PURPOSE: The purpose of this study was to identify a research trend of studies related to the Do-Not-Resuscitate (DNR) decision making process in Korea. METHODS: Assessing through five computerized databases, 889 studies were reviewed and of these 32 were included. An integrative literature review and text network analysis were applied to examine the research. The keywords from each article's abstracts were extracted by using a program, KrKwic. RESULTS: The number of studies on DNR decision has been increasing, especially since 2011. A descriptive study design (59%) was most commonly used in the research. In relation to factors affecting DNR decision, 97% of the studies stated patient factors and 66% stated family factors. 'Patient', 'DNR', 'decision', 'treatment', 'life', 'family' were the major keywords, and 'patient' and 'care' were dominant keywords that ranked high in coappearance frequency. CONCLUSION: Studies related to DNR decision have been increasing, and themes of the studies have also been broader. Further research is required to investigate factors affecting DNR decision in specific populations such as cancer patients, the elderly, patients with end-stage of chronic diseases etc. Moreover, a comparative study is necessary to define differences of research trends related to DNR decision making process between Korea and other countries.
Aged ; Chronic Disease ; Decision Making ; Humans ; Korea ; Resuscitation Orders

Purpose: The prevalence of diabetes mellitus (DM) continues to increase worldwide, and blood glucose control may reduce mortality from diabetic complications and healthcare costs. Mulberry twig (MT) has been used as a herbal medicine in Asia, and its antidiabetic efficacy has recently been reported, but research in this area is still limited. This study examined the antidiabetic effects of water extracts of MT in diabetic animals. Methods: Six weeks old male ICR mice were divided randomly into three groups; normal control (NC, n = 10), DM control (DC, n = 10), and MT (n = 10). Streptozotocin (STZ, 50 mg/ kg/day) was injected intraperitoneally into mice in the DC and MT groups for 5 consecutive days. After 10 days of the last STZ injection, the mice in the MT group were administered orally with MT water extracts (5 g/kg body weight) for 16 days. Results: The MT water extracts ameliorated the swelling of the liver in the diabetic mice and reduced the elevated levels of fasting blood and plasma glucose, total cholesterol (T-CHO), low density lipoprotein-CHO, and the ratio of high density lipotrotein (HDL)-CHO/T-CHO. The liver triglyceride (TG) and glycogen contents were also significantly lower in the MT group mice than in the DC group. The small intestine disaccharidase activity was analyzed to understand the therapeutic effects and the mechanism of MT water extracts in diabetic animals. MT group mice showed reduced lactase and sucrase activity in the proximal part of the small intestine. On the other hand, body weight, plasma insulin, TG, HDL-CHO, and hepatic T-CHO levels were similar in the DC and MT groups. Conclusion These results suggest that MT water extracts have antidiabetic effects and can be developed as a functional source to reduce the postprandial blood glucose or to prevent DM incidence.

"Hyalinizing spindle cell tumor with giant rosettes" (HSCTGR) is a recently described tumor, which is regarded as an unusual variant of low-grade fibromyxoid sarcoma. Proof of a metastatic potential was lacking. The patient in the report was a 35-yr-old woman who showed multiple bilateral pulmonary nodules with massive pleural effusion in the right side. She had a history of a mass excision in the right thigh 11 yrs ago at another hospital, which was reported as a "leiomyoma". Two years before this presentation, the patient received a routine chest radiograph which demonstrated bilateral multiple pulmonary nodules. A lobectomy of the left upper lung was performed. The histological findings revealed a well-circumscribed nodule that was characterized by a spindle-shaped fibrous to hyalinized stroma with criss-crossing short fascicles and giant collagen rosettes surrounded by a rim of spindle-shaped cells. Electron microscopy confirmed the fibroblastic nature of the tumor. This case, in addition to at least two other cases reported in the literature, demonstrates that the HSCTGR is a malignant neoplasm with the capacity to metastasize after a long hiatus.
Adult ; Female ; Humans ; Hyalin/metabolism ; Korea ; Lung Neoplasms/diagnosis/*pathology/*secondary/ultrastructure ; *Neoplasm Metastasis ; Pleural Effusion/pathology ; Sarcoma/diagnosis/*pathology/ultrastructure ; Thigh/pathology ; Time Factors

Postoperative acute cholecystitis is a rare complication of orthopaedic surgery and is unrelated to the biliary tract. In particular, in the case of immediate postoperative state after surgery such as kyphoplasty at the thoracic vertebra, symptoms related to inflammation mimic those of abdominal origin, so the diagnosis and the treatment of acute cholecystitis can be delayed leading to a fatal outcome. It is important that physicians should be aware of the postoperative patient's condition in order to make an early diagnosis and determine treatment.
Biliary Tract ; Cholecystitis, Acute ; Early Diagnosis ; Fatal Outcome ; Hydrazines ; Inflammation ; Kyphoplasty ; Spine

Minimal deviation adenocarcinoma is an extremely well differentiated variant of cervical adenocarcinoma, and is frequently misdiagnosed due to its benign-looking histopathological features. A 38-year-old woman was diagnosed as having had a minimal deviation adenocarcinoma in the cervix, metastasizing to the uterine body and bilateral adnexae. She had a history of right salpingo-oophorectomy 3 years ago, and was diagnosed as having a mucinous cystadenoma. Histologically, the tumor cells were so well-differentiated that they appeared to be almost the same as those of the non-neoplastic cervical glands. Similar glands were found in both ovaries and in the left fallopian tube. PAS staining showed a negative or apical positive pattern in the endocervical-like glands. Immunohistochemical studies for CEA, ER/PR, cytokeratin 20, and p53 were negative, but positive for cytokeratin 7. The HPV DNA microarray test was negative. Clinically, this proved to be an advanced, biologically aggressive disease.
Adenocarcinoma* ; Adenocarcinoma, Mucinous* ; Adult ; Cervix Uteri* ; Cystadenoma, Mucinous ; Fallopian Tubes ; Female ; Humans ; Keratin-20 ; Keratin-7 ; Neoplasm Metastasis* ; Oligonucleotide Array Sequence Analysis ; Ovary

PURPOSE: The purpose of this study was to identify the teaching effectiveness and adequacy of practical training in nursing students. METHODS: This descriptive research was conducted using a convenience sampling. The sample consisted of 619 nursing students with experience in practical training among five colleges, located in four cities. The data collection was performed using self-reported questionnaires. Research tools, developed by Kim (1996), were used to measure the effectiveness of clinical instructors and the adequacy of practical training developed by researchers. The data was analyzed using SPSS 20.0. RESULTS: The average of teaching effectiveness was 3.43 (out of 5) and adequacy of practical training was 3.33 (out of 5). Teaching effectiveness and adequacy of practical training showed a significant positive correlation (r=.74, p<.001). Teaching effectiveness and each sub-area: adequacy of practical training, practical contents (r=.59, p<.001), practical attitude (r=.45, p<.001), practical instructor (r=.62, p<.001), practical environment (r=.46, p<.001), and practical evaluation (r=.64, p<.001), revealed a significant positive correlation. CONCLUSION: Nursing students prefer the actual training from professors who are more professional and clinical experienced. Professors presenting the theory lectures should also be aware of clinical practice so that education can be more professional and effective in terms of clinical practice.
Data Collection ; Education ; Humans ; Lectures ; Nursing* ; Students, Nursing*

BACKGROUND/AIMS: It has been shown that circulating tumor necrosis factor α (TNF-α) is elevated in end stage renal disease patients; however, the relationship between TNF-α and the development of infection in these patients is unknown. In this study, we investigated the association of plasma TNF-α and interleukin 6 (IL-6) with infection in peritoneal dialysis (PD) patients. We also evaluated the association of their plasma levels with the production by peripheral blood mononuclear cells (PBMC), and with various clinical parameters. METHODS: We enrolled 32 patients on maintenance PD and 10 healthy controls. Plasma and PBMC were isolated from blood. PBMC were stimulated with lipopolysaccharide in vitro. RESULTS: Mean follow-up duration was 775 days. Six patients developed organ infections (five pneumonia and one liver abscess), and six patients developed PD peritonitis and eight developed exit site infection. Plasma TNF-α and IL-6 levels were significantly elevated in organ infections but not in peritonitis or in exit site infection. Plasma TNF-α was the only significant risk factor for organ infections and pneumonia in multivariate regression analysis. Patients with high plasma TNF-α levels showed a significantly greater cumulative hazard rate for organ infections compared to those with low TNF-α levels. Plasma TNF-α levels correlated with TNF-α production by PBMC and showed an inverse association with Kt/V. CONCLUSIONS: This is the first study showing that plasma TNF-α is a significant risk factor for infection in PD patients.
Follow-Up Studies ; Humans ; In Vitro Techniques ; Interleukin-6 ; Kidney Failure, Chronic ; Liver ; Peritoneal Dialysis* ; Peritonitis ; Plasma ; Pneumonia ; Risk Factors* ; Tumor Necrosis Factor-alpha*

Determining of HER-2/neu oncogene amplification has become clinically important for managing breast cancer. Fluorescent in situ hybridization (FISH) and immunohistochemistry (IHC) are currently regarded as the standard methods. Chromogenic in situ hybridization (CISH) was investigated as a new modification with an accurate, sensitive technique. From 1998 to 2002, using CISH and IHC, the amplification and protein expression of the HER-2/neu oncogene were examined using paraffin sections in 130 breast carcinomas and to determine the prognostic role of HER-2/neu for outcome after a follow-up of 24- 64 months. Amplifications by CISH and overexpression by IHC were observed in 28 (22%) and 27 cases (20.8%), respectively. Of the 104 patients, 20 patients (19.2%) with amplification had a shorter disease-free interval (34.9 months vs. 38.0 months in controls) (p=0.372). 15 patients (14.4%) had a disease recurrence, but there is no significant difference between 3 patients amplifying the oncogene and 12 patients without oncogene (20.6 months vs. 19.6 months) (p=0.862). 6 patients (5.8%) of these died. CISH is a useful alternative, particularly for confirming the IHC results. There is no relationship between the early recurrence and the HER-2/neu positive group, but lymph node status was statistically significant.
Adult ; Aged ; Breast Neoplasms/*genetics/metabolism/mortality ; Disease-Free Survival ; Female ; Follow-Up Studies ; Genes, erbB-2/*genetics ; Human ; Immunohistochemistry ; In Situ Hybridization ; In Situ Hybridization, Fluorescence ; Lymphatic Metastasis ; Middle Aged ; *Oligonucleotide Array Sequence Analysis ; Prognosis ; Protein Array Analysis ; Receptor, erbB-2/biosynthesis ; Sensitivity and Specificity ; Support, Non-U.S. Gov't ; Treatment Outcome

Mushroom-related poisoning can cause acute kidney injury. Here we report a case of acute kidney injury after ingestion of Amanita punctata, which is considered an edible mushroom. Gastrointestinal symptoms occurred within 24 hours from the mushroom intake and were followed by an asymptomatic period, acute kidney injury, and elevation of liver and pancreatic enzymes. Kidney function recovered with supportive care. Nephrotoxic mushroom poisoning should be considered as a cause of acute kidney injury.
Acute Kidney Injury* ; Agaricales ; Amanita* ; Eating ; Kidney ; Liver ; Mushroom Poisoning ; Poisoning*

Uncoupling protein-1 (UCP-1) plays a major role in thermogenesis at brown adipose tissues and has been implicated in the pathogenesis of obesity and metabolic disorders. The purpose of this study was to estimate the effects of A-3826G polymorphism in 117 Korean prepubertal children aged 8-11 years olds. Anthropometry by bioelectrical impedance analysis method, plasma lipid profiles by auto-biochemical analyzer and UCP-1 genotyping by PCR-RFLP were done. The frequencies of UCP-1 genotypes were AA; 17.7%, AG; 57.8%, GG; 26.6%. The frequencies of each G allele (55.5%) was similar to Japanese's (49%) and higher than Caucacian's (25%). No correlation UCP-1 polymorphism and BMI (kg/m2) or the degree of obesity described by the relative percentiles of the standard weight according to height in prepubertal children. However, plasma total- and LDL-cholesterol were significantly increased in G allele when sex, age and weight were adjusted. Our results suggested that G allele of UCP-1 gene was stronger risk factors in hyperLDLcholesterolemia than A allele. This impact might be progressed as the precaution against the revalence of obesity based-metabolic disease.
Aged ; Alleles ; Anthropometry ; Child ; Cholesterol, LDL ; Electric Impedance ; Genotype ; Humans ; Obesity ; Plasma ; Risk Factors ; Thermogenesis