PURPOSE: This study was conducted to examine the factors associated with meaning in life among elderly female community dwellers aged 65 or older who were living alone. METHODS: A quota sample of 222 elderly female living alone was recruited. Data were analyzed with descriptive statistics, independent t-test, one-way ANOVA, Welch's test, Pearson's correlation, and multiple regression using the SPSS 22.0 program. RESULTS: The factors associated with meaning in life included age, education level, perceived economic status, perceived health status, social support, and loneliness. This regression model explained 66% of the variance in meaning in life. CONCLUSION: Based on the results, comprehensive nursing intervention programs for enhancing meaning in life are required.
Aged* ; Education ; Female* ; Humans ; Loneliness ; Nursing

No abstract available.
Cleidocranial Dysplasia* ; Leukemia*

The generation and maintenance of consciousness are fundamental but difficult subjects in the fields of psychology, philosophy, neuroscience, and medicine. However, recent developments in neuro-imaging techniques coupled with network analysis have greatly advanced our understanding of consciousness. The present review focuses on large-scale functional brain networks based on neuro-imaging data to explain the awareness (contents) and wakefulness of consciousness.Despite limitations, neuroimaging data suggests brain maps for important psychological and cognitive processes such as attention, language, self-referential, emotion, motivation, social behavior, and wakefulness. We considered a review of these advancements would provide new insights into research on the neural correlates of consciousness.

The generation and maintenance of consciousness are fundamental but difficult subjects in the fields of psychology, philosophy, neuroscience, and medicine. However, recent developments in neuro-imaging techniques coupled with network analysis have greatly advanced our understanding of consciousness. The present review focuses on large-scale functional brain networks based on neuro-imaging data to explain the awareness (contents) and wakefulness of consciousness.Despite limitations, neuroimaging data suggests brain maps for important psychological and cognitive processes such as attention, language, self-referential, emotion, motivation, social behavior, and wakefulness. We considered a review of these advancements would provide new insights into research on the neural correlates of consciousness.

PURPOSE: Depression is common in patients with chronic renal failure on maintenance hemodialysis, though success rate of treatment is low. This study aimed to investigate the features and severity of the depressive symptoms and nutritional indices, and significant changes after antidepressant treatment. METHODS: The authors assessed 45 patients. Diagnosis of depression was made using DSM-IV-TR and the depressive symptoms were evaluated using Hamilton Rating Scale for Depression via semi- structured interview. Subjective global assessment, anthropometric measurements and nutritional indices such as Kt/V, nPCR were examined. Depressive patients were treated for 8 weeks with SSRI (citalopram), and all the variables were examined again after the treatment. RESULTS: 19 (42.2%) patients were diagnosed as depression. Nutritional status was not different between patients with depression and those without depression. Compared to non-depressed patients, depressed patients showed significantly higher depressed mood, guilty feeling, suicide idea, psychic and somatic anxiety, lower work and activities, psychomotor retardation, sleep disturbances, general somatic symptoms and hypochondriasis. After antidepressant treatment, depressed mood, guilty feeling, suicide idea, psychic anxiety, initial insomnia, middle insomnia, early awakening, work and activities and general somatic symptoms were improved significantly. TSF (p<0.05), handgrip strength (p<0.01) and hematocrit (p<0.05) were significantly increased. CONCLUSION: Antidepressant treatment is helpful not only for the improvement of depressive symptoms such as sleep and somatic symptoms but for the improvement of quality of life. Proper treatment should be more actively attempted for the hemodialytic patients with depression.
Anxiety ; Depression ; Hematocrit ; Humans ; Hypochondriasis ; Kidney Failure, Chronic ; Nutrition Assessment ; Nutritional Status ; Quality of Life ; Renal Dialysis ; Sleep Initiation and Maintenance Disorders ; Suicide ; Tosyl Compounds

Purpose: This study evaluated how artificial intelligence-based computer-assisted diagnosis (AICAD) for breast ultrasonography (US) influences diagnostic performance and agreement between radiologists with varying experience levels in different workflows. Methods: Images of 492 breast lesions (200 malignant and 292 benign masses) in 472 women taken from April 2017 to June 2018 were included. Six radiologists (three inexperienced [<1 year of experience] and three experienced [10-15 years of experience]) individually reviewed US images with and without the aid of AI-CAD, first sequentially and then simultaneously. Diagnostic performance and interobserver agreement were calculated and compared between radiologists and AI-CAD. Results: After implementing AI-CAD, the specificity, positive predictive value (PPV), and accuracy significantly improved, regardless of experience and workflow (all P<0.001, respectively). The overall area under the receiver operating characteristic curve significantly increased in simultaneous reading, but only for inexperienced radiologists. The agreement for Breast Imaging Reporting and Database System (BI-RADS) descriptors generally increased when AI-CAD was used (κ=0.29-0.63 to 0.35-0.73). Inexperienced radiologists tended to concede to AI-CAD results more easily than experienced radiologists, especially in simultaneous reading (P<0.001). The conversion rates for final assessment changes from BI-RADS 2 or 3 to BI-RADS higher than 4a or vice versa were also significantly higher in simultaneous reading than sequential reading (overall, 15.8% and 6.2%, respectively; P<0.001) for both inexperienced and experienced radiologists. Conclusion Using AI-CAD to interpret breast US improved the specificity, PPV, and accuracy of radiologists regardless of experience level. AI-CAD may work better in simultaneous reading to improve diagnostic performance and agreement between radiologists, especially for inexperienced radiologists.

To our knowledge, this is the first report of case of high-grade endometrial stromal sarcoma metastasized to the stomach. Endometrial stromal sarcoma is very rare, accounting for 0.2% of female genital tract malignancies. High-grade endometrial stromal sarcoma demonstrates more frequent infiltration into the muscle layer of the uterus or metastasis to other organs, having a poorer prognosis than low grade disease. During its clinical course, endometrial stromal sarcoma may involve ovary, fallopian tube and pelvic cavity. Distant metastasis to lung, liver, bladder, breast, heart, brain and bones have been reported. However, to the best of our knowledge, high-grade endometrial stromal sarcoma presenting with gastric metastasis has never been reported. We now report a case of a 52-year-old woman with previously diagnosed lung metastasis having stomach metastasis from endometrial stromal sarcoma of the uterus.
Accounting ; Brain ; Breast ; Endometrium ; Fallopian Tubes ; Female ; Heart ; Humans ; Liver ; Lung ; Middle Aged ; Muscles ; Neoplasm Metastasis ; Ovary ; Prognosis ; Sarcoma ; Sarcoma, Endometrial Stromal ; Stomach ; Urinary Bladder ; Uterus

PURPOSE: To evaluate the changes in corneal keratometry (K) readings after corneal collagen cross- linking (CXL) using 20% alcohol in primary keratoconus and keratectasia after refractive surgery. METHODS: Twelve eyes of 10 patients with primary keratoconus and 3 eyes of 3 patients with keratectasia after refractive surgery were included in the present study. Best-corrected visual acuity (BCVA) and mean K, corneal astigmatism by corneal topography, and mean K, corneal astigmatism, and spherical equivalent (SE) by auto refractometer were evaluated at baseline, and 6 months postoperatively. Eight eyes of 7 patients were also evaluated 1 year postoperatively. RESULTS: Mean BCVA improved from log MAR 0.66 +/- 0.50 to log MAR 0.55 +/- 0.58 (p = 0.100) at 6 month after CXL. In corneal topography, mean K significantly decreased from 50.04 +/- 5.88 D to 49.18 +/- 6.15 D (p = 0.019), and corneal astigmatism slightly decreased from 5.33 +/- 4.47 D to 5.29 +/- 4.88 D (p = 0.755) at 6 months after CXL. According to the auto refractometer, mean K significantly decreased from 48.53 +/- 5.94 D to 47.95 +/- 5.79 D (p = 0.038), corneal astigmatism significantly decreased from 3.95 +/- 2.54 D to 3.52 +/- 2.40 D (p = 0.010), and SE significantly decreased from -6.25 +/- 3.45 D to -5.40 +/- 2.91 D (p = 0.037) at 6 months after CXL. Significant mean K and corneal astigmatism decreases in topography were also observed at 1 year after CXL. Complications related to CXL were not observed. CONCLUSIONS: CXL using 20% alcohol appears to be a safe and promising treatment modality with less corneal stromal damage in progressive primary keratoconus and keratectasia after refractive surgery.
Astigmatism ; Collagen ; Corneal Topography ; Eye ; Humans ; Keratoconus ; Reading ; Refractive Surgical Procedures ; Visual Acuity

Pregnancy-related osteoporosis is a very rare condition characterized by the occurrence of fracture during pregnancy or the puerperium. Despite its relative rarity, it can be a dangerous condition that causes severe back pain, height loss and disability. Normal physiologic changes during pregnancy, genetic or racial difference, obstetrical history and obstetrical disease, such as preterm labor or pregnancy-induced hypertension, are presumed risk factors of pregnancy-related osteooporosis. However, exact etiology and pathogenesis are uncertain. The management and natural history are still poorly defined. Traditional medications for osteoporosis are calcium/vitamin D and bisphosphonate. Concerns with bisphosphonate include accumulation in bone and fetal exposure in subsequent pregnancies. The newly developed medication, teriparatide, has shown good results. We report six cases of pregnancy-related osteoporosis and spinal fracture with literature review.
Back Pain ; Female ; Hypertension, Pregnancy-Induced ; Natural History ; Obstetric Labor, Premature ; Osteoporosis* ; Postpartum Period ; Pregnancy ; Risk Factors ; Spinal Fractures* ; Teriparatide

BACKGROUND: Cellular remnants in the bioprosthetic heart valve are known to be related to a host's immunologic response and they can form the nidus for calcification. The extracellular matrix of the decellularized valve tissue can also be used as a biological scaffold for cell attachment, endothelialization and tissue reconstitution. Thus, decellularization is the most important part in making a bioprosthetic valve and biological scaffold. Many protocols and agents have been suggested for decellularization, yet there have been few reports about the effect of a treatment with hypotonic solution prior to chemical or enzymatic treatment. This study investigated the effect of a treatment with hypotonic solution and the appropriate environments such as temperature, the treatment duration and the concentration of sodium dodecylsulfate (SDS) for achieving proper decellularization. MATERIAL AND METHOD: Porcine aortic valves were decellularized with sodium dodecylsulfate at various concentrations (0.25%, 0.5%), time durations (6, 12, 24 hours) and temperatures (4degrees C, 20degrees C)(Group B). Same the number of porcine aortic valves (group A) was treated with hypotonic solution prior to SDS treatment at the same conditions. The duration of exposure to the hypotonic solution was 4, 7 and 14 hours and the temperature was 4degrees C and 20degrees C, respectively. The degree of decellularization was analyzed by performing hematoxylin and eosin staining. RESULT: There were no differences in the degree of decellularization between the two concentrations (0.25% 0.5%) of SDS. Twenty four hours treatment with SDS revealed the best decellularization effect for both groups A and B at the temperature of 4degrees C, but there was no differences between the groups at 20degrees C. Treatment with hypotonic solution (group A) showed a better decellularization effect at all the matched conditions. Fourteen hours treatment at 4degrees C with hypotonic solution prior to SDS treatment revealed the best decellularization effect. The treatment with hypotonic solution at 20degrees C revealed a good decellularization effect, but this showed significant extracellular matrix destruction. CONCLUSION: The exposure of porcine heart valves to hypotonic solution prior to SDS treatment is highly effective for achieving decellularization. Osmotic treatment with hypotonic solution should be considered for achieving decellularization of porcine aortic valves. Further study should be carried out to see whether the treatment with hypotonic solution could reduce the exposure duration and concentration of chemical detergents, and also to evaluate how the structure of the extracellular matrix of the porcine valve is affected by the exposure to hypotonic solution.
Aortic Valve ; Artificial Organs ; Bioengineering ; Detergents ; Eosine Yellowish-(YS) ; Extracellular Matrix ; Heart Valves ; Hematoxylin ; Sodium ; Transplantation, Heterologous