Purpose: This study aimed to evaluate the effects of head monted display based home-visits virtual reality simulation (HVRS) program developed for undergraduate nursing students. Methods: A nonequivalent control group with a non-synchronized design was utilized and 84 participants (experimental group, 44; control group, 40) were recruited from August 31, 2020 to November 8, 2020 in Gwangju metropolitan city. The HVRS program consisted of scenarios of three nursing cases, hypertension, diabetes mellitus, and stroke. Data were analyzed SPSS version 25.0 for Windows. Results: At the completion of HVRS, significant differences were found between groups in knowledge of home-visits (t = 4.73, p < .001), self-confidence (t = 6.63, p < .001), self-efficacy (t = 3.13, p = .002), and clinical competency (t = 4.13, p < .001). No significant difference was shown between groups in nursing knowledge about strokes, a subcategory of knowledge pertaining to home visits. Conclusion The HVRS program developed for undergraduate nursing students is effective in improving knowledge of home-visits, self-confidence, self-efficacy, and clinical competency for nursing students.

Purpose: This study aimed to evaluate the effects of head monted display based home-visits virtual reality simulation (HVRS) program developed for undergraduate nursing students. Methods: A nonequivalent control group with a non-synchronized design was utilized and 84 participants (experimental group, 44; control group, 40) were recruited from August 31, 2020 to November 8, 2020 in Gwangju metropolitan city. The HVRS program consisted of scenarios of three nursing cases, hypertension, diabetes mellitus, and stroke. Data were analyzed SPSS version 25.0 for Windows. Results: At the completion of HVRS, significant differences were found between groups in knowledge of home-visits (t = 4.73, p < .001), self-confidence (t = 6.63, p < .001), self-efficacy (t = 3.13, p = .002), and clinical competency (t = 4.13, p < .001). No significant difference was shown between groups in nursing knowledge about strokes, a subcategory of knowledge pertaining to home visits. Conclusion The HVRS program developed for undergraduate nursing students is effective in improving knowledge of home-visits, self-confidence, self-efficacy, and clinical competency for nursing students.

BACKGROUND: Topical tacrolimus is an effective anti-inflammatory therapy for acute and chronic states of atopic dermatitis (AD) in both adults and children. Topical tacrolimus has particular use at sensitive areas such as the face, anogenitals, and skin folds of neck and extremities. However, many AD patients also experience aggravated symptoms on trunk. OBJECTIVE: The aim of this study was to investigate the efficacy and safety of topical tacrolimus for AD patients with truncal lesions. METHODS: AD patients with truncal lesions who were aged ≥2 years were recruited from 20 centres in Korea. They received treatment with topical tacrolimus ointment twice daily during 4 weeks. The primary end point was change of the local eczema area and severity index (EASI) of the trunk from baseline to day 28. The secondary end points were changes in the patient global assessment (PGA) score and itch visual analogue scale (VAS) score of the trunk between baseline and day 28. RESULTS: Two hundred and ninety-one patients were recruited, and 176 patients completed the full 4-week treatment course. By the end of the treatment, the mean local EASI of the trunk (2.2±4.71) was significantly decreased from that at baseline (4.71±4.03, p < 0.001). PGA (1.71±1.15) and itch VAS score of the trunk (2.61±2.19) on day 28 were also profoundly decreased compared with the baseline (2.96±1.07 and 5.15±2.47, respectively). No serious adverse events were observed during the study period. CONCLUSION: Topical tacrolimus is an effective and safe therapy for truncal lesions in AD patients.
Administration, Topical ; Adult ; Child ; Dermatitis, Atopic* ; Eczema ; Extremities ; Humans ; Korea ; Neck ; Skin ; Tacrolimus*

BACKGROUND: The purpose of this study is to know the healthcare-associated infection (HAI)s in small and medium sized hospitals, less than 400 beds. METHODS: We had web based surveillance for HAIs in 27 hospitals from August to October 2010. The surveillance performed in 1-2 ICUs and 1 general ward in each hospitals by CDC definition. And for the multi-drug resistant organisms (MDROs), we reviewed all of blood culture results. RESULTS: We identified 319 HAIs among 269,436 patients days. The HAIs rate was 1.18 (CI 1.05-1.32)/1,000 patient-days. Urinary tract infection was the most common HAI (52.4%) in this study followed by pneumonia (18.9%), blood-stream infections (14.2%), surgical site infection (7.9%), and others (6.6%). There were 76.5% of device associated infections in UTI, 46.7% in BSI, and 18.3% in pneumonia. The rate of HAIs in ICU was higher than that of in general ward (4.6 vs 0.9/1,000 patient-days). However, the indwelling catheter associated urinary tract infection rate was lower in ICU (2.6 vs 4.4/1,000 device days). There were no significant differences in central line-associated blood stream infection rate (1.5 vs 1.8) and ventilator-associated pneumonia rate (3.0 vs 0.0). The common microorganisms found in HAIs were Escherichia coli (19.8%), Staphylococcus aureus (13.1%), and Pseudomonas aeruginosa (12.7%). Moreover, 90.9% of S. aureus were resistant to methicillin, and 38.2% of P. aeruginosa and 44.4% of Acinetobacter baumannii were resistant to imipenem. Total of 66 MDROs were isolated from blood culture and the result shows that the MRSA was 84.6% (56 case), carbapenmen-resistant Acinetobacter spp. was 10.6% (7 case), and vancomycin-resistant enterococci was 4.6% (3 case). CONCLUSION: The characteristics of HAIs in small and medium sized hospitals will be contributed to the decision making of governance policy for infection control and to provide comparable data for these hospitals.
Acinetobacter ; Acinetobacter baumannii ; Catheters, Indwelling ; Centers for Disease Control and Prevention (U.S.) ; Decision Making ; Escherichia coli ; Humans ; Imipenem ; Infection Control ; Methicillin ; Methicillin-Resistant Staphylococcus aureus ; Patients' Rooms ; Pneumonia ; Pneumonia, Ventilator-Associated ; Pseudomonas aeruginosa ; Rivers ; Staphylococcus aureus ; Urinary Tract Infections

BACKGROUND: Food exchange lists are one of the main methods of nutritional education. However, Korean food exchange lists have not been revised since 1994. Therefore, we surveyed the opinions of diabetes educators and patients with diabetes regarding the need for revision of the current food exchange lists. METHODS: For two weeks beginning on 10 March 2008, a 12-item questionnaire regarding the opinion and need for revision of the current food exchange lists was e-mailed to diabetes educators nationwide. Another 15-question survey was administered to patients with diabetes in 13 hospitals located in the Seoul and Gyeonggi regions of Korea. RESULTS: We obtained survey responses from 101 diabetes educators and 209 patients; 65 (64.3%) of the educators answered that the current food exchange lists should be revised. The items that needed revision were the glycemic index, addition of new foods and reaffirmation of exchange standard amounts. The patients demanded specific education about choosing appropriate foods, a balanced meal plan, proper snacks, and dining intake. CONCLUSION: Our survey results demonstrate the need to revise the Korean food exchange lists. This process should focus on glycemic index, the addition of new foods and reconfirmation of one exchange reference unit.
Electronic Mail ; Glycemic Index ; Humans ; Meals ; Snacks ; Surveys and Questionnaires

Malignant fibrous histiocytoma (MFH) is an uncommon soft-tissue sarcoma that occurs primarily in the extremities and rarely involves the retroperitoneum and abdomen. A 63-year-old man was admitted to the emergency room because of epigastric pain. Computed tomography revealed a large heterogeneous enhanced mass originating from the omentum with hemoperitoneum. The patient underwent laparoscopic omental mass excision and hematoma evacuation. Histological examination of the resected tumor revealed MFH. This case was therefore omental MFH presenting with hemoperitoneum.
Abdomen ; Emergencies ; Extremities ; Hematoma ; Hemoperitoneum ; Histiocytoma, Malignant Fibrous ; Humans ; Middle Aged ; Omentum ; Sarcoma

BACKGROUND: A single agent administered is not effective enough to block nociception. Combination of agents acting through different mechanisms may be one of the best ways for better analgesic methods. The purpose of this study was to investigate the spinally mediated analgesic interaction between 5-HT3 receptor agonist (m-CPBG) and NMDA receptor antagonist (MK801) in the rat formalin test. METHODS: A polyethylene catheter was inserted in the atlanto-occipital membrane to the thoracolumbar level of the spinal cord. On postoperative 7 day, the normal saline (n = 6), m-CPBG (10, 30, 100microgram: n = 18) and MK801 (0.1, 1, 10microgram: n = 18) were injected intrathecally before subcutaneous injection of 5% formalin. The combinations of each 1/2ED50 + 1/2ED50, 1/4ED50 + 1/4ED50, 1/8ED50 + 1/8ED50 were tested and the ED50 of the combination was determined. The experimental ED50 values were compared with the theoretical additive values. RESULTS: m-CPBG dose-dependently decreased the number of flinches in both phase 1 and 2. MK801 dose-dependently reduced the number of flinches in phase 2, but not in phase 1. The combination of m-CPBG and MK801 produced dose-dependent decreases of flinches on both phase 1 and 2. ED50 values (2.75microng for m-CPBG and 0.076microgram for MK801) of phase 2 in the combination were significantly less than the calculated additive values (20.0microgram for m-CPBG and 0.55microgram for MK801)(P<0.01). CONCLUSIONS: Intrathecally administered m-CPBG and MK801 had synergistic analgesic effects on formalin-induced hyperalgesia as well as antinociceptive effects in phase 1 on the rat formalin test.
Animals ; Catheters ; Dizocilpine Maleate ; Formaldehyde* ; Hyperalgesia ; Injections, Subcutaneous ; Membranes ; N-Methylaspartate* ; Nociception ; Pain Measurement* ; Polyethylene ; Rats* ; Receptors, Serotonin, 5-HT3* ; Spinal Cord

BACKGROUND: Combination of propofol and remifentanil is an ideal regimen for total intravenous anesthesia. The purpose of this study is to determine the effect-site concentration of remifentanil for prevention of hemodynamic responses to tracheal intubation during fixed propofol infusion (4microgram/ml) and to find any sexual differences. METHODS: Thirty ASA physical status I-II patients undergoing general anesthesia were assigned to male (n = 15), and female (n = 15) group. All patients received a target controlled infusion (TCI) of propofol with a fixed effect-site concentration of 4microgram/ml. After target effect-site concentration of propofol and remifentanil was reached, tracheal intubation was performed. The hemodynamic changes (systolic/diastolic blood pressure, mean arterial pressure, and heart rate) were measured at 1 and 2 min before tracheal intubation (baseline), immediately after, 1, 2, 3, 4 and 5 min following tracheal intubation. In both groups, effect-site concentration of remifentanil was initiated with 3 ng/ml. Subsequent concentration of remifentanil was determined by hemodynamic responses of the previous patient to tracheal intubation based on up and down sequential allocation. RESULTS: The mean EC50 of remifentanil for prevention of hemodynamic responses to tracheal intubation were 1.37 ng/ml (95% CI, 0.95-1.81 microgram/ml) in male group and 1.05 microgram/ml (95% CI, 0.68-1.40 ng/ml) in female group, respectively. In addition, there were no statistical significant differences between two groups. CONCLUSIONS: Relatively small dosages of remifentanil (0.68-1.81 microgram/ml) for attenuation of hemodynamic responses to tracheal intubation was needed in Korean population in propofol TCI and there were no sexual differences.
Anesthesia, General ; Anesthesia, Intravenous* ; Arterial Pressure ; Blood Pressure* ; Female ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Intubation* ; Male ; Propofol ; Sex Characteristics

BACKGROUND: Combination of propofol and remifentanil is an ideal regimen for total intravenous anesthesia. The purpose of this study is to determine the effect-site concentration of remifentanil for prevention of hemodynamic responses to tracheal intubation during fixed propofol infusion (4microgram/ml) and to find any sexual differences. METHODS: Thirty ASA physical status I-II patients undergoing general anesthesia were assigned to male (n = 15), and female (n = 15) group. All patients received a target controlled infusion (TCI) of propofol with a fixed effect-site concentration of 4microgram/ml. After target effect-site concentration of propofol and remifentanil was reached, tracheal intubation was performed. The hemodynamic changes (systolic/diastolic blood pressure, mean arterial pressure, and heart rate) were measured at 1 and 2 min before tracheal intubation (baseline), immediately after, 1, 2, 3, 4 and 5 min following tracheal intubation. In both groups, effect-site concentration of remifentanil was initiated with 3 ng/ml. Subsequent concentration of remifentanil was determined by hemodynamic responses of the previous patient to tracheal intubation based on up and down sequential allocation. RESULTS: The mean EC50 of remifentanil for prevention of hemodynamic responses to tracheal intubation were 1.37 ng/ml (95% CI, 0.95-1.81 microgram/ml) in male group and 1.05 microgram/ml (95% CI, 0.68-1.40 ng/ml) in female group, respectively. In addition, there were no statistical significant differences between two groups. CONCLUSIONS: Relatively small dosages of remifentanil (0.68-1.81 microgram/ml) for attenuation of hemodynamic responses to tracheal intubation was needed in Korean population in propofol TCI and there were no sexual differences.
Anesthesia, General ; Anesthesia, Intravenous* ; Arterial Pressure ; Blood Pressure* ; Female ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Intubation* ; Male ; Propofol ; Sex Characteristics

Renal involvement is common in systemic lupus erythematosus (SLE). The typical lupus nephropathy demonstrates polyclonal immunoglobulin immune deposits with predominance of IgG, usually heavy polytypic complement factors C1q, C3 and C4. In SLE patients, the superimposition and occurrence of non- lupus nephropathy have rarely been reported. We describe a 28-year-old, 15 weeks pregnant women affected by SLE and IgA nephropathy. She was admitted to our hospital due to generalized edema and arthralgia. The ANA titer was 1: 640, anti-ds DNA levels were 354.2 U/mL and other blood tests included thrombocytopenia and hypoclomplementemia. These clinical and laboratory data allowed the diagnosis of SLE. Renal biopsy showed modest segmental mesangial hypercellularity. Immunofluorescence microscopy revealed distinct mesangial IgA and C3 with absence of IgG, IgM, C1q, and C4. Electron microscopy confirmed the presence of electron-dense deposits throughout the mesangium. These features were consistent with the coexistence of IgA nephropathy. A course of prednisolone (50 mg/day) was given for six months and she responded well with resolution of proteinuria. At the present follow- up time point (48 months), she continues to be treated with prednisolone (5 mg/day); proteinuria and ANA are undetectable.
Adult ; Arthralgia ; Biopsy ; Complement System Proteins ; Diagnosis ; DNA ; Edema ; Female ; Glomerulonephritis, IGA* ; Hematologic Tests ; Humans ; Immunoglobulin A* ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins ; Lupus Erythematosus, Systemic ; Lupus Nephritis* ; Microscopy, Electron ; Microscopy, Fluorescence ; Nephrotic Syndrome ; Prednisolone ; Pregnant Women ; Proteinuria ; Thrombocytopenia