Development of a Team Effectiveness Scale for Nursing Units / 간호행정학회지

PURPOSE: The purpose of this study was to develop a Team Effectiveness Scale for Nursing Units (TES-NU) and verify validity and reliability of the developed scale. METHODS: A preliminary 69 item version of the TES-NU was developed through in-depth interviews. The draft scale was developed using 65 items selected following content validity evaluation. Finally, thirty items with response options on a 5-point Likert scale were selected based on internal consistency reliability and construct validity. Subsequently, convergent validity of the TES-NU was verified. RESULTS: Six factors, namely, leadership of the head nurse, cohesion, job satisfaction, competency of nurses, productivity, and coordination were identified. These factors explained 64.6% of the total variance. The TES-NU's Cronbach's α for the total scale was .94. The correlation coefficient between the scores of the TES-NU and Ahn's Team Effectiveness scale was .59. CONCLUSION: Results show that the TES-NU developed in this study has good reliability and validity. Therefore, this TES-NU is recommended as a useful tool for managing team effectiveness for nursing units.

TMF and glycitin act synergistically on keratinocytes and fibroblasts to promote wound healing and anti-scarring activity

Keratinocyte-fibroblast interactions are critical for skin repair after injury. During the proliferative phase of wound healing, proliferation, migration and differentiation of these cells are the major mechanisms leading to tissue remodeling. We have previously reported that glycitin, a major soy isoflavone, stimulates dermal fibroblast proliferation; and the phytochemical, 4′,6,7-trimethoxyisoflavone (TMF), induces migration of HaCaT keratinocyte cells. We therefore investigated whether these compounds display synergistic effects on skin cells during wound healing in vitro and in vivo. Co-treatment with TMF and glycitin synergistically promotes the proliferation and migration of both keratinocytes and dermal fibroblasts, with a 1:1 ratio of these compounds showing the greatest efficacy in our co-culture system. This keratinocyte-fibroblast interaction occurred via the secretion of TGF-β, and the induction of differentiation and proliferation was confirmed in both indirect and direct co-culture assays. In an excisional and burn wound animal model, mice treated with a 1:1 ratio of TMF and glycitin showed faster wound closure, regeneration and scar reduction than even the positive control drug. These data indicate that two isoflavones, TMF and glycitin, act synergistically to promote wound healing and anti-scarring and could potentially be developed together as a bioactive therapeutic for wound treatment.

Dexamethasone Inhibits TGF-β1-Induced Cell Migration by Regulating the ERK and AKT Pathways in Human Colon Cancer Cells Via CYR61 / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: One of the features in cancer development is the migration of cancer cells to form metastatic lesions. CYR61 protein promotes migration and the epithelial-mesenchymal transition in several cancer cell types. Evidence suggests that CYR61 and dexamethasone are relevant to colorectal cancer. However, relationships between them and colorectal cancer are still unclear. Understanding the molecular mechanism of colorectal cancer progression related with CYR61 and dexamethasone, which is widely used for combination chemotherapy, is necessary for improved therapy. MATERIALS AND METHODS: We used colorectal cancer cells, HCT116, co-treated with transforming growth factor β1 (TGF-β1) and dexamethasone to examine the inhibitory migration effect of dexamethasone by migratory assay. Alternatively, both migratory pathways, expression of AKT and ERK, and the target factor CYR61 was also tested by co-treatment with TGF-β1 and dexamethasone. RESULTS: We report that dexamethasone significantly inhibited TGF-β1-induced cell migration, without affecting cell proliferation. Importantly, we observed that TGF-β1 promoted the epithelial-mesenchymal transition process and that dexamethasone co-treatment abolished this effect. ERK and AKT signaling pathways were found to mediate TGF-β1-induced migration, which was inhibited by dexamethasone. In addition, TGF-β1 treatment induced CYR61 expression whereas dexamethasone reduced it. These observations were compatible with the modulation of migration observed following treatment of HCT116 cells with human recombinant CYR61 and anti-CYR61 antibody. Our results also indicated that TGF-β1 enhanced collagen I and reduced matrix metalloproteinase 1 expression, which was reversed by dexamethasone treatment. CONCLUSION: These findings suggested that dexamethasone inhibits AKT and ERK phosphorylation, leading to decreased CYR61 expression, which in turn blocks TGF-β1-induced migration.

Factors related to Nurses' Patient Identification Behavior and the Moderating Effect of Person-organization Value Congruence Climate within Nursing Units

PURPOSE: This research was an empirical study designed to identify precursors and interaction effects related to nurses' patient identification behavior. A multilevel analysis methodology was used. METHODS: A self-report survey was administered to registered nurses (RNs) of a university hospital in South Korea. Of the questionnaires, 1114 were analyzed. RESULTS: The individual-level factors that had a significantly positive association with patient identification behavior were person-organization value congruence, organizational commitment, occupational commitment, tenure at the hospital, and tenure at the unit. Significantly negative group-level precursors of patient identification behavior were burnout climate and the number of RNs. Two interaction effects of the person-organization value congruence climate were identified. The first was a group-level moderating effect in which the negative relationship between the number of RNs and patient identification behavior was weaker when the nursing unit's value congruence climate was high. The second was a cross-level moderating effect in which the positive relationship between tenure at the unit and patient identification behavior was weaker when value congruence climate was high. CONCLUSION: This study simultaneously tested both individual-level and group-level factors that potentially influence patient identification behavior and identified the moderating role of person-organization value congruence climate. Implications of these results are discussed.

Effects of a Discharge Education Program using Computerized Animation Video for Post-operative Colon Cancer Patients / 재활간호학회지

PURPOSE: This study was to identify the effects of a nurse-led education program using computerized animation video for post-operative colon cancer patients. METHODS: a total of 163 patients and 51 nurses were participated in this study. With a non-equivalent control group post-test design, patients were divided into three groups (77 got traditional education, 46 were applying brochure, 40 were watching video). Twelve-item animation video and brochure about the management after discharge for post-operative colon cancer patients were developed based on patient survey and the items of Korea Healthcare Accreditation. RESULTS: The computerized video watching group had better satisfaction than the others, but there was no significant difference about comprehension. When video was applied, satisfaction, usefulness, application, and perceived patients' comprehension of nurses were all increased. CONCLUSION: This video education program was developed by nurses and it had a special thing for patient to access the same program even after discharge using the authorization system. It would be helpful for nurses to be more concentrated on the direct care for hospitalized patients as well as for patients to provide self-care at home. This program would be adjusted into more various diseases and settings.

Current Status and Considerations for Education in Nursing Management / 간호행정학회지

PURPOSE: The purpose of this study was to explore the current status of education for nursing management in Korea. METHODS: A descriptive study was done using a questionnaire developed by the investigators. The data were collected by survey from 96 out of 129 nursing schools, between December 2010 and February 2011. RESULTS: For 22.9% of nursing schools, there was no faculty for nursing management. The credits and subjects included in nursing management varied among the nursing schools. Lectures in subjects related to nursing management were given not only by nursing management faculty but also by faculty with other majors. There were more faculty and credits for nursing management courses in 4-year nursing schools than in 3-year schools. CONCLUSION: To improve the quality of education in nursing management, there is a need to standardized courses and provide nursing faculty who have majored in nursing management.

Canine behavioral problems and their effect on relinquishment of the Jindo dog

The purpose of this study was to evaluate behavior problems of the Jindo dog, the native dog of Korea, based on an owner's survey and their effect on pet relinquishment. To live a better life with their own pet and prevent relinquishment, it is important to understand the innate behavior characteristics of dog breed and the potential causes of relinquishment. Information concerning various factors and demonstration of the five most common behavior problems was collected via 189 completed questionnaires. No factors significantly affected the demonstration of behavior problem. A total 151 of 189 dogs had behavior problems (79.9%) and 38 dogs did not have behavior problems (20.1%). Among 151 dogs, 139 dogs showed single behavior problem (92.1%). They were 'excessive excitability' (46.8%), 'excessive vocalization' (30.2%), 'inappropriate elimination' (17.3%), 'destructive behavior' (4.3%), and 'aggressive behavior' (1.4%), respectively. In addition, 12 dogs showed two concurrent behavior problems (7.9%) According to the results, the relinquishment of Jindo dogs was not significantly associated with canine behavior problems, which is the single greatest risk factor of relinquishment in general. The possible reasons for potential behavior problems include improper raising, lack of socialization, and insufficient dog training classes, therefore canine behavior would be improved by owner education.

Patient Safety Program and Safety Culture / 간호행정학회지

PURPOSE: To determine the impact of the Patient Safety Program on the safety culture of nursing department. METHODS: Patient Safety Program focused on medication safety was launched by QI team and patient safety committee. Patient Safety Program was composed of the establishment of improved reporting system as s way to learn from error, 'Patient Safety Guard' movement, and continuous education for medication safety. With one group pretest-posttest design, nurses' perception of the safety culture were measured with self-administered questionnaire. Subjects were all nurses and managers in nursing department of a tertiary teaching hospital in Seoul. Collected data from survey was statistically analyzed using t-test. RESULTS: Patient Safety Program had been continued for 20 months in participation of all nurses and managers. Safety culture was improved (pretest=2.84, posttest=2.90, p<.001; 4 point scale). CONCLUSIONS: This study indicates that there has been a statistically significant increase in the nurses' perception of safety culture. These findings suggest that Patient Safety Program had made great contribution toward system wide safety culture in the hospital. To improve safety culture, leadership supports and flexibility to apply tailored interventions to the hospital were required necessarily.

Analysis of the Journal of Korean Academy of Nursing Administration for 3 Years (2007-2009) / 간호행정학회지

PURPOSE: The purpose of this study was to identify the major trends of research in the Journal of Korean Nursing Administration from 2007 to 2009. METHOD: Research designs, participants, research domains, and key words were analyzed from the Journal of Korean Nursing Administration. RESULTS: Job satisfaction, organizational commitment, job stress, turnover intention, nursing performance, self-efficiency, leadership, empowerment, nursing informatics, and quality control were the major key words commonly listed in the journal articles. Of the research in the Nursing Administration Journal, quantitative methods were used in 94.5% of the research studies and qualitative methods in only 5.5%. The major participants in the research were nurses, nurse managers, and patients. Statistical methods like ANOVA, correlation, t-test, regression, chi-square test, LISREL were the dominant method of analysis used in the research. The primary domains in the journal articles were directing, organizing, control, planning, and informatics. CONCLUSION: Through this study, the trend of research in nursing administration can be identified. We recommend that collaboration, nurse work environment, evidence-based practice, scheduling, coaching, patient falls and safety, and positive culture should be included as topics for the future research.

Development and Evaluation of a Patient Safety-focused Inservice Education Program for Surgical Nurse / 간호행정학회지

PURPOSE: The aim of this project was to develop a patient safety-focused inservice education program for surgical nurse and to test the effects of this program. METHODS: Methodological designs for instruments development, a pretest-posttest and a posttest design were employed. After the education, nurses' satisfaction, confidence, usefulness and application of 137 nurses were evaluated at 15 surgical units of a tertiary teaching hospital in Seoul, Korea. The education contents are 6 skill areas (infusion pump use, suction, chest tube drainage, oxygen administration, nebulizer use, insulin administration) and medication knowledge. Teaching methods were lecture, instructor demonstration, and 1:1 skill test. Descriptive statistics, Wilcoxon test, Spearman's correlation and Stepwise regression were used. RESULTS: Satisfaction scores for skills and medication education were 4.00-4.21 (out of 5). The more performance frequency in 6 skills, the higher score in confidence as well as in usefulness and application, and the higher satisfaction with the program, the higher score in usefulness, application, confidence, and medication knowledge. Medication knowledge improved after the education (Z=-7.757, p<.001). Significant predictors of skill confidence were application of skills in job performance, medication confidence, and career in present unit. CONCLUSION: The results of this study suggest that systematic and continuous inservice education will improve patient safety by promoting nursing quality.

Genetic Analysis of 10 Unrelated Korean Families with p22-phox-deficient Chronic Granulomatous Disease: An Unusually Identical Mutation of the CYBA Gene on Jeju Island, Korea

Chronic granulomatous disease (CGD) is a rare hereditary disorder characterized by recurrent life-threatening bacterial and fungal infections. The underlying defect in CGD is an inability of phagocytes to produce reactive oxygen species as a result of defects in NADPH oxidase. Considering that CGD generally affects about 3-4 in 1,000,000 individuals, it is surprising that the prevalence of CGD on Jeju Island is 20.7 in 1,000,000 individuals. We performed genetic analysis on 12 patients from 10 unrelated families and found that all patients had an identical homozygous single-base substitution of C to T in exon 1 (c.7C>T) of the CYBA gene, which was expected to result in a nonsense mutation (p.Q3X). Because Jeju Island has long been a geologically isolated region, the high prevalence of CGD on Jeju Island is presumably associated with an identical mutation inherited from a common ancestor or proband.

Physical Development and Dietary Behaviors of Children in Low-Income Families of Seoul Area / 대한지역사회영양학회지

Since the economic crisis in 1997, the number of low income families has increased and the turmoil is likely to affect nutritional and health status of the children in low-income families. The purpose of this study was to investigate dietary behaviors and physical development of low income family children in the Seoul area. The subjects were 44 boys and 56 girls, between the ages of 7 and 12 years, from the beneficiary families of the governmental assistant program and enrolled in after school-care centers. A self-reported questionnaire, including general characteristics and dietary behaviors, was applied to the children and their parents. Skipping meal rate was higher in breakfast than in lunch or dinner, and was less frequent in parents and children families compared to that of the other types of families (p<0.05). Most students are shown that they usually keep the dietary guideline for Korean children. There were significant differences in keeping the dietary guidelines between the parents and children family group and other groups in several items. The results imply that the nutrition education program should be more focused on the families which are not composed of parents and children.

Nurses' Knowledge about and Attitude toward Cancer Pain Management: A Survey from Korean Cancer Pain Management Project / 성인간호학회지

PURPOSE: This study was conducted to examine the nurses' knowledge about and attitude toward cancer pain management. METHOD: Study subjects of this retrospective cross-sectional survey study were 343 nurses sampled conveniently in a tertiary teaching hospital in Seoul. Seven measurement tools were used to collect data on demographic data, knowledge about and attitude toward cancer pain management, barrier to cancer pain management, knowledge about and concerns for the opioid use, and professional education of cancer pain management. RESULT: Nurses showed knowledge deficit when their knowledge on the cancer pain management and the opiod use was evaluated using two case scenarios and the 15-item questionnaire respectively. Ninety-five percent of the nurses believed that cancer pain management is a major problem. However, inadequate staff knowledge of pain management was rated as the single most important barrier to adequate pain management by 20.4% of nurses. Only 10.9% and 23.2% of the nurses replied that nursing school's education and professional education in cancer pain management respectively, were adequate. CONCLUSION: This study confirms the existence of knowledge deficits and attitudinal barriers among Korean nurses that can impede cancer pain manage- ment. This study suggests a need for professional education for nurses on cancer pain management.

Perfusion MR Imaging in Gliomas: Comparison with Histologic Tumor Grade

OBJECTIVE: To determine the usefulness of perfusion MR imaging in assessing the histologic grade of cerebral gliomas. MATERIALS AND METHODS: In order to determine relative cerebral blood volume (rCBV), 22 patients with pathologically proven gliomas (9 glioblastomas, 9 anaplastic gliomas and 4 low-grade gliomas) underwent dynamic contrast-enhanced T2*-weighted and conventional T1- and T2-weighted imaging. rCBV maps were obtained by fitting a gamma-variate function to the contrast material concentration versus time curve. rCBV ratios between tumor and normal white matter (maximum rCBV of tumor / rCBV of contralateral white matter) were calcu-lated and compared between glioblastomas, anaplastic gliomas and low-grade gliomas. RESULTS: Mean rCBV ratios were 4.90'+/-1.01 for glioblastomas, 3.97'+/-0.56 for anaplastic gliomas and 1.75'+/-1.51 for low-grade gliomas, and were thus sig-nificantly different; p < .05 between glioblastomas and anaplastic gliomas, p <.05 between anaplastic gliomas and low-grade gliomas, p < .01 between glioblas-tomas and low-grade gliomas. The rCBV ratio cutoff value which permitted dis-crimination between high-grade (glioblastomas and anaplastic gliomas) and low-grade gliomas was 2.60, and the sensitivity and specificity of this value were 100% and 75%, respectively. CONCLUSION: Perfusion MR imaging is a useful and reliable technique for esti-mating the histologic grade of gliomas.

The Autonomic Nervous Function and the Yin-Yang Constitutional Characteristics of the Patients with Functional Gastrointestinal Disorders / 신경정신의학

OBJECTIVES: It was revealed that autonomic dysfunction, especially decreased parasympathetic functions, seems to be one of the major etiological factors in functional gastrointestinal disorders(FGID) The physiological characteristics of sympathetic and parasympathetic functions are externally similar to the features of Yin and Yang based on oriental medicine theory. And it was also revealed that gastrointestinal symptoms are prevalent in Lesser Yin constitutional type riginated from four types of constitution shown in Sasang constitutional theory. If we obtain the findings on the similarities or compatibilities between autonomic nervous functions and physical constitutional features in functional gastrointestinal disorders, we could apply various oriental treatment modalities to the patients with functional disorders, especially according to Yin-Yang constitutional concept. METHODS: We investigated the correlations between characteristics of physical constitution(Yin and Yang)and imbalance of the autonomic functions in patients with FGID. Subjects consisted with three groups: 27 patients with FGID (including irritable bowel syndrome, functional dyspepsia, functional abdominal pain syndrome according to the Rome criteria) 28 patients with somatoform disorders who had symptoms other than abdominal symptoms (other somatoform disorders) and 26 normal healthy controls. Characteristics of constitutions were evaluated and divided into two major groups, i.e., Lesser Yin constitution and other constitutions (Greater Yin & Yang and Lesser Yang included)according to the Je-Ma Lee's Classification Questionnaire for Four Constitutional Types (Song et al. 1993) For evaluating the autonomic functions, three parasympathetic functions and two sympathetic functions were measured. Levels of anxiety and depression were also evaluated to be used as a covariant controlling the autonomic functions. RESULTS: 1)FGID group showed significantly lower parasympathetic functions compared to healthy controls, however, there was no differences between FGID and other somatoform disorder groups. 2)Lesser Yin constitutional type was not so prevalent in FGID group. 3)When FGID and other somatoform disorder groups were combined and compared with normal healthy controls, the former group showed significantly lower parasympathetic functions than the latter group. CONCLUSIONS: According to these results, Lesser Yin constitutional type do not seem to be closely related with FGID. However, it was suggested that decreased parasympathetic functions were partly associated with this group. We could not find any correlations or compatibilities between two constitutional characteristics and autonomic dysfunction in FGID. This means that functional symptoms of FGID when those were deducted as Yin and Yang characteristics based on oriental medicine could not be understood as two oppositional and co-operative functions such as autonomic functions. Further research with more restricted symptoms selected in the functional disorders and with other physiological cues applied would be needed.

The Effect of Meditation on Depression and Anxiety / 신경정신의학

OBJECTIVES: The goal of this study was to examine the effectiveness of meditation on depression and anxiety in psychiatric outpatients. METHOD: Meditation group which had taken the meditation and participated in 20 meditation sessions, and control group which had only taken the medication were given Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory(STAI) at pre-test and post-test periods. RESULTS: Comparing pre-test score with post-test score, scores of BDI and STAI decreased at a statistically significant level in meditation group. However, scores of control group did not change significantly. CONCLUSION: The results of present study suggest that meditation have positive effects on depression and anxiety in neurotic patients.

The Relationship between Depressive Tendency in Postpartum Women and Factors such as Infant Temperament, Parentiong Stress and Coping Style / 신경정신의학

OBJECTIVES: This Study examined the relationship of depressive tendency in postpartum women with psychosocial factors such as infant temperament, parental stress and coping style. METHODS: The subjects consisted of 105 postpartum women, each of whom had an infant aged 4 to 12 months. They were assessed on demographic variables and on measures of the depressive symptomatology, infant temperament, parental stress and the coping style using Beck Depression Inventory(BDI), the EAS temperamental survey, Parenting Stress Index(PSI), the Way of Coping Checklist(WCC). And then we assessed the relationship of depressive tendency in postpartum women with psychosocial factors. RESULTS: The results were as follows: 1) Depressive tendency in postpartum women had significant relationship with emotionality(r=.26 p<0.05) and activity(r=.22 p<0.05) of infant temperament. 2) Depressive tendency in postpartum women had significant relationship with parenting stress(r=.44 p<0.001). 3) Depressive tendency in postpartum women had no significant relationship with coping style. 4) Parental stress had significant relationship with emotionality(r=.49 p<0.001) but did not have any relationship with sociability and activity of infant temperament. Parenting stress had no significant relationship with coping style. CONCLUSION: These results suggest that depressive tendency in postpartum women correlated with emotionality and activity of infant temperament correlated with parenting stress but not correlated with coping style. Infant temperament and parenting stress to child rearing are more significantly correlated with depressive tendency in postpartum women than coping style of postpartum women.

The Effect of Meditation on Problem Solving Ability and Self-Perception / 신경정신의학

This study was conducted to evaluate the effectiveness of meditation on problem solving and self-perception in psychiatric outpatients. Meditation group which had taken the medication and participated in 20 meditation session, and comparison group which had only taken the medication were given Social Problem Solving Inventory(SFSI) and Self-Perception Inventory(SPSI) at pretest and posttest period. The results were as follows: when compared pretest score and posttest score, scores of problem solving cognition subscale and problem solving emotion subscale were increased at a statistically significant level in meditation group. However, scores of comparison group were not changed. In comparison group, scores of problem solving behavior subscale and decision making subscale were decreased at a statistically significant level, and attitudes of self-perception were changed negatively whereas scores of meditation group were not. The results of present study suggested that meditation might have positive effects on perspectives of approaching the problem, and have buffering effects on decreasing of problem solving behavior, decreasing of decision making and negative change of self- perception.

A Study of Self-Engulfment in Schizophrenic Patients / 신경정신의학

OBJECTIVE: This study was conducted to identify demographic variables and illness related variables which may affect the severity of self-engulfment in the patients with schizophrenia. We also studied the relationship between self-engulfment and insight, and the relationship between self-engulfment and self-esteem. METHODS: Data on demographic variables and illness related variables for the subjects were gathered from hospital records and clinical interviews by the psychiatrists. Degree of insight far the subjects was assessed through clinical interviews by the psychiatrists. Degree of self-engulfment and self-esteem for the subject was assessed from the self-engulfment scale and the self-esteem state respectively. A total of 111 patients with schizophrenia were selected for statistical analysis. RESULTS: 1) The females exhibited significantly higher socres than the males on the self-engulfment scale . 2) There was no illness related variable, which exhibited a significant difference among subgroups on the self-engulfment scale. 3) There was no significant correlation between the self-engulfment stores and the insight scores . 4) There was a significantly inverse correlation between the self-engulfment scores and the self esteem scores. CONCLUSION: The results of this preliminary study suggest that self-engulfment may develop despite lack of insight, and that there was inverse relationship between self-engulfment and self-esteem in the patients with schizophrenia. It also suggests that females are more subject to self-engulfment than males. So, authors suggest that it is valuable to do further studies of self-engulfment in the patients with schizophrenia.

Peripheral Cholangiocarcinoma: Contrast Enhancement Characteristics on Spiral CT

PURPOSE: To evaluate the characteristics of contrast enhancement of peripheral cholangiocarcinoma, as seen on spiral CT. MATERIALS AND METHODS: Spiral CT was used to examine twelve patients with peripheral cholangiocarcinoma of the liver. All underwent conventional CT before contrast enhancement. After the administration of contrast material, two-phased spiral CT was used to investigate seven patients, and three-phased spiral CT, to investigate five. In each phase, we analysed the patterns of contrast enhancement at the central and peripheral portions of the lesion, and compared these with the patterns of normal liver parenchyma. We evaluated changes, according to time lapse, in the central low-density area, and obtained the phase-density curve with the cursor placed at the central portion of the lesion. For three-phased spiral CT examinations, we also tried to determine the phase dvring which the margin of the lesion was most clearly demonstrated. RESULTS: During the arterial phase, eight of twelve patients (67%) showed hyperdensity in the peripheral portion of the lesion; during the portal phase, four of five patients (80%) showed hypodensity in both the central and peripheral portions. During the delayed phase, six of twelve patients (50%) showed isodensity and five showed high density in the peripheral portion. Compared to those in the arterial phase, central hypodense areas relative to normal liver parenchyma in the delayed phase decreased in eleven of twelve patients (92%). On phase-density curves, the density of the central portion of the lesion increased progressively in nine of twelve patients (75%). On three-phased CT, the margin of lesion was-in all five patients - most clearly demonstrated in the portal phase. CONCLUSION: On spiral CT, the central portion of peripheral cholangiocarcinoma always showed low density and the peripheral portion showed high, low, or iso or high density, depending on the phase. In addition, spiral CT clearly demonstrated a minimal centripetal pattern of contrast enhancement. We therefore conclude that in the diagnosis of peripheral cholangiocarcinoma, the characteristics of contrast enhancement are helpful.