Histopathological and Neurobehavioral Characterization in Adult Mice Exposed to Traumatic Brain Injury

PURPOSE: Traumatic brain injury (TBI) is a significant cause of morbidity and mortality worldwide. Severity of the initial insult is one of the most significant factors affecting outcome following TBI. In order to investigate the mechanisms of cellular injury and develop novel therapeutic strategies for TBI, we designed a standardized animal TBI model and evaluated histological and functional outcomes according to the degree of impact severity. METHODS: Male adult C57Bl/6 mice underwent controlled cortical impact (CCI) at varying depths of deflection (1.0-2.0 mm). We performed hematoxylin and eosin staining at 7 days after recovery from TBI. Neurobehavioral characterization after TBI was analyzed by the Barnes maze test, passive avoidance test, open field test, rotarod test, tail suspension test, and light/dark test. RESULTS: We observed a graded injury response according to the degree of deflection depths tested (diameter, 3 mm; velocity, 3 m/s; and duration, 500 ms) compared to sham controls. In the Barnes maze test, the severe TBI (2 mm depth) group showed reduced spatial memory as compared with the sham and mild TBI (1 mm depth) groups at 7 days after TBI. There was a significant difference in the results of the open field test and light/dark test among the three groups. CONCLUSION: Our findings demonstrate that the graded injury responses following TBI resulted in differential histopathological and behavioral outcomes in a mouse experimental CCI model. Thus, a model of CCI with histologic/behavioral outcome analysis may offer a reliable and convenient design for preclinical TBI research involving mice.

Evaluation of Effect of Silvernanoparticle Treated Implant on Bone Formation

Study of a "wing-type" implant on stress distribution and bone resorption at the alveolar crest

OBJECTIVES: Implants connect the internal body to its external structure, and is mainly supported by alveolar bone. Stable osseointegration is therefore required when implants are inserted into bone to retain structural integrity. In this paper, we present an implant with a "wing" design on its area. This type of implant improved stress distribution patterns and promoted changes in bone remodeling. MATERIALS AND METHODS: Finite element analysis was performed on two types of implants. One implant was designed to have wings on its cervical area, and the other was a general root form type. On each implant, tensile and compressive forces (30 N/m2, 35 N/m2, 40 N/m2, and 45 N/m2) were loaded in the vertical direction. Stress distribution and displacement were subsequently measured. RESULTS: The maximum stresses measured for the compressive forces of the wing-type implant were 21.5979 N/m2, 25.1974 N/m2, 29.7971 N/m2, and 32.3967 N/m2 when 30 N/m2, 35 N/m2, 40 N/m2, and 45 N/m2 were loaded, respectively. The maximum stresses measured for the root form type were 23.0442 N/m2, 26.9950 N/m2, 30.7257 N/m2, and 34.5584 N/m2 when 30 N/m2, 35 N/m2, 40 N/m2, and 45 N/m2 were loaded, respectively. Thus, the maximum stresses measured for the tensile force of the root form implant were significantly higher (about three times greater) than the wing-type implant. The displacement of each implant showed no significant difference. Modifying the design of cervical implants improves the strength of bone structure surrounding these implants. In this study, we used the wing-type cervical design to reduce both compressive and tensile distribution forces loaded onto the surrounding structures. In future studies, we will optimize implant length and placement to improve results. CONCLUSION: 1. Changing the cervical design of implants improves stress distribution to the surrounding bone. 2. The wing-type implant yielded better results, in terms of stress distribution, than the former root-type implant.

Development and Evaluation of "Hospice Smart Patient" Service Program

PURPOSE: The purpose of this study was to develop and implement the Hospice Smart Patient Program and to evaluate its effectiveness. METHODS: It was quasi-experimental non-equivalent pre-post study. Breast cancer patients who underwent surgery, chemotherapy or radiotherapy, or who needed palliative care, participated in the study. Participants were divided into two groups, experimental and control groups based on their preferences. The program was developed after literature review and discussion among experts on hospice and palliative care. Participants who were in the experimental group received either face-to-face or phone "Hospice Smart Patient" Service at least once a week for 5 months. RESULTS: There was a significant difference in quality of life and communication skill between the two groups after the service was provided. In addition, participants in experimental group showed improved decision making skills, mastery sense, and understanding of hospice and palliative care, which would be beneficial in improving their quality of life. CONCLUSION: We have concluded that the "Hospice Smart Patient" Program is useful for cancer patients in decision making, improving self-control and choosing hospice care to improve their quality of life.

Tamsulosin Monotherapy versus Combination Therapy with Antibiotics or Anti-Inflammatory Agents in the Treatment of Chronic Pelvic Pain Syndrome / 대한배뇨장애요실금학회지

PURPOSE: Chronic pelvic pain syndrome (CPPS) is treated by use of various protocols. We compared tamsulosin monotherapy with tamsulosin in combination with antibiotics or anti-inflammatory agents and evaluated the efficacy of these treatments in patients with CPPS. METHODS: Patients (n=107) who were younger than 55 years and diagnosed with CPPS were randomly assigned to treatment with tamsulosin at 0.2 mg (group A), tamsulosin at 0.2 mg plus anti-inflammatory drugs (group B) or tamsulosin at 0.2 mg plus antibiotics (group C) daily. We applied the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) and the International Prostate Symptom Score (IPSS) to evaluate 100 patients who were treated for 12 weeks (7 withdrew). Scores of the three groups were compared by analysis of variance and we also evaluated subscores, which included pain, voiding and quality of life (QoL). RESULTS: All three groups showed statistically significant decreases in NIH-CPSI score, IPSS and subscore scores (P<0.05). There were no statistically significant differences between the groups except for the QoL domain of the IPSS (group A vs. C; P<0.01). CONCLUSIONS: Tamsulosin monotherapy for 12 weeks was effective for treating patients with CPPS, compared with combination therapy with antibiotics or anti-inflammatory drugs.

Effects of Tai Chi Exercise Program on Muscle Strength, Flexibility, Postural balance and Cognition in Patients with Parkinson Disease / 기본간호학회지

PURPOSE: To examine the effects of Tai Chi exercise (TCE) on muscle strength, flexibility of low extremities, postural balance and cognition in patients with Parkinson disease (PD). METHODS: A nonequivalent control-group pre and post-test design was used. Of the 30 participants 15 were assigned to the experimental group and 15 to the control group. The experimental group participated in 8 weeks of TCE which included one day of exercise with instructor on site and 3 days of self-exercise at home guided by a videotape. RESULTS: The 8 weeks of TCE were found to be significantly effective in enhancing strength of low extremities, flexibility of ankles and shoulders, time of tandem stand with eye closed and level on the K-MMSE (Korean mini mental state examination). CONCLUSION: These results suggest that TCE has positive effects on physical fitness and cognition in patients with PD. Research over an extended period with the TCE intervention is recommended to identify further effects.

Prediction of Optimal Gluteal Intramuscular Needle Length by Skinfold Thickness Measurements in Korean Adults

PURPOSE: This study was conducted to assess optimal needle length for gluteal intramuscular injections (IM) via simple skinfold thickness (SFT). METHODS: For this study, 190 healthy adults were recruited and grouped into eight groups according to gender and body mass index (BMI) (kg/m2). The Korean Society for the Study of Obesity criteria defines a BMI under 20 as underweight, 20.1-22.9 as normal, 23-24.9 as overweight and over 25 as obese. For each participant, the SFT of dorsoguteal (DG) and ventrogluteal (VG) sites were measured using a caliper. Subcutaneous tissue thickness was acquired through ultrasonic images. RESULTS: For men in the overweight and obese groups at the DG site, for the obese group at the VG site, and for women in the normal weight, overweight and obese groups at both sites, the mean subcutaneous tissue thickness exceeded 1.84 cm, the minimal length for a 1 inch needle used for IM. At the DG site, optimal intramuscular needle length (OINL) was 1.4 times in women and 1.0 times in men compared to SFT. At the VG site, OINL was 1.3 times in women and 0.9 times in men compared to SFT. CONCLUSION: The results of this study suggest that SFT is a reliable index to determine optimal needle length with minimal effort prior to IM.

Development of Educational Program for Hospice Smart Patient Service Provider / 종양간호학회지

PURPOSE: The purpose of the study was to develop an educational program reflecting the educational needs of Hospice Smart Patient service providers. METHOD: The description, goal, curriculum, method, and process evaluation of the educational program were constructed based on Modified Tyler-type Ends-Means Model followed by the analysis of current curriculum and needs of service providers. RESULTS: The curriculum was constructed based on hospice volunteer program currently offered in Korea and the recommendations of hospice service volunteers and experts. A total of 90 hr was required to complete the curriculum that was composed of 'Introduction to cancer', 'Treatment and treatment complications of cancer', 'Post-treatment nutritional care', 'Helpful information', 'Introduction to hospice and palliative care', 'Comprehension of life and death', 'Holistic hospice and palliative care', 'How to communicate as a smart patient', 'Hospice and ethics', 'Pediatric hospice', 'Bereavement management', and 'Clinical practicum'. CONCLUSION: It is necessary to implement the developed educational program and evaluate its effectiveness, as well as making the service available to a greater number of cancer patients.

Research Trends in the Journal of Korean Academy of Fundamental Nursing: Based on Analysis of the Journal of Korean Academy of Fundamental Nursing from 2001 to 2007 / 기본간호학회지

PURPOSE: The purpose of this study was to analyze articles published in the Journal of Korean Academy of Fundamental Nursing from 2001 to 2007. METHOD: Three hundred articles were analyzed using descriptive statistics. The focus was on research type, methodolgy and keywords. RESULTS: Thirty percent of the research was supported financially. Ninety-four percent was quantitative research and of these the majority were surveys (73.2%). The rate of adoption for hypotheses in experimental studies were 55.07% but only 3% of the research included conceptual framework. The most common settings for data collection were clinical settings (51.99%), followed by community settings (43.71%). For data analysis, descriptive statistics (27.5%), t-test (17.1%), ANOVA (15.3%) and chi-square (7.9%) were most frequently used. Keywords were categorized into four nursing metaparadigms : human-beings, health, nursing, and environment. The most frequently used domain was health. CONCLUSION: The number of research papers published in the Journal of Korean Academy of Fundamental Nursing has increased and the quality has improved compared with articles published before 2001 year. Research topics varied and were mostly conducted on the basis of logical positivism.

The Effects of Tai Chi Exercise on Depression, Quality of Life and Self-efficacy in Patients with Parkinson's Disease / 기본간호학회지

PURPOSE: To examine the effects of Tai Chi exercise (TCE) on depression, quality of life and self-efficacy in patients with Parkinson's disease (PD). METHOD: A nonequivalent control-group pre and posttest design was used. Of the 30 participants 15 were assigned to the experimental group and 15 to the control group. The experimental group participated in 8 weeks of TCE which included one day of exercise with instructor on site and 3 days of self-exercise at home guided by a videotape. RESULTS: The 8 weeks of TCE were found to be significantly effective in enhancing quality of life and self-efficacy. However there was no significant difference in the level of depression. CONCLUSION: These results suggest that TCE has positive effect on quality of life and self-efficacy in patients with PD. Research over an extended period with the TCE intervention is recommended to identify further effects.

The Development and Effects of a Self-management Program for Patients with Parkinson's Disease / 간호학회지

PURPOSE: This study was done to develop and examine the effects of a self-management program (SMP) on physical, psychological functions, and symptoms in patients with Parkinson's disease(PD). METHODS: In a two-group pre-and post-test design, a total of 40 patients were assigned to the experimental group(21) or the control group (19). The experimental group received eight weekly 2-hour sessions for 10-15 literate adults of all ages, while the control group did not receive any intervention. RESULTS: The experimental group showed significant improvements in muscle strength, balance, self-efficacy, depression, quality of life(QL), quality of sleep, and discomfort of constipation. It also reduced the number of participants using assistive walking devices. There were no significant changes in fear of falling and duration of sleep. CONCLUSION: The eight week SMP in patients with PD was found to be significantly effective in enhancing muscle strength, balance, self-efficacy, QL, and quality of sleep. It also decreased depression, discomfort of constipation, and assistive walking devices. These results suggest that a SMP can have effects on physical, psychological functions and symptoms in patients with PD. Further research with a larger sample and for a longer follow up period is needed to expand our understanding of the effects of a SMP for patients with PD.

An Analysis of Research Trends Published in the Journal of Korean Academy of Fundamentals of Nursing (JKAFN) based on Knowledge Development Classifications of Nursing: 2006 Year of Publication Articles in JKAFN / 기본간호학회지

PURPOSE: This study was conducted to identify the nature the research trends of articles published in the Journal of Korean Academy of Fundamentals of Nursing (JKAFN). METHOD: Comparison analysis between articles in JKAFN (Volume 13, Number 1-3) and articles in the Journal of Korean Academy of Nursing (Volume 36, Number 1-3, 5-7) based on knowledge development classification was used to identify the nature of research trends in JKAFN. RESULTS: Based on comparison with Journal of Korean Academy of Nursing, research trends in JKAFN were dominant; in personal knowledge in the pattern of knowing in nursing, in the desiderative focus in cognitive needs for nursing epistemology, in advancing of various aspects of nursing in the focus of knowledge, and practice domain in the domains for nursing. CONCLUSION: The major focuses on research trends in JKAFN were nursing practice, actions of nurses in practice and practice guideline applicable in nursing education.

Instrumental Activities of Daily Living, Leg Muscle Strength, Cognitive and Visual Function According to Demographic Variables and the Experience of Falling in Community Resident Elderly Koreans / 기본간호학회지

PURPOSE: To investigate the instrumental activities of daily living (IADL), leg muscle strength, cognitive and visual functions according to the participants' demographic characters and experiences of falling in Korean elder who are residents in the community. METHOD: Data were collected from 351 participants aged 65 or more, who were ambulatory. A structured questionnaire and several physical function measurements were used to collect the data which were analyzed using the SAS program. RESULTS: The participants' IADL scores were significantly different according to their age, educational level and living situation. The leg muscle strength of the elders were significantly different according to gender and age, and were also related the risk of falling. Cognitive scores were significantly different according to gender, age, education level and marital status. Visual acuity and depth perception were significantly different according to age, education level, and marital status. CONCLUSION: Demographic variables and experience of falling were identified as variables related to IADL, leg muscle strength, cognitive and visual function of elders. Further study with a larger and nation-wide sample is needed to identify the variables related to the physical and cognitive functions of elders.

The Development and Effect of a Tailored Exercise Program on Physical Fitness in Patients with Parkinson's Disease / 기본간호학회지

PURPOSE: To develop & to examine the effect of a Tailored Exercise Program (TEP) on physical fitness in patients with Parkinson's disease (PD). METHOD: In a two-group pre-and post-test design, from a total 41 participants. 21 were assigned th the experimental group and the remainder to the control group. The experimental group participated in a 4-day a week, 8 week program in which one session a week was by direct instruction with the self-help group and two sessions a week were by videotaped instruction at home by themselves. The control group did not receive any intervention. RESULTS: The eight week TEP in patients with PD was found to be significantly effective in enhancing muscle strength, ankle flexibility, and balance. However instrumental activities of daily living was not changed by the intervention. CONCLUSION: These results suggest that TEP can have an effect on physical fitness in patients with PD. Further research with a larger sample and for a longer follow up period is needed to expand our understanding of the effects of TEP for patients with PD.

Perceived Anxiety and Uncertainty in Hematopoietic Stem Cell Transplantation Recipients to and from Isolation Unit / 기본간호학회지

PURPOSE: To investigate the levels of uncertainty and anxiety at admission and discharge to the isolation unit for patients undergoing hematopoietic stem cell transplantation (HSCT). METHOD: The data were collected from 60 patients who were admitted to the department of HSCT. Uncertainty and anxiety were assessed using the Mishel Uncertainty in Illness Scale (MUIS) and Anxiety Inventory (STAI). Collected data were analyzed using the SAS program. RESULTS: The mean score for anxiety at admission was 2.20, and at discharge 2.10. The mean score for uncertainty at admission was 2.19, and at discharge 2.07. The anxiety at admission the group with physical discomfort was higher than that of group without physical discomfort. A positive relationship was found between anxiety and uncertainty at admission and at discharge. The major variables were expectation for cure and physical discomfort, explaining 25.87% of the anxiety at admission. The major variable was expectation for cure, explaining 20.94% of the uncertainty at admission. CONCLUSION: From the above results, it can be concluded that support and consideration are required to reduce anxiety of the inpatient in single room.

Influence of Clinical and Demographical Variables on Depression, Instrumental Activities of Daily Living, and Cognitive Function in Patients with Parkinson's Disease / 기본간호학회지

PURPOSE: To investigate the influence of clinical and demographical variables on depression, instrumental activities of daily living (IADL), and cognitive function in patients with Parkinson's disease. METHOD: Using a structured questionnaire data were collected from 100 participants registered in the neurology department of C university hospital. Duration and stage of disease, fall history, vision impairment, duration and quality of sleep, orthostatic hypotension, ambulation impairment, and use of walking aid were included in clinical variables. Depression, IADL, and cognitive function were assessed using Kee's GDSSF-K, Cho's scale, and K-MMSE. Collected data were analyzed using the SAS program. RESULTS: The depression score for the participants was 7.78, higher than cut-off score(5). Participants who were male, living with spouse, above high school education, high economic status, with no vision impairment, and no ambulation impairment revealed high cognitive scores. Average IADL score were significantly higher for participants who were male, who had high economic status, low stage of disease, and no ambulation impairment. Depression IADL & cognitive function scores were significantly different according to ambulation impairment. Scores for ADL and cognitive function were positively correlated. CONCLUSION: It is recommended that make programs for patients with Parkinson's disease, clinical and demographic variables should be considered according to their individual needs.

An Analytical Study on Quality of Life and Family Support of Patients with Parkinson's Disease / 기본간호학회지

PURPOSE: Investigation of the quality of life (QoL), family support and associated variables in patients with Parkinson's disease. METHODS: The data were collected from 102 patients registered in the neurology department of C University Hospital. QoL was assessed using the Parkinson's Disease Questionnaire (PDQ-39) and Family Support Scale. Modified Hoehn and Yahr (H & Y) stages were obtained from an interview and clinical examination by a neurologist. Collected data were analyzed using the SAS program. RESULTS: The participants' PDQ-39 average score was 34.34. The scores were significantly higher for participants who were older, who had a job, and who were over 2.5 on the H & Y stage. The average for Family support scores was 41.6. Participants who had a living spouse, religion and a job scored higher than those who did not. PDQ-39 score had a positive correlation with age, job, and H & Y stage. Family support and PDQ-39 score were also positively correlated. CONCLUSION: It is recommended a program involving family that improves family support and be developed and that it be varied according to different H & Y stages, in order to improve QoL.

Urethrovaginal Fistula due to Behcet's Disease / 대한비뇨기과학회지

Behcet's disease is a multisystem disorder presented with recurrent oral and genital ulcerations as well as ocular involvement. The principal manifestations in the urinary system are glomerulonephritis, cystitis, epididymitis, orchitis, and genital ulcerations. Urethrovaginal fistula is an unusual complication. The primary lesion of the disease is a small vessel vasculitis with endothelial deposition of immunocomplexes, and consequent inflammatory and necrotizing process of the vascular wall. We experienced a 19-year-old woman with Behcet's disease, who had a large urethrovaginal fistula on the anterior vaginal wall. The size of fistula was 2x1cm. For this patient, we tried combining bulbocavernosus muscle and labial fat pad flap (Martius flap) urethral reconstruction. This operative method seemed to be safe and effective for the urethral defect with Behcet's disease.

The Usefulness of the UBC(TM)(Urinary Bladder Cancer) Test for Screening of Transitional Cell Carcinoma of the Bladder in Patients with Hematuria / 대한비뇨기과학회지

PURPOSE: A new quantitative tumor marker, based on the combined measurement of urinary fragments of cytokeratins 8 and 18, namely the urinary bladder cancer antigen(UBC(TM)) test, has been proposed for the detection of bladder transitional cell carcinoma(TCC). We evaluated the diagnostic efficacy of UBC(TM) test in comparison with that of urinary cytology to establish UBC(TM) test for the diagnosis of TCC. MATERIALS AND METHODS: One-hundred ninety-six patients with hematuria were included in this study. Forty patients were diagnosed histologically as TCC by transurethral resection or radical cystectomy(group A), while the others had various benign urinary tract conditions(group B). RESULTS: UBC(TM) levels were significantly different between groups A (1851.39+/-4627microgram/l) and B (19.28+/-107.03microgram/l) (p<0.001). Sensitivity for diagnosis of TCC was 89.7%(36/40) in UBC(TM) test and 45%(18/40) in cytology(p<0.05). Specificity for diagnosis of TCC was 84.6%(132/156) in UBC(TM) test and 100%(156/156) in cytology. UBC(TM) test was significantly more sensitive than cytology in stage Ta(85.7% vs. 0%, p<0.05), T1 tumors(89.4% vs. 31.5%, p<0.05), and in Grades 1(83.3% vs. 25%, p<0.05) and 2(90.4% vs. 52.3%, p<0.05) tumors. UBC(TM) test was more sensitive in higher Grade(83.3% in Grade 1, 90.4% in Grade 2 and 100% in Grade 3). CONCLUSIONS: In comparison with urinary cytology, UBC(TM) test could be a valuable marker for diagnosis of TCC in patients with early stage and low grade TCC. Therefore, UBC(TM) test in association with cytology may be useful as a screening test for TCC of the bladder.

Laparoscopic Radical Cystectomy with Extracorporeal Ileal Conduit Diversion / 대한비뇨기과학회지

Since January 2003, two male patients, 60 and 47 years old, with muscle-invasive, organ-confined, transitional cell carcinomas of the urinary bladder underwent laparoscopic radical cystoprostatectomy with extracorporeal ileal conduit urinary diversion (LRCEIC). The surgical time was 8.5 hours in the first patient and 10 hours in the second. The respective blood losses were 350 and 380ml. In the first patient, ambulation resumed on day 2, bowel sounds on day 3 and oral intake on day 4, with a hospital stay of 8 days. In the second patient, due to inadvertent rectal injury, which was discovered on day 3, ambulation, bowel sounds and oral intake could not be determined. A pathological examination revealed a pT1N0M0 transitional cell carcinoma of the bladder, with the surgical margins negative for cancer, in the first patient, and a pT3bN1M0, with the surgical margins positive for cancer, in the second. Immediate postoperative complications included rectal injury and ileus in the second patient. With further experience and refinement in the operative technique, it is believe that LRCEIC can be performed safely and efficaciously in selected muscle-invasive bladder cancers.