No abstract available.
Barium* ; Enema* ; Intussusception*

Purpose: This study aimed to distinguish and describe the types of perceptions of do not resuscitate (DNR) proxy decisions among families of elderly patients in a long-term care facility. Methods: This exploratory study applied Q-methodology, which focuses on individual subjectivity. Thirty-four Q-statements were selected from 130 Q-populations formed based on the results of in-depth interviews and literature reviews. The P-samples were 34 families of elderly patients in a long-term care hospital in Busan, Korea. They categorized the Q-statements using a 9-point scale. Using the PC-QUANL program, factor analysis was performed with the P-samples along an axis. Results: The families’ perceptions of the DNR proxy decision were categorized into three types. Type I, rational acceptance, valued consensus among family members based on comprehensive support from medical staff. Type II, psychological burden, involved hesitance in making a DNR proxy decision because of negative emotions and psychological conflict. Type III, discreet decisions, valued the patients’ right to self-determination and desire for a legitimate proxy decision. Type I included 18 participants, which was the most common type, and types II and III each included eight participants. Conclusion Families’ perceptions of DNR proxy decisions vary, requiring tailored care and intervention. We suggest developing and providing interventions that may psychologically support families.

Purpose: The purpose of this study was to describe characteristics of colleges implementing the accelerated second-degree bachelor of science in nursing program in South Korea and provide insight into strategies to improve the program outcomes. Methods: An on-line questionnaire developed for this study was emailed to deans of nursing colleges who were members of the Korean Association of College of Nursing. Questions included items related to nursing college, students, curriculum, and anticipated difficulty in relation to an increase of the number of second-degree students. Results: Out of 117 nursing schools, 33 schools (28.2%) participated in the on-line survey. The actual number of second-degree students and their ratio (about 10%) to regular students significantly increased in 2019. Male students were enrolled nearly twice as many times as regular students. Among the anticipated difficulties, clinical practice institutions (3.94) and clinical practice instructors (3.73) showed relatively higher scores than other difficulties such as teaching (3.58) and education facilities (3.30). Conclusion In order to improve the quality of nursing education for second-degree students, more nursing faculties and innovative clinical practice support systems are needed. Future study is warranted to investigate the educational experience of second-degree students and graduates.

No abstract available.
Pityriasis Lichenoides* ; Pityriasis*

No abstract available.
Pityriasis Lichenoides* ; Pityriasis*

PURPOSE: This study was conducted for the purpose of a structural model analysis of family health of women who came to Korea for being married to Korean men. METHODS: The data were collected from 260 immigrant women at multicultural centers located in C and B cities from May 10th to 30th, 2012. The variance analysis on the samples was conducted by using the maximum likelihood minimization function with AMOS 7.0. The fitness was evaluated by means of the SRMR, RMSEA, CFI, and TLI with a 90% confidence interval. RESULTS: First, immigrant women's self-esteem and acculturative stress were found to have significant direct effects on their family health. Second, their self-esteem and acculturative stress have direct effects on their marital adjustment. Third, their marital adjustment was found to have significant direct effects on their family health. Forth, immigrant women's Korean language ability was found not to have significant direct effects on their marital adjustment and family health. CONCLUSION: In order to enhance the family health of immigrant women, it is necessary to develop and apply nursing programs in consideration of immigrant women's self-esteem, marital adjustment and acculturative stress.
Aminopeptidases ; Emigrants and Immigrants ; Family Health ; Female ; Humans ; Korea ; Language ; Marriage ; Models, Structural ; Negotiating ; Porphyrins ; Social Adjustment ; Transients and Migrants

PURPOSE: Restaging after neoadjuvant treatment is done for planning the surgical approach and, increasingly, to determine whether additional therapy or resection can be avoided for selected patients. MATERIALS AND METHODS: Local restaging after neoadjuvant chemoradiation therapy (nCRT) was performed in 270 patients with locally advanced (cT3or4 or N+) rectal cancer. Abdomen and pelvic computed tomography (APCT) was used in all 270 patients, transrectal ultrasound (TRUS) in 121 patients, and rectal magnetic resonance imaging (MRI) in 65 patients. Findings according to imaging modalities were correlated with pathologic stage using Cohen's kappa (κ) to test agreement and intra-class correlation coefficient α to test reliability. RESULTS: Accuracy for prediction of ypT stage according to three imaging modalities was 45.2% (κ=0.136, α=0.380) in APCT, 49.2% (κ=0.259, α=0.514) in rectal MRI, and 57.9% (κ=0.266, α=0.520) in TRUS. Accuracy for prediction of ypN stage was 66.0% (κ=0.274, α=0.441) in APCT, 71.8% (κ=0.401, α=0.549) in rectal MRI, and 66.1% (κ=0.147, α=0.272) in TRUS. Of 270 patients, 37 (13.7%) were diagnosed as pathologic complete responder after nCRT. Rectal MRI for restaging did not predict complete response. On the other hand, TRUS did predict three complete responders (κ=0.238, α=0.401). CONCLUSION: APCT, rectal MRI, and TRUS are unreliable in restaging rectal cancer after nCRT. We think that multimodal assessment with rectal MRI and TRUS may be the best option for local restaging of locally advanced rectal cancer after nCRT.
Abdomen ; Hand ; Humans ; Magnetic Resonance Imaging ; Neoadjuvant Therapy ; Neoplasm Staging ; Rectal Neoplasms* ; Ultrasonography

PURPOSE: The incidence of complications after colonoscopy is very low. The complications after colonoscopy that are of clinical concern are bleeding and perforation. The present study was conducted to determine the clinical outcomes and the risk factors of a colostomy or a colectomy after colonoscopic colon perforation. METHODS: From March 2009 to December 2012, the records of all patients who were treated for colorectal perforation after colonoscopy were reviewed retrospectively. The following parameters were evaluated: age, sex, purpose of colonoscopy, management of the colonic perforation, and interval from colonoscopy to the diagnosis of a colonic perforation. A retrospective analysis was performed to determine the risk factors associated with major surgery for the treatment of a colon perforation after colonoscopy. RESULTS: A total 27 patients were included in the present study. The mean age was 62 years, and 16 were males. The purpose of colonoscopy was diagnostic in 18 patients. The most common perforation site was the sigmoid colon. Colonic perforation was diagnosed during colonoscopy in 14 patients, just after colonoscopy in 5 patients, and 24 hours or more after colonoscopy in 8 patients. For the treatment of colonic perforation, endoscopic clipping was performed in 3 patients, primary closure in 15 patients, colon resection in 2 patients, Hartmann's procedures in 4 patients, and diverting colostomy in 3 patients. If the diagnosis of perforation after colonoscopy was delayed for more than 24 hours, the need for major treatment was increased significantly. CONCLUSION: Although a colonic perforation after colonoscopy is rare, if the morbidity and the mortality associated with the colonic perforation are to be reduced, prompt diagnosis and management are very important.
Colectomy ; Colon* ; Colon, Sigmoid ; Colonoscopy* ; Colostomy ; Diagnosis ; Hemorrhage ; Humans ; Incidence ; Intestinal Perforation ; Male ; Mortality ; Retrospective Studies ; Risk Factors

Inflammatory myofibroblastic (IMF) tumor is a rare solid tumor that often affects children. IMF tumors occur primarily in the lung, but the tumor may affect any organ system with protean manifestations. A 22-year-old woman was evaluated for palpable low abdominal mass that had been increasing in size since two months prior. Abdominal computed tomography showed a lobulated, heterogeneous contrast enhancing soft tissue mass, 6.5 x 5.7 cm in size in the ileal mesentery. At surgery, the mass originated from the greater omentum laying in the pelvic cavity and was completely excised without tumor spillage. Histologically, the mass was a spindle cell lesion with severe atypism and some mitosis. Immunohistochemistry for anaplastic lymphoma kinase-1 revealed that the lesion was an IMF tumor. Because of its local invasiveness and its tendency to recur, this tumor can be confused with a soft tissue sarcoma. Increasing physician awareness of this entity should facilitate recognition of its clinical characteristics and laboratory findings.
Child ; Female ; Humans ; Immunohistochemistry ; Lung ; Lymphoma ; Mesentery ; Mitosis ; Myofibroblasts ; Omentum ; Sarcoma ; Young Adult

PURPOSE: Although there are more than a hundred techniques, including the transabdominal and the perineal approaches, for the repair of the rectal prolapsed, none of them is perfect. The best repair should be chosen not only to correct the prolapse but also to restore defecatory function and to improve fecal incontinence throughout the patient's lifetime. The aim of this retrospective review is to evaluate clinical outcomes of the Delorme's procedure for the management of the complete rectal prolapse. METHODS: A total of 19 patients (13 females and 6 males) with complete rectal prolapses were treated by using the Delorme's procedure in St. Vincent's Hospital, The Catholic University of Korea, from February 1997 to February 2007. Postoperative anal incontinence was evaluated using the Cleveland Clinic Incontinence Score. RESULTS: All 19 patients had incontinence to liquid stool, solid stool, and/or flatus preoperatively. Three (15.8%) patients reported recurrence of the rectal prolapse (at 6, 18, 29 months, respectively, after the operation). Information on postoperative incontinence was available for 16 of the 19 patients. Twelve of the 16 patients (75%) reported improved continence (5 [31.3%] were improved and 7 [43.7%] completely recovered from incontinence) while 4 patients had unchanged incontinence symptoms. One (6.3%) patient who did not have constipation preoperatively developed constipation after the operation. CONCLUSION: The Delorme's procedure is associated with a marked improvement in anal continence, relatively low recurrence rates, and low incidence of postoperative constipation. This allows us to conclude that this procedure still has its own role in selected patients.
Constipation ; Fecal Incontinence ; Female ; Flatulence ; Humans ; Incidence ; Korea ; Prolapse ; Rectal Prolapse ; Recurrence ; Retrospective Studies