Purpose: This study aimed to investigate nursing students’ learning agility and confirm the mediating effect of self-leadership in the relationship between achievement motivation and learning agility. Methods: The study design was a descriptive survey design. The subjects were third- and fourth-year nursing students attending three universities in one region. Data were collected from November 28, 2019, to May 25, 2020, and a total of 202 data were collected using the scale of achievement motivation, self-leadership, and learning agility. Data analysis included frequency analysis, descriptive statistics, and Pearson's correlation coefficient using SPSS 25.0 statistics 25.0 software. The mediating effect of self-leadership was analyzed through regression analysis and bootstrapping using process macro ver. 3.4.1. Results: Self-leadership’s partial mediating effect was confirmed in achievement motivation and learning agility. Achievement motivation was found to affect directly learning agility, with an indirect effect through self-leadership. Conclusion The study results showed that nursing students could increase their learning agility through self-leadership improvement. Future research should focus on identifying the factors influencing nursing students’ learning agility and develop and apply programs to improve learning agility.

OBJECTIVE: To assess the axonopathy and demyelination neuropathy according to the electrophysiologic severity in diabetic neuropathy. METHOD: Electrophysiologic data of 246 patients who had been diagnosed with diabetic neuropathy was obtained and classified into suspected, possible, and definite groups by the criteria of our laboratory. Nerve conduction study was performed in the median, ulnar motor and sensory nerves, peroneal and tibial motor nerves, and sural nerve. Statistics were done with the results from the median motor and sensory, tibial motor and sural nerves. According to the severity of diabetic neuropathy, correlation and Chi-square analysis between amplitudes and latencies were performed. RESULTS: Frequencies of diabetic neuropathy according to electrophysiologic severity were as follows: 24 cases of suspected, 141 cases of possible, and 81 cases of definite neuropathy. The correlation ratios between amplitude and latency were 0.41- 0.79 (p<0.05) in the definite group of all the nerves examined, and below 0.3 in the suspected and possible groups. By Chi-square analysis, amplitude reduction was the predominant finding in the suspected and possible groups.si CONCLUSION: In the early stage of diabetic neuropathy, axonopathy might be the preceding pathogenesis, while with progression of diabetic neuropathy, axonopathy and demyelination may coexist.
Demyelinating Diseases* ; Diabetic Neuropathies* ; Humans ; Neural Conduction ; Peroneal Nerve ; Sural Nerve

OBJECTIVE: To assess the usefulness of the somatosensory evoked potentials in correlating with various clinical features and in predicting the functional outcome in patients with stroke. METHOD: The subjects were 57 patients with first stroke. Somatosensory evoked potential study was performed at the time of transfer to the rehabilitation department. Data of somatosensory evoked potential with median and tibial nerve stimulations were obtained and classified as normal (group 1), abnormal (group 2), and no response group (group 3). Modified Barthel index (MBI), motor and sensory functions were evaluated at the time of transfer and discharge. RESULTS: MBI score was statistically different among the 3 groups based on the findings of median and tibial nerve SSEP at the time of transfer, but not different at the time of discharge. Motor function was statistically different among the 3 groups at the time of transfer and discharge. Sensory function was statistically different among the 3 groups at the time of transfer, but not different at the time of discharge. CONCLUSION: Even though SSEP study reflects the functional status of the patients and correlates well with the findings of brain image, it has limitation in predicting outcome of the patients with stroke.
Brain ; Evoked Potentials, Somatosensory* ; Humans ; Rehabilitation ; Sensation ; Stroke* ; Tibial Nerve

OBJECTIVE: To investigate the anatomy of the ulnar nerve according to the degree of elbow flexion and to obtain optimal elbow position for ulnar nerve conduction study. METHODS: Eleven elbows in nine cadavers were dissected. We estimated the 10 cm elbow segment to be the distance between 2 points, 4 cm distal and 6 cm proximal to the center of the cubital tunnel, which was determined to be the halfway point between the medial epicondyle and olecranon with elbow position in extension and 45o, 90o, 135o flexion. Anatomical measurements of the actual length of ulnar nerve, distance between medial epicondyle and ulnar nerve, and distance between medial epicondyle and olecranon were obtained in each position. The actual length of the ulnar nerve was measured between two points of the ulnar nerve closest to the landmarks of the estimated 10 cm with flexible ligature. RESULTS: The actual lengths of ulnar nerve were 10.23 cm, 10.00 cm, 9.44 cm, and 9.08 cm in elbow extension, and 45o, 90o, 135o flexion, respectively. The difference between actual length and estimated lengths were least in 45o elbow flexion (p=0.0001). The distance between medial epicondyle and olecranon increased with increasing elbow flexion (p=0.0001). However, there was no difference in the distance between medial epicondyle and ulnar regardless of the elbow position. As a result, the ulnar nerve seemed to have migrated anteriorly in the cubital tunnel with increasing elbow flexion. CONCLUSION: This study suggest that the optimal angle in ulnar nerve conduction study would be 45o flexion, under the condition that the distance measurement is through the halfway point between the medial epicondyle and olecranon.
Cadaver ; Elbow* ; Ligation ; Olecranon Process ; Ulnar Nerve*

PURPOSE: Stress urinary incontinence (SUI) commonly occurs in women, and it has an enormous impact on quality of life. Surgery, drugs, and exercise have been recommended for the treatment of this disease. Among these, exercise is known to be effective for the relief of symptoms of SUI; however, the efficacy and underlying mechanisms of the effect of exercise on SUI are poorly understood. We investigated the effect of swimming the symptom of SUI in relation to the expression of nerve growth factor (NGF) in rats. METHODS: Transabdominal urethrolysis was used to induce SUI, in Sprague-Dawley rats. The experimental groups were divided into the following three groups: sham-operation group, transabdominal urethrolysis-induced group, and transabdominal urethrolysis-induced and swimming group. The rats in the swimming group were forced to swim for 30 minutes once daily starting 2 weeks after SUI induction and continuing for 4 weeks. For this study, determination of abdominal leak point pressure and immunohistochemistry for NGF in the urethra and in the neuronal voiding centers (medial preoptic nucleus [MPA], ventrolateral periaqueductal gray [vlPAG], pontine micturition center [PMC], and spinal cord [L4-L5]) were performed. RESULTS: Transabdominal urethrolysis significantly reduced the abdominal leak point pressure, thereby contributing to the induction of SUI. Abdominal leak point pressure, however, was significantly improved by swimming. The expression of NGF in the urethra and in the neuronal voiding centers (MPA, vlPAG, PMC, and L4-L5) relating to micturition was enhanced by the induction of SUI. Swimming, however, significantly suppressed SUI-induced NGF expression. CONCLUSIONS: Swimming alleviated symptoms of transabdominal urethrolysis-induced SUI, as assessed by an increase in abdominal leak point pressure. The underlying mechanisms of these effects of swimming might be ascribed to the inhibitory effect of swimming on NGF expression.
Animals ; Female ; Humans ; Immunohistochemistry ; Nerve Growth Factor ; Neurons ; Periaqueductal Gray ; Quality of Life ; Rats ; Rats, Sprague-Dawley ; Spinal Cord ; Swimming ; Urethra ; Urinary Incontinence ; Urination

Managing acute pancreatitis is clinically challenging because of the generally poor patient condition, the variety of treatment options depending on the severity and complications, and the uncertainty of outcomes. Recently, the step-up approach, which involves less invasive initial treatment and more invasive subsequent treatment, where necessary, has been proposed as the mainstay of managing pancreatitis. This paper presents a case of a 57-year-old man with severe acute pancreatitis, who developed an unexpected fistula in the rectum, which was treated successfully using the step-up approach. In managing this case, the authors faced clinical challenges in determining the infection of necrotic tissue in the early phase of the disease, the optimal timing and method of drainage, and the fistula closure or repair technique. Successful management of this case using the step-up approach validated current recommendations and suggests that it is a reasonable treatment strategy for pancreatic-colonic fistulas. This case also highlights the importance of an awareness that pancreatitis-associated complications can develop in an unexpected manner.
Colon ; Drainage ; Fistula ; Humans ; Methods ; Middle Aged ; Pancreatitis ; Pancreatitis, Acute Necrotizing ; Rectum ; Uncertainty

Managing acute pancreatitis is clinically challenging because of the generally poor patient condition, the variety of treatment options depending on the severity and complications, and the uncertainty of outcomes. Recently, the step-up approach, which involves less invasive initial treatment and more invasive subsequent treatment, where necessary, has been proposed as the mainstay of managing pancreatitis. This paper presents a case of a 57-year-old man with severe acute pancreatitis, who developed an unexpected fistula in the rectum, which was treated successfully using the step-up approach. In managing this case, the authors faced clinical challenges in determining the infection of necrotic tissue in the early phase of the disease, the optimal timing and method of drainage, and the fistula closure or repair technique. Successful management of this case using the step-up approach validated current recommendations and suggests that it is a reasonable treatment strategy for pancreatic-colonic fistulas. This case also highlights the importance of an awareness that pancreatitis-associated complications can develop in an unexpected manner.
Colon ; Drainage ; Fistula ; Humans ; Methods ; Middle Aged ; Pancreatitis ; Pancreatitis, Acute Necrotizing ; Rectum ; Uncertainty

BACKGROUND/AIMS: Recently, many studies have reported the incidence of colorectal neoplasm (CRN) to be increased in patients with gastric cancer. Thus preoperative colonoscopy is recommended for the screening of CRN. The purpose of this study is to investigate the prevalence of colorectal adenoma and cancer in patients with gastric cancer and evaluate the necessity of preoperative colonoscopy in patients with gastric cancer. MATERIALS AND METHODS: We collected data from 293 patients who underwent gastrectomy due to gastric cancer at one tertiary institution between January to December 2015. Preoperative colonoscopy was performed in 127 patients of 293 patients. To compare the prevalence of colorectal neoplasm, we selected 900 persons who underwent upper esophagogastroduodenoscopy and colonoscopy for health screening during 2015. RESULTS: The prevalence of overall CRN was similar in the gastric cancer group and the control group. The prevalence of colorectal advanced adenoma and cancer was higher in the gastric cancer group compared with control group, but it did not show statistical significance. The prevalence of colorectal advanced adenoma was significantly higher in the group of age ≥ years and smoking. CONCLUSIONS: The risk of advanced colorectal adenoma increases significantly in patients with old age but not in patients with gastric cancer. We suggest that all patients with gastric cancer might not carry a high risk for advanced colorectal adenoma compared with the normal population. Patients with old age might require surveillance colonoscopy.
Adenoma ; Colonoscopy* ; Colorectal Neoplasms ; Endoscopy, Digestive System ; Gastrectomy ; Humans ; Incidence ; Mass Screening ; Prevalence ; Smoke ; Smoking ; Stomach Neoplasms*

Background : hypercalciuria is defined as normocalcemia and increased urinary calcium excretion without any cause. Many studies have demonstrated that urinary calcium excretion is increased and glomerular hematuria is related to hypercalciuria in diabetic patients with severe proteinuria. This study was undertaken to elucidate whether patients with NIDDM are hypercalciuric and whether there is a pathophysiologic relationship between urinary calcium excretion, hematuria and the degree of diabetic nephropathy. The purpose of this study was to evaluate the incidence of hypercalciuria in NIDDM patients and the possible relationship among urinary calcium excretion, hematuria and proteinuria in diabetic nephropathy. Methods : We studied with 18 control subjects and 101 NIDDM patients without urinary infection. NIDDM patients with normal renal function (s- Cr<133micromol/L) followed at Kangbuk Samsung Hospital were included in this study from June, 1993 through March, 1995. Control group included 18 normal subjects and 101 NIDDM patients were divided into 3 groups : normoalbuminuria group, microalbuminuria group and macroalbuminuria group. Urinary albumin excretion rate (microalbumin) and urinary calcium and creatinine excretion ratio were measured. Kruskal-Wallis 1-way ANOVA test and multifactorial regression test were used to analyze. Results : 1) Age, duration of DM and serum creatinine level in macroalbuminuria group were significantly higher than normoalbuminuria group. 2) Calcium-creatinine ratio was significantly higher in NIDDM patients than in control subjects. Among diabetics it is significantly higher in microalbuminuria and macroalbuminuria groups than normoalbuminuria group. The incidence of hypercalciuria is 44.6% in patients with NIDDM. 3) Albumin excretion rate is correlated positively with calcium-creatinine ratio(r=0.26, p=0.0006), while no correlation was observed with serum creatinine, serum calcium, fasting blood glucose, postprandial 2hrs blood glucose, HbA1C, creatinine clearance, and body mass index. 4) Hematuria was observed in 3 cases with hypercalciuria(6.7%) and 4 cases without hypercalciuria(7.1%). No significant difference was observed between two groups. Conclusion : Hypercalciuria was more frequent in patients with NIDDM than in control. The severity of calciuria was correlated with the progression of diabetic nephropathy. There was no definite correlation between urinary calcium excretion and hematuria.
Blood Glucose ; Body Mass Index ; Calcium ; Creatinine ; Diabetes Mellitus, Type 2* ; Diabetic Nephropathies ; Fasting ; Hematuria* ; Humans ; Hypercalciuria* ; Incidence ; Proteinuria

Ruptured aneurysms complicate the course of polyarteritis nodosa only infrequently. Most often they occur in renal or mesenteric vessels. We experienced a case of 48-year old woman with systemic necrotizing vasculitis who developed multiorgan failure and spontaneous intra-abdominal hemorrhage. Angiography showed diffuse narrowing and spontaneous hemorrhage of medium and small sized arteries in visceral and pelvic vasculature. So emergency embolization and removal of hematoma was done. About 3000cc of blood was collected in the abdominal cavity. There were fine small aneurysmal dilatations of arteries with multiple collaterals and they oozed spontaneously. Bleeding small vessels were ligated. Pathologic findings of the involved arteries showed severe inflammation and necrosis of vessel wall. She was treated with corticosteroid and cyclophsphamide for one year and achieved improvement in her clinical status.
Abdominal Cavity ; Aneurysm ; Aneurysm, Ruptured ; Angiography ; Arteries ; Dilatation ; Emergencies ; Female ; Hematoma ; Hemorrhage* ; Humans ; Inflammation ; Middle Aged ; Necrosis ; Polyarteritis Nodosa ; Vasculitis*