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Purpose@#The purpose of this study was to explore nurses’ experience with caring for COVID-19 patients in a negative pressure room amid the spread of the pandemic. @*Methods@#This study was a qualitative research, and focus group interviews were used to collect data. Three focus groups comprising 19 nurses were interviewed from February 17 to 25, 2021. All interviews were recorded and transcribed verbatim with the consent of the participants. The verbatim transcripts were scrutinized using thematic analysis. @*Results@#Two main themes emerged from the analysis: ‘Struggling in an isolated space’ and ’Limitations of nursing infrastructure and system’. The nurses caring for COVID-19 patients experienced anxiety and fear about the infection, physical exhaustion, emotional burnout, and a sense of duty as a nurse. They also acknowledged the lack of guidelines, increased task and burden, limitations of nursing care, and the demand for improving the limitations of the nursing system. @*Conclusion@#The results of this study demonstrate that nurses caring for COVID-19 patients encounter physical and emotional problems within the limited healthcare system. The study suggests that comprehensive interventions are needed for nurses. Furthermore, detailed guidelines, strengthening of nursing personnel, and improvements to the nursing system are vital to effectively cope with the pandemic. The government and medical institutions should be aware of the needs of nurses and what they are going through, and make efforts to improve the quality of life of healthcare workers and create a safe healthcare environment.
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Recently, neuromelanin and nigrosome imaging techniques have been developed to evaluate the substantia nigra in Parkinson’s disease. Previous studies have shown potential benefits of quantitative analysis of neuromelanin and nigrosome images in the substantia nigra, although visual assessments have been performed to evaluate structures in most studies. In this study, we investigate the potential of using deep learning based automatic region segmentation techniques for quantitative analysis of the substantia nigra. The deep convolutional neural network was trained to automatically segment substantia nigra regions on 3D nigrosome and neuromelanin sensitive MR images obtained from 30 subjects. With a 5-fold cross-validation, the mean calculated dice similarity coefficient between manual and deep learning was 0.70 ± 0.11. Although calculated dice similarity coefficients were relatively low due to empirically drawn margins, selected slices were overlapped for more than two slices of all subjects. Our results demonstrate that deep convolutional neural network-based method could provide reliable localization of substantia nigra regions on neuromelanin and nigrosome sensitive MR images.
ABSTRACT
Recently, neuromelanin and nigrosome imaging techniques have been developed to evaluate the substantia nigra in Parkinson’s disease. Previous studies have shown potential benefits of quantitative analysis of neuromelanin and nigrosome images in the substantia nigra, although visual assessments have been performed to evaluate structures in most studies. In this study, we investigate the potential of using deep learning based automatic region segmentation techniques for quantitative analysis of the substantia nigra. The deep convolutional neural network was trained to automatically segment substantia nigra regions on 3D nigrosome and neuromelanin sensitive MR images obtained from 30 subjects. With a 5-fold cross-validation, the mean calculated dice similarity coefficient between manual and deep learning was 0.70 ± 0.11. Although calculated dice similarity coefficients were relatively low due to empirically drawn margins, selected slices were overlapped for more than two slices of all subjects. Our results demonstrate that deep convolutional neural network-based method could provide reliable localization of substantia nigra regions on neuromelanin and nigrosome sensitive MR images.
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Background@#The stromal vascular fraction (SVF) isolated from adipose tissue, which contains stem cells as well as other cell types, has been applied in various research fields. Although different enzymatic concentrations and treatment durations have been applied to isolate the SVF, optimal conditions have not been established. Thus, we aimed to establish the optimal conditions for isolation of the SVF from adipose tissue by automated systems. @*Methods@#The SVF was collected from removed adipose tissues of five donors during surgery. The SVF was treated with 0.1% or 0.2% collagenase type I for 20, 40, or 60 min. Then, colony forming unit (CFU) assays and flow cytometry were performed to characterize the adipose stem cells (ASCs). A cytokine array was used to investigate the correlation between colony-formation ability and the secretion of isolated ASCs. @*Results@#Treatment with 0.1% collagenase type I for 60 min resulted in a higher SVF yield, whereas treatment with 0.1% collagenase for 40 min resulted in higher CFU values. In addition, expression of interleukin (IL)-6, IL-8, and monocyte chemoattractant protein-1 in the SVF was higher in the high-CFU group than in the low-CFU group. @*Conclusion@#The optimal conditions for isolation of the SVF from adipose tissue were treatment with 0.1% collagenase type I for 40 min. We identified the conditions required for efficient SVF isolation based on high CFU values, and our results will facilitate the development of automated systems.
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Purpose@#Melanoma is a potentially fatal cutaneous malignancy and regional lymph node (LN) metastases are the most important predictors of mortality. This study aimed to analyze clinical features and risk factors of complications associated with inguinal LN dissection (LND) to establish treatment protocols. @*Methods@#This single-center retrospective study (2000 to 2018) consisted of patients who underwent inguinal area sentinel LN biopsy (SLNB) or LND due to malignant melanoma. Risk factors and outcomes were analyzed. @*Results@#One hundred patients underwent SLNB alone (n=67; patients with negative SLNB), complete LND (CLND) after positive SLNB (n=19), or radical LND without SLNB (n=14). Five-year overall survival and disease-free survival rates among these groups were 87.3%, 57.4%, and 61.9%, and 59.0%, 22.7%, and 28.1%, respectively. The complication rate in the SLNB alone group was lower than the other groups (22.4% vs. 47.4% and 35.7%, respectively; P=0.048). Seroma was the most common complication in the SLNB alone group (15.0%); lymphedema was most common in the CLND after SLNB group (21.1%). Multivariate analysis of risk factors for postoperative complications found the hazard ratio for body mass index >28 kg/m2 was 4.376 (95% confidence interval [CI], 1.243–15.401; P=0.022). The hazard ratio for LND (including CLND after SLNB and radical LND without SLNB) was 3.263 (95% CI, 1.248–8.529; P=0.016). @*Conclusion@#Inguinal LND is a higher risk procedure compared to SLNB and other sites for postoperative complications, irrespective of meticulous surgical techniques. More studies are needed to establish treatment protocols (e.g., observation vs. CLND after a positive SLNB result) and the risks and benefits in Asian populations.
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Purpose@#Melanoma is a potentially fatal cutaneous malignancy and regional lymph node (LN) metastases are the most important predictors of mortality. This study aimed to analyze clinical features and risk factors of complications associated with inguinal LN dissection (LND) to establish treatment protocols. @*Methods@#This single-center retrospective study (2000 to 2018) consisted of patients who underwent inguinal area sentinel LN biopsy (SLNB) or LND due to malignant melanoma. Risk factors and outcomes were analyzed. @*Results@#One hundred patients underwent SLNB alone (n=67; patients with negative SLNB), complete LND (CLND) after positive SLNB (n=19), or radical LND without SLNB (n=14). Five-year overall survival and disease-free survival rates among these groups were 87.3%, 57.4%, and 61.9%, and 59.0%, 22.7%, and 28.1%, respectively. The complication rate in the SLNB alone group was lower than the other groups (22.4% vs. 47.4% and 35.7%, respectively; P=0.048). Seroma was the most common complication in the SLNB alone group (15.0%); lymphedema was most common in the CLND after SLNB group (21.1%). Multivariate analysis of risk factors for postoperative complications found the hazard ratio for body mass index >28 kg/m2 was 4.376 (95% confidence interval [CI], 1.243–15.401; P=0.022). The hazard ratio for LND (including CLND after SLNB and radical LND without SLNB) was 3.263 (95% CI, 1.248–8.529; P=0.016). @*Conclusion@#Inguinal LND is a higher risk procedure compared to SLNB and other sites for postoperative complications, irrespective of meticulous surgical techniques. More studies are needed to establish treatment protocols (e.g., observation vs. CLND after a positive SLNB result) and the risks and benefits in Asian populations.
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OBJECTIVES: Open and supportive communication between parents and children is known to reduce adolescents' delinquent behavior. Recently, the risk of Internet gaming disorder (IGD) has been increasing in adolescents. The purpose of this study was to investigate the mediating effects of parent-child communication styles on the relationship between adolescent aggressiveness and risk of IGD.METHODS: Participants in this study were 402 first-year students from 4 middle schools in Seoul who enrolled in the Internet user Cohort for Unbiased Recognition of gaming disorder in Early adolescence (iCURE) and completed baseline assessment in 2016. The structural equation model was constructed based on an aggression questionnaire, the Internet game use-elicited symptom screen, a mother-child communication inventory, and a father-child communication inventory.RESULTS: Adolescents' aggressiveness was found to be related to their risk of IGD. The father-child communication style mediated the relationship between aggression and risk of IGD. However, the mother-child communication style had no mediating effect.CONCLUSIONS: Our findings suggest that fathers should make an effort to improve open and positive communication skills with their children, because the father-child communication style plays an important role in the relationship between adolescent aggressiveness and risk of IGD.
Subject(s)
Adolescent , Child , Humans , Aggression , Behavior, Addictive , Cohort Studies , Fathers , Immunoglobulin D , Internet , Negotiating , Parents , SeoulABSTRACT
OBJECTIVES@#Open and supportive communication between parents and children is known to reduce adolescents' delinquent behavior. Recently, the risk of Internet gaming disorder (IGD) has been increasing in adolescents. The purpose of this study was to investigate the mediating effects of parent-child communication styles on the relationship between adolescent aggressiveness and risk of IGD.@*METHODS@#Participants in this study were 402 first-year students from 4 middle schools in Seoul who enrolled in the Internet user Cohort for Unbiased Recognition of gaming disorder in Early adolescence (iCURE) and completed baseline assessment in 2016. The structural equation model was constructed based on an aggression questionnaire, the Internet game use-elicited symptom screen, a mother-child communication inventory, and a father-child communication inventory.@*RESULTS@#Adolescents' aggressiveness was found to be related to their risk of IGD. The father-child communication style mediated the relationship between aggression and risk of IGD. However, the mother-child communication style had no mediating effect.@*CONCLUSIONS@#Our findings suggest that fathers should make an effort to improve open and positive communication skills with their children, because the father-child communication style plays an important role in the relationship between adolescent aggressiveness and risk of IGD.
ABSTRACT
OBJECTIVES: Open and supportive communication between parents and children is known to reduce adolescents' delinquent behavior. Recently, the risk of Internet gaming disorder (IGD) has been increasing in adolescents. The purpose of this study was to investigate the mediating effects of parent-child communication styles on the relationship between adolescent aggressiveness and risk of IGD. METHODS: Participants in this study were 402 first-year students from 4 middle schools in Seoul who enrolled in the Internet user Cohort for Unbiased Recognition of gaming disorder in Early adolescence (iCURE) and completed baseline assessment in 2016. The structural equation model was constructed based on an aggression questionnaire, the Internet game use-elicited symptom screen, a mother-child communication inventory, and a father-child communication inventory. RESULTS: Adolescents' aggressiveness was found to be related to their risk of IGD. The father-child communication style mediated the relationship between aggression and risk of IGD. However, the mother-child communication style had no mediating effect. CONCLUSIONS: Our findings suggest that fathers should make an effort to improve open and positive communication skills with their children, because the father-child communication style plays an important role in the relationship between adolescent aggressiveness and risk of IGD.
Subject(s)
Adolescent , Child , Humans , Aggression , Behavior, Addictive , Cohort Studies , Fathers , Immunoglobulin D , Internet , Negotiating , Parents , SeoulABSTRACT
OBJECTIVE: To explore the structure of Internet gaming disorder (IGD) criteria and their distribution according to the different severity level of IGD. The associations of psychiatric comorbidities to each IGD symptom and to the IGD severity were also investigated. METHODS: Consecutively recruited 330 Korean middle school students underwent face-to-face diagnostic interviews to assess their gaming problems by clinicians. The psychiatric comorbidities were also evaluated with a semi-structured instrument. The data was analyzed using principal components analysis and the distribution of criteria among different severity groups was visualized by plotting univariate curves. RESULTS: Two principal components of ‘Compulsivity’ and ‘Tolerance’ were extracted. ‘Decrease in other activities’ and ‘Jeopardizing relationship/career’ may indicate a higher severity of IGD. While ‘Craving’ deserved more recognition in clinical utility, ‘Tolerance’ did not demonstrate much difference in distribution by the IGD severity. Internalizing and externalizing psychiatric disorders differed in distribution by the IGD severity. CONCLUSION: A hierarchic presentation of IGD criteria was revealed. ‘Decrease in other activities’ and ‘Jeopardizing relationship/career’ may represent a higher severity, thus indicating more clinical attention to such symptoms. However, ‘Tolerance’ was not found to be a valid diagnostic criterion.
Subject(s)
Humans , Comorbidity , Immunoglobulin D , Internet , PathologyABSTRACT
Myeloid sarcoma (MS) is an extramedullary involvement of immature myeloid proliferation. An isolated MS is defined as a myeloblastic tumor when it arises without any concomitant circulating disease. A diagnosis of MS is established using pathologic features including infiltration of myeloblasts and strong myeloperoxidase expression with negative cytokeratin immunohistochemical staining. We report a rare case of colonic MS without any peripheral blood abnormality. If the affected patient were left untreated, the MS could evolve into acute myeloid leukemia (AML) within one year. Several studies recommend the same regimens of chemotherapy as used for circulating AML to treat isolated MS. We focused on the diagnosis of MS in this study. The correct diagnosis of MS is important for adequate treatment. In conclusion, MS should be considered in the differential diagnosis of intestinal tumor.
Subject(s)
Humans , Colon , Colonic Neoplasms , Diagnosis , Diagnosis, Differential , Drug Therapy , Granulocyte Precursor Cells , Intestines , Keratins , Leukemia, Myeloid, Acute , Peroxidase , Sarcoma, MyeloidABSTRACT
BACKGROUND: High-intensity focused ultrasound (HIFU) treatment has recently emerged in response to the increasing demand for noninvasive procedures for skin lifting and tightening. OBJECTIVE: This study was aimed at evaluating the clinical efficacy of and patient satisfaction with HIFU treatment for wrinkles and laxity in seven different areas of the face in Asian skin. METHODS: Twenty Korean patients with facial wrinkle and laxity were analyzed after a single session of HIFU treatment. Two independent, blinded clinicians evaluated the clinical improvement in seven areas of the face by comparison of standardized photographs obtained before, and at 3 and 6 months after treatment. Assessment of subjective satisfaction and adverse effects of treatment were done by using questionnaires. RESULTS: The physicians' evaluation and patients' satisfaction with the clinical effects of HIFU in each area were similar regardless of the number of treatment shots. The jawline, cheek, and perioral areas were the sites where HIFU was most effective, in decreasing order. The adverse effects included erythema and swelling in six cases, and purpura and bruising in two cases. However, the adverse effects were mild and transient. CONCLUSION: HIFU could be a safe, effective, and noninvasive procedure that can be used to improve facial wrinkles and skin laxity in Asian skin. It is particularly effective for clinical improvement in the jawline, cheek, and perioral areas.
Subject(s)
Humans , Asian People , Cheek , Erythema , Lifting , Patient Satisfaction , Purpura , Skin , UltrasonographyABSTRACT
PURPOSE: The aim of this study was to investigate whether plasma angiopoietin-1 (Ang-1) and angiopoietin-2 (Ang-2) concentrations in pregnant women with chronic hypertension are different from those of normotensive pregnant women. METHODS: This hospital-based case-control study consisted of 35 pregnant women with chronic hypertension who delivered at Seoul National University Hospital. Normotensive pregnant women (n=70) were selected as controls, matched with maternal age, gestational age at delivery and birthweight. Maternal blood was drawn at the time of admission for delivery and plasma was separated and stored. The plasma Ang-1 and Ang-2 levels were measured by ELISA. Statistical analysis was done with Mann-Whitney U test, Fisher's exact test and Spearman rank correlation test using SPSS. RESULTS: Median (range) maternal age, gestational age and birthweight were 33 years (24-42), 38 weeks (32-41), and 3.08 kg (1.13-4.01). Pregnant women with chronic hypertension had significantly higher median Ang-1 and Ang-2 levels than normotensive pregnant women (for Ang-1 : median 4,111 pg/mL, range 1,415-30,172 vs. median 2,824 pg/mL range 662-14,512, P=0.015, for Ang-2 : median 5,637 pg/mL, range 1,131-29,327 vs. median 3,345 pg/mL, range 609-24,467, P=0.039). CONCLUSION: Maternal plasma Ang-1 and Ang-2 levels were elevated in pregnant women with chronic hypertension compared with normotensive pregnant women. Further study is needed to determine if this change is a cause or a compensatory mechanism to chronic hypertension.
Subject(s)
Female , Humans , Angiopoietin-1 , Angiopoietin-2 , Case-Control Studies , Enzyme-Linked Immunosorbent Assay , Gestational Age , Hypertension , Maternal Age , Plasma , Pregnant Women , SeoulABSTRACT
BACKGROUND: Cyclosporine (CS) is being successfully used for various skin diseases including psoriasis, atopic dermatitis, and chronic idiopathic urticaria. However, dermatologists have hesitated to use CSs in clinical practices due to possible adverse effects. OBJECTIVE: The aim of this study is to investigate the adverse effects of CS for dermatological uses. METHODS: We performed a retrospective study by including 1,335 patients with CS treatment. RESULTS: From 1,335 patients, 208 (15.6%) showed adverse effects and obvious laboratory changes. Twenty five patients experienced either two or more adverse effects. Gastrointestinal (GI) symptoms were the most common side effects. Other side effects included hypercholesterolemia (2.2%), hypertrichosis (2.2%), headache (1.3%), hypertension (0.9%), and hypertriglyceridemia (0.9%). Hypercholesterolemia is more frequently found in men but, GI symptoms and hypertrichosis are more frequent in women. Hypercholesterolemia, hypertriglyceridemia, and GI symptoms are more common in adults but hypertrichosis is more common in children and adolescents. Hypertension, hypercholesterolemia, and hypertriglyceridemia have been remarkable in psoriasis patients, and GI symptoms and hypertrichosis are found in patients with atopic dermatitis. GI symptoms and headaches occur more often within three months of the CS treatment; however, hypertension, hypercholesterolemia, and hypertriglyceridemia usually occur three months after. With regards to CS dose, the hypertrichosis is more common in the group with low initial dose. GI symptoms occur more often in the lower CS cumulative dose group; however, hypertension and hypertriglyceridemia are higher in the CS cumulative dose group. CONCLUSION: As compared with previous studies, the frequency of adverse effects after CS treatment in this study is proved to be low. Therefore, under dermatological fields, we suggest that CS is a relatively safe drug with periodic follow-ups and laboratory tests.
Subject(s)
Adolescent , Adult , Child , Female , Humans , Male , Cyclosporine , Dermatitis, Atopic , Dermatology , Follow-Up Studies , Headache , Hypercholesterolemia , Hypertension , Hypertrichosis , Hypertriglyceridemia , Psoriasis , Retrospective Studies , Skin Diseases , Skin , UrticariaABSTRACT
No abstract available.
Subject(s)
Humans , Infant, Newborn , Calcinosis , Calcium , Calcium Gluconate , GluconatesABSTRACT
The incidence of chronic disease is continuously increasing in Korea. Especially, office workers have higher risk of chronic disease because of their dietary habit and lifestyle. The study aimed to investigate the effect of tailored nutrition counseling on improving chronic disease risk factors. Ninety-nine male workers (age 46.9 +/- 7.0 yrs) volunteered for 12 weeks of nutrition program containing dietary intake and physical activity adjustment. Five individualized programs were performed with the main theme of weight loss (WL, n = 16), blood pressure lowering (BL, n = 34), normalizing blood glucose (GL, n = 21), lipid lowering (LL, n = 13) and reducing MS risk factors (ML, n = 15). Anthropometric data, blood-pressure, self-reported questionnaire, blood profiles were measured before and after 12weeks of nutrition education. The education program included 5 times of 1:1 interview. Compared to 0 week, anthropometric data (weight, BMI, fat, visceral fat, waist, SBP, DBP) were significantly decreased after 12 weeks (p < 0.001). Fasting blood glucose and total cholesterol were decreased (p < 0.05). The primary outcomes with individually tailored programs showed to be more effective than one general nutrition program.