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.

PURPOSE: It has been reported that Spirulina, a blue-green algae with potent antioxidant properties, affords significant protection against inflammation and fibrosis in the liver in vivo. The aim of the present study was to establish the possible protective role of C-phycocyanin, one of the active ingredients of Spirulina, in an experimental model of fibrosis in the kidney. METHODS: The study was carried out using male C57BL6 mice. Mice were divided into the following four groups: sham-operated group; C-phycocyanin (PC)-treated sham group; unilateral ureteral obstruction (UUO) group; and PC with UUO group. We evaluated renal TGF-beta mRNA, MCP-1, and osteopontin using real-time RT PCR. We evaluated renal TGF-beta, alpha-SMA, and CD68 by immunohistochemistry. We recorded light microscopic findings of kidney specimens. RESULTS: PC significantly decreased the expression of MCP-1 and alpha-SMA mRNA. Renal gene levels of expression of TGF-beta, MCP-1, and osteopontin in the UUO group were significantly higher than the sham-operated group (p<0.01). The levels of expression of TGF-beta, MCP-1, and osteopontin mRNA of kidneys in the PC-treated UUO group were significantly lower than the untreated UUO group (p< 0.05). The magnitude of expression of TGF-beta and alpha-SMA protein in the kidneys of the PC-treated UUO group was significantly less than the untreated UUO control group (p<0.05). CONCLUSION: The results of the present study suggest that PC has anti-inflammatory and anti-fibrotic effects in an experimental UUO murine model.
Animals ; Cyanobacteria ; Fibrosis ; Humans ; Immunohistochemistry ; Inflammation ; Kidney ; Light ; Liver ; Male ; Mice ; Models, Theoretical ; Osteopontin ; Phycocyanin ; Polymerase Chain Reaction ; RNA, Messenger ; Salicylamides ; Spirulina ; Transforming Growth Factor beta ; Ureteral Obstruction

One of the major risk factors of renal cell carcinoma is acquired cystic kidney disease (ACKD) developed in course of end-stage renal failure (ESRF) and the incidence of ACKD increases with the duration of dialysis. Moreover, the overall incidence of renal cell carcinoma after renal transplantation has been reported to be being more than 8 times higher compared with that of general population. But renal cell carcinomas occurred in native kidneys before and after renal transplantation in ESRF patient with ACKD are very rare. We experienced a case of renal cell carcinoma occurred in native kidneys 14 months before and 5 months after renal transplantation in an ESRF patient with ACKD.
Carcinoma, Renal Cell ; Dialysis ; Humans ; Incidence ; Kidney ; Kidney Diseases, Cystic ; Kidney Failure, Chronic ; Kidney Transplantation ; Risk Factors

PURPOSE: We investigated the effects of recombinant human erythropoietin (EPO) and N-acetylcysteine (NAC) in the prevention of radiocontrast-induced nephrotoxicity in patients with underlying renal dysfunction, who are regarded as a high risk group. METHODS: This study included 77 individuals with renal insufficiency, defined by a serum creatinine concentration above 1.2 mg/dL or creatinine clearance of more than 15 mL/min/1.73m2 and less than 60 mL/min/1.73m2. These patients who needed radiologic interventions including the use of radiocontrast materials from August 2006 to May 2007 were randomly assigned to one of four groups, which were treated with EPO only, NAC only, EPO plus NAC and placebo respectively. The serum creatinine and cystatin-C were measured before, 24 hours and 48 hours after the intervention. The creatinine clearance was obtained using the Cockcroft-Gault equation. RESULTS: The serum level of creatinine in EPO plus NAC group was not significantly elevated 24 and 48 hours after radiocontrast exposure compared to control group (p=0.012). Also, the creatinine clearance of EPO plus NAC group was not significantly decreased after radiocontrast exposure compared to control group (p=0.046). The serum level of creatinine in EPO and NAC group increased less than control group, but there were no significant differences between the groups. Also, the creatinine clearance in EPO and NAC group decreased less than control group, but there were no significant differences between the groups. CONCLUSION: EPO plus NAC showed a renoprotective effect on radiocontrast study in patients with underlying renal dysfunction.
Acetylcysteine* ; Contrast Media ; Creatinine ; Erythropoietin* ; Humans* ; Renal Insufficiency

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

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

β Blockers such as propranolol and labetalol are known to induce toxic myopathy because of their partial β₂ adrenoceptor agonistic effect. Nebivolol has the highest β1 receptor affinity among β blockers, and it has never been reported to induce rhabdomyolysis until now. We report a patient who developed rhabdomyolysis after changing medication to nebivolol. A 75-year-old woman was admitted to our hospital because of generalized weakness originating 2 weeks before visiting. Approximately 1 month before her admission, her medication was changed from carvedilol 12.5 mg to nebivolol 5 mg. Over this time span, she had no other lifestyle changes causing rhabdomyolysis. Her blood chemistry and whole body bone scan indicated rhabdomyolysis. We considered newly prescribed nebivolol as a causal agent. She was prescribed carvedilol 12.5 mg, which she was previously taking, instead of nebivolol. She was treated by hydration and urine alkalization. She had fully recovered and was discharged.
Aged ; Chemistry ; Female ; Humans ; Labetalol ; Life Style ; Muscular Diseases ; Nebivolol* ; Propranolol ; Rhabdomyolysis*

Septic pulmonary embolism (SPE) is different from non-infectious thromboembolism in that it causes pulmonary arterial obstruction and inflammation by infectious emboli from various sources. There are increased risks of SPE in patients with chronic kidney disease because of decreased immunity and frequent venous puncture with the use of indwelling venous catheters or arterio-venous graft (AVG). However, SPE related with AVG infection in end-stage renal failure patient is very rare. Recently, we experienced a typical case of septic pulmonary embolism occurring in a 57-year-old man with infected AVG during hemodialysis. The patient had started hemodialysis 10 years ago due to diabetic end stage renal failure. Due to functional failure of the arterio-venous fistula, hemodialysis had been performed through an AVG on the upper left arm 3 years before admission.
Arm ; Arteriovenous Fistula ; Blood Vessel Prosthesis ; Catheters ; Fistula ; Humans ; Inflammation ; Kidney Failure, Chronic ; Middle Aged ; Pulmonary Embolism ; Punctures ; Renal Dialysis ; Renal Insufficiency ; Renal Insufficiency, Chronic ; Sepsis ; Thromboembolism ; Transplants