A Rapid Assessing Method of Drug Susceptibility Using Flow Cytometry for Mycobacterium tuberculosis Isolates Resistant to Isoniazid, Rifampin, and Ethambutol / 결핵및호흡기질환

Background@#The current conventional drug susceptibility test (DST) for Mycobacterium tuberculosis (Mtb) takes several weeks of incubation to obtain results. As a rapid method, molecular DST requires only a few days to get the results but does not fully cover the phenotypic resistance. A new rapid method based on the ability of viable Mtb bacilli to hydrolyze fluorescein diacetate to free fluorescein with detection of fluorescent mycobacteria by flow cytometric analysis, was recently developed. @*Methods@#To evaluate this cytometric method, we tested 39 clinical isolates which were susceptible or resistant to isoniazid (INH) or rifampin (RIF), or ethambutol (EMB) by phenotypic or molecular DST methods and compared the results. @*Results@#The susceptibility was determined by measuring the viability rate of Mtb and all the isolates which were tested with INH, RIF, and EMB showed susceptibility results concordant with those by the phenotypic solid and liquid media methods. The isolates having no mutations in the molecular DST but resistance in the conventional phenotypic DST were also resistant in this cytometric method. These results suggest that the flow cytometric DST method is faster than conventional agar phenotypic DST and may complement the results of molecular DST. @*Conclusion@#In conclusion, the cytometric method could provide quick and more accurate information that would help clinicians to choose more effective drugs.

Direct Contact with Platelets Induces Podoplanin Expression and Invasion in Human Oral Squamous Cell Carcinoma Cells

Oral squamous cell carcinoma (OSCC) is mostly diagnosed at an advanced stage, with local and/or distal metastasis. Thus, locoregional and/or local control of the primary tumor is crucial for a better prognosis in patients with OSCC. Platelets have long been considered major players in cancer metastasis. Traditional antiplatelet agents, such as aspirin, are thought to be potential chemotherapeutics, but they need to be used with caution because of the increased bleeding risk. Podoplanin (PDPN)-expressing cancer cells can activate platelets and promote OSCC metastasis. However, the reciprocal effect of platelets on PDPN expression in OSCC has not been investigated. In this study, we found that direct contact with platelets upregulated PDPN and integrin β1 at the protein level and promoted invasiveness of human OSCC Ca9.22 cells that express low levels of PDPN. In another human OSCC HSC3 cell line that express PDPN at an abundant level, silencing of the PDPN gene reduced cell invasiveness. Analysis of the public database further supported the co-expression of PDPN and integrin β1 and their increased expression in metastatic tissues compared to normal and tumor tissues of the oral cavity. Taken together, these data suggest that PDPN is a potential target to regulate platelet-tumor interaction and metastasis for OSCC treatment, which can overcome the limitations of traditional antiplatelet drugs.

Evaluation of in vitro anti-oxidant and anti-inflammatory activities of Korean and Chinese Lonicera caerulea

BACKGROUND/OBJECTIVES: The honeysuckle berry (HB) contains ascorbic acid and phenolic components, especially anthocyanins, flavonoids, and low-molecular-weight phenolic acids. In order to examine the potential of HB as a hepatoprotective medicinal food, we evaluated the in vitro anti-oxidant and anti-inflammatory activities of Korean HB (HBK) and Chinese HB (HBC). MATERIALS/METHODS: Antioxidant and anti-inflammatory effects of the extracts were examined in HepG2 and RAW 264.7 cells, respectively. The anti-oxidant capacity was determined by DPPH, SOD, CAT, and ARE luciferase activities. The production of nitric oxide (NO) as an inflammatory marker was also evaluated. The Nrf2-mediated mRNA levels of heme oxygenase-1 (HO-1), NAD(P)H dehydrogenase [quinone] 1 (Nqo1), and glutamate-cysteine ligase catalytic subunit (Gclc) were measured. The concentrations of HB extracts used were 3, 10, 30, 100, and 300 µg/mL. RESULTS: The radical scavenging activity of all HB extracts increased in a concentration-dependent manner (P < 0.01 or P < 0.05). SOD (P < 0.05) and CAT (P < 0.01) activities were increased by treatment with 300 µg/mL of each HB extract, when compared to those in the control. NO production was observed in cells pretreated with 100 or 300 µg/mL of HBC and HBK (P < 0.01). Treatment with 300 µg/mL of HBC significantly increased Nqo1 (P < 0.01) and Gclc (P < 0.05) mRNA levels compared to those in the control. Treatment with 300 µg/mL of HBK (P < 0.05) and HBC (P < 0.01) also significantly increased the HO-1 mRNA level compared to that in the control. CONCLUSIONS: Thus, the Korean and Chinese HBs were found to possess favorable in vitro anti-oxidant and anti-inflammatory activities. Nrf2 and its related anti-oxidant genes were associated with both anti-oxidant and anti-inflammatory activities in HB-treated cells. Further studies are needed to confirm these in vivo effects.

Protective Effect of White-fleshed Peach (Prunus persica (L.) Batsch) on Chronic Nicotine-induced Toxicity

BACKGROUND: Nicotine is a major toxic component of tobacco smoke and has been recognized as a risk factor to induce oxidative tissue damage, which is a precursor to cardiovascular diseases, lung-related diseases, and cancers. Peaches (Prunus persica) have been used for the treatment of degenerative disorders, such as hypermenorrhea, dysmenorrhea, and infertility in Asian countries. In this study, we investigated the effects of white-fleshed peach on the excretion of nicotine metabolites and 1-hydroxypyrene in smokers and chronic nicotine-induced tissue damages in mice. METHODS: The concentrations of cotinine and 1-hydroxypyrene were measured in urine of smokers before or after intake of white-fleshed peaches. In addition, ICR mice were injected with nicotine (5 mg/kg body weight) and then orally administered with white-fleshed peach extracts (WFPE) (250 or 500 mg/kg body weight) for 36 days. The oxidative stress parameters and the activities of antioxidant enzymes were measured in liver and kidney tissues. Also, histological changes and nitrotyrosine expression were assessed. RESULTS: Intake of white-fleshed peaches increased the urinary concentration of nicotine metabolites and 1-hydroxypyrene in 91.67% and 83.33% of smokers, respectively. WFPE decreased the malondialdehyde levels and recovered the activities of antioxidant enzymes in nicotine-injected mice. In addition, WFPE inhibited nitrotyrosine expression and inflammatory responses in the liver, kidney, and lung tissues of nicotine-treated mice. CONCLUSIONS: White-fleshed peaches may increase the metabolism of toxic components in tobacco smoke in smokers and protect normal tissues against nicotine toxicity in mice. Therefore, supplementation of white-fleshed peaches might be beneficial to smokers.

Persistence of Integrated Nursing Simulation Program Effectiveness / 기본간호학회지

PURPOSE: This study was done to evaluate the persistency of effects of an integrated nursing simulation program on interest in learning, recognition of importance of communication, communication skills, and problem-solving abilities. METHOD: Forty-seven nursing students were recruited for this quasi-experimental design research. The experimental group (n=23) performed the simulation program for two weeks, and the control group (n=24) performed traditional clinical nursing practice for two weeks. Data were collected at baseline, immediately after the intervention, at 4 weeks, and finally at 8 weeks. RESULTS: With respect to all variables, no significant differences were found between the experimental group and the control group. Interest in learning showed a significant increase in the control group (F=3.59, p=.018) at 4 weeks, and there was a significant increase in problem-solving abilities in the experimental group (F=4.98, p=.004) immediately after the intervention. CONCLUSION: Findings from this study suggest that the integrated nursing simulation program is as effective as the traditional clinical nursing practice, and the integrated nursing simulation program could be used as an alternative.

The Inhibitory Effects of Forsythia Koreana Extracts on the Metastatic Ability of Breast Cancer Cells and Bone Resorption by Osteoclasts

BACKGROUND: Breast cancer is the most common malignant disease in women. The patients with advanced breast cancer develop metastasis to bone. Bone metastasis and skeletal-related events by breast cancer are frequently associated with the invasiveness of breast cancer cells and osteoclasts-mediated bone resorption. Forsythia koreana is used in oriental traditional medicine to treat asthma, atopy, and allergic diseases. The aim of this study was to evaluate the inhibitory effects of F. koreana extracts on the invasion of breast cancer cells and bone resorption by osteoclasts. METHODS: Cell viability was measured by an MTT assay and the migration and invasion of MDA-MB-231 cells were detected by a Boyden chamber assay. The formation of osteoclasts and pit was detected using tartrate-resistant acid phosphatase staining and calcium phosphate-coated plates, respectively. The activities of matrix metalloproteinases (MMPs) and cathepsin K were evaluated by gelatin zymography and a cathepsin K detection kit. RESULTS: The fruit and leaf extracts of F. koreana significantly inhibited the invasion of MDA-MB-231 cells at noncytotoxic concentrations. The fruit extract of F. koreana reduced the transforming growth factor β1-induced migration, invasion and MMPs activities of MDA-MB-231 cells. In addition, the fruit, branch, and leaf extracts of F. koreana also inhibited the receptor activator of nuclear factor kappa-B ligand-induced osteoclast formation and osteoclast-mediated bone-resorbing activity by reducing the activities of MMPs and cathepsin K. CONCLUSIONS: The extracts of F. koreana may possess the potential to inhibit the breast cancer-induced bone destruction through blocking invasion of breast cancer cells, osteoclastogenesis, and the activity of mature osteoclasts.

Effects of Integrated Nursing Practice Simulation-based Training on Stress, Interest in Learning, and Problem-Solving Ability of Nursing Students / 기본간호학회지

PURPOSE: In this study the time point of effects that repeat exposure to simulation-based nursing training has on stress, interest in learning, and problem-solving abilities were identified. METHODS: Participants for this study were 75 nursing college students in Seoul. In a preliminary survey data were collected and measured for the general characteristics, stress, interest in learning, and problem-solving abilities of the students. Then, stress was assessed before performance of each of four-rounds of simulation training scenarios. After each simulation round, interest in learning and problem-solving abilities were assessed. RESULTS: With respect to stress, no significant differences were found when comparing the results of the preliminary survey to those of each of the simulation-based training exercises. For the sub-items of interest in learning, interest in nursing knowledge and interest in clinical training significantly increased between the preliminary survey and the 4th survey. Interest in lab training increased significantly at the 1st survey. Problem solving abilities showed a significant increase from the preliminary at each of the survey points. CONCLUSION: Increasing the exposure of nursing students to simulation-based training enhances their interest in learning and problem-solving abilities. Therefore it is necessary to have education strategies that includes various simulation experiences for students.

Isoliquiritigenin Inhibits Metastatic Breast Cancer Cell-induced Receptor Activator of Nuclear Factor Kappa-B Ligand/Osteoprotegerin Ratio in Human Osteoblastic Cells

Bone destruction induced by the metastasis of breast cancer cells is a frequent complication that is caused by the interaction between cancer cells and bone cells. Receptor activator of nuclear factor kappa-B ligand (RANKL) and the endogenous soluble RANKL inhibitor, osteoprotegerin (OPG), directly play critical roles in the differentiation, activity, and survival of osteoclasts. In patients with bone metastases, osteoclastic bone resorption promotes the majority of skeletal-related events and propagates bone metastases. Therefore, blocking osteoclast activity and differentiation via RANKL inhibition can be a promising therapeutic approach for cancer-associated bone diseases. We investigated the potential of isoliquiritigenin (ISL), which has anti-proliferative, anti-angiogenic, and anti-invasive effects, as a preventive and therapeutic agent for breast cancer cell-induced bone destruction. ISL at non-toxicity concentrations significantly inhibited the RANKL/OPG ratio by reducing the production of RANKL and restoring OPG production to control levels in hFOB1.19 cells stimulated with conditioned medium (CM) of MDA-MB-231 cells. In addition, ISL reduced the expression of cyclooxygenase-2 in hFOB1.19 cells stimulated by CM of MDA-MB-231 cells. Therefore, ISL may have inhibitory potential on breast cancer-induced bone destruction.

Nursing Core Competencies Needed in the Fields of Nursing Practice for Graduates in Nursing / 간호행정학회지

PURPOSE: This study was done to provide information on issues of nursing core competencies needed in the fields of nursing practice for graduates in nursing, from the perspective of nursing managers, and to make suggestion for improving nursing education programs. METHODS: Ten nursing managers participated in this study. They were in charge of clinical nursing education in the fields of nursing practice. Data were collected using focus group interviews and analyzed with the content analysis methodology of Downe - Wamboldt's. RESULTS: Six types of nursing core competency - therapeutic nursing competency, professional nursing competency, administrative nursing competency, humanistic nursing competency, relational nursing competency, and personal nursing competency - were identified as nursing core competencies needed in the fields of nursing practice for graduates in nursing. CONCLUSION: Results of the study show important evidence for decision-making about nursing curriculum revision based on nursing core competency, both in the classroom and in nursing practice areas. These results should contribute to the development of evaluation indicators for nursing students or new nurses. Further research is required to measure degree of nursing core competency in graduates of nursing and to identify the effect of competency-based education for improving nursing core competency.

Experience and Perception of Sexual Harassment During the Clinical Practice of Korean Nursing Students

PURPOSE: The purpose of this study was to identify the experience and perception of sexual harassment during the clinical practice of Korean nursing students. METHODS: The descriptive study was conducted using a self-report questionnaire from December 2009 to January 2010. Participants were 542 nursing students recruited from 12 nursing colleges in Korea, who had finished 1,000 hours of clinical practice which is the minimum requirement for graduation. Data were analyzed by descriptive statistics. RESULTS: Ninety-seven participants (17.9%) reported that they experienced sexual harassment during clinical practice and 36 participants (6.7%) answered whether it was a sexual harassment or not. When sexual harassment was asked by the specific 18 items in the sexual harassment checklist, 52.0% (n = 282) of participants reported that they experienced at least 1 item among 18 items of sexual harassment. Sexual harassments were frequently made by the persons in their 40s (41.2%), men (97.9%) and patients (96.9%) and in the psychiatric wards (67.0%). Many respondents recognized that sexual harassment during clinical practice was caused by abnormal sexual desire of a pervert (34.5%) or men's sexual impulse (26.2%). Also, sexual harassment was perceived as a serious problem (19.4%) and education was necessary for prevention (88.3%). CONCLUSION: Education program is needed to prevent sexual harassment and enhance the gender sensitivity of nursing students, who are in the high-risk group of sexual harassment during clinical practice. This will in turn contribute to a safe educational environment for clinical practice.

The Characteristics of the Location of Medical Specialists' Office in Korea / 가정의학회지

BACKGROUND: While a great amount of practical attention has been paid to the location of medical specialists' office, little research has been published in Korean medical journals. This study examines the concentration level and the related factors of the location of medical specialists' office. For the related factors of the location, this study considers 1) the relative infl uence of resident vs. daytime population, 2) the relative infl uence of resident vs. university-graduate population, and 3) the ratio of aged population. METHODS: This study utilized the Korea Medical Association's "2006 Annual Report Membership Statistics" and the Korea National Statistical Office's "2005 National Population and Housing Census" as data sources. RESULTS: The location of plastic surgeons, dermatologists, psychiatrists, ophthalmologists, and urologists' office was more concentrated than the average, while the reverse was true for obstetricians, gynecologists, orthopedic surgeons, internists, family physicians, and general surgeon's office. Daytime population was more correlated with the location of doctors' office than resident population in most specialties, with the exception of pediatrics, orthopedic surgery and internal medicine. While university-graduates population was more associated with the location than resident population in most specialties, the reverse was true for orthopedic surgery, obstetrics & gynecology, and pediatrics. The ratio of aged population was negatively associated with the location in all the specialties. CONCLUSION: The concentration level showed considerable differences across specialties. Daytime population and university-graduate population were more related with the location of doctors' office than resident population in most specialties.

Root resection of compromised molars / 대한치주과학회지

PURPOSE: Studies reported controversial results about prognosis of root resection with 0%-38% failure rate. The purpose of this study is to consider clinical efficacy of root resection. MATERIALS AND METHODS: This study reported three cases of root resection which were performed on different sites. In first case, lower right first molar showed pus discharge and 7 mm of probing pocket depth. It was diagnosed as fracture of mesial root. Hemisection of mesial root was performed In second case, upper right first molar showed severe bone loss on disto-buccal root and 7 mm of probing pocket. Resection of disto-buccal root was performed In third case, lower left second molar showed severe bone loss on distal root including apex and 15mm of probing pocket depth. Hemisection of distal root was performed. RESULT: In these three cases of root resection, compromised molars were treated successfully and conserved. CONCLUSION: Root resection is a successful procedure treating compromised multi-rooted teeth and conserving teeth when proper case selection is performed.

Factors Influencing Basic Nursing Skill Competency in Nursing Students / 기본간호학회지

PURPOSE: This research was conducted to identify major factors that influence competency for nursing students in basic nursing skills. METHOD: Data were collected by questionnaires from 290 first year students in one college of nursing. The instrument tools included motivation for admission to nursing, concern about fundamentals of nursing, perceived importance of fundamentals of nursing, level of active participation in fundamentals of nursing, number of times to use open Lab, Lab class satisfaction, self-efficacy, self-evaluation and student attitude. RESULTS: There was no significant correlation between competency in basic nursing skills and motivation for admission to nursing, concern about fundamentals of nursing, perceived importance of fundamentals of nursing, or number of times to use open Lab. Competency in basic nursing skill in these students showed a significantly positive correlation to Lab class satisfaction, self-efficacy, self-evaluation, student attitude and level of active participation in fundamentals of nursing. The major factors that influenced competency in basic nursing skills for nursing students were student attitude, self-efficacy and number of times to use open Lab. These factors explained 15.5% of the variance in competency. CONCLUSION: Basic nursing skill practice education programs should be developed to improve self-efficacy and active participation.

Severity of Disability and Quality of Life in Handicapped Persons in Welfare Facility and Home in Goyang City

OBJECTIVE: To compare severity of disability and quality of life between the handicapped residing in a welfare facility and the handicapped living at home. METHOD: This research conducted a survey for the handicapped persons in Goyang city. The survey consisted of the following items: disability diagnosis, modified Barthel index (MBI), Korean-activities of daily living (K-ADL), 8-item short form health survey instrument (SF-8) and life domain satisfaction measure (LDSM). A total number of 144 handicapped persons participated, and 66 among them lived at home. RESULTS: In regard to the range of activities of daily living MBI, K-ADL and quality of life; SF-8, those who resided in a welfare facility showed higher scores. In terms of satisfaction of life, the two groups did not show significant difference in housing, education and family relationship. However, as for leisure and health, those who resided in a welfare facility showed higher satisfaction. CONCLUSION: The handicapped persons residing in a welfare facility could function more independently in carrying out daily activities, and they showed higher quality and more satisfaction of life compared to those who lived at home. These results support that more attention would be needed for disabled persons at home to make welfare and rehabilitation policies.

Emotional and Psychosocial Development in Siblings of Children with Cerebral Palsy

OBJECTIVE: To investigate the psychological development such as emotional and social aspects of typically developing siblings of children with cerebral palsy. METHOD: Eighteen siblings of children with cerebral palsy aged 5 to 12 years and their mothers were included and the interview and psychological assessment were administered by developmental psychologist. All children were asked to complete the Children's Depression Inventory (CDI), State- Trait Anxiety Inventory (STAI), Piers-Harris Children's Self- Concept Scale, Korea Child Behavior Checklist and Korean Educational Developmental Institute-Wechsler Intelligence Scale for Children (KEDI-WISC). All participating mother were asked to complete Minnesota Multiphasic Personality Inventory (MMPI), Beck's Depression Inventory (BDI). For control group, eighteen children with healthy sibling and their mothers were enrolled. RESULTS: Siblings of children with cerebral palsy showed higher mean score of CDI and STAI. And there were no differences in the CDI and STAI according to frequency of treatment, duration of treatment of children with cerebral palsy. There were no significant difference in Piers-Harris children's Self-Concept Scale and Korea Child Behavior Checklist between study group and control group. More than half of mothers of children with cerebral palsy showed depression in BDI and higher score of psychopathic Deviate and psychasthenia in MMPI. Children of mothers with depression in BDI showed higher mean score of CDI and STAI. CONCLUSION: It is necessary to consider extended service to promote psychosocial well-being of children with cerebral palsy and siblings in community-based service organizations.

Biomechanic Analysis of Lower Extremities in Children and Teenagers with Pes Planus

OBJECTIVE: To analyze the biomechanics of young patients with flat foot or malalignment syndrome of lower extremities and to provide some information and strategies in examining and treating them for other researchers or successive studies. METHOD: Between January 2004 and March 2006, 274 patients were engaged who had been diagnosed as flatfoot in 586 patients aged between 0 and 18. All patients were examined physically by one physiatrist to find other biomechanic abnormalities of lower extremities and to measure resting calcaneal stance position (RCSP) angle, bimalleolar angle (BMA). To detect the existence of scoliosis and the difference in leg length, radiographs were taken of the spine and the lower extremities. Flat foot was defined as when either of the feet had lower than -4degrees degrees of RCSP angle. RESULTS: When comparing the value of RCSP angle between right side and left side, the left side was more pronated than the right side. The value of RCSP angle increased in proportion to age but there are other factors that caused the persistence of foot pronation and ligament laxity. The value of BMA tends to increase in proportion to age. The foot was more pronated, the tibia of the same side was more rotated internally and tibia of the other side was more rotated externally. The most common combined biomechanic abnormality of lower extremities was toe-in gait. CONCLUSION: Because the biomechanic effect of a foot could influence the leg, pelvis of the same side and the other side lower extremity, the flat foot should be regarded as an element of malalignment syndrome, anatomical abnormality, and also functional impairment.

The effect of Ca-P coated bovine bone mineral on bone regeneration around dental implant in dogs / 대한치주과학회지

No abstract available.

Treatment of Torsion Dystonia with Motor Point Block Using Phenol : A case report

Dystonia is an abnormal movement characterized by sustained muscle contractions, frequently causing twisting and repetitive movements or abnormal postures. Torsion dystonia is characterized by torsion spasms of muscle contraction, which distorts the limbs and trunk into dystonic postures. We present a case of a patient with torsion dystonia who was recalcitrant to oral medication or even surgical operations. This patient was treated with motor point block using 5% phenol solution. Using electromyographical guidance, phenol was injected into the paraspinal and upper extremity muscles, respectively. He showed reduction of dystonia and improvement of functional abilities. Motor point block using phenol can be considered as a tool of the management for patients with torsion dystonia. MDVAQ@yumc.yonsei.ac.kr

The Clinical Features and Outcome of Therapy according to the Subtypes of Torticollis / 대한소아신경학회지

PURPOSE:We performed this study in order to investigate the clinical features and the therapeutic outcome of infants with torticollis according to the classification; congenital muscular torticollis(CMT), postural torticollis(PT) and, ocular torticollis(OT). METHODS:This study was conducted on 80 infants with torticollis who had been treated from March 2000 to July 2004 in the outpatient clinic of the pediatrics and rehabilitation medicine department of NHIC Ilsan Hospital. All the patients were physically and neurologically examined and took cervical X-rays and ultrasonographies. Based on the results the patients were classified into the subtypes of torticollis. Except OT, the patients underwent conservative treatment programs with physical therapy and home treatment programs. RESULTS:Among the three groups, the time of the first visit to the hospital was the fastest in CMT and the latest in OT. The appearance of facial asymmetry and plagiocephaly didn't show any difference between CMT and PT. The presence of asymmetric neck righting reaction was noted similarly between the two groups. The duration of the treatment was longer in the CMT group than that of the PT group. The outcomes of the treatment in CMT were not different from those of PT. CONCLUSIONS:There are no significant differences of the clinical features and the treatment results between the CMT and the PT groups except the duration of treatment. The ophthalmologic assessment is strongly recommended, if the age of an infant with torticollis is older than one year.

A Case of Adenoma Malignum of the Uterine Cervix / 대한산부인과학회지

Adenoma malignum is a well differentiated form of adenocarcinoma. Despite of benign histologic appearance, this tumor has malignant clinical course. Because of its rarity and subtle histologic changes, it may be missed. Therefore it has poor prognosis. Early diagnosis and early treatment is required by thorough examination. We report one case of adenoma malignum of uterine cervix with a brief review of the literature.