BACKGROUND: The major causes of small bowel obstruction (SBO) are postoperative adhesion, hernia, intussusception and malignancies. However, in cases of uncommon causes of SBO, surgeons are be in a dilemma because the preoperative diagnosis and the decision to operate are frequently difficult and delayed. METHODS: We reviewed retrospectively the cases of 29 patients with SBO who were operated on for unknown etiology at Daedong Hospital between Jan. 1, 1991, and Dec. 31, 1997. The common causes of SBO, such as postoperative adhesion, external hernia, congenital anomaly of the gastrointestinal tract in neonate, intussusception in children, and known intraabdominal malignancy, were all excluded. RESULTS: 1) The incidence of uncommon causes of SBO included in this study was 8.7% of all cases of SBO operated on during the same period. 2) Among the 29 cases, 12 cases were caused by tumors (41.4%), of which the number of malignant tumors was double that of benign ones. 3) Besides tumors, there were 3 cases of bezoar, two cases of congenital bands, mesenteric cysts, internal hernias, Meckel's diverticula, and intussusception, one case each of mesenteric panniculitis and Crohn's disease, and two cases with an unknown etiology of inflammation. 4) Five cases were due to adult intussusception, 3 cases of which were due to benign tumors of the small bowel. All of the SBOs by intussusception were located at the terminal ileum. 5) The most common site of obstruction was the ileum (20 cases), followed by the jejunum (7 cases), and the duodenum (2 cases). 6) Males were dominant (1.6:1) especially in cases of tumor-origin SBOs (2:1). 7) In viewing the age distribution, the incidence was relatively high in the 5th and the 8th decades. Especially, tumor-origin SBOs had their peak in the 5th decade, and all cases of bezoar were found in 8th decade. 8) Operations were performed within 72 hours in 19 cases (65.5%) after first inspection of the patients, and intussusception, congenital band, and bezoar were the common causes of the cases involved in early surgical intervention. 9) Segmental resection of the small bowel was the most common surgical procedure (19 cases, 65.5%), followed by bypass surgery (6 cases), removal of the bezoar (2 cases), and excision of the mesenteric cyst or band (1 case, respectively). Coclusions: We think it reasonable to perform an exploratory laparotomy in cases of unknown causes of SBO as early as possible because almost all the cases require surgical intervention eventually, and studies searching for the causes of obstruction will only be time-consuming. While surgeons should keep in mind that tumors are major causes of uncommon SBOs.
Adult ; Age Distribution ; Bezoars ; Child ; Crohn Disease ; Diagnosis ; Diverticulum ; Duodenum ; Gastrointestinal Tract ; Hernia ; Humans ; Ileum ; Incidence ; Infant, Newborn ; Inflammation ; Intussusception ; Jejunum ; Laparotomy ; Male ; Mesenteric Cyst ; Panniculitis, Peritoneal ; Retrospective Studies

An incisional hernia is still one of the common complications of abdominal surgical procedures and is a significant source of morbidity. The exact incidence of incisional hernias has not been well defined, although a number of reports in the literature suggest that it is between 2% and 11%. Repair of incisional hernias is a common procedure from the surgeon's viewpoint. The authors evaluated the clinical data of 34 patients with incisional hernias at the Department of Surgery, Daedong Hospital, Busan, between January 1990 and December 1996. Incisional hernias were more common in females(9 men and 25 women), and the range of ages was 29 to 79. The incidence was highest in lower midline incisions. Some factors supposed to be associated with the development of incisional hernias were a lower midline incision, increased abdominal pressure, wound infection, reincision, and previous incisional hernia. Severe vomiting, abdominal distension, severe coughing, obesity, and pregnancy contributed to the increased abdominal pressure. An appendectomy was the most common preceding operation for the occurrence of an incisional hernia, although the incidence of appendectomies at the author's hospital was the highest of all other operations. The most frequent symptom or sign of the patients was mass or bulging at the previous operation site. Herniation occurred in 18 patients (52.9%) within 1 year after the preceding operation and herniorrhaphies were performed in 14 cases (41.2%) within 1 year after herniation. The size of hernia in 32 patients (94.1%) was less than 10 cm in diameter, and mesh was used in four patients (11.8%). The method of repair was determined by the size of the defect and by the tension around the defect. Postoperative follow up was made by telephone in 20 of the 34 patients. Among them, the authors were notified of two recurrent incisional hernias: One developed after an operation for mechanical obstruction due to an appendectomy. The other recurred at the lower midline incision for an operation due to rupture of the small bowel and was accompanied by wound infection.
Appendectomy ; Busan ; Cough ; Follow-Up Studies ; Hernia* ; Herniorrhaphy ; Humans ; Incidence ; Male ; Obesity ; Pregnancy ; Rupture ; Telephone ; Vomiting ; Wound Infection

PURPOSE: The purpose of this study was to examine the cognitive function and degree of dementia patient by doing clock drawing test and to explore the relationship among other dementia screening test. METHOD: The study subjects were 94 dementia in patients department. The data was collected by face to face interview by clinical psychologist from January 2007 to February 2008. The tools were Clock Drawing Test, K-MMSE, K-3MS and CDR Scale. RESULTS: 1) The average score of CDT was 5.13 (2.54), of K-MMSE was 20.53 (4.85), of K-3MS was 61.66 (16.46), and of CDR was 1.2 (.72), those scores showed dementia. 2) There was a statistically the significant difference in CDT (F=2.83, p=.043) and CDR (F=2.00, p=.008) by age. CDT has shown the differences by gender (t=-2.42, p=.018) and education (F=7.66, p=.000). 3) There were significant relationships between CDT and K MMSE (r=-.294. p=.004), K-3MS (r=-.335, p=.001), and CDR (r=.286, p=.008). CONCLUSION: It is believed that using CDT which measures the visuospatial ability of dementia patients and K-MMSE which assesses an ability of language and orientation and K-3MS at the same time helps examining the beginning and the progressive degree of dementia more easily and objectively.
Cognition ; Dementia ; Deoxycytidine ; Humans ; Mass Screening ; Orientation

Purpose: This study aimed to investigate factors affecting the job embeddedness of clinical nurses. Methods: Participants were 204 nurses working in four general hospitals. Data were collected from September 3 to October 8, 2020 and analyzed using the SPSS/WIN 25.0 program. Results: The mean scores for positive psychological capital, organizational justice, and job embeddedness were 3.31±0.38, 3.16±0.46, and 3.17±0.38, respectively. The job embeddedness of the participants had a positive correlation with optimism (r=.57, p<.001), hope (r=.56, p<.001), self-efficacy (r=.44, p<.001), and resilience (r=.38, p<.001) in the sub-factors of positive psychological capital. It also had a positive correlation with procedural (r=.58, p<.001), distributive (r=.52, p<.001), and interactional (r=.35, p<.001) justice in the sub-factors of organizational justice. The factors affecting nurses’ job embeddness were procedural justice, optimism, position, distributive justice, and hope. In addition, the explanatory power of the model was 60% (F=39.11, p<.001). Conclusion The results suggest that to improve the job embeddedness, positive psychology-based coaching and counseling programs suitable for individual clinical nurses, organizational management through transparent procedures and objective and systematic distribution are needed. In addition, a position system suitable for the characteristics of a nursing organization is required.

Coronary artery involvement remains the most important complication with Kawasaki disease (KD). Additional myocardial injury can be caused by inflammatory response and ischemic event. However, the long-term outcome of myocardial function has not been fully known in KD. The purpose of this study is to evaluate myocardial function in school-aged children who had the past history of KD. Sixty-seven children in the second grade of elementary schools, who had the past history of KD, were included. Echocardiographic measurements of each coronary artery and myocardial function were obtained as the long-term follow-up data, and compared with the baseline data at the time of initial presentation of KD. The mean age of the subjects was 8.6 ± 2.4 years, and 4.3 ± 3.4 years have passed since the diagnosis of KD. Among the echocardiographic data, interventricular septum thickness at end-diastole (IVSd), LV internal diameters at end-systole (LVIDs), maximal velocity of late diastolic filling across mitral valve (mitral A) flow, maximal velocity of early diastolic filling across mitral valve (mitral E)/A ratio, mitral inflow E wave to peak early diastolic tissue velocity (E/E') ratio showed significant differences between the baseline and follow-up measurements. Coronary Z-score of left main artery (LMA), left anterior descending (LAD), and right coronary artery (RCA) showed no significant difference. The school-aged children with the past history of KD may have diastolic dysfunction. Therefore, appropriate assessment of myocardial function would be recommended during the follow-up period in children with KD.
Arteries ; Child* ; Coronary Vessels ; Diagnosis ; Echocardiography ; Follow-Up Studies ; Humans ; Mitral Valve ; Mucocutaneous Lymph Node Syndrome*

PURPOSE: The purposes of this study were to compare confidence in practice of intermittent gavage tube feeding and participants' satisfaction by three types of feedback; professor verbal feedback, professor feedback with smartphone video, and peer feedback with smartphone video. In addition, frequently failed items in the intermittent gavage tube feeding procedure were analyzed. METHODS: Data were collected from a convenience sample of 78 nursing college students in November 2014. Students were randomly assigned to the control group, experimental group I (smartphone video with professor feedback) or group II (smartphone video with peer feedback). Data were analyzed using descriptive statistics including chi-square test, ANOVA, and Scheffe test with SPSS 21.0. RESULTS: Confidence in practice of intermittent gavage tube feeding and satisfaction with feedback were highest in experimental group I that had professor feedback with smartphone video. For the procedure, the most frequently failed item was giving an explanation to patients about the purpose and the procedure of tube feeding. CONCLUSION: The results indicate that professor verbal feedback with smartphone video is the most benefit to the nursing students in acquiring core nursing practice skills.
Enteral Nutrition* ; Humans ; Nursing* ; Students, Nursing*

Purpose: : This study was conducted to identify the relationship between transition shock and intention to stay among newly graduated nurses and the mediating effect of positive psychological capital. Methods: This was a cross-sectional study that included a total of 155 newly graduated nurses at one hospital, recruited from June to September 2023. The data were analyzed using SPSS 27.0 and SPSS PROCESS macro model 4. Results: There were significant relationships between transition shock and intention to stay (r=-.47, p ＜.001), transition shock and positive psychological capital (r=-.64, p ＜.001), and positive psychological capital and intention to stay (r=.51, p ＜.001). Positive psychological capital showed a mediating effect in the relationship between transition shock and intention to stay among newly graduated nurses. Conclusion These results indicated that transition shock directly affected newly graduated nurses’ intention to stay, indirectly affecting it through positive psychological capital. Therefore, programs and strategies to reduce transition shock and increase positive psychological capital are needed in order to improve newly graduated nurses’ intention to stay.

Purpose: : This study was conducted to identify the relationship between transition shock and intention to stay among newly graduated nurses and the mediating effect of positive psychological capital. Methods: This was a cross-sectional study that included a total of 155 newly graduated nurses at one hospital, recruited from June to September 2023. The data were analyzed using SPSS 27.0 and SPSS PROCESS macro model 4. Results: There were significant relationships between transition shock and intention to stay (r=-.47, p ＜.001), transition shock and positive psychological capital (r=-.64, p ＜.001), and positive psychological capital and intention to stay (r=.51, p ＜.001). Positive psychological capital showed a mediating effect in the relationship between transition shock and intention to stay among newly graduated nurses. Conclusion These results indicated that transition shock directly affected newly graduated nurses’ intention to stay, indirectly affecting it through positive psychological capital. Therefore, programs and strategies to reduce transition shock and increase positive psychological capital are needed in order to improve newly graduated nurses’ intention to stay.

Purpose: : This study was conducted to identify the relationship between transition shock and intention to stay among newly graduated nurses and the mediating effect of positive psychological capital. Methods: This was a cross-sectional study that included a total of 155 newly graduated nurses at one hospital, recruited from June to September 2023. The data were analyzed using SPSS 27.0 and SPSS PROCESS macro model 4. Results: There were significant relationships between transition shock and intention to stay (r=-.47, p ＜.001), transition shock and positive psychological capital (r=-.64, p ＜.001), and positive psychological capital and intention to stay (r=.51, p ＜.001). Positive psychological capital showed a mediating effect in the relationship between transition shock and intention to stay among newly graduated nurses. Conclusion These results indicated that transition shock directly affected newly graduated nurses’ intention to stay, indirectly affecting it through positive psychological capital. Therefore, programs and strategies to reduce transition shock and increase positive psychological capital are needed in order to improve newly graduated nurses’ intention to stay.

Purpose: : This study was conducted to identify the relationship between transition shock and intention to stay among newly graduated nurses and the mediating effect of positive psychological capital. Methods: This was a cross-sectional study that included a total of 155 newly graduated nurses at one hospital, recruited from June to September 2023. The data were analyzed using SPSS 27.0 and SPSS PROCESS macro model 4. Results: There were significant relationships between transition shock and intention to stay (r=-.47, p ＜.001), transition shock and positive psychological capital (r=-.64, p ＜.001), and positive psychological capital and intention to stay (r=.51, p ＜.001). Positive psychological capital showed a mediating effect in the relationship between transition shock and intention to stay among newly graduated nurses. Conclusion These results indicated that transition shock directly affected newly graduated nurses’ intention to stay, indirectly affecting it through positive psychological capital. Therefore, programs and strategies to reduce transition shock and increase positive psychological capital are needed in order to improve newly graduated nurses’ intention to stay.