PURPOSE: This study was conducted to evaluate the effects of integrated palliative care intervention on quality of life in terminally ill patients. METHODS: A comprehensive literature search was performed via PubMed, Cochrane Library CENTRAL, LWW (Ovid), CINAHL and several Korean databases. The main search strategy was to combine terms indicating palliative care intervention, presence of terminal illness and study design. Methodological quality was assessed using Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non-randomized studies. Data were analyzed by the Stata 10 program. RESULTS: Eight clinical trials met the inclusion criteria with a total of 356 participants. Integrated palliative care interventions were administered for a mean of 6.5 weeks, 5.6 sessions and an average of 47.8 minutes per session. Effect sizes were heterogeneous, and subgroup analysis was done. Integrated palliative care interventions had a significant effect on quality of life (ES=1.83, P=0.018, l2=92%), spiritual well-being (ES=0.78, P=0.040, l2=0), depression (ES=0.86, P<0.001, l2=32) and anxiety (ES=0.69, P=0.041, l2=71.1). But integrated palliative care interventions had no significant effect on pain (ES=0.365, P=0.230, l2=69.8). CONCLUSION: Results support findings that integrated palliative care interventions were helpful in lessening depression and anxiety and improving quality of life and spiritual well-being, however, the interventions did not assist pain management in terminal cancer patients. These findings suggest that various integrated palliative care interventions can assist terminal cancer patients with better quality of life in the socio-psycho-spiritual dimension.
Anxiety ; Bias (Epidemiology) ; Depression ; Humans ; Pain Management ; Palliative Care* ; Quality of Life* ; Terminally Ill

PURPOSE: This study was performed to identify factors affecting terminal care performance of clinical nurses. METHODS: The participants in this study were 175 nurses working in hospitals in Daegu and North Gyeongsang Province. Data were collected using a self-reported questionnaire and were analyzed with the IBM SPSS WIN 19.0 program. RESULTS: Nurses' terminal care performance was significantly related with suffering experience, empathy ability and caring behaviors. Significant predictors for terminal care performance were their department, empathy ability and caring behaviors. These factors explained 43.52% of the variance in terminal care performance of clinical nurses. CONCLUSION: Our study results suggest that terminal care performance of clinical nurses can be strengthened by improving empathy ability and caring behaviors.
Daegu ; Empathy* ; Nursing Care ; Terminal Care*

No abstract available.
Bacteremia* ; Female ; Humans ; Pregnant Women*

A 50-year-old man who had suffered from chronic indigestion complained of upper abdominal pain and vomiting which had persisted for 4 days. Consequently, he had eaten two persimmons before sleeping detected each day for five days. An irregular multinodular villous filling defect was in the duodenal bulb on, the UGI series, which had its location and changed its position. It was difficult to differentiate a papillary gastric polyp or villous tumor from the duodenal bezoar, but the patient's history of having eaten persimmons was helpful. The endoscopic and pathologic study confirmed a phytobezoar which was located in the normal duodenal bulb. Subsequently we are reporting this case having reviewed the related literature of the phytobezoar which was found in the normal duodenal bulb.
Abdominal Pain ; Bezoars* ; Diospyros ; Duodenum ; Dyspepsia ; Humans ; Middle Aged ; Polyps ; Vomiting

OBJECTIVE: Ectopic pregnancy can still cause maternal death, though we have undergone it frequently. So, we survey 80 cases ectopic pregnancies treated our hospital for early detection and proper management. METHODS: In this study, the authors studied retrospectively 80 cases which had been admitted and treated at the department of Obstetrics and Gynecology, National Police Hospital from Jan. 1, 1991 to Dec. 31, 2000. RESULTS: Incidence of ectopic pregnancy was one in 68 normal deliveries for 10 years, 63.7% of cases occurred in 25~34 years-old age group, and 52.6% of patients had previous abdominal surgery including cesarean section. Average interval of tubal ligation was 6.5 years between the onset of ectopic pregnancy and tubal ligation. Lower abdominal pain was the most common clinical symptom developed in 91.3% of the patients. Average interval between the onset of symptom and LMP was 7.6 weeks. Most ectopic pregnancies were tubal pregnancies and salpingectomy was done in 56.3% of the patients. CONCLUSION: According to our study, ectopic pregnancy occurred most frequently in women in their reproductive age and one of most important prognostic factors is time between onset of symptom and arrival of patient at hospital. We must make our efforts to preserve utero-ovarian function in treatment of patients with ectopic pregnancy.
Abdominal Pain ; Cesarean Section ; Female ; Gynecology ; Humans ; Incidence ; Maternal Death ; Obstetrics ; Police ; Pregnancy ; Pregnancy, Ectopic* ; Pregnancy, Tubal ; Retrospective Studies ; Salpingectomy ; Sterilization, Tubal

Community-based health management policies are needed considering societal aging. We aimed to develop a transitional care model (TCM) program for patients with pneumonia, asthma, and chronic obstructive pulmonary disease. First, we conducted in-depth interviews with patients who were hospitalized, released, and readmitted for those three conditions to identify issues with the current hospitalization/discharge system and post-discharge processes. Next, we developed a new TCM program suited to the realities of the current medical environment. Interviews revealed problems including inadequate awareness of disease and health management; insufficient information exchange between patients, caregivers, and primary medical institutions; and absence/low usage of community-based care services. The investigation applying the new TCM program to patients and following up on readmission rates and life satisfaction after discharge is ongoing. Reviewing these results and conducting further studies in the future will allow improvements to the model.

Purpose: Type 2 diabetes mellitus is a metabolic condition marked by persistent elevated blood sugar levels resulting from insulin resistance. The effective management of diabetes mellitus involves strict regulation of the blood glucose levels. This study examined the effects of Autumn olive (Elaeagnus umbellata Thunb.) berry (AOB) on insulin resistance and hyperglycemia using a type 2 diabetes mellitus animal model. Methods: Eight-week-old C57BL/6J mice were divided into four groups. The control group received a basal diet, while the high-fat, high-sucrose (HFHS) group was fed a HFHS diet containing 27% sucrose and 33% lard for 12 weeks. The low AOB (LAOB) and high AOB (HAOB) groups were offered a HFHS diet with a 0.5% and 1.0% AOB extract, respectively. Results: The HAOB group showed significantly lower epididymal fat pad weight than the HFHS group. The LAOB and HAOB groups showed lower serum glucose levels and homeostasis model assessment for insulin resistance values than the HFHS group, and the HAOB group has lower serum insulin levels than the HFHS group. Supplementation with HAOB decreased serum cholesterol levels significantly compared with the HFHS group. The consumption of LAOB and HAOB reduced the serum triglyceride and hepatic total lipids and triglyceride levels compared to the HFHS group. In addition, LAOB and HAOB consumption in mice fed a HFHS diet increased adenosine monophosphate-activated protein kinase protein expression. Insulin receptor substrate-2 protein expression in the HAOB group was significantly higher than the HFHS group. Conclusion AOB can alleviate hyperglycemia in type 2 diabetes mellitus partly by mitigating insulin resistance.

OBJECTIVE: Vitamin D-binding protein (VDBP) mediates various biological processes in humans. The goal of this study was to investigate whether VDBP gene polymorphisms could predispose Korean women to endometriosis. METHODS: We prospectively enrolled women with endometriosis (n = 16) and healthy controls (n = 16). Total serum 25-hydroxyl vitamin D (25(OH)D) concentrations were measured using an Elecsys vitamin D total kit. Levels of bioavailable and free 25(OH)D were calculated. Concentrations of VDBP were measured using a vitamin D BP Quantikine ELISA kit. DNA was extracted using a DNeasy blood & tissue kit. Two single-nucleotide polymorphisms (SNPs; rs4588 and rs7041) in GC, the gene that codes for VDBP, were analyzed using a TaqMan SNP genotyping assay kit. The functional variant of VDBP was determined based on the results of the two SNPs. RESULTS: Gravidity and parity were significantly lower in the endometriosis patients than in the control group, but serum CA-125 levels and the erythrocyte sedimentation rate were significantly higher. Total serum 25(OH)D levels in the endometriosis patients were significantly lower than in the control group. However, serum bioavailable 25(OH)D, free 25(OH)D, and VDBP levels did not differ significantly between the endometriosis and control groups. The genotypes and allele frequencies of GC were similar in both groups. CONCLUSION: Korean women with endometriosis had lower total serum 25(OH)D concentrations than controls. Neither serum VDBP concentrations nor polymorphisms in the gene coding for VDBP were associated with endometriosis. Further studies are needed to investigate the pathophysiology and clinical implications of 25(OH)D and VDBP in endometriosis.
Biological Processes ; Blood Sedimentation ; Clinical Coding ; DNA ; Endometriosis ; Enzyme-Linked Immunosorbent Assay ; Female ; Gene Frequency ; Genotype ; Gravidity ; Humans ; Parity ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide ; Prospective Studies ; Vitamin D ; Vitamin D-Binding Protein ; Vitamins

OBJECTIVES: This study was designed to investigate the distribution of Helicobacter pylori(HP), the relationship between HP colonization and gastritis scores graded according to the Sydney system, epithelial damage, and lymphoid follicles, and to assess the effect of eradication of HP infection on the different histological parameters. METHODS: Gastritis scores, epithelial damage, and lymphoid follicles were assessed in gastric antral, body, and fundic biopsy specimens before and 4 weeks after antiHP triple therapy in 32 patients with HP-related gastritis. RESULTS: The mean initial scores of all histological parameters were higher in the antrum compared with the body and fundus. A significant, positive correlation was noted between HP score and the score for inflammation, for activity, and for mucus depletion. After eradication of HP infection, significant improvement in activity, chronic inflammation, and mucus depletion was detected in responders with a successful HP eradication ; the activity return to normal in follow-up, and chronic inflammation and mucus depletion was decreased significally in severity in responders(p<0.05). No significant reduction in severity of gastritis and mucus depletion was detected in the non-responders with persistent HP infection following anti-HP triple therapy. CONCLUSIONS: The eradication of HP results in a rapid, significant histopathological improvement in the gastritis scores and epithelial damage in gastric mucosa.
Biopsy ; Colon ; Follow-Up Studies ; Gastric Mucosa ; Gastritis* ; Helicobacter ; Helicobacter pylori ; Humans ; Inflammation ; Mucus

OBJECTIVE: The purpose of this study was to evaluate the displacement pattern and the stress distribution shown on a finite element model 3-D visualization of a dry human skull using CT during the retraction of upper anterior teeth. METHODS: Experimental groups were differentiated into 8 groups according to corticotomy, anchorage (buccal: mini implant between the maxillary second premolar and first molar and second premolar reinforced with a mini implant, palatal: mini implant between the maxillary first molar and second molar and mini implant on the midpalatal suture) and force application point (use of a power arm or not). RESULTS: In cases where anterior teeth were retracted by a conventional T-loop arch wire, the anterior teeth tipped more postero-inferiorly and the posterior teeth moved slightly in a mesial direction. In cases where anterior teeth were retracted with corticotomy, the stress at the anterior bone segment was distributed widely and showed a smaller degree of tipping movement of the anterior teeth, but with a greater amount of displacement. In cases where anterior teeth were retracted from the buccal side with force applied to the mini implant placed between the maxillary second premolar and the first molar to the canine power arm, it showed that a smaller degree of tipping movement was generated than when force was applied to the second premolar reinforced with a mini implant from the canine bracket. In cases where anterior teeth were retracted from the palatal side with force applied to the mini implant on the midpalatal suture, it resulted in a greater degree of tipping movement than when force was applied to the mini implant between the maxillary first and second molars. CONCLUSION: The results of this study verifies the effects of corticotomies and the effects of controlling orthodontic force vectors during tooth movement.
Arm ; Bicuspid ; Humans ; Incisor* ; Molar ; Skull ; Sutures ; Tooth ; Tooth Movement