PURPOSE: To analyse complications and to review usefulness of large needle(18G) in percutaneous transhepatic biliary drainage(PTBD). MATERIALS AND METHODS: 46 patients underwent PTBD in 52 occassions using large needle. 44 of 46 patients had either definite or suspicious malignant biliary obstruction, and most patients were poor in general dondition. Complications were classified as acute type if developed within 30 days and as delayed type if developed after 30 days. Acute type was subdivided into severe and mild forms. RESULTS: Severe forms of complications were death(5.8%), septicemia(3.8%), and bile peritonitis(1.9%). There were not different from the rate of complication in PTBD using fine needle but the procedure was much more simple. CONCLUSION: We PTBD using large neddie is a simple and safe procedure for prompt bile decompression.
Bile ; Decompression ; Drainage* ; Humans ; Needles*

BACKGROUND: This study was performed to develop a dietary self-efficacy questionnaire and to determine how dietary self-efficacy is related to selected biochemical markers and health-related quality of life in hemodialysis patients. METHODS: Participants included 172 patients who had been participating in a dialysis program for at least 6 months at two teaching hospitals. A questionnaire was used to assess socio-demographic factors, dialysis-related factors, dietary self-efficacy, and kidney disease quality of life (KDQOL). Serum levels of potassium and phosphorus and interdialytic weight gain were also measured. RESULTS: The internal reliability of dietary self-efficacy was 0.944 (Cronbach's alpha). Principal component analysis resulted in two factors, situational self-efficacy of compliance with dietary guidelines and self-efficacy of food choice. The correlation analysis showed a significant association between situational self-efficacy of compliance with dietary guidelines and serum potassium and KIDQOL. The average scores of situational self-efficacy of compliance with dietary guidelines and self-efficacy of food choice in the participants were 3.52+/-0.72 and 3.61+/-0.71 respectively. Multiple linear regression analysis showed that the situational self-efficacy of compliance with dietary guidelines was significantly associated with serum potassium level and KDQOL and self-efficacy of food choice was significantly associated with KDQOL. CONCLUSIONS: Based on our results, the developed dietary self-efficacy questionnaire may be a suitable survey tool for hemodialysis patients, which can play a role in predicting clinical indicators of patient and health-related quality of life. We recommend further research into clarifying whether the positive effects of increased dietary self-efficacy is maintained in long-term dialysis patients.
Biomarkers ; Compliance ; Dialysis ; Diet ; Hospitals, Teaching ; Humans ; Kidney Diseases ; Linear Models ; Phosphorus ; Potassium ; Principal Component Analysis ; Quality of Life ; Renal Dialysis ; Self Efficacy ; Weight Gain

Purpose: The purpose of this study was to analyze the influence of self-directed learning ability and self-leadership on the learning satisfaction and academic achievement of nursing students who experienced blended learning. Methods: This research was conducted from June 29 to July 17, 2023, targeting nursing students from three universities in Seoul, Gyeonggi, and Incheon who had experienced blended learning. The collected data were analyzed using a independent t-test, ANOVA, Pearson’s correlation coefficient, and multiple regression utilizing IBM SPSS 25.0. Results: Self-directed learning ability, self-leadership, learning satisfaction, and academic achievement were all found to have positive correlations. The research variables that showed a significant effect on learning satisfaction were self-directed learning ability (β=.34, p<.001) and self-leadership (β=.19, p=.041), and the explanatory power was 28.0%. The research variable that showed a significant effect on academic achievement was self-directed learning ability (β=.56, p<.001), with an explanatory power of 40.0%. Conclusion To effectively apply blended learning to nursing students in the rapidly changing field of nursing education, it is important to analyze learner factors such as self-directed learning ability and self-leadership. Continuing research is needed to explore the learner factors that influence learning satisfaction and academic achievement, and systematic educational programs that can improve these factors will have to be applied.

OBJECTIVES: This study aimed to identify psychopathologies of sexually abused children and intervening variables of symptom severity. METHODS: Eighty-four school-aged children were identified for sexual abuse from a center for child sexual abuse by psychiatrists, clinical psychologists, and social workers. We analyzed correlations among symptom severity, types of sexual abuse, gender, age, relationship with the abuser, family system, and current and past psychopathologies. RESULTS: The percentage of victims with particular psychiatric disorders (current) were 79.8%. Children without identifiable disorders were 20.2%, but these children had significantly increased scores on self report scales of anxiety (RCMAS), depression (CDI), and withdrawal scores on parental reports of child behavior checklist (K-CBCL). Sixty nine percent of abused children had primary diagnosis related to sexual abuse in DSM-IV diagnositic system. PTSD was 41.7%, depressive disorder was 38.1%, and anxiety disorder was 21.4%. Psychopathologies were more severe if perpetrators were of acquaintance or if victims had previous psychopathologies or parent-child relational problems. Types of primary caregiver and older age were also related to the severity of psychopathologies. CONCLUSION: Present study suggests that most victims of childhood sexual abuse suffer from significant psychological distress. Intervening variables are relationship with the perpetrator, previous mental health status, age of the child, type of the primary care taker, and the quality of parent-child relationship.
Anxiety ; Anxiety Disorders ; Caregivers ; Checklist ; Child Abuse, Sexual ; Child Behavior ; Child* ; Depression ; Depressive Disorder ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Korea* ; Mental Health ; Parent-Child Relations ; Parents ; Primary Health Care ; Psychiatry ; Psychology ; Psychopathology* ; Self Report ; Sex Offenses ; Social Workers ; Stress Disorders, Post-Traumatic ; Weights and Measures

No abstract available.
Erythrocyte Membrane* ; Erythrocytes* ; Hydroxyl Radical* ; Lipid Peroxidation* ; Macrophages, Alveolar* ; Mineral Fibers*

PURPOSE: This study was conducted to evaluate the economic efficiency of a community-based nursing care center to help policy makers determine whether or not to invest in similar facilities. METHODS: The subjects were 101 elderly people over 65 years who participated in a health management program from February 1 to July 31, 2007. Direct cost was estimated with center operations cost, medical cost for out-patients and pharmacy cost. Indirect cost was measured by transportation cost. Direct benefit was calculated by saved medical cost for out-patients, saved pharmacy cost, saved transportation cost, and reducing hospital charges. Indirect benefit was estimated with prevention of severe complications. Economic efficiency was evaluated by cost-benefit ratio and net benefit. RESULTS: Operating a community-based nursing care center was found to be cost-effective. Specifically, the cost of operating the center evaluated here was estimated at 135 million won while the benefit was estimated at 187 million won. Benefit-cost ratio was 1.38. CONCLUSION: The Community-based nursing care center that was described here could be a useful health care delivery system for reducing medical expenditures.
Administrative Personnel ; Aged ; Community Health Nursing ; Cost-Benefit Analysis ; Delivery of Health Care ; Diabetes Mellitus ; Health Expenditures ; Hospital Charges ; Humans ; Hypertension ; Nursing Care ; Outpatients ; Pharmacy ; Transportation

PURPOSE: This study was done to survey health behaviors in people at risk for a Cerebrovascular Accident(CVA). METHOD: From November 21 to December 29, 2005, a questionnaire survey was conducted with 171 people at risk for a Cerebrovascular Accident(LDL of above 130 mg/dl & homocysteine of above 15.0 micromol/L). Their physical composition was measured and blood was collected. RESULTS: 1. Of the subjects, 34.5% were smokers, 61.4% were drinkers, 56.7% did not exercise regularly, 57.3% did not control their weight, 26.9% preferred eating meat, and 32.2% preferred salty food. 2. The gender was different between smoking status(Chi2=10.734, p= .001), and drinking status(Chi2=7.185, p= .007), and the age was different between smoking status(Chi2=6.656, p= .010), and drinking status(Chi2=10.722, p= .001). The HbA1C level was different for regular exercise(Chi2= 4.824, p=.028) and the HDL-cholesterol was different for meat-eating preference(Chi2=7.928, p= .005). The observance of troubling signs was different for a salty food preference(Chi2=4.313, p= .038). CONCLUSION: It is necessary to develop programs for taking care of people at risk for a Cerebrovascular Accident and test the effects of the programs in order to reduce the risk factors of CVA and enhance health behavior promotion.
Aged ; Aged, 80 and over ; Alcohol Drinking ; Body Weight ; Chi-Square Distribution ; Cholesterol, HDL/blood ; Cholesterol, LDL/blood ; Exercise ; Female ; *Health Behavior ; Humans ; Male ; Middle Aged ; Nutritional Status ; Questionnaires ; Risk Factors ; Smoking ; Stroke/*epidemiology/etiology

PURPOSE: This analysis was conducted to evaluate the cost-effectiveness of gemcitabine-cisplatin chemotherapy for non small-cell lung cancer patients in an outpatient setting compared with the traditional inpatient setting. METHODS: A cost-effective analysis was conducted from a societal perspective. The effects of treatment, which was measured as an adverse event rate, were abstracted from a published literature search and empirical data from one university hospital. The costs included both direct and indirect costs. Direct costs included hospitalizations, outpatient visits, and lab tests. Pharmaceutical costs were excluded in analysis because they were same for both options. Indirect costs included productivity loss of patients as well as care-givers. In order to determine the robustness of the results, sensitivity analysis on treatment protocol was conducted. RESULTS: Literature search showed no difference in adverse effect rates between inpatient treatment protocol and outpatient treatment protocol. Therefore, this analysis is a cost-minimization analysis. Cost-savings in the outpatient setting was 555,936 won for one treatment cycle. Our sensitivity analysis indicated that the outpatient chemotherapy still showed cost-savings, regardless of changes in treatment protocol. CONCLUSION: The outpatient gemcitabine-cisplatin chemotherapy for non small-cell lung cancer resulted in cost savings compared to inpatient chemotherapy. More importantly, outpatient chemotherapy could improve the utilization of health service resources in terms of available beds.
Antineoplastic Combined Chemotherapy Protocols/*economics/therapeutic use ; Carcinoma, Non-Small-Cell Lung/*drug therapy/*economics ; Cisplatin/*economics/therapeutic use ; Cost Allocation ; Cost-Benefit Analysis ; Deoxycytidine/*analogs & derivatives/economics/therapeutic use ; Humans ; Lung Neoplasms/*drug therapy/*economics ; Outpatients

Early recognition of coalescence in pneumoconiotic lesions is important because such coalescence is associated with the respiratory symptoms and deterioration of lung function. This complicated form of pneumoconiosis also has worse prognosis than does simple pneumoconiosis. High resolution computerized tomography(HRCT) provides significant additional information on the stage of the pneumoconiosis because it easily detects coalescence of nodules and emphysema that may not be apparent on the simple radiograph. The Purpose of this study is to clarify the role of HRCT in detection of large opacity and the relationship of change between the coalescence of nodules or emphysema and lung function in dust exposed workers. 1. There was good correlation between the HRCT grade of pneumoconiosis and ILO category of profusion. 5(9.09%) in 55 study population had confluent nodule extending over two or more cuts on HRCT. HRCT could identify the pneumoconiotic nodules which was not found by simple radiography in 6 workers with category 0/0. 2. No significant difference was observed coalescence of nodules and emphysema by dust type. 3. There was no significant difference in pulmonary function according to ILO and HRCT classification. 4. HRCT could detect the significant reduction in FEV1, FEV1/FVC, PEER, FEF25, FEF50, and FEF75 and remarkable increase in RV and TLC in study persons with emphysema compared with non-emphysema group. 5. Emphysema was found more often in nodules-coalescence group than small opacity group by HRCT. We found that HRCT could easily detect areas of coalescence and complicated emphysema compared to plain chest X-ray. Also our data suggest that it is primarily the degree of emphysema rather than the degree of pneumoconiosis that determines the level of pulmonary function.
Classification ; Dust ; Emphysema ; Humans ; Lung ; Pneumoconiosis* ; Prognosis ; Radiography ; Thorax

Silica exposure results in acute inflammatory response followed by chronic fibrotic change. The mechanism for the maintenance of silica-induced inflammation has not been understood yet. Apoptosis is a morphologically distinct form of programed cell death that plays major role during homeostasis and in many diseases including cancer, acquired immune deficiency syndrome and neurodegenerative disorders. Apoptosis is characterized by cell shrinkage, membrane blebbing and nuclear condensation. To demonstrate the involvement of apoptosis in underlying mechanism for the development of silica-induced pathological changes, this study was designed in vitro and in vivo models. In in vitro study, alveolar epithelial cell line (A549) was stimulated with silica and performed flow cytometry and DNA electrophoresis. In in vivo study, bronchoalveolar lavage (BAL) was done to count the total and apoptotic cells from silica-instilled rats. The results were as follows: 1. Apoptotic cell fraction of silica-treated groups (10 and 50 microgram/cm2) was significantly higher than that of control group. 2. Genomic DNA from silica-treated groups (10 and 50 microgram/cm2 ) showed DNA ladder in agarose gel electrophoresis, while group of 1 microgram/cm2 didn't. 3. Total cell number and apoptotic cell number of BAL fluid from silica-instilled rats (10, 20 and 40 mg/kg) were significantly higher than those of control. 4. Silica induced apoptosis of cells in BAL fluid was confirmed by microscopic observation with nuclear fragmentation. These results suggest that apoptosis may contribute to development of silica-induced pathological changes.
Acquired Immunodeficiency Syndrome ; Animals ; Apoptosis* ; Blister ; Bronchoalveolar Lavage ; Cell Count ; Cell Death ; DNA ; Electrophoresis ; Electrophoresis, Agar Gel ; Epithelial Cells ; Flow Cytometry ; Homeostasis ; Inflammation ; Membranes ; Microscopy ; Neurodegenerative Diseases ; Rats ; Silicon Dioxide* ; Silicosis