Reliability of implant stability measuring devices depending on various clinical conditions: an in vitro study

PURPOSE@#. The aim of this study was to evaluate the reliability of implant stability measuring devices depending on the location of the implant and the position of the patient. @*MATERIALS AND METHODS@#. Six implants were installed in different dentate sextants of six artificial bone models. Implant stability was measured in three conditions of the bone model (without mounting on a phantom head, mounted on a phantom head in supine position, and mounted on a phantom head in upright position). A resonance frequency analysis device (Osstell) and two damping capacity analysis devices (Periotest and Anycheck) were used to measure implant stability. The values measured outside the phantom head were treated as controls, and the values inside the phantom head were compared using an independent t-test. @*RESULTS@#. Osstell showed different results in two of the six divisions in both the supine and upright positions compared to outside of the mouth (P < .05). Periotest showed different results in all six parts in the supine position and in five parts in the upright position compared to outside of the mouth (P < .05). While Anycheck showed different results in five areas in the supine position compared to outside of the mouth, it showed different results in only one area in the upright position (P < .05). @*CONCLUSION@#. In the difficult implant position for the operator to access, the implant stability measuring devices show less reliability. The accessibility of implant is greatly affected in the order of Osstell, Anycheck, and Periotest. [J Adv Prosthodont 2023;15:126-35]

Validation of the Korean Version of the Anosognosia Questionnaire for Dementia

Objective@#Anosognosia is a common phenomenon in individuals with dementia. Anosognosia Questionnaire for dementia (AQ-D) is a well-known scale for evaluating anosognosia. This study aimed to establish a Korean version of the AQ-D (AQ-D-K) and to evaluate the reliability and validity of the AQ-D-K in patients with Alzheimer’s disease (AD) dementia. @*Methods@#We translated the original English version of AQ-D into Korean (AQ-D-K). Eighty-four subjects with very mild or mild AD dementia and their caregivers participated. Reliability of AQ-D-K was assessed by internal consistency and one-month test-retest reliability. Construct validity and concurrent validity were also evaluated. @*Results@#Internal consistencies of the AQ-D-K patient form and caregiver form were high (Cronbach alpha 0.95 and 0.93, respectively). The test-retest reliability of AQ-D-K measured by intra-class correlation coefficient was 0.84. Three factors were identified: 1) anosognosia of instrumental activity of daily living; 2) anosognosia basic activity of daily living; and 3) anosognosia of depression and disinhibition. AQ-D-K score was significantly correlated with the clinician-rated anosognosia rating scale (ARS), center for epidemiological studies-depression scale (CES-D) and state-trait anxiety inventory (STAI). @*Conclusion@#The findings suggest that the AQ-D-K is a reliable and valid scale for evaluating anosognosia for AD dementia patients using Korean language.

Solitary, Endobronchial Metastasis from Renal Cell Carcinoma 20 Years after Nephrectomy

Late recurrence over 10 years after surgery and endobronchial metastasis are some of the spe‑ cific biological behaviors of renal cell carcinoma (RCC). The current report describes a case of solitary endobronchial metastasis at a subsegmental bronchus that developed 20 years after curative nephrectomy for RCC. A 71‑year‑old male was admitted to our hospital for pneumonia.Chest radiography showed multifocal ill-defined nodular opacities in the right lower lung zone, suggesting pneumonia. Subsequent chest CT confirmed pneumonic infiltration in the right lung. However, a 4.3-cm, well-defined, elongated mass with a branching pattern was also iden‑ tified in the right lower lobe, and a right nephrectomy scar was detected on the covered upper abdomen. The patient had undergone right nephrectomy 20 years ago due to clear cell RCC. Af‑ ter right lower lobectomy, the postoperative pathological diagnosis was endobronchial meta‑ static clear cell RCC. Endobronchial metastasis should be considered in a patient with a history of RCC who presents with a suspected endobronchial tumor, even decades after curative surgery.

Validation of the Korean Version of the Anosognosia Questionnaire for Dementia

Objective@#Anosognosia is a common phenomenon in individuals with dementia. Anosognosia Questionnaire for dementia (AQ-D) is a well-known scale for evaluating anosognosia. This study aimed to establish a Korean version of the AQ-D (AQ-D-K) and to evaluate the reliability and validity of the AQ-D-K in patients with Alzheimer’s disease (AD) dementia. @*Methods@#We translated the original English version of AQ-D into Korean (AQ-D-K). Eighty-four subjects with very mild or mild AD dementia and their caregivers participated. Reliability of AQ-D-K was assessed by internal consistency and one-month test-retest reliability. Construct validity and concurrent validity were also evaluated. @*Results@#Internal consistencies of the AQ-D-K patient form and caregiver form were high (Cronbach alpha 0.95 and 0.93, respectively). The test-retest reliability of AQ-D-K measured by intra-class correlation coefficient was 0.84. Three factors were identified: 1) anosognosia of instrumental activity of daily living; 2) anosognosia basic activity of daily living; and 3) anosognosia of depression and disinhibition. AQ-D-K score was significantly correlated with the clinician-rated anosognosia rating scale (ARS), center for epidemiological studies-depression scale (CES-D) and state-trait anxiety inventory (STAI). @*Conclusion@#The findings suggest that the AQ-D-K is a reliable and valid scale for evaluating anosognosia for AD dementia patients using Korean language.

Solitary, Endobronchial Metastasis from Renal Cell Carcinoma 20 Years after Nephrectomy

Late recurrence over 10 years after surgery and endobronchial metastasis are some of the spe‑ cific biological behaviors of renal cell carcinoma (RCC). The current report describes a case of solitary endobronchial metastasis at a subsegmental bronchus that developed 20 years after curative nephrectomy for RCC. A 71‑year‑old male was admitted to our hospital for pneumonia.Chest radiography showed multifocal ill-defined nodular opacities in the right lower lung zone, suggesting pneumonia. Subsequent chest CT confirmed pneumonic infiltration in the right lung. However, a 4.3-cm, well-defined, elongated mass with a branching pattern was also iden‑ tified in the right lower lobe, and a right nephrectomy scar was detected on the covered upper abdomen. The patient had undergone right nephrectomy 20 years ago due to clear cell RCC. Af‑ ter right lower lobectomy, the postoperative pathological diagnosis was endobronchial meta‑ static clear cell RCC. Endobronchial metastasis should be considered in a patient with a history of RCC who presents with a suspected endobronchial tumor, even decades after curative surgery.

The Impact of the Amendment of the Korean National Health Insurance Reimbursement Criteria for Anti-tumor Necrosis Factor-α Agents on Treatment Pattern, Clinical Response and Persistence in Patients With Rheumatoid Arthritis

Objective@#. To investigate the impact of the amendment of the Korean National Health Insurance (KNHI) reimbursement criteria for anti-tumor necrosis factor-α (TNF-α) agents based on from conventional clinical and laboratory measurements to disease activity score of 28 joints (DAS28) on treatment pattern, clinical response, and persistence rate in patients with rheumatoid arthritis (RA). @*Methods@#. This multicenter retrospective cohort study evaluated 148 RA patients eligible for the initiation of anti- TNF-α agents as the first-line biologics by either the past (n=95) or current (n=53) KNHI reimbursement criteria. Persistence was defined as the duration between the initiation and discontinuation of anti-TNFα agents. @*Results@#. In total, 106 (71.6%), 35 (23.6%), and 7 (4.7%) RA patients started treatment with adalimumab, etanercept, and infliximab, respectively. RA patients who received anti-TNF-α agents under the current reimbursement criteria had a significantly lower mean DAS28-erythrocyte sedimentation rate (ESR) (6.02 vs. 6.95, p＜0.001) and daily prednisolone-equivalent glucocorticoid dose (4.51 vs. 6.17 mg, p＜0.001) than those who received anti-TNF-α agents under the past reimbursement criteria. No significant differences in the 1-year remission rate defined by DAS28-ESR＜2.6 (17.9% vs. 30.2%, p=0.085) and the persistence rate (p=0.703) between the past and current reimbursement criteria was observed. @*Conclusion@#. Our data suggest that less active RA patients can receive reimbursement for anti-TNF-α agents under the current criteria, and the amendment of the KNHI reimbursement criteria may improve access to anti-TNF-α agents without affecting the treatment response and persistence rate.

Comparison of the Effect of Applying Polyethylene Wrap and Aircap in Maintaining Body Temperature of Preterm Infants / 임상간호연구

Purpose@#This study was an quasi-experimental study to compare the effect of applying polyethylene wrap and aircap in maintaining body temperature of preterm infants. @*Methods@#The participants were 51 preterm infants.Aircap was applied to the experimental group (n=23) and polyethylene wrap was applied to the control group (n=28) when the preterm infants admitted to neonatal intensive care unit. The data was collected at W hospital in J-province from June 2016 to May 2017. A total of 9 body temperature measurements were taken at 3 hours interval from 5 min to 24 hours after admission. Repeated measure ANOVA, independent t-test and x 2 test were conducted used with SPSS/WIN 24.0 @*Results@#There were no significant difference in the homogeneity tests for general characteristics and dependent variables prior to the experiments (t=0.57, p=.566). There was a significant difference on body temperature of preterm infants over time (F=3.24, p=.020). There was no significant difference on body temperature between polyethylene wrap and aircap application groups (F=1.29, p=.261). The interaction between the group and the time was insignificant (F=1.51, p=.214). @*Conclusion@#The findings demonstrated that both methods of applying polyethylene wrap and aircap on the body in preterm infants had effect in maintaining body temperature.

Micropigmentation for Acral Vitiligo: An Open-label Pilot Study of 12 Patients / 대한피부과학회지

Background@#Micropigmentation is a medical tattooing procedure in which pigments are implanted into the superficial dermis using a manual or electrically driven needle. @*Objective@#We aimed to assess the benefit and risk of micropigmentation in the treatment of acral vitiligo refractory to the conventional treatment. @*Methods@#An open-label study was conducted from December 2018 to March 2019. A total of 12 patients with 20 acral vitiligo lesions were treated with micropigmentation using an electric tattooing machine. The micropigmentation treatment was repeated for a few sessions to achieve optimal pigmentation. Color matching between the lesion and peri-lesional skin was assessed using a 4-point grading scale (poor, fair, good, and excellent). @*Results@#Overall, 85% (17 of 20) showed excellent color matching after a median of 2 (range: 1∼5) treatment sessions. The post-treatment color was darker than the surrounding skin immediately after the procedure, but it gradually faded over time. Pain during the procedure was not mild, but local anesthetic injection was not required. Post-treatment erythema and swelling occurred, but they resolved within a few days. No allergic reaction to the pigment or koebnerization of the vitiligo was noted. @*Conclusion@#Micropigmentation could be a promising treatment option for refractory acral vitiligo. A few treatment sessions (i.e., retouch) may be required for desired outcomes. The crucial parts of micropigmentation are pigment selection and implantation depth. It does not require injection of local anesthetics and provides immediate treatment effects after the procedure.

Comparison of Efficacy and Safety of Febuxostat in Gout Patients with Chronic Kidney Disease Stage 3 and Stage 4/5

OBJECTIVE: To compare efficacy and safety of febuxostat in gouty patients with chronic kidney disease (CKD) stage 3 and stage 4/5. METHODS: Age and sex matched patients with CKD stage 3 and stage 4/5 who were diagnosed with gout were included. The dose of febuxostat was increased according to serum uric acid (sUA) level. Adherence, the number of gout attack, the change of sUA, the change of estimated glomerular filtration rate (eGFR) and adverse events (AEs) were evaluated for 12 months. RESULTS: There were no significant differences in the baseline variables between CKD stage 3 and CKD stage 4/5. Disease duration was longer and baseline sUA was higher in the CKD stage 4/5. There were no significant differences in the mean sUA at the last follow-up, the number of patients who reached the sUA target of 6 mg/dL and the number of gout attack between the groups. There were no significant differences in the change of eGFR and decrease of eGFR between the groups. There were 2 cases of AEs. One patient in CKD stage 3 had maculopapular rash and one patient in CKD stage 4/5 had dizziness. The AEs were subsided after febuxostat was stopped. CONCLUSION: Febuxostat was efficacious and well tolerated in gout patients with CKD stage 4/5.

Human Bocavirus Infection in Adults: Clinical Features and Radiological Findings

OBJECTIVE: Human bocavirus (HBoV) is a newly identified pathogen that can cause upper and lower respiratory infections usually in children; however, its clinical characteristics and significance in respiratory infections in adults have not been well known. Our objective was to evaluate the clinical features of respiratory HBoV infection and to describe the CT findings of HBoV pneumonia in adults. MATERIALS AND METHODS: A total of 185 adult patients diagnosed with HBoV infection at a tertiary referral center between January 2010 and December 2017 were retrospectively evaluated with respect to the clinical characteristics of HBoV infection and its risk factors for pneumonia. Chest CT findings for 34 patients with HBoV pneumonia without co-infection were analyzed and compared between immunocompetent (n = 18) and immunocompromised (n = 16) patients. RESULTS: HBoV infections were predominantly noted between February and June. Among the 185 patients with HBoV infection, 119 (64.3%) had community-acquired infections and 110 (59.5%) had pneumonia. In multivariable analysis, older age (odds ratio [OR], 1.02; 95% confidence interval [CI], 1.00–1.04; p = 0.045) and nosocomial infection (OR, 2.07; 95% CI, 1.05–4.10; p = 0.037) were associated with HBoV pneumonia. The main CT findings were bilateral consolidation (70.6%) and/or ground-glass opacities (64.7%); centrilobular nodules (14.7%) were found less frequently. The pattern of CT findings were not significantly different between immunocompetent and immunocompromised patients (all, p > 0.05). CONCLUSION: HBoV infection can be a potential respiratory tract infection in adults. The most frequent CT findings of HBoV pneumonia were bilateral consolidation and/or ground-glass opacities.

Differences between One-Person and Multi-Person Households on Socioeconomic Status, Health Behavior, and Metabolic Syndrome Across Gender and Age Groups

BACKGROUND: The rising popularity of one-person households makes the health hazards they are prone to, highly relevant in epidemiological studies. This study aimed at comparing health-related characteristics like the socioeconomic status, health behavior, and metabolic syndrome of one-person households, to multi-person households in Korea.METHODS: The participants required for this study included 9,423 Koreans aged 19 and above, who took the Sixth Korean National Health and Nutrition Examination Survey. The household types were classified into “one-person” and “multi-person.” The differences between the two, based on their annual socioeconomic status, health behavior, anthropometric variables, and blood test results were analyzed.RESULTS: The percentage of men and women in one-person households was 7.2% and 10.5%, respectively. Such households had a lower annual income and education than multi-person households. The odds ratios (OR) for alcohol consumption (OR, 1.69; 95% confidence interval [CI], 1.16–2.46) and smoking (OR, 3.24; 95% CI, 1.77–5.95) were significantly higher for one-person households of women, aged 60 and above, compared to multiperson households. The OR for metabolic syndrome was considerably higher in one-person households of middle-aged people in contrast to multiperson households for both men (OR, 1.84; 95% CI, 1.14–2.95) and women (OR, 1.90; 95% CI, 1.21–2.99).CONCLUSION: The socioeconomic status was lower, and the health behaviors were worse in one-person households as compared to multi-person households. Considering the growing popularity of one-person households, it is suggested that medical plans be customized to suit the characteristics of the specific group.

Gender Perspectives on the Relationship between Red and Processed Meat Intake and Colorectal Cancer: A Systematic Review and Meta-Analysis

BACKGROUND: Men and women choose different food items, and consume different amounts of food, due to biological, cultural, and social differences. However, when dietary assessment instruments are developed, gender differences in food selection and/or the portion sizes are often not considered. METHODS: Prospective cohort studies with men and women that examined the association between red or processed meat intake and colorectal cancer and published up to July 2017, were identified using PubMed. Studies were categorized as gender-specific (GS) group if the Food Frequency Questionnaire was developed using gender-specific data, and as not gender-specific (NGS) group if not gender-specific data were used. RESULTS: For cohort studies that reported combined intake estimates of men and women, a 100 g/day increment in red and processed meat intake was positively associated with a risk of colorectal or colon cancer in GS group (relative risk [RR], 1.23; 95% confidence interval [CI], 1.14–1.32) but not in NGS group (RR, 1.13; 95% CI, 0.90–1.35). For processed meat, the RR for 50 g/day increase was 1.28 (95% CI, 1.15–1.40) in GS group and 1.15 (95% CI, 1.03–1.27) in NGS group. CONCLUSIONS: Gender differences need to be considered during development of dietary assessment tools because this may improve the quality of the findings of nutritional epidemiological studies.

Gender Perspectives on the Relationship between Red and Processed Meat Intake and Colorectal Cancer: A Systematic Review and Meta-Analysis

BACKGROUND@#Men and women choose different food items, and consume different amounts of food, due to biological, cultural, and social differences. However, when dietary assessment instruments are developed, gender differences in food selection and/or the portion sizes are often not considered.@*METHODS@#Prospective cohort studies with men and women that examined the association between red or processed meat intake and colorectal cancer and published up to July 2017, were identified using PubMed. Studies were categorized as gender-specific (GS) group if the Food Frequency Questionnaire was developed using gender-specific data, and as not gender-specific (NGS) group if not gender-specific data were used.@*RESULTS@#For cohort studies that reported combined intake estimates of men and women, a 100 g/day increment in red and processed meat intake was positively associated with a risk of colorectal or colon cancer in GS group (relative risk [RR], 1.23; 95% confidence interval [CI], 1.14–1.32) but not in NGS group (RR, 1.13; 95% CI, 0.90–1.35). For processed meat, the RR for 50 g/day increase was 1.28 (95% CI, 1.15–1.40) in GS group and 1.15 (95% CI, 1.03–1.27) in NGS group.@*CONCLUSIONS@#Gender differences need to be considered during development of dietary assessment tools because this may improve the quality of the findings of nutritional epidemiological studies.

Non-cultured Epidermal Cell Suspension Transplantation Using Suction Blisters to Treat Refractory Vitiligo: A Retrospective Study of 20 Cases / 대한피부과학회지

BACKGROUND: As nonsurgical interventions for vitiligo are not always successful, various surgical modalities have been used in patients with refractory vitiligo. Of these, non-cultured epidermal suspension transplantation (NCES) was recently introduced to treat large recipient sites using cells from small donor tissue. OBJECTIVE: We assessed the effectiveness and safety of NCES as a surgical treatment for patients with refractory vitiligo. METHODS: We retrospectively reviewed 20 cases in 17 patients (11 females; median age 25 years) who underwent NCES from July 2015 through March 2018. Suction blisters (20 mm in diameter) were collected from the patient's inner thigh at a donor-to-recipient area ratio of 1:5. After the addition of 5 mL recombinant trypsin solution to the suction blisters, followed by incubation at 37℃ for 60 min, epidermal cells were manually scraped off the blister surface, and epidermal cell suspension was obtained by centrifugation at 1,500 RPM for 5 min. The suspension was applied to the vitiligo regions after epidermal ablation of those regions. Phototherapy resumed 1 month later. Treatment success was defined as ≥75% repigmentation of the surgical site, and all adverse events were noted. RESULTS: Overall, 85.0% of cases (17/20) exhibited treatment success. Adverse events included hyperpigmentation (20%) and surgical site infection (5%), but the treatment was tolerable in all cases. CONCLUSION: NCES is a reliable surgical option for patients with vitiligo refractory to nonsurgical treatment. Large areas of vitiligo can be treated by NCES, and use of this technique should be encouraged in Korea.

Inhibition of c-Yes Induces Differentiation of HT-29 Human Colon Cancer Stem Cells through Midbody Elongation

Recent research suggests that a small group of cells, named cancer stem cells (CSCs), is responsible for initiating tumor formation, recurrence, and metastasis. c-Yes, a proto-oncogene that is a subfamily of Src family kinase, is often activated in human colon cancer; this implicates c-Yes in the onset and progression of the disease. The objective of this study was to investigate the correlation between c-Yes and CSCs. We performed a sphere formation assay and reverse transcription-polymerase chain reaction for studying the differentiation of HT-29 human colon CSCs. To demonstrate the specific role of c-Yes in CSCs, we performed live cell microscopy and a cell cycle assay. These study shows, for the first time, that c-Yes is enriched in CD133+ CSCs, compared to their CD133− counterparts, and that c-Yes depletion in CD133+ cells induces cell differentiation. Moreover, c-Yes depletion was found to elongate the midbody and increase the proliferation doubling time. This also suggested that the misregulation of microtubules during chromosomal separation causes aneuploidy. Our results suggest that c-Yes may play a crucial role in initiating, maintaining, and driving the tumorigenic property of colon cancer.

High-Resolution MRI of Intracranial Atherosclerotic Disease / 신경중재치료의학

Intracranial atherosclerotic disease (ICAD) causes up to 10% of all ischemic strokes, and the rate of recurrent vascular ischemic events is very high. Important predictors of vulnerability in atherosclerotic plaques include the degree of stenosis and the underlying plaque morphology. Vascular wall MRI can provide information about wall structures and atherosclerotic plaque components. High-resolution (HR)-MRI in ICAD poses a greater challenge in the neurologic fields, because a high in-plane resolution and a high signal-to-noise ratio are required for vessel wall imaging of ICAD. Until now, plaque imaging of ICAD has focused on assessing the presence of a plaque and evaluating the plaque load. Going forward, evaluation of plaque vulnerability through analysis of imaging characteristics will be a critical area of research. This review introduces the acquisition protocol for HR-MRI in ICAD and the current issues associated with imaging.

Regulation of microRNA-7-5p and LRP6 by Epstein-Barr Virus-Encoded RNAs in Burkitt's Lymphoma Cell Line Akata

Epstein-Barr virus (EBV)-encoded small non-coding RNAs (EBERs) are abundantly expressed in various EBV-associated malignancies, and play critical roles in cell proliferation, tumorigenesis, and apoptosis resistance. However, the mechanism how EBERs regulate cell function awaits further clarification. In this study, we investigated the effect of EBERs on the expression of cellular microRNA (miRNA) and mRNA expression. To test the effect of EBERs while unaffected by other EBV genes, we used EBERs-deleted recombinant EBV infected Burkitt's lymphoma cell line (Akata(+)EBERs(-)) as well as EBV-infected (Akata(+)) and EBV uninfected (Akata(-)) cell lines. They all have the same genetic backgrounds. First, 15 different cellular miRNAs which have reverse complementary sequences to EBERs and have reported targets were selected by bioinformatics analysis. When RT-PCR was carried out for the 16 miRNAs using RNAs from Akata(+), Akata(-), and Akata(+)EBERs(-) cells, hsa-miR-7-5p was the only one showing down-regulated expression in Akata(+) than in Akata(-) and Akata(+)EBERs(-) cells. Bioinformatics and mRNA microarray analyses for Akata(+), Akata(-), and Akata(+)EBERs(-) cell lines were then carried out to predict putative targets of hsa-miR-7-5p. Among the 6 predicted targets of hsa-miR-7-5p, only low density lipoprotein receptor-related protein 6 (LRP6) was up-regulated in EBERs-expressing cells when tested by RT-PCR and Western blot. However, luciferase reporter assay showed that the 3'-UTR of LRP6 was not directly targeted by hsa-miR-7-5p. Our data suggest that both hsa-miR-7-5p and LRP6 are regulated by EBERs in Akata cells, and these genes may partly mediate the tumorigenic function of EBERs in Burkitt's lymphoma.

Nurses' Perception on Clinical Nutrition Services by Types of Medical Institution and Area

The purpose of this study was to evaluate nurses' perception of clinical nutrition services. A cross-sectional survey design was performed. The research was accomplished by using questionnaires developed for this study and administered from September 12 to December 31, 2013 to 343 nurses at 43 tertiary hospitals and 20 general hospitals. The percentage of nurses who recognized clinical nutrition certificate as issued from nation was 27.8%. The mean scores of perceived usefulness on clinical nutrition services was 4.23/5.00, whereas that of perceived implementation was 3.76/5.00. The mean scores of necessity of disease-specialized clinical dietitian at capital hospitals were significantly higher for obesity (P<0.01), cancer (P<0.05), and infant & childhood disease (P<0.01) than at local hospitals. The rates of nurses' experience in group education on cancer at capital hospitals (21.7%) was significantly higher than that at local hospitals (10.3%) (P<0.05). The mean scores of perceived importance of clinical nutrition services were 4.46/5.00 for 'group nutrition education', 4.46/5.00 for 'individual consultation', and 4.40/5.00 for 'nutrition management for enteral nutrition (EN) patients'. The most common reason why clinical nutrition services are important was 'improving malnutritional status'. To activate clinical nutrition services especially at local hospitals, clinical dietitians should give systematic assistance to patients and also institutional supports are needed.

A Development and Evaluation of Nursing KMS using QFD in Outpatient Departments

PURPOSE: This study was done to develop and implement the Nursing KMS (knowledge management system) in order to improve knowledge sharing and creation among clinical nurses in outpatient departments. METHODS: This study was a methodological research using the 'System Development Life Cycle': consisting of planning, analyzing, design, implementation, and evaluation. Quality Function Deployment (QFD) was applied to establish nurse requirements and to identify important design requirements. Participants were 32 nurses and for evaluation data were collected pre and post intervention at K Hospital in Seoul, a tertiary hospital with over 1,000 beds. RESULTS: The Nursing KMS was built using a Linux-based operating system, Oracle DBMS, and Java 1.6 web programming tools. The system was implemented as a sub-system of the hospital information system. There was statistically significant differences in the sharing of knowledge but creating of knowledge was no statistically meaningful difference observed. In terms of satisfaction with the system, system efficiency ranked first followed by system convenience, information suitability and information usefulness. CONCLUSION: The results indicate that the use of Nursing KMS increases nurses' knowledge sharing and can contribute to increased quality of nursing knowledge and provide more opportunities for nurses to gain expertise from knowledge shared among nurses.

An asymptomatic ovarian steroid cell tumor with complete cystic morphology: A case report

Steroid cell tumors of the ovary are extremely rare, accounting for only 0.1% of all ovarian tumors. Of these, steroid cell tumors, not otherwise specified (NOS) constitute about 56% of all steroid cell tumors. Most steroid cell tumors secrete steroid hormones, and only about 10% to 15% of patients are asymptomatic. The morphology of steroid cell tumors, NOS is predominantly reported to be solid, and a review of case reports from 1979 until now revealed only 5 cases that were mainly cystic tumors. The present case, in a patient who had undergone a previous hysterectomy and surgery for a peritoneal inclusion cyst, is reported due to its rarity and its unusual presentation, together with a brief review of the literature. The tumor showed no clinical signs and symptoms typical of a steroid hormone secreting tumor and had an atypical morphology, being primarily multi-septate cystic with a minor solid portion.