The fashion of vascular anastomosis, end-to-end or end-to-side (E-to-S), are depended upon surgeon's preference or surgical situations. In E-to-S anastomosis two different methods of arteriotomy are applicable but it has been suggested the type, either elliptical or slit arteriotomy, play a different role in the flow hemodynamics. We thought that the difference is more considerable in microvascular surgery. This study examines the effects of elliptical versus slit arteriotomy on morphologic vessel patency. Twenty male Sprague-Dawley rats were divided into two groups of ten rats each. Both carotid arteries were selected as a experimental model. During the procedures the rat brain was tolerable to ischemia and all animals were survived after operations. The morphologic analysis of anastomosis site was through resin-casting method with scanning electromicroscopic examination. The results showed notable difference between two groups in three-dimensional morphology at two-month of operation. This difference may affect the flow hemodynamics and long-term vessel patency. In microvascular anastomosis, the mortpologic difference of the elliptical arteriotomy is worse than slit arteriotomy which compromises the vessel circumference.
Animals ; Brain ; Carotid Arteries ; Hemodynamics ; Humans ; Ischemia ; Male ; Models, Theoretical ; Rats ; Rats, Sprague-Dawley

PURPOSE: The purpose of this study was to analyze how a nursing student recognizes PBL with simulation education and its relationship to academic achievement. METHODS: The study objects were the students in C college who learn through PBL using simulator for 15 weeks(September 2007 to December 2007). Learning element recognition was developed by Cho(2002) and three key evaluations(performance, self-evaluation, and colleague evaluation) were designed by professors. RESULTS: Learning element recognition ranged from 2.37 to 4.83 with the average at 3.94. For Learning element recognition, students who preferred discussion score 4.15. This was statistically more significant than those who do not. Students who preferred presentations show significantly higher score in colleague evaluation. For Learning element recognition and academic achievement, self-evaluation and colleague evaluation showed relationship to PBL learning element. CONCLUSION: There was definitely a relationship with PBL learning element and academic achievement after learning the PBL with simulation education.
Achievement ; Diagnostic Self Evaluation ; Humans ; Learning ; Problem-Based Learning ; Students, Nursing

PURPOSE: The purpose of this study was to analyze nursing students' learning styles and relationship of learning style to participation and academic achievement. METHOD: The study participants were nursing students in C college learning through problem based learning (PBL). Data were collected using a questionnaire which included Kolb's learning styles. Performance evaluation and paper examination were used to evaluate academic achievement. RESULTS: Most of the students had converger type learning style. Student with a tendency to abstract conceptualization, such as converger type and assimilator type, preferred discussion and presentation. The students with converger type learning style participated and achieved better than students with diverger style. CONCLUSION: The results indicate that learning style was related to participation and academic achievement. Therefore in order to use PBL effectively, facilitators should consider students' learning styles.
Achievement ; Humans ; Learning ; Problem-Based Learning ; Surveys and Questionnaires ; Students, Nursing

The Pill Questionnaire (PillQ) has been proposed as a simple way to evaluate cognitive deficits and their impact on the daily lives of those with Parkinson’s disease (PD) by asking patients or caregivers about whether patients can independently manage their pills. We used the PillQ to investigate the association of ability to manage medication with cognition and activities of daily living (ADLs) in patients with PD. Patients were divided into two groups based on PillQ scores. The no-impact group was able to take their antiparkinsonian medication independently, and the impact group exhibited problems describing their treatment or taking their drugs independently. A total of 208 participants (93 men) were included. 111 patients (53.4%) were included in the no-impact group, and 97 (46.6%) were included in the impact group. The impact group showed significantly lower cognitive functioning, difficulties with the performance of ADLs, and severe motor dysfunction. PillQ scores were significantly correlated with Mini-Mental State Examination and the Montreal Cognitive Assessment, and Clinical Dementia Rating scores. Management of medication by PD patients is associated with cognitive function, and the PillQ is an easy and useful test for detecting cognitive impairment and its impact on daily life.

Twenty five patients (twenty seven hips) who had Chiari osteotomy at Kang Nam St. Marys Hospital between 1980 and 1995 were reviewed to evaluate the factors in the operative technique that contribute to successful outcome and assess the clinical results in various conditions. The length of follow-up ranged from one to fourteen years and the age of at operation ranged from four to twentythree years. Eighteen patients had developmental dysplasia of the hip: four, septic hip: three had another disorders, Prior to the Chiari osteotomy, fourteen hips had an femoral osteotomy and four, trochanteric arthroplasty. We used to the standard osteotomy as described by Chiari with certain modification. A pneumatic saw and osteotome are used instead of Gigli saw. This technique is simple procedure to make the correct level and angle. Bone graft was not performed in all cases even the osteotomy was displaced more than 50 percent of the iliac width. The overall results were 12 excellent, eight good, five fair, and two poor. In eleven patients, the osteotomy had to be displaced more than 50 percent to provide good coverage of the femoral head. Their results were good or excellent. A good result will be obtained if enough attention is paid to displacing the osteotomy. The osteotomy using the pneumatic saw provides accurate level and direction of osteotomy and it is an simple procedure also.
Adolescent* ; Arthroplasty ; Child* ; Femur ; Follow-Up Studies ; Head ; Hip ; Humans ; Osteotomy* ; Transplants

Although most of the known pathogenic mutations in the progranulin gene (PGRN) are null mutations leading to a reduction in the serum PGRN protein levels, missense mutations also have been identifi ed in patients with frontotemporal lobar degeneration and in patients with Alzheimer disease. Among these, p.R564C mutation was identifi ed in a late-onset AD patient with a reduced serum PGRN level. However, recently, we found the p.R564C mutation in a healthy control subject raising doubts whether this is a pathogenic mutation. In this report, we measured the serum PGRN levels in 20 subjects without the p.R564C mutation and in one subject with the p.R564C mutation, to determine whether the p.R564C mutation is associated with reduced serum PGRN levels. We found that the serum PGRN level in the subject with the p.R564C mutation was not reduced compared to the subjects without the p.R564C mutation. Our result reiterates that p.R564C may not be a pathogenic mutation.

BACKGROUND: Activation of the c-Met pathway is involved in cancer progression and the prognosis. We aimed to identify any association of c-Met protein expression with a number of clinicopathologic variables including infection of human papillomavirus and Epstein-Barr virus (EBV) in head and neck carcinomas (HNCa). METHODS: Eighty-two cases were enrolled in this study. Expression of c-Met and p16 was investigated immunohistochemically. EBV was detected by in situ hybridization and amplification of the c-Met gene by fluorescence in situ hybridization. RESULTS: The c-Met protein was expressed in 41.5% (34/82), and gene amplification was found in 1.4% (1/71). High expression of c-Met was associated with the primary location of the tumor; the hypopharynx showed the highest expression, followed by the oral cavity, larynx, and nasal cavity. Squamous cell carcinoma expressed c-Met more frequently than undifferentiated carcinoma. Also, p16 immunoreactivity or EBV infection was associated with the tumor location and well-differentiated histologic type, but were not linked to c-Met expression. The patients with positive c-Met expression showed frequent lymph node metastasis. CONCLUSIONS: Activation of the c-Met pathway might be involved in a subset of HNCa. Cases showing positive c-Met expression should be carefully monitored because of the high probability of lymph node metastasis.
Carcinoma ; Carcinoma, Squamous Cell ; Epstein-Barr Virus Infections ; Fluorescence ; Gene Amplification ; Head ; Head and Neck Neoplasms ; Herpesvirus 4, Human ; Humans ; Hypopharynx ; In Situ Hybridization ; Larynx ; Lymph Nodes ; Mouth ; Nasal Cavity ; Neck ; Neoplasm Metastasis ; Prognosis ; Proto-Oncogene Proteins c-met

Background and Objectives: This study aimed to examine factors of poor outcome by analyzing the outcomes of bilateral subthalamic deep brain stimulation in Parkinson’s disease after 3 years. Methods: We assumed that patients who could not manage independent life in their best stimulationon/medication-on condition after a defi ned period might not have been a good surgical candidate. A poor outcome is defi ned as a failure to maintain functional independence at three years during a stimulation-on/medication-on state. Results: A total of 84 patients underwent bilateral subthalamic deep brain stimulation and all were followed up for 3 years. We excluded one patient who had intracranial hemorrhage. Twenty-one patients of the 83 patients could not keep up independent life even during their best condition for the following reasons: freezing in 15 patients, dementia in 5, depression in 3, musculoskeletal problems in 7, and cancer in one patient. Conclusions: Many patients could not keep up independent life during their best condition as early as three years after deep brain stimulation. Musculoskeletal problems were one major cause of disabilities, as were freezing and dementia. We emphasize that musculoskeletal problems need more attention in the preoperative screening of deep brain stimulation candidates and during the follow up.

PURPOSE: This retrospective study compares the amount of bone resorption around implants between an autogenous tooth bone graft (AutoBT) and a synthetic bone graft after a bone-added crestally approached sinus lift with simultaneous implant placements. METHODS: In all, 37 patients participated in this study. Seventeen patients were grouped as group I and underwent an AutoBT-added sinus lift using the crestal approach. The remaining 20 patients were grouped as group II and underwent synthetic bone grafting. Both groups received the implant placements simultaneously. Of the 37 participating patients, only 22 patients were included in the final results: Eleven patients of group I and 11 patients of group II. Before the surgery, the distance from the alveolar crest to the sinus floor was measured using panoramic radiography. After the surgery, the distance was measured again from the neck of the implant thread to the most superior border of the added graft materials. Then, the amount of sinus lift was calculated by comparing the two panoramic radiographs. After a year, a panoramic radiograph was taken to calculate the resorption of the bone graft material from the radiograph that was taken after the surgery. The significance of the resorption amount between the two types of graft materials was statistically analyzed. RESULTS: The bone height was increased to an average of 4.89 mm in group I and 6.22 mm in group II. The analysis of panoramic radiographs 1 year after the surgery showed an average bone resorption of 0.76 mm and 0.53 mm, respectively. However, the degree of lifting (P=0.460) and the amount of bone-grafted material resorption (P=0.570) showed no statistically significant difference. CONCLUSIONS: Based on this limited study, AutoBT can be considered a good alternative bone graft to a synthetic bone graft in a bone-added sinus lift, when extraction is necessary prior to the surgery.
Bone Resorption* ; Bone Substitutes ; Bone Transplantation ; Dental Implants ; Humans ; Lifting* ; Neck ; Osseointegration ; Radiography, Panoramic ; Retrospective Studies* ; Sinus Floor Augmentation ; Tooth* ; Transplants*

PURPOSE: The purpose of this study was to identify the relationship between the practice environment of nursing and the critical thinking disposition of clinical nurses in local general hospitals. METHODS: A convenience sample of 468 registered nurses was obtained from three local general hospitals. Data were collected by a self-administered questionnaire during November, 2012. The survey tools were the K-PES-NWI verified by Cho et al (2011) and the critical thinking disposition instrument developed by Yoon (2004). Data were analyzed using descriptive statistics, one-way ANOVA with Scheffe test and multiple regression with SPSS/WIN 18.0. RESULTS: The mean score for practice environment of nursing was 3.3+/-0.4 and for critical thinking disposition, 2.3+/-0.4. There were statistically significant differences in critical thinking disposition according to age, education, length of career, current position, and marital status. In multivariate analysis, factors related to critical thinking disposition were collegial nurse-physician relations and education level. CONCLUSION: The results of the study indicate that collegial nurse-physician relations in the nursing practice environment are related to nurses' critical thinking disposition, and thus, it is important to improve the practice environment as well using individual approaches including on-the-job training to improve nurses' critical thinking disposition.
Education ; Hospitals, General* ; Inservice Training ; Marital Status ; Multivariate Analysis ; Nursing* ; Physician-Nurse Relations ; Surveys and Questionnaires ; Thinking*