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

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

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

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

PURPOSE: For most surgeons, colon interposition after gastrectomy remains an infrequently performed procedure because of its complexity. The aim of this study was to assess its technical feasibility and safety as a post-gastrectomy reconstruction method by reviewing our experience with colon interposition. MATERIALS AND METHODS: From March 2001 to February 2002, 30 colon interpositions after- gastrectomy were done with using the ileo-ascending or transverse colon. We analyzed the clinicopathologic features and the surgical outcomes. RESULTS: There were 16 males and 14 females in this study with a mean age of 67.5 years (range: 31 to 76 years). Twenty-five ascending colons and 5 transverse colons were used for the interposition, respectively. The mean operation time was 373 minutes (range: 204 to 600 minutes). There were 9 operative morbidities (30%) and 1 operative mortality. The restoration of bowel motility was noted at 3.8 postoperative days; a soft diet was started at 4.9 postoperative days and the duration of the hospital stay was 18.2 days. The percentage of weight loss in the patients with total, proximal and distal gastrectomy was 16.3%, 14.0% and 8.8%, respectively, at 6 months, and thereafter the weight loss gradually recovered as 8.1%, 7.5% and 5.6%, respectively, at 5 years postoperatively. Gastric stasis was the one of the most meaningful long-term complications, and especially in the patients who underwent distal gastrectomy with colon interposition. CONCLUSION: Colon interposition after gastrectomy was a very complex procedure with a long operating time and many anastomosis sites. The postoperative outcomes failed to achieve satisfactory weight gain and the patients displayed postprandial symptoms. This suggested that this procedure was not an appropriate procedure for conventional reconstruction after gastrectomy.
Colon ; Colon, Ascending ; Colon, Transverse ; Diet ; Female ; Gastrectomy ; Gastroparesis ; Humans ; Length of Stay ; Male ; Stomach Neoplasms ; Weight Gain ; Weight Loss

PURPOSE: To compare functional MR imaging of the motor cortex during active and passive movement. MATERIALS AND METHODS: Seven healthy, right-handed volunteers (M:F=6:1; age:25-30 years) were included in this study. A 1.5-T whole body scanner and the multislice EPI BOLD method were used. The motor paradigm was flexion-extension of a thumb against rest. In the active motion task, the thumb was flexed voluntarily once a second, while in the passive task, it was tied with a thread and pulled to flex and extend passively at the same interval and with the same intensity as in the active task. For image postprocessing, an SPM 96 program was used. The sites, numbers, and signal intensity of the activated pixels were determined, and the threshold for significance was set at p<0.001 to p<0.01. RESULTS: In the active motion task, strong activation at the contralateral side of the primary sensorimotor cortex and supplementary motor cortex occurred in all 14 examples in all seven volunteers. Additionally, the ipsilateral primary sensorimotor cortex and supplementary motor area were activated in 12/14 and 11/14 such tasks, respectively. During passive motion tasks, on the other hand, weak activation occurred at the contralateral side of the primary sensorimotor cortex in all cases, but in the contralateral supplementary motor cortex in only three. In the ipsilateral primary sensorimotor cortex and supplementary motor area, there was no activation. CONCLUSION: Compared with the active motion task, activation occurring in the contralateral primary sensorimotor cortex and supplementary cortex was weaker and less frequent during the passive task, and during this latter, the ipsilateral motor cortex remained inactive. These results may be useful for the clinical application of functional MR imaging in unconscious patients or in animal studies.
Animals ; Hand ; Humans ; Magnetic Resonance Imaging* ; Motor Cortex* ; Thumb ; Volunteers

BACKGROUND: Chronic shoulder pain draws the attention of doctors since it is a very common and serious disease at primary care level. The patients with this pain usually have a tendency to see many doctors, to take an abundance of medication, and sometimes to even suffer from depression. The pain and the symp- toms thereof often disable the patients in their every day lives. This study aims to seek the most efficient way of treatment between two therapies, namely, the existing drug therapy based on NSAID and the intramuscular stimulation(herein after IMS) therapy, which has re- cently been introduced, by comparing them in accordance with the following method. METHODS: The two therapies were applied for 3 weeks to female patients aged between 50 and 70 who had visited a hospital over a period of more than 3 months due to this type of pain. The patients were randomly given each therapy although the treatment and monitoring was done by the same physiotherapist. The monitoring was performed four times, the day before the start of treatment, 1 week, 2 weeks and 3 weeks after respectively. It measured the following elements: (1) pain scale by VAS(Visual Analogue Scale), (2) Sleep hygiene scale by VAS, (3) ROM(Range of Motion), Repeated measure ANOVA was used for analysis. RESULTS: While both therapies reduced the pain significantly during the 3 weeks, the study showed that IMS was more effective than the drug therapy in every element monitored(p<0.05). IMS turned out to be more effective the 1st week in every measured element, however, the drug therapy was more effective the 3rd week if compared to the 2nd week in terms of Sleep VAS score. CONCLUSION: IMS is more effective in easing chro nic shoulder pain since it has better results than NSAID in pain VAS score, sleep VAS score and ROM.
Chronic Pain ; Depression ; Drug Therapy ; Female* ; Humans ; Hygiene ; Physical Therapists ; Primary Health Care ; Shoulder Pain* ; Shoulder*

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