Perception of precocious puberty among school-aged children in South Korea with the experience of treatment for precocious puberty: a Q methodological approach

Purpose@#This study aimed to investigate the perceptions of precocious puberty and elucidate the distinct characteristics of each type of perception related to precocious puberty among school-aged children who had undergone treatment for the condition. @*Methods@#This study applied the Q methodology to identify and classify the perceptions of precocious puberty among school-aged children who had undergone treatment for the condition. The analysis involved 34 questions from the Q sample and data from 35 individuals in the P sample, using the PC-QUANL Program for analysis. @*Results@#The perceptions of precocious puberty among school-aged children who had undergone precocious puberty treatment were classified into the following four types: "shyness - passive self-management," "resentment - suppression," "anxiety - fear," and "adaptation - acceptance." @*Conclusion@#This study investigated the experiences and perceptions of children who have undergone treatment for precocious puberty. Through the identification of four types of perceptions, we can see that there is a need to develop an intervention program for nursing that is tailored to the specific type of precocious puberty.

Study on the Establishment of Fixed Night Shifts and Flexible Work Arrangements for Nurses / 임상간호연구

PURPOSE: The purpose of this study was to investigate the welfare status of nurses and the status of fixed night shifts and flexible work arrangements in both general hospitals and advanced general hospitals in Korea. METHODS: A total of 167 hospitals participated in this study, done from April to October 2018. RESULTS: There were 103 hospitals utilizing the fixed night shift system, 22 in the two-shift system, 3 in the fixed holiday shift, 79 in the fixed shift system, and 39 in the short-time working system. The average welfare benefits for nurses increased to 33.02 million won on average. However, welfare services for the nurses were poor: 41.8% of the respondents had a nurses' lounge, 81.7% were given dormitory space at their place of employment, 41.8% had access to welfare facilities, and 56.4% were provided with welfare support countermeasures. CONCLUSION: The results show an increasing trend of hospitals to utilize fixed night shift and flexible work arrangements. An institutional strategy at the national policy level should be established to implement flexible work arrangements including the fixed night shift system, which has a poor level of welfare.

Characteristics and Risk Factors for Falls in Tertiary Hospital Inpatients

PURPOSE: The aim of this study was to explore characteristics of and risk factors for accidental inpatient falls. METHODS: Participants were classified as fallers or non-fallers based on the fall history of inpatients in a tertiary hospital in Seoul between June 2014 and May 2015. Data on falls were obtained from the fall report forms and data on risk factors were obtained from the electronic nursing records. Characteristics of fallers and non-fallers were analyzed using descriptive statistics. Risk factors for falls were identified using univariate analyses and logistic regression analysis. RESULTS: Average length of stay prior to the fall was 21.52 days and average age of fallers was 61.37 years. Most falls occurred during the night shifts and in the bedroom and were due to sudden leg weakness during ambulation. It was found that gender, BMI, physical problems such elimination, gait, vision and hearing and medications such as sleeping pills, antiarrhythmics, vasodilators, and muscle relaxant were statistically significant factors affecting falls. CONCLUSION: The findings show that there are significant risk factors such as BMI and history of surgery which are not part of fall assessment tools. There are also items on fall assessment tools which are not found to be significant such as mental status, emotional unstability, dizziness, and impairment of urination. Therefore, these various risk factors should be examined in the fall risk assessments and these risk factors should be considered in the development of fall assessment tools.

Changes in Central Auditory Processing in Patients with Mesial Temporal Lobe Epilepsy after Anterior Temporal Lobectomy with Amygdalohippocampectomy

BACKGROUND AND PURPOSE: This study aimed to determine the effects of anterior temporal lobectomy with amygdalohippocampectomy (ATL-AH) on central auditory processing (CAP) in patients with mesial temporal lobe epilepsy with hippocampal sclerosis (mTLE-HS), and to identify factors that may contribute to the postoperative worsening of CAP. METHODS: Frequency-pattern, duration-pattern, and dichotic tests were performed before and after epilepsy surgery in 22 patients with normal hearing according to pure-tone audiometry. RESULTS: No significant difference in CAP scores was detected between pre- and postoperative tests, but there was a strong association between surgery in the language-dominant temporal lobe and postoperative worsening in the non-dominant-side dichotic test (p<0.05). The probability of a decreased performance in a non-dominant-side dichotic test after surgery was 7.5-fold greater in patients who underwent surgery on the dominant temporal lobe compared with the nondominant temporal lobe. No significant association of postoperative worsening in CAP with the verbal, nonverbal intelligence quotient, or right- or left-side lobectomy was noted. CONCLUSIONS: These results suggest that ATL-AH on the dominant side in patients with mTLE-HS worsens the CAP ability in the non-dominant-side dichotic test.

Seizure Frequencies and Number of Anti-epileptic Drugs as Risk Factors for Sudden Unexpected Death in Epilepsy

The purpose of this study was to investigate the association between clinical variables and sudden unexpected death in epilepsy (SUDEP) and identify risk factors for SUDEP. SUDEP is one of the most frequent causes of death in patients with epilepsy. Previous studies have reported possible risk factors associated with SUDEP, but there need to be elucidated yet. The cases were 26 patients with SUDEP and three control patients were included for each case, matched for age, sex, and date of initial clinical visit. All demographic and clinical characteristics, including age, sex, disease duration, classification of epilepsy, age at seizure onset, kind and number of antiepileptic drugs, were compared between cases and controls. Seizure frequency was higher in SUDEP cases than in controls (P=0.035). Univariate analysis using conditional logistic regression showed that higher seizure frequency (odds ratio [OR]=3.1, P=0.021) and the number of antiepileptic drugs (AEDs) (OR=2.0, P=0.009) were significantly associated with SUDEP. Only the number of AEDs remained significant in multivariate analysis (OR=1.8, P=0.026). Frequent seizures and multi-drug therapy were associated with SUDEP. This may suggest that the severity of epilepsy is associated with SUDEP, regardless of the type of AED used.

Effects of GC7101, a Novel Prokinetic Agent on Gastric Motor Function: Ex Vivo Study

BACKGROUND/AIMS: GC7101, an extract of Lonicera Flos, is a novel developing drug for reflux esophagitis and functional dyspepsia. However, the drug's exact pharmacological mechanism of action remains unclear. This study assessed the effects of GC7101 on gastrointestinal (GI) motor function. METHODS: We used male guinea pigs to evaluate the effects of GC7101 on GI motility. The contraction of antral circular muscle in the presence of different doses of GC7101 was measured in a tissue bath. The prokinetic effects of GC7101 were tested using the charcoal transit assay from the pylorus to the most distal point of migration of charcoal mixture. To clarify the mechanism of action of GC7101, atropine, dopamine and the selective 5-hydroxytryptamine 4 receptor antagonist, GR113808 were used. RESULTS: The maximal amplitude of circular muscle contraction was induced by 5 mg mL(-1) GC7101. The area under the curve of contraction was significantly increased at 5 mg mL(-1) GC7101. Addition of 10(-6) M atropine, 10(-8) M dopamine or 10(-7) M GR 113808 to GC7101 5 mg mL(-1) decreased the amplitude and area under curve compared to GC7101 5 mg mL(-1) alone. GC7101 accelerated GI transit in a dose dependent manner except 100 mg kg(-1). Delayed GI transit caused by atropine, dopamine and GR 113808 was restored by GC7101 50 mg kg(-1). CONCLUSIONS: GC7101, an extract of Lonicera Flos, exerts a gastric prokinetic effect in guinea pig through cholinergic, antidopaminergic and serotonergic mechanisms. Therefore, GC7101 might be a novel drug for the treatment of functional dyspepsia.

The Effects of Prucalopride on Postoperative Ileus in Guinea Pigs

PURPOSE: Postoperative ileus (POI) is an impairment of coordinated gastrointestinal (GI) motility that develops as a consequence of abdominal surgery and is a major factor contributing to patient morbidity and prolonged hospitalization. The aim of this study was to investigate the effects of different 5-hydroxytryptamine 4 (5-HT4) receptor agonists, which stimulate excitatory pathways, on a POI model. MATERIALS AND METHODS: The experimental model of POI in guinea pigs was created by laparotomy, gentle manipulation of the cecum for 60 seconds, and closure by suture, all under anesthesia. Different degrees of restoration of GI transit were measured by the migration of charcoal. Colonic transit was indirectly assessed via measurement of fecal pellet output every hour for 5 hours after administration of various doses of mosapride, tegaserod, prucalopride, and 5-HT. RESULTS: Charcoal transit assay showed that various 5-HT4 receptor agonists can accelerate delayed upper GI transit in a dose-dependent manner. However, fecal pellet output assay suggested that only prucalopride had a significant effect in accelerating colonic motility in POI. CONCLUSION: Although mosapride, tegaserod, and prucalopride produce beneficial effects to hasten upper GI transit in the POI model, prucalopride administered orally restores lower GI transit as well as upper GI transit after operation in a conscious guinea pig. This drug may serve as a useful candidate for examination in a clinical trial for POI.

Effects of Case-based Small Group Learning on Daycare Center Teachers' Coping Ability in Emergency Situations: Focus on Daily Life and Cardiopulmonary Resuscitation

PURPOSE: This study was conducted to examine the effects of case-based learning on the coping ability of daycare center teachers in emergency situations. In the study knowledge of emergency treatment methods, attitude, intention and ability to perform CPR between were examined in an experimental group (daycare center teachers who participated in the small groups discussing case studies and comparing them with their own experience) and a control group. METHODS: The study was designed using a nonequivalent control group pretest-posttest design. Sixty-four teachers were recruited from 40 child daycare centers in S city located in J province. Thirty-three teachers were assigned to experimental group and participated in the case-based small group learning. The data were analyzed using the SPSS 18.0 program to perform chi2-test, Pearson correlation coefficients and t-test. RESULTS: The experimental group showed significantly higher posttest scores in knowledge, attitude, intention, and performance ability than those of the control group. CONCLUSION: The study results indicate that case-based small group learning on coping ability in emergency situation is effective in increasing knowledge, attitude, intention, and performance ability for daycare center teachers.

Effects of Case-based Small Group Learning about Care of Infected Children for Daycare Center Teachers

PURPOSE: This study was conducted to develop and implement a case-based small group learning program on the care of children with infectious disease, and to examine its effects on knowledge, attitude and preventive practice behaviors of daycare center teachers compared to a control group. METHODS: Based on the need assessment, the case-based learning program for the management of infectious children was developed. For this quasi-experimental study, 69 teachers were recruited from 14 child daycare centers in a city located in J province. Thirty four teachers were assigned to experimental group and participated in the case-based small group learning once a week for 5 weeks. Data were analyzed using the SPSS 18.0 program to perform chi2-test and t-tests. Analysis of covariance was used to treat the covariate of the number of assigned children between experimental and control groups. RESULTS: The experimental group showed significantly higher posttest scores in knowledge, attitude and preventive practice behaviors than those of control group (p<.001). CONCLUSION: These findings indicate that case-based small group learning is an effective educational strategy for daycare center teachers to learn infection management through the emphasis of self-reflection and discussion.

Critical Review of the Effects of Mindfulness-Based Stress Reduction (MBSR) on Stress and Health-related Quality of Life (QOL) / 성인간호학회지

PURPOSE: In numerous studies, MBSR programs have been shown to reduce stress and improve health-related QOL. Although MBSR programs have been shown to be beneficial, its effects have not been well-determined among Korean populations in clinical nursing practice. The purpose of this review was to describe the effects of MBSR on stress and health-related QOL so that the potential benefits of this intervention may be evaluated for wider application in Korea. METHODS: Articles published in peer-reviewed journals in the English or Korean language up to 2009 were reviewed; 14 articles met the inclusion criteria for this review and there were no Korean papers. RESULTS: MBSR groups were found to have significantly reduced stress outcomes relative to non-MBSR groups in 6 of 11 studies. In regards to health-related QOL, participants of the MBSR programs had increased scores after MBSR intervention relative to control groups in 5 of 7 studies. CONCLUSION: MBSR programs was effective in decreasing stress and increased the health-related QOL in the majority of studies reviewed. MBSR merits study in Korean patients to determine whether similar salutary patient outcomes may be obtained.

Expression Pattern of the Thioredoxin System in Human Endothelial Progenitor Cells and Endothelial Cells Under Hypoxic Injury

BACKGROUND AND OBJECTIVES: The thioredoxin (TRx) system is a ubiquitous thiol oxidoreductase pathway that regulates cellular reduction/oxidation status. Although endothelial cell (EC) hypoxic damage is one of the important pathophysiologic mechanisms of ischemic heart disease, its relationship to the temporal expression pattern of the TRx system has not yet been elucidated well. The work presented here was performed to define the expression pattern of the TRx system and its correlation with cellular apoptosis in EC lines in hypoxic stress. These results should provide basic clues for applying aspects of the TRx system as a therapeutic molecule in cardiovascular diseases. SUBJECTS AND METHODS: Hypoxia was induced with 1% O2, generated in a BBL GasPak Pouch (Becton Dickinson, Franklin Lakes, NJ, USA) in human endothelial progenitor cells (hEPC) and human umbilical vein endothelial cells (HUVEC). Apoptosis of these cells was confirmed by Annexin-V: Phycoerythrin flow cytometry. Expression patterns of TRx; TRx reductase; TRx interacting protein; and survival signals, such as Bcl-2 and Bax, in ECs under hypoxia were checked. RESULTS: Apoptosis was evident after hypoxia in the two cell types. Higher TRx expression was observed at 12 hours after hypoxia in hEPCs and 12, 36, 72 hours of hypoxia in HUVECs. The expression patterns of the TRx system components showed correlation with EC apoptosis and cell survival markers. CONCLUSION: Hypoxia induced significant apoptosis and its related active changes of the TRx system were evident in human EC lines. If the cellular impact of TRx expression pattern in various cardiovascular tissues under hypoxia or oxidative stress was studied meticulously, the TRx system could be applied as a new therapeutic target in cardiovascular diseases, such as ischemic heart disease or atherosclerosis.

Transoral removal of proximal submandibular stone: report of 5 cases and review of the literature

The submandibular gland is the second largest major salivary gland, which secretes 40% of the total daily saliva. Owing to its anatomic characteristics as well as the high viscosity and basicity of the saliva, sialolithiasis is found most commonly in the submandibular gland. Sialolithiasis that cannot be treated by conservative treatment is conventionally removed by an excision of the submandibular gland. Generally, an excision of the submandibular gland is performed via an extra-oral approach but the disadvantages of this treatment include a risk of injuring the facial nerve and scar formation. Case reports have revealed an even less invasive intraoral surgical technique for the removal of sialolith that does not affect the submandibular gland function. The functional recovery of the gland, complications and recurrence rates after surgery with this conservative intraoral procedure were all successful. We report 5 patients from the department of Oral and Maxillofacial Surgery at Dental Hospital, Yonsei University, who had undergone a resection of the sialolith though the intraoral approach with successful results.

Epidemiological Prevalence of Avian Pathogenic Escherichia coli Differentiated by Multiplex PCR from Commercial Chickens and Hatchery in Korea

We examined 216 Escherichia coli (E. coli) isolated from chickens and environmental specimens from hatcheries between 2005 and 2006 in order to evaluate the epidemiological prevalence of avian pathogenic E. coli (APEC) in Korea tentatively by multiplex PCR. The multiplex PCR which was used as tentative criteria of APEC targets 8 virulence-associated genes; enteroaggregative toxin (astA), increased serum survival protein (iss), iron-repressible protein (irp2), P fimbriae (papC), aerobactin (iucD), temperature-sensitive hemagglutinin (tsh), vacuolating autotransporter toxin (vat), and colicin V plasmid operon (cva/cvi) genes. The number of detected genes could be used as a reliable index of their virulence. It was demonstrated that E. coli strains already typed as APEC always harbor 5 to 8 genes, but non-APEC strains harbor less than 4 genes. Assuming the criteria of APEC is a possession of more than 5 virulenceassociated genes, we discriminated 24 APEC strains among the 216 E. coli strains. Contamination rates of APEC in the field were 31.3% in layers, 14.0% in broilers, 2.7% in broiler breeders, and 0.0% in environmental specimens from hatcheries. The combinational tendency of APEC examined is a fundamental possession of astA, iss and iucD genes and addition of cva/cvi, tsh, vat, and irp2 genes which have a critical importance for virulent traits of APEC. Compared with intravenous chicken challenge or embryo lethality assay, multiplex PCR method could be useful to discriminate APEC rapidly for convenient diagnosis.

Degradation of the Retinoblastoma Tumor Suppressor Protein by the Human Papillomavirus-16 E7 Variants

Human papillomavirus type 16 (HPV-16) plays an etiological role in benign and malignant epithelial tumors. A critical event in HPV transformation of human cells is the inactivation of retinoblastoma protein (pRB) by the E7 protein. The metabolic half-life of pRB is decreased in cells that express high-risk HPV E7 proteins. The present study investigated the frequency of HPV-16 E7 variants in Korean women and compared the pRB degradation activity of E7 variant proteins. Of the 40 HPV-positive specimens from a total of 91 tissue specimens, 21 HPV-16 positive specimens were studied by sequencing analysis to determine the variation of E7 gene. The most frequent E7 variant was N29S (57%). The HPV-16 E7 variant was more prevalent in invasive cervical cancer tissue specimens than in those from low grade clinical stage. The degradation of pRB in HaCaT cells by HPV-16 E7 variant proteins was investigated by western blot analysis. There was no significant difference in pRB degradation activity between the HPV-16 E7 prototype protein and E7 variant proteins. The pRB degradation activity did not differ among HPV-16 E7 variants. These results suggest that the E7-induced degradation of pRB is important in cervical tumorigenesis; however, there was no relation between the pRB degradation activity and the variations in HPV-16 E7 protein among Korean women.

Obstetric Outcome after Threatened Abortion / 대한산부인과학회잡지

OBJECTIVE: Threatened abortion, one of the most common problems of pregnancy, develops 15-20% of pregnant women and progresses into the abortion in 20-50%. It is related to many obstetrical sequelae. We analyzed the prevalence of complication, disruption of pregnancy and the effect of recent treatments. In ultrasonographic examination, we divided all cases into two groups according to existence of hematoma. We compared the difference of two groups about the prognosis of pregnancy and maternal serum concentration of FP. METHODS: A total 88 cases of threatened abortion and 5741 cases of normal pregnancy were studied from Jan., 1999 through Dec., 2003 at St. Paul Hospital in Seoul, Korea. We analyzed age, gestational age of menstruation and ultrasonogram, parity, results of triple test, existence of hematoma, efficacy of treatment. In all cases, we carried out ultrasonic examination with LogiQ-400 (General Electronics Medical System, Tokyo, Japan). We checked the concentration of FP from triple test. RESULTS: The mean gestational age at diagnosis was 9.2 +/- 3.4 weeks. After threatened abortion, successful cases were 71 and mean gestational age at diagnosis was 9.6 +/- 3.6 weeks. In comparison with 17 unsuccessful cases, whose mean gestational age at diagnosis was 6.6 +/- 1.8 weeks, it was thought to be significant differences (p=0.001). The success rates of pregnancy prolongation between groups of different treatments modalities are nearly similar. Existence of hematoma seems to have little impact on prognoses of pregnancy outcome and there were no meaningful differences of maternal serum FP concentration. CONCLUSION: In this study, we could find no difference between the groups those were treated with various methods. We thought that more systematic analysis about the treatment of threatened abortion would be needed. In the cases that were diagnosed threatened abortion at later gestational age, we could find obvious improvement of the pregnancy outcome. So we conclude that gestational age at the diagnosis is potential parameter of prognosis.

Fasting and Postprandial Analysis of Bowel Sounds and Plasma 5-hydroxytryptamine Level / 대한소화기학회지

BACKGROUND/AIMS: Auscultation of bowel sounds is a traditional technique for evaluating patients with abdominal symptoms. It is, however, subjective and qualitative method in general. Recently, analysis of bowel sounds becomes possible. We analyzed bowel sounds in healthy volunteers and measured platelet depleted plasma 5-hydroxytryptamine (5-HT) that may be associated with postprandial symptoms in irritable bowel syndrome. METHODS: We recorded both fasting and postprandial bowel sounds for 30 minutes in 16 healthy volunteers with a sensitive electronic stethoscope attached to a digital recorder. The files were saved in computer as wav files and analyzed with a specialized program. Blood samples were also taken before and 1 hour after meal for 5-HT analysis. RESULTS: Meal challenge made no statistically significant changes in the 5-HT concentrations and all the sound parameters including sound to sound interval, sounds/minute, average of sound amplitudes, sound length, percentage of bowel sounds representing sound clustering and dominant frequency of sounds. CONCLUSIONS: Postprandial changes in bowel sounds and plasma 5-HT were insignificant in healthy Korean volunteers.

Approximate Entropy of the Short-term Variability of Fetal Heart Rate as an Efficient Measurement of Fetal Distress / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to evaluate the usefulness of approximate entropy on fetal heart rate variability of electronic fetal monitoring taken during antepartum and intrapartum periods as a new diagnostic method of fetal distress. METHODS: Among 76 pregnant women who underwent computerized electronic fetal monitoring and cord blood gas analysis, we divided them into 3 groups, i.e.; 36 into normal fetus group, 26 into presumed distress group and 14 into acidemic distress group. We performed a frequency analysis on time series of heart rate variability in three groups. In order to perform non-linear analysis on the raw data of the fetal heart rate, after resampling and low pass filtering, we investigated approximate entropy. RESULTS: The results of the approximate entropy showed that the value in normal fetus group was significantly high than the value in distress group. But in the distress group, ApEn value was not difference between acidemic and non-acidemic subgroup. ApEn of HRV was confirmed in nonlinear parameter without low pass filtering and resampling. CONCLUSION: The results show that the fetal heart rate variability has nonlinear characteristics and could distinguish normal fetal heart rate pattern and distress pattern numerically and objectively. And these ApEn value are useful for prediction and diagnosis of fetal distress in ante and prenatal periods.

Detection of Human Papilloma Virus Type 16 and 18 in Adenocarcinoma in situ of the Uterine Cervix / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to assess the role of HPV 16 and 18 in adenocarcinoma in situ(ACIS) of the uterine cervix. METHODS: Seventeen cases of primary cervical adenocarcinoma in situ were analyzed for HPV DNA by polymerase chain reaction. HPV 16 and 18 DNA extracted from formalin-fixed, paraffin-embedded histologic tissue sections by polymerase chain reaction. RESULTS: 35.3% and 23.5% of ACIS were positive for HPV 16 and HPV 18 DNA, respectively. From the normal tissue, 11.8% were positive for HPV 16. Human papillomavirus positive patients were younger than negative patients but statistically insignificant(mean age 42.1 vs 51.7 years). CONCLUSIONS: These results show that HPV type 16 and 18 were closely related to etiology of the ACIS of the uterine cervix.

Massive Ovarian Edema / 대한산부인과학회잡지

No abstract available.

Clinical Evaluation of ASCUS / 대한부인종양콜포스코피학회잡지

OBJECTIVE: To evaluate the significance of atypical squamous cells of undetermined significance(ASCUS) by following-up cervical cytologic smears or histologic finding. METHODS: Two hundred fifty three cases were diagnosed as ASCUS on cervical cytologic smears from January, 3, 1997 to september, 16, 1998 at cytopathology laboratory, College of Medicine, Keimyung Univemity. These cases were evaluated by cervical smears or subsequent biopsies. RESULTS: The results were as follows, On repeat cervical smears, inflammation was 19.7%, normal was 11,1% and HSIL was 1.6%. On histologic diagnosis, CIS was 13,4%, cervicitis was 12,6%, invasive cervical cancer was 4.0%, and severe dysplasia was 3.2%. CONCLUSION: A diagnosis of ASCUS on smears need careful follow-up.