Cross Mapping of Standardized Nursing Diagnoses and Problems with NANDA-I in 4 Tertiary Hospitals / 임상간호연구

Purpose@#To explore the scope and method of applying standardized nursing terminologies to nursing diagnosis and problems used in nursing practice. @*Methods@#A descriptive study was done with a retrospective analysis of the nursing records of 141,420 patients that were hospitalized in 4 tertiary hospitals. The nursing diagnosis and problems collected from the records were standardized, and the standardized nursing diagnosis and problems cross mapped with NANDA-I, confirmed in a nursing focus group. @*Results@#65 (67.7%) of the 96 standardized nursing diagnosis and problems were equal with NANDA-I and included in the 10 domains of NANDA-I. Among 86 nursing diagnosis and problems excluded from the cross mapping with NANDA-I, the 63 terms (73.3%) related to surgery/procedure were the most common. @*Conclusion@#It is meaningful that multi-tertiary hospital nursing diagnosis and problems were standardized and cross mapping with standard nursing terminologies was performed. As for the method of applying standardized nursing terminologies in nursing practice, it is appropriate to use several standardized nursing terminologies complementarily.

Cross Mapping of Standardized Nursing Diagnoses and Problems with NANDA-I in 4 Tertiary Hospitals / 임상간호연구

Purpose@#To explore the scope and method of applying standardized nursing terminologies to nursing diagnosis and problems used in nursing practice. @*Methods@#A descriptive study was done with a retrospective analysis of the nursing records of 141,420 patients that were hospitalized in 4 tertiary hospitals. The nursing diagnosis and problems collected from the records were standardized, and the standardized nursing diagnosis and problems cross mapped with NANDA-I, confirmed in a nursing focus group. @*Results@#65 (67.7%) of the 96 standardized nursing diagnosis and problems were equal with NANDA-I and included in the 10 domains of NANDA-I. Among 86 nursing diagnosis and problems excluded from the cross mapping with NANDA-I, the 63 terms (73.3%) related to surgery/procedure were the most common. @*Conclusion@#It is meaningful that multi-tertiary hospital nursing diagnosis and problems were standardized and cross mapping with standard nursing terminologies was performed. As for the method of applying standardized nursing terminologies in nursing practice, it is appropriate to use several standardized nursing terminologies complementarily.

Suggestions for a standard clinical practice curriculum and learning objectives for physical therapy education in Korea / 보건의료교육평가

No abstract available.

Community Dwellers' Perception of Past Life Recollection and Preparation for Death / 한국호스피스완화의료학회지

PURPOSE: This study is to understand how community members perceive past life recollection and preparation for death. METHODS: Using a questionnaire, we surveyed 160 adult residents of one of the districts (gu) in Seoul, Korea. Descriptive statistics were used. RESULTS: Participants chose their 30s and 40s as the most difficult time in their lives. The most painful experience was "an illness of a family member", followed by "trouble with a spouse", and "trouble with children". As for the most difficult social experience, "sense of loss in life" was ranked the highest. Personally, the happiest time was "accomplishment of a goal", while it was "happiness through children" in family relationship and "contribution to society through my career" in social life. As for the most regrettable experience, personally "having lived without purpose" was the highest, "not meeting my parents' expectation more" in family relationship; "not providing sufficient education" in relationship with children; "not having an occupation that I wanted" in work life, and "lack of social skills" in social life. More than 87% of the surveyed showed a positive attitude about the system of the do not resuscitate (DNS) order. For a situation where participants were supposed to have an incurable disease, "I want to be notified of the true condition" and "I want to write a will and advanced directives" ranked high, receiving more than 3.1 points out of 4. CONCLUSION: These results demonstrate the need for death education to provide people with an opportunity to accept their regrettable experiences in the past as part of their life. Also, this study suggests the importance of writing advanced directives for people to prepare for"death with dignity" how it can help their decision to be better respected.

Death Recognition, Meaning in Life and Death Attitude of People Who Participated in the Death Education Program / 한국호스피스완화의료학회지

PURPOSE: This study was to identify the death recognition, meaning in life, and death attitude of participants in the death education program. METHODS: A survey was conducted, and 205 data were collected. Descriptive statistics, chi-square-test, ANOVA, and Duncan test were used. RESULTS: 1) The followings were the characteristics of death recognition shown by the participants. Over half of the participants said that they had given some thoughts on their deaths, that they had agreeable view on death acceptance, and that diseases and volunteer works made them think about their deaths. Moreover, suffering, parting with family and concerns for them, etc. were the most common reasons for the difficulty of accepting death. As for 'the person whom I discuss my death with', spouse, friend, and son/daughter were the most chosen in this order. Lastly, the funeral type that most of the participants desired was cremation. 2) The means of meaning in life and death attitude were 2.92+/-0.29 and 2.47+/-0.25, respectively. There were significant differences between health status, meaning in life and death attitude. 3) A significant positive corelationship was found between meaning in life and death attitude (r=0.190, P=0.001). CONCLUSION: For an effective death education program that would fit each individual's situation, an educational content that can make a person understand the meaning of his or her life and death, includes knowledge to lessen the fear and anxiety of death, and helps a person heal from the loss of a family member is absolutely necessary.

Association Studies of the Relationship Between Endometriosis and Polymorphism of the Detoxification Enzymes GSTT1, GSTM1, and CYP1A1 / 대한산부인과학회잡지

OBJECTIVE: Enzymes belonging to the Glutathione S transferase and cytochrome P450 families are involved in the two-stage detoxification process of a number of pro-carcinogens. We genotyped each 74 women with moderate or severe endometriosis and a control group of 93 women with a normal pelvis at cesarian section to investigate whether genetic polymorphism of CYP1A1, GSTT1, and GSTM1 are associated with endometriosis. MATERIALS AND METHODS: We investigate 74 women who were operated for endometriosis and 93 women who had no endometriotic lesion proved by operation. Polymerase chain reaction (PCR) and restriction fragment length polymorphism of PCR was done to determine each participant's genotype. RESULTS: We have found no significant differences between cases and controls in the frequencies of the GSTM1 and GSTT1 null mutations, or of the CYP1A1 MspI polymorphism does not differ significantly between groups. When GSTT1 and GSTM1 null mutation was combined with CYP1A1 MspI polymorphism, there was no significant differences between groups, either. CONCLUSION: Therefore, These low penetrance genes are not associated with increased susceptibility to endometriosis. Further studies are warranted to identify major susceptibility gene (s) and the mechanism involved in endometriosis to assist in the development of better methods for early detection, diagnosis and prevention.

The Association of Histologic Chorioamnionitis and Bronchopulmonary Dysplasia in Prematurity / 대한산부인과학회잡지

OBJECTIVE: Bronchopulmonary dysplasia (BPD) is one of the most frequent and clinically significant complications of prematurity and it has been widely accepted that immaturity, barotrauma, and oxygen toxicity are major factors in the etiology of BPD. However, recent studies showed that infection may also play a role in the pathogenesis of BPD and exposure to a prenatal inflammatory process may lead to lung injury and predispose to the subsequent development of BPD. The purpose of this study was to test the hypothesis that neonates with BPD had higher incidence of histologic chorioamnionitis than those in whom BPD does not develop. METHODS: A retrospective study was conducted to examine the relationship between histologic chorioamnionitis and the occurrence of BPD in neonate. We reviewed the hospital charts of 363 women and their neonates whose gestational age at birth were between 24 weeks and 35 weeks and recorded their pregnancy outcomes, the results of placental Biopsy, perinatal outcomes including the occurrence of BPD. RESULTS: 1. Neonates who developed BPD showed higher incidence of acute histologic chorioamnionitis. The relationship remained significant even after the adjustment for gestational age (odds ratio, 3.2: 95% confidence interval, 1.6-11.3: P<0.05). 2. Higher maternal serum CRP was also associated with increased incidence of histologic chorioamnionitis and BPD (P<0.05). 3. Neonates who developed BPD also had higher incidence of infectious morbidity such as early neonatal pneumonia and sepsis (P<0.05). CONCLUSION: These results suggest that histologic chorioamnionitis is closely related to the occurrence of BPD. This support the hypothesis that intrauterine infection may cause fetal lung injury and subsequent development of BPD.

Association Study of the Relationship between Endometriosis and Polymorphism of p53 Codon 72 / 대한불임학회지

OBJECTIVE: The present study was performed to evaluate the association of p53 codon 72 polymorphism and endometriosis. MATERIALS AND METHODS: We investigate 74 women who were operated for endometriosis and 93 women who had no endometriotic lesion proved by operation. Polymerase chain reaction was used to detect p53 codon polymorphisms. Result: We have found no significant difference between endometriosis and control group in the p53 codon polymorphism. The respective proportion of arginine homozygotes, heterozygotes and proline homozygotes in endometriosis group were 18.9%, 62.2% and 18.9%, respectively, and were 12.9%, 75.2% and 11.9%, respective in the group without endometriosis. CONCLUSION: Endometriosis is not associated with p53 polymorphism in Korean endometriosis patients.

Association Study of the Relationship between Endometriosis and Polymorphism of p53 Codon 72 / 대한불임학회지

OBJECTIVE: The present study was performed to evaluate the association of p53 codon 72 polymorphism and endometriosis. MATERIALS AND METHODS: We investigate 74 women who were operated for endometriosis and 93 women who had no endometriotic lesion proved by operation. Polymerase chain reaction was used to detect p53 codon polymorphisms. Result: We have found no significant difference between endometriosis and control group in the p53 codon polymorphism. The respective proportion of arginine homozygotes, heterozygotes and proline homozygotes in endometriosis group were 18.9%, 62.2% and 18.9%, respectively, and were 12.9%, 75.2% and 11.9%, respective in the group without endometriosis. CONCLUSION: Endometriosis is not associated with p53 polymorphism in Korean endometriosis patients.

Methylenetetrahydrofolate reductase polymorphism, homocysteine, lipid levels and susceptibility to preeclampsia in Korean women / 대한산부인과학회잡지

OBJECTIVE: The purpose was to test the hypothesis that the common missense mutation of 5,10-methylenetetrahydrofolate reductase(MTHFR) is more prevalent among preeclamptic women compared with control and also was to determine whether homocysteine and other lipid profile is changed in pregnant women with preeclampsia. METHODS: We measured plasma homocysteine, cholesterol, HDL, LDL, triglyceride, apoprotein B, vitamin B12, and folate in 48 pregnant women without preeclampsia and 22 women with preeclampsia. And the MTHFR genotype was determined with a polymerase chain reaction/restriction fragment length polymorphism method. Results were analyzed with a X2 contingency table and T-test. RESULTS: The prevalence of the MTHFR C677T mutation was not significantly different between the population studied. There was no significant difference in the level of plasma homocysteine, cholesterol, HDL, LDL, triglyceride, apoprotein B, and folate between controls and preeclamptic women. Furthermore, there was a significant difference in the level of plasma vitamin B12 between the population studied. CONCLUSION: These data suggest that the MTHFR C677T mutation is not a risk factor for preeclampsia in this population. Plasma homocysteine, cholesterol, HDL, LDL, triglyceride, apoprotein B, and folate level are not elevated in preeclamptic women. However, the plasma vitamin B12 level is elevated in preeclamptic women. Further studies are necessary to determine why the plasma vitamin B12 level is elevated in preelamptic women although they did not have vitamin drug.

Methylenetetrahydrofolate reductase polymorphism, homocysteine, lipid levels and susceptibility to preeclampsia in Korean women / 대한산부인과학회잡지

OBJECTIVE: The purpose was to test the hypothesis that the common missense mutation of 5,10-methylenetetrahydrofolate reductase(MTHFR) is more prevalent among preeclamptic women compared with control and also was to determine whether homocysteine and other lipid profile is changed in pregnant women with preeclampsia. METHODS: We measured plasma homocysteine, cholesterol, HDL, LDL, triglyceride, apoprotein B, vitamin B12, and folate in 48 pregnant women without preeclampsia and 22 women with preeclampsia. And the MTHFR genotype was determined with a polymerase chain reaction/restriction fragment length polymorphism method. Results were analyzed with a X2 contingency table and T-test. RESULTS: The prevalence of the MTHFR C677T mutation was not significantly different between the population studied. There was no significant difference in the level of plasma homocysteine, cholesterol, HDL, LDL, triglyceride, apoprotein B, and folate between controls and preeclamptic women. Furthermore, there was a significant difference in the level of plasma vitamin B12 between the population studied. CONCLUSION: These data suggest that the MTHFR C677T mutation is not a risk factor for preeclampsia in this population. Plasma homocysteine, cholesterol, HDL, LDL, triglyceride, apoprotein B, and folate level are not elevated in preeclamptic women. However, the plasma vitamin B12 level is elevated in preeclamptic women. Further studies are necessary to determine why the plasma vitamin B12 level is elevated in preelamptic women although they did not have vitamin drug.

Chromosomal Abnormality of Spontaneous Abortus in Relation to Transvaginal Ultrasonographic Finding / 대한산부인과학회잡지

OBJECTIVE: To investigate the importance of transvaginal ultrasonographic findings of spontaneous abortion and the relation of transvaginal ultrasonographic finding and the karyotype of abortus. MATERIALS AND METHODS: Transvaginal sonography was undergone to 48 subjects with spontaneous abortion in their early pregnancies who had visited Ewha Womans University Mokdong Hospital, from March 1996 to June 1999. A chromosome analysis of their aborted products was done. RESULTS: The frequency of chromosome abnormalities of abortus was 47.9%. Among the chromosomal abnormalities, trisomy was 31.2%(simple trisomy 27.0%, double trisomy 4.2%), monosomy X 8.4%, poliploidy 8.4%(tripoidy 4.2%, tetraploidy 4.2%). The average maternal age for trisomy was 30.2+/-4.9, and their past number of spontaneous abortions was 1.0+/-0.9, with trisomy 16 most frequent with 23.0%. In the case with trisomy 5, 22, and double trisomy, the average maternal age was increased with 38.0, 36.0+/-2.8, 35.5+/-5.0, respectively. However, no significant relevance could be found. The average maternal age for polyploidy was 30.5+/-3.7, and their past number of spontaneous abortions was 1.0+/-2.0. No significant relevance could be found compared with normal karyotypes. The average maternal age for monosomy X was 27.5+/-1.7, which is lower than the average maternal age for normal karyotypes, but not significantly so. The mean number of past abortions was no different with 1.0+/-0.8. No significant relevance could be found between ultrasonographic findings and chromosomal abnormalities. The measured/expected crown-rump length ratio of the aborted group was smaller than those of the control group. CONCLUSION: Serial ultrasonographic findings in early pregnancies help to diagnose spontaneous abortion, but not efficient to diagnose chromosomal abnormalities in the aborted group.

A study on the association between angiotensinogen gene and angiotensin-converting-enzyme gene and pregnancy-induced hypertension in Korean women / 대한산부인과학회잡지

OBJECTIVES: Previous studies have suggested an association of pregnancy-induced hypertension(PIH) with several genes involved in cardiovascular control. The objectives of this study were to evaluate the association between PIH and angiotensinogen(AGT) M235T gene and also to study the association between PIH and angiotensin-converting- enzyme(ACE). METHODS: DNA was extracted from whole blood, cheek swabs, and blood spot cards of 39 PIH patients and 54 controls. Controls consisted of women who had undergone at least two term pregnancies unaffected by PIH. All samples were genotyped for all the polymorphism using PCR of known alleic variants. Results were ananlyzed with a kappa2 contingency table. RESULTS: Four of 13 women with mild PIH(30.8%) and thirteen of 26 women with severe PIH(50.0%) were heterozygous for AGT M235T mutation compared with 26 of 54 controls(48.1%). Two of 13 women with mild PIH(15.4%) and two of 26 women with severe PIH(7.7%) were homozygous for AGT M235T mutation compared with 10 of 54 controls(18.6%). Six of 7 women with mild PIH(85.7%) and ten of 21 women with severe PIH(47.6%) were ID type for ACE gene compared with 31 of 56 controls(55.4%). One of 7 women with mild PIH(14.3%) and seven of 21 women with severe PIH(33.4%) were DD type for ACE gene compared with 15 of 56 controls(26.7%). There was no significance between mild, severe PIH patients and controls for AGT M235T mutation and ACE gene polymorphism. CONCLUSION: In Korean population, AGT M235T mutation and ACE gene are not associated with an increased risk for PIH.

Comparing the Efficiency of 75 gm Oral Glucose Tolerance Test to 100 gm Oral Glucose Tolerance Test in Diagnosing Gestational Diabetes in Korean Women / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to compare one-step 2 hour 75 gm oral glucose tolerance test (OGTT) proposed by the World Health Organization (WHO) with two-step 3 hour 100 gm OGTT of National Diabetes Data group (NDDG) criteria for determining gestational diabetes. METHODS: Data for 111 pregnant Korean women who were diagnosed of gestational diabetes either by 75 gm OGTT or 100 gm OGTT and 100 normal controls were reviewed and analyzed retrospectively. The effectiveness of the two tests was determined by comparing the frequency of diabetes-related pregnance outcomes such as macrosomia, cesarean delivery, and preterm birth. Chi-square, Fisher's Exact test, and T-tests were used for statistical analysis. RESULTS: Among 111 gestational diabetic women, 59 (53.2%) were diagnosed by WHO criteria of 75 gm OGTT and 52 (46.8%) were diagnosed by 100 gm OGTT of NDDG criteria. Frequency of macrosomia and cesarean section was higher in 75 gm test group than in 100 gm test group (12.3% vs 5.8% and 35.1% vs 21.2%, respectively), but the difference was statistically not significant. When compared to the control group, 75 gm test group reached statistical significance in having higher incidence of macrosomia (12.3% vs 3%, p<0.05) whereas 100gm test group did not. CONCLUSION: Efficacy of the diagnostic criteria of WHO was comparable to that of NDDG for diagnosing gestational diabetes. This suggests WHO's 75 gm OGTT to be an efficient diagnostic tool for gestational diabetes in Korean women.

Comparing the Efficiency of 75 gm Oral Glucose Tolerance Test to 100 gm Oral Glucose Tolerance Test in Diagnosing Gestational Diabetes in Korean Women / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to compare one-step 2 hour 75 gm oral glucose tolerance test (OGTT) proposed by the World Health Organization (WHO) with two-step 3 hour 100 gm OGTT of National Diabetes Data group (NDDG) criteria for determining gestational diabetes. METHODS: Data for 111 pregnant Korean women who were diagnosed of gestational diabetes either by 75 gm OGTT or 100 gm OGTT and 100 normal controls were reviewed and analyzed retrospectively. The effectiveness of the two tests was determined by comparing the frequency of diabetes-related pregnance outcomes such as macrosomia, cesarean delivery, and preterm birth. Chi-square, Fisher's Exact test, and T-tests were used for statistical analysis. RESULTS: Among 111 gestational diabetic women, 59 (53.2%) were diagnosed by WHO criteria of 75 gm OGTT and 52 (46.8%) were diagnosed by 100 gm OGTT of NDDG criteria. Frequency of macrosomia and cesarean section was higher in 75 gm test group than in 100 gm test group (12.3% vs 5.8% and 35.1% vs 21.2%, respectively), but the difference was statistically not significant. When compared to the control group, 75 gm test group reached statistical significance in having higher incidence of macrosomia (12.3% vs 3%, p<0.05) whereas 100gm test group did not. CONCLUSION: Efficacy of the diagnostic criteria of WHO was comparable to that of NDDG for diagnosing gestational diabetes. This suggests WHO's 75 gm OGTT to be an efficient diagnostic tool for gestational diabetes in Korean women.

The validity of Patho_Net system: Comparative study between imaging and glass slide in the diagnosis of Papanicolaou smear / 대한산부인과학회잡지

OBJECTIVE: To validate the efficacy of Patho_Net system for cervical cytology screening. METHODS: The results of imaging diagnosis by Patho_Net system were compared to those of 102 cervical smears diagnosed by conventional light microscopy. RESULTS: There was 52.9% concordant results. The image result for the slide were 41 (80.4%) WNL or atrophy, 19 (61.3%) inflammation or benign atypia, 1 (20%) LSIL, 2 (20%) HSIL and 1 (100%) invasive squamous cell carcinoma. CONCLUSION: Patho_Net system has potential for diagnostic value as a valid alternative to the traditional glass slide screening of Pap smear.

The validity of Patho_Net system: Comparative study between imaging and glass slide in the diagnosis of Papanicolaou smear / 대한산부인과학회잡지

OBJECTIVE: To validate the efficacy of Patho_Net system for cervical cytology screening. METHODS: The results of imaging diagnosis by Patho_Net system were compared to those of 102 cervical smears diagnosed by conventional light microscopy. RESULTS: There was 52.9% concordant results. The image result for the slide were 41 (80.4%) WNL or atrophy, 19 (61.3%) inflammation or benign atypia, 1 (20%) LSIL, 2 (20%) HSIL and 1 (100%) invasive squamous cell carcinoma. CONCLUSION: Patho_Net system has potential for diagnostic value as a valid alternative to the traditional glass slide screening of Pap smear.

A Case of Female Pseudohermaphroditism with m llerian agenesis, urinary tract malformations, and imperforate anus / 대한산부인과학회잡지

Special idiopathic female pseudohermaphroditism with urinary tract, m llerian duct, and lower gastrointestinal tract anomalies, in addition to masculinization of the external genitalia, is rare phenomenon. Masculinization of external genitalia and other anomalies occur in the absence of a recognized exposure to androgen or other teratogenic factors. We report a case of a female pseudohermaphroditism with m llerian agenesis, bilateral multicystic dysplastic kidney, urethral agenesis, left double ureter, rectovesical fistula, imperforate anus, single umbilical artery, detected after therapeutic abortion at 23+5 weeks of gestational age. The final diagnosis is based on autopsy.

A Cytogenetic Study of Amenorrhea / 대한불임학회지

OBJECTIVEs: Cytogenetic investigations were carried out on 770 women with primary (n=560) and secondary amenorrhea (n=210) to determine the frequency of chromosomal or genetic causes of amenorrhea. MATERIALS AND METHODS: In 770 women with primary amenorrhea (n=560) and secondary amenorrhea (n=210), chromosomal analysis were performed. RESULTS: 1) The most prevalent age group is 16-20 years of age group with primary amenorrhea and 26-30 years of age group with secondary amenorrhea. 2) Out of 560 cases of primary amenorrhea, 343 cases (61.3%) had the normal chromosome constitution and 217 cases (38.7%) had the abnormal chromosome constitution including 46,XY. 3) In 217 cases of abnormal chromosome of primary amenorrhea, 57 cases (26.3%) had 45,X and 34 cases (15.8%) had the 46,XY, 24 cases (11.0%) had 45,X/46,X,i (Xq), 23 cases (10.6%) had 45,X/46,X,+mar and 14 cases (6.6%) had 45,X/46,XY. 4) Out of 210 cases of secondary amenorrhea, 181 cases (86.2%) had the normal chromosome constitution and 29 cases (13.8%) had 45,X/46,XX. CONCLUSION: High percentage of chromosomal abnormalities was diagnosed in primary amenorrhea and most of them were sex chromosome anomalies. In secondary amenorrhea, the prevalence was lower than primary amenorrhea, so a preselection of patients with secondary amenorrhea for cytogenetic investigations seems to be necessary.

A Cytogenetic Study of Recurrent Spontaneous Abortion / 대한불임학회지

OBJECTIVE: The purpose of this investigation is to determine the frequency of chromosomal or genetic causes of recurrent spontaneous abortion. METHODS : A cytogenetic study was made in of 921 couples for 13 years from January 1984 to December 1997 in which the woman was ascertained to have had two or more spontaneous abortions at our Cytogenetic Laboratory, Institute of Reproductive Medicine and Population, Seoul National University. RESULTS : The overall incidence of chromosome anomaly was 80 out of 921 (8.7%). There were 34 cases (3.69%) of reciprocal balanced translocation and 13 cases (1.41%) of Robertsonian translocation. Also 17 cases (1.85%) of inversion and 5 cases (0.54%) of X chromosome mosiacism was observed. In the case of reciprocal balanced translocation, chromosome 8,6,7,13 were preferentially involved over others. And in the case of Robertsonian translocation, chromosome 13 was preferentially involved. CONCLUSION: Our study demonstrates that cytogenetic analysis is indicated in couples with 2 or more spontaneous abortion and about half of these disorders are reciprocal balanced or Robertsonian translocations.