Purpose: Until now, students wrote only differential diagnoses and plans during the interstation work (IW) portion of clinical performance examinations (CPX). The contents of history taking (Hx) and the physical examination (PE) were only evaluated using checklists. This study addressed the correlations of Hx and PE scores from the checklists and the subsequent IW to research the necessity of adding Hx and PE sections in to the IW. Methods: One hundred and thrity-three students participated in a ten case CPX, and eight cases were used in this study. Immediately following the 12 minute patient encounter, students were given 6 minutes to write the IW. For the Hx and PE section, students were instructed to write the findings that they considered key information in approaching the patient's problem. The Hx and PE sections of the IW were scored using the same items that appeared on the SP checklist. Calculations of Spearman's rho were performed to find the relationship between the checklist scores and IW scores of Hx and PE sections. Results: Correlations of Hx and PE scores between the SP checklists and IW were low to moderate. Across the eight cases, the median Spearman's rho was 0.37 with a range of 0.14 to 0.54. Conclusion: We suggest that, because SP checklist scores measure only what information the students gather, but not their reasons for doing so (e.g.: relative importance), students tend gather very specific information from the patients. By analyzing of their IW, we were able to explore how students prioritize the important information they have obtained from the patients.
Objective : We compared the radiological and clinical outcomes between patients who underwent posterior fixation alone and supplemented with fusion following the onset of thoracolumbar burst fractures. In addition, we also evaluated the necessity of posterolateral fusion for patients treated with posterior pedicle screw fixation. Methods : From January 2007 to December 2009, 46 consecutive patients with thoracolumbar burst fracture were included in this study. On the basis of posterolateral fusion, we divided our patients into the non-fusion group and the fusion group. The radiological assessment was performed according to the Cobb's method, and results were obtained at immediately, 3, 6, 12 months after surgery. The clinical outcomes were evaluated using the modified Mcnab criteria at the final follow-up. Results : The demographic data and the mean follow-up period were similar between the two groups. Patients of both groups achieved satisfactory clinical outcomes. The mean loss of kyphosis correction showed that patients of both groups experienced loss of correction with no respect to whether they underwent the posterolateral fusion. There was no significant difference in the degree of loss of correction at any time points of the follow-up between the two groups. In addition, we also compared the effect of fixed levels (i.e., short versus long segment) on loss of correction between the two groups and there was no significant difference. There were no major complications postoperatively and during follow-up period. Conclusion : We suggest that posterolateral fusion may be unnecessary for patients with thoracolumbar burst fractures who underwent posterior pedicle screw fixation.
Primary cytomegalovirus (CMV) infection during pregnancy can cause congenital defects. Available data for CMV infection during pregnancy in north China are inadequate. The aim of this study was to evaluate the epidemiology of maternal CMV infection and explore the incidence of congenital infection. In this prospective study, serum CMV IgG and IgM antibodies were measured in 2,887 pregnant women using ELISA, and the IgG avidity test was performed on all IgM-positive subjects. The seroprevalence of anti-CMV IgG was 94.70%, and of anti-CMV IgM was 1.28%. CMV IgG prevalence increased significantly with age (p < 0.01). Women living in downtown areas showed higher IgG prevalence than those residing in urban areas (p = 0.023). CMV-IgM seroprevalence was highest in autumn (p = 0.021). There was no difference in IgM seroprevalence by age, socioeconomic status, geographical area, or gravida. The rate of primary CMV infection was 0.45% (13/2,887) at the first trimester. The seroconversion rate during pregnancy was 0.76% (22/2,887). One woman underwent seroconversion during pregnancy and gave birth to an infant with asymptomatic CMV infection. Congenital CMV infection was diagnosed in five of the 14 infants from 14 mothers with active infection, for a vertical transmission rate of 35.71% (5/14). Three infants were asymptomatic, whereas two infants presented symptomatic infection with hearing deficits. Although CMV IgG prevalence is relatively high in north China, significant attention to primary CMV infection during pregnancy is still needed.
Background: Oral carcinoma (OC) remains as one of the most difficult malignancies to cure. Hesa-A is an Iranian herbal-marine compound that has shown promising anti-tumor properties on various human cancer cells, although the mechanisms of action remain to be addressed. This study was conducted to evaluate the effect of two doses of Hesa-A on mRNA expression of p53 as a main prognosticator of OC. Materials and Methods: 60 rats were randomly divided into 5 groups of 12 animals each. Rats in carcinoma groups received 0, 250 and 500 mg/kg body weight of Hesa-A three times a day. The two other groups considered as treated and untreated healthy groups. At the end of experiment, animals were sacrificed and tongue tissues subjected to H and E staining and real time PCR. Results: Our results indicated that compared to healthy group, p53 over expressed ~ 40% in untreated carcinoma group. After treatment with 250mg/kg and 500mg/kg body weights of Hesa-A, p53 level dropped by 53.4% and 13.6 %, respectively, compared to untreated carcinoma group (p<0.05, p<0.0001). Moreover, there was a significant relation between p53 mRNA content and observed pathological changes in studied groups (p<0.05). Conclusions: These data provide insights into the mechanism(s) by which Hesa-A improves clinical outcome of oral carcinoma by modulation of p53 expression.
Gallegos-Vargas, JA;Sanchez-Roldan, J;Ronquillo-Sanchez, MD;Carmona-Aparicio, L;Floriano-Sanchez, E;Cardenas-Rodriguez, N
Asian Pacific Journal of Cancer Prevention
/
v.17
no.7
/
pp.3477-3482
/
2016
Background: Thyroid cancer is the most common endocrine malignancy, and exact causes remain unknown. The role of CYP450 1A1 (CYP1A1) in cancer initiation and progression has been investigated. The aim of this work was to analyze, for the first time, CYP1A1 gene expression and its relationship with several clinicopathological factors in Mexican patients diagnosed with thyroid cancer. Materials and Methods: Real-time PCR analysis was conducted on 32 sets of thyroid tumors and benign pathologies. Expression levels were tested for correlations with clinical and pathological data. All statistical analysis were performed using GraphPad Prism version 3.0 software. Results: We found that female gender was associated with thyroid cancer risk (P<0.05). A positive relationship was identified between CYP1A1 mRNA levels and the presence of chronic disease, alcohol use, tumor size, metastasis and an advanced clinical stage (P<0.05). Conclusions: The results suggest that CYP1A1 gene expression could be used as a marker for thyroid cancer.
Im, Sook Bin;Kim, Se Young;Ko, Young;Lee, Mi Young
Journal of Korean Clinical Nursing Research
/
v.18
no.2
/
pp.215-227
/
2012
Purpose: This study was conducted to examine clinical nurses' perceptions on the nursing organizational culture and investigate the differences in their perceptions according to age groups in South Korea. Methods: Participants were 1,087 nurses from 25 general hospitals in South Korea. Data were collected from July 29 to September 30 in 2011, and were analyzed using descriptive statistics, ANOVA with $Scheff{\grave{e}}$ test, and factor analysis. Results: Nurses perceived nursing as an excellent professional job which progresses continually. Autonomy and individualized reward to their professional work, however, were reported not-satisfactory to them. They agreed that nurses are punctual, polite, honest, and responsible, while disagreeing in competitiveness. There were differences in perceiving cultural factors according to age groups. The subjects in their over 40s perceived 'professionalism', 'normative', 'strictness', 'rightfulness', and 'community spirit' strongly, while nurses in their 20s perceived 'conservatism' highly. Also, nurses' perception on the organizational commitment and job satisfaction were high in over 40s while turnover intention was high in other groups. Conclusion: Nurse managers need to assess the perception on nursing organizational culture in order to improve nursing work environment better. In addition, it is necessary to take into account seriously the generation gap to build supportive nursing organizational culture.
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
/
v.27
no.1
/
pp.41-49
/
2021
Background: The purpose of this survey was to know the current states and future suggestions of orthopedic manual physical therapy (OMPT) system on Korea. Methods: Questionnaires were directly distributed to physical therapists who participated in the training and collected at the educational or clinical site. The questionnaire was sent and collected by E-mail. Data were classified into two groups, metropolitan and city, and clinical experience was grouped into four groups. Then, 337 subjects (male: 195, female: 142) were recruited from us. Results: The states of Korea, 72.1% of therapists have been executed orthopedic manual physical therapy, the fee of one treatment was 50,000 ~ 60,000 Korean won, the time of treatment was 21~30 minutes, the number of patients of one day was under 9. The suggestion of future orthopedic manual physical therapy of Korea, 83.4% of therapist were agreed with manual physical therapy system, the education center of certificate for manual therapist was manual therapy academic group, the career of clinical experiences was 3 years, the training hours was more 300 hours, academic degree was diploma. Conclusion: In the future orthopedic manual physical therapy proposal, the environment and education system differ from country to country, but Korean OMPT agreed to an accredited orthopedic manual physical therapy system and wanted systematic management.
Purpose: Type 4 gastric cancer (GC) has a very poor prognosis even after curative resection, and the survival benefit of splenectomy for splenic hilar lymph node (LN; #10) dissection in type 4 GC remains equivocal. This study aimed to clarify the clinical significance of splenectomy for #10 dissection in patients with type 4 GC. Materials and Methods: The data of a total of 56 patients with type 4 GC who underwent total gastrectomy with splenectomy were retrospectively analyzed. Postoperative morbidity, state of LN metastasis, survival outcomes, and therapeutic value index (TVI) of each LN station were evaluated. TVI was calculated by multiplying the incidence of LN metastasis at each nodal station and the 5-year overall survival (OS) of patients who had metastasis to each node. Results: Overall, the postoperative morbidity rate was 28.6%, and the incidence of #10 metastasis in the patients was 28.6%. The 5-year OS rate for all patients was 29.9%, and most patients developed peritoneal recurrence. Moreover, the 5-year OS rates with and without #10 metastasis were 6.7% and 39.1% (median survival time, 20.4 vs. 46.0 months; P=0.006). The TVI of #10 was as low as 1.92. Conclusions: The clinical significance of splenectomy in the dissection of #10 for type 4 GC is limited and splenectomy for splenic hilar dissection alone should be omitted.
Objectives: The purpose of this study was to evaluate the effect of Dental Practicality Index (DPI) training using an online video on the treatment planning decisions and confidence level of dental undergraduates (DUs). Materials and Methods: Ninety-four DUs were shown 15 clinical case scenarios and asked to decide on treatment plans based on 4 treatment options. The most appropriate treatment plan had been decided by a consensus panel of experienced dentists. DUs then underwent DPI training using an online video. In a post-DPI-training test, DUs were shown the same clinical case scenarios and asked to assign the best treatment option. After 6 weeks, DUs were retested to assess their knowledge retention. In all 3 tests, DUs completed the confidence level scale questionnaire. Data were analyzed using the related-samples Wilcoxon signed rank test and the independent-samples Mann-Whitney U test with the level of significance set at p < 0.05. Results: DPI training significantly improved the mean scores of the DUs from 7.53 in the pre-DPI-training test to 9.01 in the post-DPI-training test (p < 0.001). After 6 weeks, the mean scores decreased marginally to 8.87 in the retention test (p = 0.563). DPI training increased their confidence level from 5.68 pre-DPI training to 7.09 post-DPI training. Conclusions: Training DUs using DPI with an online video improved their decision-making and confidence level in treatment planning.
Objectives: This study aimed to evaluate the clinical performance of an alkasite restorative material in molars that had undergone root canal treatment. Materials and Methods: The research was registered in Brazilian Registry of Clinical Trials. The randomized clinical trial involved 33 patients, each with at least 1 mandibular molar requiring restoration after receiving endodontic treatment. Patients were randomly assigned to receive either bulk-fill resin composite (Tetric N Ceram Bulk Fill, Ivoclar Vivadent) or the alkasite restorative material (Cention N, Ivoclar Vivadent). Upon completion of the restorations, 3 calibrated professionals utilized the United States Public Health Service criteria to assess various factors, including retention, secondary caries, marginal adaptation, restoration color, marginal pigmentation, and anatomical form. Evaluations were conducted at intervals of 7 days, 6 months, and 17 months. Additionally, the assessment encompassed the presence of radiolucent lines adjacent to the restoration, material deficiencies or excess, contact points, and caries recurrence. The data underwent analysis using the Friedman and Mann-Whitney tests (α = 0.05). Results: After 17 months, the results revealed that the alkasite restorative material exhibited greater wear of anatomical shape compared to the bulk-fill resin composite (p = 0.0189). Furthermore, the alkasite restorative material significantly differed from the natural tooth color in most cases (p = 0.0000). However, no other criteria displayed significant differences between the materials or over time (p > 0.05). Conclusions: The alkasite restorative material (Cention N) emerges as a viable option for restoring endodontically treated teeth, displaying clinically acceptable alterations after a 17-month evaluation period.
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