PURPOSE: To examine the effects of a case management program on self-efficacy, depression and anxiety in pregnant women with gestational diabetes mellitus. METHODS: Thirty-seven patients who enrolled in a diabetes outpatient clinic were randomly assigned to either an experimental group (n=19) or a control group (n=18). The experimental group received a 2-week intervention composed of a series of one face-to-face interactive interview and five telephone interviews based on the National standards for diabetes self-management education and Bandura's self-efficacy resources of performance accomplishment, vicarious experience, verbal persuasion, and emotional arousal. The effects of the intervention were assessed by completion of a 9-item self-efficacy questionnaire, a 20-item depression questionnaire and a 20-item anxiety questionnaire prior to, and after the intervention. The statistical significances were examined using t-test. RESULTS: The change in self-efficacy was significantly greater in the experimental group than in the control group. Depression and anxiety changes in the experimental group were significantly greater compared to those in the control group. CONCLUSION: The results of study suggest that a case management program improves self-efficacy, and decreases depression and anxiety in pregnant women with gestational diabetes mellitus.
Ambulatory Care Facilities ; Anxiety ; Arousal ; Case Management ; Depression ; Diabetes, Gestational ; Female ; Humans ; Interviews as Topic ; Persuasive Communication ; Pregnancy ; Pregnant Women ; Surveys and Questionnaires ; Self Care

Vulvar leiomyoma is a rare benign solid tumor of the vulva. Their incidence is not known as most reports are of a single case or small series, and their origin is not known exactly. Most cases are asymptomatic and local excision is recommended as initial therapy and also for recurrences. We have experienced vulvar leiomyoma (the labia majora and vestibule of the vagina) in a 51 years old woman and present it with a brief review of the literatures.
Female ; Humans ; Incidence ; Leiomyoma* ; Middle Aged ; Recurrence ; Vulva

An 11-year-old girl was diagnosed with encephalitis due to Epstein-Barr virus(EBV). She was admitted to our hospital due to convulsion and decreased consciousness after several days of fever, sore throat and headache. Cerebrospinal fluid analysis showed lymphocyte-dominant pleocytosis and markedly elevated levels of protein. Magnetic resonance imaging(MRI) finding was normal, except for marked leptomeningeal enhancement. Even though she had signs and symptoms of infectious mononucleosis, EBV infection could not be considered as the underlying cause of the encephalitis until IgM for the viral capsid antigen of EBV had been detected in her blood. After treatment with acyclovir, a high dose of methylprednisolone and intravenous immunoglobulin, the neurological symptoms improved rapidly. She has not suffered from any neurological complications in the four months since being discharged. EBV infection should be considered as the main etiology in cases of childhood encephalitis, although there is no evidence of infectious mononucleosis existed.
Acyclovir ; Capsid ; Child ; Consciousness ; Encephalitis ; Epstein-Barr Virus Infections ; Fever ; Headache ; Herpesvirus 4, Human ; Humans ; Immunoglobulin M ; Immunoglobulins ; Infectious Mononucleosis ; Leukocytosis ; Magnetic Resonance Spectroscopy ; Methylprednisolone ; Pharyngitis ; Seizures

OBJECTIVE: The Connor-Davidson Resilience Scale (CD-RISC) measures various aspects of psychological resilience in patients with posttraumatic stress disorder (PTSD) and other psychiatric ailments. This study sought to assess the reliability and validity of the Korean version of the Connor-Davidson Resilience Scale (K-CD-RISC). METHODS: In total, 576 participants were enrolled (497 females and 79 males), including hospital nurses, university students, and firefighters. Subjects were evaluated using the K-CD-RISC, the Beck Depression Inventory (BDI), the Impact of Event Scale-Revised (IES-R), the Rosenberg Self-Esteem Scale (RSES), and the Perceived Stress Scale (PSS). Test-retest reliability and internal consistency were examined as a measure of reliability, and convergent validity and factor analysis were also performed to evaluate validity. RESULTS: Cronbach's alpha coefficient and test-retest reliability were 0.93 and 0.93, respectively. The total score on the K-CD-RISC was positively correlated with the RSES (r=0.56, p<0.01). Conversely, BDI (r=-0.46, p<0.01), PSS (r=-0.32, p<0.01), and IES-R scores (r=-0.26, p<0.01) were negatively correlated with the K-CD-RISC. The K-CD-RISC showed a five-factor structure that explained 57.2% of the variance. CONCLUSION: The K-CD-RISC showed good reliability and validity for measurement of resilience among Korean subjects.
Depression ; Female ; Firefighters ; Humans ; Reproducibility of Results ; Resilience, Psychological ; Stress Disorders, Post-Traumatic

OBJECTIVES: The purpose of this study was to examine the effects of positive psychological characteristics on posttraumatic stress symptoms after traumatic experiences. METHODS: The subjects were 97 firefighters (83 males and 14 females), who completed the Life Events Scale, the Rosenberg Self-Esteem Scale, the Connor-Davidson Resilience Scale, and the Impact of Event Scale-Revised Korean version. Pearson product-moment correlation coefficients were computed to examine the relationships among the variables, and Structural Equation Modeling was used to investigate the mediation process in the relationships among traumatic experiences, positive psychological characteristics, and posttraumatic stress. RESULTS: The results showed that self-esteem had a mediating effect on the relationship between traumatic experiences and posttraumatic stress symptoms. Traumatic experiences affected posttraumatic stress symptoms not only directly, but also through self-esteem to posttraumatic stress symptoms. Therefore the lower firefighters' self-esteem was, the more posttraumatic stress symptoms occurred. Resilience, however, apparently had no function as mediating variable in the relationship between traumatic experiences and posttraumatic stress symptoms. Traumatic experiences and resilience each seemed to affect posttraumatic stress symptoms directly. Hence, the lower firefighters' resilience was, the more posttraumatic stress symptoms occurred. CONCLUSION: This study showed that self-esteem had a mediating effect on the relationship between traumatic experiences and posttraumatic stress symptoms. We also found that resilience affects posttraumatic stress symptoms directly, regardless of the number of traumatic experiences. Likewise, these results showed that we should be concerned in positive psychological characteristics such as self-esteem and resilience in order to prevent posttraumatic stress symptoms.
Firefighters ; Humans ; Male ; Negotiating

PURPOSE: To evaluate the clinical usefulness of 2-D Cine PC (phase contrast) technique in visualizing the pattern and the site of abnormal CSF flow and to assess the effect of a third ventriculostomy in patients with hydrocephalus. MATERIALS AND METHODS: The study group consisted of three normal controls and 13 patients with hydrocephalus, as shown on CT or MRI, and two patients who had undergone their third ventriculostomy. The technique was EKG-gated 2-D Cine PC MRI with velocity encoding 5cm/sec, TR 80msec, TE 12.3-15msec, and flip angle 15-60 degrees. Image quality was analyzed for variable sequences, and CSF flow was observed along the CSF flow pathway. We analyzed continuity and intensity of the CSF flow signal, and obstruction site and flow velocity degree were then defined. RESULTS: Systolic high and diastolic low signal intensity along the CSF flow-pathway, with normal asynchronicity and continuation, were clearly seen in normal controls. In three patients, there was obstruction at the ventricular level while others were either normal or showed a normal pattern with a weak signal. 'Normal' was defined as noncommunicating hydrocephalus and the latter as communicating hydrocephalus. In the two patients who had undergone ventriculostomy, a signal was in one case detected at the site of the third operation. CONCLUSION: A 2-D Cine PC CSF flow study enables us to see CSF flow signals noninvasively and to detect the site of obstruction of a CSF flow-pathway. It can therefore be useful for determining the application of a ventriculoperitoneal shunt and assessing the effect of a third ventriculostomy.
Humans ; Hydrocephalus ; Magnetic Resonance Imaging ; Ventriculoperitoneal Shunt ; Ventriculostomy

Hantaan virus is widely distributed among rodent populations in Korea. Two antigenically distinct hantaviruses were isolated from Apodemus agrarius in 1976 and Rattus norvegicus in 1980 in Korea. This study was designed to investigate the serological evidence of hantavirus infection among indegenous wild rodents, which were captured in 11 mountains located in Kyunggi, Kangwon, Chungnan, Chunbug and Kyungnam province of South Korea. A total 252 wild rodents of 3 species were trapped from Myungsung Mt., Chumbong Mt., Kali Mt., Hansuk Mt., Chachil peak, Kyebang Mt., Odae Mt., Kyerong Mt., Kaya Mt., Togju Mt. and Chiri Mt. in 1997. Serologic test for hantavirus infection was performed using hantavirus antigens by indirect immunofluorescent antibody technique. Among 122 Apodemus agrarius, 88 Apodemus peninsulae and 42 Eothenomys regulus; 18 A. agrarius (14.8%), 12 A. peninsulae (13.6%) and 4 E. regulus (9.5%) were immunofluorescent antibody (IFA) positive against hantaan virus. IFA titers 3 Eothenomys regulus sera were higher against puumalavirus than hantaan virus. These data imply that above three species of rodent might be natural reservoirs of hantaviruses in Korea.
Animals ; Gangwon-do ; Gyeonggi-do ; Gyeongsangnam-do ; Hantaan virus ; Hantavirus Infections* ; Hantavirus* ; Korea* ; Murinae ; Rats ; Rodentia ; Seroepidemiologic Studies* ; Serologic Tests

In the past few years a wide variety of fetal abnormalities have been successfully prenatal diagnosed by maternal sonography. Early excision of the choledochal cyst in the newborn is considered to be the optimal treatment and may pose less risk to the patient than delayed surgical exploration. We present a new case diagnosed a choledochal cyst at 23 weeks gestation by routine ultrasound scanning. At 38 weeks gestation a female infant was born by spontaneous delivery. At 7 weeks of age the patient underwent a laparotomy performed cyst excision with Roux-en-Y hepaticojejunostomy. We experienced a case of choledochal cyst at prenatal sonography and report our case with a brief review of literature.
Choledochal Cyst* ; Female ; Humans ; Infant ; Infant, Newborn ; Laparotomy ; Pregnancy ; Prenatal Diagnosis* ; Ultrasonography

PURPOSE: This study was conducted to identify the effects of life stress and depression in undergraduates on suicidal ideation. METHODS: The participants in this study were 306 nursing students from three different cities. Collected data were analyzed using t-test, ANOVA, Pearson correlation coefficients, and stepwise multiple regression. RESULTS: The mean score for life stress was 48.48, for depression, 28.59, and for suicidal ideation, 5.90. There were positive relationships between depression and life stress, suicidal ideation and life stress, and suicidal ideation and depression. The four factors of life stress, depression, school life, and gender were identified as factors influencing on suicidal ideation in undergraduates. CONCLUSION: The findings of this study indicate that the establishment of mental health care centers in universities, and development and implementation of nursing intervention programs for suicide prevention would be helpful.
Depression ; Humans ; Mental Health ; Stress, Psychological ; Students, Nursing ; Suicidal Ideation ; Suicide ; Child Health

PURPOSE: For the successful completion of transcatheter closure of atrial septal defects with the Amplatzer septal occluder, shape of the defects should be considered prior to selecting the device. The purpose of this study is to evaluate the results of a transcatheter closure of oval shaped atrial septal defect. MATERIALS AND METHODS: From November 2009 until November 2011, cardiac computed tomography was performed on 69 patients who needed a transcatheter closure of atrial septal defect. We defined an oval shaped atrial septal defect as the ratio of the shortest diameter to the longest diameter < or =0.75 measured using computed tomography. A trans-thoracic echocardiogram was performed one day after and six months after. RESULTS: The transcatheter closure of atrial septal defect was performed successfully in 24 patients in the ovoid group and 45 patients in the circular group. There were no serious complications in both groups and the complete closure rate at 6 months later was 92.3% in the ovoid group and 93.1% in the circular group (p>0.05). The differences between the device size to the longest diameter of the defect and the ratios of the device size to the longest diameter were significantly smaller in the ovoid group (1.8+/-2.8 vs. 3.7+/-2.6 and 1.1+/-0.1 vs. 1.2+/-0.2). CONCLUSION: Transcatheter closure of an oval shaped atrial septal defect was found to be safe with the smaller Amplatzer septal occluder device when compared with circular atrial septal defects.
Echocardiography ; Heart Septal Defects, Atrial/pathology/*surgery ; Humans ; Middle Aged ; Postoperative Complications ; Republic of Korea ; Retrospective Studies ; Septal Occluder Device/*adverse effects ; Tomography, X-Ray Computed ; Treatment Outcome