PURPOSE: This study was conducted to investigate the effects of self-efficacy promoting program on self-efficacy, self-care behavior and psychosocial adaptation in patients with a colostomy. METHOD: A non-equivalent control group pre test post test design was used. The self efficacy promoting programs was composed of a CD image program based on varicaious experience, education and telephone coaching program based on verbal persuasion, and Stoma care practice, and Self care performance based on performance accomplishment. This study was carried out from July 2, 2005 to April 20, 2006 and 21 patients with a colostomy at one of 2 hospitals participated. Descriptive statistics, chi-square-test, and Mann-whitney U test were used to analyze the data. RESULTS: There were significantly different for specific self efficacy, self care and psychosocial adaptation between the experimental group and control group. CONCLUSION: The self efficacy promoting program for patients with stomas was effective in improving degree of specific self efficacy, self care and psychosocial adaptation.
Colostomy* ; Education ; Humans ; Persuasive Communication ; Self Care* ; Self Efficacy* ; Telephone

Objective: Schizophrenia-spectrum disorders and posttraumatic stress disorder (PTSD) share common clinical manifestations, genetic vulnerability, and environmental risk factors. We aimed to conduct a systematic review and meta-analysis of the comorbid prevalence of PTSD among schizophrenia-spectrum disorders. Methods: We performed a meta-analysis to identify possible contributing factors to the heterogeneity among these studies. We systematically searched electronic databases with no restrictions on language of articles. Results: We extracted 24 samples (18 for current prevalence and 6 for lifetime prevalence) from 22 studies and used a random effects model to estimate the pooled prevalence of PTSD among schizophrenia-spectrum disorders. The current and life prevalence of comorbid PTSD was 10.6% (95% confidence interval [CI]=6.3%–17.3%) and 13.0% (95% CI=5.3%–28.6%), respectively. Studies assessing psychotic experiences/involuntary admission reported the highest prevalence of comorbid PTSD (57.1%, 95% CI=43.6%–59.7%), whereas those assessing various anxiety disorders reported the lowest prevalence (1.1%, 95% CI=1.0%–5.5%). Heterogeneities of the subgroup analysis by similar objectives were largely homogeneous (I2=7.1–34.1). In the qualitative assessment, only two studies (9.1%) were evaluated as having a low risk of bias. Conclusion Our results showed that a careful approach with particular attention to assessing PTSD is essential to reliably estimate the prevalence of PTSD comorbid with schizophrenia-spectrum disorders. The reason for the wide discrepancy in the prevalence of comorbid PTSD among the four groups of studies should be addressed in future research.

BACKGROUND/AIMS: Abdominal ultrasonography is useful for the detection and diagnosis of nonalcoholic fatty liver disease (NAFLD). The aims of this study were to establish a predictive model for the selection of subjects for abdominal ultrasonography for the diagnosis of NAFLD and to assess validity of the model. METHODS: The subjects included 901 people who visited the health examination center of the Busan Medical Center. We conducted multiple logistic regression analyses of potential risk factors to identify independent risk factors for NAFLD, and developed an index system. RESULTS: Four independent risk factors were identified. The index system was developed by assigning 1 clinical scoring point to approximately 0.7 logistic regression coefficients to each factor as follows: alanine aminotransferase/aspartate aminotransferase ratio >1.5 (odds ratio [OR], 2.22; 95% confidence interval [CI], 1.21-4.07; P=0.010), 1 point; gamma-glutamyl transpeptidase >50 (OR, 2.15; 95% CI, 1.13-4.07; P=0.019), 1 point; triglyceride >150 mg/dL (OR, 1.92; 95% CI, 1.14-3.24; P=0.015), 1 point; 23 kg/m2< or =BMI<25 kg/m2 (OR, 3.68; 95% CI, 2.05-6.63; P<0.001), 2 points; and BMI 25 kg/m2 (OR, 7.65; 95% CI, 4.29-13.62; P<0.001), 3 points. The area under the receiver operating characteristics curve was 0.797 (95% CI, 0.751-0.842), and when 3 points was used as a cut-off value, the sensitivity and specificity were 71.7% and 75.9%, respectively. CONCLUSIONS: NAFLD can be predicted through the clinical application of the index system established herein. If abdominal ultrasonography is used for high-risk patients, NAFLD will be diagnosed and managed in its early stage.
Adult ; Aged ; Alanine Transaminase/blood ; Area Under Curve ; Aspartate Aminotransferases/blood ; Body Mass Index ; Fatty Liver/*diagnosis/ultrasonography ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Predictive Value of Tests ; Risk Factors ; Sensitivity and Specificity ; Severity of Illness Index ; gamma-Glutamyltransferase/blood

PURPOSE: Multifactorial in pathogenesis, bronchopulmonary dysplasia is difficult to predict based on any single factor, especially early in life. We evaluated clinical and ventilatory parameters in the first week of life, and their combinations were tested for early prediction of BPD. METHODS: Eighty-one very low birth weight (VLBW) infants born at gestational ages<32 weeks and mechanically ventilated for at least first 7 days were selected and classified into BPD (n=48, radiological findings and oxygen dependency at postconceptional age of 36 weeks) and non-BPD (n=33) groups. Clinical and ventilatory parameters on days 1, 4 and 7 were analyzed. Chi-square and t-test were used to compare individual variables between two groups. Multiple logistic regression analysis was done to identify risk factors for BPD. RESULTS: The mean gestational age and birth weight were lower in BPD group. In multivariate analysis, significant risk factors that predict BPD were gestational age<30 weeks (OR 0.112, 95% CI 0.016-0.767), maximum MAP > or =4.5 on day 7 (OR 3.982, 95% CI 1.046-15.162) and maximum FiO2> or =0.3 on day 7 (OR 7.626, 95% CI 1.570-37.054). The combination of these factors for prediction of BPD had a 79% positive predictive value with an 85% sensitivity. CONCLUSION: A number of clinical and ventilatory parameters in combination (gestation, maximum MAP and FiO2 on day 7) can predict BPD in VLBW infants early in life with a relatively high sensitivity and positive predictiveness. With early identification of infants prone to BPD, the clinicians may resort to more active measures to minimize lung injury and to prevent BPD.
Birth Weight ; Bronchopulmonary Dysplasia* ; Gestational Age ; Health Resorts ; Humans ; Infant* ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Logistic Models ; Lung Injury ; Multivariate Analysis ; Oxygen ; Respiration, Artificial* ; Risk Factors

A congenital hernia into the base of the umbilical cord is known as an exomphalos and when the size of the defect is 5 cm or less and containing only bowel, it is called as exomphalos minor. We present a case of a newborn with an exomphalos minor within a Meckel diverticulum. He underwent surgical resection of the Meckel diverticulum and repair of the abdominal wall defect. To our knowledge, this is the first reported case of Meckel diverticulum in an exomphalos minor in Korea.
Abdominal Wall ; Hernia ; Hernia, Umbilical* ; Humans ; Infant, Newborn ; Korea ; Meckel Diverticulum* ; Minors ; Umbilical Cord

PURPOSE: This study was done to develop and implement the Nursing KMS (knowledge management system) in order to improve knowledge sharing and creation among clinical nurses in outpatient departments. METHODS: This study was a methodological research using the 'System Development Life Cycle': consisting of planning, analyzing, design, implementation, and evaluation. Quality Function Deployment (QFD) was applied to establish nurse requirements and to identify important design requirements. Participants were 32 nurses and for evaluation data were collected pre and post intervention at K Hospital in Seoul, a tertiary hospital with over 1,000 beds. RESULTS: The Nursing KMS was built using a Linux-based operating system, Oracle DBMS, and Java 1.6 web programming tools. The system was implemented as a sub-system of the hospital information system. There was statistically significant differences in the sharing of knowledge but creating of knowledge was no statistically meaningful difference observed. In terms of satisfaction with the system, system efficiency ranked first followed by system convenience, information suitability and information usefulness. CONCLUSION: The results indicate that the use of Nursing KMS increases nurses' knowledge sharing and can contribute to increased quality of nursing knowledge and provide more opportunities for nurses to gain expertise from knowledge shared among nurses.
Ambulatory Care/*organization & administration ; Attitude of Health Personnel ; Humans ; Internet ; Nursing Staff, Hospital/*psychology ; *Program Development ; *Program Evaluation ; Tertiary Care Centers ; User-Computer Interface

The long-term clinical issues in Kawasaki disease are concerned with the coronary artery lesions that result in aneurysmal formation, thrombotic occlusion, progression to ischemic heart disease, and premature atherosclerosis. We here report a 3 month old infant with Kawasaki disease complicated by giant coronary aneurysm with thrombosis. After urokinase(10,000 IU/kg) and heparin(400 IU/kg) were injected for two days as thrombolytic agents, thrombi were successfully dissolved. Even though long-term oral anticoagulation with low-dose aspirin, dipyridamole and coumadin were administered, thrombosis of the left main coronary artery was slowly increased. five years later, coronary angiography showed nearly total occlusion of the left anterior descending artery and collaterals from the right posterior branch and radionuclide scan demonstrated complete reversible perfusion defect of several portions of the left ventricle.
Aneurysm ; Arteries ; Aspirin ; Atherosclerosis ; Child* ; Coronary Aneurysm* ; Coronary Angiography ; Coronary Vessels ; Dipyridamole ; Fibrinolytic Agents ; Follow-Up Studies* ; Heart Ventricles ; Humans ; Infant ; Mucocutaneous Lymph Node Syndrome* ; Myocardial Ischemia ; Perfusion ; Thrombolytic Therapy* ; Thrombosis* ; Warfarin

Background: Spontaneous pneumopericardium is a very rare condition. Spontaneous pneumothorax and pneumomediastinum have been reported to be associated with an idiopathic pulmonary fibrosis (IPF). However, spontaneous pneumopericardium has not yet been reported in association with IPF. Here we report a case of spontaneous pneumomediastinum and pneumopericardium in a patient with acute exacerbation of IPF with a review of the relevant literature.
Humans ; Idiopathic Pulmonary Fibrosis* ; Mediastinal Emphysema* ; Pneumopericardium* ; Pneumothorax

OBJECTIVE: The purpose of this study was to determine, when measuring prostate volume by TRUS, whether height is more accurately determined by transaxial or midsagittal scanning. MATERIALS AND METHODS: Sixteen patients who between March 1995 and March 1998 underwent both preoperative TRUS and radical prostatectomy for prostate cancer were included in this study. Using prolate ellipse volume calculation (height x length x width x pi/6), TRUS prostate volume was determined, and was compared with the measured volume of the specimen. RESULTS: Prostate volume measured by TRUS, regardless of whether height was determined transaxially or midsagittally, correlated closely with real specimen volume. When height was measured in one of these planes, a paired t test revealed no significant difference between TRUS prostate volume and real specimen volume (p = .411 and p = .740, respectively), nor were there significant differences between the findings of transaxial and midsagittal scanning (p = .570). A paired sample test, however, indicated that TRUS prostate volumes determined transaxially showed a higher correlation coefficient (0.833) and a lower standard deviation (9.04) than those determined midsagittally (0.714 and 11.48, respectively). CONCLUSION: Prostate volume measured by TRUS closely correlates with real prostate volume. Furthermore, we suggest that when measuring prostate volume in this way, height is more accurately determined by transaxial than by midsagittal scanning.
Human ; Male ; Middle Age ; Prostate/*pathology/*ultrasonography ; Prostatectomy ; Prostatic Neoplasms/pathology/surgery/*ultrasonography

OBJECTIVE: The purpose of this study was to determine, when measuring prostate volume by TRUS, whether height is more accurately determined by transaxial or midsagittal scanning. MATERIALS AND METHODS: Sixteen patients who between March 1995 and March 1998 underwent both preoperative TRUS and radical prostatectomy for prostate cancer were included in this study. Using prolate ellipse volume calculation (height x length x width x pi/6), TRUS prostate volume was determined, and was compared with the measured volume of the specimen. RESULTS: Prostate volume measured by TRUS, regardless of whether height was determined transaxially or midsagittally, correlated closely with real specimen volume. When height was measured in one of these planes, a paired t test revealed no significant difference between TRUS prostate volume and real specimen volume (p = .411 and p = .740, respectively), nor were there significant differences between the findings of transaxial and midsagittal scanning (p = .570). A paired sample test, however, indicated that TRUS prostate volumes determined transaxially showed a higher correlation coefficient (0.833) and a lower standard deviation (9.04) than those determined midsagittally (0.714 and 11.48, respectively). CONCLUSION: Prostate volume measured by TRUS closely correlates with real prostate volume. Furthermore, we suggest that when measuring prostate volume in this way, height is more accurately determined by transaxial than by midsagittal scanning.
Human ; Male ; Middle Age ; Prostate/*pathology/*ultrasonography ; Prostatectomy ; Prostatic Neoplasms/pathology/surgery/*ultrasonography