The aim of this study is to examine the effect of recorded video monitoring on students' self-reflection after completing their clinical performance examination. Taking into account the particular cases involved in the examination, the present study utilized history-taking, physical examination, and patient education as bases for evaluating information-establishment ability, and asking, listening, understanding, explaining, and connectedness as the bases for evaluating patient-physician interaction ability. Student self-monitoring through recorded video feedback was carried out three days after completion of their clinical performance examination. Students self-evaluated their performance with a 10-point scale before and after self-monitoring. The results of this study show that students have a general tendency to lower their own self-evaluation scores after self-monitoring. Although there was not a statistically significant change of interrelationship in the information-establishment ability evaluation, there was a meaningful change of interrelationship in the patient-physician interaction ability evaluation after self-monitoring; specifically, in the case of acute lower abdominal pain, a high correlation was found (r=0.31, p=0.02) between the evaluation scores of standardized patients and students related to patient-physician interaction ability. This implies that self-monitoring enables the students to acquire a reflective viewpoint from which to evaluate their own performance. Therefore, it can be said that self-monitoring through recorded video feedback is a valuable method for students to use in reviewing their performance in patient-physician interactions.
Abdominal Pain ; Diagnostic Self Evaluation ; Humans ; Methods ; Patient Education as Topic ; Patient Simulation ; Physical Examination ; Physician-Patient Relations ; Self-Assessment

Diabetes in pregnancy is associated with higher rates of miscarriage, pre-eclampsia, preterm labor, and fetal malformation. To prevent these obstetric and perinatal complications, women with diabetes have to control levels of blood sugar, both prior to and during pregnancy. Thus, individualized medical nutrition therapy for each stage of pregnancy is essential. We provided in-depth medical nutrition therapy to a 38-year-old pregnant woman with diabetes at all stages of pregnancy up to delivery. She underwent radiation therapy after surgery for breast cancer and was diagnosed with diabetes. At the time of diagnosis, her glycated hemoglobin level was 8.3% and she was planning her pregnancy. She started taking an oral hypoglycemic agent and received education regarding the management of diabetes and preconception care. She became pregnant while maintaining a glycated hemoglobin level of less than 6%. We provided education program for diabetes management during the pregnancy, together with insulin therapy. She experienced weight loss and ketones were detected; furthermore, she was taking in less than the recommended amount of foods for the regulation of blood sugar levels. By giving emotional support, we continued the counseling and achieved not only glycemic control but also instilled an appreciation of the importance of appropriate weight gain and coping with difficulties. Through careful diabetes management, the woman had a successful outcome for her pregnancy, other than entering preterm labor at 34 weeks. This study implicated that the important things in medical nutrition therapy for pregnant women with diabetes are frequent follow-up care and emotional approach through the pregnancy process.
Abortion, Spontaneous ; Adult ; Blood Glucose ; Breast Neoplasms ; Counseling ; Diagnosis ; Education ; Female ; Follow-Up Studies ; Hemoglobin A, Glycosylated ; Humans ; Insulin ; Ketones ; Nutrition Therapy* ; Obstetric Labor, Premature ; Pre-Eclampsia ; Preconception Care ; Pregnancy* ; Pregnant Women ; Weight Gain ; Weight Loss

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*

Gα(q)-coupled receptor stimulation was implied in the activation process of transient receptor potential canonical (TRPC)1/4 and TRPC1/5 heterotetrameric channels. The inactivation occurs due to phosphatidylinositol 4,5-biphosphate (PI(4,5)P₂) depletion. When PI(4,5)P₂ depletion was induced by muscarinic stimulation or inositol polyphosphate 5-phosphatase (Inp54p), however, the inactivation by muscarinic stimulation was greater compared to that by Inp54p. The aim of this study was to investigate the complete inactivation mechanism of the heteromeric channels upon Gα(q)-phospholipase C β (Gα(q)-PLCβ) activation. We evaluated the activity of heteromeric channels with electrophysiological recording in HEK293 cells expressing TRPC channels. TRPC1/4 and TRPC1/5 heteromers undergo further inhibition in PLCβ activation and calcium/protein kinase C (PKC) signaling. Nevertheless, the key factors differ. For TRPC1/4, the inactivation process was facilitated by Ca²⁺ release from the endoplasmic reticulum, and for TRPC1/5, activation of PKC was concerned mostly. We conclude that the subsequent increase in cytoplasmic Ca²⁺ due to Ca²⁺ release from the endoplasmic reticulum and activation of PKC resulted in a second phase of channel inhibition following PI(4,5)P₂ depletion.
Calcium ; Cytoplasm ; Endoplasmic Reticulum ; GTP-Binding Proteins ; HEK293 Cells ; Inositol ; Phosphatidylinositol 4,5-Diphosphate ; Phospholipases ; Phosphotransferases ; Protein Kinase C ; Transient Receptor Potential Channels ; Type C Phospholipases

Many individuals with short bowel syndrome (SBS) require long-term parenteral nutrition (PN) to maintain adequate nutritional status. Herein, we report a successful intestinal adaptation of a patient with SBS through 13 times intensive nutritional support team (NST) managements. A thirty-five-year-old woman who could not eat due to intestinal discontinuity visited Seoul National University Hospital for reconstruction of the bowel. She received laparoscopic Roux-en-Y gastric bypass (RYGB) due to morbid obesity in Jan 2013 at a certain hospital and successfully reduced her weight from 110 kg to 68 kg. However, after a delivery of the second baby by cesarean section in Jul 2016, most of small bowel was herniated through Peterson’s defect, and emergent massive small bowel resection was performed. Thereafter, she visited our hospital for the purpose of intestinal reconstruction. In Sep 2016, she received side–to-side gastrogastrostomy and revision of double barrel enterostomy. The remaining small bowel included whole duodenum, 30 cm of proximal jejunum, and 10 cm of terminal ileum. Pylorus and ileocecal valves were intact. The patient given only PN after surgery was provided rice-based soft fluid diet after 10 day of operation. Through intensive nutritional management care, she could start solid meals, and finally stop the PN and eat only orally at 45 days postoperatively. Three nutritional interventions were conducted over 2 months after the patient was discharged. She did not require PN during this period, and maintained her weight within the normal weight range. Similar interventions could be used for other patients with malabsorption problems similar to SBS.
Bariatric Surgery* ; Cesarean Section ; Diet ; Duodenum ; Enterostomy ; Female ; Gastric Bypass ; Humans ; Ileocecal Valve ; Ileum ; Jejunum ; Meals ; Nutritional Status ; Nutritional Support ; Obesity, Morbid ; Parenteral Nutrition ; Pregnancy ; Pylorus ; Seoul ; Short Bowel Syndrome*

no abstract available.