PURPOSE: This study was conducted to develop a resilience training program for nurses and test its effects. METHODS: A non-equivalent experimental group and a control group pretest-posttest study design was used with 56 participating nurses (28 nurses in the experimental group and 28 nurses in the control group). The resilience training program was provided to participants for 4 weeks from August 12 to September 4, 2013. Each session was scheduled for two hours per week. Participants completed the tools for resilience, positive affect, and perceived stress assessment. Data were analyzed using χ² test, Independent t-test, and 2*2 repeated measures multivariate analyses of variance (MANOVAs) with the SPSS/WIN 21.0 program. RESULTS: Application of the resilience training program significantly helped nurses enhance their resilience and positive affect to workplace adversity, and reduce their perceived stress. There were significant positive differences for these variables in the experimental group compared to the control group. CONCLUSION: The findings indicate that the resilience training program for nurses is effective and can be used as an intervention for a stress management guide for nurses.
Education* ; Multivariate Analysis

Purpose: This study explored the relationship between non-suicidal self-harm and suicidal ideation and examined the mediating role of frustrated interpersonal needs on the relationship between non-suicidal self-harm and suicidal ideation based on the Interpersonal Theory of Suicide. Methods: A cross-sectional, descriptive study was conducted with 333 college students in Korea. Subjects completed a packet of self-report questionnaires through an on-line survey. The analyses were conducted with IBM SPSS Statistics 25 using descriptive statistics, independent T-test, one-way ANOVA, and Pearson’s correlation coefficients. Bootstrapping was adopted for significance tests regarding the mediation effect. Results: Among the subjects, 156 students (46.8%) had non-suicide self-harm experiences. The levels of suicidal ideation were significantly different by gender. Students with experiences of non-suicidal self-harm reported significantly higher levels of frustrated interpersonal needs and suicidal ideation than those without such experiences. The relationship between non-suicidal self-harm and intensity of suicidal ideation was partially mediated by thwarted belongingness, but not perceived burdensomeness. Conclusion Findings of this study suggest the inclusion of effective strategies that can have a positive effect on ameliorating thwarted belongingness in developing suicide prevention programs for college students with experiences of non-suicidal self-harm.

Acute fatty liver of pregnancy (AFLP) is one of the sudden unexpected causes in pregnancy and maternal deaths. It has been considered as a potential fatal disease in pregnancy, but the postmortem findings of AFLP is not well known. Because an unexpected maternal death may lead to a legal dispute, forensic pathologists should be aware of clinical presentations and postmortem findings of AFLP. Therefore, we presented our case and reviewed with literatures.
Autopsy ; Dissent and Disputes ; Fatty Liver* ; Forensic Pathology ; Maternal Death* ; Pregnancy*

Although the frequency of composite resin restoration in children is gradually increasing, there are insufficient researches about the rate of composite resin repair in children. The purpose of this study was to evaluate the repair rate of composite resin restorations in the permanent first molar in children under 12 years old. This study retrospectively analyzed 169 children treated with composite resin restoration in the permanent first molar from May 2014 to April 2015.According to the location of the tooth, the repair rate was higher in the mandible than maxilla and in the left than right. In the classification of restoration, the repair rate was the highest in the class II cavity, and the repair rate was the lowest in the restoration of the occlusal surface only. Repair rate in two years was 14.8%, and repair hazard ratio decreased with age. The most common reason of composite resin restoration replacement was the secondary caries (74.1%).Within the limits of study, the repair rate of children was higher than that of adult due to the characteristics of children. Therefore, dentists should understand these characteristics and try to reduce the repair rate of composite resin composite restorations.
Adult ; Child ; Classification ; Dentists ; Humans ; Mandible ; Maxilla ; Molar ; Retrospective Studies ; Tooth

Nitrous oxide is medically used as an anesthetic gas and as an additive in whipped cream production. Few cases of death from nitrous oxide intoxication have been reported in Korea. However, fatalities due to inhalation of pure nitrous oxide in an amount enough to cause death have been recently increasing. We report two cases of death related to nitrous oxide abuse with a review of literature focusing on the fact that nitrous oxide abuse can be considered as a possible cause of death if appliances with nitrous oxide contents were found during the investigation, and the autopsy and toxicological findings cannot be attributed to nitrous oxide intoxication.
Autopsy ; Cause of Death ; Inhalant Abuse ; Inhalation ; Korea ; Nitrous Oxide* ; Toxicology

BACKGROUND: We reviewed a series of 188 resected pulmonary mucinous adenocarcinomas (MAs) to clarify the prognostic significance of lepidic and non-lepidic patterns. METHODS: Non-lepidic patterns were divided into bland, non-distorted acini with uncertain invasiveness (pattern 1), unequivocal invasion into stroma (pattern 2), or invasion into alveolar spaces (pattern 3). RESULTS: The mean proportion of invasive patterns (patterns 2 and 3) was lowest in small (≤ 3 cm) tumors, and gradually increased in intermediate (> 3 cm and ≤ 7 cm) and large (> 7 cm) tumors (8.4%, 34.3%, and 50.1%, respectively). Adjusted T (aT) stage, as determined by the size of invasive patterns, was positively correlated with adverse histologic and clinical features including older age, male sex, and ever smokers. aTis tumors, which were exclusively composed of lepidic pattern (n = 9), or a mixture of lepidic and pattern 1 (n = 40) without any invasive patterns, showed 100% disease- free survival (DFS). The aT1mi tumors, with minimal (≤ 5 mm) invasive patterns (n = 63), showed a 95.2% 5-year DFS, with recurrences (n = 2) limited to tumors greater than 3 cm in total size (n = 23). Both T and aT stage were significantly associated with DFS; however, survival within the separate T-stage subgroups was stratified according to the aT stage, most notably in the intermediatestage subgroups. In multivariate analysis, the size of invasive patterns (p = .020), pleural invasion (p < .001), and vascular invasion (p = .048) were independent predictors of recurrence, whereas total size failed to achieve statistical significance (p = .121). CONCLUSIONS: This study provides a rationale for histologic risk stratification in pulmonary MA based on the extent of invasive growth patterns with refined criteria for invasion.
Adenocarcinoma in Situ ; Adenocarcinoma, Mucinous* ; Disease-Free Survival ; Humans ; Lung ; Male ; Mucins* ; Multivariate Analysis ; Recurrence*

The purpose of this study was to evaluate the accuracy and precision of the three-dimensional (3D) imaging system of children’s facial soft tissue by comparing linear measurements. The subjects of the study were 15 children between the ages of 7 and 12. Twenty-three landmarks were pointed on the face of each subject and 16 linear measurements were directly obtained 2 times using an electronic caliper. Two sets of 3D facial images were made by the 3D scanner. The same 16 measurements were obtained on each 3D image. In the accuracy test, the total average difference was 0.9 mm. The precision of 3D photogrammetry was almost equivalent to that of direct measurement. Thus, 3D photogrammetry by the 3D scanner in children had sufficient accuracy and precision to be used in clinical setting. However, the 3D imaging system requires the subject’s compliance for exact images. If the clinicians provide specific instructions to children while obtaining 3D images, the 3D device is useful for investigating children’s facial growth and development. Also the device can be a valuable tool for evaluating the results of orthodontic and orthopedic treatments.

PURPOSE: Whole liver transplantation has limitation including donor shortage and fatal surgical complications. Hepatocyte transplantation, which is simpler and less expensive than whole liver transplantation, allows the use of living related donors, permits the use of a single donor organ for multiple recipients. However, hepatocytes have limitation in proliferation and lose their property during culture period. To over come these problems, here we performed differentiation of human embryonic stem cells (hESCs) into definitive endoderm in order to differentiate into hepatocytes efficiently. METHODS: Undifferentiated hESCs were maintained on mouse embryo fibroblast feeder (MEF) layer for 5~7 days. For endoderm differentiation, we used modified Kevin A D'Amour's method that added 100 ng/mL Activin A for 5 days. After differentiation, differentiated endodermal cells were collected and RT-PCR and immunostain analysis were performed. RESULTS: After 5 days of differentiation period, hES cells showed endoderm committed-cells and increased expression of endoderm-specific marker genes (Sox17 and Foxa2). Also differentiated endoderm cells were stained with Sox17 and Foxa2 whereas undifferentiated hES cells were not stained with Sox17, Foxa2. CONCLUSION: In vitro differentiotion from hES cells to definitive endoderm was done repetitively by our methods. Further well defined protocol for differentiation of definitive endoderm to hepatocytes should be made.
Activins ; Animals ; Embryonic Stem Cells* ; Embryonic Structures ; Endoderm* ; Fibroblasts ; Hepatocytes ; Humans* ; Liver Transplantation ; Mice ; Tissue Donors

OBJECTIVE: Cerebral endothelial cells have unique biological features and are fascinating candidate cells for stroke therapy. METHODS: In order to understand the molecular mechanisms of human cerebral endothelial cell (hCMEC/D3) transplantation in a rat stroke model, we performed proteomic analysis using 2-dimensional electrophoresis and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Protein expression was confirmed by quantitative real-time PCR and Western blot. RESULTS: Several protein spots were identified by gel electrophoresis in the sham, cerebral ischemia (CI), and CI with hCMEC/D3 treatment cerebral ischemia with cell transplantation (CT) groups, and we identified 14 differentially expressed proteins in the CT group. Proteins involved in mitochondrial dysfunction (paraplegin matrix AAA peptidase subunit, SPG7), neuroinflammation (peroxiredoxin 6, PRDX6), and neuronal death (zinc finger protein 90, ZFP90) were markedly reduced in the CT group compared with the CI group. The expression of chloride intracellular channel 4 proteins involved in post-ischemic vasculogenesis was significantly decreased in the CI group but comparable to sham in the CT group. CONCLUSION: These results contribute to our understanding of the early phase processes that follow cerebral endothelial cell treatment in CI. Moreover, some of the identified proteins may present promising new targets for stroke therapy.
Animals ; Blotting, Western ; Brain ; Brain Ischemia ; Cell Transplantation ; Cell- and Tissue-Based Therapy ; Electrophoresis ; Endothelial Cells* ; Fingers ; Humans* ; Ischemia ; Mass Spectrometry ; Neurons ; Proteomics ; Rats* ; Real-Time Polymerase Chain Reaction ; Stroke ; Transplants

The aim of this study is to describe the clinical characteristics of prepubertal- and adolescent-onset bipolar disorder (BD) and to identify any clinical differences between patients with prepubertal- and adolescent-onset BD. We analyzed the clinical records of 53 inpatients with BD. These patients were divided into prepubertal-onset and adolescent-onset groups. We also divided the subjects into narrow, intermediate, and broad phenotypes according to the definitions proposed by Leibenluft and colleagues. Of the total sample, 16 patients (30.2%) were in the prepubertal-onset group and 37 (69.8%) were in the adolescent-onset group. Patients with prepubertal-onset BD were more likely to display an insidious clinical presentation, atypical features, and comorbid psychopathology. And the majority of the subjects, especially in the prepubertal-onset group, were classified under the intermediate and broad phenotypes. These results suggest that the clinical presentation of BD with prepubertal-onset is different from that of adolescent-onset BD. It is inferred that a significant number of patients with prepubertal- and adolescent-onset BD do not meet DSM-IV criteria for mania or hypomania from the results of this study.