PURPOSE: This study aimed to understand meaning and essentials in work experiences of delivery room nurses. METHODS: A phenomenological perspective was used for this qualitative research. Ten delivery room nurse with more than 3 years of work experience participated in this study. Data were collected through individual in-depth interviews with the nurses, between December 2012 and April 2013. Data were analyzed using Colaizzi's method. RESULTS: Nine theme clusters and four categories emerged from the data as follows: 1) factors influencing career decision-making, 2) gap between reality and expectations, 3) difficulties with working in the delivery room, and 4) motivation to work in the delivery room. CONCLUSION: Based on the results of this study, strategies to improve working environment of the delivery room nurses are necessary. Also, better policy are required to firmly establish the role of the delivery room nurses' role as recognized professionals.
Delivery Rooms* ; Methods ; Motivation ; Qualitative Research

PURPOSE: The purpose of the study was to identify the prevalence, risk factors and clinical meanings of geriatric foot problems and to suggest implications for the future. METHODS: One hundred eighty nine elderly aged 60 and over from institution as well as community were investigated for their foot conditions by means of a questionnaire including general characteristics, self care capacity, risk factors, foot problem checklist, X-ray, podoscopy and foot scan. Descriptive statistics and chi-square-test was performed as appropriate utilizing SPSS version 14. Less than .05 of p-value was adopted as statistical significance level. RESULTS: All subjects had at least one kind of foot problem and the most prevalent ones were nail problems, foot deformities in order. Prevalence of foot pain and edema was relatively low. CONCLUSION: Foot problem in elderly is prevalent and geriatric foot is expected to emerge as one of the most important problems in the geriatric field. Therefore strategies to deal with geriatric foot should be developed and practiced for better quality of life in later life.
Aged ; Aged, 80 and over ; Female ; Foot Deformities/epidemiology ; Foot Diseases/*epidemiology/etiology ; Geriatric Assessment ; Health Status ; Humans ; Male ; Middle Aged ; Nails, Malformed/epidemiology ; Quality of Life ; Questionnaires ; Republic of Korea ; Risk Factors ; Self Care

Background: We previously developed the Korean Calcium Assessment Tool (KCAT) for assessing the intake of calcium and vitamin D in Korean women. However, based on the Korea National Health and Nutrition Examination Survey (KNHANES) VI and VII (2013–2018), major food sources for calcium and vitamin D have changed, and the National Standard Food Composition database was updated. Therefore, the present study aimed to update the KCAT and validate the Updated KCAT. Methods: A total of 285 women aged >19 years were asked to complete questionnaires of the KCAT and the Updated KCAT. Results: Calcium intake did not differ significantly between the KCAT (566±245 mg/day) and the Updated KCAT (569±248 mg/day; P=0.343). A correlation coefficient of 0.99 indicated a positive correlation on calcium intake between the KCAT and the Updated KCAT, with an almost perfect agreement by Cohen’s κ coefficients (0.95). Vitamin D intake assessed by the Updated KCAT was significantly higher than that assessed by the KCAT, which was positively correlated with a moderate agreement measured by Cohen’s κ coefficients (0.41). Conclusions The present study demonstrated that the Updated KCAT was a valid tool for the rapid evaluation of calcium and vitamin D intake for Korean women.

PURPOSE: Dyslipidemia is a major risk factor for cardiovascular disease. Pine needles (Pinus densiflora seib et Zucc) are a traditional medicine used to treat dyslipidemia in clinical settings. This study examined the potential effects of sulgidduk, a Korean traditional rice cake containing pine needle juice to protect against dyslipidemia induced by a high-fat/sugidduk diet in a rat model. METHODS: Twenty one male Sprague-Dawley rats were divided randomly into three groups: normal control (NC), Sulgidduk diet (SD), Sulgidduk diet containing pine needle juice (PSD). The blood lipid levels, production of lipid peroxide in the plasma and liver, total cholesterol and triglyceride in the liver and feces, antioxidant enzyme activities in plasma and erythrocytes were measured to assess the effects of PSD on dyslipidemia. RESULTS: A high-fat/Sulgidduk diet induced dyslipidemia, which was characterized by significantly altered lipid profiles in the plasma and liver. The food intake was similar in the three groups, but weight gain and food efficiency ratio (FER) were reduced significantly in the PSD group compared to those in the SD group. The level of total cholesterol, LDL-cholesterol and TBARS in the plasma showed tendencies to decrease in the PSD group compared to those in the SD group. The levels of high-fat/Sulgidduk diet-induced sterol regulatory element-binding protein 2 (SREBP2) gene expression were reduced significantly in the PSD group. The supplementation of PSD reduced the hepatic triglyceride and total cholesterol levels significantly, and enhanced the fecal excretion of triglyceride and hepatic antioxidant enzyme activities compared to the SD group. CONCLUSION: These results suggest that the addition of 0.4% pine needle juice to Sulgidduk may be an alternative snack to control dyslipidemia.
Animals ; Cardiovascular Diseases ; Cholesterol ; Diet ; Dyslipidemias ; Eating ; Erythrocytes ; Feces ; Gene Expression ; Humans ; Lipid Metabolism ; Liver ; Male ; Medicine, Traditional ; Models, Animal ; Needles ; Plasma ; Rats ; Rats, Sprague-Dawley ; Risk Factors ; Snacks ; Thiobarbituric Acid Reactive Substances ; Triglycerides ; Weight Gain

Choline, an essential nutrient for humans, is required for the structural integrity of the cell membranes, methyl-group metabolism, synthesis of the neurotransmitter acetylcholine, synthesis of the membrane phospholipid components of the cell membranes, and the transport of lipids and cholesterol. Choline can be synthesized in the body, but it is insufficient to meet the daily requirements and hence it must be obtained through the diet. In the United States/Canada, Australia/New Zealand, Europe, China, and Taiwan, the adequate intake (AI) and tolerable upper intake level (UL) of choline have been established, while the establishment of the 2020 Dietary Reference Intakes for Koreans (KDRI) for choline was postponed due to the lack of a choline database for Korean foods and studies on the choline intake of Koreans. However, as part of the preparation work for the 2020 DRI revision and finalization, choline intake and the possibility of disease occurrence were verified through analysis of published data. The groundwork for the subsequent establishment of a choline DRI was laid through a literature search, evaluation, and review of the literature reported from 1949 up to 2019. This can be regarded as the culmination of this project. According to the results of randomized controlled trials (RCTs), cohort studies, case-control studies, and cross-sectional observational studies in humans, approximately 400-500 mg/day of choline intake was effective in preventing liver function damage (fatty liver), neural tube damage, cardiovascular disease, breast cancer, and cognitive function improvement. The same amount of choline intake, however, also correlated with the risk of prostate and colorectal cancer. At present, there is limited information available on choline intake and health outcomes, particularly for the Korean population. More human studies, including clinical trials on the requirements and the physiological benefits associated with dietary intake, are needed to establish the KDRI for choline.

Myelofibrosis results from stimulation of bone marrow stromal fibroblasts by fibrogenic cytokines elaborated by neoplastic or reactive cells in the marrow. Chronic idiopathic myelofibrosis should be differentiated from secondary myelofibrosis resulting from bone marrow involvement of malignant lymphoma because these diseases have different therapeutic strategies. Myelofibrosis in systemic lupus erythematosus is an uncommon but well-recognized complication, and identifying an autoimmune myelofibrosis is important in diagnosing this benign cause of myelofibrosis. We report two cases of myelofibrosis presenting the clinical and radiologic findings that mimicked malignant lymphoma -a case of autoimmune myelofibrosis associated with systemic lupus erythematosus showing extensive lymphadenopathy and a case of chronic idiopathic myelofibrosis with focal intrasplenic extramedullary hematopoiesis- and discuss the importance of the clinical information and radiologic findings for the pathologic diagnosis of myelofibrosis.
Abdomen* ; Bone Marrow ; Cytokines ; Diagnosis ; Fibroblasts ; Hematopoiesis, Extramedullary* ; Lupus Erythematosus, Systemic* ; Lymphatic Diseases* ; Lymphoma* ; Primary Myelofibrosis*

There have been few reports on chromosomal abnormalities in secondary hemophagocytic lym-phohistiocytosis (HLH) including Epstein-Barr virus-associated HLH (EBV-HLH). Clonality of HLH can be determined by karyotypic analysis, T-cell receptor or IgH rearrangement studies, and EBV genome terminal repeat investigation. Chromosome analysis in EBV-HLH is the most important tool currently available for assessment of case-by-case prognosis. We report a case of fatal EBV-HLH with clonal karyotype abnormality. A 57-year-old man was admitted with persistent high fever and hepatosplenomegaly. Laboratory data revealed pancytopenia, hypofibrinogenemia, coagulation abnormalities, and marked abnormalities of liver function tests. EBV-DNA was detected in the bone marrow by PCR. The bone marrow studies showed mature, benign-looking histiocytic hyperplasia with prominent hemophagocytosis and clonal chromosomal abnormality. Although the patient was treated with immunochemotherapy and antibiotics, he died of disseminated intravascular coagu-lopathy and sepsis. Considering this fatal clinical course, it is important to take intensive therapeutic measures if karyotype abnormality is noted in the treatment of EBV-HLH cases.
Anti-Bacterial Agents ; Bone Marrow ; Chromosome Aberrations ; Fever ; Genome ; Herpesvirus 4, Human ; Humans ; Hyperplasia ; Karyotype* ; Liver Function Tests ; Lymphohistiocytosis, Hemophagocytic* ; Middle Aged ; Pancytopenia ; Polymerase Chain Reaction ; Prognosis ; Receptors, Antigen, T-Cell ; Sepsis ; Terminal Repeat Sequences

OBJECTIVES: The aim of this study was to develop auditory-verbal and visual-spatial memory tasks using smart devices for children aged 8 to 10 years and examine their validity. METHODS: One-hundred and fourteen school-aged children were recruited through internet advertising. We developed memory tasks assessing auditory-verbal memory, visual-spatial memory, and working memory, and then examined their construct validity by examining the developmental trend of the children's mean scores with age. In order to examine the concurrent validity of the tasks, we conducted correlation analyses between the children's scores on the newly developed auditory-verbal, visual-spatial memory and working memory tasks and their scores on well-known standardized tests of memory and working memory, including the auditory-verbal memory subtests of the Korean Luria-Nebraska Neuropsychological Battery for Children, Korean Rey-Osterrieth Complex Figure Test, digit span and arithmetic subtest of Korean Educational Development Institute Wechsler Intelligence Scale for Children Revised, and Corsi block test. RESULTS: The memory and working memory scores measured by the newly developed tasks tended to increase with age. Further, there were significant correlations between the scores of the four cognitive tasks and the corresponding scores of the standardized assessment tools. CONCLUSION: This study revealed promising evidence for the validity of the memory tasks using smart devices, suggesting their utility for school-aged children in research and clinical settings.
Child* ; Humans ; Intelligence ; Internet ; Luria-Nebraska Neuropsychological Battery ; Memory* ; Memory, Short-Term

When treating trauma patients with severe hemorrhage, massive transfusions are often needed. Damage control resuscitation strategies can be used for such patients, but an adequate fresh frozen plasma: packed red blood cell (FFP:PRBC) administration ratio must be established. We retrospectively reviewed the medical records of 100 trauma patients treated with massive transfusions from March 2010 to October 2012. We divided the patients into 2 groups according to the FFP:PRBC ratio: a high-ratio (> or =0.5) and a low-ratio group (<0.5). The patient demographics, fluid and transfusion quantities, laboratory values, complications, and outcomes were analyzed and compared. There were 68 patients in the high-ratio and 32 in the low-ratio group. There were statistically significant differences between groups in the quantities of FFP, FFP:PRBC, platelets, and crystalloids administered, as well as the initial diastolic blood pressure. Bloodstream infections were noted only in the high-ratio group, and the difference was statistically significant (P=0.028). Kaplan-Meier plots revealed that the 24-hr survival rate was significantly higher in the high-ratio group (71.9% vs. 97.1%, P<0.001). In severe hemorrhagic trauma, raising the FFP:PRBC ratio to 0.5 or higher may increase the chances of survival. Efforts to minimize bloodstream infections during the resuscitation must be increased.
Acute Lung Injury/epidemiology/etiology ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bacterial Infections/epidemiology ; *Blood Transfusion/adverse effects ; *Erythrocyte Transfusion/adverse effects ; Female ; Hemorrhage/etiology/*prevention & control ; Hospital Mortality ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Patients ; Respiratory Distress Syndrome, Adult/epidemiology/etiology ; Resuscitation ; Retrospective Studies ; Wounds and Injuries/complications/mortality/*therapy ; Young Adult

PURPOSE: A numerical method of designing a multiple quantum filter (MQF) is presented for the optimum detection of myo-inositol (mI), an important brain metabolite, by using in vivo proton nuclear magnetic resonance spectroscopy ((1)HMRS). MATERIALS AND METHODS: Starting from the characterization of the metabolite, the filter design includes the optimization of the sequence parameters such as the two echo times (TEs), the mixing time (TM), and the flip angle and offset frequency of the 3rd 90 degrees pulse which converts multiple quantum coherences (MQCs) back into single quantum coherences (SQCs). The optimized filter was then tested both in phantom and in human brains. RESULTS: The results demonstrate that the proposed MQF can improve the signal-tobackground ratio of the target metabolite by a factor of more than three by effectively suppressing the signal from the background metabolites. CONCLUSION: By incorporating a numerical method into the design of MQFs in 1HMRS the spectral integrity of a target metabolite, in particular, with a complicated spin system can be substantially enhanced.
Brain ; Humans ; Magnetic Resonance Spectroscopy ; Protons ; Spectrum Analysis