PURPOSE: The purpose of this study was to examine the effects of case-base learning (CBL) using video on clinical decision-making and learning motivation. METHODS: This research was conducted between June 2009 and April 2010 as a nonequivalent control group non-synchronized design. The study population was 44 third year nursing students who enrolled in a college of nursing, A University in Korea. The nursing students were divided into the CBL and the control group. The intervention was the CBL with three cases using video. The controls attended a traditional live lecture on the same topics. With questionnaires objective clinical decision-making, subjective clinical decision-making, and learning motivation were measured before the intervention, and 10 weeks after the intervention. RESULTS: Significant group differences were observed in clinical decision-making and learning motivation. The post-test scores of clinical decision-making in the CBL group were statistically higher than the control group. Learning motivation was also significantly higher in the CBL group than in the control group. CONCLUSION: These results indicate that CBL using video is effective in enhancing clinical decision-making and motivating students to learn by encouraging self-directed learning and creating more interest and curiosity in learning.
*Decision Making ; Education, Nursing, Baccalaureate ; Female ; Humans ; Male ; Motivation ; Problem-Based Learning ; Program Evaluation ; Questionnaires ; Students, Nursing/*psychology ; Videotape Recording ; Young Adult

Heavy menstrual bleeding (HMB) is a common problem in primary care clinic of gynecology. HMB could cause adverse effect on the quality of life of many women. This guideline will provide evidence based information concerning diagnosis and management of HMB. Constructive dialogue should allow patients to be able to trust the advice given by their practitioner as they will be confident that they have and will be able to use it to inform this decision-making process. This guideline has been developed with the aim of providing guidance on HMB. The effectiveness of the various treatments as well as their risks and benefits are discussed in relation to their use in the treatment of HMB. We wish the information contained in this guideline will help clinicians reach a reasonable and beneficial decision with the latest information.
Female ; Gynecology ; Hemorrhage ; Humans ; Menorrhagia ; Primary Health Care ; Quality of Life ; Risk Assessment

OBJECTIVE: To evaluate the usefulness of serum CA 125, CA 19-9, and eosinophil as biological markers for the diagnosis and recurrence of endometriosis. METHODS: One hundred seventeen patients who underwent operations for endometriosis between January 2000 and December 2006 at our department were included. A total of 50 reproductive aged women who visited our health care center were the control group. Data on serum level of CA 125, CA 19-9, and eosinophil was collected. Patients symptoms, sonographic findings, stage, treatment, recurrence were also collected. Venous blood sampling was performed 1 month before operation and 1 to 6 months after operation. We analyzed the serum level of CA 125, CA 19-9, and eosinophil according to the endometriosis stage and symptoms. We also analyzed the differences between preoperative and postoperative serum marker levels. RESULTS: The serum level of CA 125 and CA 19-9 was available in 88 patients and 45 patients, respectively. The mean eosinophil count was significantly lower in endometriosis group than in control group. In comparison between preoperative values and postoperative values, the CA 125 and CA 19-9 level showed significant reduction (P<0.05), however the eosinophil level showed no difference. The positive rate of serum CA 125 and CA 19-9 were 68.9% and 60.0% as a single test, whereas the combined positive rate of CA 125 and CA 19-9 was 82.2%. CONCLUSION: For the diagnosis and follow-up of endometriosis, serum CA 125 and CA 19-9 combination test will be valuable. Serum eosinophil count seems to be unsuitable for the screening and follow up test of endometriosis.
Aged ; Biomarkers ; Delivery of Health Care ; Endometriosis ; Eosinophils ; Female ; Follow-Up Studies ; Humans ; Mass Screening ; Recurrence

No abstract available.
Arthroplasty* ; Knee*

No abstract available.
Arthroplasty* ; Knee*

OBJECTIVE: The goal of this study was to investigate the relationship between plasma levels of insulin-like growth factors-1 (IGF-1) and IGF-binding protein-3 (IGFBP-3) and the risk for cervical intraepithelial neoplasia (CIN) and cervical cancer. METHODS: Plasma levels of IGF-1 and IGFBP-3 of 44 cervical cancer patients, 82 CIN patients and 40 neoplasm-free patients were investigated. Then the associations of the plasma levels of IGF-1 and IGFBP-3 with cervical neoplasm or its clinicopathologic parameters were analyzed. RESULTS: The mean IGF-1 concentrations were significantly different among the control, CIN, and cervical cancer groups; the levels were higher in the CIN group compared to the controls. According to the quartile category, the plasma IGF-1 level was significantly higher (p=0.0015) in the CIN group than in the controls. The IGFBP-3 level showed no association between the controls and CIN groups (p=0.842). Although the mean IGF-1/IGFBP-3 molar ratio had borderline significance (p=0.08) among the study population, the quartile comparison showed a significantly higher IGF-1/IGFBP-3 molar ratio in the CIN group compared to the control group (p=0.041). CONCLUSION: Plasma levels of IGF-1 and the IGF-1/IGFBP-3 molar ratio might be useful for the development early detection of cervical lesions and used as an adjuvant diagnostic tool for cervical neoplasia after more larger scale research.
Cervical Intraepithelial Neoplasia ; Female ; Humans ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Molar ; Plasma ; Uterine Cervical Neoplasms

Paratubal cysts come from paraovarium of the broad ligament between the fallopian tube and ovary. Overall, these cysts constitute 10% of all adnexal masses and are commonly incidental findings upon surgical exploration for other reasons. They more commonly occur in women between 30 and 40 years of age. We report two cases of rapidly growing, huge paratubal cysts in young women, which are presented with brief review of literature.
Broad Ligament ; Fallopian Tubes ; Female ; Humans ; Incidental Findings ; Ovary ; Parovarian Cyst

Surgical excision was performed on a 30-years old woman with a painful mass on her left thigh. The pathologic findings on the mass indicated fibromatosis. After the operation, she complained of allodynia and spontaneous pain at the operation site and ipsilateral lower leg. We treated her based on postoperative femoral neuropathy, but symptom was aggravated. We found a large liposarcoma in her left iliopsoas muscle which compressed the lumbar plexus. In conclusion, the cause of pain was lumbar plexopathy related to a mass in the left iliopsoas muscle. Prompt diagnosis of acute neuropathic pain after an operation is important and management must be based on exact causes.
Female ; Femoral Neuropathy ; Fibroma ; Humans ; Hyperalgesia ; Leg ; Liposarcoma ; Lumbosacral Plexus ; Muscles ; Neuralgia ; Thigh

OBJECTIVE: Pain is very common in the elderly, so there is a high prevalence of analgesic use among this population. The purpose of this study was to assess patterns of analgesic use and evaluate factors associated with analgesic use in elderly patients. METHOD: The subjects of this study were patients over 65 years old hospitalized in a teaching hospital located in Chuncheon-si, Korea between January 1, 2014 and March 31, 2014. Data collection regarding analgesic prescriptions and baseline characteristics was conducted using computerized hospital database by medical information team. Logistic regression analysis was used to identify factors related to analgesic use. RESULTS: A total of 2,394 patients were finally included. Among these patients, 700 (29.2%) took analgesics; 521 (74.4%) out of these 700 patients were received opioid analgesics and 179 (25.6%) were received only non-opioid analgesics. The most frequently prescribed opioid analgesic was pethidine (45.7%), and the most frequently prescribed non-opioid analgesic was acetaminophen (44.1%). Fracture was associated with increased odds of opioid analgesic prescriptions (OR = 2.766, 95% CI = 2.019-3.790, p < 0.001) and any analgesic prescriptions (OR = 2.394, 95% CI = 1.766-3.244, p < 0.001). Stroke or cerebral infarction was associated with decreased odds of opioid analgesic prescriptions (OR = 0.636, 95% CI = 0.471-0.858, p = 0.003). CONCLUSION: A significant proportion of hospitalized elderly patients use analgesics. Health care professionals should consider factors associated with analgesic use in this population to improve pain management.
Acetaminophen ; Aged* ; Analgesics ; Analgesics, Opioid ; Cerebral Infarction ; Data Collection ; Delivery of Health Care ; Gangwon-do ; Hospitals, Teaching ; Humans ; Korea ; Logistic Models ; Meperidine ; Pain Management ; Prescriptions ; Prevalence ; Stroke

PURPOSE: A 70-gene prognostic signature has prognostic value in patients with node-negative breast cancer in Europe. This diagnostic test known as "MammaPrint(TM) (70-gene prognostic signature)" was recently validated and implementation was feasible. Therefore, we assessed the 70-gene prognostic signature in Korean patients with breast cancer. We compared the risk predicted by the 70-gene prognostic signature with commonly used clinicopathological guidelines among Korean patients with breast cancer. We also analyzed the 70-gene prognostic signature and clinicopathological feature of the patients in comparison with a previous validation study. METHODS: Forty-eight eligible patients with breast cancer (clinical T1-2N0M0) were selected from four hospitals in Korea. Fresh tumor samples were analyzed with a customized microarray for the 70-gene prognostic signature. Concordance between the risk predicted by the 70-gene prognostic signature and risk predicted by commonly used clinicopathological guidelines (St. Gallen guidelines, National Institutes of Health [NIH] guideline, and Adjuvant! Online) was evaluated. RESULTS: Prognosis signatures were assessed in 36 patients. No significant differences were observed in the clinicopathological features of patients compared with previous studies. The 70-gene prognosis signature identified five (13.9%) patients with a low-risk prognosis signature and 31 (86.1%) patients with a high-risk prognosis signature. Clinical risk was concordant with the prognosis signature for 29 patients (80.6%) according to the St. Gallen guidelines; 30 patients (83.4%) according to the NIH guidelines; and 23 patients (63.8%) according to the Adjuvant! Online. Our results were different from previous validation studies in Europe with about a 40% low-risk prognosis and about a 60% high-risk prognosis. The high incidence in the high-risk group was consistent with data in Japan. CONCLUSION: The results of 70-gene prognostic signature of Korean patients with breast cancer were somewhat different from those identified in Europe. This difference should be studied as whether there is a gene disparity between Asians and Europeans. Further large-scale studies with a follow-up evaluation are required to assess whether the use of the 70-gene prognostic signature can predict the prognosis of Korean patients with breast cancer.
Asian Continental Ancestry Group ; Breast ; Breast Neoplasms ; Diagnostic Tests, Routine ; Europe ; Follow-Up Studies ; Gene Expression Profiling ; Genes, vif ; Humans ; Incidence ; Korea ; National Institutes of Health (U.S.) ; Prognosis