BACKGROUND: The purpose of this study was to identify predictive factors for preventive behaviors of falls in elderly inpatients. METHODS: Data on 200 elderly inpatients at one university hospital were collected. Descriptive analysis, independent t-test, analysis of variance, and stepwise multiple regression analysis were done to analyze the data. RESULTS: The high risk group, scoring higher than 5.0 in the degree of self-awareness of fall risk, scored low in knowledge about falls while subjects with activity limitations and not using hearing aids scored significantly high in the same area. Subjects with no training regarding falls and the high risk group scored low in fall efficacy while subjects with activity limitations and using hearing aids scored significantly high in the same area. The degree of self-awareness of fall risk, knowledge about falls, and fall efficacy were significant factors affecting fall prevention activities. CONCLUSIONS: These findings suggest that self-awareness of the risk of falls, knowledge about falls, and fall efficacy are significant factors in preventing falls. These factors should be considered when developing nursing assessment tools and intervention programs for elderly inpatients.
Accidental Falls ; Aged ; Hearing Aids ; Humans ; Inpatients ; Nursing Assessment

PURPOSE: This study was conducted to examine relationships between critical thinking disposition and multiple intelligences. METHOD: Participants were nursing students (N=186) who completed a questionnaire assessing critical thinking disposition and multiple intelligences. Data were analyzed using descriptive statistics, t-test, analysis of variance with post hoc comparison, and Pearson correlation coefficients. RESULTS: For type of multiple intelligences, 32.9% of students had the strongest fit for "interpersonal intelligence" type and 20.1% for "intrapersonal intelligence" type. Mean score for critical thinking disposition was 3.42+/-0.37. Factors related to critical thinking disposition were participation in club activities (F=5.962, p=.001) with a representative role in the club (t=2.140, p=.034). There were significant differences in interpersonal intelligence scores by personality traits (t=2.445, p=.015), participation in club activities (F=10.003, p<.001), and friendship (t=2.539, p=.012); and significant differences in intrapersonal intelligence scores by participation in club activities (F=3.862, p=.010), having a representative role in the club (t=2.101, p=.037), and friendship (t=2.220, p=.029). CONCLUSION: Results indicate that critical thinking disposition is significantly associated with multiple intelligences and suggest that multiple intelligences should be considered to enhance critical thinking disposition when tailored teaching is adopted in nursing education.
Education, Nursing ; Friends ; Humans ; Intelligence ; Surveys and Questionnaires ; Students, Nursing* ; Thinking*

Postoperative colonoscopy is an effective tool for management of colonic adenomas. Authors analyzed the pattern of colonic adenomas detected during follow-up colonoscopy after colorectal cancer surgery and evaluated the characteristics of adenornas, risk groups, and effective fo1low-up schedule. Study group were 222 patients and colonoscopy was performed 389 times. Patterns of adenornas were analyzed by variables as age, sex, preoperative serum CEA level, location of primary colorectal cancer, Borrmann type, Duke's stage, histologic differentiation, DNA ploidy, recurrence and histology. Metachronous adenomas were detected in 79 patients(35.6%) and both metachronous and syachronous adenomas were observed in 29 cases(13.1%). High risk variables for adenomas were male, old age and presence of synchronous adenoma. There were 2 patients with maligant change of adenomas. Yearly follow-up by complete colonoscopy over 3 years or more is recommended and follow-up interval should be shortened in the high risk groups.
Adenoma* ; Appointments and Schedules ; Colon ; Colonic Neoplasms ; Colonoscopy ; Colorectal Neoplasms* ; DNA ; Follow-Up Studies ; Humans ; Male ; Ploidies ; Recurrence

PURPOSE: The present study was designed to understand the conceptual definition and attributes of the clinical critical thinking ability(CCTA) in nursing and to grasp the characteristics of clinical critical thinking abilities. METHODS: The data were analyzed using the Hybrid model of Schwartz-Barcott and Kim(2000). RESULTS: Having the skills and dispositions to think critically, CCTA refers to something that implies the cognizant ability to interpret contextual meanings, analyze the relationships between materials or circumstances, draw out the best conclusions, predict things using relevant information and evaluate the reliability of information and the strength of inference on the one hand and the emphatic disposition to be curious, open-minded, intellectually integral, systematic and creative and to reflect on things in contextual terms on the other. CONCLUSION: CCTA is characterized by clinical circumstances, such as guessing the reasons for facts, predicting things, connecting theory to practice and approaching individual situation in total terms as well as by the Korean circumstances, such as taking another person's perspective. Hence, this study proposes developing the tools to measure the clinical critical thinking ability and the strategies to improve the clinical critical thinking ability and seeking to verify their validity, on the basis of the findings.
Chimera ; Clinical Competence ; Concept Formation ; Hand ; Hand Strength ; Problem Solving ; Thinking

No abstract available.
Fertilization* ; Oocytes*

PURPOSE: Congenital hypothyroidism(CH) is not uncommon disorder, leading to retardation of mental development and growth, if not treated early. The aim of this study is to determine the factors influencing IQ of children with CH, diagnosed after 1 month of life. METHODS : Thirteen children with CH were included. They had intelligence test by KEDI-WISC(Korean Educational Development Institute-Wechsler Intelligence Scale for Children) and their medical records were reviewed. Their T4, TSH, height, age at diagnosis were investigated retrospectively. To evaluate the influence of T4, TSH, height, age at diagnosis on IQ, children were divided into three groups ; athyroid(n=8), sublingual(n=3), inborn errors of thyroid hormone synthesis(n=2) according to the result of thyroid scan. Results : In athyroid group, IQ closely correlated to VIQ and PIQ and had close relationship to T4 at diagnosis(.p=0.0086, r=0.8427), but no relation to TSH. There was no difference in height, T4 TSH, and IQ between athyroid and sublingual group. CONCLUSION : The results suggest that intellectual function in children with CH, diagnosed after 1 month of life depends on serum level of T4 at diagnosis. Further study is mandatory to elucidate the relationship between final IQ and factors, including thyroid function, age at diagnosis, adequacy of treatment, etc.
Child* ; Congenital Hypothyroidism* ; Diagnosis ; Growth and Development ; Humans ; Intelligence ; Intelligence Tests ; Medical Records ; Retrospective Studies ; Thyroid Gland

PURPOSE: Antithyroid drug treatment is usually recommended as the initial treatment for children with Graves' disease. However, achieving remission with medical therapy usually requires many years of treatment, the risk for adverse reactions is relatively high and relapse is common after discontinuation of medication. There is therefore a debate about how Graves' disease should be treated in children. The aim of this study was to identify predictors of remission during 2 years from quitting of antithyroid drug. METHODS: We retrospectively studied children who had been treated for Graves' disease with antithyroid medication. We compared the children who achieved remission after two years with those who had persistent disease, to determine the variables associated with remission. RESULTS: 41 patients were enrolled, of whom five (12.2%) achieved remission and the rest (87.8%) could not achieve remission until the last visit. There were no significant differences in T3, free T4, antimicrosomal antibody (AMA), or thyroid stimulating hormone (TSH)-binding inhibitory immunoglobulin (TBII) between the two groups at presentation. However, the remission group had a significantly higher titer of TSH (P = 0.04) and a significantly lower titer of antithyroglobulin antibody (ATA) (P = 0.01) than the non-remission group at presentation. The non-remission group had higher ATA concentrations 3 months after treatment with antithyroid medication than the remission group did (P = 0.02). CONCLUSION: TSH and ATA concentrations at presentation can be used to stratify patients according to the likelihood of remission during 2 years from quitting of antithyroid drug.
Child ; Male ; Female ; Humans

The incidence of severe hepatitis A virus (HAV) infection has been increasing. However, clinicopathologic features of severe HAV infection that lead to liver transplantation (LT) have not been reported in Korea. We retrieved 16 LT cases with HAV infection during the last 3 years at Asan Medical Center, Seoul, Korea. Fifteen cases progressed to hepatic encephalopathy. Thirteen cases survived with or without complications, and three patients died of sepsis. The explanted liver showed massive or zonal necrosis with moderate to severe cholestasis. The zonal distribution of necrosis was frequently associated with endothelialitis of portal and/or central veins. Degenerative changes of hepatocytes were various in degree and distribution. Viral inclusions were suspected in two cases. Although HAV infection is usually confirmed by serological tests, significant venulitis of central and/or portal veins and viral inclusions, which are rarely observed, can suggest an HAV infection as a cause of massive hepatic necrosis of unknown mechanism.
Cholestasis ; Fluconazole ; Hepatic Encephalopathy ; Hepatitis ; Hepatitis A ; Hepatitis A virus ; Hepatocytes ; Humans ; Incidence ; Korea ; Liver ; Liver Transplantation ; Massive Hepatic Necrosis ; Necrosis ; Portal Vein ; Sepsis ; Serologic Tests ; Veins

BACKGROUND: Fluid overload prior to continuous renal replacement therapy (CRRT) is an important prognostic factor. Thus, precise evaluation of fluid status is necessary to treat such patients. In this study, we investigated whether fluid assessment using bioelectrical impedance analysis (BIA) can predict outcomes in critically ill patients requiring CRRT. METHODS: A prospective observational study was performed in patients who were admitted to the intensive care unit and who required CRRT. BIA was conducted before CRRT; then, the ratio of extracellular water to total body water (ECW/TBW) was derived to estimate volume status. RESULTS: A total of 31 patients treated with CRRT were included. There were 18 men (58.1%), and the median age was 67 years (interquartile range, 51 to 78 years). Fourteen patients (45.2%) died within 28 days after CRRT initiation. Patients were divided into 16 with ECW/TBW ≥0.41 and 15 with ECW/TBW <0.41. Survival rate within 28 days was different between the two groups (P = 0.044). Cox regression analysis revealed a relationship between ECW/TBW ≥0.41 and 28-day mortality, but it was not statistically significant (hazard ratio, 3.0; 95% confidence interval, 0.9 to 9.8; P = 0.061). Lastly, the area under the curve of ECW/TBW for 28-day mortality was analyzed. The area under the curve of ECW/TBW was 0.73 (95% confidence interval, 0.54 to 0.92), and this was significant (P = 0.037). CONCLUSIONS: Fluid status can be assessed using BIA in critically ill patients requiring CRRT, and BIA can predict mortality. Further large trials are needed to confirm the usefulness of BIA in critically ill patients.
Body Water ; Critical Illness* ; Electric Impedance* ; Humans ; Intensive Care Units ; Male ; Mortality ; Observational Study* ; Prospective Studies* ; Renal Replacement Therapy* ; Survival Rate ; Water

PURPOSE: The purpose of this study was to describe the clinical outcome after pancreatcetmy and its relationship with pathological appearances and clinical features in patients with persistent hyperinsulinemic hypoglycemia of infancy(PHHI). METHODS: Medical records of 10 patients(9 males and 1 female, mean age:40.4+/-1.5 months) who were diagnosed as PHHI and underwent pancreatectomy from 1988 to 2000 were reviewed. Clincal and biochemical data were recorded. Subjects were classified arbitrarily into early-onset or late-onset group according to age of onset. Pathologic appearance of pancreas was divided into 2 forms:diffuse or focal. The former had a focal pancreatic adenomatous hyperplasia and the latter was characterized by increased number of betacells with similar distribution seen in normal neonates. RESULTS: One patient had focal, and nine had diffuse lesions. After near-total pancreatectomy, 4 patients(40.0%) showed complete response, 4(40.0%) had persistent hypoglycemia, and 2(20.0%) developed diabetes mellitus. As neurological sequelae, 6 patients(60.0%) had persistent seizures, and 6(60.0%) had delayed motor and speech development. No clinical or biochemical factors related to postoperative outcome were found. CONCLUSION: This data indicate that early diagnosis of patients who present with hypoglycemic symptoms in infancy, especially early in life, and development of more effective therapy are warranted, because there is no clinical or biochemical factor predicting final outcome after near-total pancreatectomy and only 40% of patients with PHHI remained euglycemic after surgery with possible severe neurological sequelae.
Age of Onset ; Congenital Hyperinsulinism* ; Diabetes Mellitus ; Early Diagnosis ; Female ; Humans ; Hyperplasia ; Hypoglycemia ; Infant, Newborn ; Male ; Medical Records ; Pancreas ; Pancreatectomy* ; Seizures