PURPOSE: Simulation-based learning has become a powerful method to improve the quality of care and help students meet the challenges of increasingly complex clinical practice settings. The purpose of this study was to identify the learning effects using high-fidelity SimMan and multi-mode simulation. METHODS: Participants in this study were 38 students who were enrolled in an intensive course for a major in nursing at R college. Collected data were analyzed using Chi-square, t-test, and independent t-test with the SPSS 18.0 for Windows Program. RESULTS: There were no statistically significant differences in learning effects between high-fidelity SimMan and multi-mode simulation group. However, skills in clinical performance in the high-fidelity SimMan group were higher than in the multi-mode group (p=.014), communication in clinical performance in multi-mode simulation group was higher than in the high-fidelity SimMan group (p<.001). CONCLUSION: Multi-mode simulation with a standardized patient is an effective learning method in many ways compared to a high-fidelity simulator. These results suggest that multi-mode simulation be offered to students in nursing colleges which cannot afford to purchase a high-fidelity simulator, or offered as an alternative.
Adult ; Education, Nursing, Baccalaureate ; Emergency Medical Services ; Female ; Heart Arrest/*nursing ; Humans ; Learning ; Male ; Manikins ; *Patient Simulation ; Students, Nursing/psychology

Adenosquamous carcinoma originating in the stomach is relatively rare, and the occurrence of such tumor is interesting with respect to its histogenesis. We describe three cases of gastric adenosquamous carcinoma in a 39-year-old man, a 58-year-old woman and a 52-year-old man. They were grossly classified as Borrmann type III or II, revealing no difference from usual advanced gastric adenocarcinomas. Microscopically three cases showed well or moderately differentiated squamous cell carcinoma component occupying large areas of the tumors. Areas of transition from glandular to squamous epithelium were frequently observed. Metastatic foci in the regional lymph nodes also were consisted of two elements. On immunohistochemical study, CEA immunoreactivity was found not only in adenocarcinoma component but also in squamous cell components, in comparison to cytokeratin which was detected only in squamous areas. The immunohistochemical findings of CEA reactivity in both components, and the presence of microscopic transitional zones support the hypothesis of squamous metaplasia occurring in an already existing adenocarcinoma in the development of adenosquamous carcinoma of the stomach.
Female ; Male ; Humans ; Adenocarcinoma ; Neoplasm Metastasis

No abstract available.
Animals ; Brain* ; Carbon Monoxide* ; Carbon* ; Rats*

BACKGROUND: The goal of this study was to analyze the process and characteristics of withholding or withdrawal of life support (WLS) in Korean intensive care units (ICUs). METHODS: This was a single-centered retrospective analysis of patients who died in the ICUs of a tertiary hospital in Korea from January to December 2012. WLS informed consents and clinical data were analyzed. RESULTS: Of 285 deaths during the study period, informed consents for WLS were obtained from 228 patients (80.0%). All WLS decisions were made by family members after the patient's loss of decision-making capacity. Decisions were made most frequently by the patient's son (50.6%). Patients in the WLS group were older than those in the non-WLS group, and older age was associated with the WLS decision. Thirty-seven patients (16.2%) died within one hour of WLS approval, and 182 patients (79.8%) died on the day of WLS approval. The most frequently withheld life support modality was chest compression (100%), followed by defibrillation (95.9%) and pacemaker insertion (63.3%). CONCLUSIONS: Aggressive and invasive life support measures were those most frequently withheld or withdrawn by decision-makers in Korean ICUs. The most common proxy was the son, rather than the spouse.
Humans ; Informed Consent* ; Intensive Care Units* ; Korea ; Life Support Care ; Proxy ; Retrospective Studies ; Spouses ; Tertiary Care Centers ; Thorax ; Withholding Treatment

Cervical adenocarcinoma represents approximately 3-6% of the uterine cervical neoplasms. Recently, its relative incidence tends to be increased in contrast to squamous cell carcinoma. Sixty nine cases from 1985 to 1990 diagonsed as adenocarcinoma of the cervix by radical or total hysterectomy were analyzed to know their histopathological characteristics and related prognostic factors. The results wer as follows. (1) The age distribution ranged from 24 to 60 years and the mean age was 44 years and 47 years in adenocarcinoma in situ and invasive adenocarcinoma, respectively. Staging by FIGO classification showed the range from stage 0 to IIb, of which 63.8% was stage Ib. (2) Cases were composed of 7 cases of adenocarcinoma in situ(10%) and 62 cases of invasive adenocarcinomas(90%). The latter included 16 cases of adenosquamous carcinoma and 46 cases of pure adenocarcinoma which showed endocervical, endometrioid, clear cell, minimal deviation adenocarcinoma subtypes. The most frequent subtype was endocervical adenocarcinoma(51%) and the endometrioid subtype showed slightly higher incidence rate(13%) in comparison to the previous studies. (3) Coexistent squamous lesions ranging from mild dysplasia to invasive carcinoma were found in 4 out of 7 cases(57%) of adenocarcinoma in situ and 18 out of 62 cases(29%) of invasive adenocarcinoma. Severe dysplasia and carcinoma in situ comprised most(77%) of them. (4) Analyses of histopathological and clinical characteristics of adenocarcinoma of the uterine cervix revealed positive correlations between tumor size or mucin leakage and depth of invasion. The prognostic factors in relation to lymph node metastasis were considered to be th stage of disease, the size of tumor, mucin leakage in the stroma, and histologic subtypes.
Incidence ; Adenocarcinoma ; Neoplasm Metastasis

No abstract available.
Biopsy, Fine-Needle* ; Liver*

No abstract available.
Bile*

So-called sclerosing hemangioma of the lung is a rare benign neoplasm which usually presents with a coin lesion detected through routine chest X-ray. We report two cases showing characteristic cytologic appearances which have been rarely reported. Both cases were young females with coin lesions in the lung. Fine needle aspiration of each case revealed unique but some different cytologic features. Case 1 showed bland-looking polygonal epithelial cells resembling bronchioloalveolar cells having predominantly papillary configurations with loosely arranged solid sheets or isolated cells. Cytoplasms were plump, cyanophilic, and finely granular, with eccentric nuclei. The nuclei were usually monotonous, round-to-ovoid, and vesicular with a small but conspicuous nucleolus. In comparison to case 1, case 2 revealed largely loose pavement-like solid sheets or clusters rather than papillary patterns in the hemorrhagic background. The size of tumor cells were a little smaller than that of case 1. Bronchiotoalveolar carcinoma and papillary adenocarcinoma of metastatic origin were considered to be one of the important differential diagnoses with these cytologic features. Histologically, both cases exhibited findings compatible with so-called sclerosing hemangioma of the lung.
Adenocarcinoma, Papillary ; Biopsy, Fine-Needle* ; Cytoplasm ; Diagnosis, Differential ; Epithelial Cells ; Female ; Histiocytoma, Benign Fibrous* ; Humans ; Lung ; Numismatics ; Pulmonary Sclerosing Hemangioma* ; Thorax

No abstract available.
Biopsy, Fine-Needle* ; Breast*

No abstract available.
Carcinoma, Squamous Cell*