PURPOSE: The objective of our study was to figure out costs of nursing services in ICU based on the PCS in order to determine an appropriate nursing fee schedule. METHOD: Data was collected from 2 hospitals from April 15-16 to April 22-23, 2003. The costs of nursing services in the ICU were analyzed by nursing time based on the nursing intensity. The inpatients in the ICU were classified by a PCS tool developed by the Korean Clinical Nurses Association(2000). RESULTS: The distribution of patients by PCS in the ICU ranged from class IV to Class VI. The higher PCS in ICU consumed more nursing time. As a result, the higher nursing intensity, the more the daily average nursing costs in the ICU. CONCLUSION: Our study provides evidence to refine the current nursing fee schedule that does not differentiate from the volume of nursing services based on nursing time. We strongly recommend that the current reimbursement system for nursing services should be applied not only to the general nursing units but also to the ICU or other special nursing units.
Costs and Cost Analysis ; *Fee Schedules ; Humans ; Inpatients/*classification ; Intensive Care Units/*economics ; Nursing Service, Hospital/*economics ; Prospective Payment System ; Time Factors

PURPOSE: The 2000-2001 measles epidemic resulted in more than 50,000 cases with the highest attack rate occuring in infants less than one year of age, indicating the necessity of measles immunization before 12 months of age when a measles outbreak occurs again. The study was conducted to measure maternal measles antibody in infants by plaque reduction neutralization test(PRN), for the first time in Korea, to assess the optimal age for measles vaccination before the first birthday, when necessary. METHODS: Sera were obtained from 95 infants younger than 12 months of age who were healthy or recovered from mild llnesses, and had not had measles vaccination, measles infection, or blood transfusion. Measles antibodies were measured by PRN. RESULTS: Geometric mean titers and seropositive rates of measles antibody measured by PRN were 879.7 mIU/mL(100.0%), 690.0 mIU/mL(83.3%), 182.7 mIU/mL(50.0%), 91.3 mIU/mL(50.0%), 32.2 mIU/ mL(0.0)%, 25.1 mIU/mL(0.0%), 18.1 mIU/mL(0.0%), 38.4 mIU/mL(25.0%), 27.1 mIU/mL(0.0%), 31.2 mIU/mL(0.0%), 54.3 mIU/mL(0.0%), and 27.1 mIU/mL(0.0%) from 0 to 11 months respectively. CONCLUSION: By PRN, which was used for the first time to measure the measles antibody in Korea, placentally transferred measles antibody was detected in all newborns tested and decreased reciprocally to the age of infants, leaving almost all infants older than four months seronegative. These results indicate that measles vaccination at six months of age or older, which is the current recommendation during the period of epidemic issued by the Korean Society of Pediatrics, should not cause the primary vaccine failure. It seems advisable to utilize PRN further in order to find the optimal schedule for measles vaccination to infants born to women who were vaccinated.
Antibodies* ; Appointments and Schedules ; Blood Transfusion ; Female ; Humans ; Immunization ; Infant* ; Infant, Newborn ; Korea ; Measles* ; Neutralization Tests* ; Pediatrics ; Vaccination

Epidermal cysts are common benign subcutaneous lesions that occur in or on the skin. It is not very difficult to diagnose subcutaneous epidermal cysts using ultrasound imaging because they exhibit typical sonographic features. However, the differential diagnosis can be confused when epidermal cysts are found in unusual sites. The authors report a case involving a 4-year-old girl who presented with an intramuscular epidermal cyst in the gluteus maximus muscle. Magnetic resonance imaging revealed characteristic internal features of the epidermal cyst, despite being in an uncommon site, and was very useful in the preoperative diagnosis.

PURPOSE: The purpose of this descriptive study was to investigate the pattern of physical restraints used in ICUs and to identify influencing factors of application and removal of restraints. METHOD: The subjects of this study were 90 restrained patients out of 215 patients over 6 years old who were admitted to 6 ICUs in SMC during a 2 weeks period. The data was collected through a questionnaire of characte-ristics, guidelines and nursing care of restraint uses. The data were analyzed by non-parametric statistic with the use of the SAS program. RESULTS: The restraints were applied to 31.4% of subjects. Mean time of physical restraint was 36.76 55.7 hours. There were significant difference with mean time and frequency according to duty shift. GCS, restless behavior and discomfort factors, medical devices, and life sustaining devices had significant relation with application of restraints. In addition, the mean time of restraints used were related significantly with GCS, restless behavior, and discomfort factors. CONCLUSION: The used of restraints were dependent on mainly the nurses' decision. Thus ICU nurses have to develop the guidelines to applying restraints and removal of restraints in regard to patients rights and ethics. Continuous monitoring and evaluation of application of the restraints is essential in professional nursing.
Child ; Ethics ; Humans ; Intensive Care Units ; Nursing ; Nursing Care ; Patient Rights ; Restraint, Physical* ; Surveys and Questionnaires

Endoscopic treatment for obesity, especially intragastric balloon insertion, is on the rise in Korea. From 2016 to 2019, we performed intragastric balloon placement for the treatment of obesity in 12 patients at a single tertiary center. One balloon was removed on the next day due to nausea and severe abdominal pain, and the remaining 11 patients were followed up for 6 months. Body weight reduction of 8.9±5.4 kg was achieved, and the body mass index was reduced by 3.3±2.0 kg/m2. Significant effects regarding total body weight loss and excess weight loss were noted. The effect of weight reduction was greatest within 1 month after the procedure. Low density lipoprotein cholesterol significantly decreased by 18.0±18.2 mg/dL, but there were no significant changes in blood pressure, fasting blood glucose, total cholesterol, triglyceride, and high density lipoprotein cholesterol. Common adverse events were nausea and epigastric pain, but no serious adverse events occurred. Further studies regarding the long-term effects of endoscopic treatment for obesity and the improvement of metabolic syndrome are needed.

Endoscopic treatment for obesity, especially intragastric balloon insertion, is on the rise in Korea. From 2016 to 2019, we performed intragastric balloon placement for the treatment of obesity in 12 patients at a single tertiary center. One balloon was removed on the next day due to nausea and severe abdominal pain, and the remaining 11 patients were followed up for 6 months. Body weight reduction of 8.9±5.4 kg was achieved, and the body mass index was reduced by 3.3±2.0 kg/m2. Significant effects regarding total body weight loss and excess weight loss were noted. The effect of weight reduction was greatest within 1 month after the procedure. Low density lipoprotein cholesterol significantly decreased by 18.0±18.2 mg/dL, but there were no significant changes in blood pressure, fasting blood glucose, total cholesterol, triglyceride, and high density lipoprotein cholesterol. Common adverse events were nausea and epigastric pain, but no serious adverse events occurred. Further studies regarding the long-term effects of endoscopic treatment for obesity and the improvement of metabolic syndrome are needed.

Bezoars, including phytobezoars, trichobezoars, and pharmacobezoars, are accumulations of undigested substances in the gastrointestinal tract. We report three cases of gastric bezoars. Case 1: An 86-year-old woman presented with a one-month history of abdominal pain and vomiting. Esophagogastroduodenoscopy revealed gastric bezoars; consumption of 2 L of cola daily for 2 weeks resulted in complete disappearance of the bezoars. Case 2: An asymptomatic 63-year-old woman underwent esophagogastroduodenoscopy, which revealed a gastric bezoar. Cola spraying and endoscopic lithotomy were ineffective; therefore, the patient underwent laparoscopic removal of the bezoar for management of small bowel obstruction secondary to the bezoar fragments. Case 3: A 6-year-old girl with a history of pica underwent two laparoscopic surgeries 10 months apart for recurrent trichobezoars. We report our treatment approach in three patients who presented with gastric bezoars.

Bezoars, including phytobezoars, trichobezoars, and pharmacobezoars, are accumulations of undigested substances in the gastrointestinal tract. We report three cases of gastric bezoars. Case 1: An 86-year-old woman presented with a one-month history of abdominal pain and vomiting. Esophagogastroduodenoscopy revealed gastric bezoars; consumption of 2 L of cola daily for 2 weeks resulted in complete disappearance of the bezoars. Case 2: An asymptomatic 63-year-old woman underwent esophagogastroduodenoscopy, which revealed a gastric bezoar. Cola spraying and endoscopic lithotomy were ineffective; therefore, the patient underwent laparoscopic removal of the bezoar for management of small bowel obstruction secondary to the bezoar fragments. Case 3: A 6-year-old girl with a history of pica underwent two laparoscopic surgeries 10 months apart for recurrent trichobezoars. We report our treatment approach in three patients who presented with gastric bezoars.

Bezoars, including phytobezoars, trichobezoars, and pharmacobezoars, are accumulations of undigested substances in the gastrointestinal tract. We report three cases of gastric bezoars. Case 1: An 86-year-old woman presented with a one-month history of abdominal pain and vomiting. Esophagogastroduodenoscopy revealed gastric bezoars; consumption of 2 L of cola daily for 2 weeks resulted in complete disappearance of the bezoars. Case 2: An asymptomatic 63-year-old woman underwent esophagogastroduodenoscopy, which revealed a gastric bezoar. Cola spraying and endoscopic lithotomy were ineffective; therefore, the patient underwent laparoscopic removal of the bezoar for management of small bowel obstruction secondary to the bezoar fragments. Case 3: A 6-year-old girl with a history of pica underwent two laparoscopic surgeries 10 months apart for recurrent trichobezoars. We report our treatment approach in three patients who presented with gastric bezoars.

Bezoars, including phytobezoars, trichobezoars, and pharmacobezoars, are accumulations of undigested substances in the gastrointestinal tract. We report three cases of gastric bezoars. Case 1: An 86-year-old woman presented with a one-month history of abdominal pain and vomiting. Esophagogastroduodenoscopy revealed gastric bezoars; consumption of 2 L of cola daily for 2 weeks resulted in complete disappearance of the bezoars. Case 2: An asymptomatic 63-year-old woman underwent esophagogastroduodenoscopy, which revealed a gastric bezoar. Cola spraying and endoscopic lithotomy were ineffective; therefore, the patient underwent laparoscopic removal of the bezoar for management of small bowel obstruction secondary to the bezoar fragments. Case 3: A 6-year-old girl with a history of pica underwent two laparoscopic surgeries 10 months apart for recurrent trichobezoars. We report our treatment approach in three patients who presented with gastric bezoars.