Sixty-three patients with permanent sigmoid colostomy were surveyed to evaluate their satisfaction and complications with the "irrigation technique" and the "atural evacuation" of the colostomy management (irrigation technique; 32 patients, natural evacuation; 31 patients). All patients had colostomy for at least 12 months without disease recurrence. Each patient was interviewed in addition to standard questionnaire. The irrigation was not associated with any major complication including colonic perforation. The irrigation was used younger age group than the natural evacuation (53+/-10 vs. 62+/-12, P=0.01). The frequency of bowel movement was lower in the irrigation than in the natural evacuation (5.1+/-2.5/wk vs. 10.8+/-9.0/wk, P=0.04). Five patients (16%) of the irrigation experienced spontaneous bowel action but only one patient suffered from it. The time spent for managing irrigation was 59+/-13 minutes. Twenty-three patients (74%) of the natural evacuation suffered from one or moreproblems such as expensive apparatus, leakage, skin irritation or odor. Sixteen patients (52%) of the natural evacuation and 2 patients (6%) of the irrigation were restricted in social activity (P=0.0001). Thirteen patients (42%) of the natural evacuation and 1 patient (3%) of the irrigation were dissatisfied with colostomy management (P=0.002). Thus, the irrigation technique seems to be more effective and satisfactory method for managing colostomy without compromising patient's social activity when it is performed in appropriately selected patients.
Colon ; Colon, Sigmoid ; Colostomy* ; Humans ; Odors ; Surveys and Questionnaires ; Rectal Neoplasms ; Recurrence ; Skin

The cause of essential hypertension is yet unknown, but in general is caused by interaction of hereditary factors, diet, obesity, lack of exercise and stress. The aging process influences various physiological mechanism related to regulation of blood pressure. So elderly hypertensives have a tendancy to consider the disease as a result of the physiological aging process. This attitude causes many complications, worsening of the disease and even early death because of inappropriate care. In order to improve self-management of elderly hypertensives in this study the researcher examined the effect of blood pressure regulation by an education program that improves self-care behavior, through increasing self-efficacy. The education program consisted of group education on hypertension and self-care strategies, and encouraging and reinforcing self-efficacy resources such as verbal persuation, performance accomplishment and vicarious experiences. A quasi-experimental pre-and post-test design was used. Thirty-two elderly hypertensives participated in the study. Eighteen in the education group and fourteen in the control group. The education program consisted of eight sessions twice a week for four weeks. There was no intervention for the control group. Data were analysed using SPSS for Windows(Version 8.0). The results were as follows. 1. There was a significant decrease in systolic and diastolic blood pressure between the experimental group and control group over three different times, and interaction by groups and over time. 2. There was no significant difference in the level of self-care behavior between the experimental group and control group over three different times, and interaction by groups and over time. 3. There was significant difference in self-efficacy of experimental and control group, depending on the measuring period, but there was no difference between these groups on interaction by groups and over time. 4. There was positive correlation between self efficacy and self care behavior depending on the measuring period. There was negative correlation between diastolic blood pressure and self-care behavior on the posttest of the program, and between systolic blood pressure and self-care behavior on the follow-up test of the program. Findings indicate that this study will contribute to develop nursing strategies for the regulation of blood pressure for the elderly, which is easy for the elderly to learn as a nonpharmacologic approach.
Aged* ; Aging ; Blood Pressure* ; Diet ; Education* ; Follow-Up Studies ; Humans ; Hypertension ; Nursing ; Obesity ; Self Care* ; Self Efficacy

The authors performed a retrospective review on 27 eyes of 23 children with vitreous hemorrhage, to assess the natural history, the outcome of vitrectomy and the important prognostic factors. Mean age was 3. 7 years(range: birth~13.5 years). The causes of vitreous hemorrhage included trauma(6 patients), retinopathy of prematurity(5 patients), persistent hyperplastic primary vitreous(4 patients)and others(8 patients). Spontaneous absorption of vitreous hemorrhage in 11 of 27 eyes was observed and took mean 2. 5 months. Sixteen eyes had undergone vitrectomy for persistent vitreous hemorrhage(mean duration: 3. 4 months). Follow up period was mean 32. 8 months(range: 20~79 months). Visual improvement was achieved in 70%of all patients and there was no statistical significance between spontaneous absorption group and vitrectomy group. Deprivation amblyopia was complicated in 7 of 9 patients whose visual acuity could be measured in both eyes. anisometropic myopia(> OR =2. 0 diopter)was observed in 7 of 14 patients. Our results supported that causes of vitreous hemorrhage in children was variable and early vitrectomy and postoperative correction with occlusion therapy might be essential in treatment of childhood vitreous hemorrhage.
Absorption ; Amblyopia ; Child* ; Follow-Up Studies ; Humans ; Natural History ; Prognosis* ; Retrospective Studies ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage*

No abstract available.
Diagnosis*

BACKGROUND/AIMS: To investigate the diagnostic performance of diffusion-weighted imaging (DWI) for hepatic neuroendocrine tumors (NET) compared with combined DWI and contrast-enhanced magnetic resonance imaging (MRI). METHODS: Fifteen patients with hepatic NET (n=128) underwent enhanced MRI and DWI with multiple-b values. We analyzed three different sets: Precontrast set; DWI set (added DWI); combined set (added enhanced image). Two reviewers rated possibility of NET using a 5-point scale for each image set. Their diagnostic performance was compared using Jackknife alternative free-response ROC (JAFROC). RESULTS: Diagnostic performance was better on the combined set (figure of merit [FOM]=0.852, 0.761) than the precontrast set (FOM=0.427, 0.572, P〈0.05) and the DWI set (FOM=0.682, 0.620, P〈0.05). However, DWI improved performance compared with precontrast set without statistical difference. In small NETs (〈1 cm), all sets showed low sensitivity (10.7-65.9%) with high specificity (95.4-100%). Interobserver agreement was moderate in all image sets (k=0.521 to 0.589). CONCLUSIONS: Combined DWI and enhanced MRI were more useful for detecting NET. Although statistically insignficant, there was a trend in improved diagnostic performance with DWI.
Humans ; Magnetic Resonance Imaging* ; Neuroendocrine Tumors* ; Sensitivity and Specificity

PURPOSE: This study was to identify the prevalence of orthostatic hypotension and its association with risk factors of orthostatic hypotension aged over 60 in Seoul and Chungju, Korea. METHOD: The data were collected from the 22th of August, 2000 to the 7th May 2001. The participants were 74 community-dwelling aged who could stand up from sitting position without assistance. Subjects were interviewed with structured questionnaire in order to ask experience of previous falls, hours in per day, symptoms related orthostatic hypotension and demographic characteristics. Orthostatic hypotension was assessed at 1 minute after the subjects standing from sitting position and defined as 20mmHg or greater decrease in systolic blood pressure after standing. RESULT: The prevalence of orthostatic hypotension was 17.1%. The mean drop of systolic blood pressure was 27.46mmHg among orthostatic hypotension subjects. The significant variables which explain the occurrence of orthostatic hypotension was the basal systolic blood pressure, the hit ratio of discriminant function with basal systolic blood pressure was 69.7%. CONCLUSION: Finding indicate that this study will contribute to develop nursing strategies to identify risk factors and to prevent orthostatic hypotension for the aged.

PURPOSE: To identify clinical characteristics, associated ocular and systemic abnormalities, and the visual prognosis of congenital optic nerve abnormalities. METHODS: The medical records of the patients who were diagnosed to have congenital optic nerve abnormalities between 1987 and 2001 were retrospectively reviewed. RESULTS: Of the 152 patients (M: F=92: 60, 216 eyes), 42% had bilateral abnormalities. Mean follow up period was 33 months. Percentages of the congenital optic nerve abnormalities were as follows; optic nerve hypoplasia 42%, optic disc coloboma 34%, peripapillary staphyloma 9%, morning glory disc anomaly 8%, myelinated nerve fibers 5%, and optic disc aplasia 2%. Brain MRI was done in 56 patients and abnormalities were found in 64%. Associated ocular abnormalities were found in 36% of total patients and associated systemic abnormalities were found in 26%. Refractive error, especially myopia was common. Occlusion therapy was done in 57 patients and the visual acuity of 4 patients improved after follow-up of 20 months. CONCLUSIONS: Optic nerve hypoplasia was the most common congenital optic nerve abnormality. Attention must be paid to detect the associated ocular and systemic abnormalities. Visual prognosis was generally poor, but the best-corrected visual acuity must be achieved with the correction of refractive error and occlusion therapy.
Brain ; Coloboma ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Medical Records ; Myopia ; Nerve Fibers, Myelinated ; Optic Nerve* ; Prognosis ; Refractive Errors ; Retrospective Studies ; Visual Acuity

PURPOSE: This study was to identify the prevalence of postprandial hypotension and its related risk factors, and investigate the relationship between the related symptoms and the occurrence of postprandial hypotension. METHOD: The data were collected from the 22th of August, 2000 to 7th May, 2001. The participants were 74 aged over 60 in Seoul and Chungju, Korea. Blood pressure was taken in the sitting position at 15mins, 30mins and 60mins after starting meals. RESULT: 1) The prevalence of postprandial hypotension was 12.2% at 15mins, 25.7% at 30 mins, 25.7% at 60mins after starting meals. 2) There was no significant difference in age, but there was significant difference in basal systolic blood pressure between responders and nonresponders to postprandial hypotension over the three different times. 3) There was no significant relation between the occurrence of postprandial hypotension and its related symptoms over the three different times. CONCLUSION: Findings indicate that this study will contribute to develop an assessment protocol and nursing strategies to identify risk factors and to prevent postrprandial hypotension for the aged.
Blood Pressure ; Chungcheongbuk-do ; Hypotension* ; Korea ; Meals ; Nursing ; Prevalence* ; Risk Factors* ; Seoul

Purpose: To explore the scope and method of applying standardized nursing terminologies to nursing diagnosis and problems used in nursing practice. Methods: A descriptive study was done with a retrospective analysis of the nursing records of 141,420 patients that were hospitalized in 4 tertiary hospitals. The nursing diagnosis and problems collected from the records were standardized, and the standardized nursing diagnosis and problems cross mapped with NANDA-I, confirmed in a nursing focus group. Results: 65 (67.7%) of the 96 standardized nursing diagnosis and problems were equal with NANDA-I and included in the 10 domains of NANDA-I. Among 86 nursing diagnosis and problems excluded from the cross mapping with NANDA-I, the 63 terms (73.3%) related to surgery/procedure were the most common. Conclusion It is meaningful that multi-tertiary hospital nursing diagnosis and problems were standardized and cross mapping with standard nursing terminologies was performed. As for the method of applying standardized nursing terminologies in nursing practice, it is appropriate to use several standardized nursing terminologies complementarily.

Background: Anemia is a common complication of chronic kidney disease (CKD). In patients with CKD-related anemia, an inverse relationship between vitamin D and hepcidin levels has been observed. Hepcidin is a key regulator of iron homeostasis, mediated via binding to ferroportin. The aim of this study was to investigate the effects of cholecalciferol and omega-3 fatty acids (FA) on hepcidin levels using 5/6 nephrectomized (Nx) rats. Methods: Male Sprague-Dawley rats were divided into five groups: sham control, 5/6 Nx, 5/6 Nx treated with cholecalciferol, 5/6 Nx treated with omega-3 FA, and 5/6 Nx treated with both cholecalciferol and omega-3 FA. We measured the hepcidin and ferroportin levels in the kidney and liver by enzyme-linked immunosorbent assays and Western blots. We evaluated hepcidin expression in the kidney by immunohistochemical staining. Results: Among the five groups, 5/6 Nx rats exhibited the worst kidney function. Compared with the sham controls, 5/6 Nx rats showed significantly increased serum hepcidin levels and decreased vitamin D levels. Supplementation with either omega-3 FA or cholecalciferol decreased hepcidin and increased vitamin D levels, with a concurrent improvement of anemia. Furthermore, 5/6 Nx rats treated with omega-3 FA/cholecalciferol showed decreased ferroportin and ferritin levels, while iron and total iron-binding capacity levels increased. Conclusions Treatment with a combination of cholecalciferol and omega-3 FA may improve anemia in a CKD rat model by decreasing hepcidin levels.