• Korean Journal of Adult Nursing
• /
• v.27 no.3
• /
• pp.283-293
• /
• 2015

Purpose: Depression is a common sign of suffering among the patients with Parkinson's disease (PD). Frequent and severe neuropsychiatric symptoms lead to high levels of distress in patients and their caregivers, which results in the high levels of caregiver burden. The aim of this study was to determine the predictors of caregiver burden in caregivers of the patients with Parkinson's disease (PD). Methods: The study included 183 consecutive PD patients and their caregivers. Patients were assessed using the Hoehn and Yahr scale, Mini Mental State Examination (MMSE), Beck Depression Inventory (BDI), and Schwab and England Activities of Daily Living Scale. Caregivers' depressive symptoms were evaluated using the Caregiver Burden Inventor (CBI), BDI, and World Health Organization Quality of Life Scale. Results: All of the patients reported one or more neuropsychiatric symptoms. Patients' and caregivers' depressive symptoms, caregivers' age and education, time for caregiving, and quality of life were significantly associated with the increased caregiver burden. After controlling the level of education as a potential confounding variable, depression in both patients and caregivers, time for caregiving, and quality of life explained 45.6% of the variance in caregiver burden. Conclusion: Substantial attention needs to be given to the early identification of depression in PD patients and their caregivers to improve caregivers' quality of life and burden.

• Journal of Chest Surgery
• /
• v.54 no.1
• /
• pp.36-44
• /
• 2021

Background: Extracorporeal membrane oxygenation (ECMO) has become increasingly accepted as a life-saving procedure for patients with severe acute respiratory distress syndrome (ARDS). This study investigated the relationship between cumulative fluid balance (CFB) and outcomes in adult ARDS patients treated with ECMO. Methods: We retrospectively analyzed the data of adult ARDS patients who received ECMO between December 2009 and December 2019 at Korea University Anam Hospital. CFB was calculated during the first 7 days after ECMO initiation. The primary endpoint was 28-day mortality. Results: The 74 patients were divided into survivor (n=33) and non-survivor (n=41) groups based on 28-day survival. Non-survivors showed a significantly higher CFB at 1-7 days (p<0.05). Cox multivariable proportional hazard regression revealed a relationship between CFB on day 3 and 28-day mortality (hazard ratio, 3.366; 95% confidence interval, 1.528-7.417; p=0.003). Conclusion: In adult ARDS patients treated with ECMO, a higher positive CFB on day 3 was associated with increased 28-day mortality. Based on our findings, we suggest a restrictive fluid strategy in ARDS patients treated with ECMO. CFB may be a useful predictor of survival in ARDS patients treated with ECMO.

• Journal of Chest Surgery
• /
• v.56 no.3
• /
• pp.206-212
• /
• 2023

Background: Delayed sternal closure (DSC) is a useful option for patients with intractable bleeding and hemodynamic instability due to prolonged cardiopulmonary bypass and a preoperative bleeding tendency. Vacuum-assisted closure (VAC) has been widely used for sternal wound problems, but only rarely for DSC, and its efficacy for mediastinal drainage immediately after cardiac surgery has not been well established. Therefore, we evaluated the usefulness of DSC using VAC in adult cardiac surgery. Methods: We analyzed 33 patients who underwent DSC using VAC from January 2017 to July 2022. After packing sterile gauze around the heart surface and great vessels, VAC was applied directly without sternal self-retaining retractors and mediastinal drain tubes. Results: Twenty-one patients (63.6%) underwent emergency surgery for conditions including type A acute aortic dissection (n=13), and 8 patients (24.2%) received postoperative extracorporeal membrane oxygenation support. Intractable bleeding (n=25) was the most common reason for an open sternum. The median duration of open sternum was 2 days (interquartile range [25th-75th pertentiles], 2-3.25 days) and 9 patients underwent VAC application more than once. The overall in-hospital mortality rate was 27.3%. Superficial wound problems occurred in 10 patients (30.3%), and there were no deep sternal wound infections. Conclusion: For patients with an open sternum, VAC alone, which is effective for mediastinal drainage and cardiac decompression, had an acceptable superficial wound infection rate and no deep sternal wound infections. In adult cardiac surgery, DSC using VAC may be useful in patients with intractable bleeding or unstable hemodynamics with myocardial edema.

• Animal cells and systems
• /
• v.7 no.2
• /
• pp.145-149
• /
• 2003

Adult periodontitis is a chronic inflammatory disease whose etiology is not well defined. Recent studies have shown that vitamin D receptor gene has been a candidate for the susceptibility of adult periodontitis. The purpose of this study is to investigate the frequency of Taq I restriction fragment length polymorphism (RFLP) in the vitamin D receptor gene in nan periodontically healthy controls and 28 adult periodontitis patients. Taq I RFLP in the vitamin D receptor gene was detected by PCR amplification, followed by restriction enzyme digestion and 2％ agarose gel electrophoresis. There was no significant difference in the distribution of Taq I RFLP between healthy controls and adult periodontitis group (P > 0.05). Thus, Taq I RFLP in the vitamin D receptor gene may not confer the susceptibility to adult periodontitis in Korean population. However, t allele distributions of this RFLP showed various frequencies among ethnic groups studied. Further studies in other ethnic groups will be required.

• Journal of Microbiology
• /
• v.45 no.5
• /
• pp.447-452
• /
• 2007

In this study, we compared the phenotypic and genotypic characteristics of 138 MRSA isolates obtained from adult and pediatric patients (adult, 50; children, 88). The resistance rates against gentamicin, clindamycin, and ciprofloxacin were much higher in the adult MRSA isolates than in the pediatric MRSA isolates. The ermC gene, which is responsible for inducible clindamycin resistance, was detected in 52(59.1%) of the 88 pediatric MRSA isolates but in only 5(10.0%) of the 50 adult MRSA isolates. MRSA isolates of clonal type ST5 with an integration of SCCmec type II/II variants was the most predominant clone among the adult isolates, while clonal type ST72 with an integration of SCCmec IV/IVA was the most predominant clone among the pediatric MRSA isolates. Staphylococcal enterotoxin A and toxic shock syndrome toxin-1 were prevalent among the adult MRSA isolates but not among the pediatric MRSA isolates. The results of this study demonstrated remarkable differences between adult and pediatric MRSA isolates in terms of their antimicrobial susceptibility profiles, SCCmec type, multilocus sequence type, staphylococcal toxin genes, and erythromycin resistance genes.

• Anxiety and mood
• /
• v.9 no.1
• /
• pp.38-44
• /
• 2013

Objective : The end-stage renal disease patients who shared fear of death, functional impairment due to hemodialysis are vulnerable to depression, anxiety and other mental problems. It is possible that their psychiatric characteristics and related autonomic nervous functions have some differences depending on their age. We purpose to find the differences of psychiatric characteristics and related autonomic nervous functions between adult and elderly hemodialysis patients. Methods : Our subjects are end-stage renal disease hemodialysis patients composed of 39 adults (<65 years) and 24 seniors (${\geq}65$ years). Outcome measures included the 17-item Hamilton Rating Scale for Depression, The Hamilton Rating Scale for Anxiety, The Apathy Evaluation Scale and Mini-International Neuropsychiatric Interview by clinician. And subjects fulfilled self-report scale, The Positive thinking scale and The Snaith-Hamilton Pleasure Scale. The autonomic nervous functions are measured by heart rate variability. Results : There are no significant differences in demographic factors between two groups. The 17-item Hamilton Rating Scale for Depression, The Hamilton Rating Scale for Anxiety, The Apathy Evaluation Scale, The Snaith-Hamilton Pleasure Scale and autonomic nervous functions are also not different. But only positive thinking scale is higher in adult hemodialysis group than the elderly (F=5.395, p=0.024). Conclusion : This study compared depression, anxiety and autonomic nervous functions between adult and senior hemodialysis patients. There are no significant differences in psychiatric characteristics and autonomic nervous functions between two groups except positive thinking traits. Senior patients endured their chronic disease similar to adult patients did in spite of their old age. This result suggests that elderly's higher positive thinking traits affect their endurances about the negative situations.

• Korean Journal of Adult Nursing
• /
• v.16 no.4
• /
• pp.677-689
• /
• 2004

Purpose: The purpose of the study was to identify types of care needs for hospice patients through Q- methodology. Method: Twenty three Q-statements were selected through in-depth interviews of hospice patients. Data were collected from 20 hospice patients by sorting 23 Q-statements into 9 points standard and then analyzed using PC QUANL program. Result: Type 1 was named 'the need for pain control type' and patients of this type had the greatest need of physical care to be free of pain and be comfortable. Type 2 was named 'the need for love and intimacy type' and patients of this type would like to share love and intimacy with their family members. Type 3 was named 'the needs for reliance on an Absolute Being type' and patients of this type would like to receive forgiveness from their God and prayers. Type 4 was named 'the need for accomplishment and service type' and patients of this type would like to complete their on going work and to give service to others. Conclusion: The study result could be basic data to perform effective nursing interventions for satisfying the care needs of hospice patients.

• Childhood Kidney Diseases
• /
• v.19 no.2
• /
• pp.154-158
• /
• 2015

Purpose: This study aimed to evaluate the status of renal function and the presence of urinary abnormalities in early adult patients with Turner syndrome (TS). Methods: Sixty-three girls with TS, who are attending pediatric endocrine clinics in Busan Paik Hosp., were studied. Urine and blood chemistry tests were performed in every visiting times. Renal ultrasonography was performed in all patients at the initial diagnosis, and intravenous pyelography, DMSA renal scan and renal CT were also performed, if necessary. Results: Of the 63 patients, the karyotype showed 45,X in 32 (50.8%), mosaicism in 22 (34.9%) and structural aberration in 9 (14.3%). The renal function at the latest visit was shown as normal in all patients. Nephrotic syndrome had developed in one patient. Hematuria was observed in seven patients. Renal anomalies were observed in 20 of the 63 TS (31.7%). Of the 32 TS patients with 45,X karyotype, 13 (40.6%) had renal anomalies, while these were found in 7 (22.6%) of 31 TS patients with mosaicism/structural aberration. But there was no significant statistical difference between two karyotype groups. Conclusion: Based on this study, most of the patients with TS do not have any significant problems related to renal function until early adulthood, regardless of renal malformation or hematuria.

• Korean Journal of Adult Nursing
• /
• v.29 no.2
• /
• pp.166-176
• /
• 2017

Purpose: The study aimed to assess differences between nurses' and patients' perception of the communication skills to promote patients' health literacy in a hospital. Methods: The convenience sample consisted of 150 patients and 169 nurses in a university hospital. The data were collected from January to February 2014 using the Communication Skills Scale for Hospital nurses and patients. Descriptive statistics, independent t-test, ANOVA, Kruskal-Wallis test, and Lin's concordance were used to analyze the data. Results: There were significant differences (t=9.44, p<.001) between the perception of nurses ($8.18{\pm}2.00$) and patients ($5.49{\pm}2.95$) on the communication skills used by nurses. Most nurses ($3.87{\pm}0.39$) perceived that the communication skills were effective, but more patients ($4.13{\pm}0.62$) reported significantly higher scores (t=-4.34, p<.001). Conclusion: The results implied that nurses need to make sure that their communication skills are effective when they communicate with patients, and education programs for nurses to develop the advanced communication skills would be necessary.

• Journal of Biomedical Engineering Research
• /
• v.27 no.5
• /
• pp.245-249
• /
• 2006

The aim of this study is to design and develop the gait rehabilitation equipment that judge patient's movement of his/her center of gravity using pressure sensors, and to aid hemiplegic patients to balance themselves using an automatic stepper that changes the patient's center of gravity. It is hard to bear the weight on the affected side for hemiplegic patients. The gait rehabilitation equipment detects the footing phase of hemiplegic patient during training and moves the unaffected footing side of the stepper up and moves the affected footing side down simultaneously so that the patient's center of gravity can shift from unaffected side to affected side. The gait rehabilitation system was developed and applied for hemiplegic patients during exercise. Eight hemiplegic patients and one normal adult were studied. The developed gait rehabilitation system could judge not only the normal adult's intention but also the patient's intention to move his/her center of gravity. Even though the most of hemiplegic patients exercised in automatic mode and a few hemiplegic patients exercised in manual mode, the developed gait rehabilitation system can aid the hemiplegic patients to train more easily.