Factors Influencing Perception of Hospice Palliative Care in High School Students in Korea / 한국호스피스완화의료학회지

PURPOSE: This study was to investigate the relationships between spiritual well-being, attitude towards death and perception of hospice, and the factors influencing hospice perception of high school students. METHODS: A survey was conducted with 229 students in four high schools in B city from May 1, 2015 through May 31, 2015. The data were analyzed with descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, stepwise multiple regression using the SPSS 18.0 program. This study was approved by the internal review board. RESULTS: The factors influencing hospice perception of the high school students were previous recognition of hospice (β=0.412, P<0.001), attitude towards death preparation among sub-variables of attitude towards death (β=-0.244, P<0.001), subjective school life satisfaction (β=-0.215, P<0.001), and sex (β=0.191, P<0.001). The more positive the attitude towards my body after death and that towards death preparation was, the more positive recognition for hospice was. The total explanatory power of these factors was 34.5%. CONCLUSION: To improve high school students' perception of hospice, it is necessary to provide them with a hospice education program to help them with their attitudes towards death preparation and their understanding of hospice.

Spiritual Welling-Being, Attitude to Death and Perception of Hospice Care in College Students / 한국호스피스완화의료학회지

PURPOSE: The purpose of this study is to provide baseline data for the development of an educational program for hospice care for college students. METHODS: A survey was conducted at three universities in B city with 143 students from September 5, 2014 through September 26, 2014. The data were analyzed by the SPSS 18 program. This study was approved by IRB. RESULTS: The college students' spiritual well-being was at a medium level. Their attitudes to death were neutral, and perception of hospice care was at a medium level. Most of the participants (93.0%) had no training in hospice care. The participants' awareness of the purpose of hospice care was at a relatively high level. Their awareness of the need for hospice care was at a moderate level. The participants' spiritual well-being and their attitudes to death showed a weak but positive correlation (r=0.179, P=0.030). The relationship between their spiritual well-being and awareness of hospice care were positively correlated (r=0.203, P=0.015). CONCLUSION: The participants' perception of hospice care was low. Most of them had no experience of hospice care education. Also, the higher the spiritual stability was, the higher the participants' perception of the purpose and the necessity of hospice care was. And their perception of the hospice care varied depending on their family relationship, satisfaction with school life, and cognition of hospice care. Therefore, we need consider these variables to develop a hospice education program to enhance college students' attitudes to death and their perception of hospice care.

Preliminary study on the effect of inflamed TMJ synovial fluid on the intracellular calcium concentration and differential expression of iNOS and COX-2 in human immortalized chondrocyte C28/I2

OBJECTIVE: The objective of this study was to examine the hypothesis that inflammatory synovial fluid from TMJ internal derangement initiates a transient increase in intracellular calcium concentration ([Ca2+]i) in chondrocytes and the induced Ca2+ signaling affects iNOS/COX-2 gene expression patterns following exposure to inflamed synovial fluid. MATERIALS AND METHODS: Two female adult patients with symptoms of TMD who agreed to participate in the study were selected for this study. Immortalized human juvenile costal chondrocyte C-28/I2 was grown to 80% confluency and synovial fluids from two patients were added respectively to culture media for 24 hours at the concentration of 100ng/10ml. Confocal laser scanning microscope (CLSM) was used to examine changes of intracellular calcium concentration ([Ca2+]i). RT-PCR was performed to identify the expression profile of IL-1alpha, iNOS, COX-2. RESULTS: Increased [Ca2+]i was observed in chondrocytes subjected to inflamed synovial fluid compared to control cultures and in respective cultures exposed to inflamed synovial fluids from each patient, IL-1beta, COX-2 mRNA were detected. However, in neither case iNOS mRNA was expressed. IL-1alpha, COX-2, and iNOS mRNA were expressed in control culture. CONCLUSION: Our results show that immortalized chondrocytes cultured with inflamed synovial fluids from patients diagnosed as disc displacement without reduction and limitation in mouth opening showed increased calcium concentration and expression of COX-2 while inhibiting the production of iNOS, which in turn could adversely affect the chondrocytes in at least short term by hindering physiologic role of NO against inflammatory cascades. These findings suggest that inflamed synovial fluid may differentially regulate the transcriptomes of relevant inflammatory mediators, especially iNOS/COX-2 axis in chondrocytes through adjusting calcium transients.

The Effect of Preload Reduction on a New Parameter to Evaluate Left Ventricular Diastolic Function

BACKGROUND AND OBJECTIVES: The time interval between the onset of the mitral inflow and the mitral annulus velocity (TE'-E) has been proposed as a new index for representing the left ventricular (LV) relaxation and this is related to the LV filling pressure. This index has been reported to be a preload independent parameter in an experimental canine model. However, the impact of the preload on this index has not been studied in humans. SUBJECTS AND METHODS: Forty-five patients (29 men, mean age: 51+/-14 years old) who had end-stage renal disease underwent echocardiography immediately before and after hemodialysis (HD). The two-dimensional and Doppler parameters were measured, including the peak early (E) and late (A) transmitral inflow velocity. The mitral annulus velocity (E') at the septal, lateral, anterior and inferior corners of the mitral annulus, as accessed by Doppler tissue imaging (DTI), and the flow propagation velocity (Vp), as accessed by color M-mode, were also measured. The time intervals between the peak of the R wave and the onset of the mitral E velocity and also between the peak R wave and the onset of E' at the four corners of the mitral annulus were measured. RESULTS: The mean ejection fraction was 62+/-16%. The average weight reduction by the HD was 2.9+/-1.1 kg. The dimensions of the LV end-diastole, left atrium and inferior vena cava were significantly reduced. After the HD, the peak E, A and E/A ratio, the average peak E' and the Vp were significantly decreased. The TE'-E did not change significantly after the HD regardless of the LV systolic function. CONCLUSION: A new parameter for the diastolic function, i.e., the time interval between the onset of mitral inflow and the mitral annulus velocity, appears to be preload-independent in the patients with a normal or decreased LV systolic function.

The Expression of beta- & alpha-Catenin and Focal Adhesion Kinase in Invasive Cervical Cancers / 대한산부인과학회잡지

OBJECTIVE: E-cadherin/catenin adhesion complex is fundamentally involved in epithelial cancer invasion and metastasis. Focal adhesion kinase (FAK) is one of the molecules that may be involved in the regulation of focal adhesion integrity and the progression of cancer to invasion and metastasis. The present study was aimed to explore that the beta- & alpha-catenin might be involved in the invasion and metastasis of cervical carcinoma, and their expression might be related with other clinicopathologic factors or associated with FAK in cervical cancer. METHODS: The tissues were obtained from the 26 patients with cervical carcinoma and the 9 patients with normal cervix undergoing hysterectomy. The proteins were extracted and the expression of beta- and alpha- catenin and FAK were studied with a western blot analysis. The coexpression of alpha-catenin and FAK was examined with an immunoprecipitation. The clinicopathologic factors were reviewed with the charts of patients and the results were analysed with the Chi-square test and Spearman's correlation test. RESULTS: The expression of beta- and alpha-catenin in cervical carcinoma was lower than that in normal cervix (p<0.05). Their expression was not correlated with other clinicopathologic factors. The expression of FAK in cervical carcinoma was related with the expression of alpha-catenin. CONCLUSION: This study showed that the expression of beta- & alpha-catenin is involved in the invasion of cervical carcinoma and the FAK expression might be associated with the alpha-catenin expression in cervical carcinoma.

The Expression of beta- & alpha-Catenin and Focal Adhesion Kinase in Invasive Cervical Cancers / 대한산부인과학회잡지

OBJECTIVE: E-cadherin/catenin adhesion complex is fundamentally involved in epithelial cancer invasion and metastasis. Focal adhesion kinase (FAK) is one of the molecules that may be involved in the regulation of focal adhesion integrity and the progression of cancer to invasion and metastasis. The present study was aimed to explore that the beta- & alpha-catenin might be involved in the invasion and metastasis of cervical carcinoma, and their expression might be related with other clinicopathologic factors or associated with FAK in cervical cancer. METHODS: The tissues were obtained from the 26 patients with cervical carcinoma and the 9 patients with normal cervix undergoing hysterectomy. The proteins were extracted and the expression of beta- and alpha- catenin and FAK were studied with a western blot analysis. The coexpression of alpha-catenin and FAK was examined with an immunoprecipitation. The clinicopathologic factors were reviewed with the charts of patients and the results were analysed with the Chi-square test and Spearman's correlation test. RESULTS: The expression of beta- and alpha-catenin in cervical carcinoma was lower than that in normal cervix (p<0.05). Their expression was not correlated with other clinicopathologic factors. The expression of FAK in cervical carcinoma was related with the expression of alpha-catenin. CONCLUSION: This study showed that the expression of beta- & alpha-catenin is involved in the invasion of cervical carcinoma and the FAK expression might be associated with the alpha-catenin expression in cervical carcinoma.

The clinical significance of Interleukin-6 mRNA expression in cervical intraepithelial neoplasia and cervical cancer / 대한산부인과학회잡지

OBJECTIVES: Interleukin-6 is a pleiotrophic cytokine that is not only a mediator in major immunologic reactions but also a growth factor of keratinocytes. We studied IL-6 mRNA expression in cervical cancer, CIN and normal cervix. And we questioned whether its expression is related to cervical carcinogenesis and other prognostic factors. METHODS: The normal cervical and cervical cancer tissues were taken from healthy women (n=16), and the patients with CIN (n=36) and cervical cancer (n=36). The IL-6 mRNA expression was examined by quantitative competitive PCR after polymerase chain reaction amplification of reverse transcriptase copies of RNA transcripts (RT-PCR). RESULTS: There was no statistically different among cervical cancer, CIN and normal cervix (p>0.05). The IL-6 mRNA expression was not different according to the grades of CIN. Its expression was not correlated with the stage of cervical cancer, size of tumor, and histopathologic type (p>0.05). CONCLUSION: These results suggested that IL-6 mRNA expression might not be associated with the cervical carcinogenesis and prognosis of cervical cancer.

The Matrix metalloproteinase-2 & -9, Tissue inhibitor of metalloproteinase-1 & -2 mRNA Expression in Invasive Cervical Cancer / 대한산부인과학회잡지

OBJECTIVE: Invasive cancer cells penetrate the extracellular matrix(ECM), including basement membrane during the metastatic cascades. Matrix metalloproteinases(MMPs) play a critical role in tumor invasion and metastasis and their activities are regulated by specific tissue inhibitors of metalloproteinase(TIMPs). Aberrant ECM degradation in tumor biology is attributed to an imbalance in local MMP and TIMP activity, resulting in the overexpression or enhanced activation of MMPs or reduced TIMP expression. The aim of this study was to compare the MMP-2 & -9, TIMP-1 & -2 mRNA expression in cervical cancer with those in normal cervix and to investigate that their expression is related to cancer stages and other prognostic factors. METHODS: The normal cervix and cervical cancer tissues were obtained from healthy women(n=14), and the patients with cervical cancer(n=31), respectively. Total RNA was extracted and reverse transcribed into cDNA. The expression of MMP-2 & -9, TIMP-1 & -2 mRNA was examined by quantative competitive PCR(QC PCR) and each results were analyzed by t-test and univariate analysis. RESULTS: The expression of MMP-2, TIMP-1 mRNA in cervical cancer was higher than that in nomal cervix(p0.05). CONCLUSIONS: These results suggested that increased MMP-2, TIMP-1 & -2 mRNA expression is an early event during malignant transformation of cervical cancer.

Presence of circulating autoantibodies against bronchial epithelia cell in patients with nonatopic asthma

Allergic response to common environmental agents has been regarded as a main pathogenetic mechanism of bronchial asthma. However, allergic sensitization (atopy) can not be detected in a siginificant number of adult asthmatic patients. The etiology of nonatopic asthma has not yet been defined. To evaluate the possible involvement of autoimmune response against bronchial mucosa in the pathogenesis of nonatopic asthma, we performed indirect immunofluorescence staining of fresh frozen human bronchial mucosa tissue using serum samples from patients with atopic and nonatopic asthma, healthy controls, and patients with systemic lupus erythematosus. On immunostaining, circulating IgG autoantibodies against bronchial mucosa were detected in 2 (9.1%) of 22 patients with nonatopic asthma and in none of 22 patients with atopic asthma and of 22 healthy controls. IgG autoantibodies from the two patients with nonatopic asthma predominantly stained the cytoplasmic membrane of basal cells in bronchial epithelium. Serum samples from 10 patients with systemic lupus erythematosus immunostained the nucleus of epithelial cells in whole layer of bronchial epithelium. This study showed the presence of circulating IgG autoantibodies against the bronchial epithelial cell in a small portion of patients with nonatopic asthma. Further studies may be necessary to evaluate the possible involvement of autoimmune mechanism in the pathogenesis of nonatopic asthma.

The expression and tyrosine phosphorylation of E-cadherin, beta-, gamma-catenin and EGFR after treatment of EGF and TGF-alpha in Cervical Cancer Cell Lines / 대한부인종양콜포스코피학회잡지

OBJECTIVES: Cadherin/catenin adhesion complex is fundamentally involved in epithelial cancer invasion and metastasis. E-cadherin and EGFR colocalize on the basolateral membrane of epithelial cell and EGF down-regulate E-cadherin expression. In the invasion and metastasis of cancer, E-cadherin expression is decreased and growth factors receptor is overexpressed. The present study was aimed to find the role of E-cadherin, beta-and gamma-catenin, growth factors and its receptors in cervical cancer cell lines. METHODS: The cervical cancer cell cultures were treated with different time duration of EGF 30 ng/ml and TGF-a 10 ng/ml(0, 10 min, 20 min, 30 min, 1 hr, 2 hr, 4 hr, 8 hr, 24 hr). The change in cancer cell morphology and the changes in E-cadherin, beta- and gamma-catenin, EGFR and activated EGFR expression were studied with a western blot analysis and an immunoprecipitation. RESULTS: Through a western blot analysis, E-cadherin 120 kDa band and EGFR 170 kDa band were expressed in CaSki, HT-3 and ME-180 cell line, which showed epithelial contact growth. 1n these 3 cell lines, expression of E-cadherin did not decrease with time dependent manner. after the treatment of EGF and TGF- alpha. The expression of EGFR decreased and activated EGFR expression increased in 30 minutes to 1 hour but decreased subsequently. When the cells treated with EGF, there were no change in beta-and gamma-catenin expression with there dependent manner. The tyrosine phosphorylation of beta-and gamma-catenin increased in 30 minutes to 1 hour but decreased subsequently with activated EGFR. CONCLUSION: This study showed that an activated EGFR which has involved with tyrosine phosphorylation of beta- and gamma-catenin influenced by growth factors rather than expression of E-cadherin, has a role in the invasion and metastasis of the cervical cancer.

Telomerase Activity in Gestational Trophoblastic Disease / 대한산부인과학회잡지

The purpose of this study was to evaluate the significance of telomerase activity in gestational trophoblastic disease and the association of telomerase activity in complete hydatidiform mole and subsequent development of persistent gestational trophoblastic tumor. By using the standard telomerase repeat assay, we examined telomerase activity in 2 normal placentas, 31 complete hydatidiform moles, 7 invasive moles, 5 choriocarcinoma tissues and choriocarcinoma cell line (JEG-3). Telomerase activity was detected in 13 of 15 (86.7%) complete hydatidiform mole patients who eventually had chemotherapy for the treatment of persistent gestational trophoblastic tumor. All of the 9 patients with metastatic disease (FIGO Stage III) had telomerase activity in their initial molar tissue. In contrast, telomerase activity was evident in only two of 16 (12.5%) complete hydatidiform mole patients with spontaneous remission. While telomerase activity was not detected in normal placentas, high level of telomerase activity was detected in all of 7 invasive moles, 5 choriocarcinoma tissues and choriocarcinoma cell line (JEG-3). The presence of telomerase activity in a complete hydatidiform mole is associated with the development of persistent gestational trophoblastic tumor, such as invasive mole and choriocarcinoma.

Transvginal Sonography in the Prediction of Preterm Labor / 대한주산의학회잡지

OBJECTIVE: Preterm labor and delivery is probably the largest problem in modern perinatology. The early diagnosis of preterm labor is crucial for prevention of preterm birth. To predict the onset of preterm labor, we examined the diagnostic performance of serial cervical assessment by transvaginal sonography. METHODS: In this prospective study, we performed transvaginal sonography at approximately 30 and 34 weeks of gestation in women with singleton pregnancies. Cervical parameters evaluated included endocervical length, the presence of funneling, funnel length and funnel width. We then assessed the relation between cervical parameters and the risk of spontaneous preterm labor. RESULTS: We examined 258 women at approximately 30 weeks of gestation and 247 of these women again at approximately 34 weeks. Spontaneous preterm labor occurred in 9 of women examined at 30 weeks(Group 1) and in 13 at 34 weeks(Group 2). The endocervical length was normally distributed at 30 and 34 weeks(mean +/-SD, 38.26+/-6.82mm and 35.63+/-7.35mm, respectively). The endocervical length decreased significantly from 30weeks to 34 weeks(p=0.0001). Both groups showed significantly shorter endocervical length(p <0.05) and groupl more presence of funneling than group of term pregnancy(p<0.05). Receiver-operator characteristic curve and multiple logistic regression analyses indicated that endocervical length <-30mm at 30 weeks and <-25mm at 34 showed highest diagnostic index in predicting the onset of preterm labor(p=0.0001). Conclusions: Serial transvaginal ultrasound assessment of endocervical length during early third trimester is a useful predictor of preterm labor and delivery in low-risk patients.

A comparative study of bond strength of recycled brackets / 대한치과교정학회지

This study was undertaken to compare the bond strength and the fracture site of new and recycled brackets according to the base design. 252 sound premolars extracted for orthodontic treatment were collected, and Type I, Type II, Type III brackets were divided into four groups by recycling method. Each bracket was then bonded to an extracted premolar. Instron Universal Testing Machine(model 4466) was used to measure the shear bond strength, and the surface of the recycled brackets were viewed in SEM. For the analysis of the results, one way ANOVA and Scheffe's multiple range test was executed using the SPSSWIN program. 1. The shear bond strength showed statistically significant difference according to the bracket base design(P0.05). 3. In Type I, Type II brackets, frequent fracture site was bracket-resin interface, but in Type III brackets, about half of the resin was retained on the tooth surface frequently. 4. The shear bond strength was highest when about half of the resin was retained on the tooth surface(p<0.05). 5. The resin remnant on the bracket base after recycling had no effect on the shear bond strength.

Differential approaches in the maloclusion with canine impaction / 대한치과교정학회지

During diagnostic process of the orthodontic patients, it is not unusual to find canine impaction. Generally, the chief complaint of the patients is crowding or antetior crossbite which is not related with canine impaction, but sometimes they complainted delayed eruption of the canine or deviation of the adjacent teeth caused by canine impaction. Orthodondists have to make the proper treatment plan according to final treatment goals. On the following cases, two patients were diagnosed as a malocclusion with canine impaction, and were treated by different accesses, one by extraction, and the other by non-extraction each.