PURPOSE: The purpose of this study was to examine nurses' emotional responses and ethical attitudes towards elderly patients' Do-Not-Resuscitate (DNR) decision. METHODS: Data were collected using a questionnaire which was filled out by 153 nurses who worked in nursing homes and general hospitals. Data were analyzed using real numbers, percentages, means, standard deviations and Pearson's correlation coefficients with SPSS 19.0 program. RESULTS: The average score for ethical attitudes towards the DNR decision was 2.68 out of 4. Under the ethical attitudes category, the highest score was found with a statement that said 'Although they will not perform cardiopulmonary resuscitate (CPR), it is right to do their best with other treatments for DNR Patients'. Items regarding emotional responses to the DNR decision, the average score was 2.36 out of 4. Among them, the highest score was achieved on 'I understand and sympathize'. No significant correlation was found between ethical attitudes and emotional responses in relation to patients' DNR decision (r=-0.12, P=0.13). CONCLUSION: Regarding elderly patients' DNR decision, nurses showed somewhat highly ethical attitudes and slightly positive emotional response. A follow-up study is needed to investigate variables that affect our results.
Aged* ; Ethics ; Hospitals, General ; Humans ; Nursing Homes ; Resuscitation Orders ; Surveys and Questionnaires

PURPOSE: The primary prevention for cervical cancer, the human papilloma virus (HPV) vaccination, has been available in South Korea and its importance has been emphasized publicly. The purpose of this study was to investigate the knowledge regarding HPV vaccination and identify the factors associated with HPV vaccination in female university students. METHODS: A sample of 200 women among university students in Seoul was asked to answer a questionnaire on HPV-related knowledge and attitude, and influencing factors on HPV vaccination. RESULTS: Among the respondents, 12.0% were HPV vaccinated. Overall HPV-related knowledge was low, and knowledge was not different between the vaccinated and unvaccinated groups. The vaccinated group demonstrated a higher score on the knowledge about the place where people could receive HPV vaccination and the cost of the vaccination than that of the unvaccinated group. The major influencing factor on vaccination was the parent's recommendation and the major barrier for vaccination was the cost of the vaccination. CONCLUSION: A broadened public campaign is recommended to increase the knowledge and positive attitude towards HPV vaccination for university female students as well as their parents.
Surveys and Questionnaires ; Female ; Humans ; Hypogonadism ; Mitochondrial Diseases ; Ophthalmoplegia ; Papilloma ; Papillomavirus Vaccines ; Parents ; Primary Prevention ; Republic of Korea ; Uterine Cervical Neoplasms ; Vaccination ; Viruses

OBJECTIVES: We examined magical ideation in adolescent and adult group by Magical Ideation Scale (MIS). We also explored how adolescents and adults respond differently to each items of MIS. METHODS: 310 nonclinical adults and 310 Year 10 students participated in this study, and completed MIS and Symptom Checklist 90-revision (SCL-90-R). Total scores of MIS were compared between adults and adolescents. The item characteristics of MIS were evaluated by item response theory (IRT). Differential item functioning (DIF) was detected using the parameters of IRT. RESULTS: Total score of MIS was higher in adolescents than in adults, but there was no statistical significance. Item 5, 10, 13, and 16 showed significant difference on item difficulty parameters and were identified as DIF. Among DIF items, item 5 was more difficult for adolescents than adults. Item 10, 13, and 16 were more difficult for adults than adolescents. The modified MIS score excluding 4 DIF items was significantly higher in adolescents than adults. CONCLUSION: The influence of age on response to DIF items should be considered when comparing MIS scores between adolescents and adults.
Adolescent* ; Adult* ; Checklist ; Humans ; Magic*

OBJECTIVES: The purpose of this study is to investigate the characteristics of memory disturbance caused by traumatic brain injury. METHODS: We measured the memory functions of 90 patients who complained of memory impairment after traumatic brain injury and were referred for mental disability evaluation, using Rey-Kim Memory Test. The patients were divided into three groups according to Memory Quotient and brain imaging studies. We also examined their intelligence and emotional characteristics using K-WAIS and MMPI. RESULTS: 1) Among the patients who complained of memory impairment and had abnormal brain imaging after traumatic brain injury, more than half showed no actual memory disturbance. 2) The group with actual memory disturbance showed normal verbal short-term memory but showed deficits in verbal long-term memory. And their visuospatial functions were preserved but visual short- and long-term memory were impaired. 3) There was notable correlation between memory function and intelligence in patients with traumatic brain injury. 4) The group with abnormal brain imaging showed more social withdrawal than the group without abnormal brain imaging. The group without abnormal brain imaging showed more somatization than the group with abnormal brain imaging. CONCLUSION: We suggest the special memory function test as well as brain imaging studies for patients who complain of memory impairment after traumatic brain injury.
Brain Injuries* ; Disability Evaluation ; Humans ; Intelligence ; Memory* ; Memory, Long-Term ; Memory, Short-Term ; MMPI ; Neuroimaging

PURPOSE: This study aimed to develop and evaluate the lower extremity lymphedema nursing practice protocol for patients following gynecologic cancer treatment. METHODS: Thirteen web-sites were searched for eligible clinical practice guidelines (CPGs) and eleven databases were searched to identify evidence to develop a lower extremity lymphedema nursing practice protocol for patients following gynecologic cancer treatment. RESULTS: Based on the inclusion and exclusion criteria, eight CPGs and ninety-six studies, two guidelines and eight studies were identified as evidence. The protocol development group consisted of ten experts who have at least five years' experience in the related area. A lower extremity lymphedema nursing practice protocol for patients following gynecologic cancer treatment was developed including forty-three recommendations in five domains. Significant differences were found in nurses' pre and post knowledge and confidence on lower extremity lymphedema prevention and management. CONCLUSION: Nurses and other professionals could utilize this evidence based lower extremity lymphedema nursing practice protocol and apply it to patients undergoing gynecologic cancer treatment.
Female ; Genital Neoplasms, Female ; Humans ; Lower Extremity* ; Lymphedema* ; Nursing Assessment ; Nursing*

PURPOSE: To evaluate the ultrasonographic (US) or computer tomography (CT) findings of surgically proven epidermal cysts in the trunk, and to compare the echogenicity of cysts with internal contents. MATERIALS AND METHODS: Forty-five patients were retrospectively evaluated. US and CT findings of epidermal cysts were assessed in regard to location, size, shape, number, echogenicity, posterior sound enhancement, internal density, septa, mural nodule and calcification, perilesional infiltration, contrast enhancement, and internal contents. RESULTS: All 45 patients (M: F=29: 16; US in 26, CT in 19) had only one cyst, and they were located in the buttocks (n=19), back (n=13), inguinal (n=4), posterior neck (n=3), perineum (n=2), abdominal wall (n=2), presternal (n=1), and axilla (n=1). Of 26 patients who underwent US, there were 8 cases of homogeneously hypoechoic mass (30.8%), 8 of inhomogeneously hypoechoic mass (30.8%), 7 of homogeneously hypoechoic mass with internal hypoechoic lines and echogenic spots (26.9%) and 3 of homogeneously hypoechoic mass with internal echogenic spots (11.5%). Posterior sound enhancement was noted in 21 patients (80.8%). Of 19 patients who underwent CT, there were 14 cases of simple cyst (73.7%) and 5 of abscess-like lesion (26.3%). Overlying skin thickening (n=13), contrast enhancement of cystic wall (n=11), perilesional infiltration (n=7), and internal septa (n=6) were demonstrated. The internal contents of the cysts were keratinous (n=27, 60.0%) or greasy (n=15, 33.3%) material. There was no statistical significance between the echogenicity of the cysts and the internal contents (p >0.2). CONCLUSION: Epidermal cysts showed homogeneous or inhomogeneous hypoechoic mass with posterior sound enhancement on US. There was no relationship between the echogenicity of the cysts and the internal contents. In the case of ruptured cyst, an abscess-like lesion with wall enhancement and perilesional infiltration was noted on CT scan.
Abdominal Wall ; Axilla ; Buttocks ; Epidermal Cyst* ; Humans ; Neck ; Perineum ; Retrospective Studies ; Skin ; Tomography, X-Ray Computed

Purpose: The purpose of this study was to review studies investigating the effect of bereavement care provided for parents in the neonatal intensive care unit. Methods: We conducted a literature review of databases (MEDLINE, Embase, Cochrane Library, and CINAHL) for studies published in English and four databases (RISS, KISS, NANET, and KoreaMed) for Korean studies. The selection criteria included original articles that evaluated the parents’ perceptions or responses to bereavement care provided in the neonatal intensive care unit. Of 889 articles from the initial screening, 66 articles underwent full-text review and five articles were finally selected for analysis. Results: None of the studies was conducted in Korea. Only one study used a randomized control trial design. The forms of bereavement care reviewed included a provision of a memory package, grief information, and emotional and/or social support from peers or health care providers. The effectiveness of bereavement care was measured by including grief, social support, and depression. Conclusion Bereavement care can be considered to be beneficial for relieving grief reactions and enhancing the personal growth of bereaved parents. Future research should assess the needs of bereaved parents in Korea. Nurses may play a role in developing the bereavement care for parents.

Objectives: This study aimed to compare the utility of the Psychoeducational Profile-Revised (PEP-R), Korean Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition (K-WPPSI-IV), and Vineland Adaptive Behavior Scale, Second Edition (VABS-II) for evaluating developmental disabilities (DD) in preschool children. Additionally, we examined the correlations between the PEP-R, KWPPSI-IV, and VABS-II. Methods: A total of 164 children aged 37–84 months were assessed. Children’s development was evaluated using the PEP-R, K-WPPSIIV, VABS-II, Preschool Receptive-Expressive Language Scale, and Korean Childhood Autism Rating Scale, Second Edition. Results: Of the 164 children, 103 had typical development (TD) and 61 had DD. The mean of the PEP-R Developmental Quotient (DQ), K-WPPSI-IV Full-Scale Intelligence Quotient (FSIQ), and VABS-II Adaptive Behavior Composite (ABC) scores were significantly higher in the TD group than in the DD group (p<0.001). The estimated area under the curve of the PEP-R DQ, K-WPPSI-IV FSIQ, and VABS-II ABC scores was 0.953 (95% confidence interval [CI]=0.915–0.992), 0.955 (95% CI=0.914–0.996), and 0.961 (95% CI=0.932– 0.991), respectively, which did not indicate a statistically significant difference. The PEP-R DQ scores were positively correlated with the K-WPPSI-IV FSIQ (r=0.90, p<0.001) and VABS-II ABC scores (r=0.84, p<0.001). A strong correlation was observed between the KWPPSI-IV FSIQ and VABS-II ABC scores (r=0.89, p<0.001). Conclusion This study found that the PEP-R, K-WPPSI-IV, and VABS-II effectively distinguished DD from TD in preschool children, and no significant differences in utility were observed between them.

Cytokines play a pivotal role in maintaining bone homeostasis. Osteoclasts (OCs), the sole bone resorbing cells, are regulated by numerous cytokines. Macrophage colony-stimulating factor and receptor activator of NF-κB ligand play a central role in OC differentiation, which is also termed osteoclastogenesis. Osteoclastogenic cytokines, including tumor necrosis factor-α, IL-1, IL-6, IL-7, IL-8, IL-11, IL-15, IL-17, IL-23, and IL-34, promote OC differentiation, whereas anti-osteoclastogenic cytokines, including interferon (IFN)-α, IFN-β, IFN-γ, IL-3, IL-4, IL-10, IL-12, IL-27, and IL-33, downregulate OC differentiation. Therefore, dynamic regulation of osteoclastogenic and anti-osteoclastogenic cytokines is important in maintaining the balance between bone-resorbing OCs and bone-forming osteoblasts (OBs), which eventually affects bone integrity. This review outlines the osteoclastogenic and anti-osteoclastogenic properties of cytokines with regard to osteoimmunology, and summarizes our current understanding of the roles these cytokines play in osteoclastogenesis.
Cytokines ; Homeostasis ; Interferons ; Interleukin-1 ; Interleukin-10 ; Interleukin-11 ; Interleukin-12 ; Interleukin-15 ; Interleukin-17 ; Interleukin-23 ; Interleukin-27 ; Interleukin-3 ; Interleukin-33 ; Interleukin-4 ; Interleukin-6 ; Interleukin-7 ; Interleukin-8 ; Macrophage Colony-Stimulating Factor ; Necrosis ; Osteoblasts ; Osteoclasts ; RANK Ligand

PURPOSE: We wanted to evaluate whether both the colonic transit time (CTT) and defecography are necessary for diagnosing constipated patients, and we also wanted to assess the defecographic findings of patients with outlet obstruction on CTT. MATERIALS AND METHODS: Over the recent 3 years, 26 patients (21 women and 5 men, mean age: 59 years) underwent both CTT and defecography because of their chronic constipation or defecation difficulty. The mean interval between the 2 studies was 48 days. Colonoscopy, barium enema and manometry were performed in 22, 8 and all the patients, respectively. RESULTS: On CTT, 13 patients (50.0%) were normal and 13 patients (50.0%) were abnormal; the abnormal results were composed of outlet obstruction (n=8, 30.8%), outlet obstruction and colon inertia (n=2, 7.7%), colon inertia (n=2, 7.7%), and outlet obstruction and hindgut dysfunction (n=1, 3.8%). On defecography, 6 patients (23.1%) were normal and 20 patients (76.9%) were abnormal; the results were composed of rectocele (n=8, 30.7%), rectocele and perineal descent syndrome (PDS; n=4, 15.4%), PDS and rectal intussusception (n=3, 11.5%), spastic pelvic floor syndrome (SPFS; n=3, 11.5%), rectocele and SPFS (n=1, 3.8%), and rectal intussusception (n=1, 3.8%). Of the 11 patients with outlet obstruction on CTT, rectocele (n=4, 36.4%), SPFS (n=1, 9.1%), rectocele and PDS (n=1, 9.1%), and PDS and rectal intussusception (n=1, 9.1%) were demonstrated on defecography, except for the 4 normal cases. CONCLUSION: Both CTT and defecography were necessary for diagnosing the patients with chronic constipation in compensation, and 63.6% of the patients with pelvic outlet obstruction showed an abnormal pelvic defecation function.
Barium ; Colon* ; Colonoscopy ; Compensation and Redress ; Constipation* ; Defecation ; Defecography* ; Enema ; Female ; Humans ; Intussusception ; Male ; Manometry ; Muscle Spasticity ; Pelvic Floor ; Rectocele