Purpose: This study aimed to construct and test a predictive model that explains and predicts the quality of life in older men living alone. Methods: A self-report questionnaire was used to collect data from 334 older adult men living along aged 65 years or over living in Jeollanam-do provinces. The endogenous variables were depression, self-rated health, instrumental activity of daily life, health promotion behaviors, the number of social participation activities and quality of life. Data were analyzed using the SPSS 21.0 and AMOS 21.0 programs. Results: The final model with 14 of the 8 analysed paths showed a good fit to the empirical data: χ2= 173.26(p < .001, df = 53),normed χ2= 3.27, GFI = .92, NFI = .90, CFI = .93, TLI = .89, RMSEA = .08 and SRMR = .06. Activities had direct effect on quality of life of older men living alone and social support had both direct and indirect effects. Meanwhile, function and socioeconomic status showed only indirect effects.The variables included in the eight significant paths explained 83.7% of variance in the prediction model. Conclusion Instrumental activities of daily living and social support effect directly on quality of life in the older men living alone. Findings suggest that health care providers including community nurses need to provide social support as well as empowerment programs of instrumental activities of daily living and health promotion for improving quality of life of the older men living alone.

The close vicinity of the optic nerve to the sphenoid sinus may cause visual loss in the sphenoid fungus ball. We present a case of blindness secondary to sphenoid fungus ball without any evidence of orbital invasion in imaging studies. A 61-year-old man, suffering from uncomplicated diabetes, was referred for right visual loss that developed 1 day ago. He perceived hand motion on the right. CT and MRI revealed a fungus ball in the right sphenoid sinus. However, there was no evidence of orbital invasion. Endoscopic sphenoethmoidectomy was performed to remove the fungus ball. Systemic mega-dose steroid and amphotericin B were started because he lost the light perception 3 days after surgery. Biopsy revealed aspergillus fungus ball and no evidence of mucosal invasion. However, blindness was not reversed. Evidence of orbital invasion in imaging diagnosis is elusive in sphenoid fungus ball; therefore, systemic antifungal treatment should be initiated and early endoscopic sphenoidotomy should be performed in case of rapidly progressing visual loss, especially in diabetic or immunocompromised patients. Mega-dose steroid therapy for optic neuropathy should be selective because it may aggravate underlying systemic diseases to cause early termination of systemic antifungal treatment.
Amphotericin B ; Aspergillus ; Biopsy ; Blindness ; Fungi ; Hand ; Humans ; Immunocompromised Host ; Light ; Middle Aged ; Optic Nerve ; Optic Nerve Diseases ; Orbit ; Sphenoid Sinus ; Stress, Psychological

Premature ovarian failure (POF) is a condition in which the ovarian functions of hormone production and oocyte development become impaired before the typical age for menopause. POF and early menopause are present in a broad spectrum of gonad dysgenesis, from a complete cessation of ovarian function to an intermittent follicle maturation failure. Actually POF has been identified as a genetic entity (especially chromosome X), but data on genetic factors of premature menopause are limited. Until now, several cases revealed that inactivation of X chromosomes has an effect on ages of premature menopause and females with balanced or unbalanced X-autosome translocations can have several reproductive problems. On the other hand, there have been a few data that was caused by autosome-autosome translocation can lead. Therefore we report a relevant case of POF with translocation between chromosomes 1 and 4. She had her first menstrual period at the age of 12, and after 7 years she stopped menstruation. Chromosomal analysis showed 46, XX, t (1;4) (p22.3;q31.3). While evaluating this rare case, we could review various causes (especially genetic factors) of POF. To remind clinicians about this disease, we report a case of POF caused by autosome-autosome translocation with a literature review.
Female ; Gonads ; Hand ; Humans ; Menopause ; Menopause, Premature* ; Menstruation ; Oocytes ; Primary Ovarian Insufficiency ; X Chromosome

Purpose: The purpose of this study was to figure out the association of nursing activity participation and clinical practice stress with career maturity during clinical practice among nursing college students. Methods: Participants of the study were 201 nursing college students located in nationwide regions. Data collection was performed between July 18 and August 8, 2019. Data analyses were performed through an independent t-test, ANOVA, Pearson’s correlation coefficient, and multiple linear regression analysis using SPSS WIN 25.0. Results: The results of this study were as follows. We ran multiple regression analyses to see which critical factors influenced career maturity. The general characteristics significantly associated with career maturity were preference for clinical nursing, admission to nursing college due to belief, time off, and being satisfied with clinical practice. Regarding clinical practice stress, clinic environment, interpersonal relationship conflict, inappropriate role model and conflict with patients were significantly associated with career maturity. Conclusion This study suggested that, to improve nursing students’ career maturity, nursing colleges and training fields should collaboratively make an efforts to reduce students’ stress by building educational clinic environments including managing conflicts in interpersonal relationships among patients, caregivers, and medical and non-medical personnel, and improving inappropriate role models in nursing.

Objectives: ：This study aimed to investigate quality of life, severity of depression, suicidality, subjective health and subjective stress of depression with subjective cognitive decline in Korean adults. Methods: ：We used the 7th KNHANES data to enroll 415 participants with a score of 10 or higher on Patient Health Questionnaire-9 (PHQ-9), aged 20-64. Depression was divided into two groups based on the presence/absence of subjective cognitive decline. Demographic and psychological characteristics were compared between two groups. Correlation analysis of subjective cognitive decline, quality of life, depression, suicidal idea was car-ried out. To detect which variables influenced quality of life, a multiple regression analysis was carried out. Results: ：Among the 415 participants, 98 had depression with subjective cognitive decline. We identified sig-nificant differences in age, marital status, education, employment between the two groups. After adjusting for these variables, depression with subjective cognitive decline had lower EuroQol-5D index scores, more severe depressive symptoms without cognition and worse subjective health than depression without cognitive decline. There was a significant correlation between subjective cognitive decline and quality of life (r=-0.236, p<0.001), suicidal idea (r=0.182, p<0.001), depression score without cognition (r=0.108, p=0.028). Through multiple regression analysis, subjective cognitive decline was predictor of reduced quality of life (β=-0.178, p<0.001). Conclusions ：Depression with subjective cognitive decline has poor quality of life and severe depression. Cognitive decline should be considered to improve treatment result in depression.

Erlotinib is accepted as a standard second-line chemotherapeutic agent in patients with non-small cell lung cancer who are refractory or resistant to first-line platinum-based chemotherapy. There has been no previous report of bowel perforation with or without gastrointestinal metastases related to erlotinib in patients with non-small cell lung cancer. The exact mechanism of bowel perforation in patients who received erlotinib remains unclear. In this report, we report the first case of enterocutaneous fistula in a female patient with metastatic non-small cell lung cancer 9 months, following medication with erlotinib as second-line chemotherapy.
Aged ; Antineoplastic Agents/*adverse effects/therapeutic use ; Carcinoma, Non-Small-Cell Lung/complications/*drug therapy ; Female ; Humans ; Intestinal Fistula/*chemically induced/complications/radiography/surgery ; Intestinal Perforation/*chemically induced/complications/radiography/surgery ; Protein Kinase Inhibitors/*adverse effects/therapeutic use ; Quinazolines/*adverse effects/therapeutic use ; Sigmoid Diseases/*chemically induced/complications/radiography/surgery

Endoscopic retrograde cholangiopancreatography (ERCP) fails occasionally due to a surgically altered anatomy, periampullary diverticulum, difficult cannulation, or poor general condition of the patient. In these cases, alternative treatment options are necessary, including percutaneous transhepatic biliary drainage (PTBD) or percutaneous transhepatic gallbladder biliary drainage (PTGBD). Here, we report a case of cholangitis treated with percutaneous transhepatic gallbladder papillary balloon dilatation (PTGBPBD). A 61-year-old male was admitted for cholangitis associated with biliary sludge. ERCP cannulation had failed due to the position of the papilla within a large periampullary diverticulum, and PTBD had failed due to a non-dilated intrahepatic bile duct. Following PTGBD, papillary balloon dilatation was completed successfully through the PTGBD tract. The patient tolerated the procedure and was discharged without complications. We conclude that PTGBPBD is an acceptable and safe procedure in a patient with cholangitis who underwent failed ERCP or PTBD procedures.
Bile ; Bile Ducts, Intrahepatic ; Catheterization ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Dilatation* ; Diverticulum ; Drainage ; Gallbladder* ; Humans ; Male ; Middle Aged

Endoscopic retrograde cholangiopancreatography (ERCP) fails occasionally due to a surgically altered anatomy, periampullary diverticulum, difficult cannulation, or poor general condition of the patient. In these cases, alternative treatment options are necessary, including percutaneous transhepatic biliary drainage (PTBD) or percutaneous transhepatic gallbladder biliary drainage (PTGBD). Here, we report a case of cholangitis treated with percutaneous transhepatic gallbladder papillary balloon dilatation (PTGBPBD). A 61-year-old male was admitted for cholangitis associated with biliary sludge. ERCP cannulation had failed due to the position of the papilla within a large periampullary diverticulum, and PTBD had failed due to a non-dilated intrahepatic bile duct. Following PTGBD, papillary balloon dilatation was completed successfully through the PTGBD tract. The patient tolerated the procedure and was discharged without complications. We conclude that PTGBPBD is an acceptable and safe procedure in a patient with cholangitis who underwent failed ERCP or PTBD procedures.
Bile ; Bile Ducts, Intrahepatic ; Catheterization ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Dilatation* ; Diverticulum ; Drainage ; Gallbladder* ; Humans ; Male ; Middle Aged

Uterine serous adenocarcinoma (USC) is rare and invasive cancer. This cancer is more often reported in the ovary, the fallopian tube, and the endometrium than uterine cervix. No matter where the tumor is located, the tumor exhibits similar histological characteristics. So when uterine cancer is proven to be serous adenocarcinoma, it is necessary to see if the tumor originated from ovary or endometrium and invaded the cervix. We report a case of a 73-year-old postmenopausal woman with USC arising near the internal os of endocervical canal, clinically misdiagnosed as uterine cervix cancer.
Adenocarcinoma* ; Aged* ; Cervix Uteri* ; Endometrium ; Fallopian Tubes ; Female ; Humans ; Ovary ; Uterine Cervical Neoplasms ; Uterine Neoplasms ; Uterus

PURPOSE: This study was to develop and prove the effects of aself management compliance promotion program for primary hypertension patients who reside in rural communities. METHOD: The content of the self management compliance promotion program developed by this study was as follows: A leader trains patients as a group or individually, in walking, education and green tea therapy from the first to twelfth week. From the thirteenth to twenty fourth week, the patients should perform walking and green tea therapy by themselves. One hundred twenty subjects volunteered to participate in the study, who were among those registered as hypertension patients in the 14 community health clinics located in Chungcheongbuk-do. RESULT: Systolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, triglyceride, step width, and degree of obesity decreased significantly. High-density lipoprotein cholesterol, step length, knowledge of hypertension, and self management compliance significantly increased. CONCLUSION: A self management compliance promotion program for primary hypertensive patients enhances biophysical index and knowledge on hypertension, thus ultimately suggesting a nursing intervention for promoting self management compliance.
Adult ; Aged ; Aged, 80 and over ; Female ; Health Promotion ; Humans ; Hypertension/psychology/*therapy ; Life Style ; Male ; Middle Aged ; Patient Compliance ; *Patient Education as Topic ; Rural Population ; *Self Care