The purpose of this study is to build up the foundation to prepare the effective nursing intervention devices for the seriously ill patient's families nursing through the nurse understanding of the experiences of the seriously ill patient's families in the field by setting up grounded theory. In this study, the subjects is the 6 families members of ICU patients, who were being cared in university hospital and the data were collected from 4.15 to 5, 1996 by the recordings and transcring the interview. The intervention lasted from 2 hours to 2 and a half hours. The data were analyzed in the framework of grounded theory as mapped out by Strauss & Corbin. The core category in the analysis of the experiences of the families of the seriously ill patients was the process of setting the "distress". In the process of datas analysis, the categories were 19 conceptions-'serious', 'bad', 'fear', 'press', 'hearburn', 'impatient', 'insufficient', 'change of patients' status', 'economic ability', 'family relationship', 'whilled power', 'request', 'direct caring', 'passive effort', 'control', 'receive', 'tired', 'blame'. These categories were again grouped into 12 categories, including 'exigency', 'overwhelming', 'worry', 'change of status', 'economic ability', 'relationship', 'caring will' 'active caring', 'passive response', 'accept', 'exhaustion', 'blame'. In the above mentioned categories, 'overwhelming' and 'worry' were categorized into the "distress!". On the basis of the patterns that have emerged on process of data analysis, the five below were confirmed. (1) When the patient's status is worse and economic ability is bad and the family relation to the patient is close and the distress is expressed with active caring willness is strong, the distress is expressed with active caring and brings about accept and blame. (2) When the family relation to the patient is distant and the distress decrease and the subject's caring willness is weak, the distress is expressed with passive response and brings about accept and exhaustion in spite of the patient's status is worse and bad economic ability. (3) When the patient's status is worse and economic ability is bad and the family relation to the patient is close and the distress increase, the subject's caring willness is strong, the distress is subject's caring willness is strong, the distress is expressed with passive response and brings about accept and exhaustion. (4) When the patient's status is improve and economic ability is good and the distress decrease and the subject's caring willing is strong, the distress is expressed with active caring and brings about accept and blame in spite of the family relation to the patient is close. (5) When the patient's status is improve and economic ability is bad and the family relation to the patient is close and the distress increase, the subject's caring willness is strong, the distress is expressed with active caring and brings about accept and blame.
Family Relations ; Humans ; Nursing ; Statistics as Topic

The basis of surgical treatment of spondylolisthesis lies in the restoration of stability to the unstable spine and the decompression of the entrapped nerve root. Knodt's distraction rod has been thought to be one of effective distraction instruments promoting fusion for lumbar spine surgery. From December 1981 to May 1987, we performed surgical treatment of spondylolisthesis with Knodt's distraction rod instrumentation in 15 patients (Group I ) and fusion in situ in 7 patients (Group II ). Clinical analysis and changes of radiographic measurements of above two methods were evaluated and obtained following results. l. In Group I, the percentage slip and slip angle decreased to 12.1 ±6.3% and 0.2 ±6.6°, postoperatively, from 20.9 ±8.4% and 7.5 ±5.6°, respectively. In Group II, changed from 13.4 ±9.4%, 7.8 ±6.1°to 11.4 ±9.6%, 11.0 ±5.2°, respectively. 2. In Group I, the average reduction rate was 42.1% postoperatively, but decreased to 20.5% at follow-up. 3. The percentage posterior disc height increased to 49.0 ±6.7% postoperatively, from 27.4 ±10.0% in Group I and decreased to 34.7 ±5.3% at follow-up. But, in Group II, no significant changes observed. 4. The lumbar lordosis in Group I and Group II, decreased to 26.0 ±8.3°and 29.8 ±13.8°, postoperatively, from 35.5 ±7.8°and 37.6 ±1.4°, respectively. 5. There was no significant difference in clinical results between two groups. 6. Postoperstive complications in Group I, were one case of rod breakage with pseudarthrosis, 3 cases of voiding difficulty and superficial wound infection, in Group II, were 2 cases of superficial wound infection and 3 cases of transient voiding diffeculty.
Animals ; Decompression ; Follow-Up Studies ; Humans ; Lordosis ; Pseudarthrosis ; Spine ; Spondylolisthesis ; Wound Infection

PURPOSE: This study was aimed to investigate the clinical and epidemiological characteristics of the patients with acute bronchiolitis who visited in 146 Emergency Departments (EDs) in Korea in 2012. METHODS: We used the NEDIS (National Emergency Department Information System) database to obtain all children with acute bronchiolitis who visited ED under the age of 3 between January 1, 2012 and December 31, 2012. RESULTS: Totally 18,313 children with acute bronchiolitis were enrolled at this study. The male to female ratio was 1.55:1 and mean age was 10 months. The peak proportion was 17.3% in November during the whole year. The most common chief complaints were fever (38.5%), cough (37.4%), dyspnea (9.5%), gastrointestinal symptom (6.7%), and wheezing (2.5%). The most common accompanying disease was pneumonia (13.3%). The rate of hospital admission and intensive care unit admission were 34.5% and 0.3%, respectively. A predictor for admission via ED was respiratory difficulty. CONCLUSION: These data expand our understanding of clinical characteristics of patients with acute bronchiolitis who visited all ED in Korea in 2012.
Bronchiolitis* ; Child ; Cough ; Dyspnea ; Emergencies* ; Emergency Service, Hospital* ; Female ; Fever ; Humans ; Intensive Care Units ; Korea* ; Male ; Pneumonia ; Respiratory Sounds

OBJECTIVE: In patients with interstitial lung disease (ILD) associated with connective tissue disease (CTD), chronic ILD related symptoms may often dominate the clinical picture or precede systemic findings and thus often be seen by a non-rheumatologist. The purpose of this study was to evaluate the importance of rheumatologic consultation during ILD work up. METHODS: We retrospectively reviewed 64 patients with ILD from a single tertiary center for their clinical and laboratory characteristics, rheumatologic consultation status, and result of the consultation. American College of Rheumatology criteria for classification of each connective tissue disease were utilized. Undifferentiated connective tissue disease (UCTD) was classified by pre-specified criteria. RESULTS: A total of 23 (36%) of the ILD patients had associated CTD. Five (8%) patients had underlying CTD before the diagnosis of ILD, whereas 18 (28%) patients were diagnosed with CTD after the rheumatologic consultation. ILD patients with CTD were predominantly female, had significantly more frequent radiographic diagnoses of nonspecific interstitial pneumonia, increased frequencies of high titer antinuclear antibody positivity, and rheumatoid factor positivity. Rheumatologic consultation was referred in 36 (56%) patients. In 18 (50%) of the referred patients, CTD was diagnosed. In 61% of the patients diagnosed with CTD as a result of rheumatologic consultation, changes in therapy occurred. CONCLUSION: A substantial proportion of patients with ILD are found to have an underlying CTD upon evaluation by a rheumatologist. Since ILD associated with CTD mimics idiopathic interstitial pneumonia, rheumatologic consultation may have a significant impact on the clinical care of ILD.
Antibodies, Antinuclear ; Connective Tissue ; Connective Tissue Diseases ; Female ; Humans ; Idiopathic Interstitial Pneumonias ; Lung Diseases, Interstitial ; Referral and Consultation ; Retrospective Studies ; Rheumatoid Factor ; Rheumatology

BACKGROUND/AIMS: Helicobacter pylori (H. pylori) infection is a major cause of chronic gastritis and peptic ulcer and a risk factor of gastric malignancy. Antibiotics based H. pylori eradication treatment is 90% effective, however, it is expensive and causes side effects and antibiotics resistance. Probiotics could present a low-cost, alternative solution to prevent or decrease H. pylori colonization. MATERIALS AND METHODS: Eligible articles were indentified by researches of electronic databases. RESULTS: In vitro studies demonstrated an inhibitory activity of probiotics on H. pylori growth and that this effect is extremely strain specific. The probiotics seem to be efficacious for the prevention of antibiotics associated side effects and might be of help for the prevention of H. pylori complications by decreasing H. pylori density and gastritis, and for the prevention of H. pylori colonization or re-infection by inhibiting adhesion to gastric epithelial cells. There was no significant evidence that probiotics may increase the H. pylori eradication rate. CONCLUSION: Probiotics could be an accessory treatment for H. pylori related gastric diseases, but more researches will be needed.
Anti-Bacterial Agents ; Colon ; Electronics ; Electrons ; Epithelial Cells ; Gastritis ; Helicobacter ; Helicobacter pylori ; Peptic Ulcer ; Probiotics ; Risk Factors ; Sprains and Strains ; Stomach Diseases

We report an unusual case of primary extranodal non-Hodgkin's lymphoma combined with sinusitis in an AIDS patient. A 39-year-old male presented with sinusitis as initial manifestation. A nasal endoscopy revealed nasal polyposis with mucopurulent discharge in both middle meatus and paranasal sinus (PNS) CT scans demonstrated pansinusitis without lamina papyracea or skull base defect. He received antiretroviral and antibiotics therapy due to low CD4 count representing immunocompromised state. The patient was not followed up for observation and he returned with reduced right visual acuity and diplopia, and proptosis after 6 months. A PNS CT scan showed bilateral sinonasal polyposis with pansinusitis and soft tissue density in the right orbit and frontal lobe through bone defect of lamina papyracea and skull base. Endoscopic sinus surgery for orbital decompression and biopsy of intraorbital mass was performed under general anesthesia. The mass was infiltrated into orbital contents and was confirmed as an diffused large B-cell lymphoma with anaplastic variant. The patient received radiotherapy because his general condition was poor. Proptosis and ocular pain were decreased; however, he complained of a persistent headache. Brain CT and MRI showed diffused parenchymal edema around brain abscess in the right frontal lobe. Stereotactic evacuation of the right brain abscess was performed. He has no specific complaints for the last 14 months and antiretroviral therapy is concluded at the present.
Acquired Immunodeficiency Syndrome ; Adult ; Anesthesia, General ; Anti-Bacterial Agents ; B-Lymphocytes* ; Biopsy ; Brain ; Brain Abscess ; CD4 Lymphocyte Count ; Decompression ; Diplopia ; Edema ; Endoscopy ; Exophthalmos ; Frontal Lobe ; Headache ; Humans ; Lymphoma, B-Cell* ; Lymphoma, Large B-Cell, Diffuse ; Lymphoma, Non-Hodgkin ; Magnetic Resonance Imaging ; Male ; Orbit ; Radiotherapy ; Sinusitis* ; Skull Base ; Tomography, X-Ray Computed ; Visual Acuity

PURPOSE: The purpose of this study was to identify factors related to family health and develop a prediction model with an ability to explain family health in families of patients with schizophrenia.METHODS: A hypothesized model with twelve pathway forms was developed based on literature review. Family stress and social stigma were included as two exogenous variables; whereas family resilience, family empowerment, self-esteem, community integration, and family health were included as endogenous variables. Data were collected using a self-report questionnaire from 206 families of patients with schizophrenia living in Republic of Korea. Data were analyzed with PASW/WIN 18.0 and AMOS 18.0 programs.RESULTS: Social stigma had a negatively indirect and total effect on family health. Family resilience, self-esteem, and community integration had positive and direct and overall effects on family health.CONCLUSION: A prediction model for families of patients with schizophrenia is proposed and social stigma, family resilience, self-esteem, and community integration are presented as predicting factors for family health. Nursing interventions and support programs should be developed to overcome social stigma and improve family resilience, self-esteem, and community integration.
Community Integration ; Family Health ; Humans ; Nursing ; Power (Psychology) ; Republic of Korea ; Schizophrenia ; Social Stigma

Background: A national immunization program (NIP) to prevent disease and reduce mortality from vaccine preventable diseases (VPD) is very important. Methods: We analyzed only the anaphylaxis cases that occurred between 2001 and 2016 that Korea Centers for Disease Control and Prevention (KCDC) determined had a definite causal relationship with a vaccine. The clinical symptoms were assessed according to the Brighton Collaboration case definition (BCCD) level. Results: During the period, there were 13 cases of vaccine-related anaphylaxis. The median age was 9 years (range, 1 month to 59 years). The incidence of anaphylaxis per million doses was 0.090 in 2005, 0.079 in 2012, 0.071 in 2013, 0.188 in 2015, and 0.036 in 2016. Of those cases, 23.1% were influenza vaccines, and 76.9% were BCCD level 2. Epinephrine was used in 46.2%. Conclusion Vaccine-related anaphylaxis seems to have been very rare in the past, but health care professionals must always be aware of anaphylaxis.

BACKGROUND: Diagnosis of tuberculosis is more complicated because of low sensitivity and time consuming procedures of the conventional diagnostic methods as well as nonspecific clinical features. Recently the serologic diagnosis of tuberculosis has been reported as one of rapid sensitive and specific methods. We evaluated the ability of a rapid ICT Tuberculosis assay(AMRAD/ICT Diagnostics, Syndey, Australia) to detect pulmonary tuberculosis. METHODS: ICT Tuberculosis assay was performed to the sera from 50 patients with pulmonary tuberculosis (24 patients with smear positive, 26 patients with smear negative) and 105 controls (48 patients without tuberculosis, 57 healthy controls). RESULTS: Antibodies were detected in 22 of 24 (92%) smear positive patients and 22 of 26 (85%) smear negative patients who had been clinically diagnosed as having active pulmonary tuberculosis. Two (4.2%) out of 48 patients without tuberculosis and 1 (1.8%) out of 57 healthy controls had a positive antibody response. The overall sensitivity, specificity, and positive and negative predictive value of the ICT Tuberculosis assay were 88%, 97%, 94%, and 94%, respectively. CONCLUSIONS: The ICT Tuberculosis assay was not only sensitive and specific but also rapid and simple. This assay will be useful as a diagnostic method of pulmonary tuberculosis in combination with sputum smear and X-ray.
Antibodies ; Antibody Formation ; Diagnosis* ; Humans ; Sensitivity and Specificity ; Sputum ; Tuberculosis* ; Tuberculosis, Pulmonary*

PURPOSE: We investigated whether the loss of E-cadherin function was related to the peritoneal seeding in colorectal carcinomas. METHODS: Eleven patients who had undergone a palliative resection for a colorectal carcinoma, with peritoneal seeding, were enrolled onto the study. The primary tumors and seeding nodules were analyzed with regarded to mutations in the expressions of the CDH1 and protein of E-cadherin using SSCP, direct sequencing and immunohistochemical staining. RESULTS: In the primary tumors, the E-cadherin was normally expressed in 9 of the 11 cases, with 2 cases showing a reduced expression. In the seeding nodules, the E-cadherin was normally expressed in 6 of the 11 cases, with 5 cases showing a reduced expression. The degree of E-cadherin expression in the seeding nodules was significantly decreased comparing to that in the primary tumors (P<0.001). In the mutational analysis, there were no pathogenic mutations in either the primary tumors or the seeding nodules, with the exception of two silent changes in the ctgggt>ctaggt (intron 2) and GTG>GTA (codon 782). CONCLUSION: The loss of E-cadherin expression might be related to peritoneal seeding. The functional derangement of E-cadherin in peritoneal seeding could possibly be caused by a mechanism, such as promoter methylation, rather than the mutation of the CDH1.
Cadherins* ; Colorectal Neoplasms* ; Humans ; Methylation ; Polymorphism, Single-Stranded Conformational