Background and Objectives: This study aimed to investigate the association between cardiovascular events and 2 different levels of elevated on-treatment diastolic blood pressures (DBP) in the presence of achieved systolic blood pressure targets (SBP). Methods: A nation-wide population-based cohort study comprised 237,592 patients with hypertension treated. The primary endpoint was a composite of cardiovascular death, myocardial infarction, and stroke. Elevated DBP was defined according to the Seventh Report of Joint National Committee (JNC7; SBP <140 mmHg, DBP ≥90 mmHg) or to the 2017 American College of Cardiology/American Heart Association (ACC/AHA) definitions (SBP <130 mmHg, DBP ≥80 mmHg). Results: During a median follow-up of 9 years, elevated on-treatment DBP by the JNC7 definition was associated with an increased risk of the occurrence of primary endpoint compared with achieved both SBP and DBP (adjusted hazard ratio [aHR], 1.14; 95% confidence interval [CI], 1.05–1.24) but not in those by the 2017 ACC/AHA definition. Elevated ontreatment DBP by the JNC7 definition was associated with a higher risk of cardiovascular mortality (aHR, 1.42; 95% CI, 1.18–1.70) and stroke (aHR, 1.19; 95% CI, 1.08–1.30). Elevated on-treatment DBP by the 2017 ACC/AHA definition was only associated with stroke (aHR, 1.10;95% CI, 1.04–1.16). Similar results were seen in the propensity-score-matched cohort. Conclusion Elevated on-treatment DBP by the JNC7 definition was associated a high risk of major cardiovascular events, while elevated DBP by the 2017 ACC/AHA definition was only associated with a higher risk of stroke. The result of study can provide evidence of DBP targets in subjects who achieved SBP targets.

PURPOSE: This purpose of this study was to develop evidence-based practice guideline for isolation in health care settings to prevent transmission of infectious diseases utilizing guideline adaption process. METHODS: The process of guideline adaptation was performed according to the Korean hospital nurses association's guideline adaptation manual which consisted of three main phases, 9 modules, and 24 steps. RESULTS: The adapted isolation guideline consisted of introduction, overview of isolation guideline, summary of recommendations, recommendations, references, and appendices. The guideline includes 224 recommendations in 4 sections which are organizational administration, standard precautions, transmission-based precautions, and education/counselling. CONCLUSION: The adapted isolation guideline is recommended to be disseminated and utilized by nurses and clinicians nationwide to improve the isolation practices for infected or colonized patients with communicable diseases and to decrease the transmission of infections in the healthcare settings.
Colon ; Communicable Diseases ; Delivery of Health Care ; Disease Transmission, Infectious ; Evidence-Based Nursing ; Evidence-Based Practice ; Humans ; Infection Control ; Patient Isolation

OBJECTIVE: We have introduced a method of characterization of invading glioma cells by using molecular analysis of marginal invading tumor cells and molecular profiles of glioma tumor margin. METHODS: Each of tumor core and marginal tissues was obtained in 22 glioma patients. Tumor core cells and marginal cells from each glial tumor were collected by laser capture microdissection or intraoperative microdissection under the operating microscope. Expression of MMP-2, MMP-9, CD44 and RHAMM mRNA by invading glioma cells compared with tumor core was confirmed by realtime-PCR of twenty-four glioma specimens. Clinical data also were reviewed for invasion and recurrence pattern of the gliomas radiologically and invasive rim pattern microscopically. RESULTS: Overall results of the molecular analysis showed that relative overexpression of MMP-2, MMP-9 and RHAMM were noted at the invasive edge of human glioma specimens comparing to the tumor core but CD44 was highly expressed in the tumor core comparing to the margin. High marginal expression of MMP-2 and MMP-9 were noted in poorly ill-defined margin on the pathological finding. High marginal expression of CD44 and MMP-2 were demonstrated in the midline cross group on the radiological review, and that of RHAMM and MMP-2 were showed in the aggressive recurrence group. High expression of MMP-2 seems to be involved in the various invasion-related phenomenons. CONCLUSION: Up-regulation of MMP-2, MMP-9, CD44 and RHAMM was noted in invasive edge of gliomas according to the various clinical situations.
Glioma* ; Humans ; Laser Capture Microdissection ; Microdissection ; Recurrence ; RNA, Messenger ; Up-Regulation

PURPOSE: The purpose of this study was to analyze the research papers published in three nursing journals to suggest the direction for Journal of Korean Oncology Nursing (JKON). METHODS: To compare JKON with Journal of Korean Academic Society of Nursing Education and Cancer Nursing, all the research papers published in those three journals, 2010 were reviewed using an analysis criteria developed by the researchers, focusing on type of research, characteristics of authors and subjects, research design, data collection and analysis methods, sample size estimation, and ethical considerations regarding data collection. RESULTS: JKON lacked research papers which were supported by research funds, produced by multidisciplinary teams, addressing cancer survivors or patients with metastatic cancers, and written in qualitative methodologies. However, JKON showed higher ratio of research papers than the other two journals which were adapted from thesis or dissertations, describing sample size estimation process precisely, and participating subjects diagnosed with various cancers. CONCLUSION: The study found out that JKON is presenting well the area of oncology nursing in Korea and also has several weak points that need to be improved. The study therefore suggested several recommendations for the JKON to take the professional and global leader roles.
Data Collection ; Education, Nursing ; Financial Management ; Humans ; Korea ; Manuscripts as Topic ; Nursing Research ; Research Design ; Research Subjects ; Sample Size ; Survivors

BACKGROUND: Conservative management for the trigger fingers includes splinting, steroid injection and other adjuvant methods. If conservative treatment fails, a surgical release of the A1 pulley is offered. Although the success rate of the surgical intervention is high, the complications, for example, a digital nerve injury, bowstringing, infection and continued triggering, have been reported. Percutaneous release with an 18 guage needle has been reported as a safe and effective procedure for the trigger fingers. This study evaluates the safety and efficacy of the percutaneous release. METHODS: 33 patients received the percutaneous release of the A1 pulley with an 18 guage needle and steroid injection (Group A) and 36 patients did the only administration of steroid as a control group (Group B). Patients were examined with a clinical staging for the Watanabe stage (W stage) and 0-10 points verbal numerical rating scale (VNRS) score at 1 week, 3 months, 1 year after the initial treatment. RESULTS: After 1 year of the follow-up, 93.5% in the group A and 57.6% in the group B had complete release of the trigger fingers in the W stage. VNRS after the initial treatment demonstrated that the decrement of the pain score was more significant in the group A. CONCLUSIONS: We need to consider the percutaneous release with steroid injection at an early stage of the trigger fingers because of the more effective resolution of the symptoms and the better long-term prognosis than a steroid injection alone.
Fingers ; Follow-Up Studies ; Humans ; Needles ; Prognosis ; Splints

Myoclonus is one of the rare complications after the neuroaxial blockade. We report a patient who developed propriospinal myoclonus following cervical epidural steroid injection. An outpatient, 73-years-old man, complaining of a tingling sensation from the right shoulder of supraspinatous region to the ipsilateral hand, particularly along the C6 dermatome, visited our pain clinic center. In cervical magnetic resonance imaging scan, the disc between 6th and 7th cervical vertebrae was herniated and pressed the nerves to the right side. We performed cervical epidural steroid injection, using triamcinolone acetonide 40 mg with 0.25% bupivacaine HCL 5 ml. After the first injection, he had no problem, but following the second injection, myoclonic movements were developed and lasted for 6 hours along only the right side of the whole body without other neurologic complications. The myoclonic movement improved by intravenous injection of clonazepam 0.5 mg and the patient completely recovered without any neurologic sequelae on that day.
Bupivacaine ; Cervical Vertebrae ; Clonazepam ; Female ; Hand ; Humans ; Injections, Intravenous ; Magnetic Resonance Imaging ; Myoclonus ; Outpatients ; Pain Clinics ; Sensation ; Shoulder ; Triamcinolone Acetonide

Myoclonus is one of the rare complications after the neuroaxial blockade. We report a patient who developed propriospinal myoclonus following cervical epidural steroid injection. An outpatient, 73-years-old man, complaining of a tingling sensation from the right shoulder of supraspinatous region to the ipsilateral hand, particularly along the C6 dermatome, visited our pain clinic center. In cervical magnetic resonance imaging scan, the disc between 6th and 7th cervical vertebrae was herniated and pressed the nerves to the right side. We performed cervical epidural steroid injection, using triamcinolone acetonide 40 mg with 0.25% bupivacaine HCL 5 ml. After the first injection, he had no problem, but following the second injection, myoclonic movements were developed and lasted for 6 hours along only the right side of the whole body without other neurologic complications. The myoclonic movement improved by intravenous injection of clonazepam 0.5 mg and the patient completely recovered without any neurologic sequelae on that day.
Bupivacaine ; Cervical Vertebrae ; Clonazepam ; Female ; Hand ; Humans ; Injections, Intravenous ; Magnetic Resonance Imaging ; Myoclonus ; Outpatients ; Pain Clinics ; Sensation ; Shoulder ; Triamcinolone Acetonide

BACKGROUND: Clean intermittent catheterization is one of the management of the neurogenic bladder caused by such disease as spinal injury. The purpose of this study is to assess the amount of time in a microwave oven required to eliminate seven pathogens isolated from urine of the patients, and to evaluate the effect of repeated use of a microwave oven on the patency and pliability of silicon catheter. METHODS: Seven microorganisms isolated from urine of patients were used as inoculating pathogens. These included Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterococcus faecalis, Enterococcus faecium, Staphylococcus aureus, Candida albicans. The silicon catheter was divided into six pieces (4 cm) and sterilized by ethylene oxide gas, Each piece of catheter was incubated for 60 minutes in a suspension of microorganisms, and placed in a plastic container. The piece was microwaved for 0 (control catheters) to 15 minutes a dose of 1,000 watts. Two methods were used. First method was a water-free method that was microwaved after removing water from the catheter. Second method was a water-added method that was microwaved after adding 5 mL of sterile water around the catheter. Then, that was placed in 15 mL sterile phosphate buffer in a conical tube. The fluid was cultured. Using a new silicon catheter, the microwave procedure was repeated until the catheter was no longer patent or pliable. RESULTS: Using a water-free method, E, coli, C. albicans were eliminated at 5 minutes, P. aeruginosa was at 8 minutes, K. pneumoniae, E. faecalis was at 12 minutes, but S. aureus was remained until 15 minutes, Using a water-added method, all strains were eliminated at 8 minutes. The characteristics of the silicon catheter after repeated procedures were not changed in patency or pliability until 100 times. CONCLUSION: The disinfection of silicon catheters using a microwave oven after adding water around the catheter was able to sterilize the frequent pathogens including C. albicans within 8 minutes. It was clinically useful to sterilize repeatedly the catheter using microwave oven without distorting the characteristics of the silicon catheter.
Candida albicans ; Catheters* ; Disinfection ; Enterococcus faecalis ; Enterococcus faecium ; Escherichia coli ; Ethylene Oxide ; Humans ; Intermittent Urethral Catheterization ; Klebsiella pneumoniae ; Microwaves* ; Plastics ; Pliability ; Pneumonia ; Pseudomonas aeruginosa ; Silicones ; Spinal Injuries ; Staphylococcus aureus ; Sterilization ; Urinary Bladder, Neurogenic ; Water

Although 25 to 36% of systemic lymphoma patients develop cardiac involvement, a primary lymphoma involving only the heart or pericardium is much less common. We detected an intracavitary mass in the right atrium and right ventricle in a 73-year-old man with dyspnea on exertion and generalized edema using transthoracic and transesophageal echocardiography. A thoracotomy was performed due to a possible cardiac tamponade, and a myocardial biopsy showed a malignant non-Hodgkin's lymphoma of the diffuse large B cell type. We report a rare case of a primary cardiac lymphoma detected using a transthoracic and transesophageal echocardiography in patient presenting with a massive pericardial effusion.
Aged ; Biopsy ; Cardiac Tamponade ; Dyspnea ; Echocardiography, Transesophageal ; Edema ; Heart ; Heart Atria ; Heart Neoplasms ; Heart Ventricles ; Humans ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Pericardial Effusion ; Pericardium ; Thoracotomy