Diagnostic Performance of Radial Probe Endobronchial Ultrasound without a Guide-Sheath and the Feasibility of Molecular Analysis / 결핵

BACKGROUND: Radial probe endobronchial ultrasound (R-EBUS), is effective for tissue diagnosis of lung lesions. We evaluated the diagnostic performance of R-EBUS both a guide-sheath and fluoroscopy and identified factors associated with accurate diagnosis. The feasibility of molecular and genetic testing, using specimens obtained by R-EBUS, was also investigated. METHODS: The study retrospectively reviewed 211 patients undergoing R-EBUS without a guide-sheath and fluoroscopy, June 2016-May 2017. After excluding 27 patients of which the target lesion was not reached, 184 were finally included. Multivariate logistic regression was used, to identify factors associated with accurate diagnosis. RESULTS: Among 184 patients, R-EBUS-guided biopsy diagnosed malignancy in 109 patients (59%). The remaining 75 patients (41%) with non-malignant results underwent additional work-ups, and 34 were diagnosed with malignancy. Based on final diagnosis, diagnostic accuracy was 80% (136/170), and sensitivity and specificity for malignancy were 76% (109/143) and 100% (27/27), respectively. In multivariate analysis, peripheral location (adjusted odds ratio [aOR], 3.925; 95% confidence interval [CI], 1.203–12.811; p=0.023), and central position of the probe (aOR, 2.435; 95% CI, 1.424–7.013; p=0.035), were associated with accurate diagnosis of malignancy. Molecular and genetic analyses were successful, in all but one case, with inadequate specimens. CONCLUSION: R-EBUS-guided biopsy without equipment, is effective for tissue diagnosis. Peripheral location and central position of the radial probe, were crucial for accurate diagnosis. Performance of molecular and genetic testing, using samples obtained by R-EBUS, was satisfactory.

Diagnostic Performance of Radial Probe Endobronchial Ultrasound without a Guide-Sheath and the Feasibility of Molecular Analysis / 결핵및호흡기질환

BACKGROUND@#Radial probe endobronchial ultrasound (R-EBUS), is effective for tissue diagnosis of lung lesions. We evaluated the diagnostic performance of R-EBUS both a guide-sheath and fluoroscopy and identified factors associated with accurate diagnosis. The feasibility of molecular and genetic testing, using specimens obtained by R-EBUS, was also investigated.@*METHODS@#The study retrospectively reviewed 211 patients undergoing R-EBUS without a guide-sheath and fluoroscopy, June 2016-May 2017. After excluding 27 patients of which the target lesion was not reached, 184 were finally included. Multivariate logistic regression was used, to identify factors associated with accurate diagnosis.@*RESULTS@#Among 184 patients, R-EBUS-guided biopsy diagnosed malignancy in 109 patients (59%). The remaining 75 patients (41%) with non-malignant results underwent additional work-ups, and 34 were diagnosed with malignancy. Based on final diagnosis, diagnostic accuracy was 80% (136/170), and sensitivity and specificity for malignancy were 76% (109/143) and 100% (27/27), respectively. In multivariate analysis, peripheral location (adjusted odds ratio [aOR], 3.925; 95% confidence interval [CI], 1.203–12.811; p=0.023), and central position of the probe (aOR, 2.435; 95% CI, 1.424–7.013; p=0.035), were associated with accurate diagnosis of malignancy. Molecular and genetic analyses were successful, in all but one case, with inadequate specimens.@*CONCLUSION@#R-EBUS-guided biopsy without equipment, is effective for tissue diagnosis. Peripheral location and central position of the radial probe, were crucial for accurate diagnosis. Performance of molecular and genetic testing, using samples obtained by R-EBUS, was satisfactory.

Semantic Network Analysis about Comments on Internet Articles about Nurse Workplace Bullying / 임상간호연구

PURPOSE@#A significant amount of public opinion about nurse bullying is expressed on the internet. The purpose of this study was to analyze the linkage structures among words extracted from comments on internet articles related to nurse workplace bullying using semantic network analysis.@*METHODS@#From February 2018 to April 2019, comments made on news articles posted to the Daum and Naver web portal containing keywords such as “nurse”, “Taeum”, and “bullying” were collected using a web crawler written in Python. A morphological analysis performed with Open Korean Text in KoNLPy generated 54 major nodes. The frequencies, eigenvector centralities, and betweenness centralities of the 54 nodes were calculated and semantic networks were visualized using the UCINET and NetDraw programs. Convergence of iterated correlations (CONCOR) analysis was performed to identify structural equivalence.@*RESULTS@#This paper presents results about March 2018 and January 2019 because these months had highest number of articles. Of the 54 major nodes, “nurse”, “hospital”, “patient”, and “physician” were the most frequent and had the highest eigenvector and betweenness centralities. The CONCOR analysis identified work environment, nurse, gender, and military clusters.@*CONCLUSION@#This study structurally explored public opinion about nurse bullying through semantic network analysis. It is suggested that various studies on nursing phenomena will be conducted using social network analysis.

Research Trends of Articles Published in the Journal of Korean Clinical Nursing Research from 2000 to 2017: Text Network Analysis of Keywords / 임상간호연구

PURPOSE: The aim of this study was to identify the research trends of articles published in the Journal of Korean Clinical Nursing Research from 2000 to 2017 by a text network analysis using keywords. METHODS: This study analyzed 600 articles. The R program was used for text mining that extracted frequency, centrality rank, and keyword network. RESULTS: From 2000 to 2009, keywords with high-frequency were ‘nurse’, ‘pain’, ‘anxiety’, ‘knowledge’, ‘attitude’, and so on. ‘Pain’, ‘nurse’, and ‘knowledge’ showed a high centrality. ‘Fatigue’ showed no high frequency but a high centrality. Keywords such as ‘nurse’, ‘knowledge’, and ‘pain’ also showed high frequency and centrality between 2010 and 2017. ‘Hemodialysis’ and ‘intensive care unit’ were added to keywords with high frequency and centrality during the period. CONCLUSION: The frequency and centrality of keywords such as ‘nurse’, ‘pain’, ‘knowledge’, ‘hemodialysis’, and ‘intensive care unit’ reflect the research trends in clinical nursing between 2000 and 2017. Further studies need to expand the keyword networks by connecting the main keywords.

Changing Epidemiology of Nontuberculous Mycobacterial Lung Diseases in a Tertiary Referral Hospital in Korea between 2001 and 2015

This study investigated the changes in the major etiologic organisms and clinical phenotypes of nontuberculous mycobacterial lung disease (NTM-LD) over a recent 15-year period in Korea. The increase of number of patients with NTM-LD was primarily due to an increase of Mycobacterium avium complex (MAC) lung disease (LD). Among MAC cases, the proportion of M. avium increased compared with M. intracellulare, whereas the incidence of M. abscessus complex and M. kansasii LD remained relatively stable. The proportion of cases of the nodular bronchiectatic form increased compared with the fibrocavitary form of NTM-LD.

Bibliographic Analysis of Articles Published in Journal of Korean Clinical Nursing Research from 2009 to 2015 / 임상간호연구

PURPOSE: The aimof this study was to identify bibliographic characteristics and research trends of articles published in the Journal of Korean Clinical Nursing Research from2009 to 2015. METHODS: Descriptive statistics were used to analyze 268 articles. Bibliographic characteristics, appropriateness ofmethods for quantitative and qualitative studies, and key concepts of articles were analyzed. RESULTS: A clinical nurse was the first author for 184 (66.7%) articles. The number of collaborative works between hospital and university was 184 (68.7%). Study participants were patients (120, 38.1%), nurses (115, 36.5%) and others. IRB approval was given for 156 articles (58.2%). Written informed consent was obtained in 125 articles (46.7%). Quantitative research accounted for 98.6% of the articles but qualitative studies only 4 (1.4%). Types of interventions in the experimental studies were nursing skills (43, 42.6%) and health education (32, 31.7%). Major keywords were nurses, pain, knowledge, intensive care unit, anxiety, depression, fatigue, and stress. CONCLUSION: Articles in this journal deal with topics and concepts confronted in nursing practice so experimental studies on applicability of nursing interventions were frequently published. Findings in this study indicate that the authors published in the journal contribute to the development of nursing with characteristics distinctive from other nursing journals published in Korea.

Warfarin skin necrosis mimicking calciphylaxis in a patient with secondary hyperparathyroidism undergoing peritoneal dialysis

Warfarin skin necrosis (WSN) is an infrequent complication of warfarin treatment and is characterized by painful ulcerative skin lesions that appear a few days after the start of warfarin treatment. Calciphylaxis also appears as painful skin lesions caused by tissue injury resulting from localized ischemia caused by calcification of small- to medium-sized vessels in patients with end-stage renal disease. We report on a patient who presented with painful skin ulcers on the lower extremities after the administration of warfarin after a valve operation. Calciphylaxis was considered first because of the host factors; eventually, the skin lesions were diagnosed as WSN by biopsy. The skin lesions improved after warfarin discontinuation and short-term steroid therapy. Most patients with end-stage renal disease have some form of cardiovascular disease and some require temporary or continual warfarin treatment. It is important to differentiate between WSN and calciphylaxis in patients with painful skin lesions.

Chronic Myeloid Leukemia Relapsing as Isolated Extramedullary Disease Presenting as a Cardiac Mass / 대한내과학회지

Allogeneic hematopoietic stem cell transplantation is the only option for chemotherapy-refractory chronic myeloid leukemia (CML). Extramedullary relapse after transplantation is rare and usually accompanies marrow relapse. Generally, the prognosis of extramedullary relapse is poor. Here, we report a man with extramedullary relapsed CML after stem cell transplantation that presented as an isolated cardiac mass, which has shown an indolent course for more than 2 years, without evolving to medullary relapse during that period. This case implies that the CML clone might contribute to the development of quiescent extramedullary relapse with a benign course.

Nontuberculous Mycobacterial Lung Disease Caused by Mycobacterium shinjukuense: The First Reported Case in Korea / 결핵및호흡기질환

Mycobacterium shinjukuense is a novel species of nontuberculous mycobacteria (NTM) that was first reported in Japan in 2011. It is a slow-growing NTM pathogen that can cause chronic pulmonary infections. There are only a few reported cases of M. shinjukuense infections, all of which are from Japan. We reported a case of chronic lung disease caused by M. shinjukuense. The organism was identified by 16S rRNA, rpoB, and hsp65 gene sequencing. To the best of our knowledge, this was the first confirmed case of lung disease caused by M. shinjukuense outside of Japan.

Successful Retrieval of a Fractured Guidewire during Extracorporeal Membrane Oxygenator Insertion / 대한내과학회지

Recently, the use of extracorporeal membrane oxygenation has evolved rapidly and there is potential for expanding its use. There are many complications associated with extracorporeal membrane oxygenation, but the fracture of a guidewire has been reported to be very rare during extracorporeal membrane oxygenation insertion. We describe our experience of successfully removing a fractured 0.038-inch guidewire using a catheter wedge with balloon inflation following a fracture that occurred during insertion of extracorporeal membrane oxygenation through the left femoral vein.

Complete remission in CD30-positive refractory extranodal NK/T-cell lymphoma with brentuximab vedotin

No abstract available.

Quality of Life in Patients with Chronic Cardiovascular Disease / 성인간호학회지

PURPOSE: The purpose of the present study was to explore the meaning of quality of life in patients with chronic cardiovascular disease. METHODS: A grounded theory method guided data collection and analysis. A total of 16 adult outpatients with chronic cardiovascular disease was participated. Data were collected through individual in-depth interviews. All interviews were audio taped and transcribed verbatim. Coding was used to establish different concepts and categories. A theoretical sampling technique was used to obtain diverse data from many relevant categories. RESULTS: Seven categories were extracted, and they divided into constructing and intervening factors of quality of life. Constructing factors were uncertainty, recovery in the sense of control and maintaining social life. Intervening factors were symptom experiences, social support, taking care of themselves, and reflecting life. 'Keeping restrictive conditions under control' was emerged as a core category. The meaning of quality of life in patients with cardiovascular was explained according to the levels of keeping restrictive conditions under control. CONCLUSION: The result of this study may contribute for health professionals to understand the quality of life in patients with cardiovascular disease.

A Study on Knowledge and Attitudes Regarding Sexuality of Elderly People in Korea / 간호학회지

PURPOSE: The purpose of this study was to examine the level of knowledge and the attitudes of Korean adults toward sexuality of elderly people. METHODS: This was a descriptive study using a convenience sample of 241 adults. The questionnaire had 34 items for knowledge and 26 items for attitudes. RESULTS: The result showed that, related to sexuality of elderly people, the level of knowledge was average and attitudes were conservative. The level of knowledge was significantly higher in groups that were highly educated and of low economic status (p<.05). Attitudes toward sexuality of elderly people were significantly more conservative in female, older, less educated, and high economic status group. CONCLUSION: The findings suggest a need for more education for Korean adults regarding sexuality in elderly people.

Medical-and-Psychosocial Factors Influencing on the Quality of Life in Patients with Cervix Cancer / 대한방사선종양학회지

PURPOSE: Quality of life in patients with cancer may be influenced by various kinds of variables, such as personal, environmental, and medical factors. The purpose of this study was to identity the influencing factors on the quality of life in patients with cancer. MATERIALS AND METHODS: One hundred and forty seven patients, who were taking medical therapy or following up after surgery for cervix cancer, participated in the present study. Quality of life, medical variables (cancer stage, types of treatment, follow-up status, and symptom distress), and psychosocial variables (mood disturbance, orientation to life, and social support) were measured. The obtained data were computed using multiple regression analyses. RESULTS: The medical-and-psychosocial variables explained 63.3% of the total variance in the quality of life (R2=0.633, F=16.969, p=.000). Cancer stage, symptom distress, mood disturbance, social support (family), and optimistic orientation to life were significant factors influencing on the quality of life in patients with cervix cancer. CONCLUSION: An integrative care program which includes medical - and - psychosocial characteristics of patients is essential to improve quality of life in patients with cervix cancer.

Psychosocial Adjustment Process in Adolescents with Epilepsy / 간호학회지

PURPOSE: The purpose of this study was to explore the psychosocial adjustment process in adolescents with epilepsy in the context of Korean society and culture. METHOD: A grounded theory method was used for data collection and analysis. Participants for this study were 9 adolescents who regularly visited an epilepsy clinic in a university hospital. The data was collected through in-depth interviews during the period from November, 2002 to June, 2003. Data collection and analysis were performed simultaneously. RESULT: Twenty-three categories emerged including 'suffering', 'psychological stigma', and 'social isolation from one's peers'. Categories were divided into paradigms which consisted of conditions, actions/ interactions, and consequences. 'Reconstructing life' was the core category in this study. The theoretical scheme was described by organizing categories around the core category. CONCLUSION: This study provides a framework for the development of individualized nursing interventions to care for adolescents with epilepsy.

Arm Morbidity after Breast Cancer Treatments and Analysis of Related Factors / 대한방사선종양학회지

PURPOSE: To evaluate the incidence of arm morbidity following breast cancer surgery including axillary dissection and to identify related factors. MATERIASL AND METHODS: One hundred and fifty nine patients were studied using a self-report questionnaire and a clinical examination. Lymphedema, reduction of range of motion in shoulder joint and subjective symptoms (pain, impaired arm movement, numbness, stiffness) were evaluated. As related factors, demographic, oncologic characteristics and types of treatment were analysed. RESULTS: The incidence of lymphedema (> or =2 cm difference comparing to unaffected arm) was 6.3%, 10.7%, 22.6% and 23.3% at each 10 cm, 20 cm, 30 cm, and 40 cm from wrist. Reduction of range of motion in shoulder joint (> or =20 degree difference comparing to unaffected arm) was noted in more than 1/3 patients for flexion, abduction and internal rotation. Especially the reduction of range of motion in internal rotation was severe (> 50% reduction) in 1/3 patients. Approximately 50 to 60% of patients complained impaired arm movement, numbness, stiffness and pain. Body mass index (BMI) was the significant risk factor for lymphedema. CONCLUSION: Lymphedema was present in 1/3 of patients and the common sites of edema were 30 cm 40 cm proximal from the wrist. Also most severe reduction of range of motion in shoulder joint was with internal rotation. There needs weight control for lymphedema because BMI was the significant risk factor for lymphedema. Also rehabilitation program for range of motion especially internal rotation in shoulder joint should be developed.

The Relationship of Self Efficacy and Social Support to the Psychosocial Adjustment in People with Epilepsy / 간호학회지

The main purpose of this study was to identify the relationship of self efficacy and social support to the psychosocial adjustment in people with epilepsy. Data were collected from October 1 to October 15, 1999 from 101 people with epilepsy who were being treated regularly at one of the university hospitals located in Seoul. The research instruments were a questionnaire to gather demographic and disease-specific data, the Epilepsy Psycho- Social Effects Scale developed by Chaplin et al(1990), the Epilepsy Self Efficacy Scale developed by DiIorio et al(1992a) and translated by Park(1999), the Norbeck Social Support Questionnaire developed by Norbeck et al(1981) and translated by Oh(1985). Data were analyzed using the SPSS program. The results are as follow : 1. Of the 14 psychosocial adjustment areas, 75 of 101 subjects experienced problems in ten or more areas and 28 in all 14 areas. The severity of the psychosocial adjustment problem was moderate or more in six areas. 2. The score for self efficacy was an average of 1103.86 out of a possible 1800, for social support 117.57 for total functional out of a possible 720, and 48.21 for total network out of a possible 264. There were an average of five people on the network. The main network people were parents, brothers and sisters, spouse, friends. 3. Of the 14 psychosocial adjustment areas, six areas correlated with self efficacy and 'problems with taking medication' area had a negative correlation with social support. In conclusion, people with epilepsy have various problems in psychosocial adjustment. Nursing interventions using self efficacy should be developed to improve psychosocial adjustment in people with epilepsy. Also, instruments and interventions for regimen-specific supports which are suitable for epilepsy should be developed.

The Relationship of Self Efficacy and Social Support to the Psychosocial Adjustment in People with Epilepsy / 간호학회지

The main purpose of this study was to identify the relationship of self efficacy and social support to the psychosocial adjustment in people with epilepsy. Data were collected from October 1 to October 15, 1999 from 101 people with epilepsy who were being treated regularly at one of the university hospitals located in Seoul. The research instruments were a questionnaire to gather demographic and disease-specific data, the Epilepsy Psycho- Social Effects Scale developed by Chaplin et al(1990), the Epilepsy Self Efficacy Scale developed by DiIorio et al(1992a) and translated by Park(1999), the Norbeck Social Support Questionnaire developed by Norbeck et al(1981) and translated by Oh(1985). Data were analyzed using the SPSS program. The results are as follow : 1. Of the 14 psychosocial adjustment areas, 75 of 101 subjects experienced problems in ten or more areas and 28 in all 14 areas. The severity of the psychosocial adjustment problem was moderate or more in six areas. 2. The score for self efficacy was an average of 1103.86 out of a possible 1800, for social support 117.57 for total functional out of a possible 720, and 48.21 for total network out of a possible 264. There were an average of five people on the network. The main network people were parents, brothers and sisters, spouse, friends. 3. Of the 14 psychosocial adjustment areas, six areas correlated with self efficacy and 'problems with taking medication' area had a negative correlation with social support. In conclusion, people with epilepsy have various problems in psychosocial adjustment. Nursing interventions using self efficacy should be developed to improve psychosocial adjustment in people with epilepsy. Also, instruments and interventions for regimen-specific supports which are suitable for epilepsy should be developed.

The Effectiveness of Cardiopulmonary Resuscitation Training Targeted for Nursing Students / 기본간호학회지

The purpose of the study is to evaluate the effectiveness and competence level of trainees of Cardiopulmonary resuscitation training targeted for nursing students. 70 nursing students of Y nursing college are recruited as subjects from Dec. 1st, 1998 through Dec. 8th, 1998. For the pre-test, demographic data related to CPR and knowledge of CPR were evaluated. For the post-test, the next week of pre-test, three difference groups of subjects were tested their knowledge of CPR. CPR training was designed by two components which were 90 mins lecture and demonstration by one professor and individual practice using two educational models with two professors. As the tool of measurement estimating pre or post knowledge of CPR, questionnaires were developed based on self-diagnosis questionnaires of American Heart Association (AHA). The questionnaires were multiple choices (50 questions) and open end questions regarding CPR process. Each multiple choices questions valued 2 points (Score varied min. 0 point to max. 100 points.). Collected data were computerized and analyzed by SPSS-WIN. Frequency and percentage of each questions analyzed. The differences of the knowledge and competency level of subjects between pre and post test was analyses by paired t-test. The followings are research outcome. 1. In the pre-test, 95% of subjects answered that they already knew what CPR was, but only 82% described correctly what CPR was. 49% learned CPR before, and 80s5 of them learned at high school. 2. 37 questions scores increases, and 10 questions scores decreased. 3 questions didnt change their score. After getting training, ratio of 80% correct score significantly increased 4 times. 3. In post-test, knowledge level of trainees increased compared to that of pre-test. (t=-15.075, p=0.000) 4. Competence level also increased (t= -14.86, p=0.00). In result, after getting CPR training, most CPR knowledge increased except open the air tract, toddler CPR, and alternative behavior when the air tract is blocked. CPR training needs to extend the educational scope not only CPR lecture but also psychomotor skill practice. CPR trainees are in need of appropriate feedback as well as enough opportunities of skill practice.