PURPOSE: The purpose of this study was to explore ways to define the concept of health inequality. METHODS: The concept analysis process by Walker and Avant was used to clarify the meaning of health inequality. RESULTS: Defining attributes of health inequality included differences in health status between individuals or groups, infringement of fundamental rights to health, unfair use of medical services, and social discrimination. The antecedents of health inequality included differences in demographic characteristics (age, gender, education, occupation, residential location), limitations in accessibility to health care, and social exclusion. Consequences of health inequality were increased costs for medical care, decreased health-related quality of life, and lack of ability to cope with health problems resulting in crisis situations, increases in morbidity and mortality, and shortening of life span. The concept was clarified through presentation of model, borderline, related, and contrary cases. CONCLUSION: Results of this study can be used to guide the direction of future studies through concept analysis in which conceptual attributes in the context of health inequality are examined. Also, based on the result of this study, development of standardized tools to measure health inequality is recommended as well as development of educational programs to reduce health inequalities.
Delivery of Health Care ; Education ; Human Rights ; Mortality ; Occupations ; Quality of Life ; Social Discrimination ; Socioeconomic Factors*

Brunner's gland adenoma(or Brunneroma) is clinically relevant tumor-like lesion of the duodenum which is composed of submucosal Brunner's gland tissue. Since the first case by autopsy was described by Cruveihier in l935, there have been less than 190 reports in the world literature, Brunner's gland adenoma is an extremely rare entity that accounts for only 10.6% of benign duodenal tumors, which are themselves relatively rare representing 0.008% of all surgical and autopsy specimens. The clinical manifestation of this tumor are non-specific gastrointestinal complaints, such as bloating or epigastric pain, and tumor often gives rise to melena or obstruction, It is postulated that this tumor are hamartomas rather than true neoplasm. However, they undergo rarely malignant transformation. We report on a case of a large pedunculated Brunner's gland adenoma, which was successfully polypectomized.
Adenoma* ; Autopsy ; Duodenum ; Hamartoma ; Melena

Brunner's gland adenoma(or Brunneroma) is clinically relevant tumor-like lesion of the duodenum which is composed of submucosal Brunner's gland tissue. Since the first case by autopsy was described by Cruveihier in l935, there have been less than 190 reports in the world literature, Brunner's gland adenoma is an extremely rare entity that accounts for only 10.6% of benign duodenal tumors, which are themselves relatively rare representing 0.008% of all surgical and autopsy specimens. The clinical manifestation of this tumor are non-specific gastrointestinal complaints, such as bloating or epigastric pain, and tumor often gives rise to melena or obstruction, It is postulated that this tumor are hamartomas rather than true neoplasm. However, they undergo rarely malignant transformation. We report on a case of a large pedunculated Brunner's gland adenoma, which was successfully polypectomized.
Adenoma* ; Autopsy ; Duodenum ; Hamartoma ; Melena

PURPOSE: The purpose of this study was to investigate the current status of dietary education carried out by dieticians or nutrition teachers at elementary, middle, and high schools in Gyeonggi province. We compared dietary education status not only among school level but also between dieticians and nutrition teachers. METHODS: The survey using self-administered questionnaires was conducted by dieticians or nutrition teachers at 91 schools (43 elementary schools, 33 middle schools, and 15 high schools) in Gyeonggi province in December, 2015. The questionnaire consisted of questions regarding general characteristics of respondents, current status of dietary education, opinion about dietary education methods, and cooperation level of persons concerned. RESULTS: The placement rate of nutrition teachers was 50.5% overall. Only 36 out of 91 schools conducted regular dietary education, and the percentage of schools conducting regular dietary education was significantly different according to school level with the lowest percentage in high schools, equivalent to 20% (p = 0.003). The average annual dietary education time was 12.4 hours, and it was very low in high schools (5.1 hours) and in schools without a nutrition teacher (1.6 hours). The levels of cooperation and support from principals, teachers, parents, and students were significantly lower in high schools than elementary and middle schools (all p < 0.001) and in schools without a nutrition teacher than schools with a nutrition teacher (all p < 0.05). CONCLUSION: The results show that the level of dietary education is not enough and needs to be improved, especially at middle and high schools and at schools without a nutrition teacher. Government support polices need to be implemented to encourage dietary educational activities.
Education* ; Gyeonggi-do* ; Humans ; Nutritionists ; Parents ; Surveys and Questionnaires

Endoscopic retrograde cholangiopancreatography(ERCP) procedures are more difficult in patients who have undergone partial gastrectomy with Billroth II anastomosis. Because its altered anatomical relationship. the endoscopist is presented with additional problems: (i) Dfficulties in entering the afferent loop, depending on the surgical techiques used. (ii) The endoscope may be too sort to reach the papillary region unless the loops are suecessfully straightened out. (iii) Difficulties in passing the ligament of Treitz, especially in patients with Braun's anastomosis, (iv) Problems in cannulating the papilla and especially the common bile duct from a reversed position. (v) Problems in carrying out a papillotomy in a correct position. We attempted endoscopic sphincterotomy in 3 opatients previously subjected to gastrectomy with needle knife, and succeeded in 2 of them. In the two patients, successful billary drainage was achieved. And one patients with Billroth II gastrectomy, presented with CBD stone and cholangit, was successfully treated with endoscopic stone retriveial. The patient with a Billroth-II operation may unergo endscopic diagnostic as well as therapeutic procedures with a high rate of success, and can be suitable candidates for ERCP and endoscopic sphincterotomy
Cholangiography* ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Drainage ; Endoscopes ; Gastrectomy* ; Gastroenterostomy* ; Humans ; Ligaments ; Needles ; Sphincterotomy, Endoscopic

No abstract available.
Plasma Exchange* ; Plasma* ; Purpura, Thrombotic Thrombocytopenic*

No abstract available.

PURPOSE: This study was done to identify the effects of nurse-physician collaboration on nursing performance and organizational commitment in intensive care unit (ICU) nurses. METHODS: A cross-sectional survey was used and data were collected from 203 ICU nurses working in two advanced general hospitals and two general hospitals. Data were analyzed using descriptive statistics, independent t-test, One-way ANOVA, Scheffé test, Pearson correlation coefficients and Hierarchical multiple regression with SPSSWIN 23.0 program. RESULTS: The sub-domains of nursephysician collaboration were as follows: 3.77±0.51 for sharing of patient information, 3.36±0.65 for decision-making process on the cure or care, and 3.20±0.72 for relationship between nurse and physician. Nurse-physician collaboration was significantly positively correlated with nursing performance and organizational commitment. Regression analysis showed that nurse-physician collaboration explained an additional 24.9%p of nursing performance and an additional 13.4%p of organizational commitment. 'Sharing of patient information' and 'Relationship between nurse and physician' were significant predictors of nursing performance. 'Relationship between nurse and physician' was a significant predictor of organizational commitment. CONCLUSION: These results provide evidence that the collaboration between nurses and physicians should be enhanced in terms of sharing patient information and mutual respect, to improve nursing performance and organizational commitment of ICU nurses.
Cooperative Behavior ; Critical Care ; Cross-Sectional Studies ; Hospitals, General ; Humans ; Intensive Care Units ; Nursing ; Work Performance

Purpose: The purpose of this study was to compare the positive outcomes of fixed night shift, such as fatigue recovery experiences, work-life balance, and retention intentions, among nurses who had experienced both rotating shifts and fixed night shift. Methods: A single-cohort pre-post study design was used to compare the fatigue recovery experience, work-life balance, and retention intentions of nurses who have experienced fixed night shift. The study included 59 nurses working at a single university hospital in Seoul from September 1, 2023, to December 31, 2023. Data were analyzed using frequency and percentage, mean and standard deviation, t-test and ANOVA, paired t-test using the R statistical program. Results: The results revealed that acute and chronic fatigue levels decreased among nurses of night shifts during fatigue recovery assessment.However, the inter-shift recovery score did not improve, indicating that nurses' fatigue recovery was insufficient. Work-life balance scores increased, particularly in the area of work-leisure balance. Retention intention also improved among nurses of fixed night shift, but this was not statistically significant. Conclusion Based on the results of this study, the successful establishment of a fixed night shift system will reduce the turnover rate of the next generation of nurses and create a medical environment where nurses can spend more time on direct patient nursing care. Furthermore, we hope to improve the quality of life of nurses and improve the health outcomes of patients.

Purpose: The purpose of this study was to compare the positive outcomes of fixed night shift, such as fatigue recovery experiences, work-life balance, and retention intentions, among nurses who had experienced both rotating shifts and fixed night shift. Methods: A single-cohort pre-post study design was used to compare the fatigue recovery experience, work-life balance, and retention intentions of nurses who have experienced fixed night shift. The study included 59 nurses working at a single university hospital in Seoul from September 1, 2023, to December 31, 2023. Data were analyzed using frequency and percentage, mean and standard deviation, t-test and ANOVA, paired t-test using the R statistical program. Results: The results revealed that acute and chronic fatigue levels decreased among nurses of night shifts during fatigue recovery assessment.However, the inter-shift recovery score did not improve, indicating that nurses' fatigue recovery was insufficient. Work-life balance scores increased, particularly in the area of work-leisure balance. Retention intention also improved among nurses of fixed night shift, but this was not statistically significant. Conclusion Based on the results of this study, the successful establishment of a fixed night shift system will reduce the turnover rate of the next generation of nurses and create a medical environment where nurses can spend more time on direct patient nursing care. Furthermore, we hope to improve the quality of life of nurses and improve the health outcomes of patients.