PURPOSE: The purpose of this study was to conduct a grounded theoretical analysis on the hospital accreditation experience of head nurses in order to understand their behavior on the adaption of this new system. METHODS: The participants were 8 head nurses with more than 3 years of experience. The data were collected through in-depth interviews using audiotape recording analyzed by the constant comparative method described in Strauss and Corbin's methodology. RESULTS: There were 113 concepts, 26 subcategories and 12 categories identified through the open coding process. In the axial coding, the following paradigm model was proposed: 1) the causal conditions were ‘hardware problem’ and ‘software problem’, 2) the contextual conditions were ‘vertical relationship’, ‘individual preference’, and ‘family support’, 3) the intervening conditions were ‘passive conditions’ and ‘active conditions’, 4) the action/interaction strategies were ‘leading role’ and ‘dependent role’, 5) the consequences were ‘positive acceptance’ and ‘negative acceptance’, 6) the central phenomenon was ‘difficult situation’ and 7) the core category was ‘leading in harmony’. CONCLUSION: The new system led head nurses having difficulties as the middleman between the hospital administration and general nurses, but they made a continuous effort to overcome and adapt to it through a number of strategies.
Accreditation* ; Clinical Coding ; Grounded Theory ; Head* ; Hospital Administration ; Hospitals, General* ; Methods ; Nursing, Supervisory* ; Tape Recording

PURPOSE: The aim of this study was to investigate coping styles for dysmenorrhea and explore factors related with their coping styles according to different health loci of control in middle schoolers. METHODS: Data were collected by using a structured questionnaire for 572 students from three middle schools in Seoul from March 22 to April 2, 2010. The measurement included menstrual distress, coping method questionnaire and health locus of control. The data were analyzed by using t-test, ANOVA, Pearson's correlation coefficients, and multiple regression analysis. RESULTS: Middle school students used the active behavioral coping style more often than the avoidance style. There was a significant difference in means within each coping style including levels of stress, levels of health, and regular exercise. There were also significant correlations between each coping style and health locus of control. Regression analyses indicated that the health locus of control factor is the most powerful factor in each coping style. CONCLUSION: We observed that various coping methods are used for dysmenorrhea in middle school students. However, the active behavioral coping style is dominant in such a condition. Based on these results, we need to develop a health locus of control to improve coping styles for dysmenorrhea.
Adaptation, Psychological ; Dysmenorrhea* ; Female ; Fibrinogen ; Humans ; Internal-External Control ; Surveys and Questionnaires

Cavernous hemangiomas rarely involve the female genital tract. It is difficult to identify vascular malformations when these lesions are concealed in the vagina or deep vulva area. We present a rare case of vaginal cavernous hemangioma in a 30-year-old primiparous woman with an early severe postpartum hemorrhage (PPH) and delayed continuous bleeding from the episiotomy site. She was treated successfully with transarterial embolization of the left vaginal artery. To our knowledge, this is the first reported case of PPH caused by rupture of a vaginal hemangioma during vaginal delivery in English literature.
Adult ; Arteries ; Episiotomy ; Female ; Hemangioma ; Hemangioma, Cavernous* ; Hemorrhage ; Humans ; Postpartum Hemorrhage* ; Postpartum Period* ; Rupture ; Vagina ; Vascular Malformations ; Vulva

PURPOSE: The purpose of this study was to evaluate the effects of a newly developed Introduction to Clinical Nursing (ICN) program on critical thinking skills, communication competence, self-efficacy, and clinical performance self-confidence in nursing students in their third year. METHODS: One group pre-test and post-test design was used with three data collection time points (pre-test, post-test1 and post-test2). Participants were 74 third year nursing students approaching their first clinical practicum. The new program included (a) simulated clinical encounters regarding situations of assessing hospitalized patents and caring for patients with oxygenation needs, (b) objective structured clinical examination of skills, (c) lectures, and (e) field trips. Data were analyzed using paired t-tests. RESULTS: After the ICN course, critical thinking skills(significant only between pretest and post-test2), communication competence, and clinical performance self-confidence improved significantly (p<.05). There was no improvement in the self-efficacy total score but there was significant improvement in the subscale, self-regulatory efficacy. CONCLUSIONS: The study results indicate that the ICN course may be effective in increasing critical thinking skills, communication competence, and clinical performance self-confidence in nursing students. However, the effect size was very small and modifications of this program should be considered to develop more cost-effective educational programs.
Surveys and Questionnaires ; Humans ; Lectures ; Mental Competency ; Oxygen ; Students, Nursing ; Thinking

Poisoning by Phytolacca esculenta commonly occurs by misidentification as other edible plants. The root of Phytolacca esculenta is similar to other roots, such as kudzu, balloon flower, codonopsis lanceolata, and ginseng. The author experienced four cases of Phytolacca esculenta intoxication due to misidentification as a ginseng. We report on these cases with a review of the literature.
Codonopsis ; Panax* ; Phytolacca americana ; Phytolacca* ; Plant Poisoning ; Plants, Edible ; Platycodon ; Poisoning ; Pueraria

Distinguishing wild plants in spring from ingestible plants is difficult. Differentiation of budding plants from other plants is particularly difficult. Many people want to find edible plants for health during the spring season. Scopolia japonica can cause symptoms of mania. The author experienced three cases of poisoning by Scopolia japonica. We reported on the cases with literature reviews.
Bipolar Disorder ; Eating* ; Plants* ; Plants, Edible ; Poisoning ; Scopolia ; Seasons

PURPOSE: Proprotein convertase subtilisin/kexin type 9 (PCSK9) binds to the low density lipoprotein receptor (LDLR) and promotes degradation of the LDLR. Inhibition of PCSK9 either by reducing its expression or by blocking its activity results in the upregulation of the LDLR and subsequently lowers the plasma concentration of LDL-cholesterol. As a modality to inhibit PCSK9 action, we searched the chemical library for small molecules that block the binding of PCSK9 to the LDLR. MATERIALS AND METHODS: We selected 100 chemicals that bind to PCSK9 where the EGF-AB fragment of the LDLR binds via in silico screening of the ChemBridge chemical library, using the computational GOLD algorithm analysis. Effects of chemicals were evaluated using the PCSK9-LDLR binding assay, immunoblot analysis, and the LDL-cholesterol uptake assay in vitro, as well as the fast performance liquid chromatography assay for plasma lipoproteins in vivo. RESULTS: A set of chemicals were found that decreased the binding of PCSK9 to the EGF-AB fragment of the LDLR in a dose-dependent manner. They also increased the amount of the LDLR significantly and subsequently increased the uptake of fluorescence-labeled LDL in HepG2 cells. Additionally, one particular molecule lowered the plasma concentration of total cholesterol and LDL-cholesterol significantly in wild-type mice, while such an effect was not observed in Pcsk9 knockout mice. CONCLUSION: Our findings strongly suggest that in silico screening of small molecules that inhibit the protein-protein interaction between PCSK9 and the LDLR is a potential modality for developing hypercholesterolemia therapeutics.
Animals ; Cholesterol/*blood ; Cholesterol, LDL/blood ; Hep G2 Cells ; Humans ; Mice ; Mice, Knockout ; Proprotein Convertases/*metabolism ; Receptors, LDL/*metabolism ; Serine Endopeptidases/*metabolism ; *Small Molecule Libraries

PURPOSE: The aim of this study was to evaluate whether serum creatinine levels at 3 days after renal transplantation can predict long-term graft survival and its associated clinical aspects. METHODS: Three hundred and seventy six renal transplant recipients who received grafts from living donors were included. Recipients were classified into two groups according to their serum creatinine levels (1.2 mg/dL group) at 3 days after renal transplantations. Demographic characteristics (age, sex, weight, body mass index, donor/recipient body weight ratio, pre-transplant dialysis type, underlying disease and pre-transplant transfusion), transplant variables (immuno-suppressive agents, HLA mismatch and HLA DR mismatch) and post-transplant variables (routine graft biopsy, number of acute rejection episodes within first year after renal transplantation, serum creatinine level and graft survival at each first, second, and fifth years) were assessed. RESULTS: Among total 376 recipients, serum creatinine 1.2 mg/dL groups were 224 (59.6%) recipients. The characteristics of patients with good graft function (serum creatinine 1.2 mg/dL group (first year, 100% vs. 95.7%; fifth year, 96.7% vs. 89.8%; P<0.05). Conclusion: Serum creatinine levels at 3 days after renal transplantation can predict long-term kidney transplant survival. It was associated with immunological (frequency of acute rejection) and non- immunological aspect (match of kidney size and donor's age).
Biopsy ; Body Weight ; Creatinine* ; Dialysis ; Female ; Graft Survival ; Humans ; Kidney ; Kidney Transplantation* ; Living Donors ; Transplantation ; Transplants*