PURPOSE: This study investigated the relationships among parenting stress, husband's support, and breastfeeding adaptation in mothers. METHODS: A correlational survey design was utilized in this study. Data were collected from 181 breastfeeding mothers with infants under 12 months of age. Participants were recruited from the outpatient clinic, a child photo studio, or from the kid's cafe from July 22 to September 13, 2016. Instruments for collecting data included Childcare Stress Inventory (CSI), Husband's Support scale, and the Breastfeeding Adaptation scale. Data were analyzed using SPSS 21.0 by frequency, descriptive statistics, t-test, one-way ANOVA, Pearson's correlation coefficient and multiple regression. RESULTS: Of the 181 subjects, 54.7% responded they only breastfed with 75.7% who received breastfeeding education. Seventy-two percent of mothers made a decision to breastfeed by themselves. The mean score was 2.39±0.53 for parenting stress, 3.07±0.43 for husband's support, and 3.85±0.49 for breastfeeding adaptation. Factors influencing breastfeeding adaptation were identified as lower parenting stress (β=−.54), greater husband's support (β=.31), breastfeeding (β=.31), and older age of baby (β=.14), with 56.0% that explained variance. CONCLUSION: This study reports that parenting stress has negative effect on breastfeeding adaptation, while husband's support has positive effect. Results may be useful in developing new strategies for enhancing breastfeeding adaptation.
Adaptation, Psychological ; Ambulatory Care Facilities ; Breast Feeding* ; Child ; Education ; Humans ; Infant ; Mothers* ; Parenting* ; Parents*

PURPOSE: The purpose of this study was to assess hospital nurses' knowledge, importance and performance in keeping nursing records.METHODS: The research design was a descriptive study. The sample for this study was 186 nurses with at least one year of work experience at a hospital with more than 800 beds in Seoul. Knowledge was self-reported using the Nurse Charting Knowledge Scale. Importance and performance were rated on a 4-point scale of 26 items. Data were analyzed by SPSS 21.0 program and IPA.RESULTS: This study showed significant results that knowledge, importance and performance for keeping record are related to each other. The importance and performance of nurse's records were relatively higher than the mean. In the IPA Matrix, there were 2 items requiring improvement, 13 items requiring maintenance, and 11 items with low priority.CONCLUSION: Therefore, awareness of the importance of record keeping and continuous education on nursing record knowledge should be provided so that nurses can improve their record keeping skills.
Education ; Nursing Records ; Nursing ; Research Design ; Seoul

Purpose: We report a rare case of allergic contact dermatitis after the use of a non-preservative 0.5% moxifloxacin ophthalmic solution.Case summary: A 60-year-old male presented with bacterial corneal ulceration of the right eye. He was treated with 50 mg/mL of fortified cefazolin and 14 mg/mL of tobramycin that were tapered as the corneal lesion improved after 1 month, and 0.5% moxifloxacin application was started. After 2 weeks of moxifloxacin treatment, the patient developed conjunctival injection, lid swelling, redness, and itching in the right eye. An allergic reaction was suspected and moxifloxacin administration was immediately stopped. The symptoms improved after the administration of oral antihistamines, 0.5% loteprednol eye drops, and steroid combination ointment. Conclusions Patients treated with 0.5% topical moxifloxacin should be monitored for allergic contact dermatitis, even if preservative-free eye drops are used.

Purpose: This study aimed to analyze the clinical outcomes of venous thromboembolism (VTE) patients and identify the risk factors for VTE-related unfavorable outcomes, major bleeding, and 30-day all-cause mortality. Materials and Methods: From January 2016 to December 2020, 198 patients with confirmed VTE were enrolled. Potential risk factors for unfavorable outcomes, major bleeding, and all-cause mortality were analyzed. Results: VTE-related unfavorable outcomes developed in 13.1%, while 30-day all-cause mortality was 8.6%. In the multivariate analysis, a pulse ≥110/min and respiratory rate ≥30/min were statistically significant predictors for VTE-related unfavorable outcomes. Diabetes was a significant risk factor for major bleeding. In addition, a history of malignancy, no anticoagulation treatment, and need for mechanical ventilation were significant predictors of all-cause mortality. Conclusion VTE-related mortality and morbidity rates remained high. In cases of tachycardia and tachypnea, early aggressive treatment is needed to prevent unfavorable outcomes. Patients with risk factors should be closely monitored.

A 27-year-old man presented to the emergency department with sudden onset of massive gross hematuria and urinary retention. Contrast-enhanced computed tomography imaging showed uneven, dilated calices and a narrowing of the renal pelvis in the left kidney; in addition, a large hematoma was noted in the urinary bladder. An emergency cystoscopy was performed following detection of the hematoma and blood clots were removed. A lesional biopsy, a tuberculosis (TB) culture, and urine cytology showed positive results for Mycobacterium tuberculosis. The clinical manifestations of genitourinary tuberculosis are nonspecific and are usually detected at a chronic stage. In conclusion, we report an unusual cause of acute kidney injury associated with a subacute stage of genitourinary tuberculosis that caused mucosal erosion and bleeding in the bladder.
Acute Kidney Injury ; Biopsy ; Cystoscopy ; Emergencies ; Hematoma ; Hematuria ; Hemorrhage ; Kidney Pelvis ; Mycobacterium tuberculosis ; Tuberculosis ; Urinary Bladder ; Urinary Retention

Primary adenosquamous carcinoma of the ampulla of Vater is extremely rare. We report two cases of adenosquamous carcinoma of the ampulla of Vater in a 48-year-old female and an 80-year-old female patient. The gross appearance was a polypoid mass in both cases. Histologically, the majority of the two tumors was composed of squamous cell carcinoma with some intermingled glandular adenocarcinoma components in both cases. Squamous cell carcinomas showed an abrupt transition from the normal glandular epithelium or glandular adenocarcinoma. Although the two cases revealed duodenal wall invasion and lymph node metastasis was found in case 2, both patients are still alive at 19 and 46 months after surgery, respectively.
Adenocarcinoma ; Aged, 80 and over ; Ampulla of Vater* ; Carcinoma, Adenosquamous* ; Carcinoma, Squamous Cell ; Epithelium ; Female ; Humans ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis

BACKGROUNDS/AIMS: Metastatic cancer of pancreas is rarely resectable. Pancreaticoduodenectomy carries high risks of morbidities and mortalities that it is rarely performed for metastatic cancer. In this study, the clinical features and outcomes of metastatic cancer of pancreas after pancreaticoduodenectomy were reviewed and analyzed. METHODS: We retrospectively reviewed patients who underwent pancreaticoduodectomy from January 2000 to December 2012 in Samsung Medical Center. A total of 1045 patients were enrolled in this study. Inclusion criteria were patients who had metachronous lesions with tumors histologically confirmed as metastatic cancer. However, patients with tumors directly invaded pancreas head, bile duct, and duodenum were excluded from this study. Finally, a total of 12 patients who underwent pancreaticoduodenectomy due to metastatic cancer were used in this study. Clinicopathologic features and perioperative data of these 12 patients were retrospectively reviewed. RESULTS: The 12 patients included 6 females and 6 males who had metastatic lesions at pancreas head, duodenum 2nd-3rd portion, and distal common bile duct. The mean age of patients was 62.7 years old at the time of pancreaticoduodenectomy. The interval between the time of the first operation for primary cancer and pancreaticoduodenectomy was 67.7 months. The mean survival time after pancreaticoduodectomy was 38.6 months (range, 12 to 119 months). There was no fatal complication after the surgery. CONCLUSIONS: Pancreaticoduodenectomy is becoming a safer procedure with less complication compared to the past. Patients with recurrent metastatic cancer should be considered for metastectomy if tumors are resectable. Pancreaticoduodenectomy should be considered as one main treatment for patients with recurrent metastatic cancer to offer a chance of long-term survival in selected patients.
Bile Ducts ; Common Bile Duct ; Duodenum ; Female ; Head ; Humans ; Male ; Mortality ; Neoplasm Metastasis ; Pancreas ; Pancreatic Neoplasms ; Pancreaticoduodenectomy* ; Recurrence ; Retrospective Studies ; Survival Rate

OBJECTIVE: The purpose of this study was to determine whether funisitis is associated with changes in the umbilical cord plasma concentration of interleukin-6 (IL-6) and matrix metalloproteinase-8 (MMP-8), microbial invasion of the amniotic cavity and neonatal outcome. METHODS: The relationship among the presence of funisitis, IL-6 and MMP-8 concentrations in umbilical cord plasma at birth, the results of amniotic fluid culture performed within 5 days of birth was examined in 83 consecutive singleton births (20-35 weeks' gestation). Funisitis was diagnosed in the presence of neutrophil infiltration into the umbilical vessel wall or Wharton's jelly. The IL-6 and MMP-8 concentration was measured with a specific immunoassay. Amniocentesis was performed in 47 patients within 5 days of birth. RESULTS: (1) Funisitis was present in 21.7% of patients. (2) Patients with funisitis had a significant higher cord plasma IL-6 concentration, but had no significant difference in cord plasma MMP-8 concentration. (3) Clinical chorioamnionitis was more common in patients with funisitis than those without funisitis. (4) A cord plasma IL-6 > 6.34 pg/ml had a sensitivity of 77.8% and a specificity of 75.4% in the identification of funisitis. (5) No correlation between cord blood plasma IL-6 concentration and MMP-8 concentration was found. (6) There was no significant correlation between gestational age at birth and cord blood plasma MMP-8 concentrations, but there appeared to be a trend to increase of cord plasma MMP-8 concentrations as gestational ages at birth were increased. (7) Neonates with congenital sepsis had a significantly higher cord plasma IL-6 and MMP-8 concentration than those without congenital sepsis. CONCLUSION: In patient with funisitis, umbilical cord plasma IL-6 concentrations were higher than those without funisitis, but umbilical cord plasma MMP-8 concentrations had no significant difference in each group. The umbilical cord plasma IL-6 and MMP-8 can be useful as a predictor of the occurrence of congenital sepsis in preterm infant.
Amniocentesis ; Amniotic Fluid* ; Chorioamnionitis* ; Female ; Fetal Blood ; Gestational Age ; Humans ; Immunoassay ; Infant, Newborn ; Infant, Premature ; Interleukin-6* ; Matrix Metalloproteinase 8* ; Neutrophil Infiltration ; Parturition ; Plasma* ; Pregnancy ; Sensitivity and Specificity ; Sepsis ; Umbilical Cord* ; Wharton Jelly

BACKGROUND AND PURPOSE: The elderly population and the prevalence of stroke, dementia, and Parkinson's disease are increasing rapidly in Korea. The aim of this study was to establish the length of stay (LOS) for neurological geriatric diseases, and analyze this parameteraccording to healthcare institutions. METHODS: We used data from the Health Insurance Review and Assessment Service from 2003 to 2007. Nineteen neurological geriatric diseases were classified into four groups: dementia, cerebral hemorrhage, cerebral infarction, and Parkinson's disease. LOS was analyzed according to gender, age, insurance type, disease group, and type of healthcare institution. RESULTS: The LOS for neurological geriatric diseases lengthened from 5,550,193 days (10.8% of the total National Health Insurance admission days) in 2003 to 14,749,671 days (19.7%) in 2007. The mean LOS was 40.8 days in 2003, and lengthened to 71.2 days in 2007. After stratification by disease group, the mean LOS for long-term-care hospitals lengthened by 1.43 times (from 81.7 to 116.6 days) in the cerebral infarction group, 1.35 times (from 85.6 to 115.2 days) in the cerebral hemorrhage group, and 1.28 times (from 82.7 to 105.7 days) in the Parkinson's disease group. CONCLUSIONS: The LOS for neurological geriatric diseases has lengthened markedly, which isdue to an increasesin the number of hospitalized patients and the mean LOS, which have increased most rapidly in long-term-care hospitals. These results may be useful in developing geriatric health policies.
Aged ; Cerebral Hemorrhage ; Cerebral Infarction ; Delivery of Health Care ; Dementia ; Health Policy ; Humans ; Insurance ; Insurance, Health ; Korea ; Length of Stay ; National Health Programs ; Parkinson Disease ; Prevalence ; Stroke

Allopurinol is widely used to reduce serum uric acid levels and, generally, has mild side effects. Rarely, allopurinol hypersensitivity syndrome occurs and this consists of severe systemic skin lesions, fever, reduced kidney and liver function, and leukocytosis with eosinophilia. Extremely rarely, allopurinol-induced pure red cell aplasia is reported. We report a case of allopurinol hypersensitivity syndrome and pure red cell aplasia following allopurinol therapy for eight weeks and the disease response to steroid therapy in a patient with chronic renal insufficiency.
Allopurinol ; Eosinophilia ; Fever ; Humans ; Hypersensitivity ; Kidney ; Leukocytosis ; Liver ; Red-Cell Aplasia, Pure ; Renal Insufficiency, Chronic ; Skin ; Uric Acid