PURPOSE: The aim of this study was to develop and evaluate a structural model including relevant factors to identity the variables that affect school adjustment in juvenile delinquents. On the basis of a review of the literature on school adjustment of juvenile delinquents and on Bronfenbrenner's bio-ecological model, a hypothetical model was developed by setting home environmental factors (e.g.,economic conditions, parent child communication, parenting attitudes, peer relationships, and academic stress) as exogenous variables, and personal factors (e.g., ego identity and psychological well-being) as endogenous variables. METHODS: Data were collected from January 29 to March 3, 2015 by a survey of 206 students attending junior high and high schools in City B. The collected data were analyzed using the SPSS and Amos 22.0 software. RESULTS: The verification of the hypothetical model indicated a good fit for the model: χ²=0.009 df=13, χ²/df=2.161, GFI=0.97, AGFI=0.90, RMESA=0.07, CFI=0.98, TLI=0.95, and RMR=0.01. CONCLUSION: The results suggest that ego identity and parent-child communication do not directly affect school adjustment of juvenile delinquents but influence it depending on the psychological well-being of delinquents. High levels of psychological well-being, better economic conditions, better parent-child communication, and low academic stress were abserved to contribute to better school life. Therefore, to improve the school adjustment of juvenile delinquents, appropriate measures need to be taken and programs need to be designed for improving ego identity and parent-child communication, thus promoting psychological well-being.
Child ; Ego ; Humans ; Juvenile Delinquency ; Models, Structural ; Parenting ; Parents

Purpose: This study was conducted to explore the healthcare experience of residents participating in the CommunityBased Hypertension and Diabetes Registry Program. Methods: This study used qualitative content analysis. Data were collected from in depth interviews of fifteen participants, who either participated in the program hosted by the Training Center for Hypertension and Diabetes for more than two years or participated in an intensive one-on-one education program. Results: The results showed that the core theme in healthcare of participants was ‘Proactive healthcare with attention and systematic guidance of experts’. The positive reinforcement of staffs and the improvement of self-efficacy through effective close management were found to be positive influencing factors of participation. The theme consisted of the following categories: ‘Participation in the program with positive expectations on healthcare’, ‘Interest in body and health’, ‘Vitality in life’, ‘Confidence in dealing with disease’, ‘Thankfulness for close care and attention’, and ‘Desire for continuous care’. Conclusion When establishing policies on managing chronic diseases, a strategy that reflects the results of the study is required. It is necessary to build up emotional relationship among stakeholders, and expand opportunities for close healthcare such as one-on-one customized training, and mutual cooperation with various organizations in the local community.

PURPOSE: To determine the morphology and location of normal pancreatic tail, as seen on abdominal CT. MATERIALS AND METHODS: A hundred and one patients without pancreatic disease underwent CT scanning. We thendetermined how to relate the location of the pancreatic tail with the splenic hilum, left kidney, and pancreaticbody. We compared the thickness of the tail with that of the body and analysed of the morphology of the tail. RESULTS: Seventy-seven percent of all pancreatic tails were located below the splenic hilum, with 59% of thisproportion located located 1 to 2 cm below. Fifty percent of tails were located at the level of the uppermostquarter of the left kidney, and a further 27% at the level of the second quarter ; 75% were located in theventrolateral portion of this kidney and 23% in the ventral portion. In 48% of patients, the pancreatic tail andbody were the same thickness, and in a further 48%, the tail was thicker than the body. In 34% of patients, thetail showed focal bulging, and in another 32%, it tapered smoothly. Forty seven percent of tails were locatedbelow the pancreatic body and a further 37% were found at the same level as the body. CONCLUSION: Abdominal CTscans showed differing morphology and location of the pancreatic tail. The recognition of these variations willdiminish speculation as to their true nature.
Humans ; Kidney ; Pancreatic Diseases ; Tomography, X-Ray Computed

PURPOSE: To develop staffing levels for nursing personnel (registered nurses and nursing assistants) to provide inpatients with integrated nursing care that includes, in addition to professional nursing care, personal care previously provided by patients' families or private caregivers. METHODS: A time & motion study was conducted to observe nursing care activities and the time spent by nursing personnel, families, and private caregivers in 10 medical-surgical units. The Korean Patient Classification System-1 (KPCS-1) was used for the nurse manager survey conducted to measure staffing levels and patient needs for nursing care. RESULTS: Current nurse to patient ratios from the time-motion study and the survey study were 1:10 and 1:11, respectively. Time spent in direct patient care by nursing personnel and family/private caregivers was 51 and 130 minutes per day, respectively. Direct nursing care hours correlated with KPCS-1 scores. Nursing personnel to patient ratio required to provide integrated inpatient care ranged from 1:3.9 to 1:6.1 in tertiary hospitals and from 1:4.4 to 1:6.0 in general hospitals. The functional nursing care delivery system had been implemented in 38.5% of the nursing units. CONCLUSION: Findings indicate that appropriate nurse staffing and efficient nursing care delivery systems are required to provide integrated inpatient nursing care.
Caregivers ; Classification ; Hospitals, General ; Humans ; Inpatients* ; Nurse Administrators ; Nursing Care* ; Nursing* ; Patient Care ; Tertiary Care Centers

PURPOSE: This study was conducted to investigate and identify an appropriate fracture treatment method by analyzing patients in whom a femoral incompetence fracture occurred after receiving a long-term bisphosphonate administration. MATERIALS AND METHODS: The subjects of this study were 13 cases out of ten patients among those who had a history of receiving bisphosphonate for more than five years and had a fracture or an imminent fracture with a characteristic radiological finding in the femoral subtrochanteric region and the interfemoral region. The period of the drug administration, bone density, the existence of a prodromal symptom, and bilateral fracture were investigated. RESULTS: In seven out of the 13 cases, the patients complained of painat the femoral and pelvic parts as a prodrome (53.8%), and three of them showed a bilateral fracture (30%). An imminent fracture with a prodrome was observed in six cases (46.2%); for three of these cases, a prophylactic fixture pexis was performed by inserting a metal nail into the medullary cavity, and in two out of these three, a complete fracture was found within 11 months on average (3 to 19 months). In the three prophylactic fixture pexis performed cases, no postoperative complications were found, and a radiological finding of concrescence was seen within one year after the operation. Among the nine operation performed cases after the fracture, non-union was found in two. CONCLUSION: In the patients who have received bisphosphonate for a long periodof time, a prodome may be a useful indicator of a fracture in the femoral subtrochanteric region and the interfemoral region; therefore, a careful observation is necessary. A prophylactic internal fixation is recommended for patients with imminent fracture with a prodome since they have a high risk of a complete fracture is high in them.
Bone Density ; Fractures, Stress* ; Humans ; Methods ; Postoperative Complications ; Prodromal Symptoms ; Prognosis*

OBJECTIVE: To evaluate the effect of uterine weight on short-term outcome of total laparoscopic hysterectomy (TLH) for benign gynecological conditions. METHODS: A retrospective medical records review of 265 cases of patients with TLH was performed. Patients included in this study underwent TLH as benign uterine disorders at Kangnam Sacred Heart Hostpital, Hallym University from January 2008 through June 2009. These patients were stratified into three groups; Group 1 patients with uterus weighing less than 180 g (n=60), Group2 patients with uterus weighing 180 g to 350 g (n=141), Group 3 patients with uterus weighing more than 350 g (n=64). The groups were compared as regard postoperative stay, operative time, estimated blood loss, hemoglobin change, conversion to open surgery, and postoperative complications. RESULTS: There was no significant difference in age, gravidity, body mass index, previous pelvic surgery and past medical history. The overall complication rates were not significantly different. But operative time prolonged as uterine weight increased. CONCLUSION: The TLH can be performed successfully in case of enlarged uterus. Therefore the enlarged uterus is not an absolute contraindication for TLH.
Body Mass Index ; Conversion to Open Surgery ; Gravidity ; Heart ; Hemoglobins ; Humans ; Hysterectomy ; Medical Records ; Operative Time ; Retrospective Studies ; Uterus

BACKGROUND: Micro computed tomography (CT) is rapidly developing as an imaging tool, especially for mice, which have become the experimental animal of choice for many pulmonary disease studies. We evaluated the usefulness of micro CT for evaluating lung fibrosis in the murine model of bleomycin-induced lung inflammation and fibrosis. METHODS: The control mice (n=10) were treated with saline. The murine model of lung fibrosis (n=60) was established by administering bleomycin intra-tracheally. Among the 70 mice, only 20 mice had successful imaging analyses. We analyzed the micro CT and pathological findings and examined the correlation between imaging scoring in micro CT and histological scoring of pulmonary inflammation or fibrosis. RESULTS: The control group showed normal findings on micro CT. The abnormal findings on micro CT performed at 3 weeks after the administration of bleomycin were ground-glass opacity (GGO) and consolidation. At 6 weeks after bleomycin administration, micro CT showed various patterns such as GGO, consolidation, bronchiectasis, small nodules, and reticular opacity. GGO (r=0.84) and consolidation (r=0.69) on micro CT were significantly correlated with histological scoring that reflected pulmonary inflammation (p<0.05). In addition, bronchiectasis (r=0.63) and reticular opacity (r=0.83) on micro CT shown at 6 weeks after bleomycin administration correlated with histological scoring that reflected lung fibrosis (p<0.05). CONCLUSION: These results suggest that micro CT findings from a murine model of bleomycin-induced lung fibrosis reflect pathologic findings, and micro CT may be useful for predicting bleomycin-induced lung inflammation and fibrosis in mice.
Animals ; Bleomycin ; Bronchiectasis ; Fibrosis ; Lung ; Lung Diseases ; Mice ; Pneumonia

BACKGROUND: Micro computed tomography (CT) is rapidly developing as an imaging tool, especially for mice, which have become the experimental animal of choice for many pulmonary disease studies. We evaluated the usefulness of micro CT for evaluating lung fibrosis in the murine model of bleomycin-induced lung inflammation and fibrosis. METHODS: The control mice (n=10) were treated with saline. The murine model of lung fibrosis (n=60) was established by administering bleomycin intra-tracheally. Among the 70 mice, only 20 mice had successful imaging analyses. We analyzed the micro CT and pathological findings and examined the correlation between imaging scoring in micro CT and histological scoring of pulmonary inflammation or fibrosis. RESULTS: The control group showed normal findings on micro CT. The abnormal findings on micro CT performed at 3 weeks after the administration of bleomycin were ground-glass opacity (GGO) and consolidation. At 6 weeks after bleomycin administration, micro CT showed various patterns such as GGO, consolidation, bronchiectasis, small nodules, and reticular opacity. GGO (r=0.84) and consolidation (r=0.69) on micro CT were significantly correlated with histological scoring that reflected pulmonary inflammation (p<0.05). In addition, bronchiectasis (r=0.63) and reticular opacity (r=0.83) on micro CT shown at 6 weeks after bleomycin administration correlated with histological scoring that reflected lung fibrosis (p<0.05). CONCLUSION: These results suggest that micro CT findings from a murine model of bleomycin-induced lung fibrosis reflect pathologic findings, and micro CT may be useful for predicting bleomycin-induced lung inflammation and fibrosis in mice.
Animals ; Bleomycin ; Bronchiectasis ; Fibrosis ; Lung ; Lung Diseases ; Mice ; Pneumonia

Tracheal diverticula are relatively rare disease characterized by single or multiple evaginations of the tracheal wall. The tracheal diverticulum may act as a reservoir for secretions, leading to recurrent respiratory tract infections associated with chronic cough and dyspnea. A 31-year-old man had complained of a chronic productive cough for several months. Methacholine bronchial provocation test was positive. Three-dimensional computed tomography showed an air-containing cystic structure extending right posterolateral aspect of the trachea. Fiberoptic bronchoscopy demonstrated ostium arising from the right posterolateral wall at mid-third of trachea. These findings made asthma and tracheal diverticulum the diagnosis. Medical treatment was performed and symptoms were relieved.
Adult ; Asthma* ; Bronchial Provocation Tests ; Bronchoscopy ; Cough ; Diagnosis ; Diverticulum* ; Dyspnea ; Humans ; Methacholine Chloride ; Rare Diseases ; Respiratory Tract Infections ; Trachea

BACKGROUND/AIMS: Non-resolving or slow-resolving pneumonia refers to the persistence of pulmonary infiltrates for >30 days after an initial pneumonia-like illness. Organizing pneumonia (OP) can be found on a lung biopsy in association with a number of diseases. The object of this study was to elucidate the clinical characteristics of the non-resolving pneumonia with the pathology of an OP and suggest the proper diagnostic and therapeutic approaches for the reduction of unnecessary procedures. METHODS: We retrospectively analyzed 70 patients diagnosed with an OP by percutaneous transthoracic needle biopsy and that met the inclusion criteria. Their pulmonary lesions were reviewed for disease resolution. Patients were divided into either a radiologically benign group (group I, n=57) or a malignancy group (group II, n=13) based on the computed tomography (CT) findings. RESULTS: All patients in group I and 8 patients in group II improved and had a complete resolution by 81.70+/-45.36 days. The microbiology findings showed that many infectious pathogens can lead to an OP despite antibiotic therapy. Three cases in group II were ultimately diagnosed as malignancies. CONCLUSIONS: Our data suggest that non-resolving or slow-resolving lesions were strongly suspicious for a malignancy on the CT scans, despite appearing to be benign OP pathologically; such cases should be considered for re-biopsy. In cased with pathology consistent with OP and benign CT findings, careful observation for 3 months is recommended to allow for the complete radiological resolution of the benign OP associated with infection.
Biopsy ; Biopsy, Needle ; Humans ; Lung ; Pneumonia ; Retrospective Studies ; Tomography, Spiral Computed