Depression and life satisfaction among residential elderly in Xiamen city,China and Daejeon city, Korea / 中国心理卫生杂志

Objective:To compare the differences between Chinese and Korean residential elderly depression status,life satisfaction and relatedfactors in Xiamen China and Daejeon Korea.Methods:A survey was conducted on 201 elder people (≥60 years old) in Xiamen,China and 206 elder ones in Daejeon,Korea.The Geriatric Depression Scale,Life Satisfaction Index-A Scale and self-designed demographic questions were used.Data were analyzed with t-test and multiple stepwise regression analysis.Results:The LSI-A scores were higher in Korean elderly than in Chinese elderly (P ＜0.05).In Chinese elderly,social activities (β =0.37),living status (β =-0.30) and education level (β =0.16) were associated with GDS scores,and social activity (β =-0.36) and living status (β=0.17) were associated with LSI-A scores.In Korea elderly,health status (β =-0.33),social activity (β =0.24)and living status (β =-0.13) were associated with GDS scores,and health status (β =0.32),social activity (β =-0.15) and living status (β =0.16) were associated with LSI-A scores.Conclusion:It indicates that Korea elderly have better life satisfaction than Chinese elderly.

Effects of Bed Angles and Bed Rest Time Combined with Hemostatic Methods on Discomfort and the Occurrence of Hemorrhagic Complications in Patients after Transfemoral Cerebral Angiography / 임상간호연구

PURPOSE: The purpose of this study was to examine the effects of bed angles and bed rest time combined with hemostatic methods on discomfort and hemorrhagic complications in patients after transfemoral cerebral angiography. METHODS: Data were collected from 93 inpatients following transfemoral cerebral angiography, from April 20 to September 23, 2016. Patients were grouped according to bed angle (0° vs. 30°) and bed rest time combined with hemostatic methods (4-hour bed rest after manual compression vs. 2-hour bed rest after applying vascular closure device). RESULTS: There was a significant group differences on discomfort (F=46.44, p<.001). The post-hoc analysis showed the lowest score of discomfort in those with bed angle 30o and 2-hour bed rest. There was no difference in hemorrhagic complications among 4 groups. CONCLUSION: The postangiograpy discomfort can be effectively reduced with the least hemorrhagic complications by bed angle 30° elevation and 2-hour bed rest after applying vascular closure device for those underwent transfemoral cerebral angiography.

Item development process and analysis of 50 case-based items for implementation on the Korean Nursing Licensing Examination / 보건의료교육평가

PURPOSE: The purpose of this study was to improve the quality of items on the Korean Nursing Licensing Examination by developing and evaluating case-based items that reflect integrated nursing knowledge. METHODS: We conducted a cross-sectional observational study to develop new case-based items. The methods for developing test items included expert workshops, brainstorming, and verification of content validity. After a mock examination of undergraduate nursing students using the newly developed case-based items, we evaluated the appropriateness of the items through classical test theory and item response theory. RESULTS: A total of 50 case-based items were developed for the mock examination, and content validity was evaluated. The question items integrated 34 discrete elements of integrated nursing knowledge. The mock examination was taken by 741 baccalaureate students in their fourth year of study at 13 universities. Their average score on the mock examination was 57.4, and the examination showed a reliability of 0.40. According to classical test theory, the average level of item difficulty of the items was 57.4% (80%–100% for 12 items; 60%–80% for 13 items; and less than 60% for 25 items). The mean discrimination index was 0.19, and was above 0.30 for 11 items and 0.20 to 0.29 for 15 items. According to item response theory, the item discrimination parameter (in the logistic model) was none for 10 items (0.00), very low for 20 items (0.01 to 0.34), low for 12 items (0.35 to 0.64), moderate for 6 items (0.65 to 1.34), high for 1 item (1.35 to 1.69), and very high for 1 item (above 1.70). The item difficulty was very easy for 24 items (below −2.0), easy for 8 items (−2.0 to −0.5), medium for 6 items (−0.5 to 0.5), hard for 3 items (0.5 to 2.0), and very hard for 9 items (2.0 or above). The goodness-of-fit test in terms of the 2-parameter item response model between the range of 2.0 to 0.5 revealed that 12 items had an ideal correct answer rate. CONCLUSION: We surmised that the low reliability of the mock examination was influenced by the timing of the test for the examinees and the inappropriate difficulty of the items. Our study suggested a methodology for the development of future case-based items for the Korean Nursing Licensing Examination.

The job analysis of Korean nurses as a strategy to improve the Korean Nursing Licensing Examination / 보건의료교육평가

PURPOSE: This study aimed at characterizing Korean nurses' occupational responsibilities to apply the results for improvement of the Korean Nursing Licensing Examination. METHODS: First, the contents of nursing job were defined based on a focus group interview of 15 nurses. Developing a Curriculum (DACOM) method was used to examine those results and produce the questionnaire by 13 experts. After that, the questionnaire survey to 5,065 hospital nurses was done. RESULTS: The occupational responsibilities of nurses were characterized as involving 8 duties, 49 tasks, and 303 task elements. Those 8 duties are nursing management and professional development, safety and infection control, the management of potential risk factors, basic nursing and caring, the maintenance of physiological integrity, medication and parenteral treatments, socio-psychological integrity, and the maintenance and improvement of health. CONCLUSION: The content of Korean Nursing Licensing Examination should be improved based on 8 duties and 49 tasks of the occupational responsibilities of Korean nurses.

Relevance of the test content of the Korean Nursing Licensing Examination to nursing job / 보건의료교육평가

PURPOSE: This study aimed at identifying if there is a relevance of content of the Korean Nursing Licensing Examination (KNLE) revised in 2014 to nursing job. It will be able to provide the validity of revised content of the KNLE. METHODS: From October 13 to November 13, 2015, print version of 8 duties with 49-tasks, 155-job item questionnaires were distributed to 1,305 hospital nurses and 202 nursing faculties in Korea. Results were treated by descriptive statistics and comparison analysis. There were responses from 946 nurses or professors (72.5%). RESULTS: The relevance of test content of KNLE to nursing job was shown to be valid with over 3 points out of 4 point Likert scale in all items: from 3.23 at lowest to 3.64 at top. CONCLUSION: Above results showed that the revised version of KNLE in 2014 was valid to test the nursing students' knowledge for job performance.

Bisphosphonates-related osteonecrosis of the jaw in Korea: a preliminary report

OBJECTIVES: Bisphosphonates (BP) are widely used in medicine for inhibiting bone resorption; however bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a major side effect of BP. To date, there have been no specific reports on the incidence of BRONJ among Koreans. This study investigated the preliminary results from a nationwide survey of BRONJ in the Departments of Oral and Maxillofacial Surgery (OMFS) at individual training hospitals. MATERIALS AND METHODS: A total of 15 OMFS departments (10 from dental schools, 4 from medical schools, and 1 from a dental hospital) participated in a multi-centric survey. This study assessed every BRONJ case diagnosed between January 2010 and December 2010. The patient age and BP type were evaluated. RESULTS: A total of 254 BRONJ cases were collected. The majority of BRONJ cases were associated with oral BP therapy, while 21.8% of the cases were associated with intravenous administration. Alendronate was the drug most frequently related to BRONJ (59.2% of cases), followed by risedronate (14.3%) and zolendronate (17.0%). The average age of BRONJ patients was 70.0+/-10.1 years, with a range of 38-88 years of age. With the number of BP patients in Korea reported to be around 600,000 in 2008, the estimated incidence of BRONJ is at least 0.04% or 1 per 2,300 BP patients. CONCLUSION: The results suggest that the estimated incidence of BRONJ in Korea is higher than the incidence of other countries. Future prospective studies should be carried out to investigate the exact epidemiological characteristics of BRONJ in Korea.

Bisphosphonates-related osteonecrosis of the jaw in Korea: a preliminary report

OBJECTIVES: Bisphosphonates (BP) are widely used in medicine for inhibiting bone resorption; however bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a major side effect of BP. To date, there have been no specific reports on the incidence of BRONJ among Koreans. This study investigated the preliminary results from a nationwide survey of BRONJ in the Departments of Oral and Maxillofacial Surgery (OMFS) at individual training hospitals. MATERIALS AND METHODS: A total of 15 OMFS departments (10 from dental schools, 4 from medical schools, and 1 from a dental hospital) participated in a multi-centric survey. This study assessed every BRONJ case diagnosed between January 2010 and December 2010. The patient age and BP type were evaluated. RESULTS: A total of 254 BRONJ cases were collected. The majority of BRONJ cases were associated with oral BP therapy, while 21.8% of the cases were associated with intravenous administration. Alendronate was the drug most frequently related to BRONJ (59.2% of cases), followed by risedronate (14.3%) and zolendronate (17.0%). The average age of BRONJ patients was 70.0+/-10.1 years, with a range of 38-88 years of age. With the number of BP patients in Korea reported to be around 600,000 in 2008, the estimated incidence of BRONJ is at least 0.04% or 1 per 2,300 BP patients. CONCLUSION: The results suggest that the estimated incidence of BRONJ in Korea is higher than the incidence of other countries. Future prospective studies should be carried out to investigate the exact epidemiological characteristics of BRONJ in Korea.

Verification of Model on Family Adaptation in Families of Hospitalized Children: Focused on Parents of Hospitalized Children in China

PURPOSE: The purpose of this study was to identify the effect of family stressors, family strains, general family values, family values for hospitalized children and family hardiness on family adaptation based upon McCubbin's family resilience model for families of hospitalized children in China. METHODS: A survey using a self-report questionnaire was conducted with 330 hospitalized children's parents. Six instruments were used in this model. The data were analyzed using SPSS WIN 19.0 and AMOS 19.0 program. RESULTS: Family strain had a significant negative direct effect, general family values and family hardiness had a significant positive direct effect, and family values for hospitalized children had a significant positive direct effect and indirect effect on family adaptation of hospitalized children. CONCLUSION: In this study McCubbin's resilience model and resiliency factors were identified. According to the finding of this study nursing interventions to reduce family stress, enhance family hardiness and consolidate general family values and family values for hospitalized children can help to increase family adaptation in families of hospitalized children. Therefore, the significance of this study is that the results can be used to develop family nursing intervention programs based on family resilience to strengthen family adaptation in families of hospitalized children.

Multicenter clinical study on the hydrodynamic piezoelectric internal sinus elevation (HPISE) technique

OBJECTIVES: This study was to evaluate the effect of vertical bone gain and success rate and analyze the failure cases using the hydrodynamic piezoelectric internal sinus elevation (HPISE) technique. MATERIALS AND METHODS: Patients who had been operated in the three centers including Daegu Catholic University Medical Center were selected for this study. The mucoperiosteal flap was elevated, and the sinus floor was then broken by specially designed piezoelectric insert, with hydraulic pressure applied to the sinus membrane for even elevation. Afterward, implants were placed. Panoramic radiogram or computed tomogram was taken before and after surgery and at the second operation and prosthesis placement. Later, changes in vertical height were measured and compared. The survival rate was based on the criteria of Buser et al. and Cochran et al. RESULTS: In this study, 8 implants failed out of a total of 169 implants, resulting a success rate of 95.3%. These failure cases were due to insufficient initial stability or sinus membrane perforation. The mean of radiographic vertical height change at prosthesis placement was 5.7 mm (0.5-10.5 mm). CONCLUSION: In this study, HPISE technique was found to be a predictable treatment for atrophic maxilla and an alternative technique to the lateral approach.

Pulmonary hypertension due to obstructive sleep apnea in a child with Rubinstein-Taybi syndrome / 소아과

Rubinstein-Taybi syndrome (RTS) is characterized by peculiar facies, mental retardation, broad thumbs, and great toes. Approximately one-third of the affected individuals have a variety of congenital heart diseases. They can also have upper airway obstruction during sleep, due to hypotonia and the anatomy of the oropharynx and airway, which make these patients susceptible to obstructive sleep apnea (OSA). In our case, pulmonary hypertension was caused, successively, by congenital heart defects (a large patent ductus arteriosus and arch hypoplasia) and obstructive sleep apnea during early infancy. The congenital heart defects were surgically corrected, but persistent pulmonary hypertension was identified 2 months after the operation. This pulmonary hypertension was due to OSA, and it was relieved by nasal continuous positive airway pressure. This case is the first report of pulmonary hypertension from OSA in a young infant with RTS.

Pulmonary hypertension due to obstructive sleep apnea in a child with Rubinstein-Taybi syndrome / 소아과

Rubinstein-Taybi syndrome (RTS) is characterized by peculiar facies, mental retardation, broad thumbs, and great toes. Approximately one-third of the affected individuals have a variety of congenital heart diseases. They can also have upper airway obstruction during sleep, due to hypotonia and the anatomy of the oropharynx and airway, which make these patients susceptible to obstructive sleep apnea (OSA). In our case, pulmonary hypertension was caused, successively, by congenital heart defects (a large patent ductus arteriosus and arch hypoplasia) and obstructive sleep apnea during early infancy. The congenital heart defects were surgically corrected, but persistent pulmonary hypertension was identified 2 months after the operation. This pulmonary hypertension was due to OSA, and it was relieved by nasal continuous positive airway pressure. This case is the first report of pulmonary hypertension from OSA in a young infant with RTS.

Effectiveness and Safety of Percutaneous Transcatheter Implantation of Pulmonary Arterial Stent in Congenital Heart Disease

BACKGROUND AND OBJECTIVES: Pulmonary arterial stenosis is a relatively common complication after corrective operation of congenital heart disease. Unilateral stenosis of pulmonary arteries could result in decrease perfusion of affected lung, pulmonary regurgitation, or elevation of right ventricular pressure. Eventually there are increasing risks of right ventricular failure, arrhythmia, or sudden death. However we have limited data of pulmonary arterial stent in paediatric population as the treatment of branch pulmonary stenosis. This study aimed at validating the effectiveness and investigating complications of pulmonary arterial stent implantation in a single institution during mid-term follow up period. SUBJECTS AND METHODS: A total of 42 patients (50 stents) were implanted for treating branch pulmonary arterial stenosis. We used cardiac catheterization for comparing diameter after stent implantation directly and lung perfusion scan indirectly. We also investigated any adverse effect relating the procedure. RESULTS: Percent stenosis of stenotic lesions were decreased from 54.1+/-10.7% to 22.8+/-12.5% (p<0.001) and degree of decrement in affected lung perfusion was declined from 22.7+/-8.0% to 10.3+/-9.0% (p<0.001) immediately and lasts during mid-term follow up period. Complication rate relating the procedure was 12% (6 out of 12) and there was no mortality case. CONCLUSION: This series showed immediate and short term effectiveness of pulmonary arterial stent in congenital heart defects. We concluded that percutaneous transcatheter implantation of pulmonary arterial stent was safe and effective during short and mid-term follow up period.

Ridge Augmentation Using Block Type of Autogenous Tooth Bone Graft Material in Severe Alveolar Bone Resorption of Single Tooth: Case Report

Right Ventricular Outflow Tract Stenting in a Low Birth Weight Infant Born With Tetralogy of Fallot and Prostaglandin E1 Dependency

Surgical skill and strategy for the correction of tetralogy of Fallot (TOF) have improved and resulted in satisfactory outcomes. However, prematurity and low birth weight continue to remain risk factors for poor outcomes. We present a case of a 2,150 g neonate born with TOF, in whom palliation was achieved with right ventricular outflow tract (RVOT) stenting. Seventy-seven days after the procedure, stenosis of RVOT below the stent was identified. At that time his body weight was 4.9 kg and total corrective surgery was deemed feasible. Eight months following surgical repair, the patient remained well without medical intervention. RVOT stenting may be a viable interim procedure while waiting for a low birth weight neonate born with TOF and prostaglandin E1 dependency to reach optimal weight to undergo corrective surgery.

Interleukin-6 (-636 C/G) Gene Polymorphism in Korean Children With Kawasaki Disease

BACKGROUND AND OBJECTIVES: Kawasaki disease (KD) is a multi-systemic vasculitis with coronary artery involvement. Serum interleukin (IL)-6 levels during acute phase showed a significant correlation with the duration of fever in patients with KD who were not treated with intravenous immunoglobulin (IVIG), suggesting that the regulation of IL-6 expression in KD patients may differ from that in normal children. However, there are controversies surrounding the association between IL-6 (-636 C/G) gene polymorphism and development of KD. SUBJECTS AND METHODS: One hundred and nine children with KD and 191 children with congenital heart disease were included in this study. Echocardiography was performed to examine cardiac involvement in patients with KD. Genotyping of the IL-6 (-636 C/G) gene polymorphism was performed using the single-base extension method, and serum IL-6 concentrations were estimated using the sandwich enzyme immunoassay method. RESULTS: Neutrophil, platelet count, liver function test, total protein and albumin concentrations were significantly different in the KD group and the serum IL-6 concentration was significantly higher in the KD group than the control group. There was no difference between the patients with coronary arterial dilatation (CAD) and those without CAD in the IL-6 (-636 C/G) polymorphism. The serum albumin concentration was significantly lower in patients with KD who had the -636 C/G or GG genotype compared with the control group. The serum IL-6 concentration was significantly higher in patients with KD who had the -636 C/G or GG genotype. CONCLUSION: There was no association between the IL-6 (-636 C/G) gene polymorphism and development of coronary arterial lesions in KD. Further multicenter studies are required to establish the relationship between the IL-6 (-636 C/G) gene polymorphism and development of KD.

Effects of Topical Anesthetics to Reduce Pain in Preterm Infants During Percutaneous Cental Venous Catheterization (PCVC) / 대한주산의학회잡지

PURPOSE: The purpose of this study is to prove the effects of topical anesthetics (EMLA) to control pain in preterm infants during invasive procedure (percutaneous central venous catheterization, PCVC). METHODS: A total of 18 preterm infants of birth weight <2,000 g and gestational age <36 weeks born at EulJi University Hospital, at Daejeon in 2010 were randomly included in this study. EMLA was applied in nine preterm infants 40 minutes before starting PCVC and placebo was applied in another nine preterm infants. Based on PIPP (preterm infant pain profile), we evaluated their heart rate, oxygen saturation before, 15 seconds during and 30 seconds after procedure. Behavioral responses were also recorded for 2 minutes after procedure. RESULTS: Experimental group showed significantly less behavioral response during procedure (P=0.005) and 2 min after procedure (P=0.001). Also, experimental group showed less increase in heart rate (P=0.033) and reduction of behavioral state (P=0.017). CONCLUSION: Despite limitation of small size in this study, experimental group showed lower pain score compared with placebo control group during catheterization. In neonatal care unit (NICU), we recommend the use of topical anesthetics such as EMLA to control pain during invasive procedures.

Is free medical care possible?

Free medical care is currently a highly debated issue in Korea. However, from a practical point of view, 'completely free' medical care is impossible. Last year the National Health Insurance Corporation (NHIC) reported a huge deficit of up to 1.3 trillion in Korean won, which is the largest deficit in the past 10 years. NHIC expenditures are skyrocketing for many reasons: drug overuse, very expensive new drugs or devices increasing geriatric population and survivors of cancer or chronic illnesses, expanding insurance coverage for new diagnostic tests, drugs, neonates, rare diseases, disabilities, and cancer, occurrence of new diseases, increasing number of doctors, moral hazard, and wasting of resources due to the duplication and counteraction between modern medicine and Oriental medicine. What, then, should we do to provide partially free medical care? We need to reduce expenditures for drugs and increase health insurance premiums. Korean health insurance premium currently low compared to that of other countries in Organization for Economic Co-operation and Development. It is also necessary to introduce the concept of a health tax, in which healthy individuals with a high income pay higher premiums while sick or low-income individuals pay lower premiums. Expanding public health coverage such as vaccinations, regular health surveillance programs, and education on health promotion should be implemented. Private health care insurance can be introduced carefully with close monitoring. The last and most important recommendation is that society must become more ethical and transparent. Korea is entering a new era as a developed country and as a result a welfare system, including medical care is notoptional but is mandatory in some part. However, even a partially free medical care is going to be possible only if the entire health care system is operated in an ethical and efficient way for maximal utilization of limited resources while avoiding moral hazard and waste.

New bone formation using fibrin rich block with concentrated growth factors in maxillary sinus augmentation

INTRODUCTION: This study examined the predictability of new bone formation in the pneumatized maxillary sinus using only fibrin-rich blocks with concentrated growth factors as an alternative to bone grafts. MATERIALS AND METHODS: Maxillary sinus augmentation was performed in thirty-three patients with a deficient alveolar bone height (mean 3.9 mm). All patients were treated consecutively with sinus membrane elevation via the lateral window approach and panoramic radiograms and cone-beam computed tomograms were taken to evaluate the remaining bone height and the new bone formation in the maxillary sinus, before and after surgery. Four biopsy specimens were taken at the time of implant consolidation (after an average of five months healing) and were stained by H & E and Trichrome staining. RESULTS: None of the patients had postoperative complications during implant consolidation. After an average of 5 months since sinus augmentation, newly formed bone was observed in all cases by a radiographic evaluation. In 4 biopsy samples, newly formed bone was observed along the floor of the replaced bony window. The osteoblast lining and well distinguished Osteocytes in the lacunas were observed in the newly formed bone. Of the 74 implants (4 different surfaced implants - resorbable blast media-surfaced (RBM), Hydroxyapatite (HA) coated, acid-etched, sintered porous-surfaced implant) placed, one RBM implant failed. The success rate was 98.6% after a mean of 15 months. DISCUSSION: These results suggest that maxillary sinus augmentation using fibrin rich block with concentrated growth factors is a successful and predictable technique.

Log-transformed plasma level of brain natriuretic peptide during the acute phase of Kawasaki disease is quantitatively associated with myocardial dysfunction / 소아과

PURPOSE: Brain natriuretic peptide (BNP) has been considered a biochemical marker for myocarditis in Kawasaki disease. We performed this study to determine its quantitative significance. METHODS: We attempted to correlate log-transformed BNP concentrations (log-BNP) and clinical, laboratory, and echocardiographic variables in 81 children with Kawasaki disease. Stepwise multiple linear regression analysis was used to determine the variables independently associated with log-BNP concentration. RESULTS: Serum C-reactive protein level (P<0.0001), serum alanine aminotransferase concentration (P=0.0032), white blood cell count (P=0.0030), and left ventricular mass index (P=0.0024) were positively related with log-BNP, and hemoglobin level (P<0.0001), serum albumin level (P<0.0001), Na+ concentrations (P<0.0001), left ventricular fractional shortening (P=0.0080), and peak early diastolic tissue velocity of the left ventricular basal lateral segment (P=0.0045) were negatively related to the log-BNP concentration. Multiple regression analysis showed that serum albumin concentration (R2=0.31, P=0.0098) and left ventricular mass index (R2=0.09, P=0.0004) were significantly associated with the log-BNP concentration. CONCLUSION: Elevated BNP levels during the acute phase of Kawasaki disease may be attributable to cardiac dysfunction associated with the increase in left ventricular mass, and log-BNP concentration may be a quantitative biochemical marker of myocarditis in Kawasaki disease.

Comparative study of removal torque of 3 different hydroxyapatite coated implants in the femur of rabbits

INTRODUCTION: This study compared the strength of osseointegration as determined by the resistance to reverse torque rotation of three different hydroxyapatite coated implants in the rabbit femur model. MATERIALS AND METHODS: Three hydroxyapatite coated implants (HAPTITE), Tapered Screw-Vent (TSV) and BioTite-H - were used. A total of 40 implants were placed in the femur of 20 adult male rabbits. The animals were divided into two groups. In group A (n=10); one HAPTITE was placed into each right femur and one TSV was placed into each left femur. In group B (n=10); one HAPTITE was placed into each right femur and one BioTite-H was placed into each left femur. Five rabbits of each group were sacrificed at 4 and 8 weeks. The implants were removed by reverse torque rotation using a digital torque-measuring device. A total of 40 implants in 20 rabbits were used for the removal torque measurements. RESULTS: In the Group A, 4 weeks after implant placement, the mean removal torque for the HAPTITE and TSV was 70.7+/-31.6 N cm and 28.9+/-15.1 N cm, respectively. Eight weeks after implant placement, the mean removal torque for the HAPTITE and TSV was 87.9+/-26.2 N cm and 54.9+/-22.4 N cm, respectively. In the Group B, 4 weeks after implant placement, the mean removal torque for the HAPTITE and BioTite-H was 58.0+/-29.6 N cm and 37.7+/-14.1 N cm, respectively. Eight weeks after implant placement, the mean removal torque for the HAPTITE and BioTite-H was 91.4+/-47.1 N cm and 30.8+/-9.8 N cm. HAPTITE showed a higher removal torque than the other implants. CONCLUSION: These results suggest that HAPTITE increases the strength of osseointegration significantly as determined by the resistance to reverse torque rotation.