PURPOSE: The purpose of this study was to investigate RN-BSN students' clinical nursing competency in order to establish baseline data for developing nursing competency based clinical education for RN-BSN students. METHOD: A survey of 1,453 RN-BSN students from 21 nursing schools was conducted using a self administered questionnaire. RESULT: The mean score of the clinical nursing competency was 2.93. The scores for competency were shown as 2.91 for nursing management, 2.94 for developing professionalism & legal implementation, 2.95 for critical thinking, 2.96 for teaching & leadership, and data collection, basic nursing care, and communication were above 3.00. The items perceived as insufficient competency were physical examination and observation & monitoring in data collection, cardiopulmonary resuscitation, psycho-social care, spiritual care, hospice in basic nursing care, application of knowledge and theory, formulating nursing diagnosis, nursing care planning in critical thinking, education material development, leadership, delegation in teaching and leadership, analysis of organization, planning, infection control, role & job description, evaluation of nursing activities in nursing management, quality improvement, and research in developing professionalism and legal implementation. CONCLUSION: This study will contribute to developing a nursing competency based on clinical education for RN-BSN students who have various education needs and clinical backgrounds.
Adult ; Analysis of Variance ; *Clinical Competence ; Curriculum ; Data Collection ; Education, Nursing, Associate/*standards ; Education, Nursing, Baccalaureate/*standards ; Female ; Humans ; Male ; Nursing Education Research ; Questionnaires ; *Students, Nursing

*Chromosomes, Human, Pair 18 ; Down Syndrome/*diagnosis ; Female ; Genetic Markers ; Human ; Polymerase Chain Reaction/*methods ; Polymorphism (Genetics) ; Pregnancy ; Prenatal Diagnosis/*methods ; *Tandem Repeat Sequences ; Trisomy/*genetics

We report a case of acute cerebral infarction after general anesthesia. A 55-year-old man underwent total gastrectomy and splenectomy for advanced gastric cancer. Preoperatively, he has complained headache and dizziness for a year but neurologist, internist and anesthesiologist could not find any sign of cerebrovascular diseases. General anesthesia was induced with thiopental and maintained with 50% N2O and 1.5-2% enflurane in oxygen. After approximately 4h in the recovery room, he was not regained his consciousness. On physical examination, there was right hemiplegia. Immediate brain CT revealed acute cerebral infarction in left MCA and ACA territory. He was transported SICU. The following day he had a carotid Doppler ultrasonography that showed complete obstruction of both ICA. Neurologic examination showed negative eye reflex and pupil full dilation. He was discharged in a hopeless situation.
Anesthesia, General* ; Brain ; Cerebral Infarction* ; Consciousness ; Dizziness ; Enflurane ; Gastrectomy ; Headache ; Hemiplegia ; Humans ; Middle Aged ; Neurologic Examination ; Oxygen ; Physical Examination ; Pupil ; Recovery Room ; Reflex ; Splenectomy ; Stomach Neoplasms ; Thiopental ; Ultrasonography, Doppler

BACKGROUND: Phadiatop test which was developed for screening of atopy in eastern asia area, has not been sufficiently evaluated in Korea. In our previous study, the clinical usefulness of Phadiatop test for screening of atopy was evaluated on atopics and non-atopics defined by the results of skin prick tests with 10 inhalant allergens in Korea. In this study, we evaluated the usefulness of Phadiatop test for screening of atopy based on the level of CAP specific IgE in Korean asthmatics. METHODS: On 136 Korean asthmatics, the level of CAP specific IgE to 10 important inhalant allergens and the level of Phadiatop specific IgE to mixture of 8 important inhalant allergens in Korea were measured. Atopics and non-atopics were defined by the results of CAP specific IgE and the sensitivity, specificity, predictive value of a positive and negative result, and concordance rate of Phadiatop test were estimated. RESULTS: The sensitivity, specificity, predictive values of a positive and negative result, and concordance rate of Phadiatop test were 90.5%, 95.0%, 99.1%, 63.3%, and 91.2%, respectively. CONCLUSIONS: Phadiatop test was very sensitive, rapid and convenient, and corresponded well to the results of CAP specific IgE. We concluded that Phadiatop test is very useful as a screening tool of atopy in Korea.
Allergens ; Asthma ; Far East ; Immunoglobulin E* ; Korea ; Mass Screening* ; Sensitivity and Specificity ; Skin

BACKGROUND: It is reported that approximately 10.7% of Korean reproductive women use rhythm method to avoid pregnancy, which is higher in comparison to other countries. However, few surveys on practicing natural family planning methods have been done and awareness of it is also very(low). Our study examined women's interest and related factors in using natural family planning either to become pregnant or to avoid it. METHODS: A questionnaire was given to 1,700 women, ages 18 to 50, who visited general hospitals in Seoul and Kyounggido for health examination from the months beginning July and ending September in 1998. RESULTS: Of the 604 answered questionnaires, 361 were from women who were potentially fertile. Of these women 45.4% indicated that they would likely use natural family planning in the future to avoid pregnancy, and 30.5% indicated that they would likely use natural family planning in the future to become pregnant. Past use of any method of natural family planning to avoid pregnancy was associated with interest in future use of modern methods of natural family planning to avoid pregnancy. Age under 30, past use of natural family planning to become pregnant and the possible desire for future pregnancy were associated with interest in future use of natural family planning to conceive. CONCLUSION: Interest in future use of natural family planning is associated with past use of natural family planning including other factors. Many women who have not used natural family planning showed interest in using natural family planning, either to avoid pregnancy or to conceive. Therefore, clinicians should include modern natural family planning method in all of their discussions with women about family planning options.
Family Planning Services ; Female ; Hospitals, General ; Humans ; Natural Family Planning Methods* ; Pregnancy ; Seoul ; Surveys and Questionnaires

Purpose: The goal of this study was to follow benign thyroid nodules confirmed by ultrasound (US)-guided core needle biopsy (CNB) after inconclusive cytology on fine-needle aspiration (FNA) biopsy. Methods: Sixty-two thyroid nodules from 62 patients with CNB-confirmed benign histology that initially had inconclusive cytology on FNA were retrospectively included. The thyroid nodules were followed for 38.7 months (median, 27.5 months; range, 6 to 101 months), and the US findings of biopsied nodules, such as the interval change in size, US characteristics, and imaging category based on the Korean Thyroid Imaging Reporting and Data System (K-TIRADS), were evaluated. In addition, patients’ clinical records were reviewed for any further management or newly diagnosed thyroid malignancy. Results: Among 62 cases, three (4.8%) showed interval size growth, while 59 (95.2%) demonstrated no interval change or a decrease in size. There was no upgrade of K-TIRADS category or any newly diagnosed malignancy during the follow-up period. Conclusion US-guided CNB-confirmed benign thyroid nodules with inconclusive cytology on FNA showed a stable status during follow-up, and repeated CNB could be helpful in the management of nodules with inconclusive cytology on FNA.

BACKGROUND: The purpose of this study was to find the factors associated with becoming obese children during the past 2 years in 6th grade children of elementary school and then to evaluate the high risk groups for childhood obesity. METHODS: The 738 children from May to June, 2001 in 6th grade of 5 elementary schools in Busan were the subjects of this study. The children's height and weight in 4th grade and 6th grade were obtained from school health records. We calculated the body mass index in 4th and 6th grades and classified into 3 weight groups (normal, at risk for obesity, and obese) according to the age and sex-specific BMI established by the Korean Academy of Pediatrics. If children's weight group in 4th grade was changed to heavier weight group in 6th grade, we defined it as increased group. Otherwise, we defined it as non-increased group. The association between the increase in weight group and parental and children's characteristics were analyzed by x2-test, x2-test for the trend, t-test, ANOVA and multiple logistic regression. RESULTS: Among the total, 3.3% of children with normal weight and 16.9% of children at the risk for obesity in 4th grade were transformed to increased group in 6th grade, respectively (P<0.001). Children who had excessive appetite (P<0.001), watched TV greater than or equal to 2 hours per day (P=0.004) or had an obese father (P=0.044) were more likely to become increased group. After adjusting for father's obesity, appetite and TV watching time in children, the odds ratio of transforming to increased group after 2 years in children at risk for obesity or in obese child in 4th grade was 2.5 (95% CI: 1.09~5.55) compared to children with normal weight. Children having excessive appetite were 3.2 times (95% CI: 1.42~7.01) more likely to become the increased group after adjusting for father's obesity, TV watching time and weight in 4th grade. Children watching TV greater than or equal to 2 hours/day was 2.8 times (95% CI: 1.27~6.18) more likely to become increased group after adjusting for father's obesity, appetite and weight in 4th grade. CONCLUSION: The risk of becoming obese was higher in children at risk for obesity or obese children in those with excessive appetite or those who have watched TV> or =2 hours/day for the past two years. These findings suggest promotion of educational plan to prevent childhood obesity.
Appetite ; Body Mass Index ; Busan* ; Child* ; Fathers ; Humans ; Logistic Models ; Obesity ; Odds Ratio ; Parents ; Pediatric Obesity ; Pediatrics ; Risk Factors ; School Health Services

PURPOSE:This study was designed to know the clinical significance and risk factors of hyperkalemia in very low birth weight infants (VLBWI). METHODS:We compared the incidence of hyperkalemia and its associated ECG abnormalities and mortality rate according to birth weight (102 of less than 1,000 g vs. 328 of 1,000 to 1,500 g) in 430 VLBWI who were born from Jan. 2000 to July 2004, retrospectively, and also compared the several parameter according to serum potassium (35 of hyperkalemia vs. 11 of normokalemia) in 49 selected VLBWI who need mechanical ventilation for respiratory distress without oliguria within 72 hours of life to know the risk factors of hyperkalemia. RESULTS:Overall incidence of hyperkalemia in VLBWI was 21.1%, and was significantly higher in below 1,000 g than in 1,000 to 1,500 g (32.4% vs. 17.7%, P<0.05). Hyperkalemia associated ECG abnormalities, life-threatening cardiac arrhythmia, and death were also significantly higher in below 1,000 g. There were no significant differences in maternal or infant's characteristics, laboratory findings and clinical conditions between hyperkalemic vs. normokalemic group. The incidence of cardiac arrhythmia and mortality rate were also significantly higher in hyperkalemic group. CONCLUSION:Early onset nonoliguric hyperkalemia is often associated with life- threatening cardiac arrhythmia and death in VLBWI, especially less than 1,000 g. Although perinatal risk factors were not found in this study, prospective study is needed to establish the preventive strategy and to improve the outcome.
Arrhythmias, Cardiac ; Birth Weight ; Electrocardiography ; Humans ; Hyperkalemia* ; Incidence ; Infant* ; Infant, Very Low Birth Weight* ; Mortality ; Oliguria ; Potassium ; Respiration, Artificial ; Retrospective Studies ; Risk Factors

Malposition of catheter in the subdural space is a possible complication during attempted epidural anesthesia. We report here an inadvertent subdural block confirmed by the radiographic contrast materiaL Epidural anesthesia was planned for a full-term gravida and epidural catheter was inserted about 3 cm cranially at the level of L1-2. After injection of 19.5 ml local anesthetic, blood pressure was 70/50 mmHg. Fluid was rapidly infused and intravenous ephedrine 10 mg was given. After then, vital signs were well maintained and twin babies were delivered without events. Twentyfive minutes later, she complained chest tightness and became tachypneic. Ketamine 50 mg was given and endotracheal intubation was performed with ease. She obeyed command, but could not open her eyes for some duration. Self respiration returned after 110 minutes and minute ventilation was 6 liter/minute at that time. 160 minutes later, extubation was done and radiological examination was performed using contrast materiaL The cathter tip was positioned in anterior subdural space at T12 level.
Anesthesia, Epidural* ; Blood Pressure ; Catheters ; Ephedrine ; Humans ; Intubation, Intratracheal ; Ketamine ; Respiration ; Subdural Space ; Thorax ; Twins ; Ventilation ; Vital Signs

Purpose: To evaluate a deep learning model to predict recurrence of thyroid tumor using preoperative ultrasonography (US). Materials and Methods: We included representative images from 229 US-based patients (male:female = 42:187; mean age, 49.6 years) who had been diagnosed with thyroid cancer on preoperative US and subsequently underwent thyroid surgery. After selecting each representative transverse or longitudinal US image, we created a data set from the resulting database of 898 images after augmentation. The Python 2.7.6 and Keras 2.1.5 framework for neural networks were used for deep learning with a convolutional neural network. We compared the clinical and histological features between patients with and without recurrence. The predictive performance of the deep learning model between groups was evaluated using receiver operating characteristic (ROC) analysis, and the area under the ROC curve served as a summary of the prognostic performance of the deep learning model to predict recurrent thyroid cancer. Results: Tumor recurrence was noted in 49 (21.4%) among the 229 patients. Tumor size and multifocality varied significantly between the groups with and without recurrence (p < 0.05). The overall mean area under the curve (AUC) value of the deep learning model for prediction of recurrent thyroid cancer was 0.9 ± 0.06. The mean AUC value was 0.87 ± 0.03 in macrocarcinoma and 0.79 ± 0.16 in microcarcinoma. Conclusion A deep learning model for analysis of US images of thyroid cancer showed the possibility of predicting recurrence of thyroid cancer.