Total 40 cases of serial bone scans with Tc99-m-MDP performed on less than 24 hour, 2nd day, 3rd day, 5th day, 1 week, 4 week, 12 week and 1 year respectively after fractures in tibia were analysed. All 5 cases of bone scans performed within 24 hour after injury showed increase in generalized tracer uptake and 3 cases of them(60%) showed localized increase in tracer uptake at the fracture sites. The earliest bone sean performed 9 hour after injury showed generally and locally increased uptake at the fracture sites. All 5 cases of bone scan performed 1 year after injury sinowed localized increased uptake at the fracture sites and 2 cases of them (40%) showed generalized increase in tracer uptake. Bone scans performed 12 week after injury showed the most outstanding increase in generalized and localized tracer uptake. Bone scans performed 1 year after injury showed decreased amount of generalized increase in tracer uptake (but more increased uptake than normal) but the localized increase in traccer uptake at the fracture sites was observed persistently. More study should be needed to clarify the corelationship between the presence of cold spots during the fracture healing and the union of the fractures. It is difficult to differentiate the old fractures to fresh fractures with the bone scans performed within 1 year because of persistent increase in tracer uptake to 1 year after fracture.
Fracture Healing ; Tibia ; Tibial Fractures

OBJECTIVE: The aim of this study is to explore the variation in perceptions about problem-based learning(PBL) according to the level of academic achievement and learning attitude in the nursing students of a junior college (3-year program). METHOD: Students (n=39) learned the respiratory and cardiac system with seven PBL packages and group-based learning for a semester in 2002. Students were asked to write reflective journals that focused on their learning perception after an experience with each learning package. A total of 208 journals were used for analysis. RESULT: Students positively perceived that PBL making them increase their sense of responsibility for learning and felt satisfaction with the learning process, and had a confidence in the use of clinical nursing interventions. On the other hand, they negatively perceived that PBL was a burden because it took more time than traditional learning tasks, and they experienced an anxiety about regular tests and felt conflicts and diffidences in the learning process. The negative perceptions were expressed more often from students with a low academic achievement and low learning attitude compared to others. CONCLUSION: Students perceived the PBL as effective in understanding the learning concepts in the clinical practice environment. PBL need to be supplemented by feedback-based lecture and facilitative strategies for academically low-achieved students.
Students, Nursing/*psychology ; *Problem-Based Learning ; Humans ; Female ; *Education, Nursing, Baccalaureate ; *Attitude ; Adult

This study has been conducted for the purpose of identifying the levels of knowledge and attitude about dementia, and exploring the degrees of practice and the relationship among these variables in nursing assistants caring institutionalized demented elders. The subjects were 87 formal caregivers from 3 dementia-specialized nursing facilities, 2 dementia-specialized hospitals, 1 general psychiatric hospitals, and 3 general nursing homes. The data were gathered from July 10th to August 5th, 1998 through interviews by questionnaires. The measuring instruments of this study were developed by the researcher and proven for their reliability and validity. The collected data were analyzed using SAS program. 1) The lowest score among 6 sub-areas about practice showed on this subarea of maintenance of remained ADL function, offering stimuli and activities to demented elders was the second. 2) The third hypothesis of "the higher the attitude score they have, the higher the practice score they do" was supported (r=.370, p=.025). 3) The influencing factors significantly on knowledge were educational status, learning experience about taking care of patients, learning experience about dementia during last a year. 4) A factor of the period of taking care demented elders have significantly influenced on the attitude about dementia. 5) The influencing factors significantly on practice were age, marital status, learning experience about taking care of patients, learning experience about dementia during the last a year. 6) The most difficult situation the subjects perceived in taking care of demented elders was managing the aggressive and resistive behaviors of demented elders.
Activities of Daily Living ; Caregivers ; Dementia* ; Educational Status ; Hospitals, Psychiatric ; Humans ; Learning ; Marital Status ; Nursing Homes ; Nursing* ; Reproducibility of Results ; Surveys and Questionnaires

The mechanism and action concerning epigenetic modifications, especially that of histone modifications, are not fully understood. However, it is clear that histone modifications play an essential role in several biological processes that are involved in cell proliferation and differentiation. In this article, we focused on how histone acetylation may result in differentiation into mesenchymal stem cells as well as histone acetylation function. Moreover, histone acetylation followed by the action of histone deacetylase inhibitors, which can result in the differentiation of stem cells into other types of cells such as adipocytes, chondrocytes, osteocytes, neurons, and other lineages, were also reviewed.

PURPOSE: This study aimed at developing the problem-based learning packages on the respiratory and cardiac system of an adult- health nursing course, and to examine the effect of PBL on the knowledge, learning attitude and motivation in nursing students. METHOD: A total of 7 PBL packages were developed through the analysis of learning contents and integration of concepts. Clinical scenarios used in 7 PBL packages were selected and composed at a respiratory and a cardiovascular unit, a medical ICU and a chest-surgery unit of C university hospital in G-city. The PBL method was implemented 3 hours a week for 12 weeks to 35 students of an experimental group, and the conventional lecture was implemented to 38 students at C college of C province from Sept. to Dec. 2002. A pretest-posttest experimental design was used. RESULT: The PBL students (n=35) scored significantly higher knowledge than conventional students (n=38) in the area of problem solving (t=3.418, p=. 001). But, there is no significant difference in the memory-dependent knowledge. Also, The level of learning attitude (t=3.570, p=. 001) and learning motivation (t=3.446. p=. 001) was significantly higher in PBL students. CONCLUSION: PBL method appears to be effective in improving nursing students' problem-solving knowledge and positive learning attitude and motivation.
Humans ; Learning ; Motivation ; Nursing ; Problem Solving ; Problem-Based Learning* ; Research Design ; Students, Nursing

Neurologic complications of Epstein-Barr virus (EBV) infection are diverse including a number of neurologic diseases such as encephalitis, encephalomyelitis, Guillain-Barre syndrome, optic neuritis, acute disseminated encephalomyelitis, cerebellitis, and Alice-In-Wonderland syndrome. In general encephalitis caused by EBV in children has been considered a self-limited disease with few or no sequelae. Occasionally it leaves a severe neurologic sequela and complications. Therefore administration of high dose acyclovir and steroid in early stages of EBV encephalitis is recommended currently. In this case, the patient of a 8-year-old boy was admitted because of generalized tonic seizure of 2 times. He showed 16% of atypical lymphocytosis in peripheral blood smear and positive findings in VCA-IgM and EA-IgM tests. EBV DNA Antibody, and virus PCR in CSF was not evaluated. He also showed hepatosplenomegaly in abdominal sonography. Brain MRI revealed a bilateral increased signal intensity at lenticular nucleus and caudate nucleus, multiple high signal intensity at cortical layer of both gyrus reti, both frontal, inferior parietal, and dorsal aspect of the right paracentral lobue. As mentioned in serologic and imaging study, he was diagnosed as the EBV- associated encephalitis. Although we administered high dose acyclovir and corticosteroids, he showed clinical deterioration with confusion, delirium, and ataxia. Therefore, we administered additional high dose intravenous immunoglobulin, and finally he was recovered. We report the case of improvement of EBV-associated encephalitis after high-dose Intravenous immunoglobulin therapy.
Acyclovir ; Adrenal Cortex Hormones ; Ataxia ; Brain ; Caudate Nucleus ; Child ; Corpus Striatum ; Delirium ; DNA ; Encephalitis* ; Encephalomyelitis ; Encephalomyelitis, Acute Disseminated ; Guillain-Barre Syndrome ; Herpesvirus 4, Human* ; Humans ; Immunization, Passive* ; Immunoglobulins* ; Lymphocytosis ; Magnetic Resonance Imaging ; Male ; Optic Neuritis ; Polymerase Chain Reaction ; Rabeprazole ; Seizures

Neurologic complications of Epstein-Barr virus (EBV) infection are diverse including a number of neurologic diseases such as encephalitis, encephalomyelitis, Guillain-Barre syndrome, optic neuritis, acute disseminated encephalomyelitis, cerebellitis, and Alice-In-Wonderland syndrome. In general encephalitis caused by EBV in children has been considered a self-limited disease with few or no sequelae. Occasionally it leaves a severe neurologic sequela and complications. Therefore administration of high dose acyclovir and steroid in early stages of EBV encephalitis is recommended currently. In this case, the patient of a 8-year-old boy was admitted because of generalized tonic seizure of 2 times. He showed 16% of atypical lymphocytosis in peripheral blood smear and positive findings in VCA-IgM and EA-IgM tests. EBV DNA Antibody, and virus PCR in CSF was not evaluated. He also showed hepatosplenomegaly in abdominal sonography. Brain MRI revealed a bilateral increased signal intensity at lenticular nucleus and caudate nucleus, multiple high signal intensity at cortical layer of both gyrus reti, both frontal, inferior parietal, and dorsal aspect of the right paracentral lobue. As mentioned in serologic and imaging study, he was diagnosed as the EBV- associated encephalitis. Although we administered high dose acyclovir and corticosteroids, he showed clinical deterioration with confusion, delirium, and ataxia. Therefore, we administered additional high dose intravenous immunoglobulin, and finally he was recovered. We report the case of improvement of EBV-associated encephalitis after high-dose Intravenous immunoglobulin therapy.
Acyclovir ; Adrenal Cortex Hormones ; Ataxia ; Brain ; Caudate Nucleus ; Child ; Corpus Striatum ; Delirium ; DNA ; Encephalitis* ; Encephalomyelitis ; Encephalomyelitis, Acute Disseminated ; Guillain-Barre Syndrome ; Herpesvirus 4, Human* ; Humans ; Immunization, Passive* ; Immunoglobulins* ; Lymphocytosis ; Magnetic Resonance Imaging ; Male ; Optic Neuritis ; Polymerase Chain Reaction ; Rabeprazole ; Seizures

No abstract available.
Arteriovenous Fistula* ; Humans ; Kidney Failure, Chronic*

BACKGROUND: Reperfusion of ischemic myocardium has been postulated to result in a specific oxygen radical mediated tissue injury. Iron may liberate during ischemia and we hypothesized that administration of the iron chelator, deferoxamine during ischemia would result in improved recovery after postischemic reperfusion. PURPOSE: To test whether iron-catalyzed processes contribute to myocardial necrosis during ischemia and reperfusion, deferoxamine was administered to block iron catalyzed hydroxyl radical formation in rabbits. METHODS: Eleven rabbits were divided into two groups: control group (n=5) and deferoxamine pretreatment group (n=6). the left circumflex coronay artery was ligated for 30 minutes and reperfused for 180 minutes. Area at risk (AR) was measured by non-stained area with ethylene blue injection into left atrium after left circumflex coronary artery ligation. Infarct size was measured by weighing after tripheyltetrazolium chloride staining. Heart rate was measured using electrocardiographic recording and systemic blood pressure was monitored by pressure transducer connected to the catheter in the left ventricle. RESULTS: 1. There was no significant difference of heart rate and blood pressure in deferoxamine pretreatment group compared with control group. 2. There was significant decrease of serum iron concentration after continuous infusion of deferoxamine compared with serum iron concentration before ligation of coronary artery (P<0.05). 3. There was no significant difference of area at risk between control and deferoxamine pretreatment group. 4. Area at necrosis to area at risk was significantly reduced in deferoxamine pretreatment group compared with control group (P<0.05) The results suggest that deferoxamine infusion prior to coronary artery occlusion has a significant benefit in reducing infarct size in this model.
Arteries ; Blood Pressure ; Catheters ; Coronary Vessels ; Deferoxamine* ; Electrocardiography ; Heart Atria ; Heart Rate ; Heart Ventricles ; Hydroxyl Radical ; Iron ; Ischemia ; Ligation ; Myocardial Infarction* ; Myocardium ; Necrosis ; Oxygen ; Rabbits ; Reperfusion ; Transducers, Pressure

BACKGROUND/AIMS: This study was conducted to develop an optimal strategy to achive long-term survival after liver resection for hepatocellular carcinoma. METHODS: Between July 1975 and March 1995, 109 patients who underwent liver resection for hepatocellular carcinoma at Inje University Seoul Paik Hospital were analyzed retrospetively. RESULTS: 38 patients (34.9%) survived longer than 5 years after the operation. Prognostic factors of statistical significance were the diagnostic clue, ICG R15, TNM stage, extent of tumor, intrahepatic metastasis, portal vein thrombosis, serosal infiltration, tumor grade, resection margin, Glissonian approach, radicality of operation, cancer recurrence and disease free interval. For the 63 cases with no intrahepatic metastasis, there was no survival difference between the lobectomy group and the segmentectomy/subsegmentectomy group(36.8% vs. 50.0%). In those cases with satellite nodules in one segment of the liver, 66.7% of the lobectomy group lived longer than 5 years while 17.6% of lessthan- lobectomy group survived long-term(p=0.025). CONCLUSION: For long-term survival, a systemic segmentectomy/ subsegmentectomy is adquate for those tumors without intrahepatic metastasis, while the presence of satellite nodules in one segment mandates a standard hepatic lobectomy.
Carcinoma, Hepatocellular* ; Humans ; Liver* ; Neoplasm Metastasis ; Recurrence ; Seoul ; Survivors* ; Venous Thrombosis