PURPOSE: The purpose of this study was to investigate the effects of a action-learning based simulation practice program on nursing students' interpersonal communication competence and problem solving ability.METHOD: The action-learning based simulation practice program was developed by using the ADDIE mode. A single group pre-post test and time series design was used. Data was collected from senior in nursing university. 89 students participated in pretest group and 116 students participated in posttest group.RESULTS: Interpersonal communication competence and problem solving ability were significantly higher in posttest group than pretest group.CONCLUSION: Action-learning based simulation practice program is an effective teaching strategy to enhance communication competence and problem solving ability.
Evaluation Studies as Topic ; Humans ; Mental Competency ; Methods ; Nursing ; Problem Solving ; Students, Nursing

No abstract available.
Bacteria* ; Ulsan*

BACKGROUND: The pathophysiological and neurochemical changes following spinal injury are not yet elucidated. This study was designed to evaluate the morphological changes of the dorsal horn of the spinal cord and profiles of pain behaviors following intraspinal injection of NMDA in rats. METHODS: Rats were randomized into three groups: a sham-operated control group and groups where the rats received 10 mM or 100 mM N-methyl-D-aspatate (NMDA) injected into their spinal dorsal horn. Following injection, hypersensitivity to cold and mechanical stimuli and excessive grooming behaviors were assessed serially for four weeks. Morphological changes of the spinal cord were evaluated four weeks after intraspinal injection. RESULTS: Few animals in the NMDA groups developed hypersensitivity to cold and mechanical stimuli. The number of groomers and the severity of excessive grooming were significantly higher in the 100 mM NMDA group than those values of the control and 10 mM NMDA groups. The size of the neck region (lamina III-IV) was significantly smaller in the 100 mM NMDA group than in the control and 10 mM NMDA groups. CONCLUSIONS: In conclusion, intraspinal injection of NMDA in rats leads to the pathological sequela in the spinal cord and to excessive grooming behavior. These results support the use of NMDA and excessive grooming behavior after excitotoxic SCI as a model to study chronic pain after SCI.
Animals ; Chronic Pain ; Cold Temperature ; Grooming ; Horns ; Hypersensitivity ; Injections, Spinal ; N-Methylaspartate ; Neck ; Pilot Projects ; Rats ; Spinal Cord ; Spinal Cord Injuries ; Spinal Injuries

PURPOSE: This study examined the effects of fast walking training on a treadmill on the spinal alignment and muscle thickness of normal adults. METHODS: A total of 36 college students in their twenties participated in the study for eight weeks, and they were divided into the normal walking, fast walking, and speed change groups. All the groups were measured in a pre-test before training. The subjects performed exercise three times per week for six weeks. A post-test was conducted six weeks after training began, and a follow-up test was done two weeks after the training ended.Trunk and pelvic tilts were measured in Formetric 4D for the spinal alignment of the subjects. The muscle thickness was examined in the trunk with an ultrasound test. Repeated-measures ANOVA was conducted to test the main effects and interactions among the measurement variables according to time and group. RESULTS: ignificant differences were observed in the pelvic tilt according to time. There were significant differences in the external oblique, internal oblique, transverse abdominal muscle according to time. The post-test results showed significant differences in the left external oblique, internal oblique muscles between before training, six weeks into training, and two weeks after the completion of training. There were significant interactions in the left oblique muscles according to the time and group. CONCLUSION: These findings have some value for patient rehabilitation and clinical applications and interventions through walking training.
Abdominal Muscles ; Adult ; Follow-Up Studies ; Humans ; Muscles* ; Rehabilitation ; Ultrasonography ; Walking

Myoepithelioma is a rare tumor composed of cells that are morphologically similar to myoepithelial cells. Myoepithelial tumors usually occur in major and minor salivary glands, though have also been found in sweat and mammary glands. Myoepithelioma very rarely originates in lung parenchyma, though can arise from tracheobronchial submucosal glands. We encountered a case of myoepithelioma originating in lung parenchyma, and report the CT findings, including the pathologic characteristics of the disease.
Lung Neoplasms ; Lung* ; Mammary Glands, Human ; Myoepithelioma* ; Salivary Glands, Minor ; Sweat

PURPOSE: Dysregulation of gastric epithelial cell proliferation and apoptosis are important in development of ulcer, atrophy and neoplasia in Helicobacter pylori (H. pylori) infection. The aim of this study was to investigate the effect of infection of H. pylori on gastric epithelial cell proliferation and apoptosis in children. METHODS: Histological grading by updated Sydney system, PCNA immunostaining and TUNEL method were performed in H. pylori positive (N=58) and negative (N=40) gastric biopsy specimens. RESULTS: In H. pylori positive children, there were significantly higher grade of polymorphonuclear neutrophil activity (P=0.000), chronic inflammation (P=0.000), epithelial damage (P=0.000) and lymphoid follicles (P=0.000) than in H. pylori negative children. Intestinal metaplasia was not seen in H. pylori positive children. PCNA index was significantly different between H. pylori positive children (67.8+/-18.13) and H. pylori negative children (54.8+/-14.46, P=0.000). There was positive correlation between PCNA index and H. pylori density (r=0.277, P=0.007), polymorphonuclear neutrophil activity (r=0.280, P=0.007) and chronic inflammation (r=0.284, P=0.006). Apoptosis index of H. pylori positive children (0.44+/-0.447) was significantly higher than of H. pylori negative children (0.14+/-0.196, P=0.000). There was positive correlation between apoptosis index and H. pylori density (r=0.472, P=0.000), polymorphonuclear neutrophil activity (r=0.370, P=0.001) and chronic inflammation (r=0.483, P=0.000). There was positive correlation between PCNA index and apoptosis index (r=0.353, P=0.003). CONCLUSION: The PCNA and apoptosis index in H. pylori positive children were significantly higher than in H. pylori negative children. This study suggested that gastric epithelial cell proliferation and apoptosis are important to pathogenesis of H. pylori infection in children.
Apoptosis* ; Atrophy ; Biopsy ; Child* ; Epithelial Cells* ; Helicobacter pylori* ; Helicobacter* ; Humans ; In Situ Nick-End Labeling ; Inflammation ; Metaplasia ; Neutrophils ; Proliferating Cell Nuclear Antigen ; Ulcer

A dissecting aneurysm of the vertebral artery may be treated conservatively, surgically, or using an endovascular approach. Proximal clipping, wrapping or trapping are surgical treatment methods, and endovascular treatment with coils and balloons is performed where a dissecting aneurysm is located near the midline or the appropriate surgical manipulation is difficult. As the contralateral vertebral artery of this patient was hypoplastic, the stent-assisted coil embolization technique was employed to preserve the ipsilateral vertebral artery. We describe a clinical case of dissecting aneurysm of the vertebral artery occurring in a patient in whom a hypoplastic contralateral vertebral artery was successfully treated.
Aneurysm, Dissecting* ; Embolization, Therapeutic* ; Humans ; Intracranial Aneurysm ; Stents* ; Vertebral Artery*

BACKGROUND:Rotational atherectomy has been developed for several years. It is a useful tool in complex coronary lesion morphologies such as diffuse, calcific, ostial and angulated lesion. We report initial experience of the rotational atherectomy in complex coronary artery morphology. METHODS: We included 64 patients who was treated with rotational atherectomy since July 1997 to February 1999. Mean age was 56+/-9 years with 47 male patients. Clinical diagnosis was 12 acute myocardial infarction, 49 unstable angina, and 3 stable angina. Rotational atherectomy was done by transfemoral or transradial approach with adjunctive ballooning and/or stenting in all patients. RESULTS: Ninty-one percent of the treated lesions showed complex lesion morphologies (B2/C lesion) with 43 left anterior descending artery and 19 right coronary artery. Rotational atherectomy was done in 37 de novo lesion (58%) and 27 (42%) restenosis patients. Transradial approach was done in 33 patients (52%). Mean maximal burr size was 1.68 mm and mean burr to reference artery ratio was 0.63. Rotastenting were done in 58% of the patients with higher post-procedure minimal lumen diameter, % diameter stenosis and net gain than rotablator with adjunctive balloon angioplasty. Overall procedural success was 94% (62/64). Complications were one non-Q infarction, one coronary artery perforation, two slow flow, and one guidewire fracture. None of the patients showed inhospital mortality or 30 day cardiac event (death, emergency CABG, Q-infarction, or re-intervention). CONCLUSION: Rotational atherectomy is a useful technique with high success rate without showing major cardiac events during inhospital period and within 30 days.
Angina, Stable ; Angina, Unstable ; Angioplasty, Balloon ; Arteries ; Atherectomy ; Atherectomy, Coronary* ; Constriction, Pathologic ; Coronary Artery Disease* ; Coronary Vessels* ; Diagnosis ; Emergencies ; Hospital Mortality ; Humans ; Infarction ; Male ; Myocardial Infarction ; Stents

Objective To investigate the clinical outcomes of an invasive strategy for elderly (aged≥75 years) patients with acute ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock (CS). Methods Data on 366 of 409 elderly CS patients from a total of 6,132 acute STEMI cases enrolled in the Korea Acute Myocardial Infarction Registry between January 2008 and June 2011, were collected and analyzed. In-hospital deaths and the 1-month and 1-year survival rates free from major adverse cardiac events (MACE;defined as all cause death, myocardial infarction, and target vessel revascularization) were reported for the patients who had undergone invasive (n=310) and conservative (n=56) treatment strategies. Results The baseline clinical characteristics were not significantly different between the two groups. There were fewer in-hospital deaths in the invasive treatment strategy group (23.5%vs. 46.4%, P＜0.001). In addition, the 1-year MACE-free survival rate after invasive treatment was significantly lower compared with the conservative treatment (51%vs. 66%, P=0.001). Conclusions In elderly patients with acute STEMI complicated by CS, the outcomes of invasive strategy are similar to those in younger patients at the 1-year follow-up.

To classify the causes of hypogonadotropic hypogonadism in Korean patients, and to improve the endocrinologic evaluation for the disease, we retrospectively studied the clinical findings and result of combined pituitary stimulation test in 35 patients with hypogonadotropic hypogonadism. The following results were obtained.1) The ratio of male to female was 1.3:1, and the 50% of male patients was under 20 years of age and the 20% of female patients in 30th decades. 2) The chief complaints of male patients on the admission were the failure of secondary sexual characteristics(95.0%) and loss of hair(5.0%), those of female patients were amenorrhea(46.7%), infertility(26.7%), failure of secondary characteristics(13.3%) and loss of hair(13.3%). 3) The causes of male hypogonadotropic hypogonadism were craniopharyngioma(35.0%), idiopathic(30.0%), Kallmann's syndrome(15.0%), pituitary adenoma(10.0%) and germinoma(5.0%), and those of female hypogonadotropic hypogonadism were prolactinoma(13.3%), Sheehan's syndrome(26.6%), pituitary adenoma(6.7%), tuberculous granuloma(6.7%), germinoma(6.7%), idiopathic hypogonadotropic hypogonadism(40.0%).4) The responses of LH and FSH to GnRH test were absent or markedly blunted in diffuse pituitary diseases such as pituitary tuberculous granuloma, pituitary macroadenomas, Sheehan's syndrome. However those were also absent or blunted in Cushing's disease and hypothalamic disease such as Kallmann's syndrome, germinoma, craniopharyngioma, idiopathic hypogonadotropic hypogonadism. 5) The responses of LH, FSH increased after repeated injection of GnRH in a patient with germinoma. 6) In diffuse destructive pituitary diseases such as Sheehan's syndrome, nonfunctioning macroadenomas, tuberculous granuloma, large prolactinoma, the combined deficiency of pituitary hormones other than gonadotropins was observed. 7) In many cases with hypothalamic diseases, the combined defects of pituitary hormone response were also seen.These data suggest that GnRH test is not always useful to localize the lesion between pituitary and hypothalamus, and combined pituitary stimulation test revealed defects of pituitary hormones other than gonadotropin in various hypothalamic diseases.Therefore repeated GnRH test would be useful for the differential diagnosis, and CRH test and GRH test would be necessary to demonstrate whether pituitary abnormality is present.
Craniopharyngioma ; Diagnosis, Differential ; Female ; Germinoma ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Granuloma ; Humans ; Hypogonadism ; Hypopituitarism ; Hypothalamic Diseases ; Hypothalamus ; Kallmann Syndrome ; Male ; Pituitary Diseases ; Pituitary Hormones ; Prolactinoma ; Retrospective Studies