We report a case of hepatocellular carcinoma presented with severe hypoglycemia. Computerized tomography and ultrasonography revealed a massive bilateral tumor with portal vein thrombosis. The levels of IGF-I (113 ng/mL) and IGFBP- (815 ng/mL) measured in the plasma, were lower than normal range. There was strong immunoreactivity of IGF- and IGF-I in immunohistochemical stain of tumor cells.
Carcinoma, Hepatocellular* ; Carrier Proteins* ; Fibrinogen* ; Hypoglycemia* ; Insulin-Like Growth Factor Binding Proteins ; Insulin-Like Growth Factor I ; Plasma ; Reference Values ; Ultrasonography ; Venous Thrombosis

PURPOSE: This study was performed to examine if CT classification of renal blunt injury could aid in expectation of hemodynamic stability and clinical decision of whether to intervene surgically. MATERIALS AND METHODS: Over a 80-month period between July 1987 and March 1994, 41 patients were admitted to our hospital with the diagnosis of renal blunt injury. The renal blunt injuries were classified on Fedede's three-point scale CT classification methods :grade I, contusion, intrarenal hematoma, segmental infarction, and small subcapsular hematoma;grade II, complete or incomplete laceration, large subcapsular hematoma, and renal fracture;grade Ill, shattered kidney and renal pedicle injury. Hemodynamic stability, treatment method and clinical outcome of the patients with different CT grade were analyzed retrospectively. RESULTS: All 34 patients with grade I or II CT findings were hemodynamically stable and were successfully managed with conservative method. Among 7 patients with grade III CT findings, 6 patients were hemodynamically unstable. Out of the 6, One patient with grade IIIb or renal pedicle injury was expired before surgical intervention due to ischemic shock. Four patients were intervened surgically with one failure to thrive. The remaining one patient refused to be intervened surgically, and was discharged against medical advice. Only one out of 7 patients was hemodynamically stable and was managed conservatively. CONCLUSION: The patients with grade I or II CT findings are prone to be hemodynamically stable and to be managed with conservative method. But the patients with grade III CT findings are more likely to be hemodynamically unstable. Therefore patients with grade III CT findings should be closely monitored and be pre- pared for the possibility of immediate surgical intervention
Classification* ; Contusions ; Diagnosis ; Failure to Thrive ; Hematoma ; Hemodynamics ; Humans ; Infarction ; Kidney ; Lacerations ; Retrospective Studies ; Shock ; Wounds, Nonpenetrating

PURPOSE: The aim of this study was to investigate the influence of nurses' awareness of healthcare accreditation on their job stress and turnover intention. METHODS: Across-sectional correlation study design was used. Participants consisted of 143 nurses from two tertiary hospitals in Seoul and Gyunggido, South Korea. Data were collected in October 2016 using self-report questionnaires and analyzed using descriptive statistics, t-test, an ANOVA, Pearson's correlation coefficient, and multiple regression in SPSS/WIN 21.0. RESULTS: Awareness of health care accreditation correlated negatively with job stress (r=−63, p < .001) and turn over intention (r=−.50, p < .001). Awareness of health care accreditation was the factor that most influenced job stress, explaining 38% of the variance (F=23.10, p < .001). Awareness of health care accreditation and duty pattern were the factors that most influenced intention to leave, explaining 32% of the variance (F=10.35, p < .001). CONCLUSION: These findings suggest raising nurses' awareness of certification systems to reduce their job stress and turnover intentions. It will be necessary to provide support for the aggressive work nurses do and improve their work structure, highlighting the need for both manpower and institutional support. Accordingly, providing regular education programs and appropriate compensation schemes, by raising nurses' awareness of medical institutions' certification systems, is necessary.
Accreditation ; Certification ; Compensation and Redress ; Delivery of Health Care ; Education ; Intention ; Korea ; Personnel Turnover ; Seoul ; Statistics as Topic ; Tertiary Care Centers

PURPOSE: The aim of this study was to investigate the influence of nurses' awareness of healthcare accreditation on their job stress and turnover intention. METHODS: Across-sectional correlation study design was used. Participants consisted of 143 nurses from two tertiary hospitals in Seoul and Gyunggido, South Korea. Data were collected in October 2016 using self-report questionnaires and analyzed using descriptive statistics, t-test, an ANOVA, Pearson's correlation coefficient, and multiple regression in SPSS/WIN 21.0. RESULTS: Awareness of health care accreditation correlated negatively with job stress (r=−63, p < .001) and turn over intention (r=−.50, p < .001). Awareness of health care accreditation was the factor that most influenced job stress, explaining 38% of the variance (F=23.10, p < .001). Awareness of health care accreditation and duty pattern were the factors that most influenced intention to leave, explaining 32% of the variance (F=10.35, p < .001). CONCLUSION These findings suggest raising nurses' awareness of certification systems to reduce their job stress and turnover intentions. It will be necessary to provide support for the aggressive work nurses do and improve their work structure, highlighting the need for both manpower and institutional support. Accordingly, providing regular education programs and appropriate compensation schemes, by raising nurses' awareness of medical institutions' certification systems, is necessary.

During hemorrhagic shock, liver is susceptible to ischemia and decreased hepatic energy charge results in decreasing arterial ketone body ratio(AKBR). Reperfusion after hemorrhagic shock can greatly amplify the generation of toxic oxygen metabolites. As a result, the fluxes of these highly toxic metabolites can overwhelm the endogenous antioxident defense mechanisms and lead to tissue injury. In order to observe the effect of glutathione(GSH) on the AKBR in hemorrhagic shock, dogs(n=16) were anesthetized with 1% enflurane in 02. We pretreated glutathione (100 mg/kg) intravenously before hemorrhagic shock in glutathione (GSH) group (n=8). Shock was induced with bleeding and mean arterial pressure was maintained 50 mmHg for 30 minutes. Recovery from shock was done with transfusion of preserved blood and maintained for 30 minutes. We measured arterial ketone bodies and ketone body ratio before, during and after shock, and compared them to control group (n=8) which was not pretreated with glutathione. AKBR during and after hemorrhagic shock in GSH group (0.8 and 1.0) were higher than those in control group (0.5 and 0.8). Light microscopic examination of liver biopsy revealed less portal degeneration during and after hemorrhagic shock in GSH group than control group. Pharmacologic modulation of hepatocytic function with glutathione before hemorrhagic shock has shown some beneficial effect with protection of decreased AKBR and histological change during and after hemorrhagic shock.
Animals ; Arterial Pressure ; Biopsy ; Defense Mechanisms ; Dogs* ; Enflurane ; Glutathione* ; Hemorrhage ; Ischemia ; Ketone Bodies ; Liver ; Oxygen ; Reperfusion ; Shock ; Shock, Hemorrhagic*

BACKGROUND: Although good clinical effects have been reported, immunotherapy with house dust mite ( HDM ) antigen - autologous specific antibody complex ( IC - IT ) is not yet accepted as an effective immunomodulating tool in HDM allergic diseases. We aimed to prove the clinical effect of IC - IT in HDM sensitized respiratory allergic subjects. Method : Six HDM sensitized respiratory allergic subjects were enrolled. Autologous D. farinae specific IgG was purified with DEAE ion exchange and affinity chromatography. After one year of IC - IT treatment the clinical effects were analyzed with symptom scores, methacholine PC20, ELISA assay of D. farinae specific antibodies and intradermal skin reactivity. Result : The rhinitis symptom score significantly improved after a one - year administration of IC - IT ( 1.23 +/- 0.30 vs. 0.37 +/- 0.15, p< 0.05), but no significant differences were found in asthma symptom score, intradermal skin reactivity to D. farinae and ELISA optic absorbances of D. farinae specific IgE, IgG, and IgG subclasses. Methacholine PC20 values improved in all 6 patients who were administered with IC - IT ( 0.35 vs. 1.66 mg/ml, p< 0.05 ). CONCLUSION: IC - IT may be efficient for management of HDM atopic asthma. Further studies are needed before clinical application of IC - IT in house dust mite atopic subjects.
Antibodies ; Asthma ; Chromatography, Affinity ; Dermatophagoides farinae* ; Dust* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunoglobulin E ; Immunoglobulin G ; Immunotherapy* ; Ion Exchange ; Methacholine Chloride ; Pyroglyphidae* ; Rhinitis ; Skin

BACKGROUND: This study was designed to estabilish serum LDL cholesterol(LDL-C) and HDL cholestrol(HDL-C) levels in the Korean adult population and to identify the difference in sex, age, and living place and the incidence of high risk group and the affecting factors on the serum lipid levels. METHODS: The serum LDL-C and HDL-C distribution in the normal Korean abult population were studied in 5,278 cases(males 2,802 and females 2,476) in the age groups of 3rd to 8th decade. Data were collected from 33 institutes and hospitals throughout the country during the period of June 1989 to December 1990. The serum Lipid levels were examined in the state of fasting of at least 12 hours. Total cholesterol and triglyceride levels were measured by enzymatic assays and HDL-C levels were determined by precipitation methods. The level of LDL-C was determined indirectly using the formula by Friedwald [LDL-C=total cholesterol-(HDL-C+triglyceride/5)]. RESULTS: The mean level of LDL-C was 112.1mg/dl. Males had 110.0mg/dl and females had 114.5mg/dl without statistical significance between gender, but levels were significantly higher in the 4th decade in males and in the 6th, 7th and 8th decade in females. The LDL-C levels rose gradually with the increase of age. The peak level of LDL-C for the males was in the 7th decade and that for the females was in the 8th decade. The mean level of serum HDL-C was 45.1mg/dl. Males had 43.8mg/dl and females had 46.6mg/dl without statistical significance between gender, but levels were significantly higher in the 3rd, 4th, 5th and 6th decade in females. The incidence LDL-C level of > or = 160mg/dl was 10.0%. Males had 8.2% and females had 12.1% with significantly higher incidence in females, especially in 6th decade females. The incidence of LDL-C level of > or = 160mg/dl of big cities was 10.7% and that of smaller cities & towns was 8.8% with significantly higher incidence in big cities. But, there was no significant difference in gender between big cities and smaller cities & towns. The incidence of LDL-C level of > or = 160mg/dl was significantly higher in 7th decade males in big cities and that of big cities and smaller cities and smaller cities & towns was 15.9% and 5.2%, respectively. The incidence of HDL-C level of <35mg/dl was 17.4% Males had 20.0% and females had 14.5% with significantly higher incidence in males, especially in 4th decade males. The incidence of HDL-C level of <35mg/dl of smaller cities & towns was 19.8% and that of big cities was 16.2% with significantly higher incidence in smaller cities & towms. Males in smaller cities & towns had 23.1% and males in big cities had 18.1% with statistical higher in smaller cities & towns. But, there was no significant difference in females between big cities and smaller cities & towns. The incidence of HDL-C level of <35mg/dl was significantly higher in 4th and 6th decade males in smaller cities & towns and that of smaller cities & towns and big cities was 26.8%, 25.6% and 16.2%, 17.7%, repectively. The significantly positively related factors for serum LDL-C level were age, BMI, systolic blood pressure(SBP), location and occupation. And those for serum HDL-C level were SBP and family history and negatively related factor for HDL-C level were BMI, smoking, and exercise. CONCLUSION: This study can provide the basic date base for prevention and management of coronary heart disease among Korean population.
Academies and Institutes ; Adult* ; Cholesterol ; Cholesterol, HDL* ; Cholesterol, LDL* ; Coronary Disease ; Enzyme Assays ; Fasting ; Female ; Humans ; Incidence ; Korea ; Male ; Occupations ; Smoke ; Smoking ; Triglycerides

PURPOSE: This study was conducted to describe the effects of aroma inhalation on sleep and fatigue in night shift nurses. METHODS: The research design was one group pre-posttest design. The subjects were 17 night shift nurses who work at neurosurgery intensive care unit of K hospital of C university in Seoul. During three consequent night shifts, the participants were worn the Actigraph to measure the sleep pattern on their wrist since their first night shift work. The quality of sleep and fatigue was measured by survey when they awoke at 6 pm after second night shift work. And these measures were repeated during the night shifts in second and third week. Aroma inhalation was applied before going to bed after finishing each night shift work during second and third week. SPSS 12.0 program was used for data analysis. RESULTS: There were no statistically significant differences in sleep latency and total sleeping time. However, significant differences were found in the sleep efficiency, awakening number, sleep quality, subjective symptom and intensity of fatigue. CONCLUSION: These results showed that aroma inhalation had positive effects on the pattern and quality of sleep and reducing fatigue in night shift nurses.
Aromatherapy ; Fatigue ; Inhalation ; Intensive Care Units ; Neurosurgery ; Research Design ; Statistics as Topic ; Wrist

PURPOSE: This study was conducted to describe the effects of aroma inhalation on sleep and fatigue in night shift nurses. METHODS: The research design was one group pre-posttest design. The subjects were 17 night shift nurses who work at neurosurgery intensive care unit of K hospital of C university in Seoul. During three consequent night shifts, the participants were worn the Actigraph to measure the sleep pattern on their wrist since their first night shift work. The quality of sleep and fatigue was measured by survey when they awoke at 6 pm after second night shift work. And these measures were repeated during the night shifts in second and third week. Aroma inhalation was applied before going to bed after finishing each night shift work during second and third week. SPSS 12.0 program was used for data analysis. RESULTS: There were no statistically significant differences in sleep latency and total sleeping time. However, significant differences were found in the sleep efficiency, awakening number, sleep quality, subjective symptom and intensity of fatigue. CONCLUSION: These results showed that aroma inhalation had positive effects on the pattern and quality of sleep and reducing fatigue in night shift nurses.
Aromatherapy ; Fatigue ; Inhalation ; Intensive Care Units ; Neurosurgery ; Research Design ; Statistics as Topic ; Wrist

BACKGROUND: Urinary tract infections (UTIs) are the most frequent nosocomial infections and are frequently associated with indwelling urinary catheters. It is known that adherence to standard infection control measures for urinary catheters can reduce UTIs in hospitals. This study was performed to evaluate the effect of education in reducing catheter-related UTIs (CR-UTIs) in intensive care units (ICUs) of a university hospital. METHODS: CR-UTIs were prospectively monitored for all patients with indwelling urinary catheters in ICUs from July 2006 through December 2007. Recommendations based on previously known guidelines for catheter insertion, catheter management, and specimen collection to prevent CR-UTIs were formulated and educated in March 2007. Knowledge and adherence level were evaluated before and after educating healthcare workers about the recommendations using questionnaire. Changes in knowledge and adherence level before and after education were compared by Chi-square test. Changes in the rate of CR-UTIs and urinary catheter utilization ratios were also analyzed by Fisher's exact test. RESULTS: After education, knowledge level of and adherence level to most of the recommendations were improved significantly. The rate of CR-UTIs significantly decreased by 48% from 7.43/1,000 catheter-days before intervention to 3.87/1,000 catheter-days after intervention (P=0.02). CONCLUSION: Surveillance for nosocomial infections and education for standard infection control measures are very important in preventing CR-UTIs in ICUs.
Catheters ; Cross Infection ; Delivery of Health Care ; Humans ; Infection Control ; Critical Care ; Intensive Care Units ; Prospective Studies ; Specimen Handling ; Urinary Catheterization ; Urinary Catheters ; Urinary Tract ; Urinary Tract Infections ; Surveys and Questionnaires