PURPOSE: This study was conducted to study the attitude of Korean lawyers toward withdrawal of life sustaining treatment, and compare and analyze different types of their attitudes. METHODS: Research design of this project was Q methodology approach. The study population was 24 lawyers, aged from 32 to 69 years. Q sample to investigate the attitude of the lawyers toward withdrawal of life sustaining treatment included 34 statements obtained from literatures, TV debate, and depth interviews of 5 lawyers among the lawyers included. After listening to the purpose and method of the study, the 24 lawyers agreed to fill out a survey asking sociodemographic information, and the information was distributed in 9 scale Q-sample. RESULTS: The collected data were processed through QUANL PC program and sorted into 5 types as follows: The first type was 'Choosing to withdraw life sustaining treatment', the second 'Withholding life sustaining treatment' regardless of the cost, the third is neutral type that claims that humans have the right to decide the death and life, and demands the proper legalization to protect such rights, the fourth type agrees to withdrawal of life sustaining treatment, nevertheless, admits that one has a rigt to withhold one's own life treatment, categorized as self contradiction type. The fifth type believed that 'Life and death are providential' with the faith, therefore, such authority to decide life and death belongs to God, but not human beings. CONCLUSION: In conclusion, the lawyer's attitudes toward withdrawal of life sustaining treatment were grouped into five different types as follows: 'Choosing to withdraw life sustaining treatment', 'Withholding life sustaining treatment', 'Demanding legalization', 'Self contradiction type', and 'Life and death are providential'.
Aged ; Human Rights ; Humans ; Lawyers ; Nursing Methodology Research ; Q-Sort ; Research Design ; Withholding Treatment

PURPOSE: The aims of this study were to describe and interpret the nature of the experience inherent in the sex life of female breast cancer patients after treatment and understand the meaning behind it. METHODS: The participants were 10 female breast cancer patients who were married. Data were collected from March to September 2010. Van Manen's hermeneutic phenomenology was adopted in this qualitative study as a research method. RESULTS: There were 4 essential topics in the participants' experience of sex life; 'Sex life alert' was a result of negative changes in sexual relationships with spouse that they had never experienced before the breast cancer diagnosis; 'Precarious situation for pending divorce' was an experience of deteriorated sex life because of the failure to overcome 'sex life alert'; 'Sublimation of the difficulties by discovering an alternative solution' was an experience of discovering a solution to overcome the 'sexlife alert'. 'Leaving it as unsettled' was an experience of a condition in which the participants did not have any intension to resolve the difficulties in sex life due to the lack of appropriate support, thus tried to ignore the challenges faced. CONCLUSION: This study illustrates the necessity to develop proper nursing intervention on the issues related to sex life among breast cancer patients. Given the fact that the sexual topics are often considered taboo in day to day nursing practice, special attention and efforts need to be given in this area to build up nursing knowledge and evidence-based practice.
Breast ; Breast Neoplasms ; Evidence-Based Practice ; Female ; Humans ; Qualitative Research ; Sexual Behavior ; Spouses ; Taboo

PURPOSE: The purpose of this study were to develop a new restraint for the intensive care units (ICU) and to investigate the application effect in comparison with a control group using existing restraints. METHOD: A non-equivalent control group non-synchronized quasi-experimental research design was used. The participants were 40 (control 20, experimental 20) patients who were recruited by convenience sampling the ICU of a university hospital. To avoid contamination of the experiment, data for the control group were collected prior to the experimental group. Measurement variables were edema and skin damage (redness and abrasion) at the application site, and nurses' perceived convenience in applying restraints. RESULTS: Three days after applying the restraint, amount of edema at the application site was small and incidence of skin damage decreased in the experimental group in comparison with the control group. Also, score for application convenience measured by the nurses was higher in for the newly developed restraint than for existing restraints. CONCLUSION: Results indicate that the newly developed restraint has lower effects such as edema and skin damage and is more convenient compared with existing restraints, and is therefore recommended for patients in the ICU.
Edema ; Humans ; Incidence ; Critical Care ; Intensive Care Units ; Research Design ; Restraint, Physical ; Skin

In treating young women for gestational trophoblastic tumor ( G.T.T. ), all efforts are made to preserve fertility and hysterectomy is avoided unless absolutely essential. However, in some cases the operation may be lifesaving. During the last 20 years among the 310 cases of G.T.T. treated at Il Sin Christian Hospital, there were 3 cases in which hysterectomy was avoided by the excision of a localized uterine lesion thus preserving fertility.
Choriocarcinoma* ; Female ; Fertility ; Humans ; Hysterectomy ; Pregnancy ; Trophoblastic Neoplasms

Purpose: To compare the surgical outcomes of peritoneal irrigation versus suction alone during laparoscopic appendectomy and to identify the risk factors of surgical site infection in patients with uncomplicated acute appendicitis. Methods: Data from patients with uncomplicated acute appendicitis between January 2014 and March 2016 were reviewed. We compared the irrigation and suction alone groups with regard to the following parameters: postoperative complication incidence rate, length of hospital stay, operation time, time to flatus, time to diet commencement, and duration of postoperative antibiotic. Results: A total of 578 patients underwent laparoscopic appendectomy for uncomplicated acute appendicitis. Twenty-five patients were excluded from the analysis because of need for drain insertion, loss to follow-up, simultaneous surgery for another indication, presence of an appendix tumor, or pregnancy. A total of 207 patients (37.4%) had undergone irrigation, and 346 patients (62.6%) received suction alone during laparoscopic appendectomy. The preoperative fever rate was significantly higher in the irrigation group than in the suction alone group. Operative time was also significantly longer in the irrigation group than in the suction alone group (53.8 ± 18.5 minutes vs. 57.8 ± 21.4 minutes, P = 0.027). The postoperative complication rate was higher in the irrigation group than in the suction alone group (4.5% vs. 12.6%, P = 0.001). Multiple logistic regression analysis showed that irrigation and preoperative fever were risk factors for surgical site infection after laparoscopic appendectomy for uncomplicated acute appendicitis. Conclusion There is no advantage to irrigating the peritoneal cavity over suction alone during laparoscopic appendectomy for uncomplicated acute appendicitis. Irrigation may actually prolong the operative time and therefore be detrimental.

OBJECTIVES: This study investigated the prevalence of traumatic events and posttraumatic stress disorder (PTSD) in an admission cohort of schizophrenic patients from two university affiliated psychiatric units in Korea. Differences in symptomatology between those with and without trauma were also assessed. METHODS: The consecutive sixty one inpatients (32 women and 29 men), who were diagnosed with schizophrenia by SCID-I, completed the Clinician-Administered PTSD Scale (CAPS), the Positive and Negative Syndrome Scale (PANSS), Symptom Checklist-90-Revised (SCL-90-R), Beck Depression Inventory, and State-Trait Anxiety Inventory. RESULTS: Forty patients (66%) had at least one traumatic event in their life time. The most common traumatic event was child physical abuse (34%), followed by accidents (21%), traumatic loss (18%), witnessing violence (15%), child sexual abuse (10%), natural disaster (8%), adult physical assaults (8%), adult sexual assaults (5%), and psychotic symptoms (5%). Only one patient (2%), however, was diagnosed with current PTSD. Patients with traumatic events compared to those without traumatic events demonstrated significantly higher scores on State anxiety scale (p=.006) and several subscales of SCL-90-R including paranoia, anxiety, phobia, interpersonal sensitivity, and degree of psychosis. No differences of sociodemographic and clinical background variables were found between the two groups. CONCLUSION: Low rate (2%) of current PTSD found in this study is comparable to North American literature reporting 10-46% of PTSD within the schizophrenic population. Absence of substance abuse or homelessness and low rate of sexual violence in these Korean patients may explain the discrepant rates. However, distinct symptom profiles of patients with trauma may suggest that PTSD diagnosis runs short of describing such patients. The results from this study imply that schizophrenia per se may not be associated with increased prevalence in current PTSD diagnosis.
Adult ; Anxiety ; Child ; Child Abuse, Sexual ; Cohort Studies ; Comorbidity ; Depression ; Diagnosis ; Disasters ; Female ; Homeless Persons ; Humans ; Inpatients* ; Korea ; Paranoid Disorders ; Phobic Disorders ; Prevalence* ; Psychotic Disorders ; Schizophrenia* ; Sex Offenses ; Stress Disorders, Post-Traumatic* ; Substance-Related Disorders ; Violence

Our purpose was to compare the safety and efficacy of intravaginal misoprostol versus dinoprostone vaginal tablet for induction of labor at term pregnancies. Two hundred three patients with indications for induction of labor at term were randomly assigned to receive either intravaginal misoprostol or dinoprostone vaginal tablet. Fifty micrograms of misoprostol was placed in the posterior vaginal fornix every six hours, with a potential maximum of four doses. 3 milligrams of dinoprostone vaginal tablet was placed in the posterior vaginal fornix every eight hours, with a potential maximum of three doses. Further medication was withheld with the occurrence of spontaneous rupture of membrane, entry into adequate contraction pattern(twenty second sustained with two or more frequent uterine contraction in 10 minutes), nonreassuring FHR tracing, or delivery. Artificial membrane rupture with both study protocol was done at the discretion of the attending physician. After membrane rupture, in the cases of failure of active labor or arrest of dilation, oxytocin was administerated. Among those evaluated, 100 received misoprostol and 102 received dinoprostone. The average interval from start of induction to vaginal delivery was shorter in the misoprostol group(784.7 +/- 389.3 min) than in the dinoprostone group(988.3 +/- 369.5 min)(p<0.01). There was no significant difference in change of Bishop score between the two groups. No statistically significant differences were noted between two groups in case of need for oxytocin and oxytocin total dose, but significant difference was noted between two groups in case of indication for oxytocin augmentation. There were no significant differences in the routes of delivery. Intravaginal administration of misoprostol appears to be as effective as dinoprostone vaginal tablet for labor induction at full term pregnancies. Complications associated with prostaglndin administration were not statistically different between the two treatment groups.
Administration, Intravaginal ; Dinoprostone* ; Humans ; Membranes ; Membranes, Artificial ; Misoprostol* ; Oxytocin ; Pregnancy* ; Rupture ; Rupture, Spontaneous ; Uterine Contraction ; Vaginal Creams, Foams, and Jellies*

OBJECTIVES: Even though experimental studies have suggested that iron can be involved in generating oxidative stress, epidemiologic studies on the association of markers of body iron stores with cardiovascular disease or cancer remain controversial. This study was performed to examine the association of serum ferritin and transferrin saturation (%TS) with all-cause, cancer, and cardiovascular mortality. METHODS: The study subjects were men aged 50 years or older and postmenopausal women of the Third National Health and Nutrition Examination Survey 1988-1994. Participants were followed-up for mortality through December 31, 2006. RESULTS: Serum ferritin was not associated with all-cause, cancer, or cardiovascular mortality for either men or postmenopausal women. However, all-cause, cancer, and cardiovascular mortality were inversely associated with %TS in men. Compared with men in the lowest quintile, adjusted hazard ratios for all-cause, cancer, and cardiovascular mortality were 0.85, 0.86, 0.76, and 0.74 (p for trend < 0.01), 0.82, 0.73, 0.75, and 0.63 (p for trend < 0.01), and 0.86, 0.81, 0.72, and 0.76 (p for trend < 0.01), respectively. For postmenopausal women, inverse associations were also observed for all-cause and cardiovascular mortality, but cancer mortality showed the significantly lower mortality only in the 2nd quintile of %TS compared with that of the 1st quintile. CONCLUSIONS: Unlike speculation on the role of iron from experimental studies, %TS was inversely associated with all-cause, cancer and cardiovascular mortality in men and postmenopausal women. On the other hand, serum ferritin was not associated with all-cause, cancer, or cardiovascular mortality.
Aged ; Cardiovascular Diseases/blood/*mortality ; Cause of Death ; Female ; Ferritins/*blood ; Follow-Up Studies ; Health Surveys ; Humans ; Male ; Middle Aged ; Neoplasms/*mortality ; Republic of Korea/epidemiology ; Transferrins/*blood

PURPOSE: This study was conducted to investigate the trend in functional changes over time and factors associated with the number of areas showing functional decline in older adults who had been discharged from acute care hospitals. METHODS: This longitudinal study involved 156 patients aged ≥ 65 years who were admitted to one tertiary hospital in Seoul and discharged home. Authors investigated patient demographic and health-care characteristics and the number of areas showing functional decline at 1 and 3 months after discharge. The data were analyzed using univariate and multivariate Poisson regression models. RESULTS: The number of areas showing functional decline increased between admission and 1 month after discharge and had declined slightly at 3 months after discharge. The factors associated with the number of areas showing functional decline at 3 months after discharge were age, education level, and length of hospitalization (p < .05); the factors associated at 1 month after discharge were medical department and caregiver relationship (p < .05). CONCLUSION: The results indicate that older patients with no spouse or those with their elderly spouse as their caregiver are at risk of functional decline in a greater number of areas after discharge. Therefore, a comprehensive health-care policy to ensure care continuity is required for functional health maintenance for older adults after hospital discharge.
Adult ; Aged ; Caregivers ; Continuity of Patient Care ; Education ; Hospitalization ; Humans ; Longitudinal Studies ; Seoul ; Socioeconomic Factors ; Spouses ; Tertiary Care Centers

Development of swelling and pain without trauma in a scrotal hematoma is very rare. We report on a case of scrotal hematoma with active bleeding caused by sparganosis. A 75-year-old male patient who presented with left scrotal swelling and moderate pain that started one day ago was admitted to the emergency department. On the computed tomography (CT) scan, a hematoma of greater than 10 cm was observed in the left scrotum and contrast extravasation was observed on the post-enhanced CT scan. Therefore, we concluded massive left scrotal hematoma with active bleeding. The patient underwent immediate surgery, and approximately 200 cc of hematoma was evacuated, and a movable whitish colored sparganum was found and removed. In cases involving development of scrotal hematoma without trauma, confirmed by surgery, sparganosis should be suspected, and should be removed.
Emergencies ; Hematoma ; Hemorrhage ; Humans ; Male ; Scrotum ; Sparganosis ; Sparganum