Health Literacy, Knowledge and Self-care Behaviors in Patients with Pulmonary Tuberculosis Living in Community / 기본간호학회지

Purpose@#This descriptive investigative study was done to identify health literacy, knowledge and self-care behavior of patients with pulmonary tuberculosis. @*Methods@#The patients were 206 adults over the age of 19 who were diagnosed with pulmonary tuberculosis, taking anti-tuberculosis drugs and receiving care at one of the following: health centers, health center branches, public or privately affiliated hospitals in six cities nationwide. Tools used for the study were health literacy, knowledge and self-care behavior scales regarding pulmonary tuberculosis. Data were analyzed using SPSS/WIN 21.0 to identify frequency and percentages, means and standard deviation using t-test, ANOVA, Scheffé test, Pearson correlation coefficient, and multiple-regression analysis. @*Results@#Health literacy in pulmonary tuberculosis patients was found to be lower for men, patients over 60, high school graduation or less, having no religion and no family members living together. For knowledge on tuberculosis, the tuberculosis symptom field was lowest, and self-care behavior was lowest for examinations and drug intake. Factors affecting self-care behavior were knowledge related to tuberculosis prevention examinations, education, health literacy, and living together with family members. @*Conclusion@#In order to completely cure pulmonary tuberculosis and prevent recurrence, customized education is needed according to the patient’s educational background or health literacy, and assertive countermeasures are needed to enhance self-care behavior for examinations and drug intake.

A Study on Knowledge, Attitude and Prevention Behavior of Tuberculosis in Male High School Students / 農村醫學 地域保健

PURPOSE: The purpose of this study was to identify the knowledge, attitude and preventive behaviors of tuberculosis in male high school students and to identify the factors influencing preventive behaviors and to provide basic data for the development of prevention programs for tuberculosis of male high school students. METHODS: This study was conducted from May 1, 2018 to May 30, 2018, and six high school students in S city and Y city of Jeonnam were selected. 465 male high school students in the first grade were selected. Collected data were analyzed using t-test, ANOVA, pearsons's correlation and Multiple regression analysis by SPSS/WIN 21.0 program RESULTS: As a result, the knowledge score was 11.92, the attitude score was 28.32 and the prevention behavior score was 30.07. All of these correlations were statistically correlated. In addition, factors influencing preventive actions against tuberculosis were attitude toward tuberculosis, exercise, health status, and sleep time CONCLUSIONS: Based on the above results, it is thought that to improve the preventive behavior of tuberculosis in male high school students, it is necessary to develop a practice-oriented program for forming healthy lifestyle as well as to change the attitude toward tuberculosis positively.

Personalized Urination Activity Recognition Based on a Recurrent Neural Network Using Smart Band / 대한배뇨장애요실금학회지

PURPOSE: Though it is very important obtaining exact data about patients’ voiding patterns for managing voiding dysfunction, actual practice is very difficult and cumbersome. In this study, data about urination time and interval measured by smart band device on patients’ wrist were collected and analyzed to resolve the clinical arguments about the efficacy of voiding diary. By developing a smart band based algorithm for recognition of complex and serial pattern of motion, this study aimed to explore the feasibility of measurement the urination time and intervals for voiding dysfunction management. METHODS: We designed a device capable of recognizing urination time and intervals based on specific postures of the patient and consistent changes in posture. These motion data were obtained by a smart band worn on the wrist. An algorithm that recognizes the repetitive and common 3-step behavior for urination (forward movement, urination, backward movement) was devised based on the movement and tilt angle data collected from a 3-axis accelerometer. The sequence of body movements during voiding has consistent temporal characteristics, so we used a recurrent neural network and long short-term memory based framework to analyze the sequential data and to recognize urination time. Real-time data were acquired from the smart band, and for data corresponding to a certain duration, the value of the signals was calculated and then compared with the set analysis model to calculate the time of urination. A comparative study was conducted between real voiding and device-detected voiding to assess the performance of the proposed recognition technology. RESULTS: The accuracy of the algorithm was calculated based on clinical guidelines established by urologists. The accuracy of this detecting device was high (up to 94.2%), proving the robustness of the proposed algorithm. CONCLUSIONS: This urination behavior recognition technology showed high accuracy and could be applied in clinical settings to characterize patients’ voiding patterns. As wearable devices are developed and generalized, algorithms detecting consistent sequential body movement patterns reflecting specific physiologic behavior might be a new methodology for studying human physiologic behavior.

An Integrative Literature Review of Quality of Life Intervention Programs for Patients with Schizophrenia / 정신간호학회지

PURPOSE: The purposes of this study are to review the literature on quality of life intervention programs and to recommend further research and clinical considerations to improve the quality of life among patients with schizophrenia. METHODS: Three electronic databases - PubMed, CHINAHL and RISS - were searched using the search terms of “schizophrenia” AND “quality of life” AND “intervention*” OR “program*.” The search was limited to studies published in English and Korean. RESULTS: Ten studies were selected for the final analysis and evaluated in terms of contextual and methodological quality. The 10 studies consisted of 5 randomized controlled trials, 4 quasi-experimental studies, and 1 case report. The selected studies utilized an educational program, art and music therapy, physical activity therapy, and community-based integrated programs to alleviate psychological symptoms and showed effectiveness in improving quality of life. CONCLUSION: Interdisciplinary interventions and programs using multiple components reduced psychological symptoms and improved the quality of life of patients with schizophrenia.

Pheochromocytoma Developed in a Boy with Multiple Endocrine Neoplasia Type 2A Confirmed by the RET Proto-Oncogene Mutation / 임상소아혈액종양

A 9-year-old boy presented with increased sweating and abdominal pain. His mother and uncle had been diagnosed with bilateral pheochromocytoma and medullary thyroid carcinoma. Magnetic resonance imaging of the boy's abdomen revealed a 7.5 cm×7.0 cm×6.0 cm mass with a thick peripheral enhancing wall and fluid-fluid level at the right suprarenal region. His ¹²³I-meta-iodobenzylguanidine (MIBG) scan showed a large mass with increased MIBG uptake in the right adrenal gland. The levels of serum norepinephrine, urine epinephrine/norepinephrine, metanephrine, and vanillylmandelic acid were elevated. He, his mother, and two sisters tested positive for the known mutation of multiple endocrine neoplasia type 2A, Cys634Tyr in RET proto-oncogene. Laparoscopic tumor excision and right adrenalectomy were performed. Final diagnosis was pheochromocytoma with malignant behavior, based on adrenal gland scoring scale. However, there was no overt metastasis. After surgery, his symptoms resolved and abnormal laboratory tests were normalized.

Factors Influencing Nursing Students' Performance on Standard Precautions of Infection Control

PURPOSE: The purpose of this study was to identify the factors that affect nursing students' performance on standard precaution of infection control. METHODS: For the analysis of the study results, mistakes and percentages, descriptive statistics, Pearson's coefficient, and multiple regression analysis were performed. RESULTS: Among the participants, 76.5% received hospital infection education, and 72.5% experienced an exposure to blood or body fluid, and the most of the exposures were occurred during the first semester of the third year. The knowledge score was 20.08±2.09, the awareness score was 4.63±.41, and the performance score was 4.34±.55. In the relationship between the standard precautions knowledge, awareness, and performance, the awareness and the performance were in positive correlations, while the factors that affected the performance level of the standard precautions were awareness and the school year (third year), which had 37.0% of the total exposures. CONCLUSION: In order to increase the performance level of the standard precautions among the nursing department students, after identifying the differences between school years and demands of the students, it is necessary to provide continuous and regular education of standard precautions.

Pheochromocytoma Developed in a Boy with Multiple Endocrine Neoplasia Type 2A Confirmed by the RET Proto-Oncogene Mutation / 임상소아혈액종양

A 9-year-old boy presented with increased sweating and abdominal pain. His mother and uncle had been diagnosed with bilateral pheochromocytoma and medullary thyroid carcinoma. Magnetic resonance imaging of the boy's abdomen revealed a 7.5 cm×7.0 cm×6.0 cm mass with a thick peripheral enhancing wall and fluid-fluid level at the right suprarenal region. His ¹²³I-meta-iodobenzylguanidine (MIBG) scan showed a large mass with increased MIBG uptake in the right adrenal gland. The levels of serum norepinephrine, urine epinephrine/norepinephrine, metanephrine, and vanillylmandelic acid were elevated. He, his mother, and two sisters tested positive for the known mutation of multiple endocrine neoplasia type 2A, Cys634Tyr in RET proto-oncogene. Laparoscopic tumor excision and right adrenalectomy were performed. Final diagnosis was pheochromocytoma with malignant behavior, based on adrenal gland scoring scale. However, there was no overt metastasis. After surgery, his symptoms resolved and abnormal laboratory tests were normalized.

Amniotic Fluid Infection, Cytokine Levels, and Mortality and Adverse Pulmonary, Intestinal, and Neurologic Outcomes in Infants at 32 Weeks' Gestation or Less

To what extent the risks of neonatal morbidities are directly related to premature birth or to biological mechanisms of preterm birth remains uncertain. We aimed to examine the effect of exposure to amniotic fluid (AF) infection and elevated cytokine levels on the mortality and pulmonary, intestinal, and neurologic outcomes of preterm infants, and whether these associations persist after adjustment for gestational age at birth. This retrospective cohort study included 152 premature singleton infants who were born at ≤ 32 weeks. AF obtained by amniocentesis was cultured; and interleukin-6 (IL-6) and IL-8 levels in AF were determined. The primary outcome was adverse perinatal outcome defined as the presence of one or more of the followings: stillbirth, neonatal death, bronchopulmonary dysplasia, necrotizing enterocolitis, intraventricular hemorrhage, and periventricular leukomalacia. Logistic regression analysis was adjusted for gestational age at birth and other potential confounders. In bivariate analyses, elevated AF IL-6 and IL-8 levels were significantly associated with adverse perinatal outcome. These results were not changed after adjusting for potential confounders, such as low Apgar scores, mechanical ventilation, and surfactant application. However, the independent effect of elevated cytokine levels in AF disappeared when additionally adjusted for low gestational age at birth; consequently, low gestational age remained strongly associated with the risk of adverse perinatal outcome. In conclusion, elevated levels of pro-inflammatory cytokines in AF are associated with increased risk of adverse perinatal outcomes, but this risk is not independent of low gestational age at birth. Culture-proven AF infection is not associated with this risk.

Maternal Characteristics, Short Mid-Trimester Cervical Length, and Preterm Delivery

We aimed to determine the maternal characteristics (demographics, an obstetric history, and prior cervical excisional procedure) associated with a short mid-trimester cervical length (CL, defined as a CL of ≤ 25 mm) and whether having a short cervix explains the association between these maternal characteristics and spontaneous preterm delivery (SPTD, defined as a delivery before 34 weeks). This is a single-center retrospective cohort study of 3,296 consecutive women with a singleton pregnancy who underwent routine CL measurement between 20 and 24 weeks. Data were collected on maternal age, weight, height, parity, obstetric history (nulliparity; a history of at least 1 SPTD; and at least 1 term birth and no preterm birth [low-risk history group]), and prior cervical excisional procedure. In the multivariate regression analysis, an obstetric history, prior cervical excisional procedure, and gestational age at measurement were the variables significantly associated with short CL. In contrast, maternal weight, height, age, and parity were not significantly associated with short CL. By using the likelihood of SPTD as an outcome variable, logistic regression indicated that short CL and obstetric history, but not prior cervical excisional procedure, were significantly associated with SPTD after adjustment for potential confounders. A history of SPTD and prior cervical excisional procedure were associated with an increased risk of a short mid-trimester CL. A history of SPTD, but not prior cervical excisional procedure, is associated with an increased risk of SPTD, independent of a short CL.

Knowledge about Multicultural and Attitude toward Migrant Wives by Nursing Students / 農村醫學 地域保健

OBJECTIVES: The purpose of this study was to identify the correlation coefficient of knowledge about multicultural, and attitude toward migrant wives by nursing Students. METHODS: Research participants of this study were 212 students attending nursing university in Seoul, Gyeonggi-do, Jeollanam-do. A self-report instrument was used to measure knowledge about multicultural and attitudes toward migrant wives. Descriptive statistics, t-test, Mann-Whitney test, ANOVA and Pearson's correlation analysis with SPSS/Win 20.0 were used. RESULTS: The mean knowledge about multicultural was 8.10 out of 13 and the mean attitudes toward migrant wives was 2.45 out of 5. Factors affecting knowledge about multicultural were age. Factors affecting attitudes toward migrant wives were age, residential district, experience of overseas trip, experience of living abroad and foreign language fluency. There was a positive correlation between knowledge about multicultural and attitudes toward migrant wives. CONCLUSION: Developing knowledge about multicultural and positive attitudes toward migrant wives is necessary in nursing school curricula. Therefore, nursing educator should make actual and effective education program.

Simple mathematical formulae for estimation of median values of fetal biometry at each gestational age

OBJECTIVE: The aim of this study was to propose simple mathematical formulae to estimate median values of fetal biometry including biparietal diameter (BPD), abdominal circumference (AC) and femur length (FL) at each gestational age (GA) easily without looking up the previously established reference values. METHODS: Simple mathematical formulae to estimate median values of fetal biometric values at each gestational week were inferred. To validate these formulae, three different linear equations were derived from previously reported reference values of median BPD, AC and FL using regression analysis at each gestational week. Finally, calculated data through the inferred formula were compared to retrospectively collected data (observed data). RESULTS: The equation revealing the relationship between BPD and GA was: median BPD (cm)=GA (wk)/4. Using this simple mathematical formula, the absolute percentage error between observed data and calculated data ranged from 0.12% to 7.50%. The equation between AC and GA was: median AC (cm)=GA (wk)-5. Through this formula, the absolute percentage error was analyzed same as above and it ranged from 0.30% to 4.76%. Lastly the derived formula between FL and GA was: median FL (cm)=GA (wk)/5 and the absolute percentage error ranged from 4.52% to 16.75%. CONCLUSION: The three simple formulae suggested in our study showed a significantly easy way to estimate the median values of fetal biometry at each gestational week with good reliability.

Effects of Cyclo-His-Pro-enriched yeast hydrolysate on blood glucose levels and lipid metabolism in obese diabetic ob/ob mice

BACKGROUND/OBJECTIVES: We examined the hypoglycemic and anti-hyperlipidemic effect of yeast hydrolysate (YH) enriched with Cyclo-His-Pro (CHP) in the C57BL/6J ob/ob mouse model. MATERIALS/METHODS: Mice were separated into 4 groups (8 mice/group) on the basis of blood glucose and body weight: WT control, lean mice given vehicle; ob/ob control, ob/ob mice given vehicle; YH-1, ob/ob mice given 0.5 g/kg of YH; YH-2, ob/ob mice given 1 g/kg of YH. YH in saline or vehicle was administered orally in the same volume every day for 3 weeks. RESULTS: Mice treated with YH (0.5 and 1 g/kg) for 3 weeks displayed a significant reduction in overall body weight gain and perirenal and epididymal adipose tissue weight compared to the ob/ob control group. Additionally, high-density lipoprotein (HDL) cholesterol, glucose, and atherogenic indexes were significantly decreased in the blood of YH-1 and YH-2 groups compared to the ob/ob control. In ob/ob mice, YH administration significantly improved glucose tolerance and blood insulin levels. These data indicate that YH treatment produces potent hypoglycemic and anti-hyperlipidemic effects by controlling body weight, fat mass, blood lipid, insulin levels, and glucose tolerance. CONCLUSION: YH could potentially be used as a treatment option for diabetes and hyperlipidemia. The CHP-enriched YH may be a promising strategy in the development of hypoglycemic peptide nutraceuticals.

Effects of gangliosides from deer bone extract on the gene expressions of matrix metalloproteinases and collagen type II in interleukin-1β-induced osteoarthritic chondrocytes

BACKGROUND/OBJECTIVES: We investigated the anti-osteoarthritic effects of deer bone extract on the gene expressions of matrix metalloproteinases (MMPs) and collagen type II (COL2) in interleukin-1β-induced osteoarthritis (OA) chondrocytes. MATERIALS/METHODS: Primary rabbit chondrocytes were treated as follows: CON (PBS treatment), NC (IL-1β treatment), PC (IL-1β + 100 µg/mL glucosamine sulphate/chondroitin sulphate mixture), and DB (IL-1β + 100 µg/mL deer bone extract). RESULTS: The results of the cell viability assay indicated that deer bone extract at doses ranging from 100 to 500 µg/mL inhibits cell death in chondrocytes induced by IL-1β. Deer bone extract was able to significantly recover the mRNA expression of COL2 that was down-regulated by IL-1β (NC: 0.79 vs. DB: 0.87, P < 0.05) and significantly decrease the mRNA expression of MMP-3 (NC: 2.24 vs. DB: 1.75) and -13 (NC: 1.28 vs. DB: 0.89) in OA chondrocytes (P < 0.05). CONCLUSIONS: We concluded that deer bone extract induces accumulation of COL2 through the down-regulation of MMPs in IL-1β-induced OA chondrocytes. Our results suggest that deer bone extract, which contains various components related to OA, including chondroitin sulphate, may possess anti-osteoarthritic properties and be of value in inhibiting the pathogenesis of OA.

Peritoneal carcinomatosis mimicking a peritoneal tuberculosis

Symptoms of a peritoneal progression from ovarian cancer are nonspecific such as abdominal pain, abdominal distention and more. Many imaging studies and serum CA-125 help diagnosis. However, it is difficult to exclude the instances of the diffuse peritoneal diseases that mimic carcinomatosis. The elevated CA-125 level usually correlates with the peritoneal carcimatosis, but it is often found in other peritoneal diseases. Therefore, the pathologic confirmation is necessary because of other mimicking diseases. In our case, CA-125 levels were elevated. Abdominal computed tomography finding was suspected a peritoneal tuberculosis but the pathologic result was the peritoneal carcimatosis, eventually.

Proposal on the Establishment of Telemedicine Guidelines for Korea / 대한의료정보학회지

OBJECTIVES: An official guideline must be prepared for legalizing the doctor-patient telemedicine system based on the evaluations of the ongoing telemedicine demonstration project performed by the Korean government. In this study, critical items of the Korean telemedicine guideline are suggested based on the guidelines of developed countries. METHODS: To investigate the telemedicine guidelines of developed countries, a keyword of 'telemedicine guidelines' was used for Google search to find out US, Australian, and Japanese guidelines. The common items included in two or more of the followings were screened: US Core Operational Guidelines for Telehealth Services Involving Provider-Patient Interactions, the Australian New South Wales (NSW) Agency for Clinical Innovation Guidelines for the use of Telehealth for Clinical and Non Clinical Settings in NSW, and the Japanese Guidelines for the practice of home telemedicine. RESULTS: A total of 22 common items of the following four domains, which could be used for the Korean guideline were screened: the common features in overall considerations (6 items), the common features in clinical considerations (6 items), the common features in technical considerations (5 items), and the common features in privacy considerations (5 items). These 22 items were suggested as the critical items of the Korean telemedicine guideline. CONCLUSIONS: The screened 22 items of the telemedicine guideline must be further organized for details. Additional studies and professional opinions on the telemedicine cases and on the guidelines of developed countries are required to establish the Korean guideline in the near future.

Study of the Detection of Enteric Viruses and Bacteria in Spring-water and Groundwater in Busan ('10~'11)

We analyzed the occurrence of enteric viruses and bacteria at 22 places of drinkable groundwater (civil defense emergency water-supply facility), 8 places of the groundwater used for drinking water in group food services, and 10 places of spring-water. When the 40 concentrated samples were analyzed using nested RT-PCR and real-time RT PCR methods, norovirus and other enteric viruses were not detected in all samples tested. The detection percentages for total coliforms, Escherichia coli, Yersinia enterocolitica of fecal indicator were 57.5%, 22.5% and 7.5%, respectively. Colipages were not detected. These results suggest that high levels of fecal indicator bacteria in groundwater and spring-water are not directly related to occurrence of enteric viruses.

Smart Information System for Gachon University Gil Hospital / 대한의료정보학회지

OBJECTIVES: In this research, the hospital information system of Gachon University Gil hospital is introduced and a future strategy for hospital information systems is proposed. METHODS: This research introduces the development conditions of hospital information system at Gachon University Gil hospital, information about the development of the enterprise resource planning (ERP), a medical service process improvement system, and the personal health record (PHR) system. RESULTS: The medical service process and work efficiency were improved through the medical service process improvement system, which is the most common hospital information system at Gachon University Gil hospital and which includes an emergency medical service system, an online evaluation system and a round support system. CONCLUSIONS: Gachon University Gil hospital developed medical service improvement systems to increase work efficiency of medical team and optimized the systems to prove the availability of high-quality medical services for patients and their families. The PHR-based personalized health care solution is under development and will provide higher quality medical service for more patients in the future.

Establishing semantic interoperability in the course of clinical document exchange using international standard for metadata registry

Around the world electronic health records data are being shared and exchanged between two different systems for direct patient care, as well as for research, reimbursement, quality assurance, epidemiology, public health, and policy development. It is important to communicate the semantic meaning of the clinical data when exchanging electronic health records data. In order to achieve semantic interoperability of clinical data, it is important not only to specify clinical entries and documents and the structure of data in electronic health records, but also to use clinical terminology to describe clinical data. There are three types of clinical terminology: interface terminology to support a user-friendly structured data entry; reference terminology to store, retrieve, and analyze clinical data; and classification to aggregate clinical data for secondary use. In order to use electronic health records data in an efficient way, healthcare providers first need to record clinical content using a systematic and controlled interface terminology, then clinical content needs to be stored with reference terminology in a clinical data repository or data warehouse, and finally, the clinical content can be converted into a classification for reimbursement and statistical reporting. For electronic health records data collected at the point of care to be used for secondary purposes, it is necessary to map reference terminology with interface terminology and classification. It is necessary to adopt clinical terminology in electronic health records systems to ensure a high level of semantic interoperability.

The Necessity of Thyroid Function Test of Perimenopausal Women with Menopausal Symptoms / 대한폐경학회지

OBJECTIVES: Hormone therapy is generally chosen to treat women who are experiencing menopausal symptoms. Knowing the overlapping symptoms between menopause and thyroid diseases as well as their increasing trend, it is crucial to differentially diagnose among the two types of diseases. The study is focused on the thyroid function test (TFT) and its significance. It also reflects those who are in the menopausal transition state, suffering from premenopausal symptoms, and therefore, want to be treated with hormone therapy. METHODS: Endocrinologic diagnosis for menopause was performed in 139 patients who complained of menopausal symptoms and irregular menstruation within the past year and hence, visited the Department of Obstetrics and Gynecology, Kyung Hee University Hospital in order to obtain consultation from January 2007 to March 2011. We made observations using the retrograde method. Among these women, 43 patients tested for TFT for their atypical menopausal symptoms. RESULTS: Among the 43 patients who tested for TFT, 10 patients showed abnormal TFT and 3 patients who did not take TFT at our department were found to have the thyroid disease later by other clinics. CONCLUSION: In order to differentiate thyroid disease, practical guidelines should be prepared for the management of women with menopausal transition.

Haddad Syndrome with PHOX2B Gene Mutation in a Korean Infant

Congenital central hypoventilation syndrome with Hirschsprung's disease, also known as Haddad syndrome, is an extremely rare disorder with variable symptoms. Recent studies described that congenital central hypoventilation syndrome had deep relation to the mutation of the PHOX2B gene in its diagnosis and phenotype. We report a newborn male infant with clinical manifestations of recurrent hypoventilation with hypercapnea and bowel obstruction. These clinical manifestations were compatible with congenital central hypoventilation syndrome and Hirschsprung's disease, and polyalanine 26 repeats in the PHOX2B gene supported the diagnosis of congenital central hypoventilation. We described a first case of Haddad syndrome in Korean and its clinical and genetic characteristics were discussed.