The early postpartum period is crucial toward in recovery form childbirth and attainment of the maternal role. Maternal role attainment is a complex social and cognitive process of stimulus-response accomplished by learning. Helping for maternal role attainment is one of nursing goals in the early postpartum period. Based on King's conceptual framework for nursing, this study was planned as descriptive correlation study to determine the significant differences of the degree of nursery room nurses' role performance according to several variables of personal, interpersonal, and working system of nurses in nursery room, The purpose of this study was to contribute to the planning of nursing care to help maternal role attainment of the early postpartum period of mothers and to the development of relevant nursing theory, The data were collected from R3b. 3 to 28 by questionnaires with 273 nurses in nursery room. The instruments for this study were consisted of four parts: 21 questions for roll performance of nurse ; 37 questions for personal system of nurse including 31 questions for role perception of nurse ; 65 questions for interpersonal system including 63 questions for job stress of nurse ; 18 questions for working system of nurse. The toes to measure role performance and role perception, and job stress of nurse were tested for internal reliability. Cronbach's Alphas were 0.9612, 0.9058, and 0.9649. The data were analysed by using in S.A.S. computerized program and included percentage, t-test, ANOVA, Pearson Correlation Coefficient, and Duncan multiple range test. The conclusions obtained from this study are summarized as follows : 1. The mean score of the items of role performance was 2.12(SD=0.55) in Likert's 4 points scale. 2. The degree of role performance was significantly different according to role perception(p=0.0001), age(p=0.006), educational background(p=0.002), and certificate of midwife(p=0.03) among variables of personal system of subjects. 3. The degree of role performance was significantly different according to job stress(p=0.0001) and numbers of children(p=0.006) among variables of interpersonal system of subjects. 4. The degree of role performance was significantly different according to having opportunities for baby(p=0.03), the degree of flexibility to bring baby to mother's room(p=0.046), the scope of visitor for baby(p=0.016), the degree of flexibility of visiting for baby(p=0.049), the degree of participation of nurse in establishing visiting rules(p=0.017), existence and/or nonexistence of rules for breast feeding(p=0.010), existence and/or nonexistence of education for breast feeding(p=0.009), existence and/or nonexistence of breast feeding room(p=0.013), concret methods for breast feeding(p=0.003), working place(p=0.0001), and career(p=0.019) among variables of personal system of subjects.
Breast ; Breast Feeding ; Education ; Humans ; Learning ; Mothers* ; Nurseries* ; Nursing ; Nursing Care ; Nursing Theory ; Parturition ; Pliability ; Postpartum Period* ; Statistics as Topic ; Toes ; Child Health ; Surveys and Questionnaires

BACKGROUND: Non-fluent agrammatic primary progressive aphasia (naPPA) is characterized by progressive non-fluent speech disorder and might be associated with taupathy such as corticobasal degeneration (CBD) and progressive supranuclear palsy. We report a case of overlap syndrome presented with language impairment, and diagnosed as naPPA with possible CBD. CASE REPORT: A 58-year-old woman visited a memory and dementia clinic, with a 10-month history of progressive language disturbance. She was diagnosed as naPPA and overlapping CBD, based on the clinical features and neuroimaging findings including florbetaben PET. CONCLUSIONS: naPPA is pathologically caused by taupathy, and might progress to asymmetrical parkinsonism and apraxia, suggestive of CBD. Overlapping clinical features in our case represent various phenotypes of taupathy.
Aphasia, Primary Progressive* ; Apraxias ; Dementia ; Female ; Humans ; Memory ; Middle Aged ; Neuroimaging ; Parkinsonian Disorders ; Phenotype ; Supranuclear Palsy, Progressive

Spastic paraparesis is caused by various etiologies such as autoimmune, infection, genetic and metabolic disorder. Adrenomyeloneuropathy (AMN) is very rare but one of important causes in spastic paraparesis. We experienced a patient presenting with adult-onset progressive spastic paraparesis, who was diagnosed as AMN with hemizygous c.431C>T (p.A144V), a novel mutation in exon1. The level of very long chain fatty acid should be included in diagnostic work-up for patients presenting with adult-onset progressive spastic paraparesis.
Adrenoleukodystrophy ; Humans ; Muscle Spasticity ; Paraparesis, Spastic

BACKGROUND/AIMS: Endoscopic resection (ER) is a well-established treatment modality for gastric epithelial neoplasm. However, there is a discrepancy between forceps biopsy and ER specimen pathology, including a negative pathologic diagnosis (NPD) after ER. It has been suggested that pit dysplasia (PD) is a subtype of gastric dysplasia, and the aim of this study was to assess the significance of PD in cases with NPD after ER for early gastric neoplasms. METHODS: After ER, 29 NPD lesions that had an associated pretreatment forceps biopsy specimen, were correctly targeted during ER, and had no cautery artifact on the resected specimen were included in this study. RESULTS: Sixteen lesions showed PD and 13 had no neoplastic pathology. The initial pretreatment forceps biopsy diagnoses of 29 NPD lesions were low-grade dysplasia (LGD) in 17 lesions, high-grade dysplasia (HGD) in seven lesions, and adenocarcinoma in five lesions, which after review were revised to PD in 19 lesions, LGD in four lesions, adenocarcinoma in two lesions, and no neoplastic pathology in four lesions. Overall, nine lesions (31%) were small enough to be removed by forceps biopsy, four NPD lesions (14%) were initially misinterpreted as neoplastic lesions, and 16 PD lesions (55%) were misinterpreted as NPD lesions on ER slides. CONCLUSIONS: Approximately half of the lesions initially diagnosed as LGD or HGD were subsequently classified as PD. Therefore, including PD as a subtype of gastric dysplasia could reduce the diagnostic discrepancy between initial forceps biopsy and ER specimens.
Adenocarcinoma ; Artifacts ; Biopsy ; Cautery ; Diagnosis ; Neoplasms, Glandular and Epithelial* ; Pathology* ; Stomach ; Stomach Neoplasms ; Surgical Instruments

An ectopic parathyroid gland is a major cause of persistent and recurrent hyperparathyroidism. Surgical success depends on accurate preoperative localization of the parathyroid adenoma. We herein report the case of a 52-year-old male patient who suffered from primary hyperparathyroidism for several years. He initially presented with urinary frequency, hypercalcemia, and a ureter stone. Ultrasonography and a 99mTc-sestamibi scan were performed, but failed to localize the parathyroid lesion. Four years later, the patient revisited our hospital, complaining of general weakness, headache, dyspepsia, and recurrent urinary symptoms secondary to persistent primary hyperparathyroidism. In addition, renal function was decreased and severe osteoporosis was found. We performed a 99mTc-sestamibi scan with single photon emission computed tomography (99mTc-MIBI SPECT) and contrast-enhanced neck CT, and detected an ectopic parathyroid adenoma in the upper anterior mediastinum. In conclusion, the combination of both 99mTc-MIBI SPECT and neck CT could permit better preoperative parathyroid localization, especially for mediastinal adenomas.
Adenoma ; Dyspepsia ; Headache ; Humans ; Hypercalcemia ; Hyperparathyroidism ; Hyperparathyroidism, Primary ; Male ; Mediastinum ; Middle Aged ; Neck ; Osteoporosis ; Parathyroid Glands ; Parathyroid Neoplasms ; Technetium Tc 99m Sestamibi ; Tomography, Emission-Computed, Single-Photon ; Ureter

BACKGROUND/AIMS: Gastric hepatoid adenocarcinoma (GHA), a rare type of primary gastric cancer, is characterized by a histology resembling hepatocellular carcinoma. Previous case studies reported that patients with GHA have a poor prognosis due to early lymph node or liver metastasis, but information concerning GHA is still limited. Therefore, we aimed to evaluate the clinicopathological features of GHA. MATERIALS AND METHODS: We reviewed the medical records of 9 patients who were diagnosed as having GHA between January 2011 and December 2016. The clinicopathological characteristics of these patients were retrospectively analyzed. RESULTS: The median age of the patients at diagnosis was 68.9 years. Seven of the 9 patients were male. Serum AFP levels were elevated in 3 of 4 patients. All the tumors were >4 cm (range, 4~12 cm), and 7 tumors were located at the lower third of the stomach. Five tumors were classified as Borrmann's type 3, with a purple, berry-like surface. Of the 6 patients without distant metastasis, 5 received curative-intent surgery and 3 received adjuvant chemotherapy. Three patients with distant metastasis received either palliative operation and/or chemotherapy. Their median survival time was 11.8 months (range, 1~36 months). Two patients with elevated serum CEA levels had poor outcomes. CONCLUSIONS: GHA is a rare subtype of gastric cancer that is prone to liver metastasis. All GHAs are advanced gastric cancer with a purple, berry-like surface at diagnosis. Although the prognosis of advanced-stage GHA is poor, active multimodality treatment might provide some benefit.
Adenocarcinoma* ; Carcinoma, Hepatocellular ; Chemotherapy, Adjuvant ; Diagnosis ; Drug Therapy ; Endoscopy ; Humans ; Liver ; Lymph Nodes ; Male ; Medical Records ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Stomach ; Stomach Neoplasms

PURPOSE: To present preliminary results of intensity-modulated radiotherapy (IMRT) using the simultaneous modulated accelerated radiation therapy (SMART) boost technique in patients with nasopharyngeal carcinoma (NPC). MATERIALS AND METHODS: Twenty patients who underwent IMRT for non-metastatic NPC at the Asan Medical Center between September 2001 and December 2003 were prospectively evaluated. IMRT was delivered using the "step and shoot" SMART technique at prescribed doses of 72 Gy (2.4 Gy/day) to the gross tumor volume (GTV), 60 Gy (2 Gy/day) to the clinical target volume (CTV) and metastatic nodal station, and 46 Gy (2 Gy/day) to the clinically negative neck region. Eighteen patients also received concurrent chemotherapy using cisplatin once per week. RESULTS: The median follow-up period was 27 months. Nineteen patients completed the treatment without interruption; the remaining patient interrupted treatment for 2 weeks owing to severe pharyngitis and malnutrition. Five patients (25%) had RTOG grade 3 mucositis, whereas nine (45%) had grade 3 pharyngitis. Seven patients (35%) lost more than 10% of their pretreatment weight, whereas 11 (55%) required intravenous fluids and/or tube feeding. There was no grade 3 or 4 chronic xerostomia. All patients showed complete response. Two patients had distant metastases and loco-regional recurrence, respectively. CONCLUSION: IMRT using the SMART boost technique allows parotid sparing, as shown clinically and by dosimetry, and may also be more effective biologically. A larger population of patients and a longer follow-up period are needed to evaluate ultimate tumor control and late toxicity.
Chemoradiotherapy ; Chungcheongnam-do ; Cisplatin ; Drug Therapy ; Enteral Nutrition ; Follow-Up Studies ; Humans ; Malnutrition ; Mucositis ; Neck ; Neoplasm Metastasis ; Pharyngitis ; Prospective Studies ; Radiotherapy, Intensity-Modulated ; Recurrence ; Tumor Burden ; Xerostomia

PURPOSE: This study investigated the effect of goji (Lycium chinense Mill.) on erectile dysfunction in old-aged rats. MATERIALS AND METHODS: Twenty-four 18-month-old male Sprague-Dawley rats (defined as old-aged rats) were used. Treatment groups contained eight rats each: a control group, goji extract of 150 mg/kg/day group, and goji extract of 300 mg/kg/day group. Treatment was by orogastric tube once daily for 6 weeks. After 6 weeks of treatment, testes weight, serum testosterone, superoxide dismutase, nitric oxide (NO)-cyclic guanosine monophosphate (cGMP)-related parameters, intracavernous pressure/mean arterial pressure, and histological changes were examined. RESULTS: Treatments with goji extracts increased serum testosterone level, increased the expression of endothelial NO synthase, neuronal NO synthase, and cGMP, improved the oxidative stress marker, and decreased corporal fibrosis. CONCLUSIONS: Our results indicate that goji extract may have a positive effect on erectile dysfunction via its antioxidant effects.
Animals ; Antioxidants ; Arterial Pressure ; Erectile Dysfunction ; Fibrosis ; Guanosine Monophosphate ; Humans ; Infant ; Male ; Models, Animal* ; Neurons ; Nitric Oxide ; Nitric Oxide Synthase ; Oxidative Stress ; Rats* ; Rats, Sprague-Dawley ; Superoxide Dismutase ; Testis ; Testosterone