An aim of this study was to evaluate an effect of misinterpretation of pregnancy related cellular changes on the postpartum regression rate of abnormal cervical smears in pregnancy. A series of 265 cases with abnormal cervical smears in pregnancy were selected from a database of cervical smear results. The selected cases were classified as regression, persistence, and progression based on the results of postpartum cervical smears and histology. Of the selected cases, 162 cases were classified as regression and the postpartum regression rate was 61.1% (162/265). We reviewed abnormal cervical smears in pregnancy these cases. The primary cytologic diagnoses of these cases were ASCUS (118 cases), AGUS (2 cases), ASCUS/AGUS (1 case), LSIL (25 cases), LSIL R/O HSIL (2 cases), and HSIL (14 cases). With information of the pregnacy, we identified decidual cells in 24 cases, but cells identified by the Arias-Stella reaction and trophoblasts were not found. Sixteen cases out of 162 cases were reclassified as a pregnancy related change rather than an abnormal. Desidual cells were considered as ASCUS in 15 cases and as LSIL in one case. The revised postpartum regression rate was 55.5%(147/265) and was lower than the original. Consequently, misinterpretation of the pregnancy related cellular changes has an effect on a rise of the postpartum regression rate of the abnormal cervical smear in pregnancy. Pathologists may diagnose pregnancy related cellular changes as abnormal findings if they do not have information regarding the pregnancy. Therefore, clinical information of pregnancy and knowledge about the pregnancy related cellular changes are essential to prevent misinterpretation.
Objectives: This study furthers the currents understanding of alcohol use disorders, stress, mental health status and suicide among Seoul citizens. This study is to identify differences according to socio-demographic variables and variables which affect stress, mental status and suicide for developing mental health programs. Methods: The study subjects using cluster-stratified sampling method were 1234 adults over 19 years old from 17 dong, S-Ku in Seoul City. A cross-sectional study with face-to-face interview was used to collect data. A questionnaire measuring socio-demographic variables, Symptom Checklist-90-Revised (SCL-90-R) and psychosocial wellbeing index-short form (PWI-SF) was utilized. Results: Three findings in this study were discussed: (1) The prevalence of problem drinking and alcohol dependence and AUDIT score were significantly higher among male, younger age, and high level of education and income; (2) AUDIT score were related with stress, all 9 symptoms of SCL-R and suicide plan; (3) Problem drinkers were more likely to have 2.5 times of anxiety, 3.0 times of hostility, and 2.4 times psychoticism than non alcohol problem drinkers. Alcohol dependence drinkers were more likely to have 1.9 times of high risk group of stress, 4.1 times of obsessive-compulsive, 4.7 times of anxiety, 5.5 times of hostility, and 2.3 times psychoticism than non alcohol dependence drinkers. Conclusion: The findings suggest that the future intervention of Mental Health programs should be carefully designed and tailored by socio-demographic variables.
Purpose: The aim of this study was to analyze the effects of neurofeedback training for reducing stress and enhancing self-regulation in late adolescence to identify the possibility of use for nursing intervention. Methods: A nonequivalent control group pre-post quasi-experimental design was used. Participants were 78 late adolescents assigned to the experimental group (n=39) that received the neurofeedback training and the control group (n=39). Data were collected on heart rate variability (HRV) and skin conductance level (SCL) to assess stress-biomarker response. The questionnaire contained 164 items from: Positive and Negative Affect Schedule (PANAS), Symptom Checklist-90-Revised (SCL-90-R) and Self-regulatory Ability scale. The neurofeedback training was based on the general adaptation syndrome and body-mind medicine. The intervention was conducted in a total of 10 sessions for 30 minutes per session with high-beta, theta and sensory motor rhythm training on scalp at central zero. Results: There were significant difference in standard deviation of normal to normal interval (p=.036) in HRV and SCL (p=.029) of stress-biomarker response between the two groups. Negative affect (p=.036) in PANAS and obsessive compulsive (p=.023) and depression (p<.001) in SCL-90-R were statistically significant. Self-regulation mode (p=.004) in self-regulation ability scale showed a significant difference between the two groups. Conclusion: The results indicated that the neurofeedback training is effective in stress-biomarkers, psychoemotional stress response and self-regulation. Therefore, neurofeedback training using neuroscientific approach based on brain-mind-body model can be used as an effective nursing intervention for late adolescents in clinics and communities for effective stress responses.
Purpose: The purpose of this study was to investigate patient safety teaching competency of nursing faculty and the extent of teaching patient safety topics in the nursing curriculum. Methods: A national survey was conducted with full-time nursing faculty in 4-year nursing schools. Regional quota sampling method was used. An online survey was sent to 1,028 nursing faculty and 207 of them were completed. Among the 207, we analyzed data from 184 participants. The revised Health Professional Education in Patient Safety Survey was used. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson's correlation analysis, and multiple linear regression analyses. Results: The faculty's self-confidence was lower than their perceived importance of patient safety education. The mean score of teaching patient safety was $3.52{\pm}0.67$ out of 5, and the contents were mostly delivered through lectures. The extent of faculty's teaching varied depending on faculty's clinical career, teaching subjects, participation in practicum courses, and previous experience of patient safety education. The significant predictors of the extent of teaching patient safety were the faculty's self-confidence in teaching patient safety (${\beta}=.39$) during clinical practicum, their perceived importance of patient safety education during lectures (${\beta}=.23$), and the teaching subject (${\beta}=.15$). Conclusion: To enhance the competency of nursing faculty for effective patient safety education, a patient safety education program tailored to faculty characteristics should be developed and continuously provided for faculty. In addition, it is necessary to improve patient safety curriculum, strengthen clinical and school linkages, and utilize various education methods in patient safety education.
Objects : In this study, I aimed to determine the size and administration Method of pills preparation in Treatise on Cold Damage Diseases. Methods : I investigated the Treatise on Cold Damage Diseases, Newly Revised Materia Medica, Variorum of the Classic of Materia Medica, The Korean Herbal Pharmacopoeia, and recent studies. Results : There were four kinds of pills preparation. Each size of pill preparation was equal to the Odongja, Tanwhan, Yolk, and quarter of daily dosage of Decoction. One pill of Tanwhan was equivalent to 16 pills of Odongja, and one Yolk was equal to 40 pills of Odongja. The Diameter of Odongja was 6.5 mm, Tanwhan was 16.37897 mm, and Yolk was 22.11484 mm. Jeodangwhan was equal to one quarter daily dosage of Jeodangtang. Maximum size to swallow with water was Odongja and daily dosage, which was 16 pills, includes one square-inch-spoon of powder preparation. When we made the pill preparation, it is difficult to make 16 pills using one square-inch-spoon of powder. Therefore, Zhang Zhongjing made one dosage started from 10 pills to 20 pills to find out optimum dose. Due to the difficulty of making precise size of pills and considerable amount of daily dosage, there was no smaller size than Odongja. When the size of Pill preparation was larger than Odongja, it was ground or boiled slightly to make suspensions. Conclusions : These results suggest that the sizes of Pill preparation in the Treatise on Cold Damage Diseases were true compared with reality.
Purpose: This study reviewed screening and assessment tools that are used to measure delirium in patients with cancer in hospice and palliative care settings and examined their psychometric properties. Methods: Four databases were searched for studies using related search terms (delirium, tools, palliative care, cancer, and others). The inclusion criteria were a) studies that included screening/assessment tools for measuring delirium in cancer patients receiving hospice/palliative care, and b) studies published in English or Korean. The exclusion criteria were a) studies that were conducted in an intensive care setting, and b) case studies, qualitative studies, systematic reviews, or meta-analyses. Results: Out of the 81 studies identified, only 10 examined the psychometric properties of tools for measuring delirium, and 8 tools were ultimately identified. The psychometric properties of the Memorial Delirium Assessment Scale (MDAS) were the most frequently examined (n=5), and the MDAS showed good reliability, concurrent validity, and diagnostic accuracy. The Delirium Rating Scale had good reliability and diagnostic accuracy. The Delirium Rating Scale-Revised 98 also showed good reliability and structural validity, but its diagnostic performance was not examined in hospice/palliative care settings. The Nursing Delirium Screening Scale showed relatively low diagnostic accuracy. Conclusion: The MDAS showed evidence of being a valid assessment tool for assessing delirium in patients with cancer in palliative care. Few studies examined the diagnostic performance of delirium tools. Therefore, further studies are needed to examine the diagnostic performance of screening/assessment tools for the optimal detection of delirium in patients with cancer in hospice/palliative care.
The Bethesda System for Reporting Thyroid Cytopathology (TBSRCT) is crucial for cytopathologists to use a standardized, category-based reporting system for thyroid fine needle aspirations and is effective for clear communication with the referring physicians. The new Bethesda System for Reporting Thyroid Cytopathology, the third edition in 2023, provides several key updates. The most important update is the assignment of only single name for each of the six diagnostic categories: (I) nondiagnostic; (II) benign; (III) atypia of undetermined significance; (IV) follicular neoplasm; (V) suspicious for malignancy; and (VI) malignant. An implied risk of malignancy (ROM) for each of six categories has been updated based on extensively published data since the second edition of TBSRTC in 2017 and offers both an average ROM for each category and the expected range of cancer risk. Estimated final ROM after excluding "Noninvasive Follicular Thyroid Neoplasm with Papillary Like Nuclear Features (NIFTP)" for each of six categories has been updated based on the reported mean decreases in the ROM if excluding NIFTP. For atypia of undetermined significance (AUS) category, the subcategorization is simplified and more formalized into 2 subgroups, AUS-nuclear atypia or AUS-other, based on the implied ROM and molecular profiling. For the pediatric thyroid disease, pediatric ROMs and management algorithms are newly added for the same six reporting categories for this age group. New or revised disease nomenclatures including high-grade follicular-derived carcinoma has been updated according to the recently published 2022 World Health Organization Classification of Thyroid Neoplasms. Brand new two chapters are added including clinical perspectives and imaging studies (Chap. 13) and the use of molecular and other ancillary tests (Chap. 14). The atlas is updated with new images to illustrate more effectively for new disease entity and diagnostic criteria.
Journal of the Korean Academy of Child and Adolescent Psychiatry
/
v.26
no.3
/
pp.197-208
/
2015
Objectives : The purposes of this study were to examine the reliability and validity of the Korean version of Social Communication Questionnaire (K-SCQ) and to determine cut-off scores for diagnosis of autism spectrum disorder (ASD). Methods : A total of 166 subjects with ASD and their 186 unaffected siblings were recruited through child psychiatry clinics of university hospitals. Board certified child psychiatrists screened all probands suspected to have ASD based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition. To confirm the diagnoses, the Korean versions of the Autism Diagnostic Observation Schedule and the Autism Diagnostic Interview-Revised (K-ADI-R) were administered to all the subjects. All parents completed the K-SCQ and Social Responsiveness Scale (SRS). The non-ASD siblings were evaluated with the same instruments as the probands with ASD. We performed a factor analysis to examine the structure of K-SCQ. For testing the validity of K-SCQ, we compared the difference in Lifetime and Current scores of probands with ASD and their non-ASD siblings using t-test and analysis of covariance. Correlations between the K-SCQ and other measurements of ASD symptomatology, including K-ADI-R totals and domain scores and SRS, were examined. Receiver operation characteristic curve analysis was performed to extract cutoff scores discriminating affection status. Results : Four factors were extracted through factor analysis of K-SCQ ; 1) social relation and play, 2) stereotyped behavior, 3) social behavior, and 4) abnormal language. Cronbach's internal consistency was .95 in K-SCQ Lifetime, and .93 in K-SCQ Current. There were significant differences in total score of K-SCQ, both in Lifetime and Current between the ASD group and non-ASD siblings group (p<.05). K-SCQ scores were significantly correlated with K-ADI-R subdomain scores and SRS total scores (p<.05). The best-estimate cut-off scores of K-SCQ for diagnosis of ASD were 12 for 48 months and over, and 10 for below 47 months. Conclusion : Our findings suggest that the K-SCQ is a reliable and valid instrument for screening autistic symptoms in the Korean population. Lower cut-off scores than the original English version might be considered when using it as a screening instrument of ASD.
Chang, Hye Jin;Hwang, Kyung Joo;Kim, Mi Ran;Ahn, Sang Tae;Byun, Jae Guang;Lee, Eun Hee;Park, Jin Young
Clinical and Experimental Reproductive Medicine
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v.33
no.3
/
pp.199-205
/
2006
Objective: The aim of this study was to evaluate the correlation between severity of endometriosis and the incidence of endometrial polyp. Methods: The study population consisted of six hundred thirty-one women who had undergone laparoscopic operation due to infertility, severe dysmenorrhea or ovarian tumors. We divided two groups: 434 women with endometriosis (study group) and 197 women without the disease (control group). The presence of endometriosis was documented by diagnostic or therapeutic laparoscopic operation and the disease severity was scored according to revised The American Fertility Society classification. We confirmed the endometrial polyps by pathologic examination after hysteroscopic polypectomy, and compared endometrial polyp incidence according to severity of endometriosis. Results: There was no significant difference between groups with regard to age, mean duration of infertility. Endometrial polyps were found in 274 women (63.0%) with endometriosis and in 58 controls (29.8%, p=0.0000). The incidence of endometrial polyps differed significantly according to stage of endometriosis. The incidence of endometrial polyps were 77/142 (54.2%), 58/90 (64.4%), 73/108 (67.6%, p<0.05), 66/94 (70.2%, p<0.05) in endometriosis stage I, II, III, and IV. There was a linear correlation between stage of endometriosis and endometrial polyps incidence (p=0.008). Conclusion: Endometriosis is accompanied by endometrial polyps. This results showed positive correlation between severity of the endometriosis and incidence of endometrial polyps. It is the possible mechanism for low pregnancy rate in the severe endometriosis.
Objectives : As medical science develops, survival rate of cancer patients rises. Therefore, psychologic understanding and improving quality of life in cancer patients is getting greater significance. The Object of this study is to investigate sociodemographic and clinical characteristics, psychopathology, self esteem and quality of life in cancer patients and to provide useful information for therapeutic approach to cancer patients. Methods : The subjects were 41 patents who had been treated by radiotherapy and 20 normal people. Sociodemographic information and clinical characteristics of cancer patients were investigated, and SCL-90R for psychopathology, Rosenberg Self-esteem Scale for self esteem, WHOQOL-BREF for quality of life were administered to subjects. The results of both groups were compared and analysed, and correlation between variables were evaluated. Results : 1) The tendency of Somatization, obsession-compulsion, depression, anxiety, hostility, phobia, psychosis in cancer group were higher than normal group. Especially, somatization and anxiety in cancer group were significantly higher than normal group. 2) Self esteem and quality of life in cancer group were significantly lower than normal group. 3) No significance were found in comparison of psychopathology, self esteem and quality of life according to sociodemographic variables. Among clinical characteristics, higher somatization was shown in case of more weight loss, and higher somatization and lower quality of life was shown in the presence of pain. 4) Higher anxiety was significantly associated with lower self esteem, and Higher somatization and anxiety was significantly associated with lower quality of life. Conclusion : Cancer patients had various kinds of psychopathology, low self esteem and low quality of life. In particular, somatization and anxiety, self esteem and pain were found to be important factors to quality of life of cancer patients. Therefore, management of psychopathology, improving self esteem, pain control is necessary to improve quality of life in cancer patients.
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