PURPOSE: This study aimed to develop and evaluate a nursing educational program improving nursing professional's cultural competency in cancer prevention. METHODS: An eight-hour long educational program was developed based on several preliminary research projects, one ethnography and three quantitative projects, to identify the educational needs among nursing students and professionals in Korea. Thirty two nursing professionals were recruited for a one group pretest-posttest design. Three questionnaires were used to measure cultural nursing knowledge about cancer prevention, cultural competency and perceived importance of nurses' quality. RESULTS: After completing the educational program, the clinical nurses showed a significant change in the mean score of the cultural nursing knowledge about cancer prevention from 4.78±2.01 to 8.81±1.52 (t=-8.48, p<.001) and the level of the cultural competency from 72.47±8.96 to 83.59±8.61 (t=-6.16, p<.001). Clinical nurses' perception of 'Communication ability with patients and family members' changed from 6th to 2nd most importance but 'Having a passion for the patient care' remained the most important perceived factor of nurses' quality after completing the educational program. CONCLUSION: The educational program developed was effective in improving nursing professional's cultural competency in cancer prevention. However, it needs to be improved more to be culturally specific to multi-cultural clients.
Anthropology, Cultural ; Cultural Competency* ; Early Detection of Cancer ; Humans ; Korea ; Nursing ; Students, Nursing

PURPOSE: This study was conducted to investigate the relationship between cultural competency and the importance of nurses' qualities perceived by undergraduate nursing students. METHODS: Researchers developed two tools for this study after reviewing the related literature and conducting research team workshops: questionnaire of cultural competency and the importance of nurses' qualities. 200 nursing students were recruited in convenient sampling to respond to these questionnaires. Of nurses' 10 qualities, major affecting factors on the cultural competency were identified by stepwise multiple regression analysis. RESULTS: The nursing students perceived technical nursing skills and professional nursing knowledge as nurses' most important qualities. However, 'having a passion for patient care', 'demonstrating strong nursing profession's code of ethics??and 'teaching and research ability' were found as significant influencing factors on the variance of the cultural competency. These three factors explained 16% of the total variances of the cultural competency (F=13.98, p<.001). CONCLUSION: The educational strategies to improve cultural nursing competency need to incorporate students' expectations for the professional nurses' roles. Also, further studies need to develop reliable and valid measurement tools for cultural competency
Cultural Competency* ; Cultural Diversity ; Education ; Education, Nursing ; Humans ; Nursing* ; Students, Nursing*

Spontaneous intracranial hypotension (SIH) is a rare cause of labyrinthine hydrops. The otologic symptoms of SIH include ear fullness, tinnitus, and hearing loss which can result from labyrinthine hydrops. We report a case of labyrinthine hydrops caused by SIH, confirmed by an audiometric impairment that occurred only when in an upright posture.
Cochlear Aqueduct ; Ear ; Edema* ; Hearing Loss ; Intracranial Hypotension* ; Posture ; Tinnitus

BACKGROUND: Multidrug-resistant tuberculosis (MDR-TB) and extensively drug resistant tuberculosis (XDR-TB) are serious threats to worldwide tuberculosis control, but the national burden and the trends of infectious spread are largely unknown. METHODS: We retrospectively reviewed the results of drug sensitivity tests and medical records of patients that were diagnosed with culture-confirmed pulmonary tuberculosis and were admitted to the National Masan Tuberculosis Hospital between 2001 and 2005. RESULTS: From 2001 to 2005, the proportion of MDR-TB among new cases was 9.2%, 13.8%, 16.9%, 23% and 27.0% in 2001, 2002, 2003, 2004 and 2005, respectively, and the proportion of MDR-TB among previously treated cases was 58.5%, 60.2%, 62.7%, 61.7% and 71.3% in 2001, 2002, 2003, 2004 and 2005, respectively. A significant increasing trend could be discerned for MDR-TB among both new and previously treated cases (p<0.001, p=0.002 for trend, respectively). The proportion of XDR-TB among new cases was 0%, 2.3%, 3.1%, 2.5% and 6.3% in 2001, 2002, 2003, 2004 and 2005, respectively, and the proportion of XDR-TB among previously treated cases was 9.1%, 15.7%, 17.3%, 19.9% and 19.1% in 2001, 2002, 2003, 2004 and 2005, respectively. A significant increasing trend could be discerned for XDR-TB among both new and previously treated cases (p=0.005, p<0.001 for trend, respectively). CONCLUSION: Both MDR-B and XDR-TB were gradually increased among both new and previously treated cases. Integrated national surveillance, including the public and private sectors, will be needed to estimate the exact status of antituberculous drug resistance.
Drug Resistance ; Drug Resistance, Multiple ; Extensively Drug-Resistant Tuberculosis ; Hospitals, Chronic Disease ; Humans ; Medical Records ; Nitroimidazoles ; Private Sector ; Referral and Consultation ; Retrospective Studies ; Sulfonamides ; Tuberculosis ; Tuberculosis, Multidrug-Resistant ; Tuberculosis, Pulmonary

We report a rare case of hilar squamous cell carcinoma. A 62-year-old Korean woman complaining of nausea was referred to our hospital. Her biliary computed tomography revealed a 28 mm-sized protruding solid mass in the proximal common bile duct. The patient underwent left hemihepatectomy with S1 segmentectomy and segmental excision of the common bile duct. Microscopically, the tumor was a moderately differentiated squamous cell carcinoma of the extrahepatic bile duct, without any component of adenocarcinoma or metaplastic portion in the biliary epithelium. Immunohistochemically, the tumor was positive for cytokeratin (CK) 5/6, CK19, p40, and p63. Squamous cell carcinoma of the extrahepatic bile duct is rare. To date, only 24 cases of biliary squamous cell carcinomas have been reported. Here, we provide a clinicopathologic review of previously reported extrahepatic bile duct squamous cell carcinomas.
Adenocarcinoma ; Bile Ducts, Extrahepatic ; Carcinoma, Squamous Cell ; Common Bile Duct ; Drug Therapy ; Epithelial Cells ; Epithelium ; Female ; Hepatic Duct, Common ; Humans ; Keratins ; Klatskin Tumor ; Mastectomy, Segmental ; Middle Aged ; Nausea

PURPOSE: This study evaluated the effect of a teaching model to improve cultural competency (TMCC) for Korean undergraduate nursing students. METHODS: A nonequivalent control group pretest/posttest quasi-experimental study was conducted with a convenience sample of 168 undergraduate nursing students in South Korea. The experimental group of 121 seniors was taught a 13-week teaching model in order to improve cultural competence. A control group with 47 junior students underwent nursing major courses, but did not take this teaching model. Before and after the program, students' level of cultural competency was measured using the Questionnaire for Cultural Competence (QCC) consisting of three sub-scales: “awareness and desire,” “encounter,” and “nursing skill and knowledge.” RESULTS: After the experiment, the experimental group showed significantly higher improvement in the Questionnaire for Cultural Competence in the three sub-scales of “awareness and desire,” “encounter,” and “nursing skill and knowledge” than the control group (p= < .050). CONCLUSION: A teaching model to improve cultural competence was effective in improving Korean undergraduate nursing students' cultural competency. Further studies need to be repeated in order to identify the effectiveness of the teaching model to improve cultural competency with graduate or clinical nurses.
Clinical Competence ; Cultural Competency ; Cultural Diversity ; Education, Nursing ; Humans ; Korea ; Non-Randomized Controlled Trials as Topic ; Nursing ; Students, Nursing

PURPOSE: We developed and validated a fetal trisomy detection method for use as a noninvasive prenatal test (NIPT) including a Clinical Laboratory Improvement Amendments (CLIA)-certified bioinformatics pipeline on a cloud-based computing system using both Illumina and Life Technology sequencing platforms for 221 Korean clinical samples. We determined the necessary proportions of the fetal fraction in the cell-free DNA (cfDNA) sample for NIPT of trisomies 13, 18, and 21 through a limit of quantification (LOQ) test. MATERIALS AND METHODS: Next-generation sequencing libraries from 221 clinical samples and three positive controls were generated using Illumina and Life Technology chemistries. Sequencing results were uploaded to a cloud and mapped on the human reference genome (GRCh37/hg19) using bioinformatics tools. Based on Z-scores calculated by normalization of the mapped read counts, final aneuploidy reports were automatically generated for fetal aneuploidy determination. RESULTS: We identified in total 29 aneuploid samples, and additional analytical methods performed to confirm the results showed that one of these was a false-positive. The LOQ test showed that the proportion of fetal fraction in the cfDNA sample would affect the interpretation of the aneuploidy results. CONCLUSION: Noninvasive chromosome examination (NICE), a CLIA-certified NIPT with a cloud-based bioinformatics platform, showed unambiguous success in fetus aneuploidy detection.
Aneuploidy* ; Computational Biology ; DNA ; Fetus* ; Genome ; High-Throughput Nucleotide Sequencing ; Humans ; Prenatal Diagnosis ; Trisomy

Purpose: The most recent 2017 World Health Organization (WHO) classification of pancreatic neuroendocrine neoplasms (PanNENs) has refined the three-tiered 2010 scheme by separating grade 3 pancreatic neuroendocrine tumors (G3 PanNETs) from poorly differentiated pancreatic neuroendocrine carcinomas (PanNECs). However, differentiating between G3 Pan- NETs and PanNECs is difficult in clinical practice. Materials and Methods: Eighty-two surgically resected PanNENs were collected from 16 institutions and reclassified according to the 2017 WHO classification based on the histological features and proliferation index (mitosis and Ki-67). Immunohistochemical stains for ATRX, DAXX, retinoblastoma, p53, Smad4, p16, and MUC1 were performed for 15 high-grade PanNENs. Results: Re-classification resulted in 20 G1 PanNETs (24%), 47 G2 PanNETs (57%), eight G3 well-differentiated PanNETs (10%), and seven poorly differentiated PanNECs (9%). PanNECs showed more frequent diffuse nuclear atypia, solid growth patterns and apoptosis, less frequent organoid growth and regular vascular patterns, and absence of low-grade PanNET components than PanNETs. The Ki-67 index was significantly higher in PanNEC (58.2%± 15.1%) compared to G3 PanNET (22.6%±6.1%, p < 0.001). Abnormal expression of any two of p53, p16, MUC1, and Smad4 could discriminate PanNECs from G3 PanNETs with 100% specificity and 87.5% sensitivity. Conclusion Histological features supporting the diagnosis of PanNECs over G3 PanNETs were the absence of a low-grade PanNET component in the tumor, the presence of diffuse marked nuclear atypia, solid growth pattern, frequent apoptosis and markedly increased proliferative activity with homogeneous Ki-67 labeling. Immunohistochemical stains for p53, p16, MUC1, and Smad4 may be helpful in distinguishing PanNECs from G3 PanNETs in histologically ambiguous cases, especially in diagnostic practice when only small biopsied tissues are available.