PURPOSE: The aim of this study was to identify the effect of metacognition, communication skills, and confidence in the performance of core basic nursing skills on clinical competency in nursing students.METHODS: A total of 158 students were recruited from two nursing colleges in B metropolitan city. Data were collected by means of self-reported questionnaires from December 3–31, 2018 and analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients and multiple linear regression with SPSS 21.0.RESULTS: Metacognition, communication skills, and confidence in the performance of core basic nursing skills were higher than normal and the relationship between the variables metacognition (r=.69, p=<.001), communication skills (r=.69, p=<.001), and confidence in the performance of core basic nursing skills (r=.59, p=<.001) were highly positively correlated with clinical performance. Factors influencing these three variables accounted for 64.4% of clinical competency.CONCLUSION: Further research on the development of the curriculum and intervention program, and the verification of the effect are needed.
Clinical Competence ; Curriculum ; Humans ; Linear Models ; Metacognition ; Nursing ; Students, Nursing

No abstract available.
Bony Callus* ; Coinfection* ; Epidermal Cyst*

PURPOSE: To evaluate the clinical significance of antenatally detected mild fetal pelviectasia and the role of voiding cystourethrography (VCUG). METHODS: From January 1999 to September 1999, 28 neonates (44 pelviectatic kidneys) with mild fetal pelviectasia (anteroposterial diameter <10 mm) were evaluated by postnatal renal sonography and voiding cystourethrography. RESULTS: Among 44 mild pelviectatic kidneys, 29 (65.9%) kidneys had no pelviectasia and 15 (34.1%) kidneys had persistent mild pelviectasia on postnatal renal sonography. Four (9.1%) kidneys of 3 males (10.7%) without pelviectasia on postnatal renal sonography had vesicoureteral reflux (VUR) on voiding cystourethrography. Vesicoureteral reflux was not correlated with prenatal progression or regression of pelviectasia and was not correlated with postnatal pelviectasia. CONCLUSION: All neonate with mild fetal pelviectasia need to undergo voiding cystoure- thrography for early diagnosis of vesicoureteral reflux even though postnatal renal sonography shows no pelviectasia.
Early Diagnosis ; Humans ; Infant, Newborn ; Kidney ; Male ; Vesico-Ureteral Reflux

PURPOSE: The impact of previous abdominal surgery (PAS) on surgical outcomes from laparoscopic and robot surgeries is inconclusive. This study aimed to investigate the impact of PAS on perioperative outcomes from laparoscopic and robotic colorectal surgeries. METHODS: From March 2007 to February 2014, a total of 612 and 238 patients underwent laparoscopic and robotic surgeries, respectively. Patients were divided into 3 groups: those who did not have a PAS (NPAS), those who had a major PAS, and those who had a minor PAS. We further divided the patients so that our final groups for analysis were: patients with NPAS (n = 478), major PAS (n = 19), and minor PAS (n = 115) in the laparoscopy group, and patients with NPAS (n = 202) and minor PAS (n = 36) in the robotic surgery group. RESULTS: In the laparoscopy group, no differences in the conversion rates between the 3 groups were noted (NPAS = 1.0% vs. major PAS = 0% vs. minor PAS = 1.7%, P = 0.701). In the robotic surgery group, the conversion rate did not differ between the NPAS group and the minor PAS group (1.0% vs. 2.8%, P = 0.390). Among the groups, neither the operation time, blood loss, days to soft diet, length of hospital stay, nor complication rate were affected by PAS. CONCLUSION: PAS did not jeopardize the perioperative outcomes for either laparoscopic or robotic colorectal surgeries. Therefore, PAS should not be regarded as an absolute contraindication for minimally invasive colorectal surgeries.
Colectomy ; Colorectal Neoplasms* ; Colorectal Surgery ; Diet ; Humans ; Laparoscopy ; Length of Stay

Capicua (CIC) is a transcriptional repressor that regulates several developmental processes. CIC deficiency results in lymphoproliferative autoimmunity accompanied by expansion of CD44hiCD62Llo effector/memory and follicular Th cell populations. Deletion of Cic alleles in hematopoietic stem cells (Vav1-Cre-mediated knockout of Cic) causes more severe autoimmunity than that caused by the knockout of Cic in CD4+CD8+ double positive thymocytes (Cd4-Cre-mediated knockout of Cic). In this study, we compared splenic CD4+ T cell activation and proliferation between whole immune cell-specific Cic-null (Cicf/f;Vav1-Cre) and T cell-specific Cic-null (Cicf/f;Cd4-Cre) mice. Hyperactivation and hyperproliferation of CD4+ T cells were more apparent in Cicf/f;Vav1-Cre mice than in Cicf/f;Cd4-Cre mice. Cicf/f;Vav1-Cre CD4+ T cells more rapidly proliferated and secreted larger amounts of IL-2 upon TCR stimulation than did Cicf/f;Cd4-Cre CD4+ T cells, while the TCR stimulation-induced activation of the TCR signaling cascade and calcium flux were comparable between them. Mixed wild-type and Cicf/f;Vav1-Cre bone marrow chimeras also exhibited more apparent hyperactivation and hyperproliferation of Cic-deficient CD4+ T cells than did mixed wild-type and Cicf/f;Cd4-Cre bone marrow chimeras. Taken together, our data demonstrate that CIC deficiency at the beginning of T cell development endows peripheral CD4+ T cells with enhanced T cell activation and proliferative capability.

Oligomeganephronia is rare congenital anomaly characterized by striking reduction of the number of nephrons, which are markedly hypertrophied in renal hypoplasia. Since the first description of oligomeganephronia in bilateral renal hypoplasia in 1962, dozens of cases were reported. Van Acker reported the first case of oligomeganephronia developed in the solitary kidney and 8 cases were searched in the literature. We report a case of oligomeganephronia in the solitary kidney in 13 years old boy, presented with isolated proteinuria as a first case in Korea.
Adolescent ; Humans ; Kidney* ; Korea ; Male ; Nephrons ; Proteinuria* ; Strikes, Employee

PURPOSE: Suprapubic bladder aspiration(SBA) of urine is the most reliable method to obtain urine avoiding contamination in non-toilet trained infants. Ultrasonography is a useful tool for guiding the anatomic location as well as for direct visualization during procedure. We evaluated the success rate and complication of ultrasound(US) assisted SBA. METHODS: Sixty infants who visited Ewha Womans University Mokdong Hospital, with suspected urinary tract infection were randomly divided into the US assisted (n=32) and blind SBA(control, n=28) group. In US assisted SBA group, the anteroposterior(AP), transverse, and sagittal diameters and the volume of the bladder were measured. In the blind SBA group, urine was blindly aspirated when the urinary bladder was palpated at the suprapubic area. The rate of successful urine aspiration, the number of attempts until successful aspiration, aspirated urine volume were compared between the two groups. RESULTS: The success rate was 100%(32/32) in the US assisted group, which was significantly higher than 85.7%(24/28) of the control group (P<0.05). The aspirated urine volume in the US assisted group was 7.4+/-3.7 mL, which was significantly higher than 4.5+/-3.4 mL of the control group (P<0.05). The diameters and volume of bladder in successful aspiration were 2.1+/-0.7 cm in AP diameter, 3.1+/-0.6 cm in transverse diameter, 4.2+/-1.0 cm in sagittal diameter and 15.2+/-10.4 mL in volume, which were significantly higher than those (1.7+/-0.3 cm, 1.8+/-0.7 cm, 2.4+/-0.6 cm, 3.9+/-2.5) of the control group (P<0.05). The correlations between the AP(r=0.78), transverse (r=0.72), sagittal(r=0.91) diameter and bladder volume were significant (P<0.05). SBA was 100% successful in the AP diameter >3 cm, transverse diameter >4 cm, depth >4 cm and bladder volume >5 mL. CONCLUSION: US assistance can significantly improve the success rate of SBA in infant with suspected urinary tract infection.
Female ; Humans ; Infant ; Ultrasonography* ; Urinary Bladder* ; Urinary Tract Infections

Hepatitis A virus (HAV) infections occur predominantly in children, and are usually self-limiting. However, 75-95% of the infections in adults are symptomatic (mostly with jaundice), with the illness symptoms usually persisting for a few weeks. Atypical manifestations include relapsing hepatitis, prolonged cholestasis, and complications involving renal injury. Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a severe, drug-induced hypersensitivity reaction characterized by skin rash, fever, lymph-node enlargement, and internal organ involvement. We describe a 22-year-old male who presented with acute kidney injury and was diagnosed with prolonged cholestatic hepatitis A. The patient also developed DRESS syndrome due to antibiotic and/or antiviral treatment. To our knowledge, this is the first report of histopathologically confirmed DRESS syndrome due to antibiotic and/or antiviral treatment following HAV infection with cholestatic features and renal injury.
Acute Kidney Injury/diagnosis ; Anti-Bacterial Agents/*adverse effects/therapeutic use ; Cefotaxime/adverse effects/therapeutic use ; Cholestasis/complications/*diagnosis ; Cytomegalovirus/genetics ; Cytomegalovirus Infections/drug therapy/virology ; DNA, Viral/analysis ; Eosinophilia/etiology ; Exanthema/*chemically induced/pathology ; Ganciclovir/therapeutic use ; Hepatitis A/complications/*diagnosis/drug therapy ; Humans ; Hydrocortisone/therapeutic use ; Immunoglobulins/therapeutic use ; Male ; Syndrome ; Young Adult

Background: Spinal anesthesia-induced hypotension (SAH) frequently occurs in older patients, many of whom have mild left ventricular (LV) diastolic dysfunction, often asymptomatic at rest. This study investigated the association between preoperative echocardiographic measurements and SAH in older patients with mild LV diastolic dysfunction. Methods: We conducted a retrospective observational study using data from electronic medical records. The patients ≥ 65 years old who underwent spinal anesthesia for urologic surgery between January 2016 and December 2017 and whose preoperative echocardiography within 6 months before surgery revealed grade I LV diastolic dysfunction were recruited. SAH was investigated using the anesthesia records. Logistic regression and receiver operating characteristic (ROC) curve analyses were performed. Results: A total of 163 patients were analyzed. SAH and significant SAH developed in 55 (33.7%) patients. The mitral inflow E velocity was an independent risk factor for SAH (odds ratio [OR], 0.886; 95% confidence interval [CI], 0.845–0.929; P < 0.001). The area under the ROC curve for mitral inflow E velocity to predict SAH was 0.819 (95% CI, 0.752–0.875; P < 0.001). If mitral inflow E velocity was ≤ 60 cm/s, SAH was predicted with a sensitivity of 83.6% and specificity of 70.4%. Conclusions The preoperative mitral inflow E velocity demonstrated the greatest predictability of SAH in older patients with mild LV diastolic dysfunction. This may assist in identifying patients at high risk of SAH and guiding preventive strategies in the future.

Purpose: We investigated the treatment response and prognosis using the neutrophil-tolymphocyte ratio (NLR) and standardized uptake value (SUV) of 18F-fluorodeoxyglucose positron emission tomography ( 18F-FDG PET) in neoadjuvant settings. Methods: Baseline NLR and maximum SUV (SUVmax ) were retrospectively analyzed in 273 females with breast cancer who received neoadjuvant chemotherapy followed by surgery.Of these, 101 patients underwent 18F-FDG PET after 3–4 neoadjuvant chemotherapy cycles, which allowed the measurement of ΔSUVmax , an early reduction in SUVmax . NLR and early SUVmax reduction (ΔSUVmax) were classified as low and high, respectively, relative to the median values. Results: The mean NLR was lower, and the mean ΔSUVmax was higher in patients with pathologic complete response (pCR) than in those with residual tumors. The ΔSUVmax was an independent variable associated with pCR. Furthermore, the high NLR group had poor recurrence-free survival (RFS) and overall survival. Among patients with ΔSUVmax data, high NLR (adjusted hazard ratio, 2.82; 95% confidence intervals [CI], 1.26–6.28; P = 0.016) and low ΔSUVmax (adjusted hazard ratio, 2.39; 95% CI, 1.07–5.34; P = 0.037) were independent prognostic factors for poor RFS. The categorization of the patients into four groups according to the combination of NLR and ΔSUVmax showed that patients with high NLR and low ΔSUVmax had significantly poorer RFS. Conclusion Baseline NLR and ΔSUVmax were significantly associated with the prognosis of patients with breast cancer who received neoadjuvant chemotherapy. These results suggest that metabolic non-responders with defective immune systems have worse survival outcomes.