Effects of Family Conflict Mitigation Programs by Watching Documentaries on Conflicts, Autonomic Nerve Activation, and Happiness of the Elderly in Long-Term Care Hospitals

Purpose@#To determine effects of family conflict mitigation documentary programs on conflicts, autonomic nerve activation (ANA), and happiness of elderly in long-term care hospitals. @*Methods@#This study used a non-equivalent control group with a pretest-posttest design. It was conducted on 39 elderly patients (19 in the experimental group and 20 in the control group) in long-term care hospitals. The experimental group (n = 19) received family conflict mitigation documentary programs. The family conflict mitigation documentary programs consisted of four sessions (40-50 minutes per session). These programs were implemented in small groups, with each group having five elderly. Data were analyzed by sing the conflict checklist, the Oxford Happiness Questionnaire, Chi-square test with Fisher’s exact test, independent t-test, paired t-test, and repeated measure ANOVA using the SPSS/WIN 21.0 program. @*Results@#The participants in the experimental group showed significantly decreased scores of conflict (t = -2.31, p = .028) and the value of sympathetic nervous system activity (t = 8.36, p = .007) compared with those of the control group. The participants in the experimental group showed significantly increased the value of parasympathetic nervous system activity (t = -2.91, p = .008) and scores of happiness (t = 5.46, p < .001). @*Conclusion@#The family conflict mitigation documentary programs on conflicts, ANA, and happiness of the elderly in long-term care hospitals are effective intervention programs for mitigating conflicts between elderlies and their families and for improving happiness of the elderly in long-term care hospitals.

Effects of Family Conflict Mitigation Programs by Watching Documentaries on Conflicts, Autonomic Nerve Activation, and Happiness of the Elderly in Long-Term Care Hospitals

Purpose@#To determine effects of family conflict mitigation documentary programs on conflicts, autonomic nerve activation (ANA), and happiness of elderly in long-term care hospitals. @*Methods@#This study used a non-equivalent control group with a pretest-posttest design. It was conducted on 39 elderly patients (19 in the experimental group and 20 in the control group) in long-term care hospitals. The experimental group (n = 19) received family conflict mitigation documentary programs. The family conflict mitigation documentary programs consisted of four sessions (40-50 minutes per session). These programs were implemented in small groups, with each group having five elderly. Data were analyzed by sing the conflict checklist, the Oxford Happiness Questionnaire, Chi-square test with Fisher’s exact test, independent t-test, paired t-test, and repeated measure ANOVA using the SPSS/WIN 21.0 program. @*Results@#The participants in the experimental group showed significantly decreased scores of conflict (t = -2.31, p = .028) and the value of sympathetic nervous system activity (t = 8.36, p = .007) compared with those of the control group. The participants in the experimental group showed significantly increased the value of parasympathetic nervous system activity (t = -2.91, p = .008) and scores of happiness (t = 5.46, p < .001). @*Conclusion@#The family conflict mitigation documentary programs on conflicts, ANA, and happiness of the elderly in long-term care hospitals are effective intervention programs for mitigating conflicts between elderlies and their families and for improving happiness of the elderly in long-term care hospitals.

Comparative Study of Nursing Students Consciousness of Biomedical Ethics and Attitudes toward Human Tissue Donation and Transplantation According to Participation in Anatomy Camp Program / 체질인류학회지

The purpose of this study was to identify the consciousness of biomedical ethics and attitudes toward human tissue donation and transplantation among participants and non-participants in the anatomy camp program. Data collection is made from one hundred and eighty-two students who were enrolled in one university nursing department, in B metropolitan city. Ninety-six students participated in the anatomy camp program, while eighty-six students did not participate in the anatomy camp program. The total mean scores of consciousness of biomedical ethics between participants (2.03/4) and non-participants (1.96/4) were significantly different (t=2.217, p≤.028). And the total mean scores of attitudes toward human tissue donation and transplantation between participants (3.49/5) and non-participants (3.31/5) were significantly different (t=4.579, p≤.000). There were statistically significant differences between two groups in sub-categories of consciousness of biomedical ethics: organ transplantation, artificial insemination.

Anti-inflammatory effect of egg white-chalcanthite and purple bamboo salts mixture on arthritis induced by monosodium iodoacetate in Sprague-Dawley rats / 한국실험동물학회지

The aim of this study is to investigate the potential of anti-osteoarthritis effects on egg white-chalcanthite (EC), purple bamboo salts (PBS), and a mixture of EC and PBS (EC+PBS). EC is a mixture of egg white and pulverized chalcanthite. PBS has been widely used as one of functional foods in Korea and shows unique features compared with common salt. Osteoarthritis was induced by intra-articular injection of monosodium iodoacetate (MIA, 4mg/kg bw) in Sprague-Dawley (SD) rats. Test substances were administered once daily for 6 weeks at doses of 10 mg EC, EC+100 mg PBS, EC+200 mg PBS before and after MIA injection. Each substance was assessed by blood chemistry parameters, and by serum cytokines including IL-1β and IL-6, and nitric oxide (NO) and prostaglandin-E2 (PGE2). Structural changes of articular cartilage were also evaluated by histopathological examination. As a result, body weight and blood chemistry parameter were not different in all experimental groups. EC+PBS mixture reduced the production of PGE2, NO, IL-1β, and IL-6. In histological grade of osteoarthritis, EC+PBS mixture had a tendency to ameliorate damage of articular cartilage induced by MIA in a dose-dependent manner. In conclusion, EC+PBS mixture was demonstrated to have a potential for anti-inflammatory effect against osteoarthritis induced by MIA in a dose-dependent manner.

Nursing Students' Practice Experience in Neonatal Intensive Care Units

PURPOSE: This study was done to identify the meaning and substantial nature of NICU practice among nursing students by applying a research method based on hermeneutic phenomenology in an attempt to lay a foundation for enhancing theoretical and practical child nursing education. METHODS: The participants were eight nursing student who had experience in clinical practicing in NICU. In-depth interviews were performed from April to December, 2014 until data were fully saturated. Collected data were analyzed using Colaizzi's method. RESULTS: Seven theme clusters were extracted from fourteen themes. The seven theme clusters of the nursing students' clinical practice experience in NICU were: 1) Excitement about the clinical practice setting 2) Afraid of practice environment 3) Babies have priority over clinical practice 4) Comparing with adult nursing clinical practice 5) Feeling pity for babies and their parents 6) New awareness about the role of nurses 7) Demands of enhancing clinical practice. CONCLUSION: The results of the study provide useful information in understanding nursing students' practice experience in NICU and establishing effective strategies to support these nursing students.

Traumatic Diaphragmatic Ruputure: 4-Year Clinical Experience

PURPOSE: A traumatic diaphragmatic rupture (TDR) is a diagnostic challenge and the associated injuries determine the outcome in those diagnosed early. A TDR has long been considered to be a marker of the severity of injury with an average reported Injury Severity Score (ISS) between 31 and 50. This report reviewed the TDR cases in order to emphasize the method and timing of the diagnosis, associated injuries and the outcome. METHODS: A retrospective analysis was performed on 30 patient treated for TDR between August 1998 and september 2002. RESULTS: The mean age of the patients was 33.4 years and the injury predomiantly affected males (male: female=2: 1). Blunt trauma by TA was the most common cause of the TDR (25 patients). The ruptured sites were on the left in 22 cases and on the right in 8 cases. The most common symptom was chest pain (23 cases) followed dyspnea (21 cases). Liver injuries and a pneumo-hemothorax were the most common associated injuries. The mean CRAMS scale was 6.47 and Injury Severity Score (ISS) was 18.93. Eighteen TDR cases were suspected based on the abnormal chest X-ray findings. Nineteen cases underwent surgery within 6 hours after the trauma (early diagnosis). Although many complications occurred in 11 cases, there were no lethal complications. The mean size of the diaphragmatic rupture was 9.77 cm and an intraabdominal organ herniation had not occurred in ruptures smaller than 6 cm. Surgical repair of the diaphragm was performed via a laparotomy in 20 cases and thoracotomy in 7 cases. A left side TDR was preferred to a laparotomy whereas a right sided TDR was preferred to a thoracotomy. Pulmonary complications (atelectasis, pneumonia, pleural effusion) occurred in 14 cases postoperatively. CONCLUSION: The patient's complaints and physical findings were not a reliable indicator of the diagnosis, but usually a manifestation of the associated injuries. A suspicion and routine chest X-ray was the most reliable diagnostic tool, even though the chest X-ray was normal in 12 cases. A high rate of early diagnosis can be achieved using an aggresive investigation protocol, suspicion and a combined radiologic evaluation in multiple trauma patients. Although pulmonary complications occurred in the early diagnosed cases, lethal complications and long term sequela were directly related to the time of diagnosis. The higher ISS had many complications (11 cases) but there were no lethal complications, long term sequela.

Epigastric Hernia

An epigastric hernia is a protrusion of the extra-peritoneal fat to the linea alba, between the xiphoid process and the umbilicus. About 3~5% of people develop epigastric hernias. The authors have experienced a case of a 79 year-old woman who had an asymptomatic epigastric hernia, where an abdomen CT is helpful in its diagnosis. The size of the defect was large, and a hernia sac existed. The case of an epigastric hernia, which was treated by a primary repair, is reported, with a brief review of the literature.

Trocar(R)(Ethicon) Used Intraoperative Endoscopy in Acute Lower Gastrointestinal Bleeding

Occasionally it is difficult to preoperatively confirm the bleeding focus in acute lower gastrointestinal bleeding patients. Therefore, many diagnostic evaluations are needed - for example, colonoscopy, selective mesenteric angiography and Tc-99m RBC scintigraphy. However, if the bleeding focus remains unconfirmed preoperatively when the patient's state is unstable hemodynamically, the surgeon must inevitably perform exploratory laparotomy, followed by intraoperative endoscopy. We herein propose a new method of intraoperative endoscopy using Trocar(R) (Ethicon). Trocar(R) (Ethicon) was used in laparoscopic operation. This method has the merits of no air leakage, no contamination, fewer complicatons and ease of evaluation. We recommend that the use of Trocar(R) (Ethicon) in intraoperative endoscopy is essential in emergency operations for acute lower gastrointestinal bleeding.

Strangulated Obturator Hernia: Mesh-Plug Technique

Although obturator herniae are rare, they are associated with a high mortality, as diagnosis is often delayed and the condition tends to occur in the elderly. The preoperative diagnosis is difficult because of nonspecific symptoms and sign. They often produce a small bowel obstruction. The treatment is always surgical. Several repair techniques have been described: a sac ligation alone, a direct suture repair, and the use of autologous tissue or prosthetic repair. Recently, the placement of permanent mesh prostheses, in a clean contaminated operative field, has been performed due to the minimal wound-related morbidity and patient mortality. Thus, utilization of a permanent mesh in an obturator hernia is a new, simple and effective method for repair. Two cases of a strangulated obturator hernia were experienced in elderly women. The peritoneal cavity was not overly contaminated, with only necrotic foci on the herniated small bowel wall noted. A segmental resection of the small bowel was performed. Consequently, the hernia defect was closed with mesh- plug between the peritoneum and periosteum of the obturator foramen. Here, two cases of obturator herniae treated by use of a mesh-plug are reported, with a brief review of the literature.

Trauma-related Acute Spigelian Hernia in Right Upper Abdomen

Trauma-related spigelian hernia is a rare event that has been reported only sporadically. Because of its rare nature and nonspecific physical findings, its diagnosis is difficult. This hernia most commonly presents at the level of the semicircular line known as the arcuate line. A 70-year-old man was admitted after overturn of his cultivator. A scratch wound surrounding a cutaneous sign of the cultivator handlebar impact was evident on his right upper abdominal wall. Trauma-related spigelian hernia occurred in the site of the handlebar impact. We report this cases of trauma-related spigelian hernia that was treated by primary repair with a brief review of the literature.

Idiopathic Perforated Cecitis Mistaken as Perforated Appendicitis

The cecal perforation is very rare in pediatrics. Our center has experienced a 7-year-old girl with idiopathic perforated cecitis. The surgeon couldn't differentiate perforated cecitis from perforated appendicitis because of anatomical location, incidence and ambiguous radiologic result when this patient was admitted to our clinic due to RLQ pain.

Intestinal Obstruction Due to Incarcerated Hernia at CAPD Catheter Insertion Site

Patients who have undergone peritoneal dialysis can frequently experience abdominal wall complications, such as hernia due to increased intraabdominal pressure and peritoneal leakage. However, no case of incarcerated abdominal wall hernia through catheter insertion site of CAPD has yet been reported Recently the authors experienced a case of intestinal obstruction due to an incarcerated hernia at the catheter insertion site of CAPD. We report this case and present a literature review.

Significance of Heat Shock Protein 70 and Sulphomucin Expression in Gastric Adenocarcinomas

BACKGROUND: The heat shock proteins (HSPs) are stress-responsive genes present in all species and play a major role in many cellular processes. These proteins are highly conserved molecules whose expression is induced in eukaryotic cells by a variety of environmental stresses. These proteins can also be expressed in virally transformed cells and cancer cells. Especially, HSP70 is found at a higher level in growing cells than in resting cells. Sulphomucin is secreted by immature foveolar cells of stomach and expressed in gastric adenocarcinomas. Also, it is known that the population of sulphomucin-producing cells increases with long-lasting stress. The purpose of this study was to determine HSP70 and sulphomucin expressions in gastric adenocarcinoma and the significance of expressions. METHODS: Thirty-one paraffin-embeded surgical specimens of gastric adenocarcinomas were obtained from April 1992 to March 1995 and were selected for analysis. The expressions of HSP70 and sulphomucin were analyzed by immunohistochemical staining with HSP70 monoclonal antibody and the Spicer (HID) method. RESULTS: The expressions of HSP70 and sulphomucin were positive in 13 (42%) cases and 11 (35%) cases, respectively. The expression of HSP70 correlated with neither clinopathological factors nor sulphomucin expression. There was a significant correlation not only between sulphomucin expression and histologic differentiation (p=0.001) but also between disease-free survival and sulphomucin expression. CONCLUSIONS: Sulphomucin expression in gastric adenocarcinoma may be useful as a prognostic factor of gastric adenocarcinomas.

A Case of Acute Twin-Twin Transfusion Syndrome / 대한산부인과학회잡지

Twin-twin transfusion syndrome(TTTS) is a serious complication of monozygotic mu-ltiple pregnancy. TTTS is associated with high perinatal mortality rate. The acute form has been attributed to rapid transfer of blood through superficial artery-to-artery or vein-to- vein anastomoses during labor and delivery, resulting in a hypovolemic, anemic donor twin and a hypervolemic, plethoric recipient twin of similar birth weight. The authors present a case of acute twin-twin transfusion syndrome with a review of literature.

Subsequent Reproductive Experiences after Treatments for Gestational Trophoblastic Disease / 대한산부인과학회잡지

For evaluating the reproductive performances of GTD patients, we found 115 cases of GTD patients, 77 HM and 38 GTT, who became pregnant after the completion of treatments and follow-up period. The results of this study suggest subsequent pregnancies after the completion of treatments may promise normal reproductive outcomes regardless of the chemotherapy.

Clinical Implication and Evaluation and Management of Women with Low-Grade Cytologic Abnormality ( ASCUS/LSIL ) / 대한산부인과학회잡지

The evaluation of women with low-grade cytologic abnormalities including atypical cells of undetermined significance(ASCUS) and low-grade squamous intraepithelial lesion (LSIL) is a topic of considerable controversy. Some women with low-grade cytologic abnormalities will have high-grade intraepithelial neoplasia(CIN II or III) or even invasive cancer. Now, it is almost universally accepted that the majority of invasive cervical cancer and high-grade intraepithelial neoplasia are associated with Human papillomavirus(HPV). Because of this, there has been increasing tendancy on using another triaging methods for evaluating women with a low grade abnormal Papanicolaou smear. Traditionally colposcopy was used and recently HPV DNA test and cervicography was widely used as a triaging methods. This study used the data gained from 151 evaluable women with ASCUS and LSIL in the Department of Obstetrics and Gynecology, Catholic University Medical College, Kangnam St. Mary's Hospital from March 1995 to April 1996. 11,401 women had done cytology during this period and result was like this; 10,501 patients had normal cytology(92.1%), 244 patients had ASCUS(2.14%), 35 had AGCUS (atypical glandular cells of undetermined significance: 0.31%), 191 had LSIL(1.68%), 170 had HSIL(1.49%), and 160 had cervical cancers(1.41%). Patients with ASCUS were showed that CIN I WAS 5.6%(4/72), CIN II 4.2%(3/72) and CIN III 15.3%(11/72). Patients with LSIL were showed that CIN I was 5.1%(4/79), CIN II 7.6(6/79), CIN III 15.2%(12/79) and invasive cancer 7.6%(6/79). We adopted three management algorithms for evaluating women with ASCUS and LSIL. Three methods were like this; Colpscopy only or HPV DNA testing using hybrid capture which were used with DNAs extracted from the cerval swabs and tested with two pooled probes(probes containing HPV types of low oncogenic risk; 6, 11, 42, 43 and 44 or HPV types of high oncogenic risk; 16, 18, 31, 33, 35, 45, 51, 52 and 56) for HPV detection or both. We adopted only positive result with high risk HPV-probes in this article. At ASCUS group, sensitivity and specificity were 90.0% ad 32.5% in 62 women with colposcopy and 71.4%, 75% in 28 women with Hybrid Capture System. 27 women with colposcopy and Hybrid Capture System showed that sensitivity was 100%, and specificity was 26.3%. At LSIL group, sensitivity and specificity were 92.6% and 22.7% in 71 women with colposcopy and 69.2%, 65.4% in 39 women with Hybrid Capture System, 37 women with colposcopy and Hybrid Capture System showed that sensitivity was 91.7%, and specificity was 12%. Our result indicate that patients with smears showing some of ASCUS and LSIL are evaluated as CIN I, II, III and even invasive cancer. Therefore as a triage methods, the combination with colposcopy and HPV DNA test in women referred for low-grade abnormal cytology would be used as a sensitive methods for the detection of CINs. However, low -specificity of this combination approach was also considered as problem. This approach provides another information to differentiating ASCUS and LSIL into high- or low-risk group of progression.

Acute Intermittent Porphyria and Pregnancy / 대한산부인과학회잡지

The Porphyria are a group of inherited and acquired disorders characterized by partial defects in the heme biosynthetic pathway. Among the hepatic forms, acute intermittent porphyria(AIP) is the most severe and common type in western hemisphere. Though its association with pregnancy is rare, it presents the obstetrician with challenging problems in diagnosis and management and it is probable that pregnancy had some deleterious effect in acute porphyria. The authors present a cae of AIP in pregnancy with a review of literature.