PURPOSE: The aim of this study was to evaluate the effects of tailored case management using a gatekeeper on depression and life satisfaction in the single-household elderly population. METHODS: The design of Quasi experiment was applied to compare the variables before and after the management. Ninety-seven people who had depression categorized by the Korean Geriatric Depression Scale. RESULTS: Depression (t=11.22, p<.001) and life satisfaction (t=-5.36, p<.001) were improved after management in comparison to the results of pre-tests, and the differences were statistically significant. The difference in the pre-test and post-test scores of the support system (chi2=13.89, p<.001) were significant, while the differences in the perception of depression (chi2=.02, p=.891) and coping methods (chi2=.34, p=.558) were not statistically significant. CONCLUSION: Tailored case management using a gatekeeper is effective to reduce the degree of depression and improve life satisfaction in the single-household elderly population having depression. This study offers a model of individualized as well as systemic mental health care for the community of single-house hold elderly people as an effective means for prevention of and early intervention in depression.
Aged ; Case Management ; Depression ; Early Intervention (Education) ; Gatekeeping ; Humans ; Mental Health

No abstract available.
Mass Screening*

PURPOSE: The purpose of this study was to understand the meditation experiences of breast cancer survivors. METHODS: The participants were 20 breast cancer survivors who participated in 8 weeks of mind subtraction meditation at a tertiary hospital in Korea 2013. The data was collected by in-depth individual interviews, personal logs about the meditation experiences, and field diaries. Data were analyzed using Giorgi's phenomenological analysis. RESULTS: A total of 13 subthemes and 4 themes were derived from the analysis. Participants began to meditate with some doubts initially but were soon comfortable as they became familiar with the meditation method. As they discarded their negativity, they experienced positive changes in their mindset. The experiences of discarded negativity were summarized as "discarding the hate, resentment, and obsession," "discarding the depression, anxiety, and stress," and "discarding the false me." The change after meditation was named "from restraint to freedom," "from negativism to positivism," "from closed doors to the wide open world." and "looking forward to the true happiness." CONCLUSION: Breast cancer survivors reflected on their lives and experienced positive changes as they discarded their negativity through meditation. It is recommended to perform the nursing interventions utilizing the meditation and conduct further studies to examine its beneficial effects.
Anxiety ; Breast Neoplasms* ; Breast* ; Depression ; Hate ; Humans ; Korea ; Meditation* ; Methods ; Negativism ; Nursing ; Qualitative Research ; Survivors ; Tertiary Care Centers

PURPOSE: This study investigates the effect of pregnant women's growth mindset on the stress of pregnancy through ego-resilience. METHODS: The subjects included 551 pregnant women in Seoul and Gyeonggi area. Data were collected using a structured questionnaire; statistical, frequency, correlation, and structural equation analyses were performed using SPSS21 and M-plus 7.0. RESULTS: First, pregnant women's growth mindset had a direct effect on pregnancy stress. Second, the mediating pathway that influenced pregnancy stress through the ego-resilience of growth mindset was significant. CONCLUSION: These results suggest that it is important to devise and practice a method to improve the growth mindset of pregnant women, enhance ego-resilience, and reduce the negative effects of stress by reducing pregnancy stress.
Female ; Gyeonggi-do ; Humans ; Methods ; Negotiating ; Pregnancy ; Pregnant Women ; Seoul

Anesthesia for the patients with mediastinal mass may be associated with significant respiratory and cardiovaacular complications due to compression of traeheobronchial trees, the pulmonary artery, heart and superior vena cava The authors present a case of a 6-year-old girl with a large mediastinal tumor located in anterior and superior mediaetinum. Preoperatively, the patient was asymptomatic and anesthesia was induced and maintained uneventfully. Operative finding was that 8 X 14 cm sized hemangioma was extended superiorly over thoracic outlet, posteriorly aorta and SVC, medially pericardium and right hilum and inferiorly right upper lung and pleura. Because difficulties in removal of the hemangioma were expected, exploratory thoracotomy was discontinued. On emergence, as soon as the patient was extubated due to irritability, the patient became cyanotic and was noticed bulging mass on right supraclavicular area, Intubation was attempted and during direct laryngoscopy, anesthesiologist also noticed a bulging mass in right oral cavity. Postoperatively, the patients airway was kept with endotracheal tube, but cyanosis appeared on the face and skin over the chest, but not below the abdomen. Bulging mass on right supraclavicular area, distension of neck vein and conjunctival edema were noticed only when the patient was crying or suctioned. Symptoms improved by deep sedation. We assumed that enlargement of hemangioma due to increased central blood volume occasionally compressed tracheobronchial tree and sup. vena cava when patient was irritable, crying and coughing. On 11th postoperative day, patient was transferred to the another hospital for the better treatment with endotracheal intubation.
Abdomen ; Airway Obstruction* ; Anesthesia ; Aorta ; Blood Volume ; Child ; Cough ; Crying ; Cyanosis ; Deep Sedation ; Edema ; Female ; Heart ; Hemangioma ; Humans ; Intubation ; Intubation, Intratracheal ; Laryngoscopy ; Lung ; Mouth ; Neck ; Pericardium ; Pleura ; Pulmonary Artery ; Skin ; Suction ; Thoracotomy ; Thorax ; Veins ; Vena Cava, Superior

This study was understand in order to examine the effect of hardness on stress-causing factors, defined in this study as burnout in nursing. The subjects were 248 nurses working in three general hospitals in Taejon. The instruments used for this study were a survey of general characteristics, modified Health-Related Hardiness Scale(HRHS) (25 items), job stress scale (63 items), and burnout scale(20 items). Analysis of data was done through the mean, percentage, Person correlation coefficient, and stepwise multiple regression done with a SAS program. The results of this study are as follows. 1) The average item score for the job stress was high at 4.44. In the subcategories, the highest degree of stress was night duty(5.11), and work overload(4.70), responsibility for extra affairs(4.70), conflict in nurse-doctor relationships(4.69), and low reward (4.63) in that order. 2) In the stepwise multiple regression analysis, hardiness(11.55%) was a significant determinant of burnout along with job stress(17.24%) and job duration(12.94%). The results of this study show that hardiness has an effect on psychological distress caused by stress.
Daejeon ; Hardness ; Hospitals, General ; Humans ; Nursing ; Reward

BACKGROUND: This study was performed to determine the biopsy sites that are suitable for the diagnosis of Helicobacter pylori infection and to assess the sensitivity of culture, histology, and dual-priming oligonucleotide (DPO)-based multiplex PCR. Moreover, we evaluated the usefulness of PCR for the detection of 23S rRNA mutations, which are responsible for the clarithromycin resistance of H. pylori. METHODS: From 90 patients, we obtained biopsy specimens for culture, histology, and Seeplex(R) ClaR-H. pylori PCR (Seegene Inc., Korea). Phenotypic susceptibility to clarithromycin was evaluated using the E-test (AB Biodisk, Sweden). RESULTS: H. pylori was detected in 48 of 90 patients. The positive rates of infection in the antrum and body were higher than those in the biopsies obtained from the duodenal bulb. The positive rates in histology, PCR, and culture were 46.7%, 42.2%, and 34.4%, respectively. Using histology or PCR, we identified H. pylori in 46 of the 48 patients. 23S rRNA mutations were detected in 8 patients. The clarithromycin E-test showed that all the 10 wild-type patients were susceptible. However, the results of the PCR and E-test of 3 of the 8 mutation-positive patients were discrepant. CONCLUSIONS: We observed that a combination of histology and PCR affords a high detection rate of H.pylori infection and that DPO-based PCR can be practically used for the diagnosis of H. pylori infection and the determination of clarithromycin resistance. These techniques were useful for biopsy sampling simultaneously from the antrum and body for the detection of clarithromycin resistance of multiple strain infection or heteroresistance.
Anti-Bacterial Agents/*pharmacology ; Biopsy ; Clarithromycin/*pharmacology ; Drug Resistance, Bacterial ; Genotype ; Helicobacter Infections/*diagnosis/drug therapy/pathology ; Helicobacter pylori/drug effects/genetics/*isolation & purification ; Humans ; Microbial Sensitivity Tests ; Mutation ; Polymerase Chain Reaction ; RNA, Ribosomal, 23S/genetics

We have studied thirty two cases of inappropriately treatable and intractable epileptics to various anti-convulsants. Zonisamide had a definite anti-epileptic activity in eleven subjects(52.4%) of intractble epilepsy. Five patients(45.5%), who were previously inappropriately treatable epileptic patients became seizure free on zonisamide. Two subjects were withdrawn from study because of side effect and two subjects were also withdrawn because of uncontrolled seizure. Zonisamide is not only effective in intractable epileptic patients but also in first trial for untreated epileptic patients.
Epilepsy ; Humans ; Seizures

The aim of this study was to measure the cusp deflection during composite restoration for MOD cavity in premolar and to examine the influence of cavity dimension, C-factor and restoration method on the cusp deflection. Thirty extracted maxillary premolar were prepared to four different sizes of MOD cavity and divided into six groups. The width and depth of the cavity were as follows. Group 1; 1.5 x 1 mm, Group 2; 1.5 x 2 mm, Group 3; 3 x 1 mm, and Group 4-6; 3 x 2 mm respectively. Group 1-4 were restored using bulk filling method with Z-250 composite. However, Group 5 was restored incrementally, and Group 6 was restored with an indirect resin inlay. The cusp deflection was recorded at the buccal and lingual cusp tips using LVDT probe for 10,000 seconds. The measured cusp deflections were compared between groups, and the relationship between the cube of the length of cavity wall/the cube of the thickness of cavity wall (L3 / T3), C-factor and cusp deflection or %flexure (100 x cuspal deflection / cavity width) was analyzed. The cusp deflection of Group 1-4 were 12.1 microm, 17.2 microm, 16.2 microm and 26.4 microm respectively. The C-factor was related to the %flexure rather than the cusp deflection. There was a strong positive correlationship between the L3 / T3 and the cusp deflection. The cusp deflection of Group 5 and 6 were 17.4 microm and 17.9 microm respectively, which are much lower value than that of Group 4.
Bicuspid ; Inlays

The present study was aimed at investigating the regulation of atrial natriuretic peptide (ANP) system in association with either enhanced or attenuated activity of the renin-angiotensin system (RAS). The cardiac tissue mRNA and peptide levels of ANP were measured in rats with two-kidney, one clip (2K1C) or deoxycorticosterone acetate (DOCA)-salt hypertension. Plasma renin concentration was increased in 2K1C hypertension along with increases of renin mRNA and protein contents in the clipped kidney. On the contrary, it was suppressed in DOCA-salt hypertension along with decreases of renin mRNA and protein contents in the remaining kidney. The plasma ANP concentration was similarly increased in both models of hypertension. The cardiac tissue ANP contents were not significantly changed, but the tissue ANP mRNA levels were upregulated in the hypertrophied heart in these two models of hypertension. It is suggested that the cardiac ANP system is transcriptionally enhanced by cardiac hypertrophy associated with hypertension, independent of the systemic RAS.
Animal ; Atrial Natriuretic Factor/metabolism* ; Desoxycorticosterone ; Gene Expression Regulation ; Hypertension/metabolism* ; Hypertension/chemically induced ; Male ; Myocardium/pathology ; Organ Weight ; Peptides ; RNA, Messenger/analysis ; Rats ; Rats, Sprague-Dawley ; Renin/genetics* ; Renin/blood* ; Renin-Angiotensin System/physiology