Duodenal varix is a rare site of hemorrhage in patients with portal hypertension, but its rupture is a serious and often fatal event. They can be diagnosed by means of upper gastrointestinal endoscopy, selective superior mesenteric artery angiography, slenoportogram. Especially, upper gastroduodenal endoscopy is the diagnostic procedure of choice in diagnosing duodenal varices. Treatment modalities for bleeding duodenal varices are sclerotherapy, varix ligation, portocaval shunt, and duodenal resection. Endoscopic sclerotherapy has limited success in controlling active duodenal varix. Endoscopic ligation with a detachable snare is a useful therapeutic measure in the treatment of bleeding duodenal varices. Wc report a patient with bleeding duodenal varix, successfully treated by means of endoscopic ligation with a detachable snare. The endoscopic examination showed spurting bleeding from dilated vessel at the third portion of the duodenum. We successfully controlled the bleeding duodenal varix by means of endoscopic ligation with a detachable snare.
Angiography ; Duodenum ; Endoscopy ; Endoscopy, Gastrointestinal ; Hemorrhage ; Humans ; Hypertension, Portal ; Ligation* ; Mesenteric Artery, Superior ; Rupture ; Sclerotherapy ; SNARE Proteins* ; Varicose Veins*

PURPOSE: This randomized study was done to compare the effects of a 6 month Tai Chi exercise and a self-help program on balance, flexibility and muscle strength in women with osteoarthritis (OA). METHOD: In this experimental study, 82 women with OA recruited from outpatient clinics or community health centers were randomly assigned either to a Tai Chi group or a self-help group. Thirty women (mean age = 62 years) in the Tai Chi group and 39 (mean age = 59 years) in the self-help group completed posttest measures (balance, flexibility, oxygen consumption, abdominal muscle strength, back muscle strength, and grip strength) at 6 months. RESULTS: After the 6 month, Tai Chi participants had significantly greater balance (mean difference = 2.9 vs. 0.9 for the self-help), grip strength (mean difference = 4.6 vs. 0.9 for the self-help), and back muscle strength (mean difference = 4.1 vs. -0.3 for the self-help). However, flexibility, oxygen consumption, and abdominal muscle strength were not significantly different between the groups. CONCLUSION: Tai Chi increased balance, grip strength and back muscle strength in older women with osteoarthritis compared to the self-help program. Whether these changes improve physical functioning and fall prevention requires further study.
Abdominal Muscles ; Ambulatory Care Facilities ; Community Health Centers ; Female ; Hand Strength ; Humans ; Muscle Strength ; Muscles ; Osteoarthritis ; Oxygen ; Oxygen Consumption ; Pliability ; Postural Balance ; Self-Help Groups ; Tai Ji

Purpose: The purpose of this study was to identify the factors influencing organizational commitment of staffs according to the size of long-term care facility. Methods: A cross-sectional descriptive study was designed. Data collection was conducted for a total of 315 employees in long-term care facilities located in Seoul, Gyeonggi, Gangwon, Gyeongbuk, and Chungnam. Data were collected from July 2018 to October 2018 using questionnaires which included emotional labor, job satisfaction, organizational commitment, and general characteristics. In order to confirm the differences in the size of the facility, the facilities with less than 30 beds, those with 30-99 beds, and those with more than 100 beds were analyzed. Data were analyzed using descriptive statistics, t-test, ANOVA, Mann-Whitney U test, Kruskal-Wallis H test, Pearson's correlation analysis, and multiple regression. Results: The job satisfaction and organizational commitment were significantly different according to the size of long-term care facility. Organizational commitment was influenced by ‘external job satisfaction’ in less than 30 beds, was influenced by ‘external job satisfaction, and attentiveness to required display rules of emotional labor’ in 30~99 beds, and then was influenced by ‘type of job, and internal job satisfaction’ in more than 100 beds. The predict variables accounted for 23.0%, 41.0%, and 34.0% of organizational commitment respectively. Conclusion These findings show that tailored interventions should be provided depending on the size of facility in order to increase organizational commitment. In addition, organizational commitment programs should be developed by considering strategies to reduce the emotional labor and to increase job satisfaction.

Purpose: This study attempted to obtain basic data for developing a global nursing practice education program. Methods: The data collection period was from July 2 to 11, 2020. The study participants were professors with experience in design, operation and management of global nursing practice education or experts with experience in international cooperation projects, and 8 people who agreed to participate in focus group interview (FGI). FGI was conducted twice in total and the directed content analysis method was applied. Results: The categories of ‘practice design’ are ‘growing as a global nursing leader’ and ‘working together towards one goal’. The categories of ‘practice operation’ are ‘watching, listening, and performing’, ‘self-directed organizing from preparation to finishing’, and ‘learning the value of participation rather than grades’. The category of 'practice management' is 'one's own weight to carry'. Conclusion Global nursing practice education aims one goal - growing as a global nursing leader - and is self-directed course from preparation to an end with watching, listening and performing together. It is about learning the value of participation rather than grades. This can be used as basic data for the design, operation and management of global nursing practice education in the future.

PURPOSE: Tai Chi exercise, an ancient Chinese martial art, has drawn more and more attention for its health benefits. The purpose of the study was to identify the effects of a Sun-style Tai Chi exercise on arthritic symptoms (joint pain and stiffness), motivation for performing health behaviors, and the performance of health behaviors among older women with osteoarthritis. METHODS: Total of 72 women with the mean age of 63 years old were recruited from outpatients clinic or public health centers according to the inclusion criteria and assigned randomly to either the Tai Chi exercise group or the control. A Sun-style Tai Chi exercise has been provided three times a week for the first two weeks, and then once a week for another 10 weeks. In 12 weeks of study period, 22 subjects in the Tai Chi exercise group and 21 subjects in the control group completed the posttest measure with the dropout rate of 41%. Outcome variables included arthritic symptoms measured by K-WOMAC, motivation for health behavior, and health behaviors. RESULTS: At the completion of the 12 week Tai Chi exercise, the Tai Chi group perceived significantly less joint pain (t=-2.19, p=0.03) and stiffness (t=-2.24, p=0.03), perceived more health benefits (t=2.67, p=0.01), and performed better health behaviors (t=2.35, p=0.02), specifically for diet behavior (t=2.06, p=0.04) and stress management (t=2.97, p=0.005). CONCLUSION: A Sun-style Tai Chi exercise was found as beneficial for women with osteoarthritis to reduce their perceived arthritic symptoms, improve their perception of health benefits to perform better health behaviors.
Aged ; Female ; *Health Behavior ; Humans ; Korea ; Life Style ; Middle Aged ; *Motivation ; Osteoarthritis/*rehabilitation ; Quality of Life ; *Tai Ji

Laparoscopic cholecystectomy is a relatively new non-invasive surgical procedures, enjoying ever-increasing popularity and presenting new anesthetic challenges. The advantages of shorter hospital stay and more rapid return to normal activities are combined with less pain associated with the small limited incision and less postoperative ileus. During this procedure, the deliberate pneumoperitoneum with carbon dioxide(CO2) insufflation may cause some problems such as hypercarbia, hypertension, pneumomediastinum and other cardiovascular impairments. This study was performed to search a anesthetic method, which has least increase in blood pressure during CO2 insufflation, and to find out whether increased PaCO2 is a major causative factor in the changes of blood pressure during this period. Sixty patients of ASA class 1 or 2 were classified randomly into 3 groups. Group C(control group) was received enflurane-N2O-O2, and others were recieved enflurane-propofol(group P), or enflurane-propofol-fentanyl(group F), respectively. The blood pressure and heart rate were measured at 1 min before CO2 insufflation and 1 min, 5 min, 15 min after insufflation and 1 min before deflation, 5 min after deflation. Also PaCO2 were checked at 1 min before, and 15 min after insufflation. The results were follows ; 1) Changes of arterial pressure : The control group showed most prominent increasing in systolic and mean blood pressure during CO2 insufflation(P<0.05). Group F produced the least increase in blood pressure during CO2 insufflation, compared with group C and P(P<0.05). 2) Changes of heart rate : Although, in the preinsufflation period, heart rates in the group F were significantly lower than other groups, there were no significant changes in heart rates in each group. 3) Changes of PaCO2: There were no siginificant increases in PaCO2 in each group, and no differences between the groups. In conclusion, fentanyl and propofol added light enflurane anesthesia could be a method of the least increase in blood pressure during the laparoscopic cholecystectomy, and increased PaCO2 would not be a major causative factor in hypertension during CO2 insuftlation.
Anesthesia ; Anesthesia, General* ; Arterial Pressure ; Blood Pressure ; Carbon Dioxide* ; Carbon* ; Cholecystectomy, Laparoscopic ; Enflurane ; Fentanyl ; Heart Rate ; Humans ; Hypertension ; Ileus ; Insufflation ; Laparoscopy ; Length of Stay ; Mediastinal Emphysema ; Pneumoperitoneum ; Propofol

OBJECTIVE: To investigate whether polymorphisms of gene encoding CYP1B1 is associated with the risk of endometriosis in Korean women. METHODS: We investigated 199 patients with histopathologically confirmed endometriosis rAFS stage III/IV and 183 control group women who were surgically proven to have no endometriosis. The genetic distribution of four different CYP1B1 polymorphisms at G119-T, G432-C, T449-C, and A453-G were analyzed by polymerase chain reaction (PCR) and restriction fragment length polymorphism of PCR products. RESULTS: We found no overall association between each individual CYP1B1 genotype and the risk of endometriosis. The odds ratio of genotype GG/GC+GG/TC+TT/AA compared to GG/CC/CC/AA (reference) was calculated as 2.06 with a 95% confidence interval of 1.003~4.216. CONCLUSIONS: This results suggest that CYP1B1 genetic polymorphism may be associated with development of endometriosis in Korean women.
Endometriosis* ; Female ; Genotype ; Humans ; Odds Ratio ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Restriction Fragment Length

PURPOSE:The purpose of this study was to identify useful predictors for diagnosing bacterial meningitis and performing CSF studies in febrile infants three months or younger. METHODS:Six hundred and fifty two febrile infants with a rectal temperature > or =38.0 degreesC presented from January 2003 to April 2008 and were retrospectively studied. The total white blood cell count (WBC), band count, absolute neutrophil count (ANC), quantitative C-reactive protein (CRP) and blood cultures were performed on admission. The clinical variables associated with bacterial meningitis were analyzed. RESULTS:In patients with bacterial meningitis, the clinical variables including CRP (P= 0.036), band count (P=0.037), ANC (P=0.036) and age (P=0.001) were significantly different. The area under the receiver-operating characteristic curve was 0.969 for CRP, 0.946 for the band count, 0.765 for the ANC and 0.235 for age. A CRP cutoff point of 8 mg/dL was determined to maximize both the sensitivity and specificity (sensitivity 83%, specificity 95%, likelihood ratio 16.6). A CRP concentration of <7 mg/dL "ruled-out" bacterial meningitis, with a likelihood ratio of 0.17, a posttest probability of <0.1% and negative predictive value 91%. A CRP concentration greater than 9 mg/dL had a much higher likelihood ratio (20.1) than the band count (16.6) and ANC (2.2). CONCLUSION:The CRP concentration was a useful laboratory test for the differential diagnosis of bacterial meningitis among febrile infants three months of age or younger. A CRP concentration of<7 mg/dL effectively ruled out bacterial meningitis; a value > or =9 mg/dL increased the clinical suspicion of bacterial meningitis and the need for CSF evaluation.
Aged ; C-Reactive Protein ; Diagnosis, Differential ; Fever ; Humans ; Infant ; Leukocyte Count ; Meningitis ; Meningitis, Bacterial ; Neutrophils ; Retrospective Studies ; Sensitivity and Specificity

PURPOSE: To examine the effect of back massage on immune response, symptom distress, and mood state of patients undergoing allogeneic hematopoietic stem cell transplantation (allogeneic HSCT). METHODS: Subjects were thirty-seven patients undergoing sibling allogeneic HSCT (including 16 in the experimental group and 21 in the control group). Experimental subjects participated in an intervention group of back massage for 10 minutes, once a day and 5 times a week, from one week prior to the HSCT to the third week after the HSCT or a control group. A non-equivalent pretest-posttest design was used. t-test and Repeated measures ANOVA were used to examine group differences by using SAS. RESULTS: No significant group differences were found in Immune response (CD4+, CD8+,CD19+, CD56+) and symptom distress. The experimental group had significantly less mood state (anxiety, confusion) than the control group. CONCLUSION: The back massage for the patients undergoing allogeneic HSCT may be effective in altering the anxiety and confusion during hematopoietic stem cell transplantation. However, this study did not provide evidence in improving immune response and symptom distress.
Anxiety ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Humans ; Massage ; Phenothiazines ; Siblings

No abstract available.
Clomiphene*