PURPOSE: Brain-based learning has become increasingly important in nursing education. The purpose of this study is to (a) synthesize the literature on brain-based learning in nursing education using Whittemore and Knafl's integrative review method, and (b) discuss teaching strategies for nursing educators. METHOD: Searches were made through the CINAHL, OVID, PubMED, and SCOPUS databases using the terms nurs* AND (brain based OR neuroscience) AND (educa* OR learn* OR teach*). Included were original articles in the domain of undergraduate nursing education written in English in peer-reviewed journals between January 1984 and December 2013. Twenty-four papers met the criteria. RESULTS: Three themes were retrieved: (a) activate whole-brain functions, (b) establish supportive educational environments, and (c) encourage learners to be more active. CONCLUSION: Brain-based learning enhances the learning capabilities of undergraduate nursing students.
Brain ; Education ; Education, Nursing ; Humans ; Learning ; Nursing ; Students, Nursing

Mivacurium is mainly metabolized by plasma cholinesterase, whereas atracurium is removed by Hofman elimination. The purpose of this study was to compare the infusion rate of atracurium and mivacurium in maintaining surgical relaxation, and to compare their recovery indices between parturients and non-pregnant women. Muscle relaxation was maintained by the continuous infusion of relaxants to retain the first response of train-of-four (TOF) at 5% of control. When mivacurium was used, Bolus-T5 (duration from the end of mivacurium bolus injection to 5% single twitch recovery) was measured. After discontinuing the infusion, the recovery index was measured. The infusion rate of mivacurium, not atracurium, was significantly lower in parturients and Bolus-T5 of parturients was significantly longer than that of non-pregnant women. There was no significant difference in the recovery indices of both relaxants. The authors concluded that the infusion rate of mivacurium in maintaining muscle relaxation in parturients should be reduced compared to the rate in non-pregnant women and measuring Bolus-T5 may be helpful in determining the infusion rate to maintain muscle relaxation.
Adult ; Atracurium/therapeutic use ; Atracurium/administration & dosage* ; Cesarean Section* ; Comparative Study ; Female ; Human ; Injections, Intramuscular ; Isoquinolines/therapeutic use ; Isoquinolines/administration & dosage* ; Neuromuscular Nondepolarizing Agents/therapeutic use ; Neuromuscular Nondepolarizing Agents/administration & dosage* ; Pregnancy

OBJECTIVES: To investigate the effect of the occupational exposure to organic solvent on the olfactory function of shipyard painters; we measured the prevalence of olfactory function impairment between the exposure group and the controls by using the Korean Version of the Sniffin'Stick (KVSS) test through smell, and by analyzing factors related to olfactory alteration. METHODS: The olfactory function of 245 painters exposed to organic solvents was compared to that of 122 unexposed controls. A total of 367 shipyard subjects underwent questionnaire study and the olfactory function test was performed by KVSS test I from April to August 2007. Suspected subjects of abnormal findings were referred to an otorhinolaryngologist. In addition, the Biologic Exposure Index (BEI) and industrial hygiene laboratory data were collected as well as analyzed by job title in the exposure group. RESULTS: The difference in the result of KVSS test I was significantly different from the exposure group and the controls (P<0.05). For the exposure group, reduced olfaction and exposure group were correlated with statistical significance when compared to the controls (P<0.01). Adjusting for work duration, smoking, rhinitis or sinusitis history, exposure of the organic solvent (OR 1.76, 95% CI=1.05-2.96) had a statistically meaningful relationship with decreased olfaction. The data on BEI for the exposure group were collected; the difference in methylhippuric acid was significant between spray workers and others, but did not correlate well with decreased olfaction. CONCLUSION: Occupational exposure to organic solvents in shipyard painters may affect the olfactory function. Therefore, shipyard painters should be monitored on a periodic bases by the quantitative test such as KVSS test. There is no other quantitative testing method or standardized procedure that can objectively diagnose the neurotoxic effect, further enhanced quality research in this field is necessary.
Occupational Exposure ; Occupational Health ; Paintings ; Prevalence ; Questionnaires ; Rhinitis ; Sinusitis ; Smell ; Smoke ; Smoking ; Solvents

PURPOSE: The purpose of our study is to provide useful information for diagnostic methods of fatty liver by childhood simple obesity and to provide correlation between serum alanine aminotransferase (ALT) for screening test and abdominal computerized tomography (CT) and liver biopsy for confirmative diagnostic methods of fatty liver. METHODS: Among 78 obese childrens who visited our hospital, CT was carried out in 26 childrens. Of these, liver biopsy was carried out in 15 childrens who had high obesity index or severe elevated ALT. Based on the level of serum ALT, 26 cases were classified into 3 groups, and compared with physical measurements and degree of fatty infiltration on CT and liver biopsy. RESULTS: 1) Correlation between ALT and physical measurements: Of 26 obese children, ALT was abnormally elevated (>30 IU/L) in 17 cases (67.4%) but there was no significant correlation between ALT and physical measurements (p>0.05). 2) Correlation between degree of fatty infiltration on CT and ALT: Of 26 cases, 13 cases (50%) revealed fatty liver on CT. The degree of fatty liver on CT had significant correlation with elevation of ALT (p<0.05). 3) Correlation between the degree of fatty infiltration on liver biopsy and ALT: Liver biopsy was performed in 15 cases of which 14 cases revealed fatty liver. But one case had normal hepatic histology with severe obesity and normal ALT. Fourteen fatty liver cases on liver biopsy were classified into 3 groups by the degree of fatty infiltration and analysed with obesity index and ALT. The histologic hepatic steatosis had no significant correlation with obesity index (p>0.05), but significant correlation with ALT (p<0.05). 4) Correlation between CT and liver biopsy finding: Both CT and liver biopsy were performed in 15 cases of which 6 cases revealed normal finding on CT and 9 cases manifested fatty liver. There was significant correlation between CT and liver biopsy findings (r=0.6094). CONCLUSION: The results of our study suggest that abdominal CT and liver biopsy are useful and accurate methods of estimating fatty liver in the childhood obesity. But biochemical abnormalities of routine liver function tests dot not correlate well with severity of the fatty liver and liver injury.
Alanine Transaminase ; Biopsy* ; Child* ; Diagnosis* ; Fatty Liver* ; Humans ; Liver Function Tests ; Liver* ; Mass Screening ; Obesity* ; Obesity, Morbid ; Pediatric Obesity ; Tomography, X-Ray Computed*

OBJECTIVE: Necrotizing pneumonia (NP) is a severe complication of lobar pneumonia caused by various pathogens. The immunopathogenesis and clinical characteristics of NP in children are not clearly understood. We wanted to evaluate the clinical characteristics and suggest in part the immunopathogenesis of NP. METHODS: We reviewed retrospectively the medical charts and radiographic materials of eight patients with NP, who were diagnosed by chest radiography and chest computed tomography at the Department of Pediatrics, Soonchunhyang University Hospitals at Cheonan and Bucheon from January 2002 to December 2011. RESULTS: They were previously healthy, 2.1 to 4.6 years of ages (mean, 2.8+/-1.0 years) and three boys and five girls. All of them had pleural effusion. Five patients had pneumonic consolidations in right upper lung field. Three patients had pneumatocele. They developed leukocytosis (mean, 19,400+/-6,400/mm3), higher C-reactive protein level (mean, 25.1+/-8.0 mg/dL). The etiologic agents were revealed in two patients; Streptococcus pneumonia (S. pneumonia) was revealed in one patient and S. pneumonia and Mycoplasma pneumonia in the other patient. Three patients were treated with additional intravenous immunoglobulin. Clinical improvement was prolonged: fever lasted 10 to 23 days, and length of hospitalization was 15 to 36 days. NP or pneumatocele were completely resolved on the follow-up radiographic studies in all of the patients. CONCLUSION: Although the previously healthy young children with NP had protracted clinical course, they recovered without any problematic sequelae. Our results suggest that the immunopathogenesis of NP in children may be associated with the exaggerated immune reaction of the host to insults from initial bacterial infections, rather than the pathogen-induced cytopathies.
Bacterial Infections ; C-Reactive Protein ; Child* ; Chungcheongnam-do ; Female ; Fever ; Follow-Up Studies ; Gyeonggi-do ; Hospitalization ; Hospitals, University ; Humans ; Immunoglobulins ; Leukocytosis ; Lung ; Pediatrics ; Pleural Effusion ; Pneumonia* ; Pneumonia, Mycoplasma ; Radiography ; Retrospective Studies ; Streptococcus ; Thorax

OBJECTIVE: To investigate the predictive index of functional recovery after primary pontine hemorrhage (PPH) using the combined motor evoked potential (MEP) and somatosensory evoked potential (SEP) in comparison to the hematoma volume and transverse diameter measured with computerized tomography. METHODS: Patients (n=14) with PPH were divided into good- and poor-outcome groups according to the modified Rankin Score (mRS). We evaluated clinical manifestations, radiological characteristics, and the combined MEP and SEP responses. The summed MEP and SEP (EP sum) was compared to the hematoma volume and transverse diameter predictive index of global disability, gait ability, and trunk stability in sitting posture. RESULTS: All measures of functional status and radiological parameters of the good-outcome group were significantly better than those of the poor-outcome group. The EP sum showed the highest value for the mRS and functional ambulatory category, and transverse diameter showed the highest value for "sitting-unsupported" of Berg Balance Scale. CONCLUSION: The combined MEP and SEP is a reliable and useful tool for functional recovery after PPH.
Evoked Potentials, Motor ; Evoked Potentials, Somatosensory* ; Gait ; Hematoma ; Hemorrhage* ; Humans ; Posture

PURPOSE: To assess the usefulness of diffusion-weighted MR imaging in patients with intracranial tumors. MATERIALS AND METHODS: Using the single-shot spin echo EPI technique on a 1.5T unit and two gradient steps(b values of 0, 900 s/mm2), diffusion-weighted MR images (DW-MRI) of 76 patients with various intracranial tumors including high-grade glioma (n=20), meningioma (n=15), metastasis(n=14), lymphoma (n=6), low-grade glioma (n=5), schwannoma (n=4), cerebellar hemangioblastoma (n=3), - and others- were obtained. The signal intensity of each tumor was visually assessed as one of four grades, and this and apparent diffusion coefficient(ADC) were analyzed in the solid and cystic portions of tumors, normal gray matter, white matter and CSF. RESULTS: Lymphomas, metastases, meningiomas, and high- and low-grade gliomas showed low ADC values in increasing order. Tumors showing high signal intensity on DW-MRI had low ADC values. Visual assessment whowed that solid portions of high-grade gliomas were significantly more hyperintense than those of low-grade gliomas. There was, however, no significant difference in ADCs between high- and low-grade gliomas. Lymphoma a and metastases showed significantly higher signal intensities on DW-MRI and lower ADCs than did high-grade gliomas. There were significant differences in signal intensities, as seen on DW-MRI, and in ADCs, between metastatic adenocarcinomas and non-adenocarcinomas. Schwannomas and cerebellar heman-gioblastomas showed low signal intensities and high ADC values. CONCLUSION: DW-MRI appears to provide an additional means of examining intracranial tumors, not available with conventional MRI, and may thus be helpful in the grading of gliomas and the differential diagnosis of some intracranial tumors.
Adenocarcinoma ; Brain Neoplasms ; Diagnosis, Differential ; Diffusion* ; Glioma ; Hemangioblastoma ; Humans ; Lymphoma ; Magnetic Resonance Imaging* ; Meningioma ; Neoplasm Metastasis ; Neurilemmoma

Renal transplantation is the optimal treatment for end stage renal disease and it has been improved through the development of operative methods and immunosuppressants. However some patients must receive dialysis or undergo retransplantation after a loss of the primary graft due to rejection or other causes. Recently the frequency of retransplantation has begun to increase gradually. Some articles have reported that retransplantation results do not significantly differ in comparison with initial transplantation results when living related donor kidneys are used. Our study focused on the outcome of 445 first transplantation and 12 retransplantation cases. The sex distribution of retransplanted patients was 11 male and 1 female. The mean age (yrs) for recipients was 32.3 at the first transplantation and 39.1 at the retransplantation. The underlying causes of end stage renal disease were presumed to be chronic glomerulonephritis in all retransplantion patients; the mean duration of graft survival (mo) for first transplantation was 77.92. The causes of previous graft failure were as follows: 10 due to chronic rejection, 1 due to recurrent glomerulonephritis, 1 resulted from a graft rupture due to a motorcar accident. The interval (mo) between graft failure and retransplantation averaged 6.7 and 9 out of 12 patients underwent regrafting within 1 year of their previous graft loss. Recipient-donor relationships in first transplantations were as follows: 9 were living related and 3 were living non-related. Recipient-donor relationships in second transplantations were as follows: 4 were living related and 8 were living non-related. Acute rejection within 1 month of transplantation occurred in 4 primary transplantation patients and 2 retransplantation patients. The incidence of acute rejection within 1 month was as follows: 23% of 445 first renal transplantation patients, 16.7% of 12 second transplantation patients. The 1 year and 2 year graft survival rate was 100% and the mean survival duration (mo) was 33 for retransp
Dialysis ; Female ; Glomerulonephritis ; Graft Survival ; Humans ; Immunosuppressive Agents ; Incidence ; Kidney Failure, Chronic ; Kidney Transplantation ; Kidney* ; Male ; Rupture ; Sex Distribution ; Tissue Donors ; Transplants

PURPOSE: The implementation of the Korean diagnosis-related groups (DRG) payment system has been recently introduced in selected several diseases including appendectomy in Korea. Here, we report the early outcomes with regard to clinical aspects and medical costs of the Korean DRG system for appendectomies in Seoul Metropolitan Government - Seoul National University Boramae Medical Center throughout comparing before and after introduction of DRG system. METHODS: The DRG system was applied since January 2013 at our institute. After the DRG system, we strategically designed and applied our algorithm for the treatment of probable appendicitis. We reviewed the patients who were treated with a procedure of appendectomy for probable appendicitis between July 2012 and June 2013, divided two groups based on before and after the application of DRG system, and compared clinical outcomes and medical costs. RESULTS: Total 416 patients were included (204 patients vs. 212 patients in the group before vs. after DRG). Shorter hospital stays (2.98 +/- 1.77 days vs. 3.82 +/- 1.84 days, P < 0.001) were found in the group after DRG. Otherwise, there were no significant differences in the perioperative outcomes and medical costs including costs for first hospitalization and operation, costs for follow-up after discharge, frequency of visits of out-patient's clinic or Emergency Department or rehospitalization. CONCLUSION: In the Korean DRG system for appendectomy, there were no significant differences in perioperative outcomes and medical costs, except shorter hospital stay. Further studies should be continued to evaluate the current Korean DRG system for appendectomy and further modifications and supplementations are needed in the future.
Appendectomy* ; Appendicitis ; Diagnosis-Related Groups* ; Emergency Service, Hospital ; Follow-Up Studies ; Health Care Costs ; Hospitalization ; Humans ; Korea ; Length of Stay ; Local Government ; Prospective Payment System ; Seoul