The experiences of depressed pregnant women participating in a cognitive behavioral therapy program via video communication: an exploratory qualitative study

This study explored the experiences of pregnant women with depressed mood participating ina group cognitive behavioral therapy (CBT) program using video communication, based on Beck’s cognitive theory.Methods: The participants were six pregnant women out of 13 women who had participated in an 8-session group CBT program using video communication for women with depressed mood (EdinburghPostnatal Depression score of ≥9). Data were collected from February 20 through March 25, 2021. Indepth individual interviews were conducted through a video conferencing platform at 1 month post-baseline. Thematic analysis was done.Results: Three themes, 10 subthemes, and 38 concepts were derived from experiences of participating inthe 4-week group CBT program (twice a week). The first theme, entitled “continuing realization” hadsubthemes of “a negative and instable self,” “a selfish judgment that excludes others,” and “a strong beliefin self-control.” The second theme, entitled “attempt to change for restoration” had subthemes of “shift torational thinking,” “freedom from suppressed beliefs,” “tolerance of other people,” and “courage for self-expression.” The third theme, entitled “departure for a positive life,” had subthemes of “emotional healing,”“faith in oneself,” and “reestablishing the criteria for happiness.”Conclusion: Pregnant women with depressed mood expressed that continuing realizations and attemptsto change supported their transition toward a positive direction of healing. Thus, they were able to changetheir distorted thinking into rational thinking through CBT using video communication. These findingssupport the use of group CBT using video communication with pregnant women who have depressedmood.

Dual cortical tunneling method for endoscopic forehead lift

Background@#Endoscopic forehead lift with cortical tunneling is an effective option for rejuvenation of the upper third of the face. Although it has been considered safe and reliable, with relatively consistent long-term results, relapse and weakening of adhesion have been common problems. @*Methods@#We suggest the dual-tunneling method for overcoming these limitations. A total of 100 patients aged 17 to 65 years underwent forehead lifting with cortical tunneling by the senior author from August 2016 to December 2017. The single-tunnel method was applied in one half of the patients and the dual-tunnel method in the other half. Bilateral brow positions were measured immediately following surgery and 6 months later. @*Results@#For all cases, cortical tunneling was done at the central incision and both paramedian incisions; therefore, three tunnels were used in the control group and six tunnels in the experimental group. In the single-tunnel group, relapse distances were 2.39±0.83 mm for the medial brow and 3.26±0.91 mm for the lateral brow (6 months postoperatively; n=100). The dual-tunnel group showed significantly smaller (P<0.001) relapse distances, with values of 1.69±0.46 mm and 2.17±0.59 mm for the medial and lateral brow, respectively (6 months postoperatively; n=100). The experimental group did not show an increase in complications. @*Conclusions@#The dual-tunneling method, designed to minimize the cheese-wiring effect, uses a triangular plane to avoid a focal fixation. The fixation also includes the periosteum to hold the forehead tissue in place, inducing stronger adhesion.

Validity and Reliability of Metacognitive Rating Scale for Nursing Students / 정신간호학회지

Purpose@#The aim of this study was to determine the reliability and validity of the metacognition rating scale (MCRS), which is a revised version of the existing metacognition questionnaire (MCQ) with anger and anxiety added. @*Methods@#A survey was conducted on 591 nursing students at colleges in North and South Gyeongsang Provinces, South Korea. The collected data were processed for the reliability and validity of the MCRS through Cronbach’s ⍺ and confirmatory factor analysis using SPSS 26.0. @*Results@#Cronbach’s ⍺ for the reliability of MCRS was calculated at .88, .86, .77, .74, and .66 for five subfactors. Among the five subfactors, the first, second, third, and fifth factors showed high correlation in each of six items. Factor 4 was highly correlated in 5 out of 6 questions. @*Conclusion@#The data confirm that the MCQ revised to include anger and anxiety is both reliable and valid for nursing students. Therefore, this scale can be used to identify the maladaptive metacognition of nursing students in stressful situations.

Validity and Reliability of Metacognitive Rating Scale for Nursing Students / 정신간호학회지

Purpose@#The aim of this study was to determine the reliability and validity of the metacognition rating scale (MCRS), which is a revised version of the existing metacognition questionnaire (MCQ) with anger and anxiety added. @*Methods@#A survey was conducted on 591 nursing students at colleges in North and South Gyeongsang Provinces, South Korea. The collected data were processed for the reliability and validity of the MCRS through Cronbach’s ⍺ and confirmatory factor analysis using SPSS 26.0. @*Results@#Cronbach’s ⍺ for the reliability of MCRS was calculated at .88, .86, .77, .74, and .66 for five subfactors. Among the five subfactors, the first, second, third, and fifth factors showed high correlation in each of six items. Factor 4 was highly correlated in 5 out of 6 questions. @*Conclusion@#The data confirm that the MCQ revised to include anger and anxiety is both reliable and valid for nursing students. Therefore, this scale can be used to identify the maladaptive metacognition of nursing students in stressful situations.

Stromal vascular fraction injection to treat intractable radiation-induced rectovaginal fistula

Rectovaginal fistula, which can arise after an injury to the vaginal canal or rectum, is a troublesome obstacle for patients’ everyday life. In most cases, it can be covered with a local flap, but previous radiation therapy increases the recurrence rate, making it especially difficult to cure. As the application of stromal vascular fraction (SVF) obtained from enzymatically digested autologous adipose tissue has become increasingly common, several reports have advocated its effectiveness for the treatment of refractory wounds. In light of the angiogenic, regenerative characteristics of SVF, it was incorporated as a treatment option in two cases of rectovaginal fistula discussed here. As described in this report, irradiated rectovaginal fistulas in rectal cancer patients were successfully treated with SVF injection, and we suggest SVF as a feasible treatment option for cases of rectovaginal fistula that would otherwise be very difficult to cure.

Impact of Cognitive Aging on Health-Related Quality of Life in Menopausal Women

ObjectivesMenopause is a well-known risk factor for accelerating cognitive aging in women. This study aimed to assess differences in cognitive function and health-related quality of life (HRQOL) according to menopausal status to determine whether the menopause significantly affects the relationship between cognitive function and HRQOL.MethodsThis was a cross-sectional comparative study with a convenience sample of 178 Korean women including 89 naturally menopausal women (65 ± 10 years) and 89 non-menopausal women (45 ± 8 years) who met the eligibility criteria and completed neuropsychological tests and self-report questionnaires about their HRQOL, cognitive function, depression, and sleep quality. Multiple regression analyses were performed within and between groups according to menopausal status.ResultsMenopausal women had significantly worse scores on neuropsychological performance and HRQOL than non-menopausal women. A better neuropsychological performance (β = 0.34) was solely associated with a better HRQOL in menopausal women, whilst socioeconomic variables were associated with HRQOL in non-menopausal women.ConclusionMenopause is an important risk factor for HRQOL, and the association between cognition and HRQOL may differ according to menopausal status. When developing programs for target groups to improve daily functioning and HRQOL, healthcare professionals need to pay more attention to this relationship.

An Analytical Study on Research Trends in Auriculotherapy in Korea / 기본간호학회지

Purpose@#This study was done to analyze research articles and explore research trends in auriculotherapy between 2010 and 2019 in Korean academic journals. @*Methods@#Domestic databases including KMbase, RISS, KISS, and NDSL were searched for studies published between 2010 and 2019. Research trends were analyzed according to The STandards Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) guidelines including research design, control group type, and intervention details from a total of 78 domestic papers. Descriptive statistics were analyzed by frequency and percentage. @*Results@#Most studies were conducted in nursing. Regarding research design, a quasi-experimental design with a no-treatment control group was most common. There were 12 conditions with 4 participant categories. The most common intervention was four-point acupuncture-buried therapy. Interventions conducted weekly with cessation of 2 days for 6 weeks were popular. Regarding dropouts, few studies reported side-effects, with personal reasons being the most frequently reported. However, 50% of the studies failed to provide adequate information regarding intervention details according to the STRICTA guidelines, such as the practitioner background, ear point used for intervention, and a flow diagram. @*Conclusion@#Interventional studies on auriculotherapy have been steadily increasing and have included more diversified conditions. Future studies should investigate the effects of auriculotherapy with more rigorous design, and report more detailed information regarding interventions.

Prediction of survival outcomes in patients with epithelial ovarian cancer using machine learning methods / 부인종양

OBJECTIVES: The aim of this study was to develop a new prognostic classification for epithelial ovarian cancer (EOC) patients using gradient boosting (GB) and to compare the accuracy of the prognostic model with the conventional statistical method. METHODS: Information of EOC patients from Samsung Medical Center (training cohort, n=1,128) was analyzed to optimize the prognostic model using GB. The performance of the final model was externally validated with patient information from Asan Medical Center (validation cohort, n=229). The area under the curve (AUC) by the GB model was compared to that of the conventional Cox proportional hazard regression analysis (CoxPHR) model. RESULTS: In the training cohort, the AUC of the GB model for predicting second year overall survival (OS), with the highest target value, was 0.830 (95% confidence interval [CI]=0.802–0.853). In the validation cohort, the GB model also showed high AUC of 0.843 (95% CI=0.833–0.853). In comparison, the conventional CoxPHR method showed lower AUC (0.668 (95% CI=0.617–0.719) for the training cohort and 0.597 (95% CI=0.474–0.719) for the validation cohort) compared to GB. New classification according to survival probability scores of the GB model identified four distinct prognostic subgroups that showed more discriminately classified prediction than the International Federation of Gynecology and Obstetrics staging system. CONCLUSION: Our novel GB-guided classification accurately identified the prognostic subgroups of patients with EOC and showed higher accuracy than the conventional method. This approach would be useful for accurate estimation of individual outcomes of EOC patients.

Gender-Specific Relationship Between Executive Function and Self-Rated Health

OBJECTIVES: Self-rated health is a comprehensive measure of health. As gender difference in self-rated health is found, identifying gender-specific factors related to self-rated health is important. Poor executive functioning negatively affects an individual's independence and healthy lifestyle, but it is unknown relationships between executive function and self-rated health and gender differences in these relationships. Therefore, gender differences were examined in the relationship between executive function and self-rated health in the community. METHODS: Individuals completed questionnaires about their health status and subjective decline in executive function. Neuropsychological tests were also performed to assess objective executive functioning. Two separate multivariable linear regression analyses were conducted by gender. RESULTS: Better objective executive function was related to greater self-rated health scores (better self-rated health) in men alone (βs = 0.341), while better subjective executive function was significantly associated with greater self-rated health scores in both men and women (βs = 0.385 and 0.443, respectively). CONCLUSION: Gender differences are important when reporting perceived health status, in particular the different effects of subjective and objective executive function on self-rated health across genders. Clinicians need to be aware of the potential value of subjective executive function complaints when evaluating health status.

Survey on the Education System for New Graduate Nurses in Hospitals: Focusing on the Preceptorship / 의학교육논단

The purpose of this study was to identify the current status of the new graduate nurses' education system, to establish guidelines for the education of new graduate nurses, and to provide dates for the improvement of the education system. Eighty-nine hospitals participated in the survey from July to August 2018. The questionnaires consisted of 24 items including general characteristics, new graduate nurses' education system, operation of nursing education teams, and preceptorship programs. The average duration of education/training for new graduate nurses was 57.3 days, and 26.6%–58.5% of general hospitals, hospitals, and long-term care hospitals had less than 30 days of new graduate nurses education/training, which is shorter than the education/training period of tertiary hospitals. There were new nursing education guidelines in 88.8% of all medical institutions and 58.6% of them had nursing education teams. Most of the personnel in charge of nursing education were not dedicated to education. A total of 87.6% of the all participating medical institutions had preceptorship programs, while 23.1%–33.3% of hospitals and long-term care hospitals did not. The breakdown of preceptorship programs showed 68.4% as “preceptor and preceptee are in charge of one team, and preceptor is teaching preceptee,” and 19.7% were “preceptor and preceptee are in charge of each team, and preceptor is teaching preceptee at the same time.” These results show that standardization and management of new graduate nurses' education programs is necessary. For the standardization and management of new graduate nurses' education programs, joint efforts of nurses' associations and support from the government should be encouraged.

Different Effects of Cognitive and Non-exercise Physical Leisure Activities on Cognitive Function by Age in Elderly Korean Individuals

OBJECTIVES: We aimed to examine the effects of various leisure activities on cognitive impairment in young-old (aged 65–74 years) and old-old (aged ≥ 75 years) adults. METHODS: In total, 10,279 elderly Korean individuals from the 2014 Korean National Survey on Older Adults’ cohort were enrolled in our study. Cognitive impairment was assessed using the standardized score of the Mini-Mental State Examination for Dementia Screening, whereas leisure activities were recorded via self-reporting of the extent and type of leisure activity the subjects involved in over the past year. Multivariate logistic regression was used to assess the effect of leisure activities on cognitive impairment, while controlling for potential covariates. RESULTS: The subjects were more likely to participate in cognitive activities than in non-exercise physical activities. After controlling for selected covariates, involvement in cognitive activities was found to be a significant predictor of cognitive impairment in both the groups, whereas involvement in non-exercise physical activities was not a predictor of cognitive impairment in individuals aged ≥ 75 years. Moreover, depressive symptoms, rural residence, and hearing difficulties were common predictors of cognitive impairment among elderly-Korean-individuals. CONCLUSION: Leisure activity involvement may help delay cognitive impairment, which is often concomitant with aging. Hence, an early intervention service may significantly benefit both young-old and old-old individuals.

Psychological Intervention Effects of Group Music Therapy on Patients with Parkinson's Disease

PURPOSE: Music therapy is a non-pharmacological treatment of the behavioral and psychological symptoms. This study was conducted to contribute to the rehabilitation of patients with idiopathic Parkinson's disease in the areas of functionality, emotionality and sociability. METHODS: The study included 35 participants, aged between 52 and 77 years, who were diagnosed with idiopathic Parkinson's disease (IPD) and reported suffering from depression, chronic illness anticipated stigma, and worrying about quality of life . The patients were recruited from the department of outpatient neurology at School of Medicine, D University in B Metropolitan City. Group music therapy was performed for nine weeks. The results were analyzed by repeated measures ANOVA. RESULTS: In terms of stigma, there were significant differences between two groups and time (p<.05). Analysis of the interaction between time and service method revealed significant differences (p<.05). Between time, and the interaction between time and service method revealed significant differences in terms of quality of life (p<.05). CONCLUSION: The results suggest that group music therapy will be effective on the psychosocial well-being of patients with Parkinson's disease living in assisted and independent living communities.

Development of Empowerment Program for Persons with Chronic Mental Illness and Evaluation of Impact

PURPOSE: This study was done to develop an empowerment program for people with chronic mental illness and to analyze effects of the program on level of empowerment. METHODS: The research was conducted using a nonequivalent control group pretest-posttest design. Participants were 37 people with chronic mental illness (experimental group: 18, control group: 19). The empowerment program was provided for 8 weeks (15 sessions). Data were collected between July 21 and October 17, 2014. Data were analyzed using Chi-square, Fisher's exact test, Sapiro-wilk test, and Repeated measure ANOVA with SPSS/WIN 18.0. RESULTS: Quantitative results show that self-efficacy, interpersonal relationships, attitudes in the workplace, occupational performance capacity, and levels of empowered execute were significantly better in the experimental group compared to the control group. CONCLUSION: Study findings indicate that this empowerment program for persons with chronic mental illness is effective for improving self efficacy, interpersonal skills, attitudes in the workplace, occupational performance capacity, levels of empowered execute.

Proposal of Suitable On-the-Job Training for Clinical Research Coordinator in Korea

BACKGROUND: This study is intended to propose not only to introduce and evaluate the 2 years Clinical Research Coordinator (CRC) professional on-the-job training program that has been implemented in Samsung Medical Center on September of 2009, but also to develop the CRC future education program. METHODS: It is surveyed with self-report type for the 53 trainees, 18 non-trainees, and 17 investigators, the participants worked in Samsung Medical Center, and the major contents of the survey were general characteristics, training program evaluations, CRC qualification evaluation, and job satisfaction. The collected data was analyzed at the 0.05 level of significance by using SAS 9.1 version. RESULTS: The training program is conducted as 4 phases, each phase assessed separately. The Professional A course got the highest satisfaction, and it was deal with quality control (Mean=4.11 ~ 4.33). Most of the investigators answered that the trainees have high priority to be hired in the future (very much=82.45). The non-trainees answered that the training program would be helpful to improve the job competency and qualification (very much=22.2 %, somewhat=55.6 %) and 88.9 % of them answered that they have intention to participate in the training program. Finally, compared to non-trainees, the trainees have more job attachment (P=0.0036) and intention to continue CRC (P=0.0045). CONCLUSION: The CRC professional training program in Samsung Medical Center, as on the job training for 2 years, satisfies the investigators and trainees with positive effect on CRC job satisfaction and job stability. Based on this study, the education program with good quality should be developed considering the characteristics for each institution and close research field.

Surgical Resection of a Posterior Mediastinal Tumor That Was Previously Treated with Aortic Stent-graft under the Misdiagnosis of Aortic Aneurysm: A case report / 대한흉부외과학회지

A 70-year-old man was transferred to our center due to severe epigastric and back pain with the impression of a ruptured thoracic aortic aneurysm. Six months previously, he had undergone insertion of stent graft into the descending thoracic aorta at another hospital. The findings of the computed tomographic scan suggested a rapidly growing malignant mediastinal tumor rather than a ruptured aneurysm. Exploratory thoracotomy confirmed the diagnosis and the tumor was resected along with the portion of the aorta contained in it. This exemplary case should raise the concern against overzealous application of endovascular aortic repair.

The Surgical Treatment for Aorto-cutaneous Fistula after Open Heart Surgery: A case report / 대한흉부외과학회지

Aorto-cutaneous fistula is a rare complication after performing open heart surgery, but if this develops, it is a fatal condition. So, prompt diagnosis and aggressive surgical treatment is needed. We report here on a patient who had two mechanical double valves placed during heart surgery and she was treated for repeated sternal wound infections for about 5 years. She visited the ER due to abrupt bleeding at the sternal wound. She was diagnosed as having an aorto-cutaneous fistula by performing an aortogram and we then performed cardio-pulmonary bypass surgery. The patient is currently doing well and is under follow up 24 months after the repair.

Exercise type and muscle fiber specific induction of caveolin-1 expression for insulin sensitivity of skeletal muscle

It is well known that exercise can have beneficial effects on insulin resistance by activation of glucose transporter. Following up our previous report that caveolin-1 plays an important role in glucose uptake in L6 skeletal muscle cells, we examined whether exercise alters the expression of caveolin-1, and whether exercise-caused changes are muscle fiber and exercise type specific. Fifity week-old Sprague Dawley (SD) rats were trained to climb a ladder and treadmill for 8 weeks and their soleus muscles (SOL) and extensor digitorum longus muscles (EDL) were removed after the last bout of exercise and compared with those from non-exercised animals. We found that the expression of insulin related proteins and caveolins did not change in SOL muscles after exercise. However, in EDL muscles, the expression of insulin receptor beta (IRbeta) and glucose transporter-4 (GLUT-4) as well as phosphorylation of AKT and AMPK increased with resistance exercise but not with aerobic exercise. Also, caveolin-1 and caveolin-3 increased along with insulin related proteins only in EDL muscles by resistance exercise. These results suggest that upregulation of caveolin-1 in the skeletal muscle is fiber specific and exercise type specific, implicating the requirement of the specific mode of exercise to improve insulin sensitivity.

Case Report of Partial Endocardial Cushion Defect with Mild Pulmonary Hypertension in Old Age / 대한흉부외과학회지

The partial endocardial cushion defect including ostium primum atrial septal defect and anterior mitral leaflet cleft, presents less significant clinical symptoms than complete endocardial cushion defect. But, as mitral insufficiency develops, cardiomegaly, congestive heart failure, pulmonary arterial hypertension appear. So, partial endocardial cushion defect has poor prognosis and is rarely seen in elderly patients. A 67 years old woman admitted at our hospital for operative treatment with partial endocardial cushion defect. She had increased pulmonary pressure of 45/22 mmHg, mean 32 mmHg. She had repair of ostium primum defect with patch, and the mitral valve was treated with valve replacement. Because advanced atrioventricular block developed postoperatively, she received permanent pacemaker.

Case Report of Partial Endocardial Cushion Defect with Mild Pulmonary Hypertension in Old Age / 대한흉부외과학회지

The partial endocardial cushion defect including ostium primum atrial septal defect and anterior mitral leaflet cleft, presents less significant clinical symptoms than complete endocardial cushion defect. But, as mitral insufficiency develops, cardiomegaly, congestive heart failure, pulmonary arterial hypertension appear. So, partial endocardial cushion defect has poor prognosis and is rarely seen in elderly patients. A 67 years old woman admitted at our hospital for operative treatment with partial endocardial cushion defect. She had increased pulmonary pressure of 45/22 mmHg, mean 32 mmHg. She had repair of ostium primum defect with patch, and the mitral valve was treated with valve replacement. Because advanced atrioventricular block developed postoperatively, she received permanent pacemaker.

Genotypes and Clinical Characteristics of BK Virus in Kidney Transplant Recipients / 대한신장학회잡지

BACKGOUND: BK virus has emerged as a major cause of allograft loss in kidney transplant recipients over the past decade. The presence of BK virus in urine or blood indicates reactivation of the virus not necessarily accompanied by BK virus associated nephropathy. BK virus genotypes have been described based on the DNA sequence of VP1 region, and no data have been published on BK virus genotypes in Korea. In this study, we sought to determine BK virus genotypes and clinical characteristics associated with BK virus reactivation. METHODS: We isolated BK virus DNA from urine and blood of 103 kidney transplant recipients, and amplified VP1 region using polymerase chain reaction (PCR). The PCR products were sequenced and genotypes of BK virus (I-IV) were determined based on the nucleotide sequence 1744-1812 of the VP1 region. In addition, the clinical characteristics of the patients were analyzed to determine the risk factors of BK virus reactivation. RESULTS: Of 103 patients examined, 16 and 5 patients were shown to have BK viruria and viremia, respectively. Eight viral strains were demonstrated to be genotype I, but the other 8 strains neither matched with the genotypes from I to IV, nor did they fit into any other variants identified in the Western countries. Of note, 3 of these 8 unclassified strains were shown to have the same type of mutations. With respect to the risk factors of BK virus, tacrolimus and mycophenolate mofetil when combined with tacrolimus were found to be significantly associated with BK viruria and viremia. CONCLUSION: It appears that different variants of BK virus are prevalent in Korea compared with the Western countries, and that the reactivation of BK virus is significantly associated with tacrolimus.