PURPOSE: This study was conducted to evaluate clinical competency of nursing students and to examine the validity and reliability of the scale. METHODS: The Clinical Competency Scale was formed through modification of Lee's Clinical Competency Scale that was originally developed in 1990. The Clinical Competency Scale was applied to 203 nursing students. Construct validity, item convergent and discriminant validity, concurrent validity, and internal consistency reliability of the scale were evaluated. RESULTS: Exploratory factor analysis supported the construct validity with a five factor solution; that explained 63.6% of the total variance. Concurrent validity was demonstrated with the Nursing Competence Scale (r=.78, p < .001). Cronbach's α coefficient for the scale was .96. CONCLUSION: The results of this study suggest that the Clinical Competency Scale has relatively acceptable reliability and validity and can be used in clinical research to assess clinical competency for nursing students.
Clinical Competence ; Humans ; Mental Competency ; Nursing ; Psychometrics ; Reproducibility of Results ; Students, Nursing

PURPOSE: Replication-competent adenoviruses (Ads) are promising new modalities for the treatment of cancer. Selective replication of a viral agent in tumor may lead to improved efficacy over non-replicating Ads due to viral multiplication, lysis of the infected cancer cell and spread to surrounding cells. In our previous studies it was shown that the E1B 55 kD-deleted Ad (YKL-1) exhibits tumor specific replication and cell lysis, but with reduced cytolytic effects compared to the wild type adenovirus (Int J Cancer 2000;88: 454-463). Thus, improving the potency of oncolytic Ads remains an important goal for cancer gene therapy. To increase the oncolytic ability of YKL-1, an adenovirus death protein (ADP) gene was reintroduced under the control of a CMV or MLP promoter at the E3 region of the YKL-1, generating an YKL-cADP and YKL-mADP, respectively. MATERIALS AND METHODS: The in vitro cytolytic effect of ADP expressing Ads was evaluated by MTT assay, and the induction of apoptosis by ADP expressing Ads was examined by TUNEL analysis. Finally, the antitumor effect of ADP expressing Ads was demonstrated in C33A xenograft tumor model. RESULTS: The YKL-cADP exerted a markedly enhanced cytolytic effect against H460 and SK-Hep1 cancer cell lines. The TUNEL assay indicated that the ADP-mediated cytotoxicity was largely driven by apoptosis. Finally, the YKL-cADP showed a superior antitumor effect than the YKL-1 or YKL-mADP in C33A xenografts. CONCLUSION: These lines of evidence demonstrate that the YKL-cADP induces efficient cell lysis, which is critical for the addition of therapeutic value to replicating Ads in cancer gene therapy.
Adenosine Diphosphate ; Adenoviridae* ; Apoptosis ; Cell Line ; Genes, Neoplasm ; Heterografts ; In Situ Nick-End Labeling

A prerequisite for the development of a cancer cell selective targeting adenovirus is the generation of adenoviral vectors that lack native receptor binding ability and additionally contain domains redirecting the vector to cancer cell specific receptors. Towards this goal, we have generated an E1B 55kDa-deleted oncolytic and coxoackie and adenovirus receptor (CAR)-binding ablated adenovirus, YKL-K420A. This newly engineered adenovirus resulted in a dramatic reduction of transduction efficiency compared to the control adenovirus, YKL-1, in all of the cell lines tested. The malaria circumsporozoite (CS) protein interacts with glycosaminoglycans (GAG) present on the liver cell surface, and plays a prominent role in sporozoite attachment and invasion into hepatocytes. To redirect the CAR binding ablated adenovirus YKL-K420A to hepatocytes, CS protein epitope (EWSPCSVTCGNGIQVRIK) was incorporated onto the C-terminus of the YKL-K420A fiber protein, generating an YKL-K420A-hepa. The In vitro efficacy and specificity of YKL-K420A-hepa was then evaluated by comparing the cytopathic effect in hepatoma and other cancer cells from different origins. In hepatoma cells, YKL-K420A-hepa exerted upto 20-fold higher cytolytic ability compared to the control adenovirus, YKL-1, in hepatoma cell lines. Treatment with YKL-K420A-hepa also significantly suppressed tumor growth in a hepatoma xenograft tumor model when compared to YKL-1. Taken together, these studies demonstrate that the strategy to alter adenovirus tropism may greatly improve adenoviral utilities in gene therapy applications.
Adenoviridae* ; Carcinoma, Hepatocellular ; Cell Line ; Genetic Therapy ; Glycosaminoglycans ; Hepatocytes ; Heterografts ; Liver ; Malaria ; Sensitivity and Specificity ; Sporozoites ; Tropism

Non-Hodgkin's bone lymphoma is rare, accounting for only 3-4% of all primary malignant bone tumors. The femur, tibia and humerus are most frequently affected. Most lesions are located in the medul-lary cavity of the diaphysis, or in the metaphysis adjacent to the diaphysis and the majority of patients are between 20 and 40 years old. Intermittent localized pain, dull and aching, and not relieved by rest, is present in almost all patients. Classically, the lesion begins in the bone marrow as a permeative or moth-eaten lytic process. The treat-ment of choice for primary non-Hodgkin's bone lymphoma is radiation therapy and adjuvant chemotherapy. The prognosis for this tumor is better than that for the majority of other primary malignant bone tumors, and the five-year survival rate is approximately 48%. We report a case of primary non-Hodgkin's bone lymphoma in a 9-year-old boy, describing the MR and plain film imaging findings.
Adult ; Bone Marrow ; Bone Neoplasms ; Chemotherapy, Adjuvant ; Child* ; Diaphyses ; Femur ; Humans ; Humerus ; Lymphoma* ; Male ; Prognosis ; Survival Rate ; Tibia

Burkholderia cepacia is a highly virulent pathogen known to cause opportunistic infections in immunocompromised patients. It accelerates lung disease and causes necrotizing pneumonia with associated severe sepsis, known as cepacia syndrome. In particular, lung transplant recipients infected with Burkholderia cepacia show higher mortality after lung transplantation than those who are not infected with this organism. Due to broad-spectrum antibiotic resistance, a combination therapy should be used according to the results of the susceptibility test. This bacterial infection is rare in Korea, and no case was reported in lung transplant recipients. However, we report a case of pneumonia caused by Burkholderia cepacia after lung transplantation. As Burkholderia cepacia was grown from a sputum culture, the patient was treated initially with a combination of meropenem and trimethoprim/sulfamethoxazole and then ceftazidime and trimethoprim/sulfamethoxazole as a result of leukopenia. After antibiotics treatment for 20 days, sputum cultures became negative for Burkholderia cepacia and the patient successfully recovered.
Anti-Bacterial Agents ; Bacterial Infections ; Burkholderia ; Burkholderia cepacia ; Ceftazidime ; Cystic Fibrosis ; Drug Resistance, Microbial ; Humans ; Immunocompromised Host ; Korea ; Leukopenia ; Lung ; Lung Diseases ; Lung Transplantation ; Opportunistic Infections ; Pneumonia ; Sepsis ; Sputum ; Thienamycins

PURPOSE: The purpose of the study was done to identify the nursing care needs of patients in the recovery room. METHOD: The subjects in this study were 127 patients in a recovery room between 6/9/2001 and 24/9/2001. The instrument used for this study was the descriptive questionnaire developed by Shin Hyun-Jin (1999). The data was analysed by frequency, percentage, mean, standard deviation, t-test, ANOVA, and factor analysis using the SPSS program. RESULT: 1) Kaiser-Meyer-Olkin sample appropriateness was 0.799 and Bartlett's test of sphericity significant probability was 0.000. 2) The mean score for nursing care need of patients in the recovery room was 4.17+/-.51 of a total possible score of 5. The score of nursing need for different parameters was as follows: Educational need (4.31+/-.49), physical need (4.27+/-.47), emotional need (4.11+/-.52), environmental need (3.99+/-.56). 3) Differences in the needs for nursing care according to the demographics were significant for gender, marital status, operation experience, and departments consulted. General characteristic variables significantly related to nursing need were as follows: Physical need significantly related to the departments consulted (F=2.23, p=.036). Educational need significantly related to the marital status (F=2.55, P=.012), departments consulted (F=2.30, p=.031). Emotional need significantly related to the marital status (F=2.22, p=.028). Environmental need significantly related to the gender (t=-2.44, p=.016), marital status (F=2.01, p=.046), operation experience (t=-1.99, p=.048). CONCLUSION: Nursing care needs of patients in the recovery room are significantly related to educational need, physical need, emotional need and environmental need. Intervention plans and program need to be developed to improve strategies to meet nursing needs of patients in the recovery room.
Demography ; Humans ; Marital Status ; Nursing Care ; Nursing* ; Surveys and Questionnaires ; Recovery Room*

Background: Pembrolizumab, an anti-cancer drug, is known to increase the activity of the immune system, leading to side effects called immune-related adverse events (irAE), including type 1 diabetes. This study analyzed the correlation between blood glucose level and pembrolizumab administration and investigated the covariates that affect those changes in cancer treatment. Methods: The information of 133 adult cancer patients was obtained from the electronic medical record (EMR) to identify the changes in random blood glucose (RBG) levels during the pembrolizumab treatment. Subjects were classified into subgroups according to their baseline RBG level, history of diabetes, and the use of steroids, and linear regression analysis was conducted. In addition, a secondary analysis was performed within the group of subjects having a strong correlation to glycemic change, which was based on the Pearson correlation coefficient being less than -0.7 or greater than +0.7. Univariate and multivariate logistic regressions were conducted to identify the risk factors to glycemic increase. Results: The RBG level tended to descend without significant differences in total patients during the administration period of pembrolizumab. Despite the insignificance, the logistic regression analysis presents that the odds ratios of baseline RBG less than 130 mg/dL, prophylactic steroid use, and higher dose of pembrolizumab per cycle (mg/kg/ cycle) were greater than 1. Conclusions Prophylactic administration of steroids and a higher dose of pembrolizumab per cycle may increase the blood glucose level as irAE in cancer patients with a strong tendency to glycemic change.

Acute pancreatitis has two mortality peaks, which occurs within the first 2 weeks due to organ failure and then weeks or months later as result of multi-organ failure and local complications. Although there have been several clinical and multidisciplinary evaluation measures, imaging tests, and serological tests proposed to forecast severe acute pancreatitis, there is still no single test available to reliably predict the disease severity and time of death. Future large-scale studies are required to develop an assessment scale that can accurately predict the prognosis and mortality risk of severe acute pancreatitis.

Background: Pembrolizumab, an anti-cancer drug, is known to increase the activity of the immune system, leading to side effects called immune-related adverse events (irAE), including type 1 diabetes. This study analyzed the correlation between blood glucose level and pembrolizumab administration and investigated the covariates that affect those changes in cancer treatment. Methods: The information of 133 adult cancer patients was obtained from the electronic medical record (EMR) to identify the changes in random blood glucose (RBG) levels during the pembrolizumab treatment. Subjects were classified into subgroups according to their baseline RBG level, history of diabetes, and the use of steroids, and linear regression analysis was conducted. In addition, a secondary analysis was performed within the group of subjects having a strong correlation to glycemic change, which was based on the Pearson correlation coefficient being less than -0.7 or greater than +0.7. Univariate and multivariate logistic regressions were conducted to identify the risk factors to glycemic increase. Results: The RBG level tended to descend without significant differences in total patients during the administration period of pembrolizumab. Despite the insignificance, the logistic regression analysis presents that the odds ratios of baseline RBG less than 130 mg/dL, prophylactic steroid use, and higher dose of pembrolizumab per cycle (mg/kg/ cycle) were greater than 1. Conclusions Prophylactic administration of steroids and a higher dose of pembrolizumab per cycle may increase the blood glucose level as irAE in cancer patients with a strong tendency to glycemic change.

Acute pancreatitis has two mortality peaks, which occurs within the first 2 weeks due to organ failure and then weeks or months later as result of multi-organ failure and local complications. Although there have been several clinical and multidisciplinary evaluation measures, imaging tests, and serological tests proposed to forecast severe acute pancreatitis, there is still no single test available to reliably predict the disease severity and time of death. Future large-scale studies are required to develop an assessment scale that can accurately predict the prognosis and mortality risk of severe acute pancreatitis.