PURPOSE: This study was done to identify the effects of the Korean Enneagram program on college nursing students' ego-identity, interpersonal relationships and self-leadership. METHODS: A nonequivalent control group pre-posttest design was used. Twenty-nine students were in the experimental group receiving the Korean Enneagram program, and 28 were in the control group with no treatment. RESULTS: 'The experimental group will show higher scores for ego-identity (t=3.97, p<.001), interpersonal relationship (t=3.26, p=.002) and self-leadership (t=2.91, p=.007) compared to the control group 8 weeks after the program finished' was supported by significant differences in the scores between the two groups. CONCLUSION: The findings indicate that the Korean Enneagram Program has a significant effect on improving ego-identity, interpersonal skills and self-leadership in nursing college students and the program can be used as a tool to promote the ego-identity, interpersonal skills and self-leadership of nursing students.
Humans ; Interpersonal Relations ; Nursing* ; Students, Nursing

PURPOSE: A descriptive survey was used in this study to identify the relationship between nurses' critical thinking disposition, self-directed learning readiness and professional nursing competency and to examine factors that influence professional nursing competency. METHODS: The data were collected from 188 nurses and analyzed using t-test, ANOVA, Scheffe' test, Pearson correlation, and stepwise multiple regression analysis with the SPSS/WIN 20.0 PC program. RESULTS: Professional nursing competency was found to have significant pure correlations with critical thinking disposition (r=.59, p<.001), and self-directed learning readiness (r=.54, p<.001). The most influential factor influencing nurses' professional nursing competency was critical thinking disposition, followed by self-directed learning readiness (beta=.25, p=.003), work department (beta=.19, p=.001), total clinical career (beta=.19, p=.003), and position (beta=.12, p=.040), and these factors explained 43.8% of the variance in professional nursing competency. CONCLUSION: The findings indicate the necessity of developing and applying strategies and educational programs to enhance individual nurse's critical thinking disposition and self-directed learning readiness. Furthermore, exploration is needed on ways to enhance professional nursing competency.
Learning* ; Nursing* ; Thinking*

Endoscopic ultrasonography (EUS)-a combination of endoscopy a.nd ultrasonography was one of the most useful tools for diagnosis of digestive system diseases. This technique was known to be very effective in the assessment of depth of invasion in gastric cancer and in pancreatico-biliary diseases. We performed EUS in 589 patients with upper gastrointestinal and pancreatico-biliary tract lesion prior to surgery for past 22 months and examined the diagnostic accuracy of EUS, respectively. The results were compared to surgical histology in esophagus and stomach cancer,to concordance witb endoscopic retrograde cholangiopancreatography(ERCP) results for pancreaticobiliary diseases. 1) In 589 patients diagnosed with EUS, the mean age of the patients was 55.9 years with a male to female ratio of 1.7: 1. 2) Patients were divided into three groups; post-upper gastrointestinal endoscopy, post ERCP and undiagnosed with other diagnostic tools. 3) Among post-upper gastrointestinal endoscopy, 64 cases were operated due to esophageal and gastric cancer and then compared to surgical histology. After compared, EUS accuracy on depth of invasion was 78.1% and sensitivity and specificity on lymph node metastasis in gastric cancer were 76.9% and 74.3%, respectively. 4) In post-ERCP cases, EUS results were compared to ERCP results and then concordance rate was 95.4%. 5) In undiagnosed cases, EUS was performed and results were reported.
Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis* ; Digestive System Diseases ; Endoscopy ; Endoscopy, Gastrointestinal ; Endosonography ; Esophagus ; Female ; Humans ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Sensitivity and Specificity ; Stomach ; Stomach Neoplasms ; Ultrasonography* ; Upper Gastrointestinal Tract*

Endoscopic Variceal Ligation(EVL) was developed as an alternative to endoscopic injection sclerotherapy(EIS) for decreasing of complication rate. This new technique involves placement of small elastic O-rings around the variceal channels in the distal esophagus. To evaluate the efficacy of EVL for treatment of the acute bleeding esophagea1 varices and the efficacy of prophylactic EVL, we compared EVL in 88 patients who had recently bled from esophageal varices(Group 1) and prophylactic EVL in 45 patients with large size(Grade 2 or 3 or 4) and red color sign on endoscopic finding who had not previously had upper gastrointestinal bleeding(Group 2). Also, we compared prophylactic EVL group(Group 2) and control group(Group 3) who did not performed EVL. At the time of treatment 28.4%(25/88) of patients had active bleeding. They were all treated acutely with EVL and repeated treatment for the long-term goal of variceal eradication. Initial hemostatic efficacy of EVL for acute bleeding varices was 92%(23/25). Varices were eradicated or reduced to Grade 1 in 68%(17/2S). Early mortality rate within 2 weeks was 8%(2/25). Among patients who had eradicated or reduced to Grade 1 varices by repeated EVL sessions, over a mean follow-up of 11 months there was no difference between Group 1 and Group 2 in recurrent rate(49.1%(27/63) vs. 46.8% (15/32)), rebleeding rate(10.9'Yo (6/55) vs. 9.3% (3/32)), rebleeding interval(average 75 days vs, 83.6 days). There was significant difference between prophylactic EVL group and con- trol group in bleeding rate(9.3%(3/~32) vs. 43.7%(14/32))~(p<0.05). Three patients(6.6%) died in prophylactic EVL group, two from ligation site bleeding of esophageal varix, one from hepatic failure. In conclsion, EVL is an effective method for treatment of acute bleeding esophageal varices with repeated sessions. Although prophylactic EVL can be used to prevent bleeding by eradication with lower initial morbidity are necessary because of EVL-related complications.
Esophageal and Gastric Varices* ; Esophagus ; Follow-Up Studies ; Hemorrhage* ; Humans ; Ligation* ; Liver Failure ; Mortality ; Varicose Veins

BACKGROUND: A receptor tyrosine kinase for ephrin ligands, EPHB2, is expressed in normal colorectal tissues and colorectal cancers (CRCs). The aim of this study was to investigate EPHB2 expression over CRC progression and determine its prognostic significance in CRC. METHODS: To measure EPHB2 mRNA and protein expression, real-time polymerase chain reaction and immunohistochemistry were performed in 32 fresh-frozen and 567 formalin-fixed paraffin-embedded CRC samples, respectively. We further investigated clinicopathological features and overall and recurrence-free survival according to EPHB2 protein expression. RESULTS: The EPHB2 level was upregulated in CRC samples compared to non-cancerous tissue in most samples and showed a strong positive correlation with AXIN2. Notably, CD44 had a positive association with both mRNA and protein levels of EPHB2. Immunohistochemical analysis revealed no difference in EPHB2 expression between adenoma and carcinoma areas. Although EPHB2 expression was slightly lower in invasive fronts compared to surface area (p < .05), there was no difference between superficial and metastatic areas. EPHB2 positivity was associated with lymphatic (p < .001) and venous (p = .001) invasion, TNM stage (p < .001), and microsatellite instability (p = .036). Kaplan–Meier analysis demonstrated that CRC patients with EPHB2 positivity showed better clinical outcomes in both overall (p = .049) and recurrence-free survival (p = .015). However, multivariate analysis failed to show that EPHB2 is an independent prognostic marker in CRCs (hazard ratio, 0.692; p = .692). CONCLUSIONS: Our results suggest that EPHB2 is overexpressed in a subset of CRCs and is a significant prognostic marker.
Adenoma ; Colorectal Neoplasms ; Humans ; Immunohistochemistry ; Ligands ; Microsatellite Instability ; Multivariate Analysis ; Prognosis ; Protein-Tyrosine Kinases ; Real-Time Polymerase Chain Reaction ; Receptor, EphB2 ; RNA, Messenger

Objectives: This study aimed to analyze the clinicopathological prognostic factors affecting the survival of patients with oral squamous cell carcinoma (OSCC). Materials and Methods: A retrospective study was conducted on patients with OSCC who received treatment at the Oral Oncology Clinic of the National Cancer Center (NCC) from June 2001 to December 2020. The patients’ sex, age, primary site, T stage, node metastasis, TNM staging, perineural invasion (PNI), lymphovascular invasion (LVI), differentiation, surgical resection margin, smoking, and drinking habits were investigated to analyze risk factors. For the univariate analysis, a Kaplan–Meier survival analysis and log-rank test were used. Additionally, for the multivariable analysis, a Cox proportional hazard model analysis was used. For both analyses, statistical significance was considered when P<0.05. Results: During the investigation period, 407 patients were received surgical treatment at the NCC. Their overall survival rate (OS) for five years was 70.7%, and the disease-free survival rate (DFS) was 60.6%. The multivariable analysis revealed that node metastasis, PNI, and differentiation were significantly associated with poor OS. For DFS, PNI and differentiation were associated with poor survival rates. Conclusion In patients with OSCC, cervical node metastasis, PNI, and differentiation should be considered important prognostic factors for postoperative survival.

Objective: : High precision and accuracy are expected in gamma knife radiosurgery treatment. Because of the requirement of clinically applying complex radiation and dose gradients together with a rapid radiation decline, a dedicated quality assurance program is required to maintain the radiation dosimetry and geometric accuracy and to reduce all associated risk factors. This study investigates the validity of Leksell Gamma plan (LGP)10.1.1 system of 5th generation Gamma Knife Perfexion as modified variable ellipsoid modeling technique (VEMT) method. Methods: : To verify LGP10.1.1 system, we compare the treatment plan program system of the Gamma Knife Perfexion, that is, the LGP, with the calculated value of the proposed modified VEMT program. To verify a modified VEMT method, we compare the distributions of the dose of Gamma Knife Perfexion measured by Gafchromic EBT3 and EBT-XD films. For verification, the center of an 80 mm radius solid water phantom is placed in the center of all sectors positioned at 16 mm, 4 mm and 8 mm; that is, the dose distribution is similar to the method used in the x, y, and z directions by the VEMT. The dose distribution in the axial direction is compared and analyzed based on Full-Width-of-Half-Maximum (FWHM) evaluation. Results: : The dose profile distribution was evaluated by FWHM, and it showed an average difference of 0.104 mm for the LGP value and 0.130 mm for the EBT-XD film. Conclusion : The modified VEMT yielded consistent results in the two processes. The use of the modified VEMT as a verification tool can enable the system to stably test and operate the Gamma Knife Perfexion treatment planning system.

Objectives: This study aimed to analyze the treatment outcomes and to evaluate the clinicopathological prognostic factors of oral tongue cancer. Patients and Methods: We retrospectively analyzed treatment results and prognostic factors in 205 patients with oral tongue squamous cell carcinoma who were admitted to the National Cancer Center, South Korea, between January 2001 and December 2020. The patients were treated with surgery and postoperative, definitive radiotherapy (RT) or chemoradiotherapy (CRT). Results: Eighteen patients (8.8%) were treated with curative RT or CRT, while the rest (91.2%) were treated with surgery with or without postoperative RT or CRT. The median follow-up period was 30 months (range, 0-234 months). The 5-year overall survival (OS) and 5-year disease-free survival (DFS) were 72% and 63%, respectively. Multivariate analysis revealed that a positive neck nodal status (N1, N2-3) was significantly associated with poorer 5-year OS and DFS, while perineural invasion was associated with poorer 5-year DFS. Conclusion Cervical metastasis and perineural invasion are significant prognostic predictors, and combination treatments are necessary for improving OS and DFS in patients with these factors.

PURPOSE: To compare the diagnostic performance of magnetic resonance (MR) sequences for the evaluation of cerebral venous sinus thrombosis (CVST) during follow-up examinations. MATERIALS AND METHODS: Thirteen cases that were confirmed to be CVST between January 2006 and March 2016 were included in this study. Two neuroradiologists independently examined each initial and follow-up MR sequence image in random order. RESULTS: Gadolinium-enhanced T1-weighted imaging (Gd-enhanced T1WI) was the most sensitive sequence for the detection of CVST in the initial and follow-up MR examinations (82% and 55.3%, respectively). Among the non-enhanced MR sequences of the initial examination, gradient-recalled echo was the most sensitive (77.4%), fluid-attenuated inversion recovery (FLAIR) had low sensitivity (34.4%). The overall diagnostic performances of all MR sequences except for FLAIR decreased during the follow-up. FLAIR was the most sensitive during follow-up, and was also the only sequence with increased sensitivity during follow-up (from 34.4% to 55.6%). CONCLUSION Gd-enhanced T1WI had the best diagnostic performance for CVST in both initial and follow-up MR examinations. Therefore, it is reasonable to use Gd-enhanced T1WI to evaluate CVST during follow-up examinations. However, for patients who cannot tolerate MR contrast agents, the use of FLAIR to assess the remaining CVST during the follow-up may be helpful.

BACKGROUND: Increasing evidence suggests a pivotal role for neuronal inflammation in response to replicating varicella zoster virus in the development of postherpetic neuralgia (PHN). OBJECTIVE: In this study, we investigated the value of serum levels of various inflammatory markers in acute herpes zoster (HZ) as predictors for the development of PHN. METHODS: A total of 116 patients with acute HZ were enrolled in this study. We measured scores on the pain visual analogue scale (VAS) at baseline and at 1, 3, and 6 months after diagnosis of HZ. We defined PHN as pain greater than 1 on the VAS lasting for more than 6 months. Serum samples for laboratory assay, including complete blood count were obtained at the initial visit. Correlations between the levels of each inflammatory marker and the development of PHN were evaluated. RESULTS: Levels of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), lymphocyte count, and albumin showed significant correlations with development of PHN in univariate analysis. Levels of ESR, CRP, and lymphocyte count also showed significant correlations in multivariate analysis. ESR level showed stronger correlations with development of PHN than levels of CRP and lymphocyte count. CONCLUSION: In this study, we confirmed that elevated ESR was an independent and significant predictor of PHN in patients with acute HZ. To validate these results, further well-designed, randomized clinical trials are needed.
Blood Cell Count ; Blood Sedimentation ; C-Reactive Protein ; Diagnosis ; Herpes Zoster* ; Herpesvirus 3, Human ; Humans ; Inflammation ; Lymphocyte Count ; Multivariate Analysis ; Neuralgia, Postherpetic* ; Neurons