Purpose: We conducted a randomized prospective trial (KLASS-07 trial) to compare laparoscopy-assisted distal gastrectomy (LADG) and totally laparoscopic distal gastrectomy (TLDG) for gastric cancer. In this interim report, we describe short-term results in terms of morbidity and mortality. Methods: and Methods: The sample size was 442 participants. At the time of the interim analysis, 314 patients were enrolled and randomized. After excluding patients who did not undergo planned surgeries, we performed a modified per-protocol analysis of 151 and 145 patients in the LADG and TLDG groups, respectively. Results: The baseline characteristics, including comorbidity status, did not differ between the LADG and TLDG groups. Blood loss was somewhat higher in the LADG group, but statistical significance was not attained (76.76±72.63 vs. 62.91±65.68 mL; P=0.087). Neither the required transfusion level nor the operation or reconstruction time differed between the 2 groups. The mini-laparotomy incision in the LADG group was significantly longer than the extended umbilical incision required for specimen removal in the TLDG group (4.79±0.82 vs. 3.89±0.83 cm; P<0.001). There were no between-group differences in the time to solid food intake, hospital stay, pain score, or complications within 30 days postoperatively. No mortality was observed in either group. Conclusions Short-term morbidity and mortality rates did not differ between the LADG and TLDG groups. The KLASS-07 trial is currently underway.

Background: Catheter-associated urinary tract infections (CAUTIs) account for a large proportion of healthcare-associated infections and have a significant impact on morbidity, length of hospital stay, and mortality. Adherence to the recommended infection prevention practices can effectively reduce the incidence of CAUTIs. This study aimed to assess the characteristics of CAUTIs and the efficacy of prevention programs across hospitals of various sizes. Methods: Intervention programs, including training, surveillance, and monitoring, were implemented. Data on the microorganisms responsible for CAUTIs, urinary catheter utilization ratio, rate of CAUTIs per 1,000 device days, and factors associated with the use of indwelling catheters were collected from 2017 to 2019. The incidence of CAUTIs and associated data were compared between university hospitals and small- and medium-sized hospitals. Results: Thirty-two hospitals participated in the study, including 21 university hospitals and 11 small- and medium-sized hospitals. The microorganisms responsible for CAUTIs and their resistance rates did not differ between the two groups. In the first quarter of 2018, the incidence rate was 2.05 infections/1,000 device-days in university hospitals and 1.44 infections/1,000 device-days in small- and medium-sized hospitals. After implementing interventions, the rate gradually decreased in the first quarter of 2019, with 1.18 infections/1,000 device-days in university hospitals and 0.79 infections/1,000 device-days in small- and medium-sized hospitals. However, by the end of the study, the infection rate increased to 1.74 infections/1,000 device-days in university hospitals and 1.80 infections/1,000 device-days in small- and medium-sized hospitals. Conclusion We implemented interventions to prevent CAUTIs and evaluated their outcomes. The incidence of these infections decreased in the initial phases of the intervention when adequate support and personnel were present. The rate of these infections may be reduced by implementing active interventions such as consistent monitoring and adherence to guidelines for preventing infections.

As 16S ribosomal RNA (rRNA)-targeted sequencing can detect DNA from non-viable bacteria, it can be used to identify pathogens from clinical samples even in patients pretreated with antibiotics. We compared the results of 16S rRNA-targeted sequencing and culture for identifying bacterial species in normally sterile body fluid (NSBF): cerebrospinal, pericardial, peritoneal and pleural fluids. Over a 10-year period, a total of 312 NSBF samples were evaluated simultaneously using 16S rRNA-targeted sequencing and culture. Results were concordant in 287/312 (92.0%) samples, including 277 (88.8%) negative and 10 (3.2%) positive samples. Of the 16 sequencing-positive, culture-negative samples, eight showed clinically relevant isolates that included Fusobacterium nucleatum subsp. nucleatum, Streptococcus pneumoniae, and Staphylococcus spp. All these samples were obtained from the patients pretreated with antibiotics. The diagnostic yield of 16S rRNA-targeted sequencing combined with culture was 11.2%, while that of culture alone was 6.1%. 16S rRNA-targeted sequencing in conjunction with culture could be useful for identifying bacteria in NSBF samples, especially when patients have been pretreated with antibiotics and when anaerobic infection is suspected.

PURPOSE: The purpose of the non-equivalent control group pretest-posttest study was to test the effects of self-directed nursing practice using peer-tutoring, on the level of confidence, performance and learning satisfaction of nursing students in practicing core nursing skills. METHODS: The data were collected from 80 junior nursing students at a nursing college in Daejeon before and after 3 weeks of intervention on practicing six core nursing skills, according to the highest order of priority. The subjects were divided into the peer-tutoring practice group (PTPG, n=40) and the lecturer-guided practice group (LGPG, n=40). The data were analyzed using mean, frequency, and t-test. RESULTS: The PTPG scored statistically higher than the LGPG on the performance of ‘indwelling urinary catheterization’ and ‘wearing protection equipment while entering quarantine room & disposing waste’ The PTPG scored statistically higher than the LGPG on the confidence of ‘indwelling urinary catheterization’ and ‘inserting intravenous catheterization’. The PTPG scored statistically higher on learning satisfaction than LGPG. CONCLUSION: The results showed that self-directed nursing practice using peer-tutoring could be effective for nursing students in improving proficiency in core nursing skills and might be applied to core nursing skills training.
Clinical Competence ; Humans ; Learning* ; Nursing* ; Quarantine ; Students, Nursing*

PURPOSE: This study was done to identify the relationship of malnutrition, social network and health-related quality of life and to investigate the main factors influencing health-related quality of life in elders. METHODS: The research design was a descriptive survey design using a convenience sampling. Data were collected by self-report questionnaires from 196 elders. Data analysis was done using SPSS 18.0 pc+ program for descriptive statistics, Pearson correlation coefficients and stepwise multiple regression. RESULTS: The average score for health related quality of life was 3.33 (SD=0.86). Differences in health-related quality of life were statistically significant according to age, gender, occupation, presence of spouse, monthly income, source of income, economic status, medicine, and existence of chronic disease. Health-related quality of life was significantly correlated with malnutrition and social network. Major factors affecting health related quality of life for elders were malnutrition, occupation, age, social network, and economic status which explained 52.0% of the variance in health related quality of life. CONCLUSION: Findings provide a basis for developing nursing interventions to improve health-related quality of life. Future studies are needed a wide variety of variables that might influence health-related quality of life in elders.
Aged ; Chronic Disease ; Humans ; Malnutrition ; Occupations ; Quality of Life ; Surveys and Questionnaires ; Research Design ; Spouses ; Statistics as Topic

PURPOSE: The purpose of this study was to investigate differences in professionalism, organizational citizenship behavior and psychological ownership between nurses and nurse officers. METHODS: A cross-sectional survey was conducted with 1017 hospital nurses and military nurse officers. The instruments used were the Korean Version of Hall's Professionalism Inventory' modified by Baek (2007), Organizational Citizenship Behavior Qquestionnaire(OCBQ) modified by Lee (2006), and the Psychological Ownership Inventory' developed by Van Dyne and Pierce (2004). RESULTS: The average score for military nurse officers professionalism was 3.15, for organizational citizenship behavior, was 3.43 and for psychological ownership, 3.64. These scores were higher than the scores for hospital nurses. There were significant positive correlations between the variables(r=.47~.581, p<.001). CONCLUSION: The results of this study indicate an affirmable outcome and that the significant variables affected levels of Professionalism, Organizational citizenship behavior, and Psychological ownership. So in order to improve the level of variables, there is a need to consider strategies related to organization, work environment and conceptualization as related to the variables.
Cross-Sectional Studies ; Humans ; Military Personnel ; Ownership

PURPOSE: This study was to identify the health status and reported resilience according to acculturation type among Chinese students in Korea. METHODS: The subjects were 386 Chinese students studying in three universities in Chungnam province. The data were collected by standardized questionnaires and SPSS/WIN 15.0 program was used to analyze the data with descriptive statistics, Chi-square, t-test, and ANOVA. RESULTS: Subjects reported the following Acculturation type: integration (26.7%), assimilation (28.5%), separation (32.4%), and marginalization (12.4%). The reported resilience was significantly different according to economic status. The health status was significantly different according to religion and economic status. Acculturation type was significantly different according to age, educational level, length of stay, type of residency and economic status working style. The health status and resilience were significantly different according to acculturation type. CONCLUSION: The findings suggest that integration of acculturation type is most useful to health status and resilience among Chinese students in Korea. Future studies need to examine acculturation type as coping strategy for foreign students' adaptation.
Acculturation ; Asian Continental Ancestry Group ; Humans ; Internship and Residency ; Korea ; Length of Stay ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to identify the predictors of acculturative stress among Chinese students in Korea. METHODS: Between October and December 2009, two hundred one Chinese students from three universities located in Cungnam province, were included in the current study using a questionnaire survey. Data analysis was done using SPSS/WIN 17.0 program. RESULTS: The average score of acculturative stress was 38.50+/-6.97. There were significant differences in acculturative stress according to educational level, economic status, type of residence, speaking skill in Korean, listening skill in Korean, grade point average, satisfaction for studying abroad, and perceived health status. The acculturative stress was significantly correlated with depression, resilience and social support. The strongest predictor of acculturative stress among Chinese students was depression. CONCLUSIONS: The findings suggest that developing programs to improve psychological health may provide a buffer against acculturative stress experienced by migrating Chinese students. Furthermore, more studies are needed to explore variables that influence on the international students' acculturation in Korea.
Acculturation ; Asian Continental Ancestry Group ; Depression ; Humans ; Korea ; Statistics as Topic

PURPOSE: The purpose of this research was to evaluate the effects of PBL on ability of nursing students in Self-Directed Learning, Critical Thinking Disposition and Problem Solving Process. METHODS: The research design was a nonequivalent control group pretest-posttest design. For the experimental group PBL was used during one semester (14 weeks). Instruments for data collection were Self-Directed Learning Readiness Scale (Kim, 1997), Critical Thinking Disposition Scale (Kwon et al., 2006) and Problem Solving Process Scale (Lee, 1979). The data were analyzed by repeated measure ANOVA. RESULTS: There were statistically significant improvements in Self-Directed Learning and Critical Thinking between the two groups after PBL. But there was no statistically significant improvement in the Problem Solving Process. CONCLUSION: These results suggest that PBL has a positive effect on nursing students' education. Therefore, PBL should be used for more subjects in the nursing curriculum.
Surveys and Questionnaires ; Humans ; Learning ; Problem Solving ; Problem-Based Learning ; Research Design ; Students, Nursing ; Thinking

BACKGROUND: This study was to evaluate a nationwide nosocomial infection rate and antimicrobial resistance in intensive care units(ICUs) in Korea. METHODS: The study was carried out at 16 university-affiliated teaching hospitals from July through October 2004. We performed a prospective multicenter study to investigate nosocomial infection rates, device-associated infection rated, and causative pathogens and their antimicrobial resistance. RESULTS: The urinary tract was the most commonly involved site. Nosocomial infection rate was 12.48 in medical. ICU (MICU), 9.59 in medical surgical ICU (MSICU), 14.76 in surgical ICU (MSICU), and 11.60 in other lCU. Device-associated infection rates were as follow: 1) rates of urinary catheter-associated urinary tract infection were 4.26 in MICU, 3.17 in SICU, 4.88 in MSICU, and 5.87 in other ICU; 2) rates of central line-associated bloodstream infection were 3.24 in MICU, 1.56 in SlCU, 2.36 in MSICU, and 1.78 in other ICU; 3) rates of ventilator-associated pneumonia were 3.61 in MlCU, 13.05 in SICU, 1.68 in MSICU, and 4.84 in other lCU. Staphylococcus aureus was the most frequently identified microorganism in this study; 93% of S. aurues were resistant to methicillin; 17% of Pseudomonas aeruginosa isolated were resistant to imipenem; 11% of Enterococcus faecium and 18% of Enterococcus faecalis showed resistance to vancomycin. Over a half of Acinetobacter spp, Stenotrophomonas maltophilia, Klebsiella pneumoniae, and Escherichia coli showed resistant to fluoroquinolone. Conclusion: This study shows the seriousness of antimicrobial resistance and the importance of infection control in the lCU in Korea. This study should provide a theoretical strategy to enforce the infection control.
Acinetobacter ; Cross Infection* ; Enterococcus faecalis ; Enterococcus faecium ; Escherichia coli ; Hospitals, Teaching ; Hospitals, University* ; Imipenem ; Infection Control ; Intensive Care Units* ; Critical Care* ; Klebsiella pneumoniae ; Korea* ; Methicillin ; Pneumonia, Ventilator-Associated ; Prospective Studies ; Pseudomonas aeruginosa ; Staphylococcus aureus ; Stenotrophomonas maltophilia ; Urinary Tract ; Urinary Tract Infections ; Vancomycin