• Clinical and Experimental Pediatrics
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• v.61 no.10
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• pp.322-326
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• 2018

Purpose: The EDIN scale (${\acute{E}}chelle$ Douleur Inconfort Nouveau-$N{\acute{e}}$, neonatal pain and discomfort scale) and heart rate variability has been used for the evaluation of prolonged pain. The aim of our study was to assess the value of the newborn infant parasympathetic evaluation (NIPE) index and EDIN scale for the evaluation of prolonged pain in preterm infants with chest tube placement due to pneumothorax. Methods: This prospective observational study assessed prolonged pain in preterm infants with a gestational age between 33 and 35 weeks undergoing installation of chest tubes. Prolonged pain was assessed using the EDIN scale and NIPE index. Results: There was a significant correlation between the EDIN scale and NIPE index (r=-0.590, P=0.003). Prolonged pain is significantly more severe in the first 6 hours following chest tube installation (NIPE index: 60 [50-86] vs. 68 [45-89], P<0.002; EDIN score: 8 [7-11] vs. 6 [4-8], P<0.001). Conclusion: Prolonged pain can be accurately assessed with the EDIN scale and NIPE index. However, evaluation with the EDIN scale is time-consuming. The NIPE index can provide instantaneous assessment of prolonged and continuous pain.

• Clinical and Experimental Pediatrics
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• v.60 no.8
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• pp.248-253
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• 2017

Purpose: Vitamin D plays a key role in immune function. Vitamin D deficiency may play a role in the pathogenesis of infections, and low levels of circulating vitamin D are strongly associated with infectious diseases. In this study, we aimed to evaluate the effects of low vitamin D levels in cord blood on neonatal sepsis in preterm infants. Methods: One hundred seventeen premature infants with gestational age of <37 weeks were enrolled. In the present study, severe vitamin D deficiency (group 1) was defined as a 25-hydroxyvitamin D (25(OH)D) concentration <5 ng/mL; vitamin D insufficiency (group 2), 25(OH)D concentration ${\geq}5ng/mL$ and <15 ng/mL; and vitamin D sufficiency (group 3), 25(OH)D concentration ${\geq}15ng/mL$. Results: Sixty-three percent of the infants had deficient levels of cord blood vitamin D (group 1), 24% had insufficient levels (group 2), and 13% were found to have sufficient levels (group 3). The rate of neonatal sepsis was higher in group 2 than in groups 1 and 3. Conclusion: There was no significant relationship between the cord blood vitamin D levels and the risk of neonatal sepsis in premature infants.

• Korean Journal of Adult Nursing
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• v.12 no.3
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• pp.407-417
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• 2000

The purpose of this study was to examine the effect of preoperative teaching as a nursing intervention on the emotional status of the patients prior to surgery. The method of this study was Nonequivalent Control Group Non-Synchronize Design. The data were selected from H universuty hospital in Seoul, and they consisted of an experimental group-30patients, and a control group-30 patients. The questionnaire consisted of 28 Preoperative Stress Inventory(Kang, 1998), and 16 State- Trait Anxiety Inventory(Spielberger, 1972). The collected data were analized by means of frequency, percentage, $X^2$ test, t-test and paired t-test with SPSS WIN. The results of this study were as follows : 1. The level of stress prior to surgery was significantly lower for the preoperative teaching group than for the control group(t=2.61, p< .01). 2. The level of anxiety prior to surgery was not significantly lower for the preoperative teaching group than for the control group. 3. The difference level of the anxiety level the prior to surgery was significantly higher for the preoperative teaching group than for the control group(t=2.82, p< .01). In conclusion, preoperative teaching is a beneficial nursing intervention that has a positive effect on the stress and anxiety of patients prior to surgery. Therefore it is recommended to use the preoperative teaching program as a nursing intervention for patients prior to surgery.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.13
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• pp.5199-5203
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• 2015

Background: Helicobacter pylori (H.pylori) is associated with chronic gastritis, peptic ulcers, gastric adenocarcinomas and mucosa associated tissue lymphomas. Cytotoxin associated gene A (CagA) is one of the virulence factors of H.pylori. It is hypothesized that reactive oxygen species (ROS) play roles in H.pylori associated disease especially in development of gastric adenocarcinoma. Individuals infected with H.pylori bearing CagA produce more ROS than others. 8-hydroxydeoxyguanosine (8OHdG) is an in vitro marker of DNA damage and oxidative stress. The aim of this study was to investigate the relationship between 8OHdG level, H.pylori infection and CagA and alterations of serum 8OHdG level after H.pylori eradication. Materials and Methods: Patients admitted with dyspeptic complaints and upper gastrointestinal endoscopy were assessed. H.pylori was determined from histopathology of specimens. Serum 8OHdG levels of three groups (H.pylori negative, H. pylori positive CagA negative and H.pylori positive CagA positive) were compared. Patients with H.pylori infection received eradication therapy. Serum 8OHdG levels pretreatment and posttreatment were also compared. Results: In total, 129 patients (M/F, 57/72) were enrolled in the study. Serum 8OHdG level of H.pylori negative, H. pylori positive CagA negative and H.pylori positive CagA positive groups were significantly different ($5.77{\pm}1.35ng/ml$, $5.43{\pm}1.14ng/ml$ and $7.57{\pm}1.25ng/ml$ respectively, p=0.05). Furthermore, eradication therapy reduced serum 8OHdG level ($6.10{\pm}1.54ng/ml$ vs $5.55{\pm}1.23ng/ml$, p=0.05). Conclusions: Individuals infected with H.pylori bearing CagA strains have the highest serum 8OHdG level and eradication therapy decreases the serum 8OHdG level. To the best of our knowledge this is the first study that evaluated the effect of CagA virulence factor on serum 8OHdG level and the effect of eradication therapy on serum 8OHdG levels together. Eradication of CagA bearing H.pylori may prevent gastric adenocarcinoma by decreasing ROS. 8OHdG level may thus be a good marker for prevention from gastric adenocarcinoma.

• PNF and Movement
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• v.11 no.1
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• pp.69-78
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• 2013

Purpose : This study was to investigate the satisfaction of clinical practice according to medical institute. Methods : A survey was administered for 70 college students with experience in clinical practices. We investigated using a questionnaire on 'curriculum factors on practice', 'environmental factors on practice', 'time-schedule factors on practice', 'teaching factors on practice'. A statistical analysis was performed using SPSS 17.0 for window version. Results : 1. The degree of satisfaction on curriculum of clinical practice was higher college hospital than other hospital in 3 among 5 items(p<.05). 2. The degree of satisfaction on environmental factors of clinical practice was higher school hospital than other hospital in 4 among 6 items(p<.05). 3. The degree of satisfaction on time-schedule factors of clinical practice was higher college hospital than other hospital in 1 among 5 items(p<.05). 4. The degree of satisfaction on teaching factors of clinical practice was higher college hospital than other hospital in 4 among 6 items(p<.05). Conclusion : It was revealed by this survey that the satisfaction of clinical practice in school hospital had higher other hospital in curriculum, environment and teaching factors. To maximize the effects of clinical practice, a clinical practice program in school hospital is required and further research and attention are suggested.

• Journal of Korean Clinical Nursing Research
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• v.19 no.2
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• pp.275-284
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• 2013

Purpose: This study was aimed to find out the effect of core competency and teaching style on preceptor self-efficacy among preceptors. Methods: One hundred twelve nurses working at four university hospitals with previous preceptor experience participated in the survey. The data were analyzed by t-test, ANOVA, Pearson correlation coefficients and multiple regression. Results: The preceptors used 'judgment-initiative' teaching style most frequently, and reported the highest scores in the role model dimension of core competency. There were significant positive relations between age (r=.266, p=.005), clinical experience (r=.274, p=.004), preceptorship experience (r=.204, p=.032), core competency (r=.593, p<.001) and preceptor self- efficacy. But preceptor self-efficacy was not significantly different depending on the teaching style (F=0.72, p=.54). The most predictive factors of the preceptor self-efficacy were core competency and teaching style (judgment)(F=31.849, p<.001). The explained variance for preceptor self-efficacy was 35.9% in the model. Conclusion: The preceptor self-efficacy is essential for the preceptors' successful teaching experience and the clinical competency improvement of the entry level nurses. Management for an effective preceptor training program needs to focus on the improvement of core competency of preceptors, which will lead to strengthen their self-efficacy.

• Korean Journal of Clinical Laboratory Science
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• v.50 no.2
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• pp.164-169
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• 2018

The development of teaching models to strengthen practical education and actively participate in the classes of students is now required in recent education situations. This study examined the participation and satisfaction level of students' classes after applying a teaching model-integrated hospital and school laboratory (named L2L). A total of 33 students who took the subject of a clinical microbiology experiments were involved in this study. Each group representative participating in a pre-class field exercise in the hospital microbiology laboratory was asked to conduct the experiment. After applying the L2L teaching models, the academic self-efficacy ($2.87{\pm}0.58{\rightarrow}3.38{\pm}0.55$), class participation ($2.60{\pm}0.92{\rightarrow}3.62{\pm}0.78$), and class satisfaction ($2.48{\pm}1.01{\rightarrow}3.85{\pm}0.87$) increased significantly (P<0.05). This means that pre-class field exercises created interest in the student's class and boosted self-confidence, leading to increased participation and satisfaction for the class. In conclusion, the L2L teaching model is an effective teaching method to enhance the practical training for preliminary clinical laboratory technologists.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.12
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• pp.5247-5250
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• 2016

Objective: Endometriosis, one of the most common estrogen dependent gynecological disorders, can present as both benign and malignant disease. The prevalence of tumoral transformation is 0.7-1.6% and the most common tumors are clear cell and endometrioid carcinomas. Unfortunately, the pathogenesis of transformation is unknown. For this purpose, we examined molecular alterations in ovarian endometriosis and endometriosis-associated tumors. Methods: Using the data bank of Alzahra hospital pathology department and paraffin blocks from appropriate cases were identified. Sections were cut and stained for 3 markers: estrogen receptor, P53 and bcl2. Correlations between findings were investigated. Results: Nineteen cases of endometriosis-associated tumor and 19 cases of endometriosis were identified. Staining for bcl2 was documented in 14 of 19 (73.7%) of endometriosis-associated tumor cases and also 7 of 19 (36.8%) endometriosis cases (P=0.02). Only 3 of the 19 (15.8%) endometriosis-associated tumors exhibited positive staining for estrogen receptors, compared with 14 of 19 (73.7%) endometriosis cases (P<0.001). Positive staining for P53 was noted in 5 of 19 (31.6%) endometriosis-associated ovarian tumor samples but was absent in endometriosis samples (0%), (P =0.008). Conclusions: Endometriosis-associated tumors appear to be associated with overexpression of bcl2 and P53 and reduced expression of Estrogen receptor. These finding may help to diagnose tumoral transformation with a background of endometriosis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.40 no.6
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• pp.272-277
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• 2014

Objectives: Non-vascularized iliac crest bone graft (NVIBG) is a known treatment option in mandibular reconstruction following jaw resection, but no documented review of patients treated with NVIBG exists for northern Nigeria. The experience and technique from a Nigerian tertiary hospital may serve as baseline data for comparison and improvement of practice for other institutions. Materials and Methods: A retrospective review of medical records and patient case files from January 2012 to December 2013 was undertaken. All case files and other medical records of patients who had reconstruction with NVIBG for benign or malignant lesions with immediate or delayed reconstruction were selected for review. Results: Twenty patients had mandibular reconstruction with NVIBG during the study period. Two patients were excluded because of incomplete medical records. Eighteen patients' (male=14, female=4) records were reviewed. Their ages ranged from 13 to 62 years (mean $26.0{\pm}10.6years$). Indications for NVIBG included jaw tumors (n=16; 88.3%), jaw cyst (n=1; 5.6%) and gunshot injury (n=1; 5.6%). Jaw tumors seen were ameloblastoma (n=15; 83.3%) and osteosarcoma (n=1; 5.6%). Treatments done were mandibular resection with condylar resection (n=7; 38.9%), mandibular segmental resection (n=10; 55.6%) and subtotal mandibulectomy (n=1; 5.6%). Patients' postoperative reviews and radiographs revealed good facial profile and continued bone stability up to 1 year following NVIBG. Conclusion: NVIBGs provide an acceptable alternative to vascularized bone grafts, genetically engineered bone, and distraction osteogenesis for mandibular reconstruction in resource-limited centers.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.9
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• pp.5095-5099
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• 2013

Background: The overall incidence of breast cancer in South Asian countries, including Nepal, is low compared to Western countries. However, the incidence of breast cancer among young women is relatively high. Breast cancer in such cases is characterized by a relatively unfavorable prognosis and unusual pathological features. The aim of this study was to investigate clinico-pathological and biological characteristics in younger breast cancer patients (<40 years) and compare these with their older counterparts. Materials and Methods: Nine hundred and forty four consecutive female breast cancer patients, admitted to the Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal between November 1997 and October 2012, were retrospectively analyzed. Results: Out of the 944 female breast cancer patients, 263 (27.9%) were <40 years. The mean age was $34.6{\pm}5.0$ years among younger patients compared to $54.1{\pm}9.9$ for those ${\geq}40$ years. The mean age at menarche was also significantly lower ($13.5{\pm}1.5$ vs $14.2{\pm}1.5$ years p=0.001) while the mean duration of symptoms was significantly longer (7.6 vs 6.5 months p=0.004). Family history of breast cancer was evident in 3.0% of the young women versus 0.3% in the older one. Mammography was performed less frequently in younger patients (59.7%), compared to older (74.4%), and was of diagnostic benefit in only 20% of younger patients compared to 85% of older ones. At diagnosis, the mean tumor diameter was significantly larger in young women ($5.0{\pm}2.5$ vs $4.5{\pm}2.4cm$, p=0.005). Axillary lymph nodes were positive in 73% of younger patients and 59% of older patients. In the younger group, the proportion of stage III or IV disease was higher (55.1% vs 47.1%, $p{\leq}0.05$). The proportion of breast conserving surgery was higher in young patients (25.1% vs 8.7%) and a higher proportion of younger patients receive neoadjuvant chemotherapy (9.9% vs 2.8%). The most common histological type was ductal carcinoma (93.1% vs 86%). The proportion of histological grade II or III was higher in younger patients (55.9% vs 24.5%). Similarly, in the younger group, lymphatic and vascular invasion was more common (63.2% vs 34.3% and 39.8% vs 25.4%, respectively). Patients in the younger age group exhibited lower estrogen and/or progesterone receptor positivity (34.7% vs 49.8%). Although statistically not significant, the proportion of triple negative tumors in younger age group was higher (22.4% vs 13.6%). Conclusions: Breast cancer in young Nepalese women represents over one quarter of all female breast cancers, many being diagnosed at an advanced stage. Tumors in young women exhibit more aggressive biological features. Hence, breast cancer in young women is worth special attention for earlier detection.