Purpose: The purpose of this study was to develop a resilience enhancement program applying mindfulness meditation (REP-MM) and evaluate the effects of the program on post-traumatic stress (PTS), resilience, and health-related quality of life (HRQoL) in patients with ileostomy. Methods: The REP-MM was developed by combining the resilience enhancement program with mindfulness meditation according to four patterns. The program was developed through identifying patients’ needs, reviewing relevant literature, developing a preliminary program, and testing content validity and user evaluation. The participants were 55 patients with ileostomy. We conveniently assigned 27 patients to the experimental group and 28 to the control group. The study was conducted in conducted in a hospital from January 22 to May 30, 2019. The REPMM was provided to the experimental group, and conventional ileostomy care was provided to the control group using a nonequivalent control-group pretest-posttest design. Results: ANCOVA revealed that the levels of PTS (F = 321.64, p < .001), resilience (F = 111.86, p < .001), and HRQoL (F = 31.08, p < .001) in the experimental group were higher than those in the control group when comparing pretest to posttest changes. Conclusion The REP-MM is effective in PTS, resilience, and HRQoL in patients suffering from post-stoma creation crisis. The REP-MM can induce positive self-recognition changes in patients with ileostomy through dispositional, situational, relational, and philosophical interventions. We suggest nurses reduce PTS and improve resilience and HRQoL in patients with ileostomy.

Purpose: The purpose of this study was to develop a resilience enhancement program applying mindfulness meditation (REP-MM) and evaluate the effects of the program on post-traumatic stress (PTS), resilience, and health-related quality of life (HRQoL) in patients with ileostomy. Methods: The REP-MM was developed by combining the resilience enhancement program with mindfulness meditation according to four patterns. The program was developed through identifying patients’ needs, reviewing relevant literature, developing a preliminary program, and testing content validity and user evaluation. The participants were 55 patients with ileostomy. We conveniently assigned 27 patients to the experimental group and 28 to the control group. The study was conducted in conducted in a hospital from January 22 to May 30, 2019. The REPMM was provided to the experimental group, and conventional ileostomy care was provided to the control group using a nonequivalent control-group pretest-posttest design. Results: ANCOVA revealed that the levels of PTS (F = 321.64, p < .001), resilience (F = 111.86, p < .001), and HRQoL (F = 31.08, p < .001) in the experimental group were higher than those in the control group when comparing pretest to posttest changes. Conclusion The REP-MM is effective in PTS, resilience, and HRQoL in patients suffering from post-stoma creation crisis. The REP-MM can induce positive self-recognition changes in patients with ileostomy through dispositional, situational, relational, and philosophical interventions. We suggest nurses reduce PTS and improve resilience and HRQoL in patients with ileostomy.

BACKGROUND: HBsAg carriers are 6-12% of population in Korea. The patients knowledge on hepatitis B and regular follow-up tests are important, because HBsAg carriers have infectivity and the disease may progress without symptoms. We surveyed their knowledge on the hepatitis B and the frequency of follow-up blood test and sonogram. METHODS: From March 1993 through September 1994, 630 patients who were diagnosed as HBsAg positive and Anti-HBs negative in a health promotion center of college hospital were surveyed by mailing questionnaire. The questionnaire included the result of HBV viral marker test, transmission routes, complications, and prevention methods of Hepatitis B, frequency of follow-up test, and doctors recommendation. RESULTS: Of the 490 questionnaires excluded the 140 questionaires returned due to wrong address, 100 were answered, making the reply rate 20.4%. As for the result of HBV marker test, 64% answered their HBV marker as HBsAg positve, 10% answered HBsAg negative, and 26% answered I dont know. 65% answered that they are HBV carrier. As for the mode of transmission, 59% answered that HBV is transmitted by blood, 57% from carrier mother at birth, 29 % by sexual intercourse. 76% of responders know that vaccination is needed for preventing vertical transmission. When making score on their knowledge, significant differences were showed according to education, income and doctors recommendation about regular follow-up test. The number of persons who took regular blood test every 6 to 12 months were 56(56%), and the number of persons who took regular abdominal ultrasonogram were 39(39%). The number of patients who were recommended regular follow-up by doctor was 76%. In this group, 51 persons(67.0%) took regular blood test and 35 persons(35%) took regular sonogram so this frequency is significantly higher than the other group(each 20.8%, 16.7%). CONCLUSIONS: The knowledge on hepatitis B in HBsAg positive patients is relatively low and the frequency of regular follow-up test is significantly higher in the group who took doctors recommendation. So it is very important that HBsAg carriers must be educated about the infectivity, preventive methods, and regular follow-up for early detection of complication like hepatocellular cancer.
Biomarkers ; Coitus ; Education ; Follow-Up Studies* ; Health Promotion ; Hematologic Tests ; Hepatitis B Surface Antigens ; Hepatitis B* ; Hepatitis* ; Humans ; Korea ; Liver Neoplasms ; Mothers ; Parturition ; Postal Service ; Ultrasonography ; Vaccination ; Surveys and Questionnaires

Multiple system atrophy (MSA) is an idiopathic neurodegenerative disorder involving many neuronal structures. It is a heterogeneous system disorder affecting extrapyramidal, cerebellar and autonomic nervous system. Only a minority of MSA patients are diagnosed before reaching the full blown stage. Its autonomic features like orthostatic hypotension, vocal cord paralysis are directly related to mortality. Up to now, rehabilitation of MSA patients had been rarely reported. Early, proper diagnosis and comprehensive rehabilitation for their heterogeneous clinical features are important. We experienced 54 year old hemiplegic paient who overlaps MSA. He showed some improvement in ADL and cerebellar symptoms after comprehensive rehabilitation programs.
Activities of Daily Living ; Autonomic Nervous System ; Diagnosis ; Humans ; Hypotension, Orthostatic ; Middle Aged ; Mortality ; Multiple System Atrophy* ; Neurodegenerative Diseases ; Neurons ; Rehabilitation ; Stroke* ; Vocal Cord Paralysis

PURPOSE: To evaluate the short-term efficacy of intravitreal ranibizumab injection in eyes with macular edema secondary to central retinal vein occlusion (CRVO). METHODS: The records of 17 patients (17 eyes, 11 ischemic, six ischemic) who received an intravitreal ranibizumab injection for macular edema secondary to CRVO were retrospectively analyzed. The ophthalmic examination included best corrected visual acuity (BCVA) and central macular thickness (CMT) at baseline and follow-up visits. RESULTS: After intravitreal ranibizumab injection, the mean BCVA improved from log MAR 1.25 +/- 0.47 at baseline to log MAR 0.78 +/- 0.49 at 4 weeks and to log MAR 0.81 +/- 0.52 at 12 weeks (p < 0.05). Additionally, the mean CMT decreased from 679.4 +/- 230.5 microm at baseline to 224.4 +/- 129.9 microm at 4 weeks and to 271.6 +/- 174.1microm at 12 weeks (p < 0.001). In subgroup analysis, the decreases in CMT at 4 weeks and 12 weeks were similar in ischemic CRVO and non-ischemic CRVO, but no significant changes in visual acuity were found at 12 weeks in the ischemic CRVO group (p = 0.138). Ten eyes (58.8%) did not require re-injections for macular edema for up to 12 weeks. CONCLUSIONS: Intravitreal ranibizumab injection appeared to be an effective option for the treatment of macular edema secondary to central retinal vein occlusion.
Antibodies, Monoclonal, Humanized ; Eye ; Follow-Up Studies ; Humans ; Macular Edema ; Retinal Vein ; Retrospective Studies ; Visual Acuity ; Ranibizumab

PURPOSE: The purpose of this study was to evaluate the usefulness of preoperative breast MRI compared with breast US and pathologic finding in breast cancer patients MATERIALS AND METHODS: A total of 50 patients with breast cancer underwent surgery at our institute between October 2004 and August 2005. They were examined preoperatively with MRI and US. The maximum diameter and the number of the lesions on MRI and US were measured. These measurements were subsequently compared with the pathologic results. The results were divided into the equal, overestimated and underestimated groups. Changes of the therapeutic approach, based on MRI, were also evaluated. RESULTS: Breast cancer was correctly evaluated in 38 of 50 (76%) patients with MRI and in 28 of 50 (56%) patients with US; the cancer was overestimated in 7 of 50 (14%) patients with MRI and in 8 of 50 (16%) patients with US; the cancer was underestimated in 5 of 50 (10%) patients with MRI and in 14 of 50 (28%) patients with US. The therapeutic approach was changed in 11 of 50 (22%) patients, and all the cases underwent modified radical mastectomy. The therapeutic approach was correctly changed in 9 (18%) patients. Unnecessary wider excision was performed in 2 (4%) patients. CONCLUSION: In conclusion, preoperative breast MRI may be a useful modality for preoperative evaluation, especially for the local staging of tumor and the treatment planning of patients with breast cancer.
Breast Neoplasms* ; Breast* ; Humans ; Magnetic Resonance Imaging* ; Mastectomy, Modified Radical

Pulmonary function testing (PFT) is an important and fundamental method in the evaluation and treatment of respiratory diseases. Airway responsiveness assessed using histamine or methacholine by PFT is meaningful for the diagnosis of asthma. Spirometry is simple, and has been the most commonly used technique. However, in younger or uncooperative children, other commercially available tools such as impulse oscillometry (IOS), gas dilution, and plethysmography have been used. IOS is a noninvasive method that allows the measurement of airway mechanics (resistance [R] and reactance [X]) with minimal patient cooperation. Functional residual capacity (FRC) is one of the most important measurements obtained by gas dilution. Plethysmography is a gold standard to measure airway resistance and useful for lung function testing in infants. The purpose of this review is to help pediatric physicians being familiar with PFT techniques used in young children by discussing their principles, clinical applications, limitations, and current accessibility in Korea.
Airway Resistance ; Asthma ; Child* ; Diagnosis ; Functional Residual Capacity ; Histamine ; Humans ; Infant ; Korea ; Lung* ; Mechanics ; Methacholine Chloride ; Oscillometry ; Patient Compliance ; Plethysmography ; Respiratory Function Tests ; Spirometry

Malignant struma ovarii is extremely rare and difficult to diagnose histologically, particularly in cases of follicular carcinoma. This case study is intended to describe three cases of follicular proliferative lesion arising in struma ovarii that we experienced. The first case was clearly malignant given the clinical picture of multiple recurrences, but there was little histological evidence of malignancy. Our second case featured architectural and cellular atypia and necrosis and was diagnosed as malignant despite the absence of vascular and stromal invasion. Our third case exhibited solid microfollicular proliferation without any definite evidence of malignancy (even the molecular data was negative); however, we could not completely exclude malignant potential after conducting a literature review. In cases such as our third case, it has been previously suggested that a diagnostic term recognizing the low-grade malignant potential, such as "proliferative stromal ovarii" or "follicular proliferative lesion arising in the stromal ovarii" would be appropriate.
Adenocarcinoma, Follicular ; Necrosis ; Recurrence ; Struma Ovarii*

PURPOSE: Kawasaki disease (KD) is a systemic panvasculitis that causes coronary artery lesions. KD is accompanied by immunoregulatory abnormalities. Nitric oxide (NO) can induce relaxation of blood vessels by activating guanylate cyclase in smooth muscle cells and high levels of NO may result in coronary artery lesions. We investigated tumor necrosis factor (TNF)-alpha and NO production before and after intravenous immunoglobulin (IVIG) therapy to study the roles of NO and TNF-alpha in KD with coronary artery lesions. METHODS: Serum levels of NO and TNF-alpha were measured in 24 patients with KD (group I, eight patients with normal coronary artery; group II, 16 patients with coronary artery lesions) and 23 controls (group III, 13 afebrile controls; group IV, 10 febrile controls). Blood samples from each subject were drawn before and after IVIG therapy and in the convalescent stage. Serum concentrations of NO and TNF-alpha were measured by enzyme linked immuno sorbent assay. RESULTS: The NO levels before IVIG therapy were significantly higher in group II than in group I, group III and group IV. After IVIG therapy the levels of NO were significantly higher in group I and group II than in group III. The TNF-alpha levels before IVIG therapy were significantly higher in group I and group II than in group III. The serum TNF-alpha and NO levels were higher before IVIG therapy and decreased through the convalescent stage in KD patients. In the acute stage of KD patients with coronary artery lesions, serum NO levels significantly correlated with white blood cells (r=043, P< 0.05). CONCLUSION: The serum concentration levels of TNF-alpha and NO were abnormally high in KD patients and NO concentrations were statistically higher in the KD patients with coronary artery abnormalities than those without coronary abnormality during the early stage of the KD. These results suggest NO may be involved in the development of coronary artery lesions.
Blood Vessels ; Coronary Vessels ; Guanylate Cyclase ; Humans ; Immunoglobulins ; Immunoglobulins, Intravenous ; Leukocytes ; Mucocutaneous Lymph Node Syndrome* ; Myocytes, Smooth Muscle ; Nitric Oxide* ; Relaxation ; Tumor Necrosis Factor-alpha*

OBJECTIVE: This study was proposed to evaluate the electrophysiologic changes in central motor conduction and in silent period (SP) after paraspinal transcutaneous electrical stimulation near caudal area of the spinal cord. METHOD: Conditioning stimulation was applied to T12 paraspinal area for 20 minutes using interferential current therapy (80~100 Hz) in 11 healthy subjects. The amplitude and latency of central motor conduction and duration of SP were measured in motor evoked potential (MEPs) by using magnetic stimulator, before and after the conditioning stimulation. These variables were recorded in both tibialis anterior muscle, innervated from stimulated spinal area, and both abductor pollicis brevis, innervated from cervical cord not directly stimulated by electrical stimulation. RESULTS: After conditioning stimulation, the amplitudes of central motor conduction decreased (p<0.01), and the latencies did not change in both cervical and lumbar muscles in transcranial and spinal MEP studies, and the duration of SP was decreased in same manner (p<0.01). CONCLUSION: These results mean that the excitability of anterior horn cells decreases and the supraspinal inhibitory mechanism of the central motor conduction is suppressed by a certain conditioned electrical cutaneous stimulation in entire spinal cord.
Anterior Horn Cells* ; Electric Stimulation* ; Evoked Potentials, Motor ; Muscles ; Spinal Cord ; Transcutaneous Electric Nerve Stimulation