The incidence of inflammatory bowel disease (IBD) is increasing rapidly and extra-intestinal manifestations in IBD are also increasing. The prevalence of renal and urinary involvement in IBD ranges from 4–23%. Nephrolithiasis is the most common urinary complication in IBD patients. Parenchymal renal disease is rare but has been well documented and presents most commonly as glomerulonephritis or tubulointerstitial nephritis. The overall morbidity of IBD-related renal manifestations is significant. Therefore, a high index of clinical suspicion and optimal monitoring of the renal function are needed for the early diagnosis and prevention of IBD-related renal manifestations and complications.
Early Diagnosis ; Glomerulonephritis ; Humans ; Incidence ; Inflammatory Bowel Diseases ; Kidney ; Nephritis, Interstitial ; Nephrolithiasis ; Prevalence

The incidence of inflammatory bowel disease (IBD) is increasing rapidly and extra-intestinal manifestations in IBD are also increasing. The prevalence of renal and urinary involvement in IBD ranges from 4–23%. Nephrolithiasis is the most common urinary complication in IBD patients. Parenchymal renal disease is rare but has been well documented and presents most commonly as glomerulonephritis or tubulointerstitial nephritis. The overall morbidity of IBD-related renal manifestations is significant. Therefore, a high index of clinical suspicion and optimal monitoring of the renal function are needed for the early diagnosis and prevention of IBD-related renal manifestations and complications.
Early Diagnosis ; Glomerulonephritis ; Humans ; Incidence ; Inflammatory Bowel Diseases ; Kidney ; Nephritis, Interstitial ; Nephrolithiasis ; Prevalence

Purpose: This study examined the subjective frame of patient satisfaction in the comprehensive nursing care services and explored future directions by investigating subjective frame types. Methods: P-Samples were collected from 30 patients who underwent the comprehensive nursing care service. To enable a forced normal distribution, 31 Q-samples were classified on a 9-point scale considering the degree of agreement. The collected data were analyzed by principal component factor analysis and varimax rotation using the PQ method program. Results: The subjective frame of patient satisfaction with the comprehensive nursing care service was divided into four types. Considering the characteristics of each, the types were labeled as “the formation of relationships with the surroundings”, “autonomous decision-making”, “non-verbal empathy”, and “therapeutic support resources”. Each type can be classified into therapeutic relationship and therapeutic process categories. Conclusion This study revealed changes in expectations regarding new medical services and that the subjective frames that affect the formation of satisfaction are diverse. The study results are expected to be used as basic data to develop strategies for creating a therapeutic environment that improves patient satisfaction in the comprehensive nursing care service.

OBJECTIVES: Dialysis patients' nutritional indicators are quite subjective and complex and cannot be easily measured in clinical settings. Based on previous reports that total lymphocyte count (TLC) and subpopulation lymphocyte counts (SLCs) are associated with nutritional status in patients with dialysis, we designed this study to examine the relationships of the TLC and SLCs with clinical outcome and nutritional status in patients undergoing maintenance hemodialysis (HD) and peritoneal dialysis (PD). METHODS: In this prospective, observational study, we enrolled 66 patients (50 HD patients and 16 PD patients) receiving stable maintenance dialysis. We evaluated the baseline parameters of height; weight; TLC; SLCs expressing CD3, CD4, CD8 and CD19; CBC; iron profile (iron, TIBC, ferritin); BUN; Cr; Na; K; total CO2; Ca; P; iPTH; protein; albumin; total cholesterol; HDL; LDL; uric acid and CRP and calculated Onodera's prognostic nutritional index (OPNI) and the Geriatric Nutritional Risk Index (GNRI) at baseline and three months. To analyze differences in the TLC and SLCs between the HD group and the PD group, we performed an independent samples t-test. Logistic regression analysis was performed to predict malnutrition in dialysis patients. In addition, to analyze changes in TLC, SLCs expressing each marker (CD3, CD4, CD8 and CD19) and other nutritional markers, we performed general linear model (GLM)-repeated measures ANOVA. RESULTS: Mean age was 55.8 ± 12.7 years in HD paitents and 49.8 ± 14.5 years in PD patients. The duration of dialysis was 59.7 ± 52.9 months in HD patients and 66.1 ± 33.6 years in PD patients. Logistic regression analysis revealed that patients aged 60 years or older, women, and those whose CD19 SLCs were lower than 100 had a higher risk of developing malnutrition. In GLM-repeated measures ANOVA, CD19 SLCs were significantly higher in women and in patients with a shorter period of dialysis. CONCLUSIONS: Our results indicate that GNRI, OPNI, TLC and SLCs (especially CD19 count) may be significant nutritional markers in HD and PD patients.
Cholesterol ; Dialysis* ; Female ; Humans ; Iron ; Linear Models ; Logistic Models ; Lymphocyte Count* ; Lymphocytes* ; Malnutrition ; Nutrition Assessment ; Nutritional Status* ; Observational Study ; Peritoneal Dialysis ; Prospective Studies ; Renal Dialysis ; Uric Acid

Purpose: : This study aimed to understand and describe the nurses’ experiences caring for severe COVID-19 patients at isolation room with negative pressure in South Korea. Methods: : Data were collected through individual in-depth interviews from February 16 to March 31, 2021 with 11 nurses who had been caring for severe COVID-19 patients at isolation room. Verbatim transcripts were analyzed according to Colaizzi’s phenomenological analysis. Results: : As a result, 5 theme clusters were extracted about nurses’ experiences. The 5 theme clusters, “Adapting to unexpected adversity”, “Accepting unresonable and heavy work”, “Dulness and disconnection from the outside world”, “Changing in perception of new infectious diseases”, and “Pathetic isolated patients” emerged. Conclusion : The results of this study provided a deeper understanding of nurses struggling to care for COVID-19 severe patients. This study is expected to be useful in providing basic evidence for improving intensive care practices and for preparing policies in other infection disease situations.

Delayed breast reconstruction is challenging because it requires a large volume and symmetry, and the dual-pedicled deep inferior epigastric perforator (DIEP) flap is used with microvascular augmentation. However, candidate recipient vessels in patients who have undergone radiation therapy may be damaged, with uncertain patency. This report suggests a novel method, the dual-pedicled conjoined abdominal flap, in which a free DIEP flap is combined with a pedicled transverse rectus abdominis muscle (TRAM) flap. A 57-year-old female patient who had undergone modified radical mastectomy and radiotherapy 25 years previously was referred for breast reconstruction. A whole abdominal flap was needed, but supercharged anastomosis was very risky due to calcification and scarring of the internal mammary vessel. Therefore, the thoracodorsal vessels were anastomosed with a free left DIEP flap, which was combined with a right-pedicled TRAM flap. The reconstructed volume was sufficient, and the blood flow was intact. The patient presented a symmetric contour without any complications after 4 months. The dual-pedicled conjoined abdominal flap is reliable for delayed breast reconstruction that requires a large volume and skin replacement, especially in patients with radiation-injured recipient vessels. Even if microscopic anastomosis failure occurs, secondary rescue is made possible by the pedicled TRAM flap.

BACKGROUND: The purpose of this study was to assess the role of hypophosphatemia in major clinical outcomes of patients treated with low- or high-intensity continuous renal replacement therapy (CRRT). METHODS: We performed a retrospective analysis of data collected from 492 patients. We divided patients into two CRRT groups based on treatment intensity (greater than or equal to or less than 40 mL/kg/hour of effluent generation) and measured serum phosphate level daily during CRRT. RESULTS: We obtained a total of 1,440 phosphate measurements on days 0, 1, and 2 and identified 39 patients (7.9%), 74 patients (15.0%), and 114 patients (23.1%) with hypophosphatemia on each of these respective days. In patients treated with low-intensity CRRT, there were 23 episodes of hypophosphatemia/1,000 patient days, compared with 83 episodes/1,000 patient days in patients who received high-intensity CRRT (P < 0.01). Multiple Cox proportional hazards analysis showed that Acute Physiology and Chronic Health Evaluation (APACHE) III score, utilization of vasoactive drugs, and arterial pH on the second day of CRRT were significant predictors of mortality, while serum phosphate level was not a significant contributor to mortality. CONCLUSION: APACHE score, use of vasoactive drugs, and arterial pH on the second CRRT day were identified as significant predictors of mortality. Hypophosphatemia might not be a major risk factor of increased mortality in patients treated with CRRT.
Acute Kidney Injury* ; APACHE ; Critical Illness* ; Humans ; Hydrogen-Ion Concentration ; Hypophosphatemia* ; Mortality ; Renal Replacement Therapy* ; Retrospective Studies ; Risk Factors

PURPOSE: This article reports two cases of Boston (Dohlman-Doane) Type I Keratoprosthesis procedures that were performed for the first time in Korea. METHODS: Using the Boston Type I keratoprosthesis, we implanted ultimately these to two cases of corneal blinded patients. RESULTS: Two Boston (Dohlman-Doane) Type I Keratoprosthesis procedures were performed successfully. The first case had poor visual prognosis due to preexisting optic neuropathy and vitreous hemorrhage, but was showed better for cosmetic effect. The second case had maintained an uncorrected visual acuity of 0.1 at postoperative 3 months. CONCLUSIONS: We hope to perform additional procedures and long-term follow-ups to further evaluate this new surgical technique for stability and efficiency.
Follow-Up Studies ; Hope ; Humans ; Korea ; Optic Nerve Diseases ; Prognosis ; Visual Acuity ; Vitreous Hemorrhage

OBJECTIVES: The acute diarrhea is a common complaint among immunocompromised hosts, and may cause life threatening event. The infectious etiologies vary depending on virus, bacteria, and parasites. The most common etiology of acute gastroenteritis is known as enteric virus in Korea. But there are few studies about the infectious etiology of acute gastroenteritis in immunocompromised hosts. The aim of this study was to investigate the infectious etiologies of acute diarrhea in immunocompromised hosts. METHODS: Seventy three patients were enrolled prospectively in a university hospital from January 2013 to July 2014. Immunocompromised hosts included above 65-year-old people, patients with chronic diseases, solid organ or stem cell transplants, solid organ malignancies, hematologic malignancies, immunosuppressive or steroid taking patients. The clinical data were collected and stool samples collected during diarrhea were undergone laboratory analysis for enteric viruses and bacterial enteropathogens including Salmonella spp., Shigella spp., and Clostridium difficile. RESULTS: Fifty five patients were analyzed as follows : above 65 year-old people were 36 cases (66%), previous antibiotic usage was 22 cases (41.5%). 44 cases (81.1%) were admitted to general ward whereas 9 cases to ICU (17%). 41 cases (73.6%) were treated with antibiotics. Positive C. difficile toxin assays were 6 cases (11.9%). Other infectious etiologies were not found. CONCLUSIONS: C. difficile infection was more common infectious etiology while enteric viruses and other bacteria are not associated with acute diarrhea among immunocompromised hosts in this study. So C. difficile infection must be considered preferentially in immunocompromised hosts with acute diarrhea.
Aged ; Anti-Bacterial Agents ; Bacteria ; Chronic Disease ; Clostridium difficile ; Diarrhea* ; Gastroenteritis ; Hematologic Neoplasms ; Humans ; Immunocompromised Host* ; Korea ; Parasites ; Patients' Rooms ; Prospective Studies ; Salmonella ; Shigella ; Stem Cells

OBJECTIVES: This study aimed to investigate the correlation between oral health behaviors of workers by examining the oral health awareness and the need for oral health education. METHODS: After the institutional review board approval, we surveyed industrial workers in Seoul, Gwangju, Changwon, and Goksung, in Korea, from July 19 to August 29, 2016. The final questionnaires (287 in total) were assessed using the SPSS 24.0 software for Windows (SPSS Inc. Chicago, IL, USA). The data were analyzed using frequency analysis, average, standard deviation, t-test, and the Pearson's correlation coefficient. RESULTS: Through the response of “yes” for the question, “oral health education experience,” we can see the respondents have high level of interest (P<0.001). And through the response of “yes” for the question, “Periodic oral Examination” and “regular scaling” and “oral care product use” we can see the respondents have high level of interest (P<0.001) and high importance (P<0.001), there was a statistically significant difference. On analyzing the correlations between workers, there was positive correlation oral health ‘Interest’ and ‘Importance’ (r=0.598, P<0.001). Of the 287 participants, 80.1% indicated that they did not receive any previous oral health education, while 85.4% indicated a willingness to attend oral health education programs in the future. Of the 80.1% of participants with no prior oral health education, 60.0% indicated lack of oral health education because of few opportunities to participate in such programs. They most prefer “Oral Hygiene Management” 64.8% for education contents and choose “Direct-education by inviting Expert” as the best education method 75.6%. CONCLUSIONS: It is necessary to develop oral health education programs suitable for the industrial field characteristics for people in workplace, and to enhance and expand oral health education services in the workplace in order to maintain interest in oral health.
Education* ; Ethics Committees, Research ; Gwangju ; Gyeongsangnam-do ; Health Education ; Hygiene ; Korea ; Methods ; Oral Health* ; Seoul ; Surveys and Questionnaires