Purpose: The aim of this study was to develop teaching material of electrocardiography (ECG) education for nursing students. Teaching material was designed to increase ECG knowledge and self-confidence of nursing students. Methods: A convenience sample of 72 nursing students in a university of South Korea were recruited to an experimental group (n=36) or a control group (n=36). A non-equivalent control group pretest-posttest design was employed to test effects of teach material on ECG knowledge and self-confidence of nursing students.Teaching material was developed based on analysis learners, state objectives, select media & materials, utilize media & materials, require learner participation, and evaluate & revise (ASSURE) model. ECG knowledge and self-confidence were self-reported using scales developed by authors. Pre-test and post-test data were collected before and after a three-week intervention period. Results: The ECG knowledge of the experimental group was significantly higher than that of the control group (t=6.86,p<.001). And the self-confidence of the experimental group was significantly higher than that of the control group (t=3.07, p=.003). Conclusion Teaching material developed in this study was effective in improving ECG knowledge and self-confidence of nursing students. Thus, this teaching material could be used as supplementary textbook in diverse nursing practice education such as simulation or nursing skill training.

No abstract available.
Diagnosis* ; Gynecology* ; Laparoscopy*

Purpose: This study describes the development and implementation of a mechanical ventilation education program with a blended learning method for nursing students. Methods: Sixty-five nursing students were recruited either to the experimental group (n=33) or to the control group (n=32) in May 2020. This program was developed based on the analysis, design, development, implementation, and evaluation model. The analysis phase consisted of a literature review, expert consultations, and target group survey. In addition, learning objectives and a structure were designed, and an online program was developed. In the implementation phase, the program was conducted over the course of 2 weeks. The evaluation phase involved verification of the effects of the program on knowledge of mechanical ventilation, self-confidence, and ventilator nursing skills performance, as well as an assessment of satisfaction with the program. Results: The experimental group had significantly higher scores on knowledge of mechanical ventilation (t=4.29, p<.001), self-confidence (t=2.31, p=.024), and ventilator nursing skills performance (t=4.65, p<.001) than the control group. Conclusion The results indicate that this mechanical ventilation education program with blended learning was effective in meeting the needs of nursing students and can be widely used in this context.

Background and purpose: This study evaluated the changes in blood flow velocity in the anterior and posterior intracranial circulations according to the progression of moyamoya disease in adult patients. Methods: We evaluated Suzuki's angiographic stage and mean blood flow velocity (MBFV) changes in intracranial vessels from both sides in 19 adult moyamoya patients. We then analyzed the linearity of MBFV changes from early to late moyamoya stages in each intracranial vessel using piecewise linear regression models. Results: The MBFV in the middle cerebral artery, terminal internal carotid artery, and anterior cerebral artery increased non linearly until stage III, and then decreased progressively up to stage VI. The ophthalmic artery also showed nonlinear velocity changes, with an increase in MBFV up to stage IV, followed by a decrease in MBFV up to stage VI. The MBFV of the basilar artery increased linearly from a normal velocity at an early moyamoya stage to a stenotic velocity at a late stage. There was no statistically significant regression model for the relationship between the MBFV in the posterior cerebral artery and moyamoya stage. Conclusions: The nonlinear and/or linear MBFV changes associated with variable intracranial vessels might be useful in initial and follow-up evaluations of different stages of moyamoya disease.
Adult ; Anterior Cerebral Artery ; Basilar Artery ; Blood Flow Velocity ; Carotid Artery, Internal ; Glycosaminoglycans ; Hemodynamics ; Humans ; Linear Models ; Middle Cerebral Artery ; Moyamoya Disease ; Ophthalmic Artery ; Posterior Cerebral Artery

BACKGROUND: Cilostazol leads to inhibition of platelet aggregation and to vasodilatation. It is widely used for the secondary prevention of cerebral infarction. However, headache is a well-known adverse effect of cilostazol, and these headaches may be caused by the vasodilation of the cerebral artery. The goal of our study was to assess the frequency and severity of headaches following cilostazol treatment and to evaluate factors related to the development of these headaches. METHODS: Seventy patients with cerebral infarction were included in this study. We measured the carotid intima media thickness (IMT), the distensibility of the carotid artery (CAD), the brachial ankle index (ABI), and the brachial ankle pulse wave velocity (PWV) in order to quantify the degree of atherosclerosis and arterial stiffness. Patients were then given 100 mg of cilostazol in tablet form twice daily. For three days, we evaluated headache incidence and severity using a verbal rating scale (0-10). RESULTS: Twenty three (32.9%) patients reported headache during cilostazol medication and 7 patients had severe headache. Women were more likely to develop headaches than men (p=0.03). In addition, the mean IMT was lower in subjects with cilostazol-induced headache than in the headache-free subjects (0.8+/-0.1 vs 1.01+/-0.2 mm, p=0.001), while CAD was higher in these subjects (0.3+/-0.1 vs 0.25+/-0.1, p=0.03). There was no difference in PWV and ABI. CONCLUSIONS: Lower carotid IMT, increased CAD, and female gender may be associated with the development of cilostazol-induced headache in patients with cerebral inafarction, but not the systemic arterial stiffness.
Animals ; Ankle ; Atherosclerosis ; Carotid Arteries ; Carotid Intima-Media Thickness ; Cerebral Arteries ; Cerebral Infarction ; Female ; Headache ; Humans ; Incidence ; Male ; Platelet Aggregation ; Pulse Wave Analysis ; Secondary Prevention ; Tetrazoles ; Vascular Stiffness ; Vasodilation

BACKGROUND AND PURPOSE: The effect of low molecular weight heparin (LMWH) in the management of cerebral venous thrombosis (CVT) remains unclear. The present study was performed to determine the safety and feasibility of subcutaneous LMWH, with particular attention to hemorrhagic conversions. METHODS: LMWH (nadroparin, 7,500 ICU, every 12 hours) was administered subcutaneously for 14 days to 12 patients diagnosed with CVT. Initial clinical manifestations, etiologies and the clinical courses after LMWH treatment were also evaluated. Possible hemorrhagic side effects, including aggravation of the initial hemorrhage and/or newly developed-hemorrhagic conversions were monitored by image analysis. RESULTS: Headaches and convulsive movements were frequent presenting symptoms for CVT. Clinical improvement was usually observed within 2 to 8 days after LMWH. Symptom stabilization was observed within 4 to 60 days. Neither clinical aggravations, nor newly developed parenchymal lesions were observed during LMWH maintenance. Associated parenchymal lesions were observed in 9 of the 12 patients, 5 of which manifested with hemorrhagic conversion, as detected by image analysis. However, no clinical and radiologic aggravation was noted in these 5 patients. CONCLUSIONS: Our results suggest that LMWH may be safe and feasible in the management of CVT.
Headache ; Hemorrhage ; Heparin ; Heparin, Low-Molecular-Weight* ; Humans ; Sinus Thrombosis, Intracranial* ; Venous Thrombosis

PURPOSE: To assess the usefulness of three-dimensional spiral CT angiography in the diagnosis and as a guide for the treatment of arteriosclerosis obliterans of the lower extremity. MATERIALS AND METHODS: During a recent one-year period, CTA and conventional angiography were performed in 12 patients with suspected ASO. From the upper margin of the third lumbar vertebral body to below the knee joint, helical CT scanning was performed 30-45 seconds after the injection of Ultravist 370(150-180ml) by a power injector at the rate of 2.5-3.0ml/sec via the antecubital vein. The resulting data were reformatted by SSD after reconstruction of 5mm intervals, and CTA was compared with CA for site and degree of stenotic or occlusive lesion. RESULTS: On CTA and CA, twenty-three occlusive lesions above the tibioperoneal artery were detected in 12 patients. On CA, three mild seven moderate and eight severe stenoses were seen, as well as five occlusions. There were three cases of overgrading and three of undergrading. Overall diagnostic accuracy was 73.9%(17/23). Calcifications were detected at on axial CT scanning in the two of three underestimated lesions. Migration of the thrombi was noted in one case. CONCLUSION: CTA may be useful in the evaluation of the arteries of the lower extremities, and valuable in the planning and follow-up of treatment.
Angiography* ; Arteries* ; Arteriosclerosis Obliterans ; Constriction, Pathologic ; Diagnosis ; Humans ; Knee Joint ; Lower Extremity* ; Silver Sulfadiazine ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed ; Veins

Intracranial venous infarction and drainage alteration are rare clinical events developing after intracranial operation. Immediate anticoagulation has been recommended to restore the alteration of the intracranial venous drainage. However, for the venous drainage alteration or infarction developed just after intracranial operation, the bleeding tendency induced by the anticoagulation should be considered. We report a case of successfully managed cortical venous infarctions developed immediately after intracranial operation using low molecular weight heparin.
Drainage* ; Hemorrhage ; Heparin, Low-Molecular-Weight* ; Infarction

BACKGROUND: This study evaluated the relationships between endogenous estrogen levels and vascular risk factors in healthy men and women. METHODS: Demographics and laboratory data were collected from normotensive subjects (123 men and 154 women) in their thirties, forties and fifties who had normal laboratory profiles and no cardiovascular risk factors. Initially, estradiol, low-density lipoprotein (LDL)-cholesterol, triglyceride, and high-density lipoprotein (HDL)-cholesterol, systolic and diastolic blood pressure (SBP and DBP), NO2/NO3, homocysteine, and body mass index (BMI) were measured. Then, the relationships between estradiol and the evaluated items were analyzed with comparison of means and correlation, and stepwise multiple regression analysis based on genders and age-groups. RESULTS: Estradiol levels decreased with aging in women. Lower LDL and triglyceride, higher HDL levels, and lower SBP and DBP observed in women were correlated with decreasing age as well as increasing estradiol level. On the multivariate analysis, however, estradiol levels were negatively correlated with the changes in SBP, DBP, and triglyceride among the lipid variables. BMI was positively related with the increase of SBP and DBP and the estradiol levels. Although higher NO2/NO3 and lower homocysteine levels were observed in women than men, the NO2/NO3 and homocysteine levels had no significant correlation with estradiol changes. CONCLUSION: The study observed the beneficial relationships between endogenous estrogen, and blood pressures and lipids in healthy women. The estrogen-related benefits observed in this study were lower TG levels, SBP, and DBP in young women than those in older women or in men.
Aging ; Blood Pressure ; Body Mass Index ; Cholesterol ; Demography ; Estradiol ; Estrogens ; Female ; Homocysteine ; Humans ; Lipoproteins ; Male ; Multivariate Analysis ; Nitric Oxide ; Risk Factors ; Vascular Diseases

Primary malignant melanoma arising from the ovarian mature cystic teratoma is extremely rare, with only 31 cases have been described in the literature. It is one of the rarest forms of malignant transformation of ovarian mature cystic teratoma and usually develops unilaterally after menopause. Recently, we experienced a case of primary malignant melanoma arising from ovarian mature cystic teratoma in 71-year-old woman. The diagnosis was confirmed by positive immunohistochemical results of S-100 protein and HMB 45. Here we report the rare case with review of literature.
Aged ; Female ; Humans ; Melanoma ; Menopause ; S100 Proteins ; Teratoma