Factors associated with Empathy in Patients with Schizophrenia in Psychiatric Rehabilitation Centers / 정신간호학회지

Purpose@#Empathy is the most important communication skill, and patients with schizophrenia in recovery should be taught empathy for vocational rehabilitation and social life. The purpose of this study was to investigate factors affecting empathy, as well as motivation-pleasure and social anhedonia, in patients with schizophrenia in psychiatric rehabilitation. @*Methods@#This study followed a descriptive design using a cross-sectional survey to assess the empathy, social anhedonia, and motivation-pleasure levels of patients with schizophrenia. The participants were 118 patients with schizophrenia from five mental health rehabilitation centers in South Korea. @*Results@#The results of this study show a high correlation among empathy, motivation-pleasure, and social anhedonia. The variables affecting empathy were age, motivation-pleasure, and social anhedonia, and the explanatory power of the variables was 32.6%. @*Conclusion@#The results of this study suggest that improving communication skills and negative symptoms will contribute positively to patients’ social lives and vocational rehabilitation.

Feasibility of Laparoscopic Surgery for Intussusception in Pediatric Patients and Risk of Bowel Resection

PURPOSE: Intussusception is a common cause of intestinal obstruction in children. While most patients can be treated by enema reduction, about 20% require surgery. We investigated the usefulness and feasibility of laparoscopic surgery and the intraoperative risk of bowel resection. METHODS: We retrospectively reviewed pediatric patients who underwent surgery for intussusception from 2010 to 2017. We collected data for age, gender, body weight, associated symptoms, duration of symptoms, white blood cell count, operating time, and postoperative complications. RESULTS: Of 155 patients, 37 (23.8%) underwent surgery due to enema reduction failure in 29 (78.3%), recurrence in 6 (16.3%), a suspicious lead point in 1, and suspicious ischemic change observed on ultrasonography in 1. The mean age was 26.8±18.9 months (range, 3.5~76.7 months), and the mean body weight was 12.9±3.9 kg (range, 5.4~22.2 kg). Laparoscopic surgery was successful in 29 patients (78.4%), and 7 (18.9%) needed bowel resection and anastomosis. The mean operating time was 56.7±32.8 min. A lead point was found in 3 patients in the bowel resection group (p=0.005); in addition, the operating time and hospital stay were longer in this group. There were no intra- or postoperative complications. CONCLUSION: Laparoscopic surgery was successful in 78.4% of the patients with a short hospital stay and early oral intake. The only predictive factor for bowel resection was the presence of a lead point. Laparoscopic surgery may be an optimal treatment intervention for children with intussusception, except for those who show initial peritonitis.

Effects on Critical Thinking Disposition and Empathy on Cultural Competency in Nursing Students / 정신간호학회지

PURPOSE: This study was conducted to investigate the effects of critical thinking disposition and empathy on cultural competency in nursing students. METHODS: The participants were 199 nursing students from D, H, and W universities in J province. Data were collected from April 1 to May 30, 2016, and analyzed using SPSS/WIN 21.0. RESULTS: The mean score for critical thinking disposition was 3.53±0.37, for empathy, 3.73±0.33, and for cultural competency, 3.23±0.40. Critical thinking disposition showed a positive correlation with cultural competency (r=.32, p<.001) and empathy showed a positive correlation with cultural competency (r=.31, p<.001). Critical thinking disposition showed a positive correlation with empathy (r=.36, p<.001). Significant factors that influenced cultural competency were critical thinking disposition, empathy, foreign residents in the family, and participating in cultural education. These variables explained 18% of cultural competency. CONCLUSION: These findings indicate that critical thinking disposition and empathy enhancement programs should be developed to increase cultural competency in nursing students. There is also a need for further studies to examine effects of developed programs.

A Study on the Retentive Force of Stud Attachments for Implant Overdenture / 치위생과학회지

The purpose of this study was to compare the changes of retentive force in different stud attachment systems for implant retained overdenture. Two commercially available attachments with different retentive forces were investigated: Kerator (pink, blue, red) and O-ring (orange, red). Two implant fixtures were vertically embedded in base mountings. Five pairs of each attachment were evaluated. A universal testing machine was used to evaluate the retentive force of two attachments during wear simulation. Surface characteristics of each attachment system were evaluated with scanning electron microscopy. Five pairs of each attachment were evaluated. Kerator pink showed the highest initial retention. After 2,500 cycles of wear-simulation, Kerator pink noted the largest decrease in retention. According to results of surface analysis, Worn surfaces were obtained in matrices and patrices. Heavy wears were observed in matrices. After 2 year-wear simulation, most attachments exhibited retention loss. Attachments using different kind of material exhibited dissimilar surface alterations.

Regulation of Stem Cell Fate by ROS-mediated Alteration of Metabolism

Stem cells have attracted much attention due to their distinct features that support infinite self-renewal and differentiation into the cellular derivatives of three lineages. Recent studies have suggested that many stem cells both embryonic and adult stem cells reside in a specialized niche defined by hypoxic condition. In this respect, distinguishing functional differences arising from the oxygen concentration is important in understanding the nature of stem cells and in controlling stem cell fate for therapeutic purposes. ROS act as cellular signaling molecules involved in the propagation of signaling and the translation of environmental cues into cellular responses to maintain cellular homeostasis, which is mediated by the coordination of various cellular processes, and to adapt cellular activity to available bioenergetic sources. Thus, in this review, we describe the physiological role of ROS in stem cell fate and its effect on the metabolic regulation of stem cells.

First Case of Continuous Ambulatory Peritoneal Dialysis-Related Peritonitis Caused by Cryptococcus arboriformis

No abstract available.

Effects of 'Happy Plus Program' for Family Caregivers of Patients with Demenia on Sleep, Depression, Burden, and Quality of Life of Caregivers / 정신간호학회지

PURPOSE: This study was conducted to verify how a program for family caregivers can affect the negative effects of loss of sleep, depression, burden of caring and poor quality of life in people who care for a family member suffering from dementia. METHODS: This was a quasi-experimental study using a single-group pre-test-post-test design. This study was conducted between March 28, and May 30, 2013 in A city. The program was provided for 9 weeks. Eleven caregivers with a family member suffering from dementia participated in this study. RESULTS: The second hypothesis on lowering the depression index (Z=-2.93, p=.003) and fourth hypothesis on improving quality of life (Z=2.02, p=.044) were supported. CONCLUSION: The results of the study indicate that the program for family caregivers is effective in lowering the depression index and improving quality of life of people who care for a family member who is a patient with dementia. More programs for caregivers are needed and should be developed and provided for family caregivers in the near future.

A Case of Aortic Dissection with Marfan Syndrome and Ankylosing Spondylitis / 대한내과학회지

A 33-year-old male presented with an acute onset of back pain and abdominal pain. He was 189.9 cm tall and had an arm span of 194 cm, and had mild pectus carinatum as well as arachnodactyly. Plain radiographs showed kyphoscoliosis of the lumbar spine, bamboo spine of the thoracic spine, and sacroiliitis of the pelvis. Abdominal computed tomography revealed debakey type 3 aortic dissection. We prescribed beta blockers to control his blood pressure. According to the modified New York criteria, we diagnosed him with HLA negative ankylosing spondylitis and initiated therapy with nabumetone and sulfasalazine. We later diagnosed Marfan syndrome based on the Ghent criteria and mutation screening at the fibrillin-1. After treatment, he has been followed up without symptoms or complications.

A Case of Delftia acidovorans Peritonitis in a Peritoneal Dialysis Patient Managed with Preserving the Dialysis Catheter / 대한신장학회지

Delftia acidovarans is aerobic, nonfermentative Gram-negative rod commonly found in soil and water. Generally it is nonpathogenic but it unusually can cause bacteremia in immunocompromised patients. We present a case of peritonitis due to D. acidovorans in a patient on continuous ambulatory peritoneal dialysis. A 75-year-old woman was admitted with abdominal pain and cloudy peritoneal effluent. She was empirically treated with intraperitoneal (IP) cefazolin and ceftazidime, and then IP ceftazidime and oral ciprofloxacin, but peritonitis did not improve. Seven days after admission, D. acidovorans was identified from the peritoneal effluent, which was sensitive to amikacin, ceftazidime, ciprofloxacin and imipenem. Catheter removal was considered with regard to poor response to adequate antibiotics; however, 4 days after changing to IP imipenem/cilastatin, abdominal pain, the leukocyte count of peritoneal effluent and C-reactive protein decreased. She was treated with imipenem/cilastatin for two weeks and discharged with the dialysis catheter intact.

The Lived Experience of the Women with Schizophrenia Taking Antipsychotic Medication

PURPOSE: This study was done to identify some natural meaning through the dosage experience of psychoactive drugs in women patients with schizophrenia. METHODS: The Hermeneutic phenomenology written by van Manen was used. The period for data collection was from November 2009 to January 2010. This study took place in mental health hospitals and mental health centers in two cities in North Jeolla Province. Nine patients with schizophrenia participated. Data collection was done through individual in-depth interview. RESULTS: The seven natural subjects demonstrated by participants from this study were 'Pills forcibly taken like veiled threats', 'A terrible side effect, a side effect rooted slowly', 'Shame which cannot be hidden as a woman', 'A bad medicine took away from motherhood', 'The fate of a wife who can't be equal', 'A struggle for the complete recovery without promise', and 'Participants want the future without medicine'. CONCLUSION: The results of this study indicate that the urgent need to develop a safe and believable psychoactive drug for woman patients considering the time of menstruation, pregnancy, childbirth, and child raising.

Hepatic Subcapsular Steatosis in a Diabetic CAPD Patient Receiving Subcutaneous Insulin / 대한신장학회지

Hepatic subcapsular steatosis is a rare and unique form of fatty change in the liver. It is a specific finding in diabetic patients receiving continuous ambulatory peritoneal dialysis (CAPD) and intraperitoneal insulin treatment. Intraperitoneal administration of insulin and high glucose cause a unique pattern of fatty infiltration in the subcapsular location of the liver. We report a case of hepatic subcapsular steatosis in a diabetic CAPD patient who has not received intraperitoneal insulin. A 63-year-old diabetic woman on CAPD presented with uncontrolled blood glucose. The patient received a total amount of 44 units of NPH via subcutaneous injection. Her initial blood chemistry showed mildly increased serum lipid profiles. Abdominal CT scan images and MRI revealed characteristic findings consistent with hepatic subcapsular steatosis. We report a case of hepatic subcapsular steatosis in a diabetic patient not taking intraperitoneal insulin who recovered through strict blood sugar control without changing dialysis modality.

Bleeding Complications Associated With the Use of Low Molecular Weight Heparin According to the Degree of Renal Impairment / 대한신장학회지

PURPOSE: Low molecular weight heparin (LMWH) is safe and effective in the treatment of acute coronary syndrome (ACS) and venous thromboembolism. Compared with unfractionated heparin (UFH), it is known to have less bleeding tendency in the general population. However, it is not certain whether bleeding complications are decreased by LMWH in patients with renal failure. We postulated that the use of LMWH may lead to increase in bleeding tendency in patients with renal dysfunction. METHODS: We conducted a retrospective study in 486 hospitalized patients who were diagnosed as cerebral infarction or ACS, and treated with enoxaparin or nadroparin from January 2008 to December 2009. Bleeding complications were compared in 3 groups according to estimated glomerular filtration rate (GFR> or =60, 30-59, and <30 mL/min/1.73m2). Age, hypertension (HTN), diabetes mellitus (DM), smoking and usage of antithrombotics were examined and the relationship of these variables with bleeding tendency was analyzed. RESULTS: Compared with group I, the frequency of total bleeding complications increased in patients with group II (p=0.002) and III (p=0.005) regardless of adequate dose reduction. Multiple logistic regression analysis after adjustment for age, HTN, DM, and usage of antithrombotics revealed that decreased GFR groups [odds ratio (OR) of group II was 5.79 (95% confidence interval (CI), 1.23-29.97; p=0.042), OR of group III 5.92 (95% CI, 1.22-27.61; p=0.029)] and DM [OR of DM 7.88 (95% CI; 1.46-46.32, p=0.026)] were two independent factors which affect major bleeding. CONCLUSION: These findings suggest that renal insufficiency, even if it is mild, could affect major bleeding complications in the use of LMWH.

Central Venous Stenosis Caused by Traction of the Innominate Vein due to a Tuberculosis-Destroyed Lung

We report a case of central venous stenosis due to a structural deformity caused by a tuberculosis-destroyed lung in a 65-year-old woman. The patient presented with left facial edema. She had a history of pulmonary tuberculosis, and the chest X-ray revealed a collapsed left lung. Angiography showed leftward deviation of the innominate vein leading to kinking and stenosis of the internal jugular vein. Stent insertion improved her facial edema.

IS6110-Restriction Fragment Length Polymorphism and Spoligotyping Analysis of Mycobacterium tuberculosis Clinical Isolates for Investigating Epidemiologic Distribution in Korea

The Beijing family of Mycobacterium tuberculosis has been emerging in the world. However, there are few nationwide data of genotypic distribution in Korea. This study aimed to identify the genotypic diversity of clinical isolates of M. tuberculosis and to demonstrate the population of Beijing family in Korea. We collected 96 clinical M. tuberculosis isolates from 11 university hospitals nationwide in Korea from 2008 to 2009. We observed 24 clusters in IS6110-RFLP analysis and 19 patterns in spoligotyping. Seventy-five isolates were confirmed to be Beijing family. Two isolates of the K strain and 12 isolates of the K family strain were also found. We found that drug resistance phenotypes were more strongly associated with Beijing family than non-Beijing family (P=0.003). This study gives an overview of the distribution of genotypes of M. tuberculosis in Korea. These findings indicate that we have to pay more attention to control of M. tuberculosis strains associated with the Beijing family.

Tracheal collapsibility measured using end-expiratory chest CT in chronic airway disease / 대한내과학회지

BACKGROUND/AIMS: Partial tracheal narrowing can occur during expiration in the normal population. It is not certain whether the trachea collapses more readily in chronic airway disease. We evaluated the tracheal narrowing at end-expiration using computed tomography (CT). METHODS: We investigated 45 patients and 22 normal subjects who underwent high-resolution CT and pulmonary function tests. In each subject, two CT images at the same level of the aortic arch were compared: one at end-inspiration and the other at end-expiration. The cross-sectional area and sagittal diameter of the trachea were measured using a hand-tracing method, using the in-program measuring tools of Medical Image Viewer, and the percentage changes of each value were calculated. RESULTS: Of the 45 patients with chronic airway disease, 21 had chronic obstructive pulmonary disease, 16 had bronchial asthma, and 8 had bronchiectasis. The mean change in the cross-sectional area was 13.3% in the patients and 9.0% in the normal subjects (p0.05). The decrease in tracheal cross-sectional area was greatest in bronchiectasis, while the greatest decrease in sagittal diameter was in bronchial asthma. There was no significant difference in tracheal collapsibility among the disease groups. The percent change in the tracheal cross-sectional area was correlated with the % predicted FVC (r=-0.033, p<0.05) and FEV1 (r= 0.277, p<0.05) in both the patients and normal controls. CONCLUSIONS: The decrease in tracheal cross-sectional area at end-expiration measured using chest CT was greater in chronic airway disease than in normal subjects, and was associated with ventilatory function.

Comparative Quantification of Plasma hnRNP B1 mRNA in Non-small Cell Lung Cancer Patients by Real-time PCR / 대한진단검사의학회지

BACKGROUND: Circulating cell-free nucleic acids are known to be a noninvasive diagnostic tool for cancer detection. Heterogeneous nuclear ribonucleoprotein (hnRNP) B1, a nuclear core complex, is overexpressed in early stage lung cancer. We intended to evaluate the usefulness of plasma hnRNP B1 mRNA in differentiating non-small cell lung cancer (NSCLC) from other benign lung diseases, especially pulmonary tuberculosis, which is highly prevalent in Korea and often difficult to distinguish from lung cancer. METHODS: Plasma RNA was extracted from 30 patients with NSCLC, 30 patients with benign lung diseases including pulmonary tuberculosis, and 10 healthy controls. Plasma hnRNP B1 mRNA was measured by TaqMan Gene Expression Assay (Applied Biosystems, USA), and pre-developed beta-actin (ACTB) mRNA was used for normalization. We analyzed the relative gene expression data using the delta-delta Ct method. RESULTS: Plasma hnRPN B1 mRNA was measurable in 93.3% (28/30) of NSCLC patients. Normalized 2-DeltaDeltaCt of plasma hnRPN B1 mRNA was 62.2 (95%Cl, 6.4-210.1) in NSCLC patients and 2.7 (95%Cl, 0.5-13.6) in benign lung disease patients (P<0.001, Mann-Whitney U test). CONCLUSIONS: Plasma hnRNP B1 mRNA was significantly increased in patients with lung cancer compared with that in patients with other benign lung diseases. Plasma hnRNP B1 mRNA may be useful as a potential marker for the detection of NSCLC.

Strain Typing of Mycobacterium tuberculosis Isolates from Korea by Mycobacterial Interspersed Repetitive Units-Variable Number of Tandem Repeats / 대한진단검사의학회지

BACKGROUND: Mycobacterium tuberculosis is one of the most clinically significant infectious agents. Especially during mass outbreaks, accurate identification and monitoring are required. The proportion of Beijing family members is very high among infecting strains, and spoligotyping is not suitable for strain typing. Therefore, we studied the homogeneity of isolates using the mycobacterial interspersed repetitive units-variable number of tandem repeats (MIRU-VNTR) method and identified its utility for carrying out molecular epidemiologic analysis. METHODS: Eighty-one clinical M. tuberculosis isolates that had previously been analyzed by spoligotyping were used in this study. We used the 12 standard MIRU loci and further four exact tandem repeat (ETR) loci (ETR-A, -B, -C, and -F). Four strains each of randomly selected Beijing and Beijing-like families were subjected to IS6110- restriction fragment length polymorphism analysis. RESULTS: All 81 samples showed amplification products of all VNTR loci, and all of them showed differences in at least one locus. The calculation of the Hunter-Gaston diversity index (HGDI) for MIRU-VNTR gave the value of 0.965. Discriminatory index in the six loci (MIRU-10, -16, -26, -31, -39, and ETR-F) were found to be highly discriminated (HGDI >0.6). Beijing and Beijing-like family isolates were discriminated into different MIRU-VNTR types. CONCLUSIONS: MIRU-VNTR analysis by using well-selected loci can be useful in discriminating the clinical M. tuberculosis isolates in areas where the Beijing family is predominant.

The endoscopic findings in patients with noncardiac chest pain who have a normal coronary angiogram / 대한내과학회지

BACKGROUND/AIMS: Noncardiac chest pain (NCCP) mainly results from esophageal lesions in the developed world. By contrast, gastroesophageal reflux disease (GERD) is a less frequent cause of NCCP than peptic ulcer disease in China and Japan. Therefore, both esophageal lesions and stomach and duodenal lesions are likely to be important causes of NCCP in Korea. We used upper gastrointestinal endoscopy to evaluate lesions of the esophagus, stomach, and duodenum in NCCP patients after cardiac chest pain was ruled out by coronary angiography (CAG). METHODS: From the patients who underwent CAG between 2004 and 2008, we identified 89 patients who had normal CAG or minimal disease. We retrospectively analyzed the endoscopic findings of these 89 patients who were diagnosed with NCCP. RESULTS: At endoscopy for the 89 patients, the percentages of GERD, gastric ulcer, and duodenal ulcer were 20.2% (n=18), 14.6% (n=13), and 3.3% (n=3) respectively. Of the 16 cases diagnosed as peptic ulcer, 11 were evaluated by biopsy or the Campylobacter-like organism (CLO) test for suspected Helicobacter pylori infection. Six (54%) cases were positive for H. pylori and five (46%) were negative. CONCLUSIONS: In Korea, the incidence of peptic ulcer disease (17.9%) as a cause of NCCP is similar to that of GERD (20.2%). Consequently, we should perform endoscopy to determine the cause of NCCP.

Paradoxical Response Developed during the Antituberculous Treatment in Tuberculous Pleurisy / 결핵및호흡기질환

BACKGROUND: A paradoxical response is defined as the radiological and clinical worsening of a previous lesion or the development of new lesion after initial improvement during theprocess of antituberculous treatment. The related factors for the development of a paradoxical response in patients with tuberculous pleurisy are not certain. METHODS: We selected patients with tuberculous pleurisy who had been treated for more than 4 months. The changes onthe serial chest X-ray findings before and after treatment were reviewed. Paradoxical responses were regarded as any worsening or development of new lesion at least 2 weeks after the initiation of treatment. The baseline clinical characteristics and laboratory findings of the peripheral blood and pleural fluid were compared between the patients with a paradoxical response and the patients without a paradoxical response. RESULTS: Paradoxical responses appeared in sixteen patients (21%) among the 77 patients.It took a mean of 38.6 days after the treatment and the time to resolve the paradoxical response was a mean of 32.1 days. For the patients with a paradoxical response, the median age was younger (30.5 years vs 39.0 years, respectively) and the lymphocytic percentage of white blood cells in the pleural fluid was higher (82.1% vs 69.6%, respectively) than for the patients without a paradoxical response. CONCLUSION: The development of a paradoxical response during the treatment of patients with tuberculous pleurisy was not rare and this was related with the age of the patients and the percentage of lymphocytic white blood cells in the pleural fluid.

A Case of Treatment with Etanercept in Rheumatoid Arthritis Patient on Hemodialysis / 대한류마티스학회지

Disease-modifying antirheumatic drugs (DMARDs) have been used for rheumatoid arthritis (RA) with the aim of controlling synovitis and reducing radiologic progression. Although methotrexate (MTX) is one of the most effective DMARDs, it may cause severe adverse effects. Especially, hematologic toxicity including leukopenia, thrombocytopenia, and fatal pancytopenia is reported in patients with impaired renal function, since renal excretion constitutes the major route of MTX elimination. Tumor necrosis factor-alpha (TNF alpha) inhibitors are well-established biologic agents for the treatment of RA and their clinical efficacy and safety are already demonstrated. But there were few reports on the efficacy and safety in dialysis patients. We described a case of hemodialysis patient with refractory RA that was successfully treated with etanercept, and discussed with literature review.