• Child Health Nursing Research
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• v.2 no.1
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• pp.112-126
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• 1996

The purpose of this study was to investigate the current status of the need of telephone call and to identify the status of nursing intervention through telephone. Head nurses of the pediatric nursing unit and a nurse of pediatric outpatient clinic wrote down the telephone record of calls by parents of children discharged from hospital from 7 am to 3 pm during the period of March to June, 1995. Content of 120 telephone calls but for 26 calls with incomplete record among 146 calls were analyzed into frequency of general characteristics, needs and nursing intervention. The needs of telephone call were identified and classified into 11 areas and analyzed into frequency of detailed content by 11 areas. Nursing intervention was identified and classified into 10 categories, and analyzed into frequency of detailed content by 10 categories. The findings of this study were as follows ; The need of telephone call was identified with nutritional state, medication, vital signs, language retardation, personal hygiene, vaccination, administration procedure, physical symptoms, follow up care management and others. The most frequent needs were physical symptoms and vaccination. A kind of food among nutrition dose of drugs among medication, fever among vital signs, cough among physical symptoms, and content of vaccination among vaccination was the most frequent needs. Nursing intervention through telephone was identified with instruction, knowledge offer, information offer, judgement, solicitation, referral and instruction, referral, connection, reassurance, reservation, and regulation. Instruction, knowledge offer and information offer was the most frequent nursing intervention by telephone call. Instruction was about a visit to hospital, a visit to nearby clinic, instruction about symptoms,, instruction about nursing care procedure, retelephoning and vaccination. Knowledge offer was about vaccination, knowledge related to medication, and dental care. Information offer and judgement was about vaccination and medication. Referral and instruction delivery was about instruction delivery following consultation to doctor, visit to emergency room and a visit to hospital following consultation to doctor. These results suggest that telephone call intervention program should be established as a field of extended pediatric nursing role in health care delivery system for the children.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.4
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• pp.366-376
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• 2020

Purpose: To assess the association between birth weight and the development of functional gastrointestinal disorders (FGIDs) in the first year of life. Methods: This is a secondary analysis of a prospective cohort multicenter study including neonates, consecutively enrolled at birth, and followed up for one year. At birth all infants were classified by birth weight as extremely low (ELBW), very low, or low when <1,000, <1,500, and <2,500 g, respectively, and by birth weight for gestational age as appropriate (AGA, weight in the 10-90th percentile), small (SGA, weight <10th percentile), and large (LGA, weight >90th percentile) for gestational age. FGIDs were classified according to the Rome III criteria and assessed at 1, 3, 6, and 12 months of life. Results: Among 1,152 newborns enrolled, 934 (81.1%) completed the study: 302 (32.3%) were preterm, 35 (3.7%) were ELBW, 104 (11.1%) were SGA, 782 (83.7%) were AGA, and 48 (5.1%) were LGA infants. Overall, throughout the first year of life, 718 (76.9%) reported at least one FGID. The proportion of infants presenting with at least one FGID was significantly higher in ELBW (97%) compared to LBW (74%) (p=0.01) and in LGA (85.4%) and SGA (85.6%) compared to AGA (75.2%) (p=0.0001). On multivariate analysis, SGA was significantly associated with infantile colic. Conclusion: We observed an increased risk of FGIDs in ELBW, SGA, and LGA neonates. Our results suggest that prenatal factors determining birth weight may influence the development of FGIDs in infants. Understanding the role of all potential risk factors may provide new insights and targeted approaches for FGIDs.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.3
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• pp.1337-1340
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• 2016

Background: There is a noticeable change in the approach with which women nowadays seek help for diseases like breast cancer, primarily due to awareness campaigns, but what happens after surgical procedures is of great significance too. This study focused on the several psychological connotations attached to mastectomy and how the patients cope. Objective: To understand the pattern of anxiety and level of depression among Pakistani patients undergoing mastectomy. Materials and Methods: The sample size consisted of 88 patients who had undergone mastectomy at the different surgical units of the Civil Hospital, Karachi, from January 2012-December 2014; The questionnaire was administered before they were discharged i.e. within 3 days of surgical procedures. The patients were asked if they were willing to participate in this study, those who agreed signed the consent form and then we preceded by asking questions with a standardized tool. A self made questionnaire was constructed keeping in mind the nature and specification of the disease, which consisted of 20 questions related to anxiety and depression, focusing on a mixture of psychological and physiological symptoms. Results: There were a total of 88 patients out of which 36 (41%) were aged 51 to 60 years, 24 (27.2%) of the patients were in the age category of 41 to 50 years, 17 aged 61 and above (19.3%) and only 11 (12.5%) 30-40 years of age, the youngest of all the age categories. The pattern of depression and anxiety was found to be similar among all age categories, severe depression and anxiety predominating over moderate level of such symptoms, with only relatively few patients sufering mild or no depression symptoms. Conclusions: It was concluded that going through mastectomy leads to moderate to severe levels of depression and anxiety, primarily because the females feel incomplete and insecure after losing a part of themselves.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.1
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• pp.599-602
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• 2013

Objectives: To evaluate the frequency of cytohistologic discrepancy of high-grade squamous intraepithelial lesions (HSILs) in Pap smears and associated factors. Methods: Medical records of 223 women with HSIL Pap smears who were treated at Thammasat University Hospital were reviewed. Data on age, parity, menopausal status, contraceptive use and colposcopic directed biopsy and loop electrosurgical excision procedure (LEEP) pathology results were recorded. Results: Mean (SD) age of patients was 38.0 (9.4) years. The majority were premenopausal (86.5%) and multiparous (83.9%). Cytohistologic discrepancy between the Pap test and colposcopic-directed biopsy histology was 45.7% and that between the Pap test and LEEP histology was 29.5%. Fifty-four (24.2%) women had no high-grade CIN on both colposcopic directed biopsy and LEEP. Nulliparity, postmenopausal status and having no oral contraceptive pills use were factors associated with cytohistologic discrepancy. Conclusion: The exact cytohistologic discrepancy rate was relatively high (24.2%). Factors associated with cytohistologic discrepancy were nulliparity and postmenopausal status and having no oral contraceptive pill use.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.18 no.4
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• pp.238-245
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• 2015

Purpose: The aim of this study was to evaluate bolus transit during esophageal swallow (ES) and gastroesophageal reflux (GER) events and to investigate the relationship between the characteristics of ES and GER events in a population of term and preterm newborns with symptoms of gastroesophageal reflux disease (GERD). Methods: The study population consisted of term and preterm newborns referred to combined multichannel intraluminal impedance (MII) and pH monitoring for GERD symptoms. The frequency and characteristics of ES and GER events were assessed by two independent investigators. Statistical significance was set at p<0.05. Results: Fifty-four newborns (23 preterm) were included in the analyses. Median bolus head advancing time corrected for esophageal length (BHATc) was shorter during mealtime than during the postprandial period (median, interquartile range): 0.20 (0.15-0.29) s/cm vs. 0.47 (0.39-0.64) s/cm, p<0.001. Median bolus presence time (BPT) was prolonged during mealtime: 4.71(3.49-6.27) s vs. 2.66 (1.82-3.73) s, p<0.001. Higher BHATc (p=0.03) and prolonged BPT (p<0.001) were observed in preterm newborns during the postprandial period. A significant positive correlation between BHATc and bolus clearance time was also observed (${\rho}=0.33$, p=0.016). Conclusion: The analysis of ES and GER events at the same time by MII provides useful information to better understand the physiopathology of GERD. In particular, the analysis of BHATc during the postprandial period could help clinicians identify newborns with prolonged esophageal clearance time due to impaired esophageal motility, which could allow for more accurate recommendations regarding further tests and treatment.

• Journal of Pharmacopuncture
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• v.21 no.2
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• pp.126-131
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• 2018

This study investigates the effect of a combination of homeopathic medicine and electro- acupuncture in two patients with breast cancer and severe liver disease who could not receive standard anaesthesia therapy due to liver problems. Specifically, measurable and quantifiable parameters were used to evaluate whether an integrated approach-consisting of electro- acupuncture and a homeopathic medicine diluted above Avogadro's limit (that is, above a potency of 12CH) during the pre-surgical, surgical and post-surgical phases -can improve general well-being of a patient undergoing breast cancer surgery. In breast cancer surgery, we employed an integrated approach consisting of induction with hypnotics and muscle relaxants, followed by maintenance with anaesthetic gas, combined with a homeopathic treatment (Arnica montana 15CH and Apis mellifica 15CH) before and after surgery and an electro- acupuncture treatment performed in the pre- and post-surgical phases without any analgesic/pain relieving medications. Both of the patients treated with the integrated approach improved their overall condition without need for other common pain relieving medicines. Additionally, thanks to their rapid awakening, the patients were not relocated to a protected area and the hospitalization was shorter. A multidisciplinary approach incorporating homeopathic medicine and electro-acupuncture can be a solution for patients who need or ask about a different and/or safer alternative to the standard treatment. This approach can offer a safe, much less expensive, non-invasive and viable alternative for such cases. Moreover it can be useful for an opioids free anesthesia.

• Clinics in Shoulder and Elbow
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• v.24 no.2
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• pp.98-105
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• 2021

Background: Our aim is to determine the interobserver reliability for surgeons to detect Hill-Sachs lesions on magnetic resonance imaging (MRI), the certainty of judgement, and the effects of surgeon characteristics on agreement. Methods: Twenty-nine patients with Hill-Sachs lesions or other lesions with a similar appearance on MRIs were presented to 20 surgeons without any patient characteristics. The surgeons answered questions on the presence of Hill-Sachs lesions and the certainty of diagnosis. Interobserver agreement was assessed using the Fleiss' kappa (κ) and percentage of agreement. Agreement between surgeons was compared using a technique similar to the pairwise t-test for means, based on large-sample linear approximation of Fleiss' kappa, with Bonferroni correction. Results: The agreement between surgeons in detecting Hill-Sachs lesions on MRI was fair (69% agreement; κ, 0.304; p<0.001). In 84% of the cases, surgeons were certain or highly certain about the presence of a Hill-Sachs lesion. Conclusions: Although surgeons reported high levels of certainty for their ability to detect Hill-Sachs lesions, there was only a fair amount of agreement between surgeons in detecting Hill-Sachs lesions on MRI. This indicates that clear criteria for defining Hill-Sachs lesions are lacking, which hampers accurate diagnosis and can compromise treatment.

• The Korean Journal of Physiology and Pharmacology
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• v.25 no.4
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• pp.375-383
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• 2021

The intestinal barrier function disrupted in sepsis, while little is known about the variation in different phases of sepsis. In this study, mouse models of sepsis were established by caecal ligation and puncture (CLP). The H&E staining of sections and serum diamine oxidase concentration were evaluated at different timepoint after CLP. TUNEL assay and EdU staining were performed to evaluate the apoptosis and proliferation of intestinal epithelium. Relative protein expression was assessed by Western blotting and serum concentrations of pro-inflammatory cytokines was measured by ELISA. The disruption of intestinal barrier worsened in the first 24 h after the onset of sepsis and gradually recovered over the next 24 h. The percentage of apoptotic cell increased in the first 24 h and dropped at 48 h, accompanied with the proliferative rate of intestinal epithelium inhibited in the first 6 h and regained in the later period. Furthermore, the activity of nuclear factor kappa B (NF-κB) presented similar trend with the intestinal barrier function, shared positive correction with apoptosis of intestinal epithelium. These findings reveal the conversion process of intestinal barrier function in sepsis and this process is closely correlated with the activity of NF-κB signaling.

• Quality Improvement in Health Care
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• v.9 no.2
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• pp.134-147
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• 2002

Background : As an empirical study, current research about the quality of social services carried out in general and teaching hospitals across the country. In the flux of health care reforms and market transformation, the quality of social services in the hospital becomes increasingly significant. Methods : A sample of total 80 hospitals, including general hospitals with one social worker at least and single-department hospital with two social workers or more, were identified nationwide through the registry of Korean Association of Medical Social Workers and Korean Association of Hospitals. The subjects of this survey were 80 leaders of social service units. The survey data from each subjects were measured to evaluate level of quality that service provider perceived of sample hospitals. Under the method of one-way ANOVA and multiple regression, the level of quality in social work service was analyzed. Results : The major findings were as following ; First, the level of quality perceived showed less score, especially the lowest was the score of quality of outcome. Second, the key variables of each hospital which turned out significantly different in quality of social work service were the departmental form of social work unit, unit leader's age, educational level, field experience, and job rank. Third, the level of quality of social work service correlated positively with the field experience of unit leader, the size of social work unit, the job rank of the unit leader. Conclusion : The most influential variables to the quality of social work service proved departmental form of social work unit, leader of social work unit. Therefore, to assure the proper level of quality, social work unit in hospital must be structured single, independent department in which entitled social worker is supposed to supervise and manage. And a leadership-development program for leaders in social work unit are strongly recommended.

• The Journal of Advanced Prosthodontics
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• v.9 no.2
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• pp.124-129
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• 2017

PURPOSE. This study evaluated the effect of span length on the adaptation of implant-supported cobalt chromium frameworks fabricated by three techniques. MATERIALS AND METHODS. Models with two solid abutment analogs at different inter-abutment distances were digitized using a laboratory scanner. Frameworks of two-, three-, and four-unit fixed prostheses were designed by a computer. Six dots with a diameter of 0.2 mm were preset on the surface of each framework. A total of 54 implant-supported cobalt chromium frameworks were fabricated by milling, selective laser melting (SLM), and cast techniques. The frameworks were scanned and exported as Stereolithography files. Distances between two dots in X, Y, and Z coordinates were measured in both the designed and fabricated frameworks. Marginal gaps between the framework and the abutments were also evaluated by impression replica method. RESULTS. In terms of distance measurement, significant differences were found between three- and four-unit frameworks, as well as between two- and four-unit frameworks prepared by milling technique (P<.05). Significant differences were also noted between two- and three-unit frameworks, as well as between two- and four-unit frameworks prepared by cast technique (P<.05). The milling technique presented smaller differences than the SLM technique, and the SLM technique showed smaller differences than the cast technique at any unit prostheses (P<.05). Evaluation with the impression replica method indicated significant differences among the span lengths for any fabrication method (P<.05), as well as among the fabrication methods at any unit prostheses (P<.05). CONCLUSION. The adaptation of implant-supported cobalt chromium frameworks was affected by the span length and fabrication method.