Nursing Students' Practice Experience on Community Visiting Nursing

Purpose@#The purpose of this study was to explore the experiences of nursing students' practice on community visiting nursing. @*Methods@#For this study, in-depth interviews were conducted with a total of 12 nursing students, and data were collected through individual in depth interviews from September to December 2018. The data were analyzed using the phenomenological analysis method suggested by Colaizzi. @*Results@#The experience of visiting nursing practice consisted of four themes. Four themes are ‘Understanding visiting nursing work: Tight time and problems to overcome’, ‘Understanding visiting nursing object: People waiting for a visiting nurse’, ‘Visiting nursing practice experience: Sometimes to get reprimanded but rewarding practice’, and ‘Expectations for visiting nursing business: Hopes for development’. @*Conclusion@#Findings from this study presented vivid experiences of nursing students who on community home visit nursing. Community visiting nursing practice became an opportunity for students to understand visiting nursing and target people and to think about the necessity of visiting nursing and future development direction. It is necessary to develop an institutional and policy basis with regard to the increasing number and role expansion of community visit nurses.

Nursing Students' Practice Experience on Community Visiting Nursing

Purpose@#The purpose of this study was to explore the experiences of nursing students' practice on community visiting nursing. @*Methods@#For this study, in-depth interviews were conducted with a total of 12 nursing students, and data were collected through individual in depth interviews from September to December 2018. The data were analyzed using the phenomenological analysis method suggested by Colaizzi. @*Results@#The experience of visiting nursing practice consisted of four themes. Four themes are ‘Understanding visiting nursing work: Tight time and problems to overcome’, ‘Understanding visiting nursing object: People waiting for a visiting nurse’, ‘Visiting nursing practice experience: Sometimes to get reprimanded but rewarding practice’, and ‘Expectations for visiting nursing business: Hopes for development’. @*Conclusion@#Findings from this study presented vivid experiences of nursing students who on community home visit nursing. Community visiting nursing practice became an opportunity for students to understand visiting nursing and target people and to think about the necessity of visiting nursing and future development direction. It is necessary to develop an institutional and policy basis with regard to the increasing number and role expansion of community visit nurses.

Virtual Non-Contrast CT Using Dual-Energy Spectral CT: Feasibility of Coronary Artery Calcium Scoring

OBJECTIVE: To evaluate the feasibility of coronary artery calcium scoring based on three virtual noncontrast-enhanced (VNC) images derived from single-source spectral dual-energy CT (DECT) as compared with true noncontrast-enhanced (TNC) images. MATERIALS AND METHODS: This prospective study was conducted with the approval of our Institutional Review Board. Ninety-seven patients underwent noncontrast CT followed by contrast-enhanced chest CT using single-source spectral DECT. Iodine eliminated VNC images were reconstructed using two kinds of 2-material decomposition algorithms (material density iodine-water pair [MDW], material density iodine-calcium pair [MDC]) and a material suppressed algorithm (material suppressed iodine [MSI]). Two readers independently quantified calcium on VNC and TNC images. The Spearman correlation coefficient test and Bland-Altman method were used for statistical analyses. RESULTS: Coronary artery calcium scores from all three VNC images showed excellent correlation with those from the TNC images (Spearman's correlation coefficient [ρ] = 0.94, 0.88, and 0.89 for MDW, MDC, and MSI, respectively; p < 0.001 for all pairs). Measured coronary calcium volumes from VNC images also correlated well with those from TNC images (ρ = 0.92, 0.87, and 0.91 for MDW, MDC, and MSI, respectively; p < 0.001 for all pairs). Among the three VNC images, coronary calcium from MDW correlated best with that from TNC. The coronary artery calcium scores and volumes were significantly lower from the VNC images than from the TNC images (p < 0.001 for all pairs). CONCLUSION: The use of VNC images from contrast-enhanced CT using dual-energy material decomposition/suppression is feasible for coronary calcium scoring. The absolute value from VNC tends to be smaller than that from TNC.

Tooth color reduction and consequent patient satisfaction after office and home bleaching: a 6-month follow-up study / 대한구강보건학회지

OBJECTIVES: The quest for a happy life is accompanied by an increase in social activities, living standards, and socioeconomic development, with individuals showing increased interest in health and esthetics. In the field of dentistry, not only prevention and treatment but also esthetics is gaining popularity. The aim of this study was to identify tooth color reduction and consequent patient satisfaction over a period of 6 months after office and home bleaching. METHODS: Thirty subjects were divided using the convenience sampling method into two groups based on the bleaching agent used: 10% carbamide peroxide (CP10; home bleach) and 15% hydrogen peroxide (office bleach). CP10 was used at home in a tray for 2 h/day over 14 days, while 15% hydrogen peroxide was light-activated for 15 min, three times/session (total, 45 min). A control set of teeth without any bleaching treatment was used as reference. Shade evaluation was conducted using the Shade Eye NCC at baseline, 1 week, and 1 and 6 months after bleaching. Data were analyzed using the Mann-Whitney U test and the nonparametric Friedman test. RESULTS: There were significant differences in tooth color before and after bleaching in both the home and office bleach groups, although intergroup differences were not observed. Although b* values after bleaching were lower than the original values, only slight tooth color reduction was observed at 6 months. DeltaE*, which represents the overall change in color, at 1 and 6 months after bleaching was significantly different from that at baseline in the home bleach group, while it showed no significant differences in the office bleach group. According to a patient satisfaction survey, patient satisfaction significantly increased over time in the home bleach group, although it did not differ significantly between groups. CONCLUSIONS: Tooth whitening was observed after bleaching in both groups. However, slight color reduction was observed at 6 months after bleaching, and complete restoration to the color before bleaching did not occur; therefore, long-term observation of color reduction is required.

A Study on Current Status of University Health Care Programs / 한국간호교육학회지

PURPOSE: To identify current status of university health care program. METHODS: Data and information from homepages of 309 colleges or universities in South Korea were collected. The data was analyzed by frequencies, t-test, chi2 test with SPSS Ver. 18.0. RESULTS: 117(37.9%) universities had organization of health care. Whether university had health care program or not had shown significantly depended on number of students, types of school (university or college), region, and existence of medical and nursing course. Medical course was shown as a strong predictor for facilitating university health care program limitedly focusing on diseases treatment. Health promotion programs have been operated in 15 universities, vaccination programs in 10 universities, and health screening in 20 universities. CONCLUSION: It is strongly recommended to revise the School Health Law for constructing a comprehensive university health care program consolidating health counseling and physical training.

Strategies for Successful Percutaneous Revascularization of Chronic Total Occlusion of the Femoropopliteal Arteries When the Antegrade Passage of a Guide Wire Fails

OBJECTIVE: To evaluate the efficacy of various strategies for revascularization of chronic total occlusion of femoropopliteal arteries when the guide wire does not pass in an anterograde direction. MATERIALS AND METHODS: Twenty-four patients with totally occluded femoropopliteal arteries (mean occlusion length 13.75 cm; range, 6-22 cm) were treated by using a retrograde approach and two novel catheters. After successful recanalization or reentry, balloon angioplasty followed by stent placement was performed to complete the revascularization. RESULTS: In 16 cases in which to cross the occlusion via intraluminal or subintimal route was failed, we used Frontrunner catheters in five cases and Outback catheters in 11 cases. In eight cases in which to reenter after subintimal passage of the guide wire was failed, we used Outback catheters. Successful recanalization was achieved intraluminally or subintimally in all cases. One perforation occurred during subintimal passage of the guide wire that was controlled by recanalization of another subintimal tract. There were no cases of distal thromboembolism or other complications. CONCLUSION: A retrograde approach and using the Frontrunner and Outback catheters are safe and effective for successful revascularization of chronic total occlusion of femoropopliteal arteries. In particular, they are useful when the initial antegrade attempts at recanalization have failed.

Fine Needle Aspiration of Focal Lung Lesion under CT Fluoroscopic Guidance

PURPOSE: We wanted to assess the efficacy of using CT fluoroscopy during Fine Needle Aspiration (FNA) for focal lung lesion. MATERIALS AND METHODS: We retrospectively reviewed 22 patients who had undergone FNA under CT fluoroscopic guidance. The final diagnosis of focal lung lesion was based on surgery, the results of biopsy taken from another site or the clinical diagnosis with imaging follow-up. We reviewed the imaging and recorded the location of the lesion, the lesion size and the depth from the puncture site. RESULTS: In 24 cases of 22 patients, 16 lesions were benign and 8 were malignant. The sensitivity and specificity for malignant lesions were 100%, and 75%, respectively. The mean size of the malignant lesions was 3.75+/-1.68 cm, and that of the benign lesion was 3.05+/-2.98 cm. The mean depth of the lesion divided by the size was 1.85+/-1.09 for 20 lesions of the correct result group and 3.13+/-1.73 for 4 lesions of the incorrect result group; the difference between the two groups was statistically different (p=0.030). The complications after FNA were pneumothoraces in three cases and parenchymal hemorrhage in one case, but no significant complication was noted after the procedures. CONCLUSION: We could perform the FNA accurately and safely under CT fluoroscopy guidance, so this technique can be used for FNA of focal lung lesion for obtaining a correct result with fewer complications.

Establishment of Quality Assessment Standard for Mammographic Equipments: Evaluation of Phantom and Clinical Images

PURPOSE: The purpose of this study was to establish a quality standard for mammographic equipment in Korea and to eventually improve mammographic quality in clinics and hospitals throughout Korea by educating technicians and clinic personnel. MATERIALS AND METHODS: For the phantom test and on site assessment, we visited 37 sites and examined 43 sets of mammographic equipment. Items that were examined include phantom test, radiation dose measurement, developer assessment, etc. The phantom images were assessed visually and by optical density measurements. For the clinical image assessment, clinical images from 371 sites were examined following the new Korean standard for clinical image evaluation. The items examined include labeling, positioning, contrast, exposure, artifacts, collimation among others. RESULTS: Quality standard of mammographic equipment was satisfied in all equipment during on site visits. Average mean glandular dose was 114.9 mRad. All phantom image test scores were over 10 points (average, 10.8 points). However, optical density measurements were below 1.2 in 9 sets of equipment (20.9%). Clinical image evaluation revealed appropriate image quality in 83.5%, while images from non-radiologist clinics were adequate in 74.6% (91/122), which was the lowest score of any group. Images were satisfactory in 59.0% (219/371) based on evaluation by specialists following the new Korean standard for clinical image evaluation. Satisfactory images had a mean score of 81.7 (1 S.D.=8.9) and unsatisfactory images had a mean score of 61.9 (1 S.D=11). The correlation coefficient between the two observers was 0.93 (p<0.01) in 49 consecutive cases. CONCLUSION: The results of the phantom tests suggest that optical density measurements should be performed as part of a new quality standard for mammographic equipment. The new clinical evaluation criteria that was used in this study can be implemented with some modifications for future mammography quality control by the Korean government.

A Case of Metabolic Syndrome in a Child with Normal Weight / 대한소아내분비학회지

The worldwide obesity epidemic is realized during the past few decades. The risk of developing metabolic syndrome increases steeply with increasing obesity. Increasing childhood obesity heralds a greater health burden in adult life. The metabolic syndrome associated with obesity includes insulin resistance, dyslipidemia, hypertension, fatty liver, coronary heart disease and stroke. Excessive fat is a well known risk factor of insulin resistance. Not only the amount of fat, also its pattern of regional distribution is important. Moreover in Asia, there is a demand for a more limited range for normal BMIs because of the high prevalence of obesity related diseases, particularly diabetes and hypertension. Asian populations have a greater percent body fat even at a low BMI and progression in the prevalence of diabetes with increasing BMI is seen. Anthropometric measurement such as height, weight and BMI is not enough to predict the disease risk, body composition analysis should be followed. Here we report a case of metabolic syndrome in a child with weight within normal range with the review of literatures to emphasize the importance body composition analysis.

A Comparison Study between Compound Imaging and Conventional Ultrasonography in Subareolar Area / 한국유방암학회지

PURPOSE: The subareolar area is often difficult to evaluate ultrasonographically due to tissue shadowing, which obscures visualization of ducts and parenchymal tissue. The purpose of this study is to determine if real-time compound imaging improves evaluation of normal subareolar tissue and solid nodules in subareolar area compared to conventional ultrasonography. METHODS: 190 images of the subareolar area were obtained from 135 patients from March 2001 to July 2002. Thirty-three of 190 images showed solid nodules, extraductal nodules in 30 and intraductal nodules in three. We scanned both conventional and compound imaging with a stationary probe, to maintain an identical projection and tissue pressure. We used two compound techniques; survey mode (S) is made by 3 coplanar images and target mode (T) by 9 coplanar images. The evaluating points were 1) reduction in the density of shadowing, 2) resolution of duct wall, 3) resolution of duct lumen, 4) margin of nodule, and 5) internal echoes of nodule. In a blinded fashion, three radiologists graded the quality of images on a 5-point scale. RESULTS: For reviewer 1/2/3, S showed grade improvements in 1) reduction in the density of shadowing (0.4+/-0.6/1.1 0.6/0.5+/-0.5), 2) resolution of duct wall (0.9+/-0.2/1.5+/-0.6/1.0+/-0.5), 3) resolution of duct lumen (0.9+/-0.2/1.6 +/-0.6/0.7+/-0.6), 4) margin of nodule (1.0+/-0.3/1.5+/-0.5/1.2+/-0.5), and 5) internal echoes of nodule (1.1+/-0.3/1.5+/- 0.5/1.2+/-0.4) and T showed grade improvements in 1) reduction in the density of shadowing (0.4+/-0.6/1.2+/-0.6/0.7+/-0.7), 2) resolution of duct wall (1.0+/-0.3/1.5+/-0.6/1.1+/-0.5), 3) resolution of duct lumen (0.9+/-0.3/1.6+/-0.6/0.8+/-0.6), 4) margin of nodule (1.0+/-0.3/1.5+/-0.6/1.2+/-0.5), and 5) internal echoes of nodule (1.1+/-0.3/1.5+/-0.6/1.3+/-0.4). In all evaluating points, two modes of real-time compound imaging were superior to conventional imaging (P<0.05). There was no significant difference between two modes of compound imaging. CONCLUSION: Real-time compound imaging improves evaluation of normal subareolar tissue and subareolar solid nodules compared to conventional ultrasonography by reducing shadowing and increasing anatomic resolution of ducts.

Clinical Features of Diffuse Pigmented Villonodular Synovitis in the Knee Joint / 대한정형외과학회잡지

PURPOSE: Diffuse pigmented villonodular synovitis (PVNS) is a rare benign disorder characterized by an exuberant inflammation on synovial membrane. The purpose of this study was to report clinical manifestations and the results of treatment in eight cases of PVNS. MATERIALS AND METHODS: Eight patients presenting with PVNS were analyzed from the patient records and the pathologic records. The seven of the patients had been managed with arthroscopic synovectomy and one patient underwent open synovectomy and total joint replacement. Four of the eight patients had magnetic resonance imagings (MRI). Recurrence after synovectomy was considered to have occurred, if there were noteworthy clinical symptoms and signs. RESULTS: The average age of the eight patients with PVNS was thirty years-old. They complained of nonspecific pain and discomfort. Four knees on MRI scans had irregularity with loss and deformity of the intracapsular fat pad (infrapatellar, the suprapatellar and the quadriceps fat pad). Recurrence occurred in three of the eight patients (one total synovectomy, two partial synovectomy). CONCLUSION: We observed characteristic changes in the intracapsular fat pads on the MR images of patients with PVNS. The recurrence rate was high after arthroscopic synovectomy.

Estudio de las mutaciones del gen XLRS-1 asociadas a la retinosquisis juvenil / Study of the mutations of gene XLRS-1 associated to the youthful retinosquisis

Objetivo: Identificar las mutaciones en los pacientes con Retinosquisis Juvenil li-gada al sexo y correlacionarlas con los fenotipos clínicos. Material y Métodos: Los exones del gen XLRS (X-linked Retinoschisis)-1 fueron amplificados por el método PC usando los partidores diseñados para flanquear los intrones. El análisis mutacional fue realizado por medio del Secuenciador directo. Resultados: Las mutaciones fueron identificadas en 12 pacientes de 10 familias. Detectamos 14 portadoras. Todos los afectados fueron sintomáticos antes de los 8 años de edad. Todos revelaron esquisis foveal, y 10 de los 12 pacientes esquisis periférica. Cinco mutaciones se asociaron a hemovítrea y otras 2 a desprendimiento de retina. Todas las mutaciones fueron las transiciones con sentido equivocado, excepto una, y todas fueron localizadas dentro del dominio de "discoidin", proteína implicada en la interacción y adhesión celular. Encontramos 2 mutaciones nuevas. El análisis de DNA permitió identificar una portadora previo al desarrollo de cambios electrorretinográficos. Conclusiones: Nuestros datos sugieren que las mutaciones del gen XLRS-1 causan la Retinosquisis Juvenil. Una variedad de mutación dentro del gen XLRS-1 fue descrita y correlacionada con los fenotipos clínicos

Medical Counseling by the Internet / 대한의료정보학회지

Recent progress in medical informatics enable to use various medical regardless of time or place, to make a diagnostic and therapeutic plan, with increasing need about health of general population. There are many homepages on the web, which provide medical common senses, hospital information. and medical counseling on the web. Virtual Hospital, which is comprehensive medical information system on the web, has medical counseling program with various health information such as self-diagnosis, first-aid treatment information, drug information, Q and A, and so on. The aim of this study is to examine the content and purpose of medical counseling on the web. The subjects consisted of 277 counsels which visited 'Medical Counseling' in the Virtual Hospital for December 1996 through May 1997. Many questioners wanted to consult about their symptoms, to know prevention and treatment strategies, and to know specific medical knowledge. The most common questions are as follows: general and unspecified, digestive, musculoskeletal, and skin problems. These findings suggest medical counseling may be used to supplement the lack of direct medical Interviews with doctors.

Endoanal Ultrasound in Benign Anal Disorders: Findings and Usefulness

PURPOSE: To evaluate the usefulness of endoanal ultrasonography and to determine the imaging features of patients with fecal incontinence, anal abscess or anal fistula. MATERIALS AND METHODS: Twenty five patients underwent endoanal ultrasonography between October 1995 and July 1996. Ten of these were fecal incontinence cases, eight had an anal abscess, and seven, an anal fistula. The incontinence grading scale (IGS) was used for clinical grading of fecal incontinence and pudendal nerve terminal motor latency (PNTML) for pudendal nerve injury. Endoanal ultrasonographic features and operative findings were retrospectively reviewed. RESULTS: Endoanal ultrasonography revealed defective sphincteric muscles in all three patients with myogenic fecal incontinence, but in six of seven cases with neurogenic fecal incontinence, these muscles were not defective. Myogenic and neurogenic incontience showed different findings (p=0.033). In comparison with surgical findings, endoanal ultrasonography was 88% accurate in anal abscess cases and 86% accurate in those of anal fistula. CONCLUSION: Endoanal ultrasonography in conjunction with PNTML was very useful for the detection of the site and severity of sphincteric muscle defect and diagnosis of the etiology of fecal incontinence. Through analysis of the site and type of lesion, the procedure can also serve as a guide to the surgical treatment of patients with anal abscess or fistula.

A Case of Xanthogranulomatous Pyelonephritis Associated with Xanthogranulomatous Epididymoorchitis

Xanthogranulomatous pyelonephritis is an atypical severe renal parenchymal infection, characterized macroscopically by a yellow lobulated mass, and microscopically by massive inflammatory cells and foamyhystiocytes. Preoperatively it can be confused with hypernephroma, pyonephrosis with stone or other renal inflammatory diseases, We present a case of xanthogranulomatous pyelonephritis associated with xanthogranulomatous epididymoorchitis. To our knowledge this is the first report of xanthogranulomatous pyelonephritis associated with xanthogranulomatous epididymo-orchitis.

Necrotizing Fasciitis: Plain Radiographic and CT Findings

PURPOSE: To evaluate the plain radiographic and CT findings of the necrotizing fasciitis. MATERIALS AND METHODS: We retrospectively reviewed the radiologic findings of 4 cases with necrotizing fasciitis. Three cases were proven pathologically. We evaluated pattern and extent of the gas shadows in plain films. CT findings were analysed, with emphasis on : (a) gas pattern, (b) extent, (c) location and involved site, (d) associated focal abscess, and (e) swelling of the adjacent muscles. RESULTS: On plain radiographs, four cases showed streaky or mottled gas densities in the pelvis, three cases in the perineum, one case in the abdomen, and two cases in the thigh. On CT images, gas pattern was mottled and streaky appearance with swelling of the adjacent muscles. Gasshadows located in the extraperitoneal space in four cases, fascial layer in four cases, and subcutaneous layer infour cases. There were gas shadows in pelvic wall, perineum, abdominal wall, buttock, thigh, and scrotum. Focallow density lesion suggestive of focal abscess was not visualized. CONCLUSION: Plain radiography is useful forearly diagnosis of the necrotizing fasciitis and CT is very useful for detection of precise location and extent of the disease. CT is also useful for differentiation of necrotizing fasciitis from focal abscess and cellulitis.

Gastric Duplication in the Newborn

Duplications of the stomach account for only 3.8% of gastrointestinal duplication, mainly discovered during first year of life. Etiopathogenesis is unknown. The most widely accepted theory is recannalization with fusion of longitudinal epithelial fold. The most frequent presented symptoms and signs include gastric outlet obstruction with vomiting, and palpable mass in the epigatric area. An upper gatrointestinal series usually reveals evidence of extrinsic mass effect of intramural lesion. An abdominal ultrasonographic finding is cystic mass lesion with double layer. Histologically, the wall of intramural cyst is composed of orderly layers of alimentary mucosa, submucosa, and muscle fibers. Recommended management is complete excision & simple closure of duplication without violation of the gastric lumen. In this case, 3-day old male newborn suffered from symptoms of gastric outlet obstruction, multiple gastric duplication cysts were found in pyloric canal and greater curvature. The cystic wall was composed with typical 3 layers of gastric mucosa, submucosa, and muscle fibers. The cystic wall was composed with typical 3 layers of gastric mucosa, submucosa, and muscle fibers. Surgical excision was successfully done.

Multicystic Mesothelioma of the peritoneum: A case Report

We report a case of multicystic mesothelioma in the visceral peritoneum anterior of the ascending colon. A 39-year-old female patient visited hospital with a palpabel tender mass in the right flank. An ultrasonogram showed multiple cystic mass lesions in the right flank and CT scan showed a multicystic rative mass with enhancing wall and septum in front of the ascending colon. The patient underwent explolaparotomy and the mass. which inpathology turned out to be a benign multicystic masothelioma, was removed.

Chronic Eosinophilic Pneumonia: A Case Report

Chronic eosinophilic pneumonia is a rare diasease characterized by chronic infiltration of the lung with ~eosinophils, usually associated with peripheral eosinophilia. In 65% of cases, the chest rad Ogroaph shows typiical nonsegmental air-space consolidation confined to the outer third of the lung and in 25)/0 of case "photographic negative of pulmonary edema". Typical lung manifestations with 'peripheral eosinophiliSa' tahrcharacteristic of chronic eosinophilic pneumonia. In the remaining cases, radiographic findings are nonspecific and require lung biopsy for confirmation. We repot a case of chronic eosinophilic pneumonia in which chest radiograph and CT scans revealed bilateral patchy or diffuse opacity with nodules scattered throughout the lungs.

CT Images of Gossypiboma

PURPOSE: Surgical sponges retained after laparotomy can cause serious problem if they were not be identified in early state. In these circumstances, abdominal CT yields the accurate diagnostic images. The purpose of this report is to present highly indicative findings permitting correct preoperative diagnosis of the gossypiboma. we experienced three cases in which CT showed the images sufficiently characteristic to suggest the correct preoperative diagnosis. MATERIALS AND METHODS: We evaluated retrospectively the radiological images of gossypiboma confirmed by operation. Three patients were admitted due to palpable masses. Two female patients had mdical histories of cesarean sections and a male patient had been operated due to malignant fibrous histiocytoma, previously. RESULTS: Abdominal CT scan of one case revealed huge ovoid hypodense mass with enhanced peripheral rim. Calcific spots and whirl-like stripes were noted within the lesion. Towel was found in pathologic specimen. CT images of two patients showed well-encapsulated, mixed fluid and soft tissue density mass with several gas bubbles. Surgical sponges were found within abscesses. CONCLUSION: The authors conclude that these characteristic CT findings and careful histories of surgery are very useful for correct pre-operative diagnosis and permit the guideline for the optimal plan of the surgical treatment.