PURPOSE: The purpose of the study was to identify characteristics of nursing and caring concepts measured by nursing competencies or caring behaviors tools for general nurses working in acute care hospitals. METHODS: Five major nursing literature databases were used to identify the relevant tools. The study included 19 nursing competencies tools with a total of 843 measurement items and 12 caring behaviors tools with 334 items. According to the International Council of Nurses (ICN)'s Competencies Framework and 8Cs suggested by Roach (1987) and Pusari (1998), the measurement items were classified by two researchers independently first and in agreement finally. RESULTS: Competency of ‘key principles of care’ including sub-areas of the ICN Framework was most commonly found: on average 49.3% of nursing competencies items and 91.9% of caring behaviors items. 97.0% of the caring behaviors items were classified into one of six Cs: competence (27.5%), confidence (21.3%), compassion (17.1%), commitment (16.5%), communication (9.9%), or conscience (4.8%). CONCLUSION: Nursing competencies tools were more likely to measure ‘what to do’ focusing on tasks, while caring behaviors tools were to measure ‘how to do’ focusing on nurses' attitudes or values. Nursing practices should be evaluated with both nursing competencies and caring behaviors tools, considering that nursing and caring were differently conceptualized in the quantitative tools.
Clinical Competence ; Conscience ; Empathy ; International Council of Nurses ; Mental Competency ; Nursing Care ; Nursing* ; Professional Competence ; Surveys and Questionnaires

No abstract available.

When the tumor is advanced with distant metastasis or unresectable initially, preoperative chemotherapy could be applied in the treatment of Wilms' tumor We experienced 6 cases of favorable type of Wilms' tumor, 1 case of clear cell sarcoma and 1 case of renal cell carcinoma. They were treated with preoperative chemotherapy and underwent CT Scans before and after the therapy. Pathologic changes after chemotherapy in Wilms' tumor were known from previous reports as subtotal hemorrhagic necrosis, cystic change, clusters of foamy histiocytes, granulation tissue formation, primitive nephrogenic tissues and peripherally remained focal areas of blastemal infiltration. Changes of CT findings after chemotherapy were internal necrosis(6/6), decrease in size(5/6), decrease and absence of regional lymph node enlargement(4/6) and improved or disappeared metastatic lesions(3/3). Although our study had some limitations such as small numbers of cases and all cases were favorable types, we thought that there were good correlations between change of CT findings and subtotal hemorrhagic necrosis after preoperative chemotherapy in Wilms' tumor.
Carcinoma, Renal Cell ; Drug Therapy* ; Granulation Tissue ; Histiocytes ; Lymph Nodes ; Necrosis ; Neoplasm Metastasis ; Sarcoma, Clear Cell ; Tomography, X-Ray Computed ; Wilms Tumor

Spigelian hernia is an uncommon hernia of the ant. abdominal wall. Because of its insidious nature and nonspecific physical findings, the diagnosis of this hernia is often not made. Typically, the hernia orifice is small, and strangulation of the contents of the hernial sac can occur. Computed tomography permits the distinction between Spigelian hernia and other anterial abdominal wall or intraabdominal masses. Spigelian hernia requires surgical correction to prevent complication of acute abdomen with strangulation or incarceration. The typical site of a Spigelian hernia is at the level of the semicircular fold of Douglas known as the arcuate line. Spigelian hernia can occur above the umbilicus, high Spigelian hernia, but its very unusual site. We report a case of Spigelian hernia on upper abdomen and review the literature.
Abdomen* ; Abdomen, Acute ; Abdominal Wall ; Ants ; Diagnosis ; Hernia* ; Umbilicus

Small bowel diverticulum, although not common and usually asymptomatic, can give rise to unexpected problems such as malabsorption, perforation, obstruction and bleeding. Bleeding from a diverticulum is often sudden and massive, therefore requiring emergency operation. We report herein a case of a 75-year-old man who presented with massive bleeding from multiple jejunal diverticula. He had been diagnosed with hypertensive end stage renal disease and treated with hemodialysis since 14 years previously. He was admitted with both hematemesis and hematochezia, and treated conservatively at first. However, bleeding continued and the anemia did not improve despite blood transfusions. An gastroduodenofiberscope and selected angiography revealed no bleeding focus. An emergency laparotomy was performed and multiple jejunal diverticula, distributed from 15 to 60cm distal to the ligament of Treitz, were found. A segment of the jejunum containing all diverticula was resected and end to end anastomosis was performed. A histologic examination revealed some dilated blood vessels in the submucosa of the diverticulum, which was compatible with the findings of the angiodysplasia. Based on these findings, we suggest that angiodysplasia was the cause of bleeding from the jejunal diverticula in this case.
Aged ; Anemia ; Angiodysplasia* ; Angiography ; Blood Transfusion ; Blood Vessels ; Diverticulum* ; Emergencies ; Gastrointestinal Hemorrhage ; Hematemesis ; Hemorrhage* ; Humans ; Jejunum ; Kidney Failure, Chronic* ; Laparotomy ; Ligaments ; Renal Dialysis

BACKGROUNDS: Gamma band oscillatory activity is considered to be related to congnitive functions and illustrates that the concept of event-related oscillations bridges the gap between single neurons and neural assemblies. An event-related gamma oscillation is the time - locked responses of specific frequency, and can be identified by computing the amplitude frequency characteristics of the averaged event-related potentials(ERPs) after stimulation. OBJECTIVES: We purposed to present experimental paradigm to investigate @-band oscillation activities from the recording of ERPs by using auditory oddball paradigm and investigate the difference of @-band activity between schizophrenia and normal controls. METHODS: The ERPs resulting from auditory stimuli with oddball paradigm in a group of schizophrenics(n=11) and also a group of age-, sex- and handedness matched normal controls, were recorded by 128 channel EEG. The @-band oscillatory activities were calculated by using time-frequency wavelet decomposition of the signal between 20 and 80Hz. The @-band oscillatory activities of both groups were compared by t-test. RESULTS: The @-band oscillatory of the leads Fz,Gz and Pz of both groups were represented well in the time - frequency maps. Significant increases of the @-band activity in normal controls compared with schizophrenics were observed around 160 msec. 350msec. and 800 msec after stimulation. CONCLUSIONS: Our results suggested that the increment in @-band oscillatory activity during cognitive operations and decreased @-band activity in schizophrenics may be associated with the cognitive dysfunctions and the pathophyiology of the schizophrenia.
Electroencephalography ; Evoked Potentials* ; Functional Laterality ; Neurons ; Schizophrenia

A 69-year old man presented with severe epigastric pain for 1 day. He had early gastric cancer at the antrum and underwent a distal subtotal gastrectomy and Billorth II gastrojejunostomy one month later without any post-operative complications. Radiologic examination revealed a large amount of retroperitoneal free air formation. Because of unremitting pain and unstable vital sign, exploratory laparotomy was followed. During the operation, a perforated duodenal diverticulum at the posterior wall of the 2nd portion of the duodenum was identified. He underwent diverticulectomy and primary closure. He was discharged on the 18th post operative day and has been followed up without any evidence of comlpication for several months.
Aged ; Diverticulum* ; Duodenum ; Gastrectomy* ; Gastric Bypass* ; Humans ; Laparotomy ; Stomach Neoplasms ; Vital Signs

PURPOSE: The aim of this study was to compare the short-term operative outcomes of laparoscopy-assisted total gastrectomy (LATG) with those of open total gastrectomy (OTG) for patients suffering with advanced upper gastric cancer. MATERIALS AND METHODS: Of the 47 patients who underwent LATG with D1+beta or D2 lymphadenectomy from July 2004 to March 2008, 29 patients with pathologically proven advanced gastric cancer were compared with 35 patients who underwent conventional OTG during the same time period. The comparison was based on the clinicopathological characteristics, the surgical outcome, the follow-up survival and tumor recurrence. RESULTS: The patients' age, gender and body mass index were similar between the two groups. However, there were statistically differences in tumor size (9.2+/-3.9 vs 6.1+/-3.6 cm, P=0.002) and the proximal resected margin (2.1+/-2.0 vs 3.6+/-2.1 cm P=0.004). There was no significant difference in most of the peri- and post-operative courses such as the time to first flatus, the time to starting a solid diet and the length of the hospital stay, except for a longer operating time (289.0 vs. 361.3 minutes, P<0.001) in the LATG group. The complication rate was higher in the LATG group (13.8%) than that in the OTG group (5.7%). The mean overall survival and disease free survival times were 32 and 31 months, and 24 and 28 months, respectively, with an average 18.8 months follow-up duration. The main recurrent sites were peritoneum and lymph node in both groups. CONCLUSION: The early results of the current study suggest that LATG for AGC is technically feasible and it does not show any inferiorities of the postoperative outcomes as compared to those of conventional open total gastrectomy.
Body Mass Index ; Diet ; Disease-Free Survival ; Flatulence ; Follow-Up Studies ; Gastrectomy ; Humans ; Length of Stay ; Lymph Node Excision ; Lymph Nodes ; Peritoneum ; Stomach Neoplasms ; Stress, Psychological

PURPOSE: Retinoic acid (RA) has been known to inhibit the proliferation, and to induce apoptosis, of various cancer cell lines. We investigated the correlation between the protein levels of the RAR and RXR receptor families, IGFBP-3 and AFP, and the RA sensitivity in hepatoma cell lines. MATERIALS AND METHODS: The cell growth inhibition was examined by assaying various 1 to 10muM RA treated hepatoma cell lines. Western blot analysis for the RAR and RXR families, AFP and IGFBP-3 were performed after treatment with 10muM RA. RESULTS: The 1 to 10muM RA treatment induced growth inhibition in the SNU368, SNU354, SNU398 and HepG2 cells. The cell growth of SNU449 and Hep3B were not suppressed by 1muM, but were slightly suppressed by 10muM RA. An increased expression of IGFBP-3 in HepG2, SNU354, SNU398 and SNU368 cells, and a decreased expression of alpha-fetoprotein (AFP), was observed from the western blot analysis in all hepatoma cells tested, whereas no confirmed tendency of RAR expressions was seen. CONCLUSION: Our result showed that the growth inhibition of RA differed according to the sensitivity of the type of cells to RA. We supposed that RA-induced cell growth inhibition may be related to the expressions of IGFBP-3 and AFP, but no exact correlation exists between the growth inhibition and receptor expression status in hepatoma cell lines.
alpha-Fetoproteins ; Apoptosis ; Blotting, Western ; Carcinoma, Hepatocellular* ; Cell Line* ; Hep G2 Cells ; Humans ; Insulin-Like Growth Factor Binding Protein 3* ; Tretinoin*

Primary segmental omental infarction in adults is very rare and occasionally occurs due to impaired perfusion to the greater omentum. Most authors believe that the condition results from an embryologic variant associated with anomalous and fragile blood supply of the right lower portion of the greater omentum, which is consequently susceptible to infarction. Since there are no characteristic clinical findings, the clinical presentation often mimics acute appendicitis or cholecystitis. However, in the proper clinical setting, the correct diagnosis can be established by the radiologist; therefore, unnecessary surgery can be avoided in many cases. Cross-sectional imaging by ultrasound or computed tomography will demonstrate characteristic findings in a location corresponding to the patient's point of maximal tenderness. These findings consist of an ovoid or cake-like mass in the omental fat with surrounding inflammatory changes. We report a case of primary segmental omental infarction in an adults who was treated conservatively after the diagnosis was established with clinical findings.
Abdominal Pain ; Adult ; Appendicitis ; Cholecystitis ; Diagnosis ; Humans ; Infarction* ; Omentum ; Perfusion ; Ultrasonography ; Unnecessary Procedures