Purpose: The purpose of this study was to develop and test the validity and reliability of the Ethical Sensitivity Scale for Clinical Nurses (ESSCN). Methods: 40 items for the preliminary instrument of ESSCN were developed through a literature review and deep interviews with 8 clinical nurses. The scale validation was conducted with a convenience sample of 344 nurses recruited from four general hospitals in Busan and the Gyeongnam area. Content validity, construct validity, criterion validity, convergent validity and discriminative validity were used to evaluate the validity. Cronbach’s ⍺ and test-retest were used to evaluate the reliability of ESSCN. Results: The 36-item ESSCN was found to have eight subscales- patient respect, professional ethics, nursing practice responsibilities, willingness to do good, ethical contemplation, ethical burden, perception of ethical situation and empathy- explaining 61.4% of the total variance. The correlation coefficient between ESSCN and the Korean Moral Sensitivity Questionnaire was .52 (p<.001). Criterion-related validity was supported by known-group comparison. The Cronbach's ⍺ reliability coefficient was .92 and test-retest reliability coefficient was .89 (p<.001). Conclusion The results of this study suggest that the ethical sensitivity scale is a reliable and valid instrument for measuring ethical sensitivity by clinical nurses.

PURPOSE: The purpose of this study was to explore decision making experiences of Korean women with breast cancer who underwent breast reconstruction with/after a mastectomy. METHODS: Data were collected during 2015-2016 through individual in-depth interviews with 10 women who had both mastectomy and breast reconstruction, and analyzed using phenomenological method to identify essential themes on experiences of making a decision to have breast reconstruction. RESULTS: Five theme clusters emerged. First, “expected loss of sexuality and discovery of autonomy” illustrates various aims of breast reconstruction. Second, “holding tight to the reputation of doctors amid uncertainty” specifies the importance of a trust relationship with their physician despite a lack of information. Third, “family members to step back in position” describes support or opposition from family members in the decision making process. Fourth, “bewilderment due to the paradox of appearance-oriented views” illustrates paradoxical environment, resulting in confusion and anger. Lastly, “decision to be made quickly with limited time to oneself” describes the crazy whirling process of decision making. CONCLUSION: Findings highlight aims, worries, barriers, and facilitators that women with breast cancer experience when making a decision about breast reconstruction. Deciding on breast reconstruction was not only a burden for women in a state of shock with a diagnosis of breast cancer, but also an opportunity to decide to integrate their body, femininity, and self which might be wounded from a mastectomy. These findings will help oncology professionals provide effective educational counselling before the operation to promote higher satisfaction after the operation.
Anger ; Breast Neoplasms* ; Breast* ; Decision Making* ; Diagnosis ; Female ; Femininity ; Humans ; Mammaplasty* ; Mastectomy ; Methods ; Qualitative Research ; Sexuality ; Shock ; Wounds and Injuries

To compare the dietary intakes and body composition in the stage of puberty, this study was conducted with 360 girls aged 9 to 12 years in Seoul Korea. Girls's general information and 3-day diet records were collected, fat mass was measured by Inbody 3.0, bone mass at right calcaneus was measured by PIXI and pubertal development was self-assessed by picture of Tanner stages. The results are as follows: Girls who had breast development were 79.7% and 15.8% had pubic hair development. Mean of BMI, BMC and BMD were significantly higher at breast stage3+ (19.6 kg/m2, 1.62 kg, 0.47 g/cm2) than at the breast stage2 (18.2 kg/m2, 1.47 kg, 0.44 g/cm2) or breast stage1 (16.3 kg/m2, 1.32 kg, 0.39 g/cm2)(p < 0.001). Percent body fat of breast stage1, 2, and 3+ were 19.7%, 23.1%, 25.3% respectively and significantly increased during the puberty (p < 0.001). The mean of energy intake was 1629 kcal in stage1, 1664 kcal in stage2 and 1577 kcal in stage3+ showed significant difference in the breast stages (p < 0.05). Energy adjusted sodium intakes and crude fiber intakes were significantly higher in breast stage3+ than other breast stages. For zinc and iron, proportions of subjects with intake levels less than 75% of Korean RDA was over 40% and significantly higher in breast stage3+ than other stages (p < 0.05); for protein and vitamin E, the proportions of subjects with intake levels more than 125% RDA was significantly higher in the stage1. The nutrient adequacy ratio (NAR) for protein and phosphorous was significantly lower in breast stage3+ than other stages. The food groups of seed and nut were 4.7 g/day, 2.3 g/day, 1.8 g/day, respectively, and was significantly higher in breast stage1. In summary, mean of BMI, BMD, BMC and percent of body fat were increased with pubertal development, and those who had higher breast developmental stage showed a lower amount of consumption level in energy, seeds and nuts, and also showed a higher amount of consumption level in energy adjusted sodium and fiber among Korean girls.
Adipose Tissue ; Adolescent ; Body Composition* ; Breast ; Calcaneus ; Diet ; Diet Records ; Energy Intake ; Female* ; Hair ; Humans ; Iron ; Korea ; Nuts ; Puberty ; Seoul ; Sodium ; Vitamin E ; Vitamins ; Zinc

Through a systematic review and meta-analysis of epidemiological studies on dementia, we assessed the prevalence of dementia and its subtypes-Alzheimer' disease (AD) and vascular dementia (VaD)-in Korea. We searched for epidemiological studies on dementia published in 1990-2013 using PubMed, Scopus, EMBASE, KoreaMed, KISS, and RiCH. Dementia prevalence in elderly patients (aged> or =65 yr) was 9.2% (95% confidence interval [CI], 8.2%-10.4%) from 11 studies, which was higher than those from Western and other Asian countries. AD was the most prevalent dementia type, with a prevalence of 5.7% (95% CI, 5.0%-6.4%) from 10 studies compared with 2.1% (95% CI, 1.6%-2.7%) for VaD from 9 studies. The age-specific prevalence of dementia approximately doubled with each 5.8-yr increase of age. Although a significant increasing trend of dementia prevalence was not observed, it increased slightly from 7.3% to 8.7% after 2005; AD prevalence increased after 1995 and VaD prevalence decreased after the early 2000s. The AD/VaD ratio increased from 1.96 in the early 1990s to 4.13 in the 2010s, similar to the worldwide ratio. Owing to this high prevalence in the aging population, dementia will impose significant economic burdens to Korean society.
Age Factors ; Alzheimer Disease/epidemiology ; Asian Continental Ancestry Group ; Databases, Factual ; Dementia/*epidemiology ; Dementia, Vascular/epidemiology ; Humans ; Prevalence ; Quality Assurance, Health Care ; Republic of Korea

PURPOSE: To determine whether the wall thickening of the maxillary sinus is a characteristic finding in aspergillosis. MATERIALS AND METHODS: In 103 patients, including 26 with aspergillosis, 21 with inverted papilloma (IP), and 56 with unilateral chronic sinusitis, the thickness of the maxillary sinus wall was determined by CT scanning. All cases were proven pathologically, and patients with a history of previous surgery or bone destruction were excluded. Two neuroradiologists retrospectively reviewed the CT scans using bone window settings for sinus wall hyperostosis and the presence of intrasinus calcification. Thickening of the maxillary sinus wall was assessed visually in a semiquantitative manner, and graded as 'none'(absence of thickening), 'mild'(thickening of up to 1.5 times), or moderate to severe(over 1.5 times thicker than normal contralateral sinus wall at its thickest point). RESULTS: Moderate to severe wall thickening was found only in patients with aspergillosis (21/26, 80.8%). Mild wall thickening was seen in two patients with aspergillosis (2/26, 7.7%), in 12 of 21 with IP (57.1%), and in 5 of 56 with chronic maxillary sinusitis (8.9%). Most cases of chronic maxillary sinusits (51/56, 91.1%), 9/21 IP cases (42.9%), and 3/26 cases of aspergillosis (11.5%) showed no thickening of the maxillary sinus wall. Calcifications were found in 18 patients with aspergillosis (69.2%), in no patient with IP (0%), and in one with chronic maxillary sinusitis (1.8%). CONCLUSION: We suggest that 'moderate to severe' wall thickening of the maxillary sinus is the characteristic finding of aspergillosis. Although various sinonasal diseases can cause bone change, CT findings of hyperostosis of the maxillary sinus and intrasinus calcification are very helpful in differentiating fungal sinusitis from other types of chronic inflammatory lesions.
Aspergillosis* ; Humans ; Hyperostosis* ; Maxillary Sinus* ; Maxillary Sinusitis ; Papilloma, Inverted ; Retrospective Studies ; Sinusitis ; Tomography, X-Ray Computed

Purpose: Although Mycoplasma pneumoniae (M. pneumoniae) infection can cause wheezing in non-asthmatic children, the mechanisms of this symptom remain unclear. Vascular endothelial growth factor (VEGF) is a major mediator of angiogenesis and vascular permeability, and is also known to be elevated in cases of chronic pulmonary disease such as asthma. We hypothesized that VEGF may increase in children with acute M. pneumoniae pneumonia and wheezing. Methods: Nine patients with clinical and laboratory evidence of acute M. pneumoniae pneumonia were enlisted from children admitted to Korea University Hospital. They had had more than one episode of wheezing during the illness, which was confirmed by a physician; they comprised the wheezer group. The individuals with M. pneumoniae pneumonia without wheezing were 63 in number, and they comprised the non-wheezer group. Patients with a history of asthma or who had received asthma medications were excluded. Serum concentrations of VEGF, total IgE, eosinophil cationic protein (ECP), and peripheral blood eosinophil counts were measured. Results: The serum VEGF concentrations were higher in the wheezer group (mean+/-SD; 650.2+/-417.9 pg/mL) than in the non-wheezer group (376.5+/-356.2 pg/mL, P=0.049). M. pneumoniae antibody (1:1,380 vs. 1:596, P=0.048) and serum total IgE (591.8 IU/mL vs. 162.2 IU/mL, P=0.032) were higher in the wheezer group than in the non-wheezer group. There were no differences between the two groups in terms of serum ECP concentration or blood eosinophil count. Conclusion: In the presence of wheezing, serum VEGF concentrations were higher in the children with M. pneumoniae pneumonia. This finding suggests that VEGF may associate with wheeze-related symptoms in children with acute M. pneumoniae pneumonia.
Asthma ; Capillary Permeability ; Child ; Eosinophil Cationic Protein ; Eosinophils ; Humans ; Immunoglobulin E ; Korea ; Lung Diseases ; Mycoplasma ; Mycoplasma pneumoniae ; Pneumonia ; Pneumonia, Mycoplasma ; Respiratory Sounds ; Vascular Endothelial Growth Factor A

We report a case of a large peritoneal loose body diagnosed on computed tomography. The most common causes of a peritoneal loose body are thought to be torsion and separation of the appendices epiploicae. Peritoneal loose bodies are usually small, 0.5 to 2.5 cm in diameter. However, "giant" peritoneal loose bodies, larger than 4 cm in diameter, are an uncommon disease and present with various symptoms, and are difficult to diagnose preoperatively. Especially, abdominal large peritoneal loose bodies are frequently misdiagnosed as tumorous disease preoperatively. In our case, the loose body appeared as a round pelvic mass with central calcifications and a distinct fat plane separating it from adjacent organs. Preoperatively, we suspected a tumorous lesion from the wall of the upper rectum; however, at laparoscopy, a large peritoneal loose body was detected. An extraction of the giant peritoneal loose body was performed laparoscopically.
Laparoscopy

Rounded atelectasis is a focal, pleural-based lesion that is the result of pleural and subpleural scarring and atelectasis of the adjacent lung tissue. We experienced a case of asbestosassociated rounded atelectasis that had developed in a 50-year-old male. When examined with routine chest radiography, the patient was shown to have an asymptomatic chest mass.Computed tomography showed a pleural-based mass with a curvilinear shape about 4.2 cmin greatest diameter in the medial basal segment of the right lower lobe. To exclude the possibilityof malignancy the mass was excised by video-assisted thoracotomy. The mass wasround and firm, and was gray and yellow in color. Microscopically, marked pleural fibrosisextended into the underlying lung parenchyme and then resulted in atelectasis. There areferruginous bodies in dense fibrous pleura.
Asbestos ; Cicatrix ; Humans ; Lung ; Lung Diseases ; Male ; Middle Aged ; Pleura ; Pulmonary Atelectasis* ; Radiography ; Thoracotomy ; Thorax

Malignant pleural mesothelioma is an uncommon neoplasm which is accompanied extremely rarely by osteoblastic heterologous elements. The CT manifestations of this tumor have been reported in several references. And, to our knowledge, only one case report provides a description of the bone scan findings. Here, we report the case of a rapidly progressing malignant pleural mesothelioma with heterologous osteoblastic elements. A CT scan reveals diffuse irregular pleural thickening and very coarse nodular calcifications along the right pleura and major fissure. A bone scan revealed an area of extensive increased radioactivity consistent with the pleural calcifications on the CT scan in the right hemithorax. A follow-up CT scan performed 40 days later suggests the presence of rapidly progressing nodular coarse calcifications.
Follow-Up Studies ; Mesothelioma ; Osteoblasts ; Osteogenesis ; Pleura ; Pleural Neoplasms ; Radioactivity ; Tomography, X-Ray Computed

Propylthiouracil (PTU) is a drug that's used to manage hyperthyroidism and it can, on rare occasions, induce antineutrophil cytoplasmic antibody-associated vasculitis that involves multiple organ systems and it can also cause extremely rare isolated or diffuse pulmonary hemorrhage. We report here on a case of a patient who developed diffuse pulmonary hemorrhage after she had been taking PTU for five years. The patient is a 33-year-old woman who presented with hemoptysis. Simple chest radiographs and the chest CT showed bilateral ground-glass opacity, consolidation and pulmonary arterial hypertension. The bronchoalveolar lavage fluid revealed alveolar hemorrhage. The laboratory values showed increased perinuclear-antineutrophil cytoplasmic antibody (p-ANCA) and anti-peroxidase antibody titers.
Adult ; Bronchoalveolar Lavage Fluid ; Cytoplasm ; Female ; Hemoptysis ; Hemorrhage* ; Humans ; Hypertension ; Hyperthyroidism ; Propylthiouracil ; Radiography, Thoracic ; Tomography, X-Ray Computed ; Vasculitis