Purpose: This pilot study aimed to examine the influence of death counseling on perceptions, preparedness, and anxiety regarding death and dying among family caregivers of hospice patients. Methods: Death counseling developed based on the SPIKES model was provided to 37 family caregivers in a hospice and palliative care unit. Perceptions, preparedness, and anxiety regarding death were assessed with a self-administered structured questionnaire, and participants’ scores before and after counseling were compared using the paired t-test. Results: Significant changes were found in perceptions, preparedness, and anxiety regarding death after counseling. Compared to before counseling, the scores for perceptions of death (t=-4.90, P＜0.001) and preparedness for death and dying (t=-16.23, P＜0.001)improved, while anxiety (t=3.72, P=0.001) decreased after counseling. Some changes were also found in the types of support that family caregivers needed to prepare for the death of their family members in the hospice care unit. Conclusion The findings demonstrate that death counseling could help family caregivers prepare for the death of their loved ones.Hospice and palliative care providers should play a key role in supporting family caregivers of hospice patients by developing strategies for counseling.

Purpose: The aim of this study was to compare the short-term outcomes of two-dimensional (2D) and three-dimensional (3D) laparoscopic surgery for total extraperitoneal (TEP) primary inguinal hernia repair. Methods: This was a single-center, retrospective, observational database study of 38 patients who underwent laparoscopic TEP inguinal hernia repair from March 1, 2019 to August 30, 2019 at Kyung Hee University Hospital at Gangdong in Seoul, Korea. Results: There was no significant difference in sex ratio, age, or body mass index between the two groups. The 2D group had two patients with direct hernia and 18 patients with indirect hernia. The 3D group had five patients with direct hernia, 11 patients with indirect hernia, and two patients with femoral hernia. The mean operation time was 38.2 minutes in the 2D group compared with 37.2 minutes in the 3D group. There was no severe intraoperative bleeding in either group. During the operation, peritoneal tearing occurred in 12 out of 20 patients in the 2D group compared with five out of 18 patients in the 3D group (p = 0.02). The average length of hospital stay was 1.3 days in both groups. The numeric rating scale score was 3.3 and 3 in the 2D group and the 3D group, respectively. In the 2D group, two patients revisited the outpatient clinic because of the postoperative occurrence of seroma and varicocele. Conclusion A 3D laparoscopic surgery is feasible and safe for inguinal hernia repair and showed less peritoneal tearing compared with 2D laparoscopic surgery for primary inguinal hernia repair.

Purpose: The aim of this study was to compare the short-term outcomes of two-dimensional (2D) and three-dimensional (3D) laparoscopic surgery for total extraperitoneal (TEP) primary inguinal hernia repair. Methods: This was a single-center, retrospective, observational database study of 38 patients who underwent laparoscopic TEP inguinal hernia repair from March 1, 2019 to August 30, 2019 at Kyung Hee University Hospital at Gangdong in Seoul, Korea. Results: There was no significant difference in sex ratio, age, or body mass index between the two groups. The 2D group had two patients with direct hernia and 18 patients with indirect hernia. The 3D group had five patients with direct hernia, 11 patients with indirect hernia, and two patients with femoral hernia. The mean operation time was 38.2 minutes in the 2D group compared with 37.2 minutes in the 3D group. There was no severe intraoperative bleeding in either group. During the operation, peritoneal tearing occurred in 12 out of 20 patients in the 2D group compared with five out of 18 patients in the 3D group (p = 0.02). The average length of hospital stay was 1.3 days in both groups. The numeric rating scale score was 3.3 and 3 in the 2D group and the 3D group, respectively. In the 2D group, two patients revisited the outpatient clinic because of the postoperative occurrence of seroma and varicocele. Conclusion A 3D laparoscopic surgery is feasible and safe for inguinal hernia repair and showed less peritoneal tearing compared with 2D laparoscopic surgery for primary inguinal hernia repair.

PURPOSE: To understand the essentials of rearing conflict experience by three shift nurses in advanced general hospitals. METHODS: The design was a qualitative research of phenomenology. Participants were 7 shift nurses working in advanced general hospitals who were rearing young children. Data were collected individually through in-depth interview on their life experiences. Data were analyzed by Colaizzi's phenomenological methodology. RESULTS: Eighteen themes were drawn from 256 meaningful experiences and these themes were integrated to six theme clusters. The most influencing themes were ‘Regret that I cannot satisfy even the slightest wish’, ‘Fail to care for kids’, and ‘Mutual feeling to care giver between appreciation and inconvenience’. Other themes were as follows: ‘Body and mind are broken’, ‘The need for a three-shift system to support nurses who are rearing children’, ‘Doing my best for work and child rearing’. CONCLUSION: The nature of three-shift nurses working in advanced hospital and caring kids is explained as ‘lives with conflict’ between work and home. This study suggests it is necessary to establish a 24-hour care center for 3-shift nurses to keep working while rearing their children.
Caregivers ; Child ; Hospitals, General ; Humans ; Life Change Events ; Qualitative Research

Background: and Purpose The purpose of this study was to describe the clinical presentation and features in electrodiagnostic and imaging investigations of young South Korean males diagnosed with Hirayama disease (HD). Methods: We reviewed the electronic medical records of South Korean enlisted soldiers who were diagnosed with HD and discharged from military service during 2011–2021. We investigated the clinical characteristics and results of electrodiagnostic and magnetic resonance imaging (MRI) investigations. We analyzed laterality and identified the involved muscles using needle electromyography (EMG). Loss of lordosis, localized cervical cord atrophy, loss of attachment between the posterior dura and subjacent lamina, asymmetric flattening of the cord, crescent-shaped mass in the posterior epidural space, and noncompressive intramedullary T2-weighted high signal intensity were investigated using neutral- or flexion-position MRI. Results: Forty-two male patients aged 20.2±0.8 years (mean±standard deviation) were identified. All patients complained of hand weakness, and 10 complained of hand tremor (23.8%).Four patients (9.5%) had symptoms in both upper limbs, and five (11.9%) had sensory disturbances. Needle EMG revealed that muscles in the C7–T1 myotome were commonly involved, and C5–C6 involvement of the deltoid (10.5%) and biceps brachii (12.5%) was also observed.In cervical MRI, localized cord atrophy (90.0%) was the most characteristic finding, and cord atrophy was most severe at the C5–C6 level (58.3%). Conclusions This is the first description of a large number of patients with HD in South Korea.The clinical presentation and features found in electrodiagnostic and imaging investigations will improve the understanding of HD in the young South Korean male population.

OBJECTIVES: Smoking is known to be associated with nephropathy in patients with diabetes. The distinct effects of smoking before and after diabetes has been diagnosed, however, are not well characterized. We evaluated the association of cigarette smoking before and after a diagnosis of diabetes with the presence of diabetic nephropathy. METHODS: We analyzed data from the 2011-2013 editions of the Korea National Health and Nutrition Examination Survey. A total of 629 male patients diagnosed with diabetes were classified as non-smokers (90 patients), former smokers (225 patients), or continuing smokers (314 patients). A "former smoker" was a patient who smoked only before receiving his diagnosis of diabetes. A "continuing smoker" was a patient who smoked at any time after his diabetes had been diagnosed. Diabetic nephropathy was defined as the presence of albuminuria (spot urine albumin/creatinine ratio ≥30 mg/g) or low estimated glomerular filtration rate (<60 mL/min/1.73 m2). Multiple logistic regression models were used to assess the independent association after adjusting for age, duration of diabetes, hemoglobin A1c, body mass index, systolic blood pressure, medication for hypertension, and medication for dyslipidemia. Female patients were excluded from the study due to the small proportion of females in the survey who smoked. RESULTS: Compared to non-smokers, continuing smokers had significantly higher odds ratio ([OR], 2.17; 95% confidence interval [CI], 1.23 to 3.83) of suffering from diabetic nephropathy. The corresponding OR (95% CI) for former smokers was 1.26 (0.70 to 2.29). CONCLUSIONS: Smoking after diagnosis of diabetes is significantly associated with the presence of diabetic nephropathy in the Korean male population.
Aged ; Albumins/analysis ; Asian Continental Ancestry Group ; Blood Pressure ; Body Mass Index ; Creatinine/urine ; Diabetes Mellitus, Type 2/complications/*diagnosis ; Diabetic Nephropathies/epidemiology/*etiology ; Female ; Glomerular Filtration Rate ; Hemoglobin A, Glycosylated/analysis ; Humans ; Logistic Models ; Male ; Middle Aged ; Nutrition Surveys ; Odds Ratio ; Prevalence ; Republic of Korea ; Smoking/*adverse effects

Metastatic tumors to the heart are far more frequent than primary tumors of the heart. Cardiac metastasis may be detected up to 30 percent of patients with fatal lung cancers. Metastatic cancer to the heart is difficult to suspect. Where cardiac metastasis is diagnosed ante-mortem, signs and symptoms of the primary cancer are usually the presenting features and the presence of cardiac involvement is often incidentally detected. We experienced a case of 35-year-old woman with metastatic lung cancer invading the left atrium via pulmonary vein, which was not proved pathologically. She presented with hemoptysis and chest pain. Transthoracic echocardiography demonstrated massive cardiac infiltration with tumor and decreased cardiac wall motion, correlating with the chest CT findings, which were also remarkable for the presence of intracardiac mass and direct invasion to adherent pericardium, pulmonary vein and left atrium. We suggest that careful examination of 2D echocardiography can be noninvasive and valuable tool for diagnosis of metastatic cancer to the heart.
Adult ; Carcinoma, Large Cell* ; Chest Pain ; Diagnosis ; Echocardiography ; Female ; Heart ; Heart Atria* ; Hemoptysis ; Humans ; Lung Neoplasms ; Lung* ; Neoplasm Metastasis* ; Pericardium ; Pulmonary Veins ; Tomography, X-Ray Computed

PURPOSE: Human parechovirus (HPeV) and enterovirus (EV) are causative agents of a sepsis-like illness in neonates and of infections of the central nervous system in young children. The objectives of this study were to assess the prevalence of HPeV3 and EV infection in young children with a sepsis-like illness or with meningitis in Jinju, Korea. METHODS: Cerebrospinal fluid (CSF) samples were collected from 267 patients (age range, 1 day to 5 years) and assessed for HPeV and EV by performing reverse transcription polymerase chain reaction assay. Amplification products of the VP3/VP1 region of HPeV and of the VP1 region of EV were sequenced to identify the virus type. RESULTS: HPeV and EV were detected in 3.4% and 7.5% of the total CSF samples assessed, respectively. The age distribution of EV-positive patients (median age, 1.4 months) had a significantly broader range than that of HPeV-positive patients (median age, 7.8 months). The peak seasons for HPeV and EV infection were spring and summer, respectively. The clinical symptoms for HPeV and EV infection were similar, and fever was the most common symptom. Pleocytosis was detected in 22.2% of HPeV-positive patients and 35.5% of EV-positive patients. The VP3/VP1 gene sequence of the nine Korean strains clustered most closely with the Japanese strain (AB759202). CONCLUSION: The data indicate that HPeV infection is predominant in young infants (<6 months) and that meningitis without pleocytosis was caused by both HPeV and EV infection in children.
Age Distribution ; Asian Continental Ancestry Group ; Central Nervous System ; Cerebrospinal Fluid* ; Child* ; Enterovirus* ; Fever ; Gyeongsangnam-do ; Humans ; Infant ; Infant, Newborn ; Korea ; Leukocytosis ; Meningitis ; Parechovirus* ; Polymerase Chain Reaction ; Prevalence* ; Reverse Transcription ; Seasons

STUDY DESIGN: A radiological analysis of the sagittal balance in younger and older aged volunteers. OBJECTIVES: To determine the normal range of the sagittal spinal alignment, and define significant spinopelvic compensations over the hip axis for the sagittal balance with aging. SUMMARY OF LITERATURE REVIEW: Normative data of the sagittal spinal alignment has wide variation and limited clinical usefulness. In addition, the extent to which the "normal"sagittal spinal contour changes with aging remains unknown. MATERIALS AND METHODS: Inclusion criteria were an age between 20 and 29 years (n=50), group A, and between 55 and 65 years (n=50), group B, for the asymptomatic subjects. Measurements made on the standing lateral radiographs included the following: thoracic kyphosis, lumbar lordosis and sagittal vertical axis. In addition, measurements of the sacropelvic translation, spinopelvic balance, pelvic incidence, pelvic tilting and sacral slope were made. RESULTS: The average thoracic kyphosis was 24 degrees, ranging from 3 to 42 degrees, in group A, and 33 degrees, ranging from 9 to 53 degrees, in group B (p<0.001). The average lumbar lordosis was -47 degrees, ranging from -65 to -23 degrees, and -51 degrees, ranging from -69 to -33 degrees, in groups A and B, respectively (p>0.05). The C7 plumb line, on average, fell 15.4 mm more anteriorly to the posterosuperior corner of S1 in group B than in group A (p<0.05). The anterior positioning of the C7 was also positively correlated with decreasing lordosis (p<0.001). The average sacropelvic translation was -41mm, ranging from -76 to 20 mm, and -48 mm, ranging from -76 to -17 mm, in groups A and B, respectively (p<0.05). The average spinopelvic balance was -57 mm, ranging from -104 to -4 mm, and -49 mm, ranging from -101 to -3 mm, in groups A and B, respectively. The C7 plumb line fell posterior to the hip axis in all cases. The average pelvic incidence was 46 degrees, ranging from 30 to 61 degrees, and 54 degrees, ranging from 28 to 76 degrees, in groups A and B, respectively (p<0.05). The average pelvic tilt was 14 degrees, ranging from 4 to 33 degrees, and 19 degrees, ranging from 3 to 37 degrees, in groups A and B, respectively (p<0.05). The average sacral slope was 32 degrees, ranging from 17 to 47 degrees, and 35 degrees, ranging from 25 to 50 degrees, in groups A and B, respectively (p<0.05). There was significant correlation between pelvic incidence and lumbar lordosis (p<0.001). CONCLUSIONS: The sagittal spinal balance is maintained by spinopelvic compensations over the hip axis with aging, and sacropelvic parameters over the hip axis are important for the evaluation of the sagittal spinal balance.
Aging ; Animals ; Axis, Cervical Vertebra ; Hip ; Incidence ; Kyphosis ; Lordosis ; Pelvis ; Reference Values ; Volunteers*

STUDY DESIGN: A radiological analysis of the sagittal balance in younger and older aged volunteers. OBJECTIVES: To determine the normal range of the sagittal spinal alignment, and define significant spinopelvic compensations over the hip axis for the sagittal balance with aging. SUMMARY OF LITERATURE REVIEW: Normative data of the sagittal spinal alignment has wide variation and limited clinical usefulness. In addition, the extent to which the "normal"sagittal spinal contour changes with aging remains unknown. MATERIALS AND METHODS: Inclusion criteria were an age between 20 and 29 years (n=50), group A, and between 55 and 65 years (n=50), group B, for the asymptomatic subjects. Measurements made on the standing lateral radiographs included the following: thoracic kyphosis, lumbar lordosis and sagittal vertical axis. In addition, measurements of the sacropelvic translation, spinopelvic balance, pelvic incidence, pelvic tilting and sacral slope were made. RESULTS: The average thoracic kyphosis was 24 degrees, ranging from 3 to 42 degrees, in group A, and 33 degrees, ranging from 9 to 53 degrees, in group B (p<0.001). The average lumbar lordosis was -47 degrees, ranging from -65 to -23 degrees, and -51 degrees, ranging from -69 to -33 degrees, in groups A and B, respectively (p>0.05). The C7 plumb line, on average, fell 15.4 mm more anteriorly to the posterosuperior corner of S1 in group B than in group A (p<0.05). The anterior positioning of the C7 was also positively correlated with decreasing lordosis (p<0.001). The average sacropelvic translation was -41mm, ranging from -76 to 20 mm, and -48 mm, ranging from -76 to -17 mm, in groups A and B, respectively (p<0.05). The average spinopelvic balance was -57 mm, ranging from -104 to -4 mm, and -49 mm, ranging from -101 to -3 mm, in groups A and B, respectively. The C7 plumb line fell posterior to the hip axis in all cases. The average pelvic incidence was 46 degrees, ranging from 30 to 61 degrees, and 54 degrees, ranging from 28 to 76 degrees, in groups A and B, respectively (p<0.05). The average pelvic tilt was 14 degrees, ranging from 4 to 33 degrees, and 19 degrees, ranging from 3 to 37 degrees, in groups A and B, respectively (p<0.05). The average sacral slope was 32 degrees, ranging from 17 to 47 degrees, and 35 degrees, ranging from 25 to 50 degrees, in groups A and B, respectively (p<0.05). There was significant correlation between pelvic incidence and lumbar lordosis (p<0.001). CONCLUSIONS: The sagittal spinal balance is maintained by spinopelvic compensations over the hip axis with aging, and sacropelvic parameters over the hip axis are important for the evaluation of the sagittal spinal balance.
Aging ; Animals ; Axis, Cervical Vertebra ; Hip ; Incidence ; Kyphosis ; Lordosis ; Pelvis ; Reference Values ; Volunteers*