PURPOSE: The purpose of this study was to identify relationships between quality of sleep, symptom cluster, depression, environmental disorder, and quality of life among hospitalized cancer patients. METHODS: The subjects were 114 patients who underwent chemotherapy for colon cancer, gastric cancer, gynecologic cancer and breast cancer. They were recruited from the cancer center of a university hospital. Data were collected from August 4th to 30th, 2011. The questionnaires included the Korean sleep scale A (quality of sleep), MDASI-K (symptom cluster), the environmental sleep disturbing scale, Zung's depression scale, and the Korean version of EORTC QLQ-C30. The collected data was analyzed by t-test, ANOVA, multiple regression analysis using the SPSS 19.0 program. RESULTS: Functional QOL was negatively associated with symptom QOL (r=-.798, p<.001). Symptom cluster, depression, & spouse (46.3%) were the most powerful predictors for functional QOL (46.3%) and symptom QOL (53.4%). CONCLUSION: It is evident that oncology nurses need to evaluate two dimensions of quality of life for cancer patients, for example, functional and symptom QOL. We recommend nurses develop specific protocols for relieving physical symptoms and alleviating depression, and furthermore test the effectiveness of them.
Breast Neoplasms ; Colonic Neoplasms ; Depression ; Humans ; Quality of Life ; Spouses ; Stomach Neoplasms ; Surveys and Questionnaires

BACKGROUND: Nosocomial urinary tract infection (UTI) is the most frequent nosocomial infection and could be prevented through the intensive nosocomial infection control (NIC) or restricting the use of indwelling urinary catheter. The efficiency of the intensive NIC to prevent UTI for the patients with indwelling urinary catheter was investigated. METHODS: Study population consisted of 296 patients with indwelling urinary catheter in the intensive care unit (lCU) who didn't have UTI on admission. The incidence rates of nosocomial UTI were compared between 146 patients being provided with ordinary NIC from March 15 to July 31, 1995 (control group) and 150 patients being provided with intensive NIC from January 16 to October 31, 1996 (NIC group). RESULTS: There was significant decrease in the incidence of nosocomial UTI in the NIC group (35 UTI among 150 patients, 23.8%) than in me control group (68 UTI among 146 patients, 46.6%) (P<0.01). But there were no differences in age distribution, sex, admission route to the ICU and underlying diagnoses between two groups. Interval between insertion of urinary catheter and development of UTI was significantly prolonged in the NIC group (10.0 +/- 3.5 days) than in the control group(7.6 +/- 3.9 days) (p < 0.01) despite there were no differences in the duration of urinary catheterization in two groups. The most common organism isolated from the urine of the patients was Candida tropicalis in both groups and the other organisms were in the order of Enterococcus faecium, Pseudomonas putida, Staphylococcus epidermidis in the control group and in the order of Staphylococcus aureus, Acinetobacter baumannii, Enterococcus faecalis in the NIC group. Four of five Staphylococcus aureus isolated in NIC group were MRSA. CONCLUSION: This study result confirms the efficiency of intensive NIC fur decrease in the incidence of nosocomial UTI in patients with indwelling urinary catheter. But the incidence of nosocomial UTI should be decreased further through the continuous emphasis on NIC and it seems to be necessary to study the effect of each component of NIC with proper control of the risk factors for the development of nosocomial UTI in the future.
Acinetobacter baumannii ; Age Distribution ; Candida tropicalis ; Cross Infection* ; Diagnosis ; Enterococcus faecalis ; Enterococcus faecium ; Humans ; Incidence ; Intensive Care Units* ; Critical Care* ; Methicillin-Resistant Staphylococcus aureus ; Pseudomonas putida ; Risk Factors ; Staphylococcus aureus ; Staphylococcus epidermidis ; Urinary Catheterization ; Urinary Catheters ; Urinary Tract Infections* ; Urinary Tract*

Myotonic dystrophy is a multisystemic disorder inherited as an autosomal dominant trait. The characteristic clinical features include the presence of myotonia, atrophy of the muscles of the face and the sternocleidomastoids and numerous nonmusclar manifestations such as cataracts, frontal baldness, gonadal dysfunctions and cardiac abnormalities. We experienced one case of myotonic dystrophy with prolonged atrial flutter in 30-year-old male who was admitted because of palpitation. We present this case with reviewing literatures.
Adult ; Alopecia ; Atrial Flutter* ; Atrophy ; Cataract ; Gonads ; Humans ; Male ; Muscles ; Myotonia ; Myotonic Dystrophy*

BACKGROUND: Stunned myocardium may be mediated by intracellular Ca2+ overloading or oxygen derived-free radicals. Halothane and propofol have been shown to block Ca2+ channels. Propofol is also known to have antioxidant properties. The present study was aimed to investigate the effects of anesthetics on recovery of postischemic, reperfused myocardium in open-chest dogs. Incidence of ventricular arrhythmia upon ischemia and reperfusion was also determined. METHODS: Forty dogs were subjected to 15 min occlusion of left anterior descending coronary artery (LAD) followed by 3 hr reperfusion during halothane (n=10), fentanyl (n=12), or propofol plus fentanyl (n=11) anesthesia. Regional contractile function was assessed using percent systolic shortening (%SS), the preload recruitable stroke work slope (Mw), and peak systolic intramyocardial pressure (IMPs). Diastolic function was evaluated using time constant for isovolumic intramyocardial pressure decline of left ventricle (IMP-tau) and percent post-systolic shortening (%PSS). RESULTS: %SS in the halothane, fentanyl, and propofol-fentanyl groups was similar at 3 hours of reperfusion (58%, 60%, and 55% of baseline value, respectively). Moreover, Mw recovered to the baseline values in the early reperfusion period in all three groups. However, IMP-tau was significantly prolonged in the halothane group throughout the 3 hour reperfusion period, whereas it remained unchanged in the fentanyl and propofol-fentanyl groups. Coronary occlusion was associated with 9, 33, and 0% mortality rate due to ventricular fibrillation upon ischemia and reperfusion in the halothane, fentanyl, and propofol-fentanyl groups, respectively. CONCLUSION: These findings indicate that halothane, but not fentanyl and propofol- fentanyl, impairs myocardial relaxation, while recovery pattern of contractile function do not differ among three groups, and that halothane and propofol reduce reperfusion arrhythmia in the canine model of myocardial stunning.
Anesthesia* ; Anesthetics ; Animals ; Arrhythmias, Cardiac ; Coronary Occlusion ; Coronary Vessels ; Dogs* ; Fentanyl* ; Halothane* ; Heart Ventricles ; Incidence ; Ischemia ; Mortality ; Myocardial Stunning* ; Myocardium ; Oxygen ; Propofol ; Relaxation ; Reperfusion ; Stroke ; Ventricular Fibrillation

Objective: The present study aimed to assess the relationship between incidental abnormalities on thoracic computed tomography (CT) and mortality in a general screening population using a long-term follow-up analysis. Materials and Methods: We retrospectively collected the medical records and CT images of 840 participants (mean age ± standard deviation [SD], 58.5 ± 6.7 years; 564 male) who underwent thoracic CT at a single health promotion center between 2007 and 2010. Two thoracic radiologists independently reviewed all CT images and evaluated any incidental abnormalities (interstitial lung abnormality [ILA], emphysema, coronary artery calcification [CAC], aortic valve [AV] calcification, and pulmonary nodules). Kaplan–Meier analysis with log-rank and z-tests was performed to assess the relationship between incidental CT abnormalities and all-cause mortality in the subsequent follow-up. Cox proportional hazards regression was performed to further identify risk factors of all-cause mortality among the incidental CT abnormalities and clinical factors. Results: Among the 840 participants, 55 (6%), 171 (20%), 288 (34%), 396 (47%), and 97 (11%) had findings of ILA, emphysema, CAC, pulmonary nodule, and AV calcification, respectively, on initial CT. The participants were followed up for a mean period ± SD of 10.9 ± 1.4 years. All incidental CT abnormalities were associated with all-cause mortality in univariable analysis (p < 0.05). However, multivariable analysis further revealed fibrotic ILA as an independent risk factor for all-cause mortality (hazard ratio, 2.52 [95% confidence interval, 1.02–6.22], p = 0.046). ILA were also identified as an independent risk factor for lung cancer or respiratory disease-related deaths. Conclusion Incidental abnormalities on screening thoracic CT were associated with increased mortality during the long-term follow-up. Among incidental CT abnormalities, fibrotic ILA were independently associated with increased mortality. Appropriate management and surveillance may be required for patients with fibrotic ILA on thoracic CT obtained for general screening purposes.

BACKGROUND: Polymerase chain reaction (PCR) methods from direct specimen are widely used for the rapid and accurate detection of mycobacteria infection. In this study, we evaluated two domestically developed detection kits for Mycobacterium tuberculosis (MTB) and nontuberculous mycobacteria (NTM) using real-time PCR. METHODS: A total of 348 samples from patients with suspected tuberculosis were tested with real-time PCR over seven months. We performed real-time PCR using the recently developed Anyplex plus MTB/NTM Detection kit (Seegene) with the CFX 96TM Realtime PCR System (Bio-Rad Laboratories) and the conventional AdvanSure TB/NTM real-time PCR kit (LG Life Sciences) with the SLAN Real-time PCR detection system (LG Life Sciences) to evaluate their performance for detecting MTB and NTM. RESULTS: The two real-time PCR systems showed 96.8% concordance rate for MTB-positive, NTM-positive, and negative results. Based on culture results, the sensitivity and specificity for the detection of MTB using PCR were 71.0% and 94.9% for Anyplex plus, and 78.1% and 93.9% for AdvanSure, respectively. For the detection of NTM, the sensitivity and specificity were 33.3% and 98.4% for Anyplex plus, and 51.7% and 97.9% for AdvanSure. Both PCR systems showed high MTB positive results in bronchial washing and sputum samples. CONCLUSION: In detecting MTB and NTM, Anyplex plus MTB/NTM (Seegene) and AdvanSure TB/NTM real-time PCR (LG Life Sciences) showed high concordance rate with each other in all samples. Therefore both detection kits can be used as rapid and reliable detection tool for MTB.
Humans ; Mycobacterium tuberculosis* ; Nontuberculous Mycobacteria* ; Polymerase Chain Reaction ; Real-Time Polymerase Chain Reaction ; Sputum ; Tuberculosis

PURPOSE: A graft patency is influenced by various factors; the degree of preoperative ischemia, type of procedure, kinds of the conduit and the stati of inflow and outflow vessels. The aim of this study was to evaluate the patency rate according to the distal anastomosis level, kinds of conduit and the impact of runoff score. METHODS: Between August 1998 and August 2003, 141 lower extremity arterial bypass operations were performed. The runoff scores of the outflow arteries were graded according to the system proposed by the Ad Hoc Committee on Reporting Standards, SVS/ISCVS. The graft patency was determined by clinical examination, and ABI measurements, and with a Duplex scan if required, and assessed by a regular follow-up schedule. RESULTS: The primary patency rates according to the level of distal anastomosis at 1, 3 and 5 years were as follows; femoral artery (FA) 94.8, 87.1 and 87.1%, above-knee popliteal artery (AKPA) 83.7, 79.3 and 68.0%, below-knee popliteal artery (BKPA) 85.9, 64.4 and 42.9%, respectively, and the secondary patency rates; FA 95, 87.6 and 87.6%, AKPA 91.6, 68.3 and 38.6%, BKPA 83.8, 69.9 and 46.6%, respectively. The patency rates of below-knee popliteal bypass showed no statistical difference between each conduit, but showed a tendency to increase in the order: PTFE, vein patch and vein graft. No significant difference in the patency rate was shown except between a runoff score of 1 and above 1 at each level. CONCLUSION: The patency rates for the relatively proximal site of the distal anastomosis were superior to those of the distal site. The choice of conduit influenced the patency of infrapopliteal bypass grafts. The patent outflow vessels and the autogenous vein graft at infrapopliteal artery were more favorable for good graft patency. The recommended runoff score system seems to be revision in order to improve the predictability of a graft patency.
Appointments and Schedules ; Arteries ; Femoral Artery ; Follow-Up Studies ; Ischemia ; Lower Extremity* ; Polytetrafluoroethylene ; Popliteal Artery ; Transplants* ; Veins

We tried to develop itemized evaluation criteria and a clinical rater qualification system through rating training of inter-rater consistency for experienced clinical dental hygienists and dental hygiene clinical educators. A total of 15 clinical dental hygienists with 1-year careers participated as clinical examination candidates, while 5 dental hygienists with 3-year educations and clinical careers or longer participated as clinical raters. They all took the clinical examination as examinees. The results were compared, and the consistency of competence was measured. The comparison of clinical competence between candidates and clinical raters showed that the candidate group's mean clinical competence ranged from 2.96 to 3.55 on a 5-point system in a total of 3 instruments (Probe, Explorer, Curet), while the clinical rater group's mean clinical competence ranged from 4.05 to 4.29. There was a higher inter-rater consistency after education of raters in the following 4 items: Probe, Explorer, Curet, and insertion on distal surface. The mean score distribution of clinical raters ranged from 75% to 100%, which was more uniform in the competence to detect an artificial calculus than that of candidates (25% to 100%). According to the above results, there was a necessity in the operating clinical rater qualification system for comprehensive dental hygiene clinicians. Furthermore, in order to execute the clinical rater qualification system, it will be necessary to keep conducting a series of studies on educational content, time, frequency, and educator level.
Calculi ; Clinical Competence ; Dental Hygienists ; Education ; Humans ; Mental Competency ; Oral Hygiene*

Subclavian steal syndrome is understood to be an occlusion or stenosis of the subclavian artery proximal to the origin of the vertebral artery with a retrograde flow of blood through the ipsilateral vertebral artery. It is characterized most prominently and most consistently by unequal blood pressures of both arms. In this case, we found incidentally unequal arm pressures during emergence. After the surgery, the 95% stenosis of left anterior descending coronary artery and total occlusion of subclavian artery was proved angiographically. This patient had the risk factors of atherosclerosis such as male, DM, hypertension, smoking and hyperlipidemia. In conclusion, pressures should be taken from both arms during initial visit, when the patient has the risk factors of atherosclerosis.
Arm* ; Atherosclerosis ; Constriction, Pathologic ; Coronary Vessels ; Humans ; Hyperlipidemias ; Hypertension ; Male ; Risk Factors ; Smoke ; Smoking ; Subclavian Artery ; Subclavian Steal Syndrome* ; Vertebral Artery

PURPOSE: Studies on cytomegalovirus (CMV) infections in immunocompetent children are lacking, and minimal information is available in the medical literature on hepatic manifestations and complications of CMV. The aims of this study were to evaluate the clinical characteristics, laboratory data, and prognosis of children with CMV hepatitis, and to investigate its prevalence at a single medical center in Korea over a 10-year period. METHODS: One hundred thirty-two children diagnosed with CMV infection based on specific markers (anti-CMV IgM, CMV polymerase chain reaction in blood and urine, or CMV culture of urine) were included in the study. Clinical and biochemical characteristics, immunological markers, and outcomes of hepatic CMV infection were determined. RESULTS: The median age of patients (n=132) was 8.5 months (range, 14 days–11.3 years). Peak total bilirubin and alanine aminotransferase levels in serum ranged from 0.11–21.97 mg/dL, and 5–1,517 IU/L, respectively. Alanine aminotransferase remained elevated from 2–48 weeks. Jaundice was the most common clinical feature of hepatic CMV infection during infancy. The hematologic findings revealed anemia, leukocytosis, and monocytosis in CMV-infected patients. All participants recovered without administration of ganciclovir. CONCLUSION: In children with CMV hepatitis, fever was the most common symptom at presentation, and jaundice was the most common clinical feature of hepatic CMV infection in infants younger than 3 months of age. Hepatic CMV infection in immunocompetent children is often a self-limited illness that does not require antiviral therapy, as most patients in this study had favorable outcomes.
Alanine Transaminase ; Anemia ; Bilirubin ; Child* ; Cytomegalovirus Infections* ; Cytomegalovirus* ; Epidemiology ; Fever ; Ganciclovir ; Hepatitis ; Humans ; Immunoglobulin M ; Infant ; Jaundice ; Korea* ; Leukocytosis ; Polymerase Chain Reaction ; Prevalence ; Prognosis*