Validation of initial nutrition screening tool for hospitalized patients / 한국영양학회지

PURPOSE: Poor nutrition in hospitalized patients is closely linked to an increased risk of infection, which can result in complications affecting mortality, as well as increased length of hospital stay and hospital costs. Therefore, adequate nutritional support is essential to manage the nutritional risk status of patients. Nutritional support needs to be preceded by nutrition screening, in which accuracy is crucial, particularly for the initial screening. To perform initial nutrition screening of hospitalized patients, we used the Catholic Kwandong University (CKU) Nutritional Risk Screening (CKUNRS) tool, originally developed at CKU Hospital. To validate CKUNRS against the Patient-Generated Subjective Global Assessment (PG-SGA) tool, which is considered the gold standard for nutritional risk screening, results from both tools were compared. METHODS: Nutritional status was evaluated in 686 adult patients admitted to CKU Hospital from May 1 to July 31, 2018 using both CKUNRS and PG-SGA. Collected data were analyzed, and the results compared, to validate CKUNRS as a nutrition screening tool. RESULTS: The comparison of CKUNRS and PG-SGA revealed that the prevalence of nutritional risk on admission was 15.6% (n = 107) with CKUNRS and 44.6% (n = 306) with PG-SGA. The sensitivity and specificity of CKUNRS to evaluate nutritional risk status were 98.7% (96.8 ~ 99.5) and 33.3% (28.1 ~ 39.0), respectively. Thus, the sensitivity was higher, but the specificity lower compared with PG-SGA. Cohen's kappa coefficient was 0.34, indicating valid agreement between the two tools. CONCLUSION: This study found concordance between CKUNRS and PG-SGA. However, the prevalence of nutritional risk in hospitalized patients was higher when determined by CKUNRS, compared with that by PG-SGA. Accordingly, CKUNRS needs further modification and improvement in terms of screening criteria to promote more effective nutritional support for patients who have been admitted for inpatient care.

Agitation in Home-dwelling Persons with Dementia and Coping Behaviors in Primary Care-givers to the Agitation

PURPOSE: The purpose of this study was to investigate agitation in home-dwelling persons with dementia and coping behaviors of primary family care-givers to agitation. METHODS: The research was designed as a descriptive study. A total of two hundred and five subjects had participated in this study. To measure agitation in persons with dementia, Cohen-Mansfield Agitation Inventory was used. To measure coping behaviors of primary family care-givers to the agitation, a questionnaire was used. Descriptive statistics, t-test, ANOVA, Scheffe test were used to answer the research objectives. RESULTS: 'Repetitive mannerisms' and 'repeating sentences' were the most commonly occurred agitation in home-dwelling persons with dementia. 'Leaving the situation', 'allowing certain time', and 'soothing by talking' were the most common coping behaviors occurred in primary care-givers. CONCLUSION: The findings of the current study would provide meaningful data to develop nursing programs to control agitation for home-dwelling persons with dementia and education programs for primary care-givers to cope with persons' agitation.

Herpes Simplex Encephalitis Showing Prominent Spatial Disorientation with Visual Hallucination

A 58-year-old woman was admitted to hospital due to memory impairment and visuospatial dysfunction. Brain MRI revealed high signal lesions on both the temporal and inferior frontal lobes. She was diagnosed as having herpes simplex encephalitis based on her clinical and laboratory findings. Twelve months later she still presented with spatial disorientation, although her amnesia was improved. Neuropsychological testing revealed multiple cognitive impairments, and especially visuospatial dysfunction. This patient represents a case of herpes simplex encephalitis associated with spatial disorientation even when the amnesia had disappeared.

Changes on Cognitive Function after Carotid Artery Stenting in Patients with Severe Carotid Artery Stenosis: A Prospective, 3 Months Follow-up Study

BACKGROUND: Carotid artery stenting (CAS) is emerging as an alternative to carotid endarterectomy for the treatment of carotid stenosis. The effects of CAS on cognitive function have not been fully addressed. The aim of this study was to assess the effect of carotid stenting on cognitive function from baseline to 3 months in patients with severe carotid artery stenosis through the use of a detailed neuropsychological test. METHODS: We recruited 28 patients with carotid artery stenosis (> or =70%) at baseline on a consecutive basis between February, 2009 and December, 2010. Twenty-two patients out of 28 cases, who had undergone CAS and follow-up neuropsychological evaluation after 3 months, were included in our analysis. Main cognitive outcome measures were the Seoul Neuropsychological Screening Battery-Dementia version (SNSB-D), which containing detailed cognitive tasks. We evaluated the baseline clinical characteristics and changes of cognitive outcome measures using SNSB-D in our cases from baseline to 3 months follow-up period, respectively. RESULTS: After a 3 month follow-up period, patients that underwent CAS showed significant improvement in cognitive function in total SNSB-D score compared to the baseline state of 18.1 points at 3 months (p<0.05). The other cognitive outcome measures showed significant improvements (p<0.05) in the task of confrontational naming, visual memory, and the scale of clinical dementia rating sum of box. CONCLUSION: We found that there might be a positive effect of carotid artery stenting on cognitive function from baseline to 3 months in patients with severe carotid artery stenosis.

Analysis of Nursing Students' Knowledge, Attitude and Ability to Perform Cardiopulmonary Resuscitation / 기본간호학회지

PURPOSE: This study was designed to provide a systematic understanding of nursing students' knowledge, attitude and ability to perform cardiopulmonary resuscitation (CPR). Fundamental data regarding CPR education was processed in order to analyze factors influencing knowledge, attitude and ability. METHODS: A total of 663 nursing students from G city and South Jeolla Province participated in this study during March and April 2009. Questionnaires were used to gather the data. Descriptive statistics, t-test, ANOVA, and Pearson correlation coefficients with SPSS WIN 12.0 were used for data analysis. RESULTS: The mean score for knowledge regarding CPR was 7.84 of a total possible score of 15, for attitude, 39.90 of a total possible score of 55 and for performance ability, 40.17 of a total possible score of 75. There was a positive correlation between CPR knowledge, attitude and performance ability. As knowledge increased so did attitude and performance ability. CONCLUSION: In order to develop positive attitudes in nursing students toward the performance of CPR, we need to strengthen education related to CPR and create effective education programs which are focused particularly on practical training for the students.

Influence of Self-Esteem and Social Support on the Depression Stati of Some Clinical Nurses / 대한산업의학회지

OBJECTIVES: The purpose of this study was to examine the influence of self-esteem and social support on the depression stati of some clinical nurses, and propose basic data for a depression care program. METHODS: Between March 31 and April 5 at 2006, a self-reporting questionnaire survey was administered to 200 nurses at a general hospital located in Gyeonggi-do. The Beck's Depression Inventory (BDI) was used to assess the subjects'depression stati. RESULTS: The average BDI score of the clinical nurses was 8.9+/-7.5, with 59% belonging to the normal category, 28% having mild depressive symptoms, and 13% with a moderate degree of depressive symptoms. The degree of depression was significantly increased in the clinical nurses with a lower self-esteem and less social support. The degree of depression was significantly increased in the clinical nurses with a lower self-esteem and less social support. According to a multivariate regression analysis, a significant association was found between self-esteem and social support in relation to the depression of clinical nurses. The effect of social support was found to not be significant in cases where the self-esteem was high: however, depression was significantly influenced by social support in cases where the self-esteem was low. CONCLUSION: Self-esteem and social support were observed to influence the depression stati of clinical nurses. Therefore, it is suggested that an increase in depression management programs is required to create systematic management to maintain an atmosphere of high self-esteem and close relationships to manage the depression of clinical nurses.

Analysis of Nursing Interventions used in Orthopedic Nursing Unit / 기본간호학회지

PURPOSE: This study was done to identify the Domains, Classes, labels and nursing activities of nursing interventions used with 117 patients who were admitted to orthopedic nursing units. METHOD: Data were collected in January and February, 2004 using a computerized nursing process program that contained nursing diagnosis-outcome-intervention (NNN) linkages. The program was developed by the researcher. Frequencies and percentages were used in the analysis. RESULTS: Sixty-five nursing intervention labels were identified. The Domains of the nursing interventions showed higher percentages for 'physiological: basic' (75.9%), 'physiological: complex' (12.9%), 'behavioral' (7.8%) 'family' (1.3%), and 'safety' (1.1%). The Classes of nursing interventions showed higher percentages for 'activity and exercise management' (30.8%), 'physical comfort promotion' (19.3%), 'immobility management' (14.5%), 'drug management' (8.1%), and 'coping assistance' (5.6%). Nursing intervention labels showed higher percentages for 'pain management' (14.7%), 'body mechanics promotion' (8.0%), 'exercise therapy : ambulation' (7.2%), 'splinting' (5.4%), and 'positioning' (5.1%). In the comparison of numbers between performed nursing activities and nursing activities of NIC according to nursing intervention label, the mean of combined rate was 52.3%. CONCLUSION: These findings will help in building of a standardized language for orthopedic nursing units and enhance the quality of nursing care.

A Case of Sheehan's Syndrome Presenting Central Diabetes Insipidus / 대한내분비학회지

Sheehan's syndrome occurs as a result of ischemic pituitary necrosis due to severe postpartum hemorrhage. The manifestations of this clinical syndrome are most often caused by a deficiency in the hormones produced by the anterior pituitary gland, whereas the neurohypophysis is usually preserved but can be involved in severe cases that manifest as diabetes insipidus. This is a report of Sheehan's syndrome that manifested with diabetes insipidus as presenting symptom 2 month's after delivery. The patient suffered massive bleeding, so received a blood transfusion. A combined pituitary stimulation and water deprivation test revealed deficiencies of not only anterior pituitary hormones, such as growth hormone and prolactin, but also of anti-diuretic hormone. We report this case, with a review of the literature.

A Case of Sheehan's Syndrome Presenting Central Diabetes Insipidus / 대한내분비학회지

Sheehan's syndrome occurs as a result of ischemic pituitary necrosis due to severe postpartum hemorrhage. The manifestations of this clinical syndrome are most often caused by a deficiency in the hormones produced by the anterior pituitary gland, whereas the neurohypophysis is usually preserved but can be involved in severe cases that manifest as diabetes insipidus. This is a report of Sheehan's syndrome that manifested with diabetes insipidus as presenting symptom 2 month's after delivery. The patient suffered massive bleeding, so received a blood transfusion. A combined pituitary stimulation and water deprivation test revealed deficiencies of not only anterior pituitary hormones, such as growth hormone and prolactin, but also of anti-diuretic hormone. We report this case, with a review of the literature.

Analysis of Test Items for National Qualifying Examination in Fundamentals of Nursing / 기본간호학회지

PURPOSE: The purpose of this study was to explore changes in the test items in the preparation book for the national qualifying examination. Test items which developed in the year 2000 and 2004 through nationwide faculty workshop in Fundamentals of Nursing were examined. METHOD: Test items for the national qualifying examination for 2000 and 2004 in Fundamentals of Nursing were analyzed using frequencies and percent. RESULTS: The test items for the national qualifying examination for 2004 in Fundamentals of Nursing showed an increase in the number of test item over the year 2000. According to McGuire's taxonomy, domains of the test items in 2000 were recall(65.1%), interpretation (22.0%), and problem solving(12.9%) in that order. In 2004 items for the recall domain(74.7%) increased 9.6% above the level of 2000, and interpretation and problem solving domains showed a slight decrease. With regard to type of test items, the proportion of A type in 2004 was the same with 37.6% as 2000, and that of K type(61.5%) increased by 0.7% over the year 2000(60.8%). CONCLUSION: The test items for the national qualifying examination of 2000 and 2004 were not different except for the increase in the number of test items.

Development and Application of a Computerized Nursing Process Program for Orthopedic Surgery Inpatients: NANDA, NOC, and NIC Linkages / 간호학회지

PURPOSE: The purpose of this study was to develop and to apply the NANDA, NOC, and NIC (NNN) linkages into a computerized nursing process program using the classification systems of nursing diagnoses, nursing outcomes and nursing interventions. METHOD: The program was developed with planning, analysis, design and performance stages. The program was applied to 117 patients who were admitted to orthopedic surgery nursing units from January to February, 2004. RESULTS: Thirty-five of fifty-three nursing diagnoses were identified. Five nursing diagnoses in order of frequency were: Acute pain (28.4%), Impaired physical mobility (15.6%), Impaired walking (8.7%), Chronic pain (5.5%) and Risk for disuse syndrome (5.0%). The nursing outcomes of the 'Acute pain' nursing diagnosis tended to have higher frequencies (cumulative) in order of Pain management (95.2%), Comfort level (35.5%) and Pain level (17.7%). The nursing interventions of the 'Acute pain' nursing diagnosis tended to have higher frequencies (cumulative) in order of Pain management (71.0%), Splinting (24.2%) and Analgesic administration (17.7%). In comparison of outcome indicator scores between before and after the intervention according to the 61 nursing outcomes, the mean scores of 52 outcome indicators after the intervention were significantly higher than before the intervention. CONCLUSION: It is expected that this program will help nurses perform their nursing processes more efficiently.

Initial Prednisolone Treatment for Primary Nephrotic Syndrome in Children-4 Weeks versus 6 Weeks

PURPOSE: Recently the merits of 6 weeks of initial prednisolone treatment for pediatric primary nephrotic syndrome have been reported, and the use of the 6 week regimen is increasing. We compared our experiences with the 6 week treatment versus the 4 week treatment for Korean patients. METHODS: We conducted a retrospective analysis of 69 children who had primary nephrotic syndrome and who were followed up for at least 12 months in the 4 major medical centers in Daegu. The remission rate, the relapse rate, the frequency of relapse and complication of steroid treatment were compared between the 4 weeks and 6 weeks treatment group. RESULTS: Of the 69 children, 42 were in the 4 week treatment group and 27 were in the 6 week group. The median age, blood pressure, serum total protein, serum albumin, cholesterol, creatinine, estimated creatinine clearance, 24 hour urine protein and 12 month cumulative dose did not differ between the two groups. Among the children who relapsed after steroid treatment, the relapse time was significantly later for the 6 week treatment group. The relapse rate after 1 year of treatment was 62% in the 4 week treatment group and 52% in the 6 week treatment group; however, there was no statistically significant difference between the two groups. The frequency of relapse at 12 months was 1.5+/-1.2 times in the 4 week treatment group and 1.1+/-1.2 times in the 6 week treatment group, and there was not different between the two groups. The most common side effects of steroid treatment were an increase of appetite and a cushingoid appearance, and there was no statistical difference between the two groups. Among the 27 children who had kidney biopsies performed, 21 suffered from minimal change nephrotic syndrome. CONCLUSION: The first relapse time after steroid treatment was significantly later in the 6 week steroid treatment group. The frequency of relapse and the 12 month cumulative dose of steroid were lower in the 6 week treatment group, but there was no statistical significance between the two groups. The side effects of steroid treatment did not differ between the two groups. We need to study the long term side effects and the advanced regimens of steroid treatment in the future.

A Correlation Study of Perceived Importance of Nursing Interventions with Performance Frequency in Psychiatric Nursing Units Using the 3th NIC / 간호학회지

PURPOSE: The purpose of this study was to identify the perceived importance of nursing intserventions of psychiatric nurses according to domains, classes and interventions using the 3th NIC. METHOD: In this study, a 435 of 486 nursing interventions were selected from 75% consent reached by experts. Data were collected from 9 hospitals and 141 nurses(return rates : 94.0%) in Seoul, Kyonggi, Chungnam, Gwang-ju and Chonnam region from January, 2002 to February, 2002 using 4 point Likert scale. RESULT: Total perceived importance score was 2.905+/-0.463 and total correlation score with performance frequency was r=0.295. The most important perceived domain and class was found to be 'safety' (3.217+/-0.465) and 'community health promotion' (3.285+/-0.866). The most correlated domain and class with performance frequency appeared to be 'behavioral' (r=0.431, p=0.000) and 'communication enhancement' (r=0.439, p=0.000). The most important perceived nursing intervention was found to be 'active listening' (3.652+/-0.549). CONCLUSION: In conclusion, nurses in clinical settings were found to perform less than perceive its importance. Therefore, further researches are needed to identify factors related to impede and develop strategies to improve the performance of nursing interventions.

A Case of Corpus Callosum Agenesis with Ileal Atresia and Duplication

Agenesis of corpus callosum occurs sporadically and may be transmitted as sex-linked, or autosomal-dominant or recessive traits. It has been associated with different syndromes. Clinical pictures vary from severe intellectual and neurologic abnormalities to asymptomatic and normaly intelligent cases. Agenesis of corpus callosum may occur alone, but it is more frequently associated with a high incidence of other anomalies. We report a male infant with agenesis of corpus callosum who was diagnosed to have ileal atresia and duplication.

A case of Primary Hemangiopericytoma of the Lung / 결핵

Primary hemangiopericytomas of the lung are uncommon sarcomas that arise from pericytes that surround the basement membrane of capillaries and small venules within the lung parenchyma. The presenting symptoms and signs depend on the location of the tumor and radiologic features are not diagnostic. The behavior of pulmonary hemangiopericytomas is difficult to predict and all tumors should be considered potentially malignant. Wide surgical excision remains the mainstay of treatment. We report a case of primary hemangiopericytoma of the lung with a brief review of literature.

A Case of Duodenal Bulb Carcinoid Tumor Causing a Carcinoid Syndrome without Liver Metastasis / 대한소화기내시경학회지

A primary duodenal carcinoid tumor causing carcinoid syndrome is rare. In case of accompanying carcinoid syndrome in a primary duodenal carcinoid tumor, it mostly suggests massive liver metastasis. In rare case, venous drainage of carcinoid tumor and systemic venous drainage are directly connected without passing through the portal system. Therefore, it is rare and interesting case which a primary duodenal carcinoid tumor accompanies carcinoid syndrome without liver metastasis. We experienced an occasion of a primary carcinoid tumor located in duodenal bulb in a 56 year-old woman. This patient came to our hospital because of intermittent diarrhea, epigastric pain and facial flushing. And it was surely diagnosed as carcinoid tumor by gastrointestinal endoscopic biopsy. She was hospitalized for surgery and we were able to confirm that carcinoid syndrome was accompanied through biochemical test. However, metastatic lesion was not found at liver, small and large intestine. We report this case with reference to documents due to rarity.

Maximum pubertal spurts in cranial base and mandible / 대한치과교정학회지

The purpose of this study was to investigate not only the variability in the timing and amount of the maximum pubertal spurt in cranial base and mandible, but also its interrelationship with the timing of peak height velocity. This study was carried out by analysing biannual serial lateral cephalometric radiographs of twenty-six males and twenty-one females who were taken from 8.5years to 16.5years old of mean age, according to the established land-marks and linear measurements. The results of this study were summarized as follows. 1. Prevalance of the maximum growth spurt more than 80 percentage was occurred in all measurements of cranial base and mandible, except posterior cranial base length in the female. 2. In all measurements of cranial base and mandible, the maximum spurt was occurred earlier in the female than the male while it was greater in male in all measurements except ramal height. 3. In body height measurement, the peak height velocity was occurred 2 years earlier for the female(11.0 years old) than the male(13.0 years old). 4. The timing of maximum spurt in anterior cranial base length and total mandibular length in both sexes and ramal height in the female were coincided with PHV. The maximum spurt was occurred in both sexes in all measurements 2 years before or after PHV, except mandibular body length and posterior cranial base length the in female. 5. In all ages, there was significant correlation between th etotal mandibular length and ramal height, and was also correlation between total cranial base length and anterior cranial base length(P0.05).