Cedrol, a Sesquiterpene Isolated from Juniperus chinensis, Inhibits Human Colorectal Tumor Growth associated through Downregulation of Minichromosome Maintenance Proteins

Cedrol, a sesquiterpene alcohol, isolated from Juniperus chinensis has been reported to inhibit minichromosome maintenance (MCM) proteins as cancer biomarkers in human lung cancer in vitro. In the present study, we investigated the anti-cancer activity of cedrol in vitro and in vivo using human colorectal cancer HT29 cells and a human colorectal tumor xenograft model. Cedrol inhibited MCM protein expression and cell growth in HT29 cells, which are associated with G1 arrest and the induction of apoptosis. We demonstrated that cedrol effectively reduced HT29 tumor growth without apparent weight loss in a human tumor xenograft model.Compared with vehicle- and adriamycin-treated tumor tissues, cedrol induced changes in the tumor tissue structure, resulting in a reduced cell density within the tumor parenchyma and reduced vascularization. Moreover, the expression of MCM7, an important subunit of MCM helicase, was significantly suppressed by cedrol in tumor tissue. Collectively, these results suggest that cedrol may act as a potential anti-cancer agent for colorectal cancer by inhibiting MCM protein expression and tumor growth.

Fruit Intake and Changes of Cardio-Metabolic Risk Factors in People with Obesity / 가정의학회지

Background@#This study aimed to explore the relationship between fruit intake, changes in fruit intake, and changes in cardiometabolic factors in people with obesity. @*Methods@#A total of 21,270 subjects (8,718 men, 12,552 women) aged 40 years and over, from the Korean-based Genome and Epidemiology Study, were followed up for an average of 4.4 years. Fruit intake was assessed using a food frequency questionnaire at baseline and the second follow-up. The beta coefficient and confidence intervals for changes in cardiometabolic risk factors according to fruit consumption were calculated using a linear regression model. @*Results@#In men, the abdominal circumference decreased with changes in fruit intake (P=0.029). Fruit intake and increased fruit intake in men were associated with a lower systolic blood pressure (P=0.012 and P=0.02, respectively) and lower triglyceride levels (P=0.002 and P<0.001, respectively). In women, abdominal circumference decreased with both fruit intake and increased fruit intake (P<0.001 and P=0.013, respectively). Systolic blood pressure and triglycerides tended to decrease only with fruit intake (P=0.048 and P<0.001, respectively). Unlike in men, fasting blood glucose tended to decrease in women with both fruit intake and increased fruit intake (P=0.011 and P=0.005, respectively). @*Conclusion@#Fruit intake and increased fruit intake may have beneficial effects on cardiometabolic risk factors among individuals who are obese.

Fruit Intake and Changes of Cardio-Metabolic Risk Factors in People with Obesity / 가정의학회지

Background@#This study aimed to explore the relationship between fruit intake, changes in fruit intake, and changes in cardiometabolic factors in people with obesity. @*Methods@#A total of 21,270 subjects (8,718 men, 12,552 women) aged 40 years and over, from the Korean-based Genome and Epidemiology Study, were followed up for an average of 4.4 years. Fruit intake was assessed using a food frequency questionnaire at baseline and the second follow-up. The beta coefficient and confidence intervals for changes in cardiometabolic risk factors according to fruit consumption were calculated using a linear regression model. @*Results@#In men, the abdominal circumference decreased with changes in fruit intake (P=0.029). Fruit intake and increased fruit intake in men were associated with a lower systolic blood pressure (P=0.012 and P=0.02, respectively) and lower triglyceride levels (P=0.002 and P<0.001, respectively). In women, abdominal circumference decreased with both fruit intake and increased fruit intake (P<0.001 and P=0.013, respectively). Systolic blood pressure and triglycerides tended to decrease only with fruit intake (P=0.048 and P<0.001, respectively). Unlike in men, fasting blood glucose tended to decrease in women with both fruit intake and increased fruit intake (P=0.011 and P=0.005, respectively). @*Conclusion@#Fruit intake and increased fruit intake may have beneficial effects on cardiometabolic risk factors among individuals who are obese.

Validation of Adult Fall Assessment Scale Korean Version for Adult Patients in General Hospitals in Korea / 임상간호연구

Purpose@#The purpose of this study was to test the predictive validity of the Fall Assessment Scale-Korean version (FAS-K) and to find the most appropriate cutoff score to screen high-risk fall groups in adult patients in general hospitals in Korea. @*Methods@#We performed a prospective evaluation study in medical and surgical ward patients at two major general hospitals in Seoul. Data were collected from Nov. 1, 2018 to Feb. 28, 2019, nurses performed 651 observation series. The researcher measured the fall risk assessment score by applying FAS-K, MFS (Morse Fall Scale), and JHFRAT (Johns Hopkins Hospital Fall Risk Assessment tool) to the patients twice a week between 10 am and 12 noon. Data were analyzed using Pearson's corelation coefficients, and the sensitivity, specificity, predictive value, and the area under the curve (AUC) of the three tools. Results: The FAS-K was positively correlated with the MFS (r=.70, p<.001) and the JHFRAT (r=.82, p<.001). According to the receiver operating characteristics (ROC) curve analysis of the FAS-K, sensitivity, specificity, and positive and negative prediction values were 85.3%, 49.4%, 8.5%, and 98.4%, respectively, when the FAS-K score was 4. Therefore, the cut-off score of the FAS-K to identify groups with high fall risk was 4. @*Conclusion@#The FAS-K is a valid tool for measuring fall risk in adult inpatients.In addition, the FAS-K score, 4, can be used to identify high-risk fall groups and know specific points in time to provide active interventions to prevent falls.

Effects of Nurses' Patient Safety Management Importance, Patient Safety Culture and Nursing Service Quality on Patient Safety Management Activities in Tertiary Hospitals / 간호행정학회지

Purpose@#This study was done to identify effects of nurses' nursing service quality, importance of patient safety management and patient safety culture on patient safety management activities. @*Methods@#The participants were 246 nurses in tertiary hospitals. Data were analyzed using descriptive statistics, t-test, Mann-Whitney U test, ANOVA, Pearson correlation coefficients, multiple regression with SPSS/WIN 24.0. @*Results@#A mean score of 4.43±0.44 out of 5 was found for patient safety management activities and a mean score of 3.29±0.27 out of 4 for nursing service quality. A mean score of 3.89±0.48 out of 5 was found for importance of patient safety management and a mean score of 3.28±0.25 out of 5 for patient safety culture. Patient safety management activities were positively correlated with importance of safety management, and with patient safety culture. The results show that importance of patient safety management, patient safety culture, and length in workplace were predictive of patient safety management activities (R2=.25, p<.001). @*Conclusion@#These results suggest that importance of patient safety management and patient safety culture are associated with patient safety management activities. Intervention programs to improve patient safety management activities are needed to promote the importance of patient safety management as well as patient safety culture.

Effects of Leader-Member Exchange of Nurses who Return to Work after Parental Leave on Conflict between Work and Family: Focus on the Mediating Effects of Job Stress / 간호행정학회지

Purpose@#This study was done to analyze effects of leader-member exchange as perceived by nurses who returned to work after parental leave: conflict between work and family via job stress. @*Methods@#A cross-sectional study design was adopted and data were collected from 140 nurses. Collected data were analyzed using the SPSS 23.0 program (descriptive statistics, t-test, ANOVA, Pearson correlation, and regression analysis). @*Results@#Mean scores were 3.44±0.64 out of 5 for leader-member exchange, 3.45±0.59 out of 5 for job stress, and 2.82±0.80 out of 5 for conflict between work and family. The leader-member exchange had negative correlations with job stress (r=-.31, p=.003) and conflict between work and family (r=-.36, p<.001). The leader-member exchange had direct impacts on conflict between work and family (β=-.26, p=.002) and indirect via job stress (β=.35, p<.001). Job stress had partial mediating effects on relations between leader-member exchange and conflict between work and family (Z=-3.00, p<.001). The leader-member exchange and job stress explained 41% of the conflict between work and family. @*Conclusion@#The findings from this study indicate that active human resource management policies should be established in order to increase the leader-member exchange.

Sedentary Lifestyle: Overview of Updated Evidence of Potential Health Risks / 가정의학회지

One-third of the global population aged 15 years and older engages in insufficient physical activities, which affects health. However, the health risks posed by sedentary behaviors are not well known. The mean daily duration of sedentary behavior is 8.3 hours among the Korean population and 7.7 hours among the American adult population. Sedentary lifestyles are spreading worldwide because of a lack of available spaces for exercise, increased occupational sedentary behaviors such as office work, and the increased penetration of television and video devices. Consequently, the associated health problems are on the rise. A sedentary lifestyle affects the human body through various mechanisms. Sedentary behaviors reduce lipoprotein lipase activity, muscle glucose, protein transporter activities, impair lipid metabolism, and diminish carbohydrate metabolism. Furthermore, it decreases cardiac output and systemic blood flow while activating the sympathetic nervous system, ultimately reducing insulin sensitivity and vascular function. It also alters the insulin-like growth factor axis and the circulation levels of sex hormones, which elevates the incidence of hormone-related cancers. Increased sedentary time impairs the gravitostat, the body’s weight homeostat, and weight gain, adiposity, and elevated chronic inflammation caused by sedentary behavior are risk factors for cancer. Sedentary behaviors have wide-ranging adverse impacts on the human body including increased all-cause mortality, cardiovascular disease mortality, cancer risk, and risks of metabolic disorders such as diabetes mellitus, hypertension, and dyslipidemia; musculoskeletal disorders such as arthralgia and osteoporosis; depression; and, cognitive impairment. Therefore, reducing sedentary behaviors and increasing physical activity are both important to promote public health.

Negligible Egg Positive Rate of Enterobius vermicularis and No Detection of Head Lice among Orphanage Children in Busan and Ulsan, Korea (2014)

To determine whether pinworm infections and head lice infestations spread among children in orphanages, 117 children from 4 orphanages in Busan-si and Ulsan-si, Korea, were examined for enterobiasis and head lice infestation between January and February 2014. The overall rate of Enterobius vermicularis egg positivity was 0.85%, whereas none of the children had head lice infestations. The rate of pinworm infection was much lower among the orphanage children compared to the rates observed in previous studies among kindergarten and primary school students. Moreover, the risk factors for enterobiasis were less frequent among these subjects than previously reported. The personal hygiene and health of the orphanage children were supervised by a regular, employed nurse through a health education program. In conclusion, pinworm infection was efficiently controlled among the children in orphanages, and this might be related to good personal hygiene practices in Korea.

The Effect of Infant-child CPR Education for Early Childhood Education Students' CPR Knowledge, Attitude and Self-efficacy

PURPOSE: The objective of this study was to evaluate the effects of infant-child CPR education on CPR knowledge, attitude, and self-efficacy of early childhood education students. METHODS: The subjects were 18 early childhood education students. Infant-child CPR education with theory and practice was composed of a 1:9 instructor-to-student ratio during a period of 3 hours. CPR knowledge, attitude, and self-efficacy were measured, along with CPR performance on the effect of education. The data were acquired from October 19 to November 2 in 2013. RESULTS: Significant improvement was observed for CPR knowledge (z=-3.63, p<.001), attitude (z=-3.42, p=.001), and self-efficacy (z=-3.25, p=.001). All of the subjects passed the performance test for infant-child CPR. CONCLUSION: Implemented infant-child CPR education is helpful in improving CPR knowledge, attitude, and self-efficacy.

Employment Experiences of Nurses Caring for Foreign Patients / 간호행정학회지

PURPOSE: The purpose of this study was to identify employment experiences of nurses caring for hospitalized foreign patients. METHODS: For this study, 10 nurses caring for foreign patients for more than 6 months were chosen purposively. Data were collected through in-depth individual interviews from July to September 2013 and analyzed in terms of Giorgi's phenomenological methodology. RESULTS: Five themes-clusters were identified from fifteen themes; 1) Awesome challenges; 2) Laborious dealing with barriers; 3) Acceptance of cultural differences; 4) Complete concentration of personal energy; 5) Taking a powerful step towards tomorrow. CONCLUSION: Results of this study reveal the significance of nurses' experiences in caring for foreign patients for the first time in Korea. The following are suggested: First, facilitation and training is necessary for language proficiency, communication skills and ability to understand cultural traits of foreign patients. Second, manuals and international guidelines for caring for foreign patients should be systematically developed to improve quality of healthcare services.

Development and Effectiveness of a Drug Dosage Calculation Training Program using Cognitive Loading Theory based on Smartphone Application

PURPOSE: This study was done to develop and evaluate a drug dosage calculation training program using cognitive loading theory based on a smartphone application. Calculation ability, dosage calculation related self-efficacy and anxiety were measured. METHODS: A nonequivalent control group design was used. Smartphone application and a handout for self-study were developed and administered to the experimental group and only a handout was provided for control group. Intervention period was 4 weeks. Data were analyzed using descriptive analysis, chi2-test, t-test, and ANCOVA with the SPSS 18.0. RESULTS: The experimental group showed more 'self-efficacy for drug dosage calculation' than the control group (t=3.82, p<.001). Experimental group students had higher ability to perform drug dosage calculations than control group students (t=3.98, p<.001), with regard to 'metric conversion' (t=2.25, p=.027), 'table dosage calculation' (t=2.20, p=.031) and 'drop rate calculation' (t=4.60, p<.001). There was no difference in improvement in 'anxiety for drug dosage calculation'. Mean satisfaction score for the program was 86.1. CONCLUSION: These results indicate that this drug dosage calculation training program using smartphone application is effective in improving dosage calculation related self-efficacy and calculation ability. Further study should be done to develop additional interventions for reducing anxiety.

The experimental study of the bone regeneration on rabbit maxillary sinus grafting with beta-TCP

PURPOSE:Maxillay sinus grafting is an effective treatment procedure to improve bone height in the posterior maxillar area for implant installation. Beta-tricalciumphosphate(beta-TCP) was introduced to be grafting substitute material, providing a reasonable bio-degradation time, no need for harvesting procedure. The purpose of this study is to evaluate bone healing and regeneration phase using histomorphometric and immunohistochemical analysis. MATERIAL AND METHODS:Sixteen rabbits were divided into 4 groups. Bi-lateral maxillary sinus membranes were elevated at each rabbits, beta-TCP was augmented in left sinus, autogenous bone was augmented in right sinus. The rabbits were sacrificed at 2, 4, 8 and 12 weeks. We investigated the bone regeneration and growth factor expression. RESULTS: 1. The mean new bone volume formation was 28.99+/-6.55%, 49.54+/-5.47%, 69.09+/-8.90% in autogenous grafted area, and 22.86+/-5.56%, 24.00+/-4.09%, 34.11+/-3.37% in beta-TCP area at 4, 8, 12 weeks. Therefore, new bone formation in autogenous bone was significantly higher than beta-TCP (p<0.05). 2. The BMP 2/4 expression in autogenous bone grafted area was higher at 4, 8 weeks. 3. There was no difference in expression pattern of BMP-7/PDGF/VEGF during grafted bone regeneration. CONCLUSION:The authors we conclude that the autogenous bone graft was faster than beta-TCP in bone regeneration, and the BMP 2/4 were more important in graft bone regeneration.

The experimental study of the bone regeneration on rabbit maxillary sinus grafting with beta-TCP

PURPOSE:Maxillay sinus grafting is an effective treatment procedure to improve bone height in the posterior maxillar area for implant installation. Beta-tricalciumphosphate(beta-TCP) was introduced to be grafting substitute material, providing a reasonable bio-degradation time, no need for harvesting procedure. The purpose of this study is to evaluate bone healing and regeneration phase using histomorphometric and immunohistochemical analysis. MATERIAL AND METHODS:Sixteen rabbits were divided into 4 groups. Bi-lateral maxillary sinus membranes were elevated at each rabbits, beta-TCP was augmented in left sinus, autogenous bone was augmented in right sinus. The rabbits were sacrificed at 2, 4, 8 and 12 weeks. We investigated the bone regeneration and growth factor expression. RESULTS: 1. The mean new bone volume formation was 28.99+/-6.55%, 49.54+/-5.47%, 69.09+/-8.90% in autogenous grafted area, and 22.86+/-5.56%, 24.00+/-4.09%, 34.11+/-3.37% in beta-TCP area at 4, 8, 12 weeks. Therefore, new bone formation in autogenous bone was significantly higher than beta-TCP (p<0.05). 2. The BMP 2/4 expression in autogenous bone grafted area was higher at 4, 8 weeks. 3. There was no difference in expression pattern of BMP-7/PDGF/VEGF during grafted bone regeneration. CONCLUSION:The authors we conclude that the autogenous bone graft was faster than beta-TCP in bone regeneration, and the BMP 2/4 were more important in graft bone regeneration.

The cephalometric study of korean mandibular angle

The contour of mandibular angle is important for facial esthetics in the oriental population, because the wide and square face is thought to have had an unhappy life. A prominent mandibular angle produces a characteristics quardrangle, coase, and muscular appearance. So, uni- or bi-lateral mandibular angle reduction is usually performed. However, there is little guideline for bi-lateral angle reduction. So, this study was to investigate the pattern of Korean mandibular angle for bi-lateral mandibular angle reduction as guideline. This study was included 66 adult men and women over 19 years old who are having the normal mandibular angle. We measured the posterior border, angle, and inferior border of mandible using cephalometric view. The results of study was as followed : 1. The ratio of posterior mandible was 96.6, 97.3% in male, and 103.0, 106.0% in female. 2. The ratio of mandibular angle(R1-Go/R1-R2) was 120.2% in male, and 117.3% in female. 3. The ratio of inferior mandible(D5, 6, 7, E, F, G/D4) was 97. 3, 90.9, 79.5, 65.2, 57.8, 46.9% in male, and 98.5, 91.2, 80.5, 67.6, 59.1, 50.2 % in female. The results of this study should be useful to decide accurate amount of reduction.

Prevalence of Hepatitis G Virus Infection in Patients with Chronic Renal Failure / 대한간학회지

BACKGROUNDS/AIMS: To investigate the prevalence and clinical implications of hepatitis G virus (HGV) infection in patients with chronic renal failure, a cross-sectional study of 131 hemodialysis patients and 33 kidney transplantation recipients was conducted. METHODS: HGV RNA was amplified by reverse-transcription (RT) polymerase chain reaction (PCR) assay with primers from the 5'-untranslated region of the viral genome. RESULTS: The prevalence of HGV infection in patients with chronic renal failure was 25%(41/164). The following factors were taken into consideration: the mean age(43.15+/-11.97 years vs 46.46+/-13.08 years), the male to female ratio(2.15:1 vs 1.86:1), the mean of the dialysis duration(4.58+/-3.18 years vs 3.90+/-3.31 years), transfusion history (75.6% vs 62.6%), the mean of the ALT level during the prior 6 months(25.78+/-21.50 IU/L vs 23.00+/-59.49 IU/L), and the amount of transfusion(6.22+/-8.03 units vs 5.74+/-9.44 units). The anti-HCV(4.88% vs 8.94%) showed no difference between HGV RNA positive and negative group. The HBsAg positive ratio was 19.5% and 5.81% in HGV RNA positive group and negative group, respectively. CONCLUSION: The prevalence of HGV infection in patients with chronic renal failure was 25%. There was a higher rate of HBsAg positivity in the HGV RNA positive group rather than in the negative group. HGV infection did not seem to be associated with clinically significant hepatitis.

Helical CT of a Tracheobronchial Phantom: Angle and Optimal Window Affecting Size Measurements of ThreeDimensional Images

PURPOSE: To determine the effect of angle variation, relative to scan plan and optimal window setting, on thesize of three dimensional spiral CT images of a tracheobronchial tree using a phantom. MATERIALS AND METHODS:Spiral CT[collimation(mm)/table speed(mm/sec): 3/3; reconstruction interval:1.5 mm] was performed on atracheobronchial phantom consisting of a box filled with saline solution containing air-filled 5cc syringesoriented at varying angles relative to the scan plan. The diameter of three dimensional images was measured ateach window(minimal threshold value; -1000 HU; maximaml threshold value: from -300 HU to -500 HU; 50 HU interval). RESULTS: The inner diamenter of syringes used for tracheobronchial phantom was 12.55 +/-3.19mm. At all windows,as the angle became more perpendicular, the diameter of three-dimensional images increased, and at all angles, asmaxinal HU increased, measured diameter also increased(p<0.0001). In particular, at a maximal value of -500HU,measured values were closest to control values at all angles. CONCLUSION: Diameter can be measured close tocontrol value from three dimensional spiral CT images at maximal HU of -500 window, regardless of angle.

Clinical Applications of Cine MR

Evaluation of intracranial CSF flow was accomplished by the use of cine MR technique. In the cine MR, there were two methods of evaluation in CSF flow pattern. Qualitative and quantitative methods were called magnitude reconstruction and phase contrast mapping method, respectively. The image of magnitude reconstruction method can demonstrate areas of decreased CSF flow and help explain the cause of hydrocephalus. The image of phase contrast mapping method is more sensitive to fluid motion and may increase utility in the future for analysis of fluid flow. Cine MR is capable of showing both normal and abnormal intracranial CSF flow. Such a study can be easily added as an extra pulse sequence at the end of a routinely acquired MR examination. We evaluated 2 cases of the normal pattern of pulsatile flow within subarachnoid space and 3 cases of abnormal patterns of CSF flow(communicating hydrocephalus: 2 cases, arachnoid cyst in posterior fossa: 1 case). These observations were compared with pre- and post-operative CSF flow state. In conditions which result in alterations of flow, cine MR shows either obstruction or excessively turbulent flow within the CSF pathways. In our studies, the most distinctive pathological finding was bulk flow in the aqueduct of Sylvius. The authors suggest that this technique can be applied in a wide range of conditions where CSF pathway is altered including hydrocephalus, evaluation of the function of the shunt system and communication between arachnoid cyst and subarachnoid space . Moreover correct diagnosis is possible in patients with hydrocephalus, in whom the exact level of CSF obstruction can be determined. We believe that surgical decisions can be aided by careful analysis of these CSF cine MR studies. We discuss the normal and abnormal CSF flow findings and indications of cine MR CSF flow technique with literature review.

A Case of Intradural Epidermoid Tumor of the Lumbar Spine

Histologically, epidermoid tumors are composed only of dermal epithelium and associated connective tissue. They arise from the epithelial tissue displaced during the closure of the neural tube between the third and fifth weeks of gestation. This tumor accounts for 0.6 to 1.1% of all spinal cord tumors; intradural and extramedullary epidermoid tumors are rarely found within the spinal canal. The authors describe a case of intradural epidermoid tumor, in which The patient presented with low back pain and weakness of the lower extremities. On axial and sagittal T1-weighted magnetic resonance imaging of the lumbar spine, a round, high signal intensity response revealed the presence of an intradural tumor at L3-4; it was totally removed. The pathological and clinical characteristics of epidermoid tumors are discussed.

Clinical Analysis of Prognostic Factors for Hypertensive Intracerebral Hemorrhage

The authors reviewed medical records of 219 patients who were admitted due to the hypertensive intracerebral hemorrhage(HICH) between January 1993 and December 1994. The relationship between the patient's age and sex, Glasgow Coma Scale(GCS) on the admission, location and volume of intracerebral hematoma, Graeb score, ventriculocranial ratio(VCR) and the maximum transverse diameter of fourth ventricle were analyzed. The neurological outcome for survivors was determined two years after admission. Forty normal brain scans were obtained to determine the normal range of VCR and the maximum transverse diameter of fourth ventricle. From reviewing the cases, the authors found; the most common age group of HICH was 7th and 8th decades with slight male preponderance(1:0.75); VCR of the lateral ventricle and maximum transverse diameter of the 4th ventricle were 0.16 and 1.14 cm in 40 normal brain scans, respectively; basal ganglia(42%) and thalamus(29.2%) were the most common sites of HICH hemorrhage in 219 patients followed by subcortex(13.7%), pons(7.3%) and cerebellum(4.6%); the fourth ventricular dilation(>1.35cm in diameter) and increased VCR(>0.24) were the most significant predictors for poor outcome.

Multiple Intracranial Meningiomas: Case Report

Meningioma is the third most common intracranial tumor and different from meningiomatosis and multiple meningiomas. Multiple meningiomas without the stigma of Von Recklinghausen's disease are rare. The incidence of multiple meningiomas has been reported in 1-8.9% of all intracranial meningiomas. Although the pathogenic factors related to the multiple meningiomas are unknown, various theories have been studied and reported. The authors report two cases with multiple meningiomas without evidence of the Von Recklinghausen's diseases treated successfully by staged operation. The clinical, radiological and histopathological features of these lesions are discussed.