PURPOSE: The purpose of this study was to identify the effects of structured self-debriefing using 3S models on the clinical competency, self-efficacy, and educational satisfaction in nursing students after simulation. METHODS: For this study, 76 third-year undergraduate nursing students from S university were invited. They were divided into two groups, which consisted of a self-debriefing (SDG=41) group and an instructor-led debriefing group (ILDG=35). Collected data was analyzed using Chi-square, t-test, and an independent t-test with the PASW statistics 18.0 for Windows Program. RESULTS: Clinical competency was generally high in the SDG, and statistically significant differences between the SDG and the ILDG occurred after simulations 3, 4, and 5. There were no statistically significant differences in self-efficacy and educational satisfaction between the SDG and the ILDG. However, educational satisfaction in the SDG was slightly higher, while self-efficacy was low compared to the ILDG. CONCLUSION: The results indicate that the method of structured self-debriefing using a 3S model can be effective in improving clinical competency. Further studies need to be investigated.
Humans ; Nursing* ; Patient Simulation ; Students, Nursing*

PURPOSE: We compared the performance of virtual gastrography (VG) using multi-detector (MDCT) with two-dimensional (2D) CT in the diagnosis of early gastric cancer (EGC). MATERIALS AND METHODS: We performed conventional gastroscopy and MDCT examination after gaseous distension of the stomach in 50 consecutive patients who were confirmed as EGC by surgery and endoscopic mucosal resection. Unenhanced images were obtained in the prone position and contrast enhanced images were obtained in the supine position. Contrast enhanced imaging was done 70 seconds after intravenous injection of 150 mL of ionic contrast material at the rate of 3 mL/sec. 2D CT and VG images were analyzed by two radiologist with consensus to assess the location and gross morphologic type of EGC. Crosstabs were used to determine the diagnostic accuracy of EGC on 2D CT and VG. RESULTS: The diagnostic specificity for 50 patients with EGC was significantly higher with VG (72%) than with 2D CT (88%) (p<0.05). VG depicted EGC in eight patients (type I = 1; type IIa = 3; type IIb = 1; type IIc = 2; type IIa + IIc = 1) that were missed on the 2D CT. The lesions were located in the antrum (n = 6), angle (n = 1), and body (n = 1). However, VG frequently misdiagnosed EGCs of type IIb (n = 4), IIc (n = 1), and III (n = 1), as well as the location at the angle (n = 3), antrum (n = 1), and body (n = 1). CONCLUSION: VG showed excellent result in the detection of EGC compared with 2D CT. However, it had limitations in the diagnosis of EGC type IIb or gastric angle tumor.
Consensus ; Diagnosis* ; Gastroscopy ; Humans ; Injections, Intravenous ; Neuroma, Acoustic ; Prone Position ; Sensitivity and Specificity ; Stomach ; Stomach Neoplasms* ; Supine Position

PURPOSE: The purpose of this study was to describe the ultrasonographic features and assess the diagnosticvalue of sonography in the evaluation of children with Henoch-Schonlein purpura. MATERIALS AND METHODS: BetweenOctober 1993, and Febuary 1998, 67 children with Henoch-Schonlein purpura underwent abdominal ultrasonography,which in 13 was used for follow up. Bowel wall thickness and location, pattern of color Doppler signal in thethickened bowel wall, the size and location of enlarged mesenteric lymph node and the presence of ascites wereevaluated. RESULTS: In 42 cases(63%), sonographic findings were positive, and indicated mesentericlymphadenopathy(n=21), small bowel wall thickening(n=20), and ascites(n=17). Thickened bowels were demonstrated atthe ileum in 11 cases, the jejunum in five, the duodenum in one, and combined wall thickening at the duodenum andjejunum in two ; thickening of the duodenum and ileum was seen in one case. Thickness varied from 3 to 10mm(mean :6.5 mm). On follow-up sonography, regression of bowel wall thickening was observed earlier than that of mesentericlymphadenopathy or ascites, and correlated well with improved abdominal symptoms. CONCLUSION: Abdominalultrasonographic manifestations of Henoch-Schonlein purpura were bowel wall thickening, mesenteric lymphadenopathyand ascites. Sonography was a simple and useful method for the evaluation of gastrointestinal manifestation ofHenoch-Schonlein purpura.
Ascites ; Child ; Duodenum ; Follow-Up Studies ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Ileum ; Jejunum ; Lymph Nodes ; Purpura ; Purpura, Schoenlein-Henoch* ; Ultrasonography

A newly developed third generation enzyme immunoassay(Lucky HCD 3.0 EIA) for hepatitis C virus(HCV) antibodies was added with the envelope(E1E2)/NS4 fusion proteins and expanded NS5 proteins as well as the core/NS3 fusion proteins. Authors evaluated the HCD 3.0 EIA with the previously available second generation EIA(HCD 2.0) in 10,435 Red Cross blood donors. Among 10,435 donors who were screened for the presence of HCV antibodies by HCD 2.0 assay, 22(0.21%) sera were repeatedly reactive. All of these sera were tested for further testing. Only 13 of all tested sera were reactive by HCD 3.0 EIA, and nine sera were not reactive. Nine of 13 HCD 3.0 positive sera were reactive by recombinant immunoblot assay(Lucky-Confirm). Also seven of these 13 sera had detectable HCV genomic RNA by reverse transcriptase-polymerase chain reaction(RT-PCR). None of nine HCD 3.0 negative samples had detectable immunoblot assay and HCV genomic RNA. It is concluded that the new HCV EIA can decrease a significant false positivity of second generation EIA in a blood donor population. This new assay correlates well with detection of HCV-RNA by RT-PCR and identifies donors who are truly infected.
Antibodies ; Blood Donors* ; Hepatitis C ; Hepatitis C Antibodies ; Humans ; Immunoblotting* ; Red Cross ; RNA ; Tissue Donors

PURPOSE: Although a significant number of reports on new therapeutic options for refractory Kawasaki disease (KD) such as steroid, infliximab, or repeated intravenous immunoglobulin (IVIG) are available, their effectiveness in reducing the prevalence of coronary artery lesions (CAL) remains controversial. This study aimed to define the clinical characteristics of patients with refractory KD and to assess the effects of adjuvant therapy on patient outcomes. METHODS: We performed a retrospective study of 38 refractory KD patients from January 2012 to March 2015. We divided these patients into 2 groups: group 1 received more than 3 IVIG administration+ steroid therapy, (n=7, 18.4%), and group 2 patients were unresponsive to initial IVIG and required steroid therapy or second IVIG (n=31, 81.6%). We compared the clinical manifestations, laboratory results, and echocardiographic findings between the groups and examined the clinical utility of additional therapies in both groups. RESULTS: A significant difference was found in the total duration of fever between the groups (13.0±4.04 days in group 1 vs. 8.87±2.30 days in group 2; P=0.035). At the end of the follow-up, all cases in group 1 showed suppressed CAL. In group 2, coronary artery aneurysm occurred in 2 patients (6.4 %). All the patients treated with intravenous corticosteroids without additional IVIG developed CALs including coronary artery aneurysms. CONCLUSION: No statistical difference was found in the development of CAL between the groups. Prospective, randomized, clinical studies are needed to elucidate the effects of adjunctive therapy in refractory KD patients.
Adrenal Cortex Hormones ; Aneurysm ; Coronary Disease ; Coronary Vessels ; Echocardiography ; Fever ; Follow-Up Studies ; Humans ; Immunoglobulins ; Immunoglobulins, Intravenous ; Infliximab ; Mucocutaneous Lymph Node Syndrome* ; Prevalence ; Prospective Studies ; Retrospective Studies

No abstract available.
Adult ; Carcinoma, Hepatocellular/diagnosis/radiography ; *Cell Transformation, Neoplastic ; Humans ; Liver Neoplasms/diagnosis/*radiography ; *Magnetic Resonance Imaging ; Male ; *Tomography, X-Ray Computed

No abstract available.
Adenoma, Liver Cell/*diagnosis/radiography/surgery ; Adult ; Humans ; Liver Neoplasms/*diagnosis/radiography/surgery ; *Magnetic Resonance Imaging ; Male ; *Tomography, X-Ray Computed

Purpose: This study was conducted to determine which factors influence the ability of abdominal ultrasonography (US) to detect focal pancreatic lesions identified using endoscopic ultrasonography (EUS). Methods: In this study, 338 consecutive patients with focal pancreatic lesions (cyst, n=253; adenocarcinoma, n=54; pancreatic neuroendocrine tumor, n=24; solid pseudopapillary neoplasm, n=4; intrapancreatic accessory spleen, n=1; metastasis, n=1; and lymphoma, n=1) detected by EUS who underwent US were enrolled. We reviewed their radiologic reports and assessed the presence or absence of a focal lesion, the multiplicity of the lesions, and their size and location on US. We evaluated how these parameters differed depending on whether the lesion was solid or cystic. Univariate and multivariate logistic regression analysis were performed. Results: The overall detection rate of focal pancreatic lesions by US was 61.5% (208 of 338). Using US, the detection rate of cystic lesions was 58.5% (148 of 253), while that of solid lesions was 70.6% (60 of 85). In the univariate analysis, location in the neck or body, solid characteristics, and a relatively large size (15.50±10.08 mm vs. 23.09±12.93 mm) were associated with a significantly higher detection rate (P<0.001, P=0.047, and P<0.001, respectively). In the multivariate analysis, location in the neck or body (odds ratio [OR], 3.238; 95% confidence interval [CI], 1.926 to 5.443; P<0.001) and size (OR, 1.070; 95% CI, 1.044 to 1.096; P<0.001) were proven to be significant predictors of detectability (P<0.001). Conclusion US is useful for detecting focal pancreatic lesions, especially when they are located in the neck or body and are relatively large.

No abstract available.
alpha-Fetoproteins* ; Mass Screening*

A totally implanted venous access system was inserted in 19 children with cancer. The devices were utilized for the administration of antineoplastic drugs, parenteral fluids, antibiotics, and blood products. Total duration of implantation was 4,046 days for 23 implanted system (range 7-445 days). Complications included cather infection (0.247/100 catheter days), occlusion (0.692/100 catheter days), and dislodgement of needle (0.643/100 catheter days). There were major complications that necessitated removal of catheters, including systemic infections (0.09/100 catheter days) and complete occlusions (0.09/100 catheter days). The system was thought to be safe and convenient in chemotherapy, and permitted full physical activity.
Anti-Bacterial Agents ; Antineoplastic Agents ; Catheters ; Child* ; Drug Therapy ; Humans ; Motor Activity ; Needles ; Prospective Studies*