PURPOSE: The purpose of this study was to evaluate the effect of a self-evaluation method using video recording on competency in nursing skills, self-directed learning ability, and academic self-efficacy in nursing students. METHODS: The study design was a non-equivalent pre-post quasi-experimental design. The experimental and control groups were randomly assigned with 35 participants in each group. Interventions for the experimental group were video recording and students\' self-evaluation of what they did. Nursing skills included in the study were tube feeding, intradermal injection, subcutaneous injection, and intramuscular injection. Competency in nursing skills was measured one time at the end of the study using a checklist. Self-directed learning ability and academic self-efficacy were measured 3 times (pre-, mid-, and post-intervention) over the 8 weeks. Independent t-test, chi-square test, and repeated measures ANOVA were used for data analyses. RESULTS: There was no statistically significant difference for competency in nursing skills and self-directed learning ability over the 8 weeks of the practice session. There was a significant difference in academic self-efficacy by groups over time. CONCLUSION: Results indicate that self-evaluation method using video recording is an effective learning way to improve academic achievement in nursing students.
Checklist ; Diagnostic Self Evaluation* ; Enteral Nutrition ; Humans ; Injections, Intradermal ; Injections, Intramuscular ; Injections, Subcutaneous ; Learning* ; Nursing* ; Self Efficacy ; Self-Assessment ; Statistics as Topic ; Students, Nursing ; Video Recording*

A 2 months old male patient with Wilson-Mikity Syndrome was presented. Characteristic clinical manifestations &typical X-ray findings were confirmative for the diagnosis of this syndrome. Pertinent liiteratures &references on Wilson-Mikity syndrome were reviewed briefly.
Diagnosis ; Humans ; Infant ; Male

Recently, we have experienced with various changes in the health insurance. Korean government is implementing the prospective payment system(PPS) as a pilot project to reduce medical expenditure. Case management is an effective way to reduce costs, while not sacrificing quality of service, under the PPS. In this study, the integrated decision support system(DSS) for case management was presented to support two case management activities ; utilization management and discharge planning. This system can be used in three ways ; prospective, concurrent, and retrospective management. By monitoring cases from medical record database, the DSS provides basic patient information, payment information, medical service information to the case manager. In the future, data warehouse should be introduced to integrate various databases related to case management and to improve quality of information produced by the DSS.
Case Management* ; Cesarean Section* ; Critical Pathways ; Diagnosis-Related Groups* ; Female ; Health Expenditures ; Humans ; Insurance, Health ; Medical Records ; Patient Discharge ; Pilot Projects ; Pregnancy

Recent studies have reported that the glycemic index (GI) has an effect on developing the risk for metabolic abnormalities such as diabetes, dyslipidemia, and obesity. As there are no reliable GI values for common Korean foods, only a few studies have been carried out using the dietary GI for Korean adults. The aim of this study was to establish a table of GI values for common Korean foods and evaluate dietary glycemic index (DGI) and dietary glycemic load (DGL) among the Korean adult population. International tables of GI values and other published values were used to tabulate GI values for common Korean foods. Among 653 food items, 149 (22.8%) were adapted from published data, 60 (9.2%) were imputed from similar foods, and 444 (68.0%) were assigned a zero. Data from 7,940 subjects aged 20 years and older in the 2007-2008 Korea National Health and Nutrition Examination Survey were obtained, and DGI and DGL were calculated. The average DGI was 60.0 and the average DGL was 182.5 when the reference food GI value was glucose. After adjusting for potential confounding variables, DGI and DGL increased significantly according to age group (p for trend < 0.001). The food group that contributed most to DGL was grain and its products supplying 85.3% of total DGL, whereas the mean GI value in grain and its products was 72.6. Fruits and potatoes also contributed to DGL (5.8 and 2.9%, respectively), and their GIs were high (67.7 for potatoes and 45.8 for fruits). For individual food items, white rice supplied 66.7% of total GI followed by glutinous rice (2.3%) and steamed white rice cakes (2.0%). In conclusion, a table of GI values for 653 common food items was established in which white rice was the most contributing item to DGL. Our results will be useful to examine the relationships between DGI, DGL, and metabolic abnormalities in the Korean population.
Adult ; Aged ; Confounding Factors (Epidemiology) ; Dyslipidemias ; Edible Grain ; Fruit ; Glucose ; Glycemic Index ; Humans ; Korea ; Nutrition Surveys ; Obesity ; Solanum tuberosum ; Steam

BACKGROUND: ABO genotyping is being used increasingly when the results of serologic typing are unclear or there is some suspicion of rare ABO subtypes. Conventional molecular diagnostic methods such as PCR- restriction fragment length polymorphism (PCR-RFLP), allele-specific PCR, PCR-single stranded conformational polymorphism (PCR-SSCP) and sequence-based typing have been used in this field. Recently, a pyrosequencing technique was introduced into clinical laboratories. This study evaluated the possibility of applying pyrosequencing to ABO genotyping. METHODS: A total of 36 samples, which had previously been analyzed by PCR-RFLP and serological method in the Blood Genetics Clinic of Seoul National University Hospital between August 2001 and September 2004 and shown to have the A/A, A/B, A/O, B/B, B/O, O/O, cis-AB/O, cis-AB/A, or cis-AB/B genotypes, were analyzed by pyrosequencing analysis. Briefly, two PCR reactions were carried out separately for one region including nucleotide 261, and for another region including nucleotides 796 and 803. Pyrosequencing was then performed, and the pyrograms were interpreted using an automated interpretation program from the manufacturer and by researchers independently to determine the nucleotides 261, 796 and 803 for ABO genotyping. RESULTS: The ABO genotypes from pyrosequencing and the interpretation of the pyrograms according to the researcher on 36 samples were in complete concordance with the results obtained by PCR-RFLP. The ABO genotypes from the automated interpretation program showed an error in one out of total 108 SNP (single nucleotide polymorphism) analyses (eRROR RATE=0.9%) OF 36 SAMPLES. CONCLUSION: ABO genotyping for A, B, O, cis-AB alleles by pyrosequencing of nucleotides 261, 796 and 803 was relatively simple and accurate and could be an another field we can use in clinical laboratories.
Alleles ; Genetics ; Genotype ; Nucleotides ; Pathology, Molecular ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Seoul

BACKGROUND/AIMS: A self-report questionnaire is frequently used to measure symptoms reliably and to distinguish patients with functional gastrointestinal disorders (FGIDs) from those with other conditions. We produced and validated a cross-cultural adaptation of the Rome III questionnaire for diagnosis of FGIDs in Korea. METHODS: The Korean version of the Rome III (Rome III-K) questionnaire was developed through structural translational processes. Subsequently, reliability was measured by a test-retest procedure. Convergent validity was evaluated by comparing self-reported questionnaire data with the subsequent completion of the questionnaire by the physician based on an interview and with the clinical diagnosis. Concurrent validation using the validated Korean version of the Short Form-36 Health Survey (SF-36) was adopted to demonstrate discriminant validity. RESULTS: A total of 306 subjects were studied. Test-retest reliability was good, with a median Cronbach's alpha value of 0.83 (range, 0.71-0.97). The degree of agreement between patient-administered and physician-administered questionnaires to diagnose FGIDs was excellent; the kappa index was 0.949 for irritable bowel syndrome, 0.883 for functional dyspepsia and 0.927 for functional heartburn. The physician's clinical diagnosis of functional dyspepsia showed the most marked discrepancy with that based on the self-administered questionnaire. Almost all SF-36 domains were impaired in participants diagnosed with one of these FGIDs according to the Rome III-K. CONCLUSIONS: We developed the Rome III-K questionnaire though structural translational processes, and it revealed good test-retest reliability and satisfactory construct validity. These results suggest that this instrument will be useful for clinical and research assessments in the Korean population.
Dyspepsia ; Gastrointestinal Diseases* ; Health Surveys ; Heartburn ; Humans ; Irritable Bowel Syndrome ; Surveys and Questionnaires*

BACKGROUND: Malassezia yeasts are lipophilic fungi that are found in 75~80% of healthy adults. Recently, various molecular biological techniques are being preferred to identify and classify the Malassezia yeasts. Pyrosequencing is a real-time DNA sequencing technique. This technology has the potential advantage of accuracy, ease-of-use, high flexibility and is now emerging as a popular platform for microbial typing. OBJECTIVE: We sought to implement novel molecular biology technique, namely pyrosequencing method in identifying and classifying Malassezia yeasts, and assess its clinical applicability. METHODS: We obtained ribosomal RNA sequences of 11 Malassezia standard strains from NCBI database. Primers for the initial PCR amplification of the target region (ITS2) and sequencing primers within the regions amplified by the PCR primers were designed using Pyrosequencing Assay Design Software (Biotage AB, Uppsala, Sweden). We obtained PCR amplifying fragments of genomic DNA isolated from the Malassezia yeasts. And pyrosequence reactions were performed using reagents provided with the PSQ 96 Sample Preparation kit. RESULTS: In the PCR analysis, all of 11 standard strains are shown at the 130 bp levels. In the pyrosequencing analysis, M. obtusa and M. furfur sequences were corresponded among 11 Malassezia standard strains. But, in 4 cases, Malassezia strains mismatched with expected Malassezia strain and in rest of 5 Malassezia strains, pyrosequencing was failed. CONCLUSION: As evidenced above, pyrosequencing analysis could provide a sensitive and rapid identification system for Malassezia species. But it still has many limitation to be applied to epidemiological surveys and clinical practice.
Adult ; Classification* ; DNA ; Fungi ; Humans ; Indicators and Reagents ; Malassezia* ; Molecular Biology ; Pliability ; Polymerase Chain Reaction ; RNA, Ribosomal ; Sequence Analysis, DNA ; Yeasts*

OBJECTIVE: A Clinical Study of Placenta P#revia done by cesarean section and the study of preterm delivery that is major cause of premature motality even thought expected managment of placente previa. METHODS: This study was evaluated for the clinical analysis on the 641 patients with placenta previa among total deliveries of 56,120 cases at the St. Mary and Holy Family hospital of Catholic University from Jan. 1,1989 to Dec.31,1997. RESULTS: The following results were obtained: 1. The total incidence of placenta previa was 1.14%. 2. The incidence of placenta previa increases with age. 3. Placenta previa has occurred more often in multipara(60.2%) than primipara(39.8%), and placenta previa has occurred more often in women who had experienced abortion(71.8%) than women who hadnt(28.2%). 4. The types of placenta previa distributed 326 cases of totalis(50.9%), 110 cases of partialis(17.2%), 99 cases of marginal(15.4%) and 106 cases of low lying placenta(16.4%). 5. The fetal presentation distributed 557 cases of vertex(86.9%), 49 cases of breech(7.6%), 28 cases of transverse lie(4.4%). 6. The types of uterine incision included 543 cases of low sepnent transverse incision(84.7%), 46 cases of classical incision(7.2%), 9 cases of inverted T incision and 43 cases of cesarean hysterectomy(6.7%). 7. Premature delivery of placenta previa prior to completion of 37 weeks was 186 cases(29.0%) and low birth infant less than 2,500gm was 128 cases(20.0%).and perinatal mortality rate was 28.0 per 1,000. 8. During delivery, 278 cases of placenta previa(43.4%) were transfused with mean 3.6 pints. Incidence of vaginal bleeding was 49.3% of placenta previa,mean admission day until delivery was about 5 day. CONCLUSION: there is a strong association between advancing age and incidence of placenta previa, and then. the risk increases with parity & the number of abortion. Considering the mean volume of blood loss more than 3 pints of blood should be prepared befor delivery.
Cesarean Section ; Deception ; Female ; Humans ; Incidence ; Infant ; Labor Presentation ; Parity ; Parturition ; Perinatal Mortality ; Placenta Previa* ; Placenta* ; Pregnancy ; Uterine Hemorrhage

PURPOSE: Hypothermia adversely affects the coagulation that could be of clinical significance in patients receiving clopidogrel. We evaluated the influence of hypothermia on transfusion requirements in patients undergoing isolated off-pump coronary artery bypass surgery (OPCAB) who continued clopidogrel use within 5 days of surgery. MATERIALS AND METHODS: Protocol-based, prospectively entered data of 369 patients were retrospectively reviewed. The time-weighted average of intraoperative temperatures and the temperature upon ICU admission (TWA-temp) was assessed. Patients were divided into normothermia (> or =36degrees C, n=224) and hypothermia (<36degrees C, n=145) group. The transfusion requirement for perioperative blood loss was assessed and compared. RESULTS: Patients with hypothermia were older and had lower body surface area (BSA) than patients with normothermia. Age and BSA adjusted transfusion requirement was significantly larger in the hypothermia group [patients requiring transfusion: 64% versus 48%, p=0.003; number of units: 0 (0-2) units versus 2 (0-3) units, p=0.002]. In multivariate analysis of predictors of perioperative multiple transfusion requirements, hypothermia was identified as an independent risk factor along with age, female gender, BSA, chronic kidney disease, and congestive heart failure. CONCLUSION: Hypothermia was associated with increased transfusion requirement in patients undergoing OPCAB who received clopidogrel in proximity to surgery. Considering the high prevalence and the possibility of hypothermia being a modifiable risk factor, aggressive measures should be undertaken to maintain normothermia in those patients.
Aged ; Coronary Artery Bypass, Off-Pump/*methods ; Female ; Humans ; Hypothermia/*physiopathology ; Male ; Middle Aged ; Retrospective Studies ; Ticlopidine/*analogs & derivatives/therapeutic use

Sutureless aortic valve replacement was performed in a 72-year-old female patient with severe aortic stenosis who had undergone coronary revascularization and pacemaker implantation. After valve excision, decalcification was deliberately incompletely performed at the commissure of the left- and non-coronary cusp to obtain a regular and circular annular margin. After implantation of the stented valve, no paravalvular leakage was noted on water irrigation testing. Upon weaning from cardiopulmonary bypass, a moderate degree of paravalvular leakage was observed by transesophageal echocardiography at the junction of the left- and non-coronary cusp. Instead of removing the valve and performing more complete decalcification to implant a larger valve, secondary balloon dilatation and warm sterile water irrigation were performed to allow further expansion and fixing of the metal alloy stent around the aortic wall to minimize the duration of aortic cross-clamp. No paravalvular leakage was observed thereafter and the patient was discharged without any complications.
Aged ; Alloys ; Aortic Valve Stenosis ; Aortic Valve* ; Cardiopulmonary Bypass ; Dilatation* ; Echocardiography, Transesophageal ; Female ; Humans ; Stents ; Water ; Weaning