PURPOSE: This study was conducted to examine the effects of a delirium management program on nursing practice and nurses' stress in comprehensive nursing care service units. METHODS: A non-equivalent control group pretest-posttest design was used. The participants were 70 nurses in comprehensive nursing care service units. The nurses were assigned to either a experimental group (n=35) or a control group (n=35). The experimental group received a delirium management program. Data were analyzed using χ² test, Fisher's exact test, independent t-test and ANCOVA. RESULTS: The experimental group showed higher nursing practice than the control group (F=7.86, p=.007). The experimental group showed lower nurses' stress than the control group (F=10.73 p=.002). CONCLUSION The findings indicated that a delirium management program was an effective intervention to improve nursing practice and reduce nurses' stress in comprehensive nursing care service units.

Isolated torsion of the fallopian tube in postmenopausal women is rare. In this case report, we detail the case of a 53-year-old patient who presented with adenomyosis and a left hydrosalpinx with high levels of CA 125 and CA 19-9. The isolated torsion of the left hydrosalpinx was observed during the operation. The serum levels of CA 125 and CA 19-9 were reduced from 129.62 and 348 to 58.2 and 12.41 U/mL, respectively, after total laparoscopic hysterectomy with salpingectomy. On radiologic evaluation, there were no other factors that may have influenced the increase in serum levels of CA 125 and CA 19-9 in this patient, which were reduced after operation. To the best of our knowledge, this is the first case of association between perioperative changes in CA 19-9 levels and isolated torsion of the fallopian tube.
Adenomyosis ; CA-125 Antigen ; CA-19-9 Antigen ; Fallopian Tubes ; Female ; Humans ; Hysterectomy ; Middle Aged ; Salpingectomy

The purpose of this study was examine the general characteristics of relapsed pulmonary tuberculous patients (i.e. age, sex, weight, occupation, previous forms of treatment, drug sensitivity, and the frequency of relapse) in order to improve future treatments of tuberculosis as well as to perpetuate health education. The data was obtained from the medical records of 186 relapsed pulmonary tuberculosis patients who were registered for treatment at various public health officers in Seoul during the year of 1994. The major findings obtained from the study were as follows; l) The male to female ratio of relapsed pulmonary tuberculous patients was about 7:3, more specifically 23.7% of the men and 30.9% of the women were between 20 and 29 years of age. 2) Comparing initial less aggravated states to relapsed states, patients with minimal x-ray findings later proved moderately advanced X-ray findings. Furthermore, patients with negative sputum AEB findings later proved positive sputum AFB findings. 3) of the l86 patients studied, 91.9% suffered, relapse and 8.1% suffered 2 or more relapses. Of the patients who suffered at least 1 relapse, 54.8% received short-term treatment, 26.9% received long-term treatment, and 18.3% received treatment of an unknown during their initial tuberculosis treatment periods. 4) Fifty five point four percent of the patients had no reaction to the drug treatment(not available), 25.9% of the patients had sensitive reaction to the drug treatment, 18.7% of the patients had resistant reaction to the drug treatment. Drug resistance was higher in patients to exhibited positive X-ray findings as well as in patients that exhibited positive sputum findings furthermore, patients receiving treatment of an unknown nature(35.5%) exhibited higher drug resistance than those receiving short-term treatment(13.6%) and long-term treatment(l7.0%). 5) Of the 160 patients who suffered relapses, 8.8% suffered a relapse within 1 year after treatment and 91.2% suffered a relapse at least 1 year after treatment. Furthermore, our study showed that women, under 30, who received short-term treatment and encounterd complications during their primary treatment suffered relapses faster than any other groups studied. In addition, minimal X-ray findings and sputum AFB findings were not correlated to the time relapse occurred. Therefore, the greater efforts are needed to prevent relapsed pulmonary tuberculosis.
Drug Resistance ; Female ; Health Education ; Humans ; Male ; Medical Records ; Occupations ; Public Health* ; Recurrence ; Seoul* ; Sputum ; Tuberculosis ; Tuberculosis, Pulmonary

Anticardiolipin antibodies(ACA) were assayed by an enzyme-linked immunosorbent assay (ELISA) in 68 patients with Behçet's disease. Twenty seven (39.7 %) patients showed levels of ACA five standard deviations above the value of the control group. The frequency of ACA isotype IgM was found to be significantly increased in these patients. However, ACA was not found to have a significant association with clinical activity, thrombosis, positive Venereal Disease Research Laboratory(VDRL) test or antinuclear antibodies (ANA).
Antibodies, Anticardiolipin* ; Antibodies, Antinuclear ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunoglobulin M ; Sexually Transmitted Diseases ; Thrombosis

Noninvasive prenatal test (NIPT) is a novel screening method for the diagnosis of fetal chromosomal aneuploidies. NIPT is based on technology that detects cell-free fetal DNA in maternal plasma and analyzes it with massively parallel sequencing technology to determine whether the fetus is at risk of trisomy 21, trisomy 18, trisomy 13 or sex chromosome abnormalities (SCAs). NIPT has been reported to have sensitivity of 99% and a false positive rate of less than 1% for detecting trisomy 21 and trisomy 18. Although extension of the application of NIPT to other SCAs has been attempted, there are concerns in extending NIPT to SCAs because of maternal or fetal mosaicism, undetected maternal SCAs, and multiple pregnancies. Recently, we assessed a pregnancy with the rare Turner syndrome mosaicism 45, X/47, XXX, which was reported as 45, X with NIPT. We present the case here and briefly review the current literatures on NIPT in testing for fetal monosomy X. To the best of our knowledge, this is the first report of the 45, X/47, XXX mosaicism in Korea to be reported as 45, X by NIPT with whole genome sequencing. This case report will provide valuable information for counseling women who want to undergo NIPT.
Aneuploidy ; Counseling ; Diagnosis ; DNA ; Down Syndrome ; Female ; Fetus ; Genome ; High-Throughput Nucleotide Sequencing ; Humans ; Korea ; Mass Screening ; Mosaicism* ; Plasma ; Pregnancy* ; Pregnancy, Multiple ; Prenatal Diagnosis ; Sex Chromosome Aberrations ; Trisomy ; Turner Syndrome*

A 59-year-old man was rushed to the emergency room. The patient complained of headache with impaired memory function. Brain MRI showed a necrotic tumor in Lt cerebral hemisphere, with severe peritumoral edema (Fig. 1). Pathologic examination of the brain lesion confirmed that the tumor was a small cell lung cancer (SCLC). Chest computed tomography revealed a large soft tissue mass with central necrosis at subcarinal area in spite of an initial normal chest X-ray (Fig. 2). Bronchoscopic biopsy of the polypoid mass at subcarina revealed that the mass was a SCLC (Fig. 3). This is the case of SCLC only with an extrapulmonary symptoms despite of a normal chest X-ray. When metastatic brain tumor was found, appropriate chest evaluation should be performed even though chest X-ray was normal because brain is a common site of invasion of lung cancer.
Biopsy ; Brain ; Brain Neoplasms ; Cerebrum ; Edema ; Emergencies ; Headache ; Humans ; Lung Neoplasms ; Memory ; Middle Aged ; Necrosis ; Small Cell Lung Carcinoma ; Thorax

No abstract available.
Endometriosis* ; Female ; Humans

OBJECTIVE: The aim of our study is to reveal the correlation between the posterior vaginal wall and apex in pelvic organ prolapse. METHODS: We retrospectively reviewed the records of all new patient visits to a urogynecology clinic between January 2013 and December 2015. RESULTS: Four hundred five cases were enrolled in our study. When all POP stages were included, the Bp (pelvic organ prolapse quantification point) had a moderate correlation with the C (Pearson's r=0.419; P < 0.001). Cases where Bp was stage 3 and above presented strong positive correlations with C (Spearman's ρ=0.783; P < 0.001). Cases where C was stage 3 and above presented also strong positive correlations with Bp (Spearman's ρ=0.718; P < 0.001). CONCLUSION: Posterior vaginal wall prolapse and apical prolapse were correlated with each other, and this correlation was more prominent as stage increased. Therefore, when admitting a patient suspected of posterior vaginal wall prolapse or apical prolapse, it is necessary to evaluate both conditions. Especially in cases more severe or equal to stage 3, it is a must to suspect both conditions as the 2 are strongly correlated.
Cystocele ; Humans ; Pelvic Organ Prolapse* ; Prolapse ; Rectocele ; Retrospective Studies ; Uterine Prolapse ; Vagina

Endotracheal intubation has many advantage such as airway protection, maintenance of patent airway, pulmonary toilet, application of positive pressure ventilation, and maintenance of adequate oxygenation. But risks that develop complications related to endotracheal tube always present, when we insert a tube into the trachea. We have experienced an armored tube obstruction with bulged inner wall after EO gas sterilization. So, it is important that we have to pretest a tube and check pateney of the inside of a tube, before endotracheal intubation.
Airway Obstruction* ; Intubation, Intratracheal ; Oxygen ; Positive-Pressure Respiration ; Sterilization ; Trachea

PURPOSE: Acute necrotizing encephalopathy (ANE) is a fulminant disease of the brain characterized by bilateral thalamic lesions, and is prevalent among children in East Asia. The prognosis of ANE is usually poor with a high mortality rate and neurological sequelae. This study aimed to delineate the clinical characteristics and prognostic factors of ANE. METHODS: We retrospectively analyzed clinical data of 399 pediatric patients with encephalitis who were admitted to Samsung Medical Center from December 1998 to March 2011. We enrolled ten patients (11 cases) with ANE and analyzed their demographic, clinical, and neuroimaging data. The location and extent of the brain regions were checked based on fluid-attenuated inversion recovery, T1-, and T2-weighted imaging findings; the presence of contrast enhancement, restricted diffusion, and hemorrhage. RESULTS: Ten patients were identified, including one patient with two episodes. The median age of onset was 1.5 years (0.4-8.4 years). The mortality rate was 40%, and only 30% of patients survived without neurological sequelae. The definite involvement of the brainstem on brain magnetic resonance imaging was significantly correlated with mortality (P=0.04). CONCLUSION: Broad and extensive brainstem involvement suggested the fulminant course of ANE. Early diagnosis of ANE before brainstem involvement, through careful identification of symptoms of brain dysfunction, may be the best way to achieve better neurological outcomes.
Age of Onset ; Brain ; Brain Stem* ; Child ; Diffusion ; Early Diagnosis ; Encephalitis ; Far East ; Hemorrhage ; Humans ; Korea ; Magnetic Resonance Imaging ; Mortality ; Neuroimaging ; Pediatrics ; Prognosis ; Retrospective Studies