Purpose: The purpose of this study was to investigate the actual utilization of clinical practice guidelines developed by Hospital Nurses Association. Methods: The subjects were 70 nurses who were in charge of guideline distributions in 70 advanced general hospital and general hospitals with 500 beds or more nationwide.Data were collected between June and August, 2020 by mail (return rate: 88.6%). Data were analyzed using descriptive statistics, t-test, and ANOVA with SPSS/WIN 24.0. Results: Among the clinical practice guidelines developed by Hospital Nurses Association, 72.9~90.1% were placed with book and electronic file in nursing department and 24.3~35.8% were placed with book and electronic file in each nursing unit at hospital. The average number of utilized clinical practice guidelines were 3.96±3.88, and average score of guideline utilization was score 2.85±0.79 which means ‘use sometimes’. Conclusion To improve the distribution and utilization of the clinical practice guidelines, it is necessary to enhance the recognition of values of evidence based nursing practice targeting head of nursing department and to stimulate the distribution and utilization of the clinical practice guidelines using diverse education programs for staff nurses.

Women in the reproductive age group diagnosed with cervical cancer can receive radical trachelectomy for fertility preservation. Extremely short cervix following radical trachelectomy could result in cervical incompetence. Although prophylactic cervicoisthmic cerclage is placed at the time of radical trachelectomy, it might not be sufficient to prolong pregnancy. We present a successful term pregnancy after laparoscopic radical trachelectomy and concurrent cervicoisthmic cerclage for early stage cervical cancer.
Cervix Uteri ; Female ; Fertility Preservation ; Humans ; Pregnancy ; Trachelectomy ; Uterine Cervical Neoplasms

PURPOSE: The aim of this study was to determine the influence of various factors on preterm labor symptoms (PLS) and preterm birth (PB). METHODS: This prospective cohort study included 193 women in the second stage of pregnancy. Multiple characteristics including body mass index (BMI), smoking, and pregnancy complications were collected through a self-report questionnaire. Pregnancy stress and PLS were each measured with a related scale. Cervical length and birth outcome were evaluated from medical charts. Multiple regression was used to predict PLS and logistic regression was used to predict PB. RESULTS: Multiple regression showed smoking experience, pregnancy complications and pregnancy specific stress were predictors of PLS and accounted for 19.2% of the total variation. Logistic regression showed predictors of PB to be twins (OR=13.68, CI=3.72~50.33, p<.001), shorter cervix (<25mm) (OR=5.63, CI=1.29~24.54, p<.05), BMI >25 (kg/m²) (OR=3.50, CI=1.35~9.04, p<.01) and a previous PB (OR=4.15, CI=1.07~16.03, p<.05). CONCLUSION: The results of this study show that the multiple factors affect stage II pregnant women can result in PLS or PB. And preterm labor may predict PB. These findings highlight differences in predicting variables for pretrm labor and for PB. Future research is needed to develop a screening tool to predict the risk of preterm birth in pregnant women.
Body Mass Index ; Cervical Length Measurement ; Cervix Uteri ; Cohort Studies ; Female ; Humans ; Logistic Models ; Mass Screening ; Obstetric Labor, Premature* ; Parturition ; Pregnancy ; Pregnancy Complications ; Pregnancy Trimester, Second* ; Pregnancy* ; Pregnant Women ; Premature Birth* ; Prospective Studies ; Smoke ; Smoking ; Twins

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PURPOSE: The purpose of this study was to evaluate the effect of abdominal massage on alleviating pain caused by the injection of recombinant gonadotropin for In Vitro Fertilization (IVF) among infertile women. METHODS: This study employed a nonequivalent control group non-synchronized design. A total sample of 149 infertile women who never experienced in vitro fertilization was recruited at C fertility center. Seventy women were assigned into experimental group and 79 into controls. The experimental group had been informed to do abdominal massage prior to the injection and to record their subjective pain using visual analogue scale. The control group had been informed to record their subjective pain in the same way just after the injection. RESULTS: Compared to the pre-tested pain scores, the pain scores in experimental group were significantly reduced by 0.7 points, whereas the control group increased by 0.9 points (t=-4.55, p=.001). CONCLUSION: This study confirms that the use of abdominal massage prior to the injection is an effective way to alleviate pain on injection site. This massage may be a useful intervention for infertile women about pain alleviation.
Female ; Fertility ; Fertilization in Vitro* ; Gonadotropins ; Humans ; In Vitro Techniques* ; Massage*

PURPOSE: This study was aimed to understand the meaning and essentials of the experience of burnout for hospital nurses with turnover intention. METHODS: The design was a qualitative research of phenomenological study. Participants: Seven hospital nurses who had worked over three years and had experiences of turnover intention in a hospital with over 400 beds were included. RESULTS: Nine meaningful themes related to burnout experiences and four theme clusters of 1) battery warning sounds almost out; 2) the player who hit the drum and double-headed drum; 3) the target flying arrow without a break; and 4) the pendulum swaying to turn over. Registered nurses (RNs) felt burnout with an overload of work and by the thought that it was illegal action for registered nurses to receive insufficient rewards for their work. RNs also experienced there were no problem solving strategies to verbal violence by patient and medical team. CONCLUSION: The findings show that burnout experiences for those who had turnover intention was developed from the insight that insufficient training to do work independently with over-load for nurses was not ethical. It suggests that it is necessary to rethink training systems for nursing and hospitals to relieve turnover intention.
Diptera ; Humans ; Intention* ; Nursing ; Problem Solving ; Qualitative Research ; Reward ; Violence

Atypical adenomatous hyperplasia (AAH) has been considered to be a precursor lesion of bronchioloalveolar carcinoma (BAC) and pulmonary adenocarcinoma. It usually coexists with BAC and/or an adenocarcinoma. Chest computed tomography reveals multiple well-defined nodules with ground-glass opacity. Usually, AAH does not exceed 10 mm in size. AAH with extensive involvement on one side of the lung field or one that is larger than 2 cm has not been previously reported. We herein report a case of a 71-year-old nonsmoking female with lung AAH of larger than 2 cm.
Adenocarcinoma ; Adenocarcinoma, Bronchiolo-Alveolar ; Female ; Humans ; Hyperplasia ; Lung ; Precancerous Conditions ; Thorax

Larval excretory-secretory products of Anisakis simplex are known to cause allergic reactions in humans. A cDNA library of A. simplex 3rd-stage larvae (L3) was immunoscreened with polyclonal rabbit serum raised against A. simplex L3 excretory-secretory products to identify an antigen that elicits the immune response. One cDNA clone, designated as alpha-methylacyl CoA racemase (Amacr) contained a 1,412 bp cDNA transcript with a single open reading frame that encoded 418 amino acids. A. simplex Amacr showed a high degree of homology compared to Amacr orthologs from other species. Amacr mRNA was highly and constitutively expressed regardless of temperature (10-40degrees C) and time (24-48 hr). Immunohistochemical analysis revealed that Amacr was expressed mainly in the ventriculus of A. simplex larvae. The Amacr protein produced in large quantities from the ventriculus is probably responsible for many functions in the development and growth of A. simplex larvae.
Amino Acid Sequence ; Animals ; Anisakis/*enzymology/genetics ; Cloning, Molecular ; Cluster Analysis ; Gene Expression Profiling ; Gene Library ; Humans ; Immunohistochemistry ; Larva/enzymology/genetics ; Mice ; Mice, Inbred ICR ; Molecular Sequence Data ; Phylogeny ; Rabbits ; Racemases and Epimerases/genetics/*metabolism ; Sequence Homology, Amino Acid

We have reported that a 24 kDa protein (22U homologous; As22U) of Anisakis simplex larvae could elicit several Th2-related chemokine gene expressions in the intestinal epithelial cell line which means that As22U may play a role as an allergen. In order to determine the contribution of As22U to allergic reactions, we treated mice with 6 times intra-nasal application of recombinant As22U (rAs22U). In the group challenged with rAs22U and ovalbumin (OVA), the number of eosinophils in the bronchial alveolar lavage fluid (BALF) was significantly increased, as compared to the group receiving only OVA. In addition, mice treated with rAs22U and OVA showed significantly increased airway hyperresponsiveness. Thus, severe inflammation around the airway and immune cell recruitment was observed in mice treated with rAs22U plus OVA. The levels of IL-4, IL-5, and IL-13 cytokines in the BALF increased significantly after treatment with rAs22U and OVA. Similarly, the levels of anti-OVA specific IgE and IgG1 increased in mice treated with rAs22U and OVA, compared to those treated only with OVA. The Gro-alpha (CXCL1) gene expression in mouse lung epithelial cells increased instantly after treatment with rAs22U, and allergy-specific chemokines eotaxin (CCL11) and thymus-and-activation-regulated-chemokine (CCL17) gene expressions significantly increased at 6 hr after treatment. In conclusion, rAs22U may induce airway allergic inflammation, as the result of enhanced Th2 and Th17 responses.
Administration, Intranasal ; Animals ; Anisakiasis/*immunology/parasitology ; Anisakis/*immunology/metabolism ; Bronchoalveolar Lavage Fluid ; Chemokines/metabolism ; Cytokines/analysis/*metabolism ; Eosinophils/metabolism ; Female ; Gene Expression Regulation/*immunology ; Helminth Proteins/*immunology ; Hypersensitivity/*immunology/parasitology ; Immunoglobulin E/immunology ; Immunoglobulin G/immunology ; Larva/immunology/metabolism ; Lung/metabolism ; Mice ; Mice, Inbred C57BL ; Recombinant Proteins/immunology ; Th17 Cells/metabolism ; Th2 Cells/metabolism

PURPOSE: To evaulate the effects of chlorhexidine and H2O2 on matrix metalloproteinase-1 (MMP-1), tissue inhibitor of metalloproteinase(TIMP-1, TIMP-2), Type 1 collagen, fibronectin and UNCL expressions in human periodontal ligament fibroblasts (hPDLF). MATERIALS AND METHODS: 1.2x10(-1)%, 1.2x10(-2)% and 1.2x10(-3)% CHX and 3x10(-3)%, 3x10(-4)% and 3x10(-5)% H2O2 and mixture of CHX and H2O2 were applied to hPDLF for 1 min and 30 min. The mRNA expressions of MMP-1, TIMP-1 and 2, Type 1 collagen, fibronectin and UNCL in hPDLF were analysed by RT-PCR. RESULTS: The result were as follows: 1. The expression of UNCL mRNA was higher than that of other mRNAs. 2. 1.2x10(-3) % CHX increased mRNA expressions of hPDLF as application time increased. 3. H2O2 lower than 3x10(-3) % increased expression of UNCL mRNA, and did not decrease mRNA expression of hPDLF. 4. hPDLF treatment with 1.2x10(-1) % CHX (with or without H2O2) resulted in no gene expression. 5. hPDLF treatment with 1.2x10(-2) % CHX (with or without H2O2) for 30 minutes resulted in no gene expression. CONCLUSION: Because low concentration of CHX and H2O2 increased UNCL mRNA expression of hPDLF, low concentraction of CHX and H2O2 may have an antioxidative effect.
Chlorhexidine ; Collagen Type I ; Fibroblasts ; Fibronectins ; Humans ; Matrix Metalloproteinase 1 ; Periodontal Ligament ; RNA, Messenger ; Tissue Inhibitor of Metalloproteinase-1