We report a caae of hepatic and intestinal infestation with paragonimus wewstermani complicating abscess formation. The pathway by which the paragonimus westermani reaehea liver and intestine is not well understood. However, there was possiblity that it may become lodged in other organs that the lung because of polonged larval migrations through the diaphragm or into various sites in the abdomen. The patient, 52-year-old female gave a history of having reyeatedly consumed raw crabs. An x-ray film of the chest showed clear lunga Skin test for paragonimus-westermani was positive. Abdominal ultrasonogram showed enlargement of the liver with multiple hypoechoic lesiona ERCP revealed multiple ie lesions in the right lobe of the liver. Abdaminal CT showed multifocal abscess cavities with slight rim enhancements. Above meetioned diagnostic procedures suggested liver abscess or hepatoma. Then, an exploratory laparotomy was done for a definite diagnosis, Frozen biopsy, from liver and surgically exe mass from ileocecal region revealed extrpulmonary paragnomiasis involving liver and cecum. Thus, the patient was treated with prasiquantel. Three months later, abdominal ultrasonogram demonstrated slight enlargement of the liver but no evidence of abnormal mass like lesions.
Abdomen ; Abscess ; Biopsy ; Carcinoma, Hepatocellular ; Cecum* ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis ; Diaphragm ; Female ; Humans ; Intestines ; Laparotomy ; Liver Abscess ; Liver* ; Lung ; Middle Aged ; Paragonimiasis* ; Paragonimus ; Paragonimus westermani ; Praziquantel ; Skin Tests ; Thorax ; Ultrasonography ; X-Ray Film

A polymerase chain reaction (PCR) method for detection of the pathogenic Yersinia pestis from other Yersinia spp. was developed. Five Y. pestis strains, ninety-two other Yersinia species and twenty-four Enterobacteriaceae strains were collected in Korea and from other countries. Oligonucleotide primers were designed from pathogenic gene of antiphagocytic protein capsule gene (fra 1) and plasminogen activator gene (pla). The 428 bp DNA fragment was amplified from five Y. pestis which contained the fra I gene. No product was amplified from other Yersinia species and other strains of the Enterobacteriaceae. The 439 bp DNA fragment was amplified from three K pestis which contained the pla gene. No product was amplified from two Y. pestis, other Yersinia species and other strains of the Enterobacteriaceae. These showed that the designed primers were specific for detection of Y. pestis among other Yersinia species and Enterobacteriaceae strains. Amplification was successful whether the template was derived from purified DNA or from aliquots of boiled bacterial suspension. The detection limits were 100 pg of DNA and 100 colony forming units (CFU) for fra I and 100 pg DNA and 10 CFU for pla, respectively. Our results prove that the PCR method using specific primers for Y. pestis is a rapid and convenient procedure for routine clinical detection and identification of Y. pestis.
DNA ; DNA Primers ; Enterobacteriaceae ; Korea ; Limit of Detection ; Plasminogen Activators ; Polymerase Chain Reaction* ; Stem Cells ; Yersinia pestis* ; Yersinia*

OBJECTIVES: The purpose of this study was to develop a Web-based computer-tailored education program to promote self-care for patients with total hip replacement. RESULTS: Phase 1: Program content was developed, including the educational needs of patients with total hip replacement, based on a review of previous research and literature. Phase 2: A computer-tailored algorithm written as a series of 'if-then' statements was developed to offer the appropriate type of intervention based on an individual's personal health characteristics. Phase 3: A professional Web programmer produced then the program for use on the Web. Phase 4: An expert evaluation was performed focusing on two aspects, Web contents and website design. SPSS ver. 16.0 was used for the analysis, and grade point averages were used to compare each evaluation item. Phase 5: Based on comments from the experts' evaluation, modifications and revisions were made, and the program was completed. CONCLUSIONS: The developed program presented tailored messages using animations, video and flash considering the individual health status and characteristics of the primary target generation. In addition, the expert evaluation confirmed the validity of the program's content and design.
Arthroplasty ; Arthroplasty, Replacement, Hip* ; Computer-Assisted Instruction ; Education* ; Hip ; Humans ; Multimedia ; Postoperative Care ; Postoperative Period ; Self Care

OBJECTIVES: The purpose of this study was to develop and cross-culturally validate the Korean version of SMArtphone's uSability Heuristics (K-SMASH). METHODS: In the study, it was used the adaptation process consisted of five stages, namely, translation, synthesis, back translation, expert committee review, and pretesting. In the pretesting stage, a mobile application, using the prefinal K-SMASH, was evaluated for the severity of usability problems by three experts in computer science and informatics. Each participant completed the evaluation and was interviewed about their understanding, interpretation, and opinion of the cultural relevance of the prefinal K-SMASH. Next, we reviewed the differences in the experts’ opinions and the questionnaire results. RESULTS: Twelve SMASH items, words and sentences, were translated, back translated, and revised, considering the conceptual meaning in the context of the Korean culture, by experts in various fields, including a Korean linguist and a bilingual translator, through the first stage to the fourth stage. In the pretesting stage, the results showed no major differences among the severity ratings of participants. Furthermore, all participants answered that there were no critical discrepancies or inconsistencies with the cultural relevance of the prefinal K-SMASH. CONCLUSIONS: The results of the study provide preliminary evidence that the modified K-SMASH can be used for heuristic evaluation, one of the usability tests, when developing applications in Korea.
Buprenorphine ; Evaluation Studies as Topic ; Heuristics* ; Informatics ; Korea ; Mobile Applications ; Smartphone

Purpose: Various intervention strategies are needed to reduce the suicide rate among late adolescents. Therefore, we aimed to investigate the factors that can help overcome suicidal tendencies in late adolescents from the perspective of case managers. Methods: This qualitative study explored the reinforcing factors that can help overcome suicidal behaviors in late adolescents, by conducting focus group interviews with case managers from the local community. Interviews with 10 case managers were recorded and transcribed, and the data were analyzed using the content analysis method. Results: The main theme of this study was “a step in a new direction”. Three categories were derived: “inner changes”, “another possibility opened up by the interest of significant others”, and “connecting with community resources to help overcome”. Each category had subcategories that influenced the intention and course of action of behaviors to overcome the suicide crises. Conclusion Our findings, from the exploration of the experiences of case managers, provide an in-depth understanding of the reinforcing factors for overcoming suicide among late adolescents. They provide useful preliminary data for the development of effective suicide prevention programs for the adolescents.

PURPOSE: This study aimed to examine the effects of team-based learning using concept mapping on critical thinking disposition and metacognition on college of nursing students. METHODS: A non-equivalent control group pretest-posttest design was used. The experimental group was provided team-based learning using concept mapping. The control group was provided team-based learning. A total of 77 nursing students participated. RESULTS: The experimental group increased significantly in critical thinking, however, there were no significant differences in critical thinking or metacognition between the two groups. The four essential themes extracted were as follows: (1) Expanding the scope of thinking; (2) Strengthening learning competency; (3) Enhancing communication skill; and (4) Burden of new learning method. CONCLUSION: The findings indicate that team-based learning using concept maps may be an effective teaching-learning method for nursing students.
Humans ; Learning ; Metacognition ; Methods ; Nursing ; Students, Nursing ; Thinking

Purpose: This qualitative study is aimed to explore the factors in the aspect of the community that made it difficult for field experts to conduct counseling and case management. Methods: A total of four focus group interviews composed of 15 field experts including nurses were conducted. Results: A theme, six categories and 22 subcategories were derived. As for the theme, it was found that legal, educational, and environmental systems reflecting non-suicidal self-injury of the characteristics in adolescents were insufficient. In the legal aspect, the defect of the parental education legal system, the reality of having to rely on parental consent when supporting adolescents with non-suicidal self-injury; in the educational aspect, the lack of manuals and education for counseling and case management for adolescents with non-suicidal self-injury; in the environmental aspects, the defect of economic burden and support, a lack of information systems for various organizations in the local community, absence of a dedicated support system for adolescent with non-suicidal self-injury and a lack of human and physical resources. Conclusion Based on the results of this study, there needs to be a responsible institution that can comprehensively manage the non-suicidal self-injury of adolescents, and efforts to develop the competence of community nurses.

PURPOSE: The purpose of this study was to investigate the relationship between sexual knowledge, attitude, and satisfaction of sex education in university freshman. METHODS: The participants were 275 freshman students under the age of 20 years old. Data were collected in 2017 using a self-report questionnaire. RESULTS: The average scores of participants' sexual knowledge, attitude, and satisfaction of sex education were 24.22±4.94 out of 38 points, 90.81±15.86 out of 168 points, and 11.05±3.08 out of 20 points, respectively. With respect to the demographic characteristics, there were statically significant differences in sexual knowledge according to chances of relationship engagement (F=6.19, p=.002) and residence type (F=3.67, p=.013). Both sexual attitudes and satisfaction of sex education showed significant differences by major (t=3.20, p=.002; t=2.65, p=.009), types of high school (F=3.39, p=.019; F=3.53, p=.015), and interest in previous sex education during teenage years (F=2.88, p=.015; F=6.22, p<.001). Sexual knowledge showed a statistically significant correlation with attitudes (r=.153, p=.011). CONCLUSION: There is insufficient sex information available for college students. It is necessary in the future to develop sex education programs that are matched to college students' needs.
Education ; Humans ; Sex Education ; Sexuality

Purpose: The aim of this qualitative study is to explore the health problems and coping experiences of middle-aged and elderly women in the community. Methods: A total of five focus group interviews were conducted with three groups of middle-aged and two groups of elderly women. All interviews were recorded and transcribed. Data were analyzed using the content analysis method. Results: Health problems were categorized as confusion caused by problems that are difficult to handle alone in the middle-aged group and suffering originated by confronting changes in roles and environment in the elderly group. The health problems included stress, suffering, anxiety and social withdrawal as subcategories for the middle-aged women, and the stress, sense of loss, fear, and limited social activities caused by their life events for the elderly women. Meanwhile, the contents of categories about coping were revealed as the beginning of care for the body and mind for healthy life in the middle-aged group and active practice with insight into a healthy lifestyle in the elderly group. While the middle-aged women focused on themselves, attempted changes and started to take care of themselves, the elderly women interacted with the outside world, hardened their mind, made efforts for a dignified death, and managed health by their own methods. Conclusion There were differences in the experiences of middle-aged and elderly women in accepting their health problems and coping. Nursing interventions reflecting these findings can help to manage and promote the health of middle-aged and elderly women based on an integrated perspective.

PURPOSE: The purpose of this study was to evaluate the diagnostic accuracy of Tc-99m labeled antigranulocyte antibody immunoscintigrapy in the diagnosis of osteomyelitis and compare with the results of triphasic bone scan. MATERIALS AND METHODS: The study population was 39 patients (22 male, 17 female) who had uncertain diagnoses of osteomyelitis. Fifteen patients had history of orthopedic surgery, and 5 had previous fracture. One milligram of monoclonal antibody against NCA-95 was labeled with 370 MBq of Tc-99m, injected intravenously, and 4 hour images were obtained. Triphasic bone scan images were obtained in 30 p;tients. The final diagnosis was confirmed by bacteriologic culture, biopsy or long term clinical follow up. RESULTS: Twenty one patients were confirmed to have osteomyelitis (1 acute, 20 chronic). Eighteen patients were without osteomyelitis. Antigranulocyte antibody immunoscintigraphy had a sensitivity of 71% (15/21), and a specificity of 89% (16/18), while the sensitivity and specificity of triphasic bone scan was 93% (13/14) and 38% (6/16), respectively. Antigranulocyte antibody scan showed higher specificity of 100% (11/11) in comparison with 33% (3/9) of triphasic bone scan in patients with history of orthopedic surgery or fracture. CONCLUSION: Antigranulocyte antibody immunoscintigraphy is more specific than that of triphasic bone scan and may be helpful in patients with history of surgery or fracture. However, sensitivity is lower than triphasic bone scan in the detection of chronic osteomyelitis.
Biopsy ; Diagnosis ; Follow-Up Studies ; Humans ; Male ; Orthopedics ; Osteomyelitis ; Sensitivity and Specificity