Purpose: The purpose of this study was to validate the effects that the structured pamphlet and education through tablets regarding the daily life management and disease nursing education program has towards pneumonia patients in compliance, and self-efficacy. Methods: This study used the quasi-experimental study design based upon the nonequivalent control group pretest-posttest design. A total of 100 patients-50 patients who were hospitalized February 2020 as the control group and 50 patients who were hospitalized March 2020 as the experimental group – were used as material for the statistical analysis. These data were analyzed with a significance level of p< .05 using the SPSS WIN 21.0 program. Results: The patients’ compliance, and self-efficacy had no significance difference between the two previous scores, meaning homogeneity in the two groups. Through verifying the experimental group who had disease and daily-life managing nursing education will have higher scores in compliance (t= 20.95, p< .001), and self-efficacy (t= 17.24, p< .001) than the control group who had not received those education, were statistically significantly different leading to all hypothesis being supported. Conclusion For improving pneumonia patients’ compliance, the methods should be simple, easy to understand, effective in numerous clinical situations, require constant education and reinforcement, and periodic nursing education program.

Purpose: This study aimed to explore the experience of clinical nurses regarding training programs for critically ill patients with coronavirus disease 2019 (COVID-19) and their educational needs. Methods: Qualitative data were analyzed using content analysis, and quantitative data were analyzed according to Borich's formula. Data for the study were collected in March 2021 from 16 nurses who had completed a nursing program for critically ill patients with COVID-19 and were working at three hospitals designated for COVID-19. Results: Participants' experiences were classified into three major categories, namely “Participation experiences and perceptions of the training program,” “Recommendations for improving the training program,” and “Perceptions of working in an infectious environment,” and 10 subcategories. According to Borich's formula, the most pressing educational needs in respiratory and non-respiratory nursing, respectively, were for “nursing care for patients on extracorporeal membrane oxygenation” and “application of continuous renal replacement therapy and caring for patients.” Conclusion To prepare for the periodic emergence of communicable infectious diseases throughout the world and cultivate nursing staff to care for critically ill patients, it is necessary to develop nursing education programs with content corresponding to nurses' needs. This study can be used as base data for cultivating nursing staff for critically ill patients with communicable infectious diseases in keeping with clinical nurses’ educational needs and basic educational materials for nursing students.

Duchenne muscular dystrophy usually affects males. However, females are also affected in rare instances. Approximately 8% of female Duchenne muscular dystrophy (DMD) carriers are manifesting carriers and have muscle weakness to some extent. We investigated the clinical features of 3 female patients with dystrophinopathy diagnosed by clinical, pathological, and genetic studies at our neuromuscular disease clinic. The onset age of manifesting symptoms varied (8-28 years). Muscle weakness grade varied as follows: patient 1 showed asymmetrical bilateral proximal upper and lower extremities weakness, patient 2 showed asymmetrical bilateral upper extremities weakness similar to scapulohumoral muscular dystrophy, and patient 3 had only bilateral asymmetric proximal lower extremities weakness. Two patients had familial histories of DMD (their sons were diagnosed with DMD), but the 1 remaining patient had no familial history of DMD. The serum creatine kinase level was elevated in all patients, but it was not correlated with muscular weakness. An electromyography study showed findings of myopathy in all patients. One patient was diagnosed with a DMD carrier by a muscle biopsy with an immunohistochemical stain (dystrophin). The remaining 2 patients with familial history of DMD were diagnosed by multiplex ligation-dependent probe amplification (MLPA). There were inconsistent clinical features in the female carriers. An immunohistochemical analysis of dystrophin could be useful for female carrier patients. Also, multiplex ligation-dependent probe amplification is essential for the diagnosis of a manifesting female carrier DMD in female myopathic patients because conventional multiplex PCR could not detect the duplication and is less accurate compared to MLPA.
Adult ; Child ; Female ; Humans ; Muscular Dystrophy, Duchenne/*diagnosis

Duchenne muscular dystrophy usually affects males. However, females are also affected in rare instances. Approximately 8% of female Duchenne muscular dystrophy (DMD) carriers are manifesting carriers and have muscle weakness to some extent. We investigated the clinical features of 3 female patients with dystrophinopathy diagnosed by clinical, pathological, and genetic studies at our neuromuscular disease clinic. The onset age of manifesting symptoms varied (8-28 years). Muscle weakness grade varied as follows: patient 1 showed asymmetrical bilateral proximal upper and lower extremities weakness, patient 2 showed asymmetrical bilateral upper extremities weakness similar to scapulohumoral muscular dystrophy, and patient 3 had only bilateral asymmetric proximal lower extremities weakness. Two patients had familial histories of DMD (their sons were diagnosed with DMD), but the 1 remaining patient had no familial history of DMD. The serum creatine kinase level was elevated in all patients, but it was not correlated with muscular weakness. An electromyography study showed findings of myopathy in all patients. One patient was diagnosed with a DMD carrier by a muscle biopsy with an immunohistochemical stain (dystrophin). The remaining 2 patients with familial history of DMD were diagnosed by multiplex ligation-dependent probe amplification (MLPA). There were inconsistent clinical features in the female carriers. An immunohistochemical analysis of dystrophin could be useful for female carrier patients. Also, multiplex ligation-dependent probe amplification is essential for the diagnosis of a manifesting female carrier DMD in female myopathic patients because conventional multiplex PCR could not detect the duplication and is less accurate compared to MLPA.
Adult ; Child ; Female ; Humans ; Muscular Dystrophy, Duchenne/*diagnosis

OBJECTIVES: The aim of this study was to determine whether children with Tourette disorder (TD) have functional impairment and executive dysfunction in comparison to children with attention-deficit hyperactivity disorder (ADHD) and non-affected controls. METHODS: From January 2006 to December 2013, 45 children and adolescents with TD and 50 children and adolescents with ADHD diagnosed at the Soonchunhyang University Bucheon Hospital and 50 non-affected controls were enrolled in this study. Functional impairment of the subjects was assessed using the Child and Adolescents Functioning Impairment Scale (CAFIS), parent and teacher versions. In addition, neuropsychological tests including Stroop color-word Test, Finger windows Test (FWT), and Digit span were administered. Outcomes were compared across the TD, ADHD, and non-affected controls. RESULTS: No difference in CAFIS-parent and CAFIS-teacher results was observed between children with TD and non-affected controls, whereas, children with ADHD showed more impairments relative to non-affected controls in the CAFIS-parent. According to the Stroop color-word Test, FWT, and Digit span, executive function in children with TD did not differ from non-affected controls. Children with ADHD had poorer performance in measures of the Stroop color-word Test compared to children with TD. CONCLUSION: Children and adolescents with TD but not ADHD were not significantly different from non-affected controls on most measures of functional impairment and executive function. These findings suggest that an education program and intervention for children with TD would be important to reducing the stigma of TD.
Adolescent ; Child* ; Education ; Executive Function ; Fingers ; Gyeonggi-do ; Humans ; Neuropsychological Tests ; Parents ; Tourette Syndrome*

PURPOSE: This study aimed to assess the usefulness of second-look ultrasounds performed on suspicious lesions found from breast MRIs which were taken as preoperative evaluations of breast cancer. MATERIALS AND METHODS: From May 2008 to July 2011, second-look ultrasounds were performed for 98 lesions in 80 patients that were initially detected on preoperative breast MRIs for known breast cancer. In this study, identification was made on the findings from second-look ultrasounds on the target lesions. The histopathological results were used to assess the effects of second-look ultrasounds on the treatment plans for patients, in the context of operation records. RESULTS: Among the total 98 lesions, sonographic correlation was made in 85 lesions (87%). In total, 82 lesions were identified with histopathological results. Among them were 18 malignancies (22%) and 64 benign lesions (78%). Sonographically-correlated lesions showed a higher prevalence for malignancy (20% [17/85]) than non-correlated lesions (8% [1/13]). From 44% (43/98) of the total target lesions, the unnecessary expansion of the extent of surgical resection was suppressible through second-look ultrasounds. CONCLUSIONS: Second-look ultrasounds subsequent to breast MRIs in patients with breast cancer are useful for preoperative evaluation and enables them to make the histopathological confirmation of suspicious lesions conveniently found from breast MRIs.
Breast ; Breast Neoplasms ; Humans ; Magnetic Resonance Imaging ; Prevalence

Sturge Weber syndrome (SWS) is a rare, congenital neurocutaneous syndrome. We rarely experienced neurocutaneous disorders in forensic practice but there are unexpected sudden deaths of patients with SWS due to epilepsy, intracranial hemorrhage, thromboses and secondary accident. We introduce a case of drowning death probably due to an epileptic attack of a person diagnosed as a patient of SWS by an autopsy. We review some of the neurocutaneous syndromes and a discussion of autopsy approach is presented.
Autopsy ; Death, Sudden ; Drowning ; Epilepsy ; Humans ; Intracranial Hemorrhages ; Neurocutaneous Syndromes ; Sturge-Weber Syndrome ; Thrombosis

The brown bowel syndrome (BBS) is an uncommon disorder, which is characterized by brown pigmentation of the intestine due to the accumulation of lipofuscin in the smooth muscle cells. Vitamin E deficiency has generally been considered as the cause of this malady. BBS has been reported in a wide variety of malabsorptive diseases involving the pancreas, liver and gastrointestinal tract. We report here on a case of brown bowel syndrome that occurred in a 73-year-old man who had undergone total gastrectomy 11 years ago for gastric adenocarcinoma. He has complained about intestinal obstructive symptoms for several years, and these symptoms were recently aggravated. He showed a low serum concentration of total protein, albumin and cholesterol, and he had been treated for megaloblastic anemia due to vitamin B12 and folate deficiency several months ago. The resected small bowel showed lipofuscin deposition in the muscle layer of the intestine and large vessels. The electron microscopic examination revealed multiple electron dense lipofuscin deposits with irregular shapes and sizes in the cytoplasm.
Male ; Humans

BACKGROUND: It is not clear whether microangiopathies are associated with subclinical atherosclerosis in type 2 diabetes mellitus (T2DM). We investigated the relation of cardiac autonomic neuropathy (CAN) and other microangiopathies with carotid atherosclerosis in T2DM. METHODS: A total of 131 patients with T2DM were stratified by mean carotid intima-media thickness (CIMT) > or = or <1.0 mm and the number of carotid plaques. CAN was assessed by the five standard cardiovascular reflex tests according to the Ewing's protocol. CAN was defined as the presence of at least two abnormal tests or an autonomic neuropathy points > or =2. Diabetic microangiopathies were assessed. RESULTS: Patients with CAN comprised 77% of the group with mean CIMT > or =1.0 mm, while they were 29% of the group with CIMT <1.0 mm (P=0.016). Patients with diabetic retinopathy (DR) comprised 68% of the group with CIMT > or =1.0 mm, while they were 28% of the group without CIMT thickening (P=0.003). Patients with CAN comprised 51% of the group with > or =2 carotid plaques, while they were 23% of the group with < or =1 carotid plaque (P=0.014). In multivariable adjusted logistic regression analysis, the patients who presented with CAN showed an odds ratio [OR] of 8.6 (95% confidence interval [CI], 1.6 to 44.8) for CIMT thickening and an OR of 2.9 (95% CI, 1.1 to 7.5) for carotid plaques. Furthermore, patients with DR were 3.8 times (95% CI, 1.4 to 10.2) more likely to have CIMT thickening. CONCLUSION: These results suggest that CAN is associated with carotid atherosclerosis, represented as CIMT and plaques, independent of the traditional cardiovascular risk factors in T2DM. CAN or DR may be a determinant of subclinical atherosclerosis in T2DM.
Atherosclerosis ; Carotid Artery Diseases* ; Carotid Intima-Media Thickness ; Diabetes Mellitus, Type 2 ; Diabetic Angiopathies ; Diabetic Neuropathies* ; Diabetic Retinopathy ; Humans ; Logistic Models ; Odds Ratio ; Reflex ; Risk Factors

BACKGROUND: It is not clear whether microangiopathies are associated with subclinical atherosclerosis in type 2 diabetes mellitus (T2DM). We investigated the relation of cardiac autonomic neuropathy (CAN) and other microangiopathies with carotid atherosclerosis in T2DM. METHODS: A total of 131 patients with T2DM were stratified by mean carotid intima-media thickness (CIMT) > or = or <1.0 mm and the number of carotid plaques. CAN was assessed by the five standard cardiovascular reflex tests according to the Ewing's protocol. CAN was defined as the presence of at least two abnormal tests or an autonomic neuropathy points > or =2. Diabetic microangiopathies were assessed. RESULTS: Patients with CAN comprised 77% of the group with mean CIMT > or =1.0 mm, while they were 29% of the group with CIMT <1.0 mm (P=0.016). Patients with diabetic retinopathy (DR) comprised 68% of the group with CIMT > or =1.0 mm, while they were 28% of the group without CIMT thickening (P=0.003). Patients with CAN comprised 51% of the group with > or =2 carotid plaques, while they were 23% of the group with < or =1 carotid plaque (P=0.014). In multivariable adjusted logistic regression analysis, the patients who presented with CAN showed an odds ratio [OR] of 8.6 (95% confidence interval [CI], 1.6 to 44.8) for CIMT thickening and an OR of 2.9 (95% CI, 1.1 to 7.5) for carotid plaques. Furthermore, patients with DR were 3.8 times (95% CI, 1.4 to 10.2) more likely to have CIMT thickening. CONCLUSION: These results suggest that CAN is associated with carotid atherosclerosis, represented as CIMT and plaques, independent of the traditional cardiovascular risk factors in T2DM. CAN or DR may be a determinant of subclinical atherosclerosis in T2DM.
Atherosclerosis ; Carotid Artery Diseases* ; Carotid Intima-Media Thickness ; Diabetes Mellitus, Type 2 ; Diabetic Angiopathies ; Diabetic Neuropathies* ; Diabetic Retinopathy ; Humans ; Logistic Models ; Odds Ratio ; Reflex ; Risk Factors