PURPOSE: This study was conducted to develop a simulation-based education program for newborn emergency care based on most needed topics found from the needs assessment. This study consisted of two phases: developing the program and evaluating its effectiveness. METHODS: The effectiveness of the program was tested in July, 2012, with 49 junior nursing students from C Nursing College in Seoul, who did not have any clinical experience in newborn care. The experimental group was given a three-hour lecture, three hours of clinical training, and a two-hour simulation program, whereas the control group only had the three-hour lecture. RESULTS: There was significant improvement in knowledge in both groups, but no significant differences according to educational methods. The experiment group was more confident of their care (4.32+/-.29) than the control group (3.60+/-.29) with the difference being significant (t=8.85, p<.001), and the experimental group was also more satisfied with the program (chi2=4.60, p=.032). CONCLUSION: As the results indicate 'the neonatal emergency care program' increased learners' knowledge, confidence and satisfaction with the program, it should be integrated into clinical training in pediatric nursing curriculum and in-service programs for nurses. To increase generalization further verification studies with various learner groups are needed.
Adult ; Education, Nursing, Baccalaureate ; Educational Measurement ; *Emergency Medical Services ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Infant, Newborn ; Male ; *Pediatric Nursing ; Personal Satisfaction ; *Program Development ; *Program Evaluation ; Questionnaires ; Students, Nursing/*psychology ; Young Adult

STATEMENT OF PROBLEM: The effects of various core buildup materials which differs in the mechanical properties on the fracture strength of metal-free crowns is unknown. PURPOSE: This study was carried out to evaluate the fracture strengths of Artglass ceromer crowns supported by 3 different core materials in clinically simulated anterior tooth preparation. Material and methods. Ten crowns from each group were constructed to comparable dimensions on the various dies made by gold alloy, Ni-Cr alloy, and composite resin. The ten crowns were then cemented onto the dies and loaded until catastrophic failure took place. Fracture resistance to forces applied to the incisal edges of the anterior crowns supported by three types of dies was tested. RESULTS: The ceromer crowns on the composite resin dies fractured at significantly lower values(287.7 N) than the ceromer crowns on the metal dies(approximately 518.4 N). No significant difference was found between the fracture values of the ceromer crowns on the dies of gold alloy and Ni-Cr alloy. CONCLUSION: The failure loads of the ceromer crowns on the metal dies were almost the same and not affected by the differences of casting alloys. However, the fracture values of the ceromer crowns on the resin dies were significantly reduced by the relative weak properties of composite resin core material.
Alloys ; Crowns* ; Resin Cements ; Tooth Preparation

Schizophrenia is a psychiatric disease which requires a long term treatment. Thus, patient's therapeutic compliance can be very crucial to the disease's prognosis. Moreover, the adverse effects of drugs are also important to determine the patient's therapeutic compliance. The atypical antipsychotic drugs have been improved in the way to strengthen therapeutic effects and to reduce adverse effects. Blonanserin, an atypical antipsychotic, is a selective serotonin-dopamine agonist which blocks the dopamine D2/D3 receptors and serotonin 5-HT2A receptor. Blonanserin is well known to include parkinsonism, akathisia and insomnia. In this case report, Blonanserin treatment was given to patients who admitted to the closed ward due to psychotic symptoms such as idea of reference, persecutory delusion, auditory hallucination and blunted affect. The patients showed manic symptoms including elated mood, talkativeness, hyperactivity after the increase of Blonanserin dose up to 24 mg. Such manic symptoms were improved after Blonanserin dose was decreased to 16 mg. Many researches have reported newly-evoked manic/hypomanic episodes in schizophrenic patients after the use of atypical antipsychotics such as Risperidone, Olanzapine and Ziprasidone. However, there is no report of Blonanserin-induced manic/hypomanic episode. Therefore, further study is necessary to evaluate the manic/hypomanic episodes which are thought to be the adverse effects of Blonanserin.
Antipsychotic Agents ; Benzodiazepines ; Bipolar Disorder ; Compliance ; Delusions ; Dopamine ; Hallucinations ; Humans ; Parkinsonian Disorders ; Piperazines ; Piperidines ; Prognosis ; Psychomotor Agitation ; Receptor, Serotonin, 5-HT2A ; Risperidone ; Schizophrenia ; Serotonin ; Sleep Initiation and Maintenance Disorders ; Thiazoles

Schizophrenia is a psychiatric disease which requires a long term treatment. Thus, patient's therapeutic compliance can be very crucial to the disease's prognosis. Moreover, the adverse effects of drugs are also important to determine the patient's therapeutic compliance. The atypical antipsychotic drugs have been improved in the way to strengthen therapeutic effects and to reduce adverse effects. Blonanserin, an atypical antipsychotic, is a selective serotonin-dopamine agonist which blocks the dopamine D2/D3 receptors and serotonin 5-HT2A receptor. Blonanserin is well known to include parkinsonism, akathisia and insomnia. In this case report, Blonanserin treatment was given to patients who admitted to the closed ward due to psychotic symptoms such as idea of reference, persecutory delusion, auditory hallucination and blunted affect. The patients showed manic symptoms including elated mood, talkativeness, hyperactivity after the increase of Blonanserin dose up to 24 mg. Such manic symptoms were improved after Blonanserin dose was decreased to 16 mg. Many researches have reported newly-evoked manic/hypomanic episodes in schizophrenic patients after the use of atypical antipsychotics such as Risperidone, Olanzapine and Ziprasidone. However, there is no report of Blonanserin-induced manic/hypomanic episode. Therefore, further study is necessary to evaluate the manic/hypomanic episodes which are thought to be the adverse effects of Blonanserin.
Antipsychotic Agents ; Benzodiazepines ; Bipolar Disorder ; Compliance ; Delusions ; Dopamine ; Hallucinations ; Humans ; Parkinsonian Disorders ; Piperazines ; Piperidines ; Prognosis ; Psychomotor Agitation ; Receptor, Serotonin, 5-HT2A ; Risperidone ; Schizophrenia ; Serotonin ; Sleep Initiation and Maintenance Disorders ; Thiazoles

OBJECTIVES: To assess clinical improvement and change in plasma brain-derived neurotrophic factor(BDNF) level after repetitive transcranial magnetic stimulation(rTMS) in patients with treatment-resistant schizophrenia. METHODS: Seven patients with DSM-IV schizophrenia, who were proven to be treatment-resistant, were treated with 15 sessions of rTMS for three weeks as an adjuvant therapy to antipsychotic treatment. Clinical improvement and change in plasma BDNF level were measured after the treatment period. The symptom severity was assessed with the Positive and Negative Syndrome Scale(PANSS) and the Korean Version of Calgary Depression Scale for Schizophrenia(K-CDSS) at baseline and 7 days after the treatment. Plasma BDNF level was measured by enzyme-linked immunosorbent assay(ELISA) at baseline and 7 days after the treatment. RESULTS: After the rTMS treatment, there was no significant improvement in PANSS total score(Z=-1.693, p=0.090) and no significant change in plasma BDNF was found(Z=-1.183, p=0.237). Negative correlations were found between percentage change in PANSS positive subscale score and duration of illness(rho=-0.991, N=7, p<0.0005, two-tailed), and PANSS negative subscale score at baseline and percentage change in plasma BDNF level(rho=-0.821, N=7, p=0.023, two-tailed). CONCLUSION: This preliminary study suggests that rTMS didn't make a significant change in clinical symptoms nor in plasma BDNF level in treatment-resistant schizophrenia. Percentage change in plasma BDNF, however, might be correlated with treatment resistance in schizophrenic patients. This is a pilot study with a small sample size, therefore, a further study with a larger sample size is needed.
Brain-Derived Neurotrophic Factor ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Magnetics ; Magnets ; Pilot Projects ; Plasma ; Sample Size ; Schizophrenia

Natural isoflavones and flavones are important dietary factors for prostate cancer prevention. We investigated the molecular mechanism of these compounds (genistein, biochanin-A and apigenin) in PC-3 (hormone-independent/p53 mutant type) and LNCaP (hormone-dependent/p53 wild type) prostate cancer cells. A cell growth rate and apoptotic activities were analyzed in different concentrations and exposure time to evaluate the antitumor activities of genistein, biochanin-A and apigenin. The real time PCR and Western blot analysis were performed to investigate whether the molecular mechanism of these compounds are involving the p21 and PLK-1 pathway. Apoptosis of prostate cancer cells was associated with p21 up-regulation and PLK-1 suppression. Exposure of genistein, biochanin-A and apigenin on LNCaP and PC-3 prostate cancer cells resulted in same pattern of cell cycle arrest and apoptosis. The inhibition effect for cell proliferation was slightly greater in LNCaP than PC-3 cells. In conclusion, flavonoids treatment induces up-regulation of p21 expression, and p21 inhibits transcription of PLK-1, which promotes apoptosis of cancer cells.
Antineoplastic Agents/*pharmacology ; Apigenin/pharmacology ; *Apoptosis ; Cell Cycle/drug effects ; Cell Cycle Proteins/biosynthesis/*genetics/metabolism ; Cell Line, Tumor ; Cell Proliferation ; Cyclin-Dependent Kinase Inhibitor p21/biosynthesis/*metabolism ; Flavonoids/*pharmacology ; Gene Expression Regulation, Neoplastic/drug effects ; Genistein/pharmacology ; Humans ; Male ; Prostatic Neoplasms/genetics/metabolism/*pathology ; Protein Kinase Inhibitors/pharmacology ; Protein-Serine-Threonine Kinases/biosynthesis/*genetics/metabolism ; Proto-Oncogene Proteins/biosynthesis/*genetics/metabolism ; Transcription, Genetic/drug effects

Background: TSH binding inhibiting imunoglobulins(TBII) are autoimmune antibody causing autoimmune thyroid diseases such as Graves disease or Hashimoto's thyroiditis, while intercellular adhesion molecule-1(ICAM-1) is known as a substance expressed at the site of autoimmune reaction in relation with lymphocyte infiltration. The serum TBII activity is used as an index of the disease course and prognosis of Graves disease treated with antithyroid drugs, propylthiouracil or methimazole. The aim of this study is to understand the change of serum ICAM-1 level according to the change of the degree of autoimmunity and clinical course of Graves disease. Methods: In order to study the change of soluble ICAM-1 and relationship to the immune mechanism of Graves' disease, we measured serum levels of TBII and ICAM-1 in patients(n 35) with Graves disease before and after treatment with antithyroid drugs and in relapsed patients using a highly sensitive ELISA method. Results: The serum levels of TBII and ICAM-1 were markedly elevated in patients with Graves disease before treatment than normal controls and there were good correlation between TBII and ICAM-1 level. In patients with normalized TBII levels after 22 months antithyroid drug treatment, the ICAM-1 levels became normal but in the patients with high serum TBII level showed high serum level of ICAM-1 even with clinical remission with same treatment. The serum levels of TBII and ICAM-1 in relapsed patients were elevated as those of patients before treatment. Conclusion: With the above results, we can conclude that not only the TBII level but seru ICAM-1 level also reflect the degree of autoimmune activity of Graves disease and may be used as an index of the disease course and prognosis of Graves disease treated with antithyroid drugs.
Antithyroid Agents ; Autoimmunity ; Enzyme-Linked Immunosorbent Assay ; Graves Disease ; Humans ; Intercellular Adhesion Molecule-1 ; Lymphocytes ; Methimazole ; Methods ; Prognosis ; Propylthiouracil ; Thyroid Diseases ; Thyroid Gland ; Thyroiditis

BACKGROUND: In the diagnosis of acute myocardial infarction, measurement of CK-MB is widely used as an enzyme test, but it needs special instruments, lacks specificity in the presence of concomitant skeletal muscle injuries, and has narrow diagnostic time window. Cardiac specific troponin T-a new marker for the diagnosis of myocardial injury-is now available. Besides the quantitative assay, rapid qualitative asay is also possible with the development of rapid assay Kit. We studied about the efficacy of the Troponin T rapid assay Kit in early doagnosis of actue myocardial infarction in the emergency room. METHODS: Total Ck, Ck-MB, LDH and serum troponin T activities were determined when the patients arrived at the emergency room and at the same time Troponin T rapid assay kit test was done. Final diagnosis was made through the serial measurement of CK, CK-MB and LDH. Diagnostic efficacy of each rest was evaluated. RESULTS: Overall diagnostic sensitivity and specificity of Troponin T rapid assay kit were 0.97 and 0.91. When evaluated only with the initial results, Troponin T rapid assay kit showed sensitivity 0.87, specificity 0.97, serum troponin T 0.75, 0.92, and Ck-Mb 0.81,0.95. In one patient who was finally diagnosed as a septic shock, Ck-MB was elevated but serum troponin T was not and Troponin T rapid assay kit test showed negative result. CONCLUSION: Troponin T rapid assay kit test seems to show nearly the same sensitivity and specificity in diagnosis of acute myocardial infarction compared to CK-MB. This test can be done simply and easily in a short time. Thus, with the use of this test, morbidity, mortality and economic loss due to misdiagnosis and delay of diagnosis of myocardial infarction might be reduced.
Diagnosis ; Diagnostic Errors ; Early Diagnosis* ; Emergency Service, Hospital ; Humans ; Mortality ; Muscle, Skeletal ; Myocardial Infarction* ; Sensitivity and Specificity ; Shock, Septic ; Troponin T* ; Troponin*

BACKGROUND: Cardiovascular instability after induction of intravenous anesthetics may be explained partly by direct negative inotropic effects. We studied the effects of etomidate and propofol on the inward calcium currents (ICa) of rat ventricular myocytes using the whole-cell voltage-clamp technique. METHODS: ICa was elicited by progressively depolarizing cells from -40 to -50 mV. The peak amplitude of ICa was measured before, during and after the administration of equimolar concentrations of etomidate and propofol. RESULTS: Exposure to etomidate and propofol produced a concentration-dependent inhibition of ICa.; 1, 10, 100 and 300 micrometer of etomidate decreased the peak ICa (mean +/- SEM) by 14.5 +/- 6.3, 25.9 +/- 9.4, 31.9 +/- 12.1, 42.5 +/- 8.8% and 1, 10, 100 and 300 micrometer of propofol decreased the peak ICa by 15.7 +/-3.4, 21.3 +/-2.5, 59.2 +/-2.0, 69.9 +/-2.8%, respectively. COCLUSIONS: These results suggest that etomidate and propofol have a direct negative inotropic effect via inhibition of inward calcium currents in rat ventricular myocytes.
Anesthetics, Intravenous ; Animals ; Calcium* ; Etomidate* ; Muscle Cells* ; Patch-Clamp Techniques ; Propofol* ; Rats*

This study was undertaken to develop species-specific forward and universal reverse PCR primers for the detection of Streptococcus sobrinus. These primers target the variable regions of the 16S ribosomal RNA coding gene (rDNA) and their specificity was tested against 10 strains of S. sobrinus strains and 20 different species of oral bacteria using serial dilutions of the purified genomic DNA of S.sobrinus ATCC 33478T . Our data show that species-specific amplicons were obtained from all the S. sobrinus strains tested but not from other species. Both direct and nested PCR could detect as little as 400 pg and 4 fg of genomic DNA from S. sobrinus ATCC 33478T , respectively. This result suggests that these PCR primers are highly specific and sensitive and applicable to the detection of S. sobrinus.
Bacteria ; Clinical Coding ; Collodion ; DNA ; Polymerase Chain Reaction ; RNA, Ribosomal, 16S ; Sensitivity and Specificity ; Streptococcus ; Streptococcus sobrinus