• The Korean Journal of Rehabilitation Nursing
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• v.5 no.1
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• pp.27-37
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• 2002

During acute stages of hospitalized stroke patients, family caregivers face many challenges. They often experience emotional distress, social isolation, and financial constraints. However, the burden of caregiving of stroke patients in acute stages has never been studied properly. The purpose of this study was to investigate the factors related to the caregivers' burden with acute stroke. The subjects were 123 acute stroke patients and their caregivers who were admitted to neurology and neurosurgery units at Dan Kook University Hospital in Chung-Nam area. An interview was performed with the use of standardized questionnaire which included data pertaining to the patients/caregivers characteristics, caregiver burden (Modified Zarit's Burden Scale), and social support (Personal Resource Questionnaire). Our results showed that the mean burden score was 3.11, indicating high level of burden. Among the sub-domain scores, financial burden was the highest. In univariate analysis, the factors related to caregiver burdens were: inability to communicate between patients and caregiver(p<.001); low cognitive function of the patients(p<.001); low level of ADL(p<.001); the gender of caregiver(p<.001); the current employment status of caregivers(p<.01); the presence of social support for caregiver(p<.001); and the availability of alternative caregivers(p<.001). In multiple regression analysis, social support for family caregivers (87%), low level of patient's cognition (2%), availability of 2nd caregiver (1%), and gender of caregiver (female, 0.4%) were significant explanatory factors of overall burden. The caregivers' burden in acute stages during hospitalization following stroke was high. Recognition of high levels of caregivers' burden and those relating factors affecting caregiver burden may allow us to develop different nursing strategies to unload the level of burden for caregivers in acute stages of stroke.

• Journal of The Korea Institute of Healthcare Architecture
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• v.26 no.3
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• pp.17-26
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• 2020

Purpose: This paper presents research evidence that the environmental design of the doffing area in a biocontainment unit (BCU) can have a measurable impact on increasing the safety of frontline healthcare workers (HCW) during doffing of high-level personal protective equipment (PPE), and proposes optimized biocontainment unit design. Methods: From 2016 to 2019, The SimTigrate Design Lab conducted 3 consecutive studies, focusing on ways in which the built environment may support or hinder safe doffing. In the first study, to identify the risky behaviors, we observed 56 simulation exercises with HCWs in 4 BCUs and 1 high-fidelity BCU mockup. In the second study, we tested the effectiveness of a redesigned doffing area on improving the HCWs performance and used simulation, observation, and rapid prototyping in 1 high-fidelity mockup of a doffing area. In a follow-up study, we used simulation and co-design with HCWs to optimize the design of a safer doffing area in a full-size pediatric BCU mock-up. Results: We identified 11 specific risky behaviors potentially leading to occupational injury, or contamination of the PPE, or of the environment. We developed design strategies to create a space for safer doffing. In the second study, in a redesigned doffing area, the overall performance of HCW improved, and we observed a significant decrease in the number of risky behaviors; some risky behaviors were eliminated. There was a significant decrease in physical and cognitive load for the HCWs. Finally, we propose an optimized layout of a BCU for a safer process of PPE doffing. Implications: The proposed BCU design supports better staff communication, efficiency, and automates safer behaviors. Our findings can be used to develop design guidelines for spaces where patients with other highly infectious diseases are treated when the safety of the patient-facing HCWs is of critical importance.

• Quality Improvement in Health Care
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• v.19 no.1
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• pp.30-42
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• 2013

Objectives: This study was intended to check if the "Creating Clean Wards" project, which is an innovative reinforced campaign activity targeting infection control strategies and active surveillance cultures for VRE (vancomycin resistant enterococci) high-risk patients to be admitted in the NS (neuro-surgery) wards, would be reduced the incidence rates of VRE acquisition, transmission rates. Methods: 75 subjects of the VRE high-risk patients were surveyed by carrying out active surveillance cultures of VRE colonization 11 times from January to March, 2012. And the retrospective study was conducted dividing them into two groups. Results: The incidence rates of VRE acquisition was reduced to 3.67 cases per 1,000 patients day in the control group and to 2.88 cases in experimental group, which was not statistically significant (p = .753). VRE transmission rates of 0.0015 per day before the project tended to increase to 0.0019, although not statistically significant (p = .650). As a result of multivariate analysis with regard to using glycopeptide antibiotics in order to find out risk factors of VRE colonization, the patients who had been treated with glycopeptide until VRE colonization showed 274.41 times higher rate. Conclusion : For effective VRE infection control in NS wards, We should carry out active surveillance culture regularly, especially patient of using glycopeptide. And block the spread of VRE by strengthening infection control through the strict isolation and the changed mind-set of members motivated by the "Creating Clean Wards" campaign.

• Parasites, Hosts and Diseases
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• v.40 no.1
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• pp.17-24
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• 2002

We have cloned a cDNA encoding a cysteine proteinase of the Acanthamoeba healui OC-3A strain isolated from the brain of a granulomatous amoebic encephalitis patient. A DNA probe for an A. healui cDNA library screening was amplified by PCR using degenerate oligonucleotide primers designed on the basis of conserved amino acids franking the active sites of cysteine and asparagine residues that are conserved in the eukaryotic cysteine proteinases. Cysteine proteinase gene of A. healui (AhCPI) was composed of 330 amino acids with signal sequence, a proposed pro-domain and a predicted active site made up of the catalytic residues, $Cys^{25},{\;}His^{159},{\;}and{\;}Asn^{175}$. Deduced amino acid sequence analysis indicates that AhCPI belong to ERFNIN subfamily of C 1 peptidases. By Northern blot analysis. no direct correlation was observed between AhCPI mRNA expression and virulence of Acanthamoeba, but the gene was expressed at higher level in amoebae isolated from soil than amoeba from clinical samples. These findings raise the possibility that AhCPI protein may play a role in protein metabolism and digestion of phagocytosed bacteria or host tissue debris rather than in invasion of amoebae into host tissue.

• Research in Community and Public Health Nursing
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• v.15 no.1
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• pp.56-66
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• 2004

Objectives: The purpose of this study was to verify a change for family nursing phenomena and satisfaction of clients of vulnerable families in an urban community. Methods: The study subjects were 711 families, randomly selected, who had chronic diseases(arthritis diabetes, stroke, hypertension, mental disease, cancer, dementia) with basic social welfare services from the nation and had disabled persons in an urban community, South Korea. The instruments used were the family nursing phenomena in Korea by ICNP and client satisfaction. Client satisfaction consisted of client satisfaction on home visiting nurses(4 Likert scales) and home visiting services(3 Likert scales). Results: The average visiting number is 3.82. The service number of education and counseling is 3.16, patient and symptom management 3.08, assessment and diagnosis 3.08, test 2.02, medication service 1.71회, dressing 1.01, referral to social welfare institute 1.00회, referral to medical service institute 0.21. In both, pre home visiting and post home visiting, the highest rated phenomenon was the 'lack of social support system' and following that 'deficit of financial management skill and support'. 'lack of family interaction in community', and 'social isolation' 'unhealthy life style' and 'inadequate care management of sick member', in that order. The percentages of phenomena besides 'deficit of financial management skill and support' decreased. The satisfaction level of clients towards the nurses was 3.27 points on a scale of 4, and the nursing services was 2.70 points on a scale of 3. Conclusion: Home visiting nursing services should continue to provide comprehensive healthcare services and support for vulnerable families, in urban communities.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.10
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• pp.185-196
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• 2017

This study was conducted to investigate the practical experience of nurses in MERS patients care. Nine nurses in one general hospital in S city underwent in-depth interviews from August 2015 to March 2016. The collected data were analyzed according to the procedure of the phenomenological method of Colaizzi. The following five categories were derived: '1. Anxiety and burden due to the risk of transmission of new infectious diseases', '2. Social isolation because of being the nurse in charge of MERS patients', '3. Faced with problems due to an unprepared treatment environment', '4. Overcome the burdensome MERS patient care process', '5. Reflect on the steps for preparing against new infectious diseases'. These results suggest that it is important to draw positive experiences as well as the negative effects of nurses who are involved in treatment of various infectious diseases, including MERS. Based on this, it can be used as a basis for reducing negative psychological and social impacts and improving positive adaptation. Additionally, it is necessary for healthcare workers including nurses to establish the necessary workforces, departments and guidelines for nursing new infectious disease patients.

• Journal of Veterinary Clinics
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• v.28 no.2
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• pp.254-257
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• 2011

A 2-year-old bearded dragon was referred to the Veterinary Medical Center at the College of Veterinary Medicine, Chungbuk National University with reduced activity and anorexia. On fecal examination, over growth of a bacteria and the proliferation of a yeast-like organism were found. The patient diagnosed with enteritis. By using fungal cultures and molecular typing, the yeast was identified as Pichia (P.) burtonii. The bearded dragon was treated with oral ketoconazole and trimethoprim/sulfamethoxazole. After 3 days, the dragon was recovered and fecal examination showed that the yeast had disappeared from the feces. The strain P. burtonii is supposed opportunistic pathogen in bearded dragon with enteritis according to its reports in a human. This report is the first paper about overgrowth of P. burtonii in a bearded dragon.

• Restorative Dentistry and Endodontics
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• v.34 no.1
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• pp.38-41
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• 2009

When we use the total-etch dentin adhesive system for composite resin restorations, gel or liquid acid etchant such as 37% phosphoric acid is commonly used. Thirty seven percentage phosphoric acid is very powerful erosive agent, and can cause severe harmful effects when it contacts with an oral mucosa and facial skin. This case describes iatrogenic chemical burn on facial skin caused by phosphoric acid which was happened during composite resin restorative procedure. Chemical burn by acid etchant can be evoked by careless handling of remnant and syringe. In order to prevent these iatrogenic injuries, we should check the complete removal of the etching agent both in intra and extra-oral environments after etching and rinsing procedure and it is necessary to use of the rubber dam or isolation instruments. If accidental burn were occurred. immediate wash with copious water. And bring the patient to the dermatologist as soon as possible.

• Restorative Dentistry and Endodontics
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• v.38 no.4
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• pp.258-262
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• 2013

The restorative management of deep carious lesions and the preservation of pulp vitality of immature teeth present real challenges for dental practitioners. New tricalcium silicate cements are of interest in the treatment of such cases. This case describes the immediate management and the follow-up of an extensive carious lesion on an immature second right mandibular premolar. Following anesthesia and rubber dam isolation, the carious lesion was removed and a partial pulpotomy was performed. After obtaining hemostasis, the exposed pulp was covered with a tricalcium silicate cement (Biodentine, Septodont) and a glass ionomer cement (Fuji IX extra, GC Corp.) restoration was placed over the tricalcium silicate cement. A review appointment was arranged after seven days, where the tooth was asymptomatic with the patient reporting no pain during the intervening period. At both 3 and 6 mon follow up, it was noted that the tooth was vital, with normal responses to thermal tests. Radiographic examination of the tooth indicated dentin-bridge formation in the pulp chamber and the continuous root formation. This case report demonstrates a fast tissue response both at the pulpal and root dentin level. The use of tricalcium silicate cement should be considered as a conservative intervention in the treatment of symptomatic immature teeth.

• Interdisciplinary Bio Central
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• v.4 no.3
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• pp.6.1-6.12
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• 2012

Parkinson's disease (PD) is a complicated neurodegenerative disorder although it is oftentimes defined by clinical motor symptoms originated from age dependent and progressive loss of dopaminergic neurons in the midbrain. The pathogenesis of PD involves dopaminergic and nondopaminergic neurons in many brain regions and the molecular mechanisms underlying the death of different cell types still remain to be elucidated. There are indications that PD causing disease processes occur in a global scale ranging from DNA to RNA, and proteins. Several PD-associated genes have been reported to play diverse roles in controlling cellular functions in different levels, such as chromatin structure, transcription, processing of mRNA, translational modulation, and posttranslational modification of proteins. The advent of quantitative high throughput screening (HTS) tools makes it possible to monitor systemic changes in DNA, RNA and proteins in PD models. Combined with dopamine neuron isolation or derivation of dopamine neurons from PD patient specific induced pluripotent stem cells (PD iPSCs), HTS techonologies will provide opportunities to draw PD causing sequences of molecular events in pathologically relevant PD samples. Here I discuss previous studies that identified molecular functions in which PD genes are involved, especially those signaling pathways that can be efficiently studied using HTS methodologies. Brief descriptions of quantitative and systemic tools looking at DNA, RNA and proteins will be followed. Finally, I will emphasize the use and potential benefits of PD iPSCs-derived dopaminergic neurons to screen signaling pathways that are initiated by PD linked gene mutations and thus causative for dopaminergic neurodegneration in PD.