Search

Background: This study was designed to compare the efficacy of remifentanil and alfentanil without the venous occlusion technique in preventing the withdrawal response associated with rocuronium injection in children. Methods: One hundred and twenty children aged between 3 and 10 years were randomly allocated into one of four groups to receive either i.v. remifentanil 0.5 μg·kg−1 (remi 0.5 group), remifentanil 1 μg·kg−1 (remi 1.0 group), alfentanil 15 μg·kg−1 (alfentanil group) or saline 5 ml (saline group). Anesthesia was induced with 2.5% thiopental sodium 5 mg·kg−1 and the test drug was injected over 30 s. One minute later, 1% rocuronium 0.6 mg·kg−1 was injected over 5 s and the response was recorded. Mean arterial pressure (MAP) and heart rate (HR) were recorded on arrival in the operating room, before and 1 min after tracheal intubation. Results: The incidence of withdrawal movement in the saline group (93%) was significantly higher than that in the remi 0.5, remi 1.0, and alfentanil groups (53%, 17%, and 20%, respectively) ( P < 0.05). The incidence in the remi 1.0 and alfentanil groups was significantly less than that in the remi 0.5 group ( P < 0.05). After intubation, MAP and HR were significantly higher in the saline group than that in remi 1.0 and alfentanil groups. Conclusions: Both remifentanil 1 μg·kg−1 and alfentanil 15 μg·kg−1 can be used to prevent rocuronium-associated withdrawal movement in children because they are equally effective and attenuate the increase in MAP and HR after intubation. [ABSTRACT FROM AUTHOR]

Among the 51 clinical isolates collected from a university hospital in Korea, nine isolates were resistant to cephamycins. Nine isolates were shown to produce CMY-11 and these also included three isolates producing TEM-1. The results from ERIC-PCR revealed that dissemination of CMY-11 was due to outbreaks of resistant species and to the intra-species spread of resistance to cephamycins in Korea. CMY-11 β-lactamase genes from nine clinical isolates that were responsible for resistance to cephamycins (cefoxitin and cefotetan), amoxicillin, cephalothin and amoxicillin-clavulanic acid, were cloned and characterised. A sequence identical to the common regions in In6, In7 and a novel integron from pSAL-1 was found upstream from blaCMY-11 gene at nucleotide 1–71. Eighteen nucleotides between position 71 and 72 were inserted into the blaCMY-11 gene. [Copyright &y& Elsevier]

Aim: We examined Korean nurses professional quality of life, emotional labour and workplace violence to guide development of interventions to improve nurses professional quality of life. Background: Nurses face heavy exposure to emotional labour and workplace violence. Stress experienced by nurses reduces compassion satisfaction and increases compassion fatigue. Methods: Participants comprised 399 clinical nurses chosen by convenience sampling. Questionnaires measured demographic characteristics, emotional labour, workplace violence and professional quality of life. Results: Nurses professional quality of life was affected by emotional labour and workplace violence. Graduate educational level, emotional exposure and emotional supervision were associated with compassion satisfaction. Burnout was commonly associated with emotional exposure, experience and supervision of workplace violence. Secondary traumatic stress was associated with emotional exposure and experience of workplace violence. Conclusions: We elucidated the relationship between professional quality of life, emotional labour and workplace violence. Raising professional quality of life among nurses requires regular analysis of emotional labour and provision of organizational‐level interventions. Counselling programmes that address violence prevention education and comprehensive response strategies among nurses and policies that foster an organizational culture of respect and cooperation in hospitals are needed. SUMMARY STATEMENT: What is already known about this topic? Promoting nurses professional quality of life is important in managing the quality of nursing care.Nurses with exposure to emotional labour show negative health effects, reduced willingness and ability to work, frequent absences, dissatisfaction and turnoverWorkplace violence negatively affects professional quality of life among clinical nurses. What is already known about this topic? Compassion satisfaction was highly related to organizational management systems for emotional labour and workplace violence.Burnout was associated with the magnitude of exposure to emotional labour and experience of workplace violence and negative organizational management systems for workplace violence.Secondary traumatic stress was associated with the magnitude of exposure to emotional labour and experience of workplace violence. The implications of this paper: To increase nurses professional quality of life, organizational management systems that address and reduce emotional labour and workplace violence are critical.It is necessary to develop programmes that address violence prevention education and comprehensive response strategies regarding emotional labour.Counselling programmes that address violence prevention education and comprehensive response strategies among nurses and policies that foster an organizational culture of respect and cooperation in hospitals are needed. [ABSTRACT FROM AUTHOR]

OBJECTIVE. The purposes of this study were to identify the similarities and differences among the Korean Thyroid Imaging Reporting and Data System (TIRADS), American College of Radiology (ACR) TI-RADS, and European TIRADS and to compare the diagnostic performance of sonographic fine-needle aspiration (FNA) criteria for detecting malignant thyroid nodules. MATERIALS AND METHODS. This study included 2274 consecutively evaluated thyroid nodules 1 cm or larger in 1836 patients with final diagnoses from January 2011 to December 2016. US features of the nodules were retrospectively reviewed and classified according to three published guidelines from international societies. We compared the US lexicons, categories, and diagnostic performance of the FNA criteria for malignant nodules among the three reporting systems. RESULTS. Of the 2274 thyroid nodules, 1974 (86.8%) were benign and 300 (13.2%) were malignant; 93.7% of all malignancies were papillary carcinoma. Most of the US lexicons were similar among the three systems except for the definition of echogenicity of a nodule of mixed echogenicity in European TIRADS. Although the categories had strong correlations ( r = 0.777-0.877, all p < 0.001) among the three systems, significant differences were observed in categories 5, 4, and 3 of nodules (all p < 0.001) and in the sensitivity, specificity, and rate of unnecessary FNA of the FNA criteria for malignancy (all p < 0.001). CONCLUSION. Although the three systems had similarities in most US lexicons, significant differences were observed in the classified categories and diagnostic performance of the FNA criteria for malignancy.

This study confirms that Taq DNA polymerase could be contaminated with the blaTEM-1(a) gene. It also proposes two different methods that could be used to overcome DNA contamination: (i) DNase I treatment prior to PCR amplification; and (ii) the use of a highly purified Taq DNA polymerase which was devoid of detectable contamination.

We investigated an outbreak of Acinetobacter baumannii in an intensive care unit and in the surgery, medicine, neurology, and urology wards of the Kosin University Gospel Hospital in Busan, Korea. The outbreak involved 36 cases of infection by A. baumannii producing the OXA-23 beta-lactamase over an 8-month period and was caused by a single pulsed-field gel electrophoresis clone. The epidemic isolates were characterized by a modified cloverleaf synergy test. Isoelectric focusing of crude bacterial extracts detected one nitrocefin-positive band with a pI value of 6.65. PCR amplification and characterization of the amplicons by direct sequencing indicated that the epidemic isolates carried a bla(OXA-23) determinant. The epidemic isolates were characterized by a multidrug resistance phenotype that remained unchanged over the outbreak, including penicillins, cephamycins, extended-spectrum cephalosporins, carbapenems, monobactams, and aminoglycosides. This study shows that the bla(OXA-23) resistance determinant may become an emerging therapeutic problem.

To determine the prevalence and genotypes of beta-lactamases among clones of a metagenomic library from the cold-seep sediments of Edison seamount (10,000 years old), we performed pulse-field gel electrophoresis, antibiotic susceptibility testing, pI determination, and DNA sequencing analysis. Among the 8,823 clones of the library, thirty clones produced beta-lactamases and had high levels of genetic diversity. Consistent with minimum inhibitory concentration patterns, we found that five (16.7%) of thirty clones produced an extended-spectrum beta-lactamase. 837- and 259-bp fragments specific to blaTEM genes were amplified, as determined by banding patterns of PCR amplification with designed primers. TEM-1 was the most prevalent beta-lactamase and conferred resistance to ampicillin, piperacillin, and cephalothin. TEM-116 had a spectrum that was extended to ceftazidime, cefotaxime, and aztreonam. The resistance levels conferred by the pre-antibiotic era alleles of TEM-type beta-lactamases were essentially the same as the resistance levels conferred by the TEM-type alleles which had been isolated from clinically resistant strains of bacteria of the antibiotic era. Our first report on TEM-type beta-lactamases of the pre-antibiotic era indicates that TEM-type beta-lactamases paint a picture in which most of the diversity of the enzymes may not be the result of recent evolution, but that of ancient evolution.