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

A 38-year-old female presented with abdominal pain, radiating to her back. Her medical history included type 2 diabetes, which had been uncontrolled for 8 months. Her initial laboratory tests showed marked hyperglycemia, metabolic acidosis, and elevated serum amylase and lipase levels, although the results were inconclusive in terms of a direct diagnosis of acute pancreatitis (AP). Abdominal computed tomography showed only minimal fluid collection at the pancreas tail. As her serum triglyceride (TG) level was 9,884 mg/dL, we made a working diagnosis of AP due to hypertriglyceridemia, and she was treated with massive hydration with an insulin infusion. Subsequently, she recovered rapidly from the abdominal pain, her serum glucose was controlled, and her serum TG decreased. Hypertriglyceridemia is a well-accepted underlying cause of AP. When extremely high hypertriglyceridemia is detected in patients with type 2 diabetes or metabolic syndrome, complications should be considered and managed.
Abdominal Pain ; Acidosis ; Adult ; Amylases ; Blood Glucose ; Diabetes Mellitus, Type 2 ; Diagnosis ; Female ; Humans ; Hyperglycemia ; Hypertriglyceridemia ; Insulin ; Lipase ; Pancreas ; Pancreatitis* ; Triglycerides

BACKGROUND: Triple negative breast cancer (TNBC) is defined as a lack of the expression of estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 in breast cancer. Many TNBCs show a profound infiltration of tumor infiltrating lymphocytes (TILs). It is still uncertain whether these TILs are protumoral or antitumoral. Regulatory T cells (Tregs) play a role in inducing immune tolerance to antigens, and they may be selectively recruited by cancer cells. This study was conducted to evaluate the significance of TILs with an emphasis on forkhead box p3 (Foxp3), which is a marker for CD25+CD4+ Treg in TNBC. METHODS: We investigated the Foxp3, CD8 and CD4 expressions in 100 cases of TNBC by immunohistochemistry and using a tissue microarray. The Foxp3 expression was divided as the high and low infiltration groups (cut-off value=20). RESULTS: The high infiltration group was correlated with higher histologic and nuclear grades. However, Foxp3+ Tregs were decreased in the T3 and T4 TNBCs as compared to that of the T1 and T2 TNBCs. No significant differences were found for the nodal status, lymphovascular invasion, stage, recurrence and overall survival. CONCLUSIONS: High Foxp3+ Treg infiltration in TNBC is correlated with the nuclear and histologic grades, but there was no relation to recurrence and overall survival.
Breast ; Breast Neoplasms ; Estrogens ; Forkhead Transcription Factors ; Humans ; Immune Tolerance ; Immunohistochemistry ; Lymphocytes ; Lymphocytes, Tumor-Infiltrating ; Receptor, Epidermal Growth Factor ; Receptor, erbB-2 ; Receptors, Progesterone ; Recurrence ; T-Lymphocytes, Regulatory

BACKGROUND: This study was done to see if there were correlations between anatomic and molecular parameters such as microvessel density (MVD), lymphatic vessel density (LVD), and vascular endothelial growth factor receptor (VEGFR)-3 expression and various clinical parameters for papillary thyroid carcinomas of size > 1.0 cm (PTCs) and size < or = 1.0 cm (papillary thyroid microcarcinomas, PTMCs). PTMCs were divided into two subgroups (0-5 mm and 6-10 mm). METHODS: We analyzed 197 thyroid carcinomas including 113 PTCs and 84 PTMCs. Tissue samples form 30 patients from each group matched for clinical characteristics were selected for immunostaining. RESULTS: Although PTCs and PTMCs showed significant differences in clinical characteristics, they did not show significant difference in MVD, LVD, or VEGFR-3 expression. There was a significantly higher LVD in the PTMC subgroup with the larger tumors but no difference in clinical characteristics. LVD was higher in patients > 45 years old (more apparent in the PTC group) and LVD had suggestive correlations with multicentricity and extrathyroidal extension depending on analytic conditions. CONCLUSIONS: Since LVD showed variable correlations with clinical variables for papillary carcinoma of the thyroid depending on analytic conditions, the individually planned treatments based on overall clinicopathological factors are advised.
Carcinoma ; Carcinoma, Papillary ; Factor IX ; Glycosaminoglycans ; Humans ; Lymphangiogenesis ; Lymphatic Vessels ; Microvessels ; Neovascularization, Pathologic ; Receptors, Vascular Endothelial Growth Factor ; Thyroid Gland ; Thyroid Neoplasms ; Vascular Endothelial Growth Factor Receptor-3

BACKGROUND: This study was done to obtain comprehensive data on changes in the structural components of the enteric nervous system in pediatric patients with intestinal pseudo-obstruction (IPO). We evaluated routinely processed, in formalin-fixed tissues by quantitative morphometric analysis. In addition, we used formalin-fixed tissue to explore the possibility of using previously proposed diagnostic criteria to evaluate frozen serial sections for intestinal neuronal dysplasia (IND) type B and hypoganglionosis. METHODS: We analyzed data for 19 IPO cases. Morphometric analysis for quantification of ganglia and ganglion cells (GCs) was done for the myentric and the submucous plexus. In addition, we determined the presence of immature GCs and the distribution of nerve fibers and interstitial cells of Cajal (ICC). RESULTS: Nine patients showed combined hypoganglionosis, IND, and decreased ICC; others showed various combinations of these. Several morphometric factors were significantly different between patient groups as well as being different than the control group. CONCLUSIONS: Our pediatric IPO cases showed extensive overlapping of pathological findings. And the findings suggest the utility of using previously proposed morphometrically measured factors in multiple frozen sections as diagnostic criteria for IND type B and hypoganglionosis in formalin-fixed tissue.
Enteric Nervous System ; Frozen Sections ; Ganglia ; Ganglion Cysts ; Humans ; Interstitial Cells of Cajal ; Intestinal Pseudo-Obstruction ; Nerve Fibers ; Neurons ; Submucous Plexus