing the emergence and spread of VRE colonization in the NICU.
Anti-Bacterial Agents ; Birth Weight ; Central Venous Catheters ; Colon ; Heart Diseases ; Humans ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Korea ; Medical Records ; Parturition ; Prevalence ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Thorax ; Vancomycin ; Vancomycin Resistance

The cause of essential hypertension is yet unknown, but in general is caused by interaction of hereditary factors, diet, obesity, lack of exercise and stress. The aging process influences various physiological mechanism related to regulation of blood pressure. So elderly hypertensives have a tendancy to consider the disease as a result of the physiological aging process. This attitude causes many complications, worsening of the disease and even early death because of inappropriate care. In order to improve self-management of elderly hypertensives in this study the researcher examined the effect of blood pressure regulation by an education program that improves self-care behavior, through increasing self-efficacy. The education program consisted of group education on hypertension and self-care strategies, and encouraging and reinforcing self-efficacy resources such as verbal persuation, performance accomplishment and vicarious experiences. A quasi-experimental pre-and post-test design was used. Thirty-two elderly hypertensives participated in the study. Eighteen in the education group and fourteen in the control group. The education program consisted of eight sessions twice a week for four weeks. There was no intervention for the control group. Data were analysed using SPSS for Windows(Version 8.0). The results were as follows. 1. There was a significant decrease in systolic and diastolic blood pressure between the experimental group and control group over three different times, and interaction by groups and over time. 2. There was no significant difference in the level of self-care behavior between the experimental group and control group over three different times, and interaction by groups and over time. 3. There was significant difference in self-efficacy of experimental and control group, depending on the measuring period, but there was no difference between these groups on interaction by groups and over time. 4. There was positive correlation between self efficacy and self care behavior depending on the measuring period. There was negative correlation between diastolic blood pressure and self-care behavior on the posttest of the program, and between systolic blood pressure and self-care behavior on the follow-up test of the program. Findings indicate that this study will contribute to develop nursing strategies for the regulation of blood pressure for the elderly, which is easy for the elderly to learn as a nonpharmacologic approach.
Aged* ; Aging ; Blood Pressure* ; Diet ; Education* ; Follow-Up Studies ; Humans ; Hypertension ; Nursing ; Obesity ; Self Care* ; Self Efficacy

Though the occurrence of multiple primary malignant tumor is a rare finding but the reported cases of it has increased in recent years. We collected multiple primary cancer of different organ, tissue and the multicentric origin of bilaterally paired organs. This paper reports 6 cases of multiple primary malignant tumors which were experienced at Yeungnam university hospital in Taegu during the past 2 years with review of journals. The results were as follows. 1. The incidence of multiple primary cancer was 0.31% for 2 years (1987-1988). 2. The ratio between male and female was 1:1 and mean age of incidence was 54.1 years. 3. The ratio between synchronous and metachronous (interval more than 6 months) was 1:1. 4. The time interval between first and second cancer was average 2.7 years in metachronous cases. 5. The most frequent involved organ was stomach, breast and colon in order of frequency. 6. The incidence of familial cancer associations was found in one out of 6 cases. 7. The test of DNCB, multitest CMI and ratio of T4 to T8 were performed in 4 cases but there was no definitive evidence of abnormality. We concluded that every effort should be made to discover the presence of synchronous malignancies in the patients who are being treated for a known tumor, and also special care should be given to detect new metachronous lesions is required.
Breast ; Colon ; Daegu ; Dinitrochlorobenzene ; Female ; Humans ; Incidence ; Male ; Neoplasms, Second Primary ; Stomach

BACKGROUND: Postoperative admission to the surgical intensive care unit (S-ICU) is commonly planned to prevent and treat complications, unnecessary admission to the S-ICU increases medical costs and length of hospital stay. This study aimed evaluated outcome and the predictive factors for mortality in patients admitted to the S-ICU after abdominal surgery. METHODS: The 168 patients admitted to the S-ICU immediately after abdominal surgery were reviewed retrospectively from January to December 2011. RESULTS: The mortality rate of patients admitted to the S-ICU after abdominal surgery was 8.9% (15 of 168). Two preoperative factors (body mass index [BMI] < 18.5 kg/m2 [p < 0.001] and serum albumin < 3.0 g/dL [p = 0.018]), two operative factors (the need for transfusion [p = 0.008] or vasopressors [p = 0.013] during surgery), and three postoperative variables (mechanical ventilation immediately following surgery [p < 0.001], sequential organ failure assessment [p = 0.001] and SAPS II [p = 0.001] score) were associated with mortality in univariate analysis. After adjusting for age, gender, and SAPS II by a Cox regression, which revealed that BMI < 18.5 kg/m2 (p < 0.001, hazard ratio [HR] 9.690, 95% confidence interval [CI] 2.990-25.258) and the use of mechanical ventilation on admission to S-ICU (p < 0.001, HR 34.671, 95% CI 6.440-186.649) were independent prognostic factors. CONCLUSIONS: In patients in S-ICU after abdominal surgery, low BMI and postsurgical mechanical ventilation should be considered important predictors of mortality.
Abdomen* ; Body Mass Index ; Humans ; Critical Care ; Intensive Care Units ; Length of Stay ; Mortality ; Postoperative Complications ; Prognosis* ; Respiration, Artificial ; Retrospective Studies ; Serum Albumin ; Ventilation

Fetal bilateral renal agenesis is a lethal congenital anomaly. An early and reliable prenatal diagnosis is extremely important as it may offer options for pregnancy termination as early as possible. The criteria for the ultrasonographic diagnosis of bilateral renal agenesis are severe oligohydramnios, nonvisualization of the bladder, and the empty renal fossa. However, severe oligohydramnios makes it difficult to diagnose the disease because of poor sonographic resolution. We present two cases of bilateral renal agenesis, one is diagnosed by ultrasonography after amnioinfusion at 24 weeks gestation, the other is diagnosed postnatally after term delivery.
Diagnosis ; Female ; Oligohydramnios ; Pregnancy ; Prenatal Diagnosis ; Ultrasonography ; Urinary Bladder

Surgeries performed for patients with coronavirus disease 2019 (COVID-19) place the medical staff at very high risk of infection. We suggest recommendations for appropriate operation preparation, anesthetic management, and infection control for COVID-19 patients in operating rooms.Current Concepts: Surgeries must be performed in an airborne infection isolation room, such as a negative-pressure operating room. It is recommended that scheduled surgeries for COVID-19 patients be postponed to an acceptable extent, with the exception of emergency cases. Moreover, the number of medical staff participating in the surgery should be minimized. Medical staffs should practice proper hand hygiene and wear an appropriate level of personal protective equipment depending on the infection risk. While performing surgery and inducing anesthesia in COVID-19 patients, endotracheal intubation should be performed by trained anesthesiologists with a video laryngoscope, preferably using high-efficiency viral filters, which can prevent contamination in the anesthesia machine. Use of disposable equipment or COVID-19 patient-specific devices is recommended to prevent the spread of infection, but instruments that require sharing among multiple patients must be thoroughly cleaned and disinfected before their use for the next patient.Discussion and Conclusion: Medical staff performing surgeries for COVID-19 patients are at very high risk of infection. Therefore, the use of appropriate personal protective equipment, high-efficiency viral filters in breathing circuits during anesthesia, and disinfection of contaminated equipment after the operation are mandatory.

Surgeries performed for patients with coronavirus disease 2019 (COVID-19) place the medical staff at very high risk of infection. We suggest recommendations for appropriate operation preparation, anesthetic management, and infection control for COVID-19 patients in operating rooms.Current Concepts: Surgeries must be performed in an airborne infection isolation room, such as a negative-pressure operating room. It is recommended that scheduled surgeries for COVID-19 patients be postponed to an acceptable extent, with the exception of emergency cases. Moreover, the number of medical staff participating in the surgery should be minimized. Medical staffs should practice proper hand hygiene and wear an appropriate level of personal protective equipment depending on the infection risk. While performing surgery and inducing anesthesia in COVID-19 patients, endotracheal intubation should be performed by trained anesthesiologists with a video laryngoscope, preferably using high-efficiency viral filters, which can prevent contamination in the anesthesia machine. Use of disposable equipment or COVID-19 patient-specific devices is recommended to prevent the spread of infection, but instruments that require sharing among multiple patients must be thoroughly cleaned and disinfected before their use for the next patient.Discussion and Conclusion: Medical staff performing surgeries for COVID-19 patients are at very high risk of infection. Therefore, the use of appropriate personal protective equipment, high-efficiency viral filters in breathing circuits during anesthesia, and disinfection of contaminated equipment after the operation are mandatory.

For treatment of partially edentulous patients, a treatment using implant is widely used. Treatment method using implant are implant fixed prostheses and removable partial dentures, and for patients with severe bone resorption, removable implant overdenture with the effects of aesthetic and reducing cost can be used as treatment options. Specially, prosthesis with milled-bar and attachment has the effect of being splinted between implant fixtures, higher retention and stability than conventional removable partial denture. And it has the effect of improvement of aesthetic through lip support by denture base. In this case, the patient with severe alveolar bone resorption and partial edentulous maxilla and mandible was treated by implant-assisted removable partial denture using Milled-bar and ADD-TOC attachment. The esthetic was improved by removing the clasp because of effects of additional retention by using the attachment, and reducing palatal coverage of implant-assisted removable partial denture. The clinical results were satisfactory on the aspect of aesthetic and masticatory function.