A Study on Knowledge, Importance and Performance in Nursing Records of University Hospital Nurses / 중환자간호학회지

PURPOSE: The purpose of this study was to assess hospital nurses' knowledge, importance and performance in keeping nursing records.METHODS: The research design was a descriptive study. The sample for this study was 186 nurses with at least one year of work experience at a hospital with more than 800 beds in Seoul. Knowledge was self-reported using the Nurse Charting Knowledge Scale. Importance and performance were rated on a 4-point scale of 26 items. Data were analyzed by SPSS 21.0 program and IPA.RESULTS: This study showed significant results that knowledge, importance and performance for keeping record are related to each other. The importance and performance of nurse's records were relatively higher than the mean. In the IPA Matrix, there were 2 items requiring improvement, 13 items requiring maintenance, and 11 items with low priority.CONCLUSION: Therefore, awareness of the importance of record keeping and continuous education on nursing record knowledge should be provided so that nurses can improve their record keeping skills.

Anti-proliferative Activity of T-bet

T-bet is a critical transcription factor that regulates differentiation of Th1 cells from CD4+ precursor cells. Since T-bet directly binds to the promoter of the IFN-gamma gene and activates its transcription, T-bet deficiency impairs IFN-gamma production in Th1 cells. Interestingly, T-bet-deficient Th cells also display substantially augmented the production of IL-2, a T cell growth factor. Exogenous expression of T-bet in T-bet deficient Th cells rescued the IFN-gamma production and suppressed IL-2 expression. IFN-gamma and IL-2 reciprocally regulate Th cell proliferation following TCR stimulation. Therefore, we examined the effect of T-bet on Th cell proliferation and found that T-bet deficiency significantly enhanced Th cell proliferation under non-skewing, Th1-skewing, and Th2-skewing conditions. By using IFN-gamma-null mice to eliminate the anti-proliferative effect of IFN-gamma, T-bet deficiency still enhanced Th cell proliferation under both Th1- and Th2-skewing conditions. Since the anti-proliferative activity of T-bet may be influenced by IL-2 suppression in Th cells, we examined whether T-bet modulates IL-2-independent cell proliferation in a non-T cell population. We demonstrated that T-bet expression induced by ecdysone treatment in human embryonic kidney (HEK) cells increased IFN-gamma promoter activity in a dose dependent manner, and sustained T-bet expression considerably decreased cell proliferation in HEK cells. Although the molecular mechanisms underlying anti-proliferative activity of T-bet remain to be elucidated, T-bet may directly suppress cell proliferation in an IFN-gamma- or an IL-2-independent manner.

Enhancement of Allergen-induced Airway Inflammation by NOX2 Deficiency

BACKGROUND: NADPH oxidase (NOX) modulates cell proliferation, differentiation and immune response through generation of reactive oxygen species. Particularly, NOX2 is recently reported to be important for regulating Treg cell differentiation of CD4+ T cells. METHODS: We employed ovalbumin-induced airway inflammation in wild-type and NOX2-deficient mice and analyzed tissue histopathology and cytokine profiles. RESULTS: We investigated whether NOX2-deficiency affects T cell-mediated airway inflammation. Ovalbumin injection which activates T cell-mediated allergic response increased airway inflammation in wild-type mice, as evidenced by increased immune cell infiltration, allergic cytokine expression, and goblet cell hyperplasia in the lung. Interestingly, NOX2 knockout (KO) mice were more susceptible to allergen-induced lung inflammation compared to wild-type mice. Immune cells including neutrophils, lymphocytes, macrophages, and eosinophils were drastically infiltrated into the lung of NOX2 KO mice and mucus secretion was substantially increased in deficiency of NOX2. Furthermore, inflammatory allergic cytokines and eotaxin were significantly elevated in NOX2 KO mice, in accordance with enhanced generation of inflammatory cytokines interleukin-17 and interferon-gamma by CD4+ T cells. CONCLUSION: These results indicate that NOX2 deficiency favorably produces inflammatory cytokines by T cells and thus increases the susceptibility to severe airway inflammation.

Transcriptional Regulation of T Helper 17 Cell Differentiation

The third lineage of T helper subsets, Th17, has recently been identified as an IL-17-producing CD4+ Th cell, and its functions and regulatory mechanisms have been extensively characterized in immune responses. Functional studies have provided evidence that Th17 cells are important for the modulation of autoimmune responses, such as chronic asthma, rheumatoid arthritis, inflammatory bowel diseases, and multiple sclerosis. Murine Th17 cell differentiation is enhanced by the coordinated functions of distinct cytokines including TGFbeta, IL-6, IL-21, and IL-23, whereas IL-2, IL-4, IFNgamma, and IL-27 inhibit its differentiation. In addition, Th17 cells are controlled by several transcription factors such as RORgamma t, IRF4, BATF, FoxP3, T-bet, PPARgamma, E-FABP, and SOCSs. This review focuses on the functions and regulatory mechanisms of several transcription factors in the control of Th17 cell differentiation.

Evaluation of Nutritional Status of Inpatients with Medical Health Problems / 재활간호학회지

PURPOSE: To investigate nutritional status of inpatients by using subjective. and objective evaluation methods and to find the relationship between them. METHOD: The subjects were 101 inpatients with medical health problems at a university hospital. Nutritional status was evaluated by the Subjective Global Assessment (SGA) and physical assessment including percentage of weight loss, serum albumin, hemogloin, and hematocrit. Data were analyzed using frequency, percentage, mean, Kendall's tau. RESULTS: Grouping by the SGA, 61.4% were classified as severe malnutrition group. When applying the objective methods{physical assessment). 1.9~42.6% were diagnosed as malnutrition each item. The percentage of weight loss during previous 1-6month(r=.43~.54. P=.0001), serum albumin(r=-.26, P=.0003), hemoglobin of male(r=-.38, P=.0001), and hematocrit of male(r=-.34, P=.0001) were significantly correlated with SGA score. The coincidence rate of nutrition evaluation between the objective methods and SGA were 27.7 35.6%, 20.8%, 47.5%, 58.4% in percentage of weight loss, albumin, hemoglobin, and hematocrit. CONCLUSION: These findings showed a majority of inpatients were exposed to the risk of malnutrition. We recommend to evaluate inpatients' nutritional status periodically and to develop nursing intervention to solve their nutritional problems.