Purpose: This study aimed to identify and explore how perioperative scrub nurses embody their situational awareness to elucidate the association between research and application. Methods: This qualitative study employed an analytical induction approach. The analytical method reconstructed by Bloor (1978) and modified by Johnson (2004) was used to investigate and analyze the phenomenon in clinical practice. The study was conducted from January 12 to May 20, 2019. Data were collected using semi-structured interviews; the study subjects included 12 perioperative scrub nurses working at three university hospitals. Results: Perioperative scrub nurses embodied situational awareness by comparing and identifying general and abnormal situations throughout surgical procedures, setting priorities in their tasks, responding to situations according to the degree of emergency in the operating room, and developing an integrated view. Perioperative scrub nurses embodied situational awareness through typical patterns involving empirical cases based on experiences, apprenticeship-oriented training, information exchange among surgical team members, and self-directed simulation. Professional responsibility and the level of surgical emergency played an essential role in embodying these patterns. Conclusion These findings will provide practical categories that will contribute to the development of strategies for practical education of novice perioperative scrub nurses and nursing students.

Acidosis ; Adult ; Anesthesia ; Anesthetics ; Cyanosis ; Dantrolene ; Early Diagnosis ; Humans ; Incidence ; Male ; Malignant Hyperthermia ; Muscle, Skeletal ; Pentobarbital ; Succinylcholine ; Tachycardia

BACKGROUND: The regular meal pattern with consistent day-to-day calorie and carbohydrate intake is one of the most important determinants of good glycemic control in diabetes. This study was aimed to investigate the meal pattern and their relationships with total energy intake, nutrients intake and glycemic and lipid profile in type 2 diabetes. METHODS: 1,084 subjects were divided according to glycemic status into three groups: the diabetes (DM), dysglycemia (DG) and normal (N). The meal frequency (MF), meal interval (MI) and daily intake of total energy, macronutrient and micronutrient were estimated with the 24 hours dietary recall from the Korean National Health and Nutrition Examination Survey (KNHANES) in 2001 and Eulji hospital. For analysis of meal pattern and it's relations with the nutrients intake, we regrouped into meal skipper (G1), non-meal skipper with unreasonable MI (G2), and non-meal skipper with reasonable MI (G3). RESULTS: 17.5% of DM, 21.8% of DG, 23.3% of N skipped at least one meal a day without significant difference across the groups. 55.9% of non-meal skipper had unreasonable MI. Meal was more regular in older age, lower educated person, employee, and female. G1 took higher fat, and more calories form snack and less micronutrient density, compared with G3 (P < 0.05). HbA1c, total cholesterol and triglyceride values were higher in G1 compared with other two groups (P < 0.05). CONCLUSION: Many type 2 diabetics had the irregular meal patterns, which was associated with poor glycemic control, lipid profiles and less micronutrient density. This suggested that another treatment strategy might be required for those who had irregular lifestyle.
Cholesterol ; Energy Intake ; Female ; Humans ; Life Style ; Meals ; Micronutrients ; Nutrition Surveys ; Snacks

OBJECTIVES: To identify dentists' perceptions regarding the possible introduction of private health insurance plans, thereby providing basic data to improve the existing dental health insurance system. METHODS: A self-report survey was conducted with a total of 126 dentists in Jeollabuk-do Province. The survey was designed to gather information on the dentists' positions, perceptions and attitudes toward on a proposed introduction of privately run insurance schemes. RESULTS: A negative general consensus was found for the privately run scheme. Also it appeared that an overall review was required. CONCLUSIONS: Considering the high percentage of negative responses in the present study, it seems necessary to pro-actively reflect and complement potential issues in the current system before implementing privately run schemes in efforts to establish a solid foundation for operating dental insurance plans best suitable to the needs and characteristics of premium payers.
Complement System Proteins ; Consensus ; Dentists ; Humans ; Insurance ; Insurance, Dental ; Insurance, Health

Leiomyoma is a neoplasm of smooth muscle relatively common in the stomach, but very rare in the duodenal location. Recurrent bouts of severe melana remain the most frequent presenting symptom for leiomyoma. A 69-year-old man presented to us with a 4-day history of melena. Endoscopy revealed norinal mucosa covered ovoid elevated lesion with central linear depression and ulcer at the second portion of duodenum. Endoscopic biopsy showed chronic inflammation only. Duodenal mass was excised through a duodenotomy. Pathological diagnosis was leiomycena.
Aged ; Biopsy ; Depression ; Diagnosis ; Duodenum ; Endoscopy ; Esophagus* ; Hemorrhage* ; Humans ; Inflammation ; Intestines* ; Leiomyoma* ; MART-1 Antigen ; Melena ; Mucous Membrane ; Muscle, Smooth ; Stomach* ; Ulcer

Naringenin (NAR) as one of the flavonoids observed in grapefruit has been reported to exhibit an anti-cancer activity. However, more detailed mechanism by which NAR exerts anti-cancer properties still remains unanswered. Thus, in this study, we have shown that NAR down-regulates the level of cyclin D1 in human colorectal cancer cell lines, HCT116 and SW480. NAR inhibited the cell proliferation in HCT116 and SW480 cells and decreased the level of cyclin D1 protein. Inhibition of proteasomal degradation by MG132 blocked NAR-mediated cyclin D1 downregulation and the half-life of cyclin D1 was decreased in the cells treated with NAR. In addition, NAR increased the phosphorylation of cyclin D1 at threonine-286 and a point mutation of threonine-286 to alanine blocked cyclin D1 downregulation by NAR. p38 inactivation attenuated cyclin D1 downregulation by NAR. From these results, we suggest that NAR-mediated cyclin D1 downregulation may result from proteasomal degradation through p38 activation. The current study provides new mechanistic link between NAR, cyclin D1 downregulation and cell growth in human colorectal cancer cells.
Alanine ; Cell Line ; Cell Proliferation ; Citrus paradisi ; Colorectal Neoplasms* ; Cyclin D1* ; Down-Regulation* ; Flavonoids ; Half-Life ; Humans ; Phosphorylation ; Point Mutation

OBJECTIVE: The purpose of this study is to evaluate the effectiveness and safety of uterine artery embolization for the treatment of symptomatic leiomyomas in the patients who want to preserve uterus, want fertility or feel fear for operation. METHODS: From January 2003 to June 2005, among the patients with symptomatic uterine leiomyoma, fifteen women who wanted to preserve uterus or wanted fertility or had fear for operation were included in this retrospective study. Bilateral Uterine artery embolization (UAE) was performed. At the preprocedure and at 2, 6, and 12 weeks of postprocedure, transvaginal ultrasonography was performed for all patients. Clinical symptoms and follow-up information for each patient were evaluated. RESULTS: 15 leimyomas were treated with UAE. The initial mean volume of leiomyomas was 55.4 (46.3-67.4) cm3. The mean volume decrease was 58.6+/-9.7%, 77.5+/-12.3%, 86.8+/-23.5% at 2, 6, 12 weeks. The outcome of clinical symptoms were as followed; 'much improved' 20% (3/15), 'somewhat improved' 60% (6/15), 'no improvement' 20% (3/15), 'somewhat worsen's 0% (0/15), and 'much worsen' was 0% (0/15). There was no case of hysterectomy or myomectomy after UAE. And also no case of increasement of volume nor worsening of clinical symptoms were found. Lower abdominal pain was the most common symptoms after UAE, but complications were not detected. CONCLUSION: In this study, UAE to treat patients with uterine leiomyoma is proved to be effective not only in volume reduction, but also in symptom improvement. And it is a relatively less-invasive procedure which decreases the risk of side effects of operation. Above all things, it preserves fecundity in young women. Therefore, UAE is very effective and safe procedure in the treatment of symptomatic uterine leiomyoma.
Abdominal Pain ; Female ; Fertility ; Follow-Up Studies ; Humans ; Hysterectomy ; Leiomyoma* ; Retrospective Studies ; Ultrasonography ; Uterine Artery Embolization ; Uterus

Uterine artery embolization for the treatment of uterine leiomyomas is gaining acceptance as an effective alternative to surgical treatment in preserving uterus and reducing symptoms. Vaginal expulsion of leiomyomas after UAE is uncommon, and has been regarded as a side effect of the procedure, as well as a natural phenomenon of treatment response. A-28-year-old unmarried woman who has been suffered from menorrhagia underwent UAE. MRI revealed the remnant leiomyomas were reduced in size and volume and also symptoms of leiomyomas were much improved. After 6 month, We've made sure about non-visualization of leiomyoma on follow-up pelvic dynamic MRI. We report this rare case of vaginal expusion of intramural leoimyoma with a brief literature.
Female ; Follow-Up Studies ; Humans ; Leiomyoma* ; Magnetic Resonance Imaging ; Menorrhagia ; Single Person ; Uterine Artery Embolization* ; Uterine Artery* ; Uterus

OBJECTIVES: The purpose of this study was to examine the relationship of dental anxiety with oral health behavior and dental caries experience among adolescents. METHODS: The subjects were 469 teenagers (238 middle school students and 231 high school students) in 15 different schools located in 7 regions of Bucheon in Gyeonggi Province, Daejeon, and others. A survey and interviews were conducted to evaluate subjects' oral health behavior and dental anxiety. Dental anxiety was additionally assessed by Corah's Dental Anxiety Scale. The caries experience of subjects was examined. RESULTS: There were no regional differences in dental anxiety. Girls felt more dental anxiety than boys did. Adolescents who did not receive treatment even when they needed it felt more dental anxiety than those who did receive treatment. There were also statistically significant differences in dental anxiety according to the type of treatment received. Adolescents who received extraction treatment or underwent oral surgery experienced more dental anxiety than those who received orthodontic or aesthetic treatment. Those who had a toothache or who experienced gingival bleeding felt more dental anxiety than those who did not have those conditions. Subjects with poor perceived oral health also had more dental anxiety. The number of decayed teeth and filled teeth was significantly correlated with dental anxiety. CONCLUSIONS: In adolescents, dental anxiety is related to their oral health behavior, the type of conditions they present with, the treatment received, and dental caries experience. Therefore, the kind of systematic programs that could relieve adolescents of dental anxiety should be prepared.
Adolescent* ; Dental Anxiety* ; Dental Caries* ; DMF Index ; Female ; Gyeonggi-do ; Hemorrhage ; Humans ; Oral Health* ; Surgery, Oral ; Tooth ; Toothache

The objective of this study was to examine effects of spontaneous adipocyte generation on osteogenic differentiation of porcine skin-derived stem cells (pSSCs). Correlation between osteogenic differentiation and adipocyte differentiation induced by osteocyte induction culture was determined using different cell lines. Osteogenic differentiation efficiency of pSSCs was then analyzed by controlling the expression of adipocyte-specific transcription factors during osteogenic induction culture. Among four cell lines, pSSCs-II had the lowest lipid droplet level but the highest calcium content (p < 0.05). It also expressed significantly low levels of peroxisome proliferator-activated receptor gamma 2 (PPARγ2) and adipocyte protein 2 (aP2) mRNAs but very high levels of runt-related transcription factor 2 (Runx2) and alkaline phosphatase (ALP) mRNAs as osteogenic makers (p < 0.05). Oil red O extraction was increased by 0.1 µM troglitazone (TGZ) treatment but decreased by 50 µM bisphenol A diglycidyl ether (BADGE) (p < 0.05). Calcium content was drastically increased after BADGE treatment compared to that in osteogenic induction control and TGZ-treated pSSCs (p < 0.05). Relative expression levels of PPARγ2 and aP2 mRNAs were increased by TGZ but decreased by BADGE. Expression levels of Rucx2 and ALP mRNAs, osteoblast-specific marker genes, were significantly increased by BADGE treatment (p < 0.05). The expression level of BCL2 like 1 was significantly higher in BADGE-treated pSSCs than that in TGZ-treated ones (p < 0.05). The results demonstrate that spontaneous adipocyte generation does not adversely affect osteogenic differentiation. However, reducing spontaneous adipocyte generation by inhibiting PPARγ2 mRNA expression can enhance in vitro osteogenic differentiation of pSSCs.
Adipocytes ; Alkaline Phosphatase ; Calcium ; Cell Line ; Ether ; In Vitro Techniques ; Lipid Droplets ; Osteocytes ; Osteogenesis ; PPAR gamma ; RNA, Messenger ; Stem Cells ; Transcription Factors