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The authors report a successful outcome after percutaneous transabdominal placement of a self-expandable metallic stent in a patient who had afferent loop syndrome caused by recurrent common bile duct adenocarcinoma. Enhanced abdominal CT showed marked dilation of the afferent loop adjacent to the anterior peritoneum, multiple hepatic metastases and lymph node metastasis around the choledochojejunal anastomosis site without marked dilation of intrahepatic bile ducts. Percutaneous drainage catheter was successfully placed to the dilated afferent loop just below the abdominal wall. Subsequent successful palliation of the afferent loop obstruction was achieved by placing a self-expandable metallic stent via the transabdominal route with the aid of cone-beam CT.

Purpose To evaluate the diagnostic usefulness of diffusion-weighted MR imaging (DWI) compared with contrast-enhanced MR imaging for the detection of the lipid-rich necrotic core (LRNC) of symptomatic carotid atherosclerotic plaques. Materials and Methods Twenty-five patients (median age: 66 years; range: 45–78 years) with moderate-to-severe symptomatic carotid stenosis confirmed with contrast-enhanced carotid MR angiography who underwent carotid plaque MR imaging were retrospectively reviewed. An echo-planner DWI with b0, b200, b400, b800, and b1000 was performed along with carotid plaque MR imaging. Plaque visualization on DWI was analyzed by 2 reviewers on consensus. The contrast-to-noise ratio between the lumen and plaque was analyzed between variable b-values. Results Carotid atherosclerotic plaques were identified on carotid DWI in 8 patients. Confirmed carotid atherosclerotic plaques were not identified on carotid DWI in 16 patients. The DWI-identified group had plaques with significantly greater maximal wall thickness and longitudinal length, as compared with the non-identified group. DWI with b200 had a higher contrast-to-noise ratio between the lumen and LRNC (p < 0.001). The mean apparent diffusion coefficient value from DWI with b200 for the LRNC was 0.51 ± 1.55 × 10-3 mm2/s. Conclusion There was less frequent identification of carotid atherosclerotic plaques with carotid DWI, as compared with contrast-enhanced MR imaging. This study suggested that carotid DWI cannot replace contrast-enhanced MR imaging for the detection of carotid plaques, including LRNC.

Purpose : This study aimed to identify the prevalence and risk factors of cognitive impairment in survivors discharged from the intensive care unit (ICU). Methods : This secondary analysis study utilized data from a multicenter prospective cohort of post-ICU patients. We analyzed the data of 175 patients enrolled in the primary cohort who completed the cognitive function evaluation three months after ICU discharge. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) scale. The cut-off points for cognitive impairment were < 23 for face-to-face evaluation and < 18 for telephone evaluation. Results : The prevalence of cognitive impairment three months after ICU discharge was 32.6%. Significant risk factors for cognitive impairment were age ≥ 60 years (OR=10.52, 95% CI=3.65-30.33, p<.001), education < high school graduation (OR=2.53, 95% CI=1.07-6.01, p=.035), unplanned ICU admission (OR=4.01, 95% CI=1.45-11.14, p=.008), and delirium in the ICU (OR=4.33, 95% CI=1.08-17.23, p=.038). Conclusion : ICU nurses should use preemptive strategies to reduce post-ICU cognitive impairment of patients with risk factors. It is necessary to frequently assess and detect early delirium in critically ill patients, while attempting various non-pharmacological interventions. [ABSTRACT FROM AUTHOR]

Purpose : This study aimed to investigate the prevalence and risk factors of mental health problems in patients discharged from the intensive care unit (ICU). Methods : This was a secondary analysis study using data from a multicenter prospective cohort of post-ICU patients. We analyzed data of 311 patients enrolled in the primary cohort study who responded to the mental health questionnaire three months after the discharge. Anxiety and depression were measured on the Hospital Anxiety-Depression Scale, and post-traumatic stress disorder (PTSD) was measured on the Posttraumatic Diagnostic Scale. Results : The prevalence of anxiety, depression, and PTSD in patients at three months after ICU discharge were 25.7%, 17.4%, and 18.0%, respectively, and 7.7% of them experienced all three problems. Unemployment (OR=1.99, p=.033) and unplanned ICU admission (OR=2.28, p=.017) were risk factors for depression, while women gender (OR=2.34, p=.009), comorbid diseases (OR=2.88, p=.004), non-surgical ICUs (trauma ICU: OR=7.31, p=.002, medical ICU: OR=3.72, p=.007, neurological ICU: OR=2.95, p=.019) and delirium (OR=2.89, p=.009) were risk factors for PTSD. Conclusion : ICU nurses should proactively monitor risk factors for post-ICU mental health problems. In particular, guidelines on the detection and management of delirium in critically ill patients should be observed. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to identify the effects of a direct breastfeeding program for premature infants in neonatal intensive care units (NICUs)., Methods: This quasi-experimental study was conducted during August 2016 to April 2017. Sixty mothers of premature infants were assigned to the experimental (n = 31) or control groups (n = 29). The program was comprised of breastfeeding education and direct breastfeeding support. The experimental and control groups were provided with education and counseling on breastfeeding at the time of admission and discharge. In the experimental group, the mothers initiated oral feeding with direct breastfeeding and engaged in breastfeeding at least seven times during the NICU stay. The collected data were analyzed by the χ²-test and repeated measures ANOVA using an SPSS program., Results: The experimental group showed a higher direct breastfeeding practice rate (χ² = 19.29, p < .001), breastfeeding continuation rate (χ² = 3.76, p < .001), and self-efficacy (F = 25.37, p < .001) than the control group except for maternal attachment., Conclusion: The direct breastfeeding program in the NICU has significant effects on the practice and continuation rate of breastfeeding and breastfeeding self-efficacy. Therefore, this program can be applied in the NICU settings where direct breastfeeding is limited., Competing Interests: The authors declared no conflict of interest., (© 2021 Korean Society of Nursing Science.)

Purpose: The study was done to identify lower urinary tract symptoms (LUTS) and to evaluate the factors affecting LUTS for the people with Parkinson's disease., Methods: The research design was a cross-sectional study with interviews using a structured questionnaire. The participants were 72 patients with Parkinson's disease who were seen in the Neurology clinic of a university hospital from September to November 2005., Results: Mean score of LUTS for the participants was 10.11. In each symptom score of LUTS (range 0-5), weak stream was the highest 2.06, followed by nocturia 1.71, and urgency 1.61. The severity of LUTS was moderate to severe group for 51%. LUTS were significantly different by regular exercise. Positive correlations were observed between Hoehn and Yahr stage (stage of disease severity) and frequency and between Hoehn and Yahr stage and urgency (r=.280, p=.018; r=.328, p=.005). LUTS were significantly predicted by regular exercise (p=.001) which explained 15.0% of the variance in LUTS., Conclusion: Regular exercise was found to be a very important factor associated with LUTS for patients with Parkinson's disease.

Purpose: This was a methodological research to develop an instrument to assess the emotional response of family members of physically restrained patients., Methods: A primary instrument with 68 questions was developed based on literature review and semi-structured interviews with family members. A group of experts revised individual questions and removed 4 irrelevant questions. This secondary instrument, then, was tested with 199 family members of physically restrained patients in intensive care units of a university hospital. The validity and reliability of the instrument were tested by factor analysis., Results: After item analysis, 3 questions with a correlation coefficient under .30 were discarded and the questions with a factor loading under .45 on Varimax Rotation were also removed. After factor analysis on the final 37 questions, 7 factors were identified; avoidance, shock, helplessness, grudge, depression, anxiousness, and acceptance. The total variance explained was 55.63%. The reliability of this instrument was 0.93 of Cronbach's alpha., Conclusion: This instrument was statistically reliable and valid to measure family's emotional response to physical restraints of the patients. This instrument can be useful in assessing the effects of nursing interventions for family members of restrained patients.

In order to rapidly detect and analyze the presence of a target ligand of interests in environmental or industrial fluids as well as biological samples, numerous test systems have been designed and developed, which have been based on the combination of a test reagent and absorbing paper or membrane. The main limitations of these conventional devices are the difficulty of quantitative or semi-quantitative detection and poor detection limit (around nanogram/ml range detection capability). In this paper, new approaches and research trends which use nano/MEMS (micro electro mechanical systems) technology is introduced, which has a concept of fast, precise, and massive diagnosis and analysis of target molecules using very small amount of samples.

Purpose: The purpose of this study was to investigate the effects of exercise training using biofeedback and constraint-induced movement on the upper extremity function of hemiplegic patients., Method: A non-equivalent pretest-posttest design was used. Study subjects were a conveniently selected group of 40 hemiplegic patients(20 experimental subjects, 20 control subjects) who have been enrolled in two community health centers. After biofeedback training the subjects of experimental group were given constraint-induced movement, involving restraint of unaffected U/E in a sling for about 6 hours in a day over a period of two weeks, while at the same time intensively training the affected U/E. Outcomes were evaluated on the basis of the U/E motor ability(hand function, grip power, pinch power, U/E ROMs), and motor activity(amount, quality)., Result: 1. After 2 weeks of treatment, the motor abilities of affected U/E(hand function, grip power, pinch power, ROMs of wrist flexion, elbow flexion and shoulder flexion/extension) were significantly higher in subjects who participated in exercise training than in subjects in the control group with no decrement at 4-week follow-up. However, there was no significant difference in wrist extension between experimental or control group. 2. After 2 weeks of treatment, the amount of use and the quality of motor activity of affected U/E were significantly higher in subjects who participated in exercise training than in subjects in the control group with no decrement at 4-week follow-up., Conclusion: The above results state that exercise training using biofeedback and constraint-induced movement could be an effective intervention for improving U/E function of chronic hemiplegic patients. Long-term studies are needed to determine the lasting effects of constraint-induced movement.

Purpose: This study was aimed to investigate the health related quality of life and related factors of organ transplant recipients., Method: The participants were 188 people who had liver(86), kidney(81), or heart(24) transplanted. Data on the demographic characteristics, transplantation-related characteristics, symptom frequency or discomfort measured by Transplant Symptom Frequency and Symptom Distress Scale by Lough et al(1987), and health related quality of life measured by SF-36(version 2) were collected., Result: Overall health related quality of life score was 492.1 for 100 scoring and, 344.9 for norm based. Physical functioning showed the highest quality of life score (77.5) and vitality showed the lowest(51.1). The kidney transplanted showed the highest quality of life (504.4) and the heart transplanted showed the lowest(426.7) Quality of life was related with occupation(p=.016) and symptom discomfort(p<.0001)., Conclusion: The health related quality of life of transplated patients was lower than the norm of American. Further studies need to be done to identify the norm of Korean and to investigate the effect of releving symptom discomfort on the increasing the health related quality of life.