PURPOSE: The purpose of this research was to describe the decision making of nurses in a VIP ward. METHOD: The methodology of collecting and analyzing the data was based on the grounded theory of Strauss and Corbin (1998). The data were collected through an in-depth interview, which were audio-taped and transcribed. The data were collected from 10 nurses from July to November 2007. RESULTS: The core category on VIP ward nurses' decision making was named as "adjusting with flexibility and deepened insight." The causal condition was established by 'the patients who wanted to be treated specially.' The contextual conditions included 'caring patients from various departments,' 'differences depending on the nurses' clinical experience,' and 'client-centered atmosphere in the VIP ward.' The intervening conditions included 'problem solving styles of nurses', 'attitudes of patients and family members', 'nurse-doctor relationships', and 'accessibility to information.' It was confirmed that nurses changed their action-interaction strategies depending on the intervening conditions, thus resulted in the nurses' role conflict and the need to expand their consciousness. CONCLUSION: The result of this study indicates that nurse's decision making depends on their experiences and the nature of social context in which nursing occurs.
Atmosphere ; Consciousness ; Decision Making ; Humans ; Pliability ; Qualitative Research

BACKGROUND: A healthy diet is important for the prevention and management of major chronic diseases including cancer, cardiovascular disease, diabetes, and obesity. However, the effect of dietary intervention-based education and consultation has not been satisfactory. This study sought to investigate the effects of a diet intervention supplying food directly to the workplace cafeteria. METHODS: Study subjects included 36 employees (23 men) staffed at two companies located in Seoul and Gyeonggi-do. Participants were supplied with liquid meals made mainly with fruits and vegetables for breakfast and dinner. Lunch was supplied as well and comprised of a balanced diet. Consumption of other foods, except water and provided snacks, were prohibited. The program also included light exercise, yoga, and mind-body control for 20 minutes, three times a week. Changes in anthropometric and metabolic parameters were evaluated. RESULTS: None of the subjects complained of serious adverse effects or dropped out of the program. Post-intervention mean body weight and body fat mass decreased significantly (-3.3 kg and -2.0 kg respectively, p<0.001 for both comparisons). There were additional reductions in systolic blood pressure (-6.7 mmHg, p<0.001), fasting glucose (-9.0 mg/dL, p<0.001), total cholesterol (-13.9 mg/dL, P=0.005), triglyceride (-44.0 mg/dL, p<0.001), and insulin (-2.4 uIU/mL, P=0.007). The satisfaction rate of the program was 88%. CONCLUSIONS: This study showed that a diet intervention supplying food directly to the workplace cafeteria could succeed in decreasing body weight and improving metabolic parameters, most likely due to high compliance.
Adipose Tissue ; Blood Pressure ; Body Weight ; Breakfast ; Cardiovascular Diseases ; Cholesterol ; Chronic Disease ; Compliance ; Diet ; Fasting ; Fruit ; Glucose ; Insulin ; Light ; Lunch ; Meals ; Obesity ; Pilot Projects ; Snacks ; Triglycerides ; Vegetables ; Yoga

Picosulfate sodium/Magnesium citrate (PS/MC) is a common bowel cleansing agent for colonoscopy. It is equally effective and better tolerated by patients with regard to taste and volume than polyethylene glycol. However, because of its osmotically active characteristics, PS/MC can cause plasma volume depletion and electrolyte disturbances, such as hyponatremia. Here, we report a case of severe hyponatremia combined with loss of consciousness in a 59-year-old woman following ingestion of PS/MC as bowel preparation for a screening colonoscopy. Upon arrival, serum sodium level was 109 mEq/L and urine osmolality and sodium levels were 393 mOms/Kg and 99 mmol/L, respectively. She was euvolemic and showed normal kidney, thyroid, and adrenal function. Based on these findings, inappropriate anti-diuretic hormone syndrome (SIADH) was diagnosed. She was treated with 3% hypertonic saline and completely recovered without any neurologic sequelae. This case shows that SIADH can be caused by PS/MC (not accompanied by dehydration), even in patients without any underlying renal, heart, or liver diseases.
Citric Acid* ; Colonoscopy ; Detergents ; Eating* ; Female ; Heart ; Humans ; Hyponatremia* ; Inappropriate ADH Syndrome ; Kidney ; Liver Diseases ; Mass Screening ; Middle Aged ; Osmolar Concentration ; Plasma Volume ; Polyethylene Glycols ; Sodium ; Thyroid Gland ; Unconsciousness

PURPOSE: This study was undertaken to correlate the CT and histopathologic findings of abscess wall. MATERIALS AND METHODS: The CT findings of 12 patients with pathologically proven brain abscess were retrospectively analyzed with particular attention to the thickness, smoothness and uniformity of enhancing abscess wall, and the results were correlated with histopathologic findings. RESULTS: Two patients with acute cerebritis showed an isodense ring on non-contrast CT(NCCT), but a true capsule formation could not be identified at pathologic examination. Six other patients with isodense ring on NCCT consisted of early to late cerebritis(3 cases), late cerebritis to early capsule(1 case), early capsule(1 case), and late capsule(1 case). These 6 cases showed ring enhancement on contrast enhanced CT(CECT) and true capsule formation pathologically. There was no isodense ring on NCCT in the remaining four patients. They consisted of early to late cerebritis(2 cases), late cerebritis(1 case), and late cerebritis to early capsule formation(1 case). These also showed ring enhancement on CECT and true capsule formation pathologically. CONCLUSION: We found that it is difficult to predict the exact stage of brain abscess on preoperative CT findings. It is suggested that clinical findings and sequential dynamic CT may provide more detailed informations for evaluation of abscess staging.
Abscess ; Brain Abscess* ; Brain* ; Humans ; Retrospective Studies

To evaluate the clinical characteristics of unilateral open-angle glaucoma, patients diagnosed with unilateral open-angle glaucoma from January 2017 to October 2018 were divided into primary open-angle glaucoma and normal-tension glaucoma groups according to the type of glaucoma diagnosed. The glaucoma and the contralateral eyes were compared, and the contralateral eye was analyzed for conversion to glaucoma and its risk factors were assessed during the 2-year follow-up period. Among 99 patients, 36 were diagnosed with primary open-angle glaucoma and 63 with normal-tension glaucoma. When comparing the glaucoma eye with the contralateral eye, the visual field mean deviation value (all p<0.001), peripapillary retinal nerve fiber layer thickness (all p<0.001), macular ganglion cell layer-inner plexiform layer thickness (p< 0.001, p=0.003), and optic nerve cup-disc ratio (p=0.005, p<0.001) were significantly different in both the primary open-angle glaucoma and normal-tension glaucoma groups. In normal-tension glaucoma, peripapillary retinal nerve fiber layer thickness was significantly thinner in the glaucoma conversion group than in the glaucoma non-conversion group (p=0.008). It was significantly associated with glaucoma conversion (odds ratio=0.97, p=0.023). In conclusion, in patients with unilateral open-angle glaucoma, the contralateral eye may develop glaucoma. In particular, if the peripapillary retinal nerve fiber layer thickness is decreased in normal-tension glaucoma, the possibility of glaucoma conversion is high; hence, careful examination is required.

To evaluate the clinical characteristics of unilateral open-angle glaucoma, patients diagnosed with unilateral open-angle glaucoma from January 2017 to October 2018 were divided into primary open-angle glaucoma and normal-tension glaucoma groups according to the type of glaucoma diagnosed. The glaucoma and the contralateral eyes were compared, and the contralateral eye was analyzed for conversion to glaucoma and its risk factors were assessed during the 2-year follow-up period. Among 99 patients, 36 were diagnosed with primary open-angle glaucoma and 63 with normal-tension glaucoma. When comparing the glaucoma eye with the contralateral eye, the visual field mean deviation value (all p<0.001), peripapillary retinal nerve fiber layer thickness (all p<0.001), macular ganglion cell layer-inner plexiform layer thickness (p< 0.001, p=0.003), and optic nerve cup-disc ratio (p=0.005, p<0.001) were significantly different in both the primary open-angle glaucoma and normal-tension glaucoma groups. In normal-tension glaucoma, peripapillary retinal nerve fiber layer thickness was significantly thinner in the glaucoma conversion group than in the glaucoma non-conversion group (p=0.008). It was significantly associated with glaucoma conversion (odds ratio=0.97, p=0.023). In conclusion, in patients with unilateral open-angle glaucoma, the contralateral eye may develop glaucoma. In particular, if the peripapillary retinal nerve fiber layer thickness is decreased in normal-tension glaucoma, the possibility of glaucoma conversion is high; hence, careful examination is required.

By using (99m)Tc-Pertechnetate, we evaluated the thyroid function of 136 persons with uptake slopeindex(U.S.I.) which was calculated by computerized dynamic flow study. Also, we compared our results of U.S.I.with those of established ¹³¹I-24 hr uptake % in given materials by comparative analysis of their correlation with the hormonal values of T3, T4, Free T4. The results wre as follows: 1. The U.S.I. of euthyroidismal group and hyperthyrodismal group were 4.87±2.26, 27.67±9.56 respectively. The ¹³¹I-24 hr uptake % of above groups were29.22±10.23, and 71.45±15.51. So the differentiation of the two groups could be done more easily by using (99m)Tc-Pertenchnetate U.S.I. than by using ¹³¹I-24 hr uptake %. 2. The correlation rates between (99m)Tc-Pertechnetate U.S.I. and other laboratory hormon levels, T3, T4, Free T4, ar almost parallel with thosebetweeen ¹³¹I-24 hr uptake % and the values of T3, T4, Free T4. Also the direct correlation rate between (99m)Tc-Pertechnetate U.S.I. and ¹³¹I-24 hr uptake % was 0.898. So, the method of thyroidal function evaluation by (99m)Tc-Pettechnetate U.S.I. is very reliable. 3. The (99m)Tc-Pertechnetate U.S.I. is very helpful to evaulate thefunctions of each lobe respectively incases of having obviously different radioactivity between both lobes. 4. (99m)Tc-Pertechnetate used dynamic thyroid function study and scan can be performed during the short time without preparation and especially helpful in debilitating patient and patients under antithyroid drug therapy, who need repetitive follow-up examination.
Drug Therapy ; Follow-Up Studies ; Humans ; Methods ; Radioactivity ; Thyroid Gland

No abstract available.
*Diagnostic Errors ; Eosinophilia/*diagnosis/pathology/radiography ; Fluorodeoxyglucose F18/*diagnostic use ; Humans ; Liver Abscess/*diagnosis/pathology/radiography ; Liver Neoplasms/diagnosis/secondary ; Male ; Middle Aged ; Positron-Emission Tomography ; Radiopharmaceuticals/*diagnostic use ; Tomography, X-Ray Computed

BACKGROUND: In unilateral ureteral obstruction (UUO), the obstructed kidney is characterized by interstitial fibrosis and an increase in transforming growth factor (TGF)-beta1. Interstitial expression of TGF-beta1 is important in tublointerstitial fibrosis. The objectives of this study is to make new ribbon-type antisense oligodeoxynucleotides (ODN) for TGF-beta1 which are resistant to exonuclease and to examine the effcets of TGF-beta1 on reducing tubulointerstitial fibrosis of the kidney. METHODS: We introduced a new ribbon-type antisense ODN for TGF-beta1 in rats using the UUO model to block interstitial fibrosis by tail vein injection. A combination of one antisense sequences for TGF-beta1 was adopted to construct a large antisense molecule with a loop and stem. Artificial viral envelope (AVE)-type hemagglutinating virus of Japan (HVJ)-liposomes were used as a vector system for the delivery of antisense ODN. RESULTS: The levels of TGF-beta1 mRNA was decreased more in the cultured mesangial cells treated with ribbon-type antisense ODN than in that of a linear-type antisense ODN for TGF-beta1. TGF-beta1 mRNA was increased markedly in the interstitium of untreated obstructed kidneys. Northem analysis revealed that the levels of TGF-beta1 mRNA were decreased in the obstructed kidneys treated with antisense ODN. The fibrosis of the obstructed kidneys treated with ribbon-type antisense ODN was dramatically less than that of the untreated group. CONCLUSIONS: These results demonstrate that the introduction of new ribbon-type antisense ODN for TGF-beta1 may be a potential therapeutic maneuver for preventing interstitial fibrosis.
Animals ; Fibrosis ; Kidney ; Mesangial Cells ; Oligodeoxyribonucleotides* ; Rats ; RNA, Messenger ; Sendai virus ; Transforming Growth Factor beta1 ; Transforming Growth Factors ; Ureter* ; Ureteral Obstruction* ; Veins

Since 1976, 938 cases of E.R.C.P. were performed at the Kwangju Christian Hospital & since December 1981, 19 cases of Endoscopic papillotomy(E.P.T.) were performed, following Results were obtained: 1) Out of 19 cases which were diagnosed by E.R.C.P.; 17 cases of C.B.D. stones, 1 case of ascaris in bile duct, 1 case of remained C.B.D. stone diagnosed by T-tube cholangiogram after operation, & E.P.T. was done in total 19 casees. 2) During 1st E.P.T., 2 cases were removed by Dormia basket under direct visualization & during 2nd E.P.T., 5 cases were removed by Dormia basket under direct visulization & 12 cases were passed in stool & 3x3.5cm large stone passage was found. 3) Complications of E.P.T. were noted in 2 cases: 1 case of bleeding was treated by blood transfusion & 1 case of Acute pancreatitis was treated by medical care.
Ascaris ; Bile Ducts ; Blood Transfusion ; Common Bile Duct* ; Gwangju ; Hemorrhage ; Pancreatitis ; Sphincterotomy, Endoscopic*