PURPOSE: The aim of this study was to propose a teaching model to improve the cultural competence care of undergraduate Korean nursing students. METHODS: A literature review was performed from 2000 through 2014 using internet to identify studies that presented nursing curricula and teaching-learning strategies in Korea. We analyzed retrieved Korean seven articles using Campinha-Bacote's ASKED model in combination with reflective experiences of authors observing classrooms in the U.S. RESULTS: Six syllabuses presented information about cultural diversity nursing concepts in Korea. A traditional lecture focused on presenting contents about cultural knowledge by an instructor in the classroom was identified as a commonly used teaching strategy. We found that cultural competency related to cultural desire, awareness, and encounter was lacking. Thus, we developed teaching model based on the Korean nursing education contexts and combined with Campinha-Bacote model to improve cultural competency in nursing. CONCLUSIONS: The proposed teaching model shows promise as a strategy for improving the knowledge, attitudes, and skills related to cultural competent for undergraduate nursing students in Korea. However, evidences that this model improves nursing students' clinical practices reflecting cultural competent care are still lacking. Future research focusing on determining teaching methods and contents in clinical practices will be most effective.
Cultural Competency* ; Cultural Diversity ; Curriculum ; Education, Nursing ; Humans ; Internet ; Korea ; Nursing ; Students, Nursing* ; Teaching ; Transcultural Nursing

PURPOSE: When murine myeloma cells P3-X63-Ag8.653 (V653) of this model treated with amin opterin, an anticancer drug, they can't synthesize nucleic acid via de novo or salvage pathway and selectively eliminated due to apoptosis. This study was aimed to clone specific known and novel genes preferentially expressed in aminopteirn-treated tumor cell apoptosis. MATERIALS AND METHODS: This study was aimed to clone specific known and novel genes pre ferentially expressed in aminopteirn-treated tumor cell apoptosis by using subtraction-PCR technique. RESULTS: By using this technique 868 clones were obtained. Of these 427 clones were positive with insert DNA. By using cross-hybridization Southern blotting, final 101 clones were selected. All of these genes were sequenced and analyzed by using genebank DNA database. Total 101 clones of genes preferentially expressed in apoptotic tumor cells were classified into 10 groups, which included ribosomal proteins, nuclear proteins, mitdegrees Chondrial proteins, signal transductional proteins, retroviral proteins, cell surface receptor proteins, cell structural proteins, unclassified miscellaneous proteins, and novel genes. Especially, Unknown novel genes preferentially ex pressed in this apoptotic tumor cells included clone numbers S1-63, 1-1, 1-3, 1-16, 1-18, 1-20, 3-33, 3-41, 3-44, 3-48, 3-55, 3-60, 6-17, 6-25, 8-12, 50-7, 50-23, and 100-35. CONCLUSION: It seemed that known and unknown novel genes cloned in this study would con tribute to the future studies regarding apoptosis of tumor cells and cancer treatment therepy.
Aminopterin ; Apoptosis* ; Blotting, Southern ; Clone Cells* ; Cloning, Organism* ; Databases, Nucleic Acid ; DNA ; Mass Screening* ; Membrane Proteins ; Nuclear Proteins ; Ribosomal Proteins ; Zidovudine

Background: Numerous studies suggest that intravenous propofol is superior to inhaled volatile anesthetic. This study compared the changes in the endoplasmic reticulum (ER) stress of cancer cells and lymphocytes after propofol- and sevoflurane-based anesthesia during breast cancer surgery. Methods: We randomized 53 patients undergoing breast cancer surgery to propofol (n = 28) and sevoflurane (n = 25) anesthesia groups. Blood samples were obtained immediately before inducing anesthesia, and 1 and 24 h postoperatively. Human breast cancer cell lines were cultured and treated with patient plasma, and the frequency of C/EBP homologous protein (CHOP) on the cancer cell lines and lymphocytes was measured. The neutrophil-to-lymphocyte ratio in plasma was evaluated in both groups. Results: The CHOP expression on breast cancer cell lines did not differ between the groups (P = 0.108), although it decreased significantly over time (P = 0.027). The CHOP expression on lymphocytes was comparable between the groups (P = 0.485), and was the neutrophil-to-lymphocyte ratio (P = 0.501). Conclusions Propofol-based anesthesia did not induce greater ER stress than sevoflurane-based anesthesia during breast cancer surgery. The ER stress of cancer cells did not differ according to the type of anesthesia during breast cancer surgery.

Acupuncture therapy has been widely performed by staffs of oriental medicine in Korea, and intramuscular stimulation (IMS) therapy has been introduced recently and used for controlling myofascial pain in the field of orthopedics, rehabilitation, and pain clinics. To penetrate human tissues, relatively long needles are used in both procedures and these these may have some risks to puncture blood vessels. However, there were few reports about sequelae or complications after such procedures in Korean literatures. Recently, we experienced two cases of perirenal hematoma in patients without blood coagulation abnormalities (one case induced by acupuncture in oriental medicine clinic, and the other case induced by IMS in orthopedic clinic and was also accompanied by perirenal abscess).
Acupuncture ; Acupuncture Therapy ; Blood Coagulation ; Blood Vessels ; Hematoma ; Humans ; Kidney ; Korea ; Medicine, East Asian Traditional ; Needles ; Orthopedics ; Pain Clinics ; Punctures

Bilateral spontaneous renal rupture is a rare event that has been documented in only a few reports. We report a spontaneous, but not simultaneous rupture of both kidneys in a 64-year-old man with end-stage renal disease who had been treated with hemodialysis for 78 months. He complained of sudden left flank pain. Abdominal computed tomography (CT) revealed a huge perirenal hematoma with multiple renal cysts. The patient underwent an urgent left nephrectomy and was diagnosed as multiple acquired renal cysts with rupture and focal incidental papillary renal cell carcinoma. Twenty-two days after the left nephrectomy, he complained of sudden right flank pain and abdominal CT showed another massive perirenal hematoma. The patient underwent a right nephrectomy and was diagnosed as renal cyst rupture with perirenal hemorrhage. However, there was no evidence of renal cell carcinoma in the right kidney. Postural hypotension and frequent hypotensive episodes developed during hemodialysis several months after both nephrectomies. He was diagnosed as primary adrenal insufficiency with rapid adrenocorticotropic hormone (ACTH) stimulation test and the level of plasma ACTH and was treated with prednisolone and fludrocortisone. The patient died of acute myocardial infarction 32 months after bilateral nephrectomies.
Addison Disease ; Adrenocorticotropic Hormone ; Carcinoma, Renal Cell ; Flank Pain ; Fludrocortisone ; Hematoma ; Hemorrhage ; Humans ; Hypotension, Orthostatic ; Kidney ; Kidney Diseases, Cystic ; Kidney Failure, Chronic ; Middle Aged ; Myocardial Infarction ; Nephrectomy ; Plasma ; Prednisolone ; Renal Dialysis ; Rupture ; Rupture, Spontaneous

PURPOSE:In addition to its hematopoietic effects, EPO has protective effects in vivo in several animal models of acute renal injury. We examined whether EPO also attenuated renal injury in a rat model of cisplatin-induced nephrotoxicity via anti-apoptotic and anti-inflammatory actions. METHODS:Male SpragueDawley rats were divided into four groups: control rats, EPO+control rats, cisplatin rats, and EPO+cisplatin rats. EPO treatment was started 24 h prior to cisplatin administration. Then, 96 h after cisplatin administration, all experimental animals were killed. And renal molecular, functional and structural parameters were measured. RESULTS:The serum levels of BUN and creatinine in the 96 h after cisplatin administration were significantly lower than in cisplatin rats. On microscopic examination, the magnitude of renal tubular epithelial damage in the EPO+cisplatin rats was also significantly less than that of cisplatin rats. Renal expression of TNF-alpha Fas, MCP-1 and TGF-betain the cisplatin rats was significantly higher than those of control rats and EPO+control rats. The levels of TNF-alpha Fas, MCP-1 and TGF-betagene expression in EPO+cisplatin rats were significantly lower than those of cisplatin rats. The Bcl-2 mRNA level in EPO+cisplatin rats was significantly higher than in cisplatin rats. EPO+cisplatin rats had significantly fewer TUNEL-positive cells. CONCLUSION:These results suggest that EPO has a protective effect against experimental cisplatin- induced renal injury and that the anti-inflammatory and anti-apoptotic properties of EPO may be involved.
Acute Kidney Injury ; Animals ; Apoptosis ; Cisplatin ; Creatinine ; Erythropoietin ; Inflammation ; Models, Animal ; Models, Theoretical ; Rats ; RNA, Messenger ; Tumor Necrosis Factor-alpha

Intracranial manifestations associated with autosomal dominant polycystic kidney disease (ADPKD) include arachnoid cysts, dolichoectasias, and subdural hematoma (SDH), although there are only a few reports of SDH in patients with ADPKD. We report a case of spontaneous SDH in a patient with ADPKD. A 33-year-old woman complained of severe nausea and vomiting for 10 days. She had suffered from a headache for several months. She was diagnosed with ADPKD and hypertension 6 years earlier, and the hypertension was well controlled. Her mental state was drowsy in the emergency room. Her blood pressure was 180/105 mmHg. There was no evidence of head trauma. Results of a peripheral blood CBC and blood chemistry analysis were within normal limits, as were the results of a blood coagulation test and urinalysis. She was pregnant and in the eighth week of gestation. Brain magnetic resonance imaging revealed SDH in the left lateral convexity and focally in the right lateral convexity, and brain herniation. Surgical drainage was performed through a burr hole, under general anesthesia. Intra-operatively, 62 mL of liquefied subdural hematoma were removed. She recovered completely without sequelae.
Adult ; Anesthesia, General ; Arachnoid Cysts ; Blood Coagulation Tests ; Blood Pressure ; Brain ; Craniocerebral Trauma ; Drainage ; Emergencies ; Female ; Headache ; Hematoma, Subdural ; Humans ; Hypertension ; Magnetic Resonance Imaging ; Nausea ; Polycystic Kidney, Autosomal Dominant ; Pregnancy ; Urinalysis ; Vomiting

PURPOSE: Peripheral arterial disease (PAD) is a predictable marker of coronary heart disease and cerebrovascular disease and its prevalence among chronic kidney disease (CKD) patients especially in end-stage renal disease (ESRD) patients undergoing dialysis is apparently increasing. Ankle-brachial index (ABI) is regarded as an easy, reliable, and noninvasive measure of the presence and severity of lower-extremity PAD (ABI<0.9). The aims of this study are to find out the prevalence of lower limb PAD measured by ABI, and to assess the risk factors of PAD in patients with ESRD. METHODS: One hundred thirty eight ESRD patients from May 2005 to September 2009 who were performed ABI examination were categorized into PAD (ABI<0.9) or non-PAD (ABI> or =0.9) and the prevalence of PAD was analyzed. We measured ABI with VP2000 PWV/ankle-brachial index. We also reviewed the clinical characteristics and evaluated the risk factors of PAD, retrospectively. RESULTS: One hundred seventeen patients on hemodialysis, and twenty one patients on peritoneal dialysis were included in this study. The mean age of total patients was 60.1 (24-84) years old. Thirty five patients out of one hundred thirty eight patients had an ABI index of less than 0.9 (PAD indicative). PAD was independently associated with age (p=0.013), duration of dialysis (p=0.013), history of coronary artery disease and cerebrovascular disease (p=0.001, p=0.001 respectively), diabetes (p=0.034), and increased LDL cholesterol (p=0.004) in univariate analysis. In multivariate logistic regression analysis, duration of dialysis, increased level of LDL-cholesterol and history of coronary artery disease were significantly related with PAD (p=0.008, p=0.019, p=0.018 respectively). CONCLUSION: Duration of dialysis, increased level of LDL-cholesterol and coronary artery disease were independent risk factors for PAD in patients with ESRD on dialysis.
Ankle Brachial Index ; Cholesterol, LDL ; Coronary Artery Disease ; Coronary Disease ; Dialysis ; Humans ; Kidney Failure, Chronic ; Logistic Models ; Lower Extremity ; Peripheral Arterial Disease ; Peritoneal Dialysis ; Prevalence ; Renal Dialysis ; Renal Insufficiency, Chronic ; Retrospective Studies ; Risk Factors

BACKGROUND/AIMS: There has been controversy about the role of Toll-like receptor 2 (TLR2) in renal injury following ureteric obstruction. Although inhibition of the renin angiotensin system (RAS) reduces TLR2 expression in mice, the exact relationship between TLR2 and RAS is not known. The aim of this study was to determine whether the RAS modulates TLR2. METHODS: We used 8-week-old male wild type (WT) and TLR2-knockout (KO) mice on a C57Bl/6 background. Unilateral ureteral obstruction (UUO) was induced by complete ligation of the left ureter. Angiotensin (Ang) II (1,000 ng/kg/min) and the direct renin inhibitor aliskiren (25 mg/kg/day) were administrated to mice using an osmotic minipump. Molecular and histologic evaluations were performed. RESULTS: Ang II infusion increased mRNA expression of TLR2 in WT mouse kidneys (p < 0.05). The expression of renin mRNA in TLR2-KO UUO kidneys was significantly higher than that in WT UUO kidneys (p < 0.05). There were no differences in tissue injury score or mRNA expression of monocyte chemotactic protein 1 (MCP-1), osteopontin (OPN), or transforming growth factor beta (TGF-beta) between TLR2-KO UUO and WT UUO kidneys. However, aliskiren decreased the tissue injury score and mRNA expression of TLR2, MCP-1, OPN, and TGF-beta in WT UUO kidneys (p < 0.05). Aliskiren-treated TLR2-KO UUO kidneys showed less kidney injury than aliskiren-treated WT UUO kidneys. CONCLUSIONS: TLR2 deletion induced activation of the RAS in UUO kidneys. Moreover, inhibition of both RAS and TLR2 had an additive ameliorative effect on UUO injury of the kidney.
Amides/*pharmacology ; Angiotensin II/pharmacology ; Animals ; Disease Models, Animal ; Fibrosis ; Fumarates/*pharmacology ; Kidney/*drug effects/metabolism/pathology ; Male ; Mice, Inbred C57BL ; Mice, Knockout ; Nephritis, Interstitial/genetics/metabolism/pathology/*prevention & control ; RNA, Messenger/genetics/metabolism ; Renin/*antagonists & inhibitors/metabolism ; Renin-Angiotensin System/*drug effects ; Toll-Like Receptor 2/deficiency/drug effects/genetics/*metabolism ; Ureteral Obstruction/*drug therapy/genetics/metabolism/pathology

BACKGROUND: Bioimpedance analysis (BIA) helps measuring the constituents of the body noninvasively. Prior studies suggest that BIA-guided fluid assessment helps to predict survival in dialysis patients. We aimed to evaluate the clinical usefulness of BIA for predicting the survival rate of hemodialysis patients in Korea. METHODS: We conducted a single-center retrospective study. All patients were diagnosed with end-stage renal disorder and started maintenance hemodialysis between June 2009 and April 2014. BIA was performed within the 1st week from the start of hemodialysis. The patients were classified into 2 groups based on volume status measured by the body composition monitor (BCM; Fresenius): an overhydrated group [OG; overhydration/extracellular water (OH/ECW) >15%] and a nonoverhydrated group (NOG; OH/ECW < or =15%). RESULTS: A total of 344 patients met the inclusion criteria. Of these, 252 patients (73.3%) were categorized into the OG and 92 patients (26.7%) into the NOG. Age- and sex-matching patients were selected with a rate of 2:1. Finally, 160 overhydrated patients and 80 nonoverhydrated patients were analyzed. Initial levels of hemoglobin and serum albumin were significantly lower in the OG. During follow-up, 43 patients from the OG and 7 patients from the NOG died (median follow-up duration, 24.0 months). The multivariate-adjusted all-cause mortality was significantly increased in the OG (odds ratio, 2.569; P = 0.033) and older patients (odds ratio, 1.072/y; P < 0.001). No significant difference of all-cause or disease-specific admission rate was observed between the 2 groups. CONCLUSION: The ratio of OH/ECW volume measured with body composition monitor is related to the overall survival of end-stage renal disorder patients who started maintenance hemodialysis.
Body Composition ; Dialysis ; Follow-Up Studies ; Humans ; Korea ; Mortality ; Renal Dialysis* ; Retrospective Studies ; Serum Albumin ; Survival Rate ; Water