• Journal of Korean Academy of Nursing
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• v.47 no.6
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• pp.842-853
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• 2017

Purpose: This study was conducted to identify effects of debriefing based on the clinical judgment model for nursing students on their knowledge, skill performance, clinical judgment, self-confidence and learner satisfaction during simulation based end-of-life care (ELC) education. Methods: Simulation based ELC education was developed in six steps as follows: selection of learning subjects and objects, development of learning tools, a trial run of simulation-based education, students' skill training, and evaluators' training. Forty-eight senior nursing students (25 in the experimental group and 23 in the control group) participated in the simulation-based ELC education using a high-fidelity simulator. Debriefing based on the clinical judgment was compared with the usual debriefing. Results: ANCOVA showed that there were differences in knowledge (F=4.81, p=.034), skill performance (F=68.33, p<.001), clinical judgment (F=18.33, p<.001) and self-confidence (F=4.85, p=.033), but no difference in satisfaction (t=-0.38, p=.704) between the experimental and control groups. Conclusion: This study found that debriefing based on the clinical judgement model is effective for supporting nursing students for reflecting on clinical judgment and improving their diverse competencies in complex clinical settings such as ELC.

• Journal of Oriental Neuropsychiatry
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• v.32 no.2
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• pp.111-127
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• 2021

Objectives: To review and analyze clinical and preclinical evidence of effectiveness, safety, and underlying mechanisms of yokukansan (YKS), a herbal medicine, in alleviating aggression. Methods: Classical records on YKS were searched in the Korean Traditional Medicine Knowledge Database (KTMKD). By searching five electronic databases, prospective clinical studies and preclinical studies of YKS for alleviating aggression/agitation published up to March 30, 2021 were included. Results: Only two classical records on YKS were found from the KTMKD. A total of 11 clinical studies and 15 preclinical studies were found from the five electronic databases. Among 11 clinical studies, seven enrolled patients with dementia and four enrolled patients with other neuropsychiatric disorders. Most clinical studies reported significant improvement in one or more outcomes related to aggression in the YKS group after treatment. Among 15 preclinical studies, all studies except two reported a significant decrease in aggression/agitation-related behavior of YKS or yokukansankachimpihange. Suggested underlying mechanisms of YKS or yokukansankachimpihange for aggression/agitation in these studies included regulation of serotonin receptor, amelioration of abnormal glucocorticoid level related to the hypothalamic-pituitary-adrenal axis, regulation of orexin secretion, amelioration of degeneration in brain cells including glia cells, and suppression of excessive glutamatergic or dopaminergic activity. Conclusions: There were some clinical and preclinical evidence supporting the effectiveness and safety of YKS for alleviating aggression. Given that aggression is the most frequent and destructive symptoms of behavioral and psychological symptoms of dementia, applicability of YKS as a herbal medicine should be further investigated in future high-quality research.

• Clinical and Experimental Reproductive Medicine
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• v.39 no.1
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• pp.22-27
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• 2012

Objective: To evaluate the effectiveness of GnRH antagonist multiple dose protocol applied during early and late follicular phase (MDP-EL) in comparison with standard GnRH agonist luteal long protocol (LP) in each non-obese and obese polycystic ovary syndrome (PCOS) women undergoing IVF. Methods: Two hundred eleven infertile women with PCOS were recruited and randomized to undergo either GnRH antagonist MDP-EL (antagonist group) or standard GnRH agonist luteal LP (agonist group). IVF cycle outcomes were compared between the two groups. Results: Total dose and days of recombinant human follicle stimulating hormone (rhFSH) administered were significantly fewer in the antagonist group than in the agonist group. Incidence of severe ovarian hyperstimulation syndrome was significantly lower in the antagonist group. However, IVF and pregnancy outcomes were similar in the two groups. When all subjects were divided into non-obese and obese subgroups, in non-obese PCOS subgroup, IVF and pregnancy outcomes were comparable in the antagonist and agonist groups but total dose and days of rhFSH were also significantly fewer in the antagonist group. Similar findings were also observed in obese PCOS subgroup. Conclusion: GnRH antagonist MDP-EL is at least as effective as GnRH agonist LP and may be a more patient-friendly alternative in controlled ovarian stimulation for PCOS patients undergoing IVF, independent of body mass index.

• Korean Journal of Adult Nursing
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• v.22 no.2
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• pp.121-129
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• 2010

Purpose: In numerous studies, MBSR programs have been shown to reduce stress and improve health-related QOL. Although MBSR programs have been shown to be beneficial, its effects have not been well-determined among Korean populations in clinical nursing practice. The purpose of this review was to describe the effects of MBSR on stress and health-related QOL so that the potential benefits of this intervention may be evaluated for wider application in Korea. Methods: Articles published in peer-reviewed journals in the English or Korean language up to 2009 were reviewed; 14 articles met the inclusion criteria for this review and there were no Korean papers. Results: MBSR groups were found to have significantly reduced stress outcomes relative to non-MBSR groups in 6 of 11 studies. In regards to health-related QOL, participants of the MBSR programs had increased scores after MBSR intervention relative to control groups in 5 of 7 studies. Conclusion: MBSR programs was effective in decreasing stress and increased the health-related QOL in the majority of studies reviewed. MBSR merits study in Korean patients to determine whether similar salutary patient outcomes may be obtained.

• Perspectives in Nursing Science
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• v.8 no.2
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• pp.148-155
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• 2011

Purpose: The aims of this study were to (1) summarize the HF self-management interventions and (2) identify gaps and priorities for further investigation. Methods: A computer search of the literature over the past decade yielded 9 HF self-management studies. Six studies used non-experimental design; only 3 (33%) studies used quasi-experimental design which were included in this review. Results: The three pivotal HF self-management interventions studies were important because they highlight the positive effects of self-management compliance and other quality of life outcomes as well as discussing various issues. The informational booklet and telephone follow-up were the most common modalities in these interventions. The periodic telephone counseling offered in 2 studies effectively facilitated patient self-management compliance. There were some methodological flaws such as small sample sizes (range 8~21 in each group) and lack of experimental designs, long-term follow-up, and random group assignment. Additionally, the use of valid, reliable outcome measures is necessary to compare the effects of the interventions worldwide. Conclusion: More clinical evidence on HF self-management is needed using a larger sample size and the efficacy needs to be tested for various outcomes, including morbidity, mortality, and health care cost.

• Journal of Chest Surgery
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• v.50 no.6
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• pp.415-423
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• 2017

Background: Recently, many surgeons have chosen sublobar resection for the curative treatment of lung tumors with ground-glass opacity, which is a hallmark of lepidic lung cancer. The purpose of this study was to evaluate the oncological results of sublobar resection for non-lepidic lung cancer in comparison with lobectomy. Methods: We conducted a retrospective chart review of 328 patients with clinical N0 non-small cell lung cancer sized ${\leq}2cm$ who underwent curative surgical resection from January 2009 to December 2014. The patients were classified on the basis of their lesions into non-lepidic and lepidic groups. The survival rates following lobectomy and sublobar resection were compared within each of these 2 groups. Results: The non-lepidic group contained a total of 191 patients. The 5-year recurrence-free survival rate was not significantly different between patients who received sublobar resection or lobectomy in the non-lepidic group (80.1% vs. 79.2%, p=0.822) or in the lepidic group (100% vs. 97.4%, p=0.283). Multivariate analysis indicated that only lymphatic invasion was a significant risk factor for recurrence in the non-lepidic group. Sublobar resection was not a risk factor for recurrence in the non-lepidic group. Conclusion: The oncological outcomes of sublobar resection and lobectomy in small-sized non-small cell lung cancer did not significantly differ according to histological type.

• Journal of Korean Traditional Oncology
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• v.22 no.1
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• pp.13-22
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• 2017

Objective: The purpose of this study is to report the effect of Nobongsangki-Jeong on skin rash caused by Olmutinib. Methods: A female Non-Small cell lung carcinoma patient (Adenocarcinoma, Stage IV, Epidermal Growth Factor Receptor positive) suffered from skin rash due to the side effect of Olmutinib administration. She was treated with Nobongsangki-Jeong for the symptom management for 14 days. The clinical outcomes were measured by numeric rating scale (NRS) and National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) version 4.03. Results: After treatment, skin rash was improved from NRS 5 to 1. Pruritus and pain of skin were improved from NCI-CTCAE grade 2 to 1. Conclusion: This case study suggests that Nobongsangki-Jeong may have the efficacy for the treatment of skin rash caused by Olmutinib.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.5
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• pp.2435-2438
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• 2016

Background: MiRNAs, small non coding RNAs, play a role in the regulation of hematopoiesis, with effects on cell growth, differentiation, and apoptosis. In addition, MiRNAs are thought to play an important role in tumorigenesis. The miR146a G>C polymorphism can lead to alteration of miR146 expression, which appears to be associated with development and progression of several cancers. This study aimed to investigate the association of the miRNA146a (rs2910164) G>C polymorphism and susceptibility to childhood acute lymphoblastic leukemia (ALL) and clinical outcomes. Materials and Methods: Totals of 100 childhood ALL patients and 200 healthy children were studied for miR146a polymorphisms using polymerase chain reaction-restriction fragment-length polymorphism (PCR-RFLP). Results: The frequency of the miR146a G allele in controls was 0.40 compared with 0.38 in ALL patients. There was no association between miRNA146a (rs2910164) G>C polymorphism and susceptibility to childhood ALL (OR=1.484, 95%CI=0.712-3.093, p=0.290). Moreover, the frequencies of miR146a (rs2910164) G>C polymorphism were not associated with demographic data and clinical outcomes in ALL cases. Conclusions: The miRNA146a polymorphism was not significantly associated with susceptibility to Thai childhood ALL or any clinico-pathological variables.

• Clinical and Experimental Reproductive Medicine
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• v.25 no.3
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• pp.341-348
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• 1998

Objective: To determine the reproductive outcomes of women undergoing microsurgical reversal of tubal sterilization at age 36 years or older. Materials and Methods: A series of 133 patients who received microsurgical reversal of the previously sterilized fallopian tubes at Seoul National University Hospital from July, 1980 to January, 1992 was reviewed and evaluated for clinical characteristics, pregnancy rates, and factors influencing the outcome of tubal reversal. Results: Of 133 patients, 78 (58.6%) had been sterilized by laparoscopic cautery. Loss of children was a leading cause for tubal reversal. The mean interval from tubal sterilization to tubal reversal was 65.0 months. The overall pregnancy rate was 52.6% (70/133), and the mean interval was 9.4 months from tubal reversal to pregnancy. Excluding 7 patients who were lost to follow-up, 76 pregnancies were confirmed in 63 patients with the delivery rate per patient of 66.7% (42/63). There were no significant differences in age, duration of tubal sterilization, postoperative tubal length between pregnant and non-pregnant groups. Conclusions: Microsurgical reversal of tubal sterilization could be a justifiable method in women 36 years age or older.

• Journal of Korean Neurosurgical Society
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• v.59 no.3
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• pp.287-291
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• 2016

Objective : Because elderly patients are undergoing more surgeries, the importance of postoperative cognitive impairment (CI) evaluations is rising, especially for spine surgery, which is related to subjective pain. We investigated the prevalence of undiagnosed CI among elderly patients who underwent spine surgery and the impact of CI on postoperative outcomes. Methods : The preoperative cognitive statuses of 129 patients over 65 who underwent lumbar spine surgery from 2012 to 2014 were determined with the Mini-Mental State Examination, and patients with scores under 24 were diagnosed with CI. The patients were then divided into a CI group (n=49) and non-cognitive impairment (NCI) group (n=80). Results : Among the 129 patients, 49 (38.0%) were diagnosed with CI, and 9 (7.0%) had severe CI. The age of the CI group ($72.88{\pm}6.20years$) was significantly greater than that of the NCI group ($69.96{\pm}4.53years$). In contrast, the postoperative visual analog scale scores and performance statuses did not differ significantly. However, postoperative delirium was more frequent and the hospital stay length was longer in the CI group compared with the NCI group (p<0.05). Conclusion : A high prevalence of undiagnosed CI was discovered among elderly patients undergoing spine surgery. The existence of CI was associated with higher rates of postoperative delirium and prolonged hospital stays, which affected clinical outcomes. Thus, CI assessments should be included in preoperative evaluations of elderly patients prior to spine surgery.