PURPOSE: The aim of this study was to explore how characteristics of ADHD children affect social support for mothers, parenting stress, parenting sense of competence, coping, and quality of life. The conceptual model was based on the Lazarus and Folkman's stress-evaluation-coping theory. METHODS: Data were collected 208 mothers of children with ADHD. Data were analysed using SPSS 18.0 and AMOS 18.0 programs. RESULTS: The proposed model was good fit for the data based on the model fit indices. Parenting stress, parenting sense of competence and coping directly affected quality of life but characteristics of the children and social support had only an indirect effect. The explanatory power of these variables was 52.1%. CONCLUSION: The results of this study indicate that nursing strategies to increase social support for mothers with ADHD children, lowers parenting stress, improves parenting sense of competence, and guides the parents to choose appropriate coping. In particular, as social support has the strongest influence on the quality of life, it is necessary to develop nursing intervention programs that utilize social support for parents with ADHD children.
Attention Deficit Disorder with Hyperactivity* ; Child* ; Humans ; Mental Competency ; Mothers* ; Nursing ; Parenting ; Parents ; Quality of Life*

Purpose: This study used a mixed methods research design in an attempt to verify the effects of robot-assisted rehabilitation on the gait ability of stroke patients with hemiplegia, and thereby further understand the benefits and challenges of stroke patients’ experiences relying on robot-assisted rehabilitation. Methods: An exploratory sequential mixed methods study design was used in order to combine both quantitative and qualitative data. For the quantitative data collection, a total of 30 stroke patients with hemiplegia were recruited from one rehabilitation hospital. Qualitative data were collected through individual interviews using semi-structured questionnaires for a group of 15 patients who were currently undergoing robot-assisted rehabilitation. The data were analyzed through qualitative content analysis. Results: As a result of the quantitative analysis, there were significant differences between the two groups in terms of daily living activity patterns, total number of steps, and average walking speed. As a result of the qualitative analysis, the four main themes derived consisted of, ‘curiosity about the usage of robot-assisted rehabilitation,’ ‘pleasure experienced while using the robots,’ ‘insufficient information about robots,’ and ‘a lack of education about robot-assisted rehabilitation.’ Conclusions Robot-assisted rehabilitation had a significant effect on the walking ability of stroke patients with hemiplegia. Additionally, stroke patients with hemiplegia experienced difficulty during the course of their robot-assisted rehabilitation, due to a lack of sufficient information on correct usage techniques. These quantitative and qualitative findings could provide the basic foundation for the development of an educational program on robot-assisted rehabilitation.

PURPOSE: This study was done to identify predictive factors influencing suicide probability in Korean adolescents. METHODS: Participants in the study were 575 adolescents from 17 schools with quota sampling by each region in D city. The data were collected from October to November, 2010 using self-report questionnaires about interpersonal relationships and suicide probability (SPS) and analyzed using descriptive statistics, one-way ANOVA with Scheffe of Post Hoc, Pearson's correlation coefficients, and stepwise multiple regression analysis with SPSS/WIN 16.0 program. RESULTS: Suicide probability showed a significantly negative correlation for interpersonal relations with parents, friends and teachers. Interpersonal relationship with parents (p<.001) explained 32% of suicide probability, compared to relationships with peers or teachers, which together was accounted for 46% of the variance. CONCLUSION: The findings suggest that interpersonal relationships with parents should be considered when adolescents suffer from suicidal thinking. Various effective strategies to improve relationships with parents are important to reduce suicide in adolescents.
Adolescent ; Friends ; Humans ; Interpersonal Relations ; Parents ; Surveys and Questionnaires ; Suicide ; Thinking

Hypocomplementemia is found in all types of membranoproliferative glomerulonephritis (MPGN) but not in all patients. Hypocomplementemia can be ascribed to at least two circulating complement reactive modalities. The activation of the classical pathway produced by circulating immune complexes and the presence in the blood of anticomplement autoantibodies, called "nephritic factor"(NF). The activation of the classical pathway by circulating immune complexes is probably the major mechanism responsible for hypocomplementemia in idiopathic MPGN type I. Nephritic factors have been shown to be responsible for the hypocomplementemia in both MPGN type II and III. NFa is probably the major mechanism responsible for the hypocomplementemia of idiopathic MPGN type II. NFt appears to be solely responsible for the hypocomplementemia in MPGN type III. Judging from the complement profile, NFt also may be present in some patients with MPGN type I. Although infection by meningococcus has been associated with deficiency of any of the plasmatic proteins of complement, it more commonly involves deficiency of the terminal components of the complement pathway(C5-C9). We experienced a patient who had MPGN and meningococcal meningitis. We examined the complement level and significantly lower levels of C3, C5 were found persistently. C7 was low at first and it returned to normal range after 2 months. C9 was normal at first, and was low after 2 months. This is the first reported case in which MPGN with meningococcal meningitis occurred.
Antigen-Antibody Complex ; Autoantibodies ; Complement System Proteins* ; Glomerulonephritis, Membranoproliferative* ; Humans ; Meningitis, Meningococcal* ; Neisseria meningitidis ; Reference Values

Background: As the coronavirus disease 2019 (COVID-19) has continued for a couple of years, the long-term effects of the pandemic and the subsequent school curriculum modification on the mental health of children and parents need to be investigated. To clarify the changes that can occur during one school year and to predict the risk factors for vulnerable groups, this study identified parameters relative to children’s screen time, their problematic behavior, and parental depression. Methods: A total of 186 participants were analyzed who were parents of elementary schoolchildren in South Korea. These parents were required to complete a web-based questionnaire twice. The questionnaires were conducted in June 2020 and September 2021. Participants’ general demographics including family income, children’s screen time, sleep patterns, problematic behavior, and parental depression were assessed via the parental questionnaire that included various measurement tools. Results: Children’s body mass index (BMI) increased significantly in 2021 (18.94 ± 3.75 vs. 18.14 ± 3.30, P < 0.001). Smartphone frequency of use per week (5.35 vs. 4.54, P < 0.001) and screen time per day (3.52 vs. 3.16, P < 0.001) significantly increased during the period of the COVID-19 pandemic. The television screen time (2.88 vs. 3.26, P < 0.001), frequency of viewing (3.77 vs. 4.77, P < 0.001), and children’s problematic behaviors significantly decreased (9.15 vs. 11.85,P < 0.001). A lower income household was a key predictor of increased smartphone frequency (B = 1.840, 95% confidence interval [CI], 0.923–2.757, P < 0.001) and smartphone screen time (B = 1.992, 95% CI, 1.458–2.525, P < 0.001). The results showed that the lower income household (B = 5.624, 95% CI, 2.927–8.320, P < 0.001) and a child’s psychiatric treatment history (B = 7.579, 95% CI, 5.666–9.492, P < 0.001) was the most significant predictor of problematic behaviors of children and parental depression (B = 3.476, 95% CI, 1.628–5.325, P < 0.001; B = 3.138, 95% CI, 1.827–4.450, P < 0.001). Conclusion This study suggested that children’s smartphone screen time and BMI increased during COVID-19 because of the school curriculum modification following school closures in South Korea. The increased children’s problematic behaviors and parental depression were predicted by lower-income households and the previous psychiatric history of children. These results indicate that multiple social support systems to the vulnerable group are needed during the ongoing pandemic and that a modified school setting is required.

Duodenal intramural hematoma is mostly caused by blunt abdominal trauma. It is also less commonly reported as a complication of anticoagulation therapy or as a blood dyscrasia, and as a complication of diagnostic/ therapeutic endoscopy. The presentation of these patients is abdominal pain, vomiting, fever and hematochezia, and this is rarely accompanied with intestinal obstruction, severe pancreatitis and acute peritonitis as its complications. The diagnosis is made clear by performing abdominal ultrasonography and abdominal computed tomography. We reported here on one case of intramural duodenal hematoma and hemoperitoneum after performing endoscopic hemostasis in a chronic renal failure patient who was on maintenance hemodialysis.
Abdominal Pain ; Diagnosis ; Duodenum ; Endoscopy* ; Fever ; Gastrointestinal Hemorrhage ; Hematoma* ; Hemoperitoneum* ; Hemostasis, Endoscopic ; Humans ; Intestinal Obstruction ; Kidney Failure, Chronic* ; Pancreatitis ; Peritonitis ; Renal Dialysis ; Ultrasonography ; Vomiting

Hemoptysis in patients with lung cancer is not uncommon and sometimes have dangerous consequences. Hemoptysis has been managed with various treatment options other than surgery and medicine, such as endobronchial tamponade, transcatheter arterial embolization and radiation therapy. However, these methods can sometimes be used only temporarily or are not suitable for a patient's condition. We present a case in which uncontrollable hemoptysis caused by central lung cancer was successfully treated by inserting a covered self-expanding bronchial stent. The patient could be extubated and was able to undergo further palliative therapy. No recurrent episodes of hemoptysis occurred for the following three months. As our case, airway stenting is a considerable option for the tamponade of a bleeding lesion that cannot be successfully managed with other treatment methods and could be used to preserve airway patency in a select group of patients.
*Bronchi ; Carcinoma, Non-Small-Cell Lung/*complications/therapy ; Hemoptysis/etiology/radiography/*therapy ; Humans ; Intubation ; Lung Neoplasms/*complications/therapy ; Male ; Middle Aged ; Palliative Care ; *Stents ; Tomography, X-Ray Computed

BACKGROUND/AIMS: Various strategies to expand the ablation zone have been attempted using hepatic radiofrequency ablation (RFA). The optimal strategy, however, is unknown. We compared hepatic RFA with an internally cooled wet (ICW) electrode and vascular inflow occlusion. METHODS: Eight dogs were assigned to one of three groups: only RFA using an internally cooled electrode (group A), RFA using an ICW electrode (group B), and RFA using an internally cooled electrode with the Pringle maneuver (group C). The ablation zone diameters were measured on the gross specimens, and the volume of the ablation zone was calculated. RESULTS: The ablation zone volume was greatest in group B (1.82+/-1.23 cm3), followed by group C (1.22+/-0.47 cm3), and then group A (0.48+/-0.33 cm3). The volumes for group B were significantly larger than the volumes for group A (p=0.030). There was no significant difference in the volumes between groups A and C (p=0.079) and between groups B and C (p=0.827). CONCLUSIONS: Both the usage of an ICW electrode and hepatic vascular occlusion effectively expanded the ablation zone. The use of an ICW electrode induced a larger ablation zone with easy handling compared with using hepatic vascular occlusion, although this difference was not statistically significant.
Animals ; Catheter Ablation ; Dogs ; Electrodes ; Handling (Psychology) ; Liver

Here we report the case of a 20-year-old female patient previously diagnosed with Hashimoto's thyroiditis and overt hypothyroidism, and who had been taking synthetic thyroxine (100micro/day) for eight months. She experienced intermittent dizziness and generalized weakness, and was diagnosed as having severe autoimmune hemolytic anemia (AIHA). We prescribed prednisolone treatment and continued synthetic thyroxine administration. Two years and five months later, she developed idiopathic thrombocytopenic purpura (ITP) and was diagnosed with Evans' syndrome. Thereafter, laparoscopic splenectomy was performed because her autoimmune hemolytic anemia was refractory and dependent on steroid therapy. The HLA genotypes of the patient were HLA-A*020101/A*2602, HLA-B*270502/B*5401, HLA-Cw*0102/Cw*020202, HLA-DRB1*0404/DRB1*0405, and HLA-DQB1*0302/DQ B1*0401. Hashimoto's thyroiditis is often associated with other nonendocrine autoimmune diseases, and antithyroid antibodies are frequently observed in Evans' syndrome (coexistence of AIHA and ITP). However, there is no report of Evans' syndrome developing in patients with overt hypothyroidism and Hashimoto's thyroiditis. This case suggests that three autoimmune diseases (AIHA, ITP, and Hashimoto's thyroiditis) might share a common immunogenetic pathway in pathogenesis.
Purpura, Thrombocytopenic/blood/*complications ; Humans ; Hashimoto Disease/*complications/radionuclide imaging ; Female ; Anemia, Hemolytic, Autoimmune/blood/*complications ; Adult

PURPOSE: The early detection of breast cancer by screening mammography is important to reduce breast cancer mortality rate. The purpose of this study was to investigate the characteristics of breast cancer patients detected by screening mammography. MATERIALS AND METHODS: Surgically treated 1,265 patients at Asan Medical Center from Jul. 1989 to Dec. 1997 were evaluated. Among them, 119 patients (9.4%) were detected by screening mammography. These patients were compared with clinically detected symptomatic breast cancer group. RESULTS: The characteristics of breast cancer patients detected by screening mammography were as follows: The most common finding of mammography was microcalcifications (62.2%); The less invasive or more conservative minimal and non-destructive surgical treatments such as breast conserving surgery (21.0%), simple mastectomy (8.4%), breast reconstruction (8.4%) were performed more frequently; The median tumor size of invasive cancers was 16 mm; Node-negative cancers (83.2%) were more frequent; The early breast cancer of stage 0 and I was 70.6%; DCIS (29.4%) was highly proportionated; and The 5-year overall (95.8%) and 5-year disease-free survival rate (92.0%) were significantly higher than in clinically detected symptomatic breast cancer patients. CONCLUSION: The screening mammography was significant for detecting non-palpable, early stage breast cancer. Ultrasonography was needed as an adjunct for the accurate detection in dense breast or young women. According to early detection, the 5-year survival rate was high.
Breast Neoplasms* ; Breast* ; Carcinoma, Intraductal, Noninfiltrating ; Chungcheongnam-do ; Disease-Free Survival ; Female ; Humans ; Mammaplasty ; Mammography* ; Mass Screening* ; Mastectomy, Segmental ; Mastectomy, Simple ; Mortality ; Survival Rate ; Ultrasonography