The Relation of Autologous Serum Skin Test andAutologous Plasma Skin Test Result with VariousClinical and Laboratory Findings in Patients withChronic Spontaneous Urticaria

Background@#Despite the autologous serum skin test (ASST)and autologous plasma skin test (APST) is widely used test accessingwhether a patient with chronic spontaneous urticaria(CSU) has autoreactivity or not, the clinician often encounterdifficulty making correlation between the test result and clinicalimplications. @*Objective@#This study was aimed to findany clinical and laboratory findings related to the ASST andAPST response. Agreement and correlation between the twotests was also analyzed. @*Methods@#A retrospective study wasconducted on 300 CSU patients who underwent ASST, APST.The subjects were divided into four groups according to theskin test result. Also, the degree of serum and plasma responsewas recorded. @*Results@#Both ASST and APST positivegroup had shorter duration of the disease, higher incidenceof at least one episode of angioedema than negative group.There were no significant differences in the positivity for autoantibodiesincluding antinuclear, ds-DNA, and thyroid-relatedbetween the two groups. The predicted positive rate ofASST and APST according to age showed bimodal peak and decreasing pattern according to disease duration. Predictedpositivity of both tests declined with increase in total immunoglobulineE (IgE) level. In the correlation study, the twotests showed high correlation coefficients. @*Conclusion@#ASSTand APST positivity may be related to disease duration andseverity of CSU. The two tests showed a generally consistentresult. Autoreactivity may be gradually lost as disease continues.We suggest the autoreactivity in CSU could arise independentlyfrom IgE mediated immune process.

A Meta-Analytic Path Analysis on the Outcome Variables of Nursing Unit Managers’ Transformational Leadership: Systemic Review and Meta-Analysis

Purpose@#The purpose of this study was to identify the outcome variables of nursing unit managers’ transformational leadership and to test a hypothetical model using meta-analytic path analysis. @*Methods@#A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. Data analysis, conducted using R version 3.6.2 software, included 49 studies for the meta-analysis and 119 studies for meta-analytic path analysis. @*Results@#In the meta-analysis, four out of 32 outcome variables were selected. These four variables were empowerment, nursing performance, job satisfaction, and organizational commitment, which showed larger effect sizes than the median and more than five k. The hypothetical model for the meta-analytic path analysis was established by using these four variables and transformational leadership. A total of 22 hypothetical paths including nine direct effects and 13 indirect effects were set and tested. The meta-analytic path analysis showed that transformational leadership had direct effects on the four variables. Finally, eight direct effects, 12 indirect effects, and six mediating effects were statistically significant, and the hypothetical model was verified. @*Conclusion@#Nursing unit managers can use the transformational leadership to improve empowerment, nursing performance, job satisfaction, and organizational commitment of nurses. This study empirically showed the importance of transformational leadership of nursing managers. This finding will be used as evidence to develop strategies for enhancing transformational leadership, empowerment, nursing performance, job satisfaction, and organizational commitment in nursing science and practice.

A Meta-Analytic Path Analysis on the Outcome Variables of Nursing Unit Managers’ Transformational Leadership: Systemic Review and Meta-Analysis

Purpose@#The purpose of this study was to identify the outcome variables of nursing unit managers’ transformational leadership and to test a hypothetical model using meta-analytic path analysis. @*Methods@#A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. Data analysis, conducted using R version 3.6.2 software, included 49 studies for the meta-analysis and 119 studies for meta-analytic path analysis. @*Results@#In the meta-analysis, four out of 32 outcome variables were selected. These four variables were empowerment, nursing performance, job satisfaction, and organizational commitment, which showed larger effect sizes than the median and more than five k. The hypothetical model for the meta-analytic path analysis was established by using these four variables and transformational leadership. A total of 22 hypothetical paths including nine direct effects and 13 indirect effects were set and tested. The meta-analytic path analysis showed that transformational leadership had direct effects on the four variables. Finally, eight direct effects, 12 indirect effects, and six mediating effects were statistically significant, and the hypothetical model was verified. @*Conclusion@#Nursing unit managers can use the transformational leadership to improve empowerment, nursing performance, job satisfaction, and organizational commitment of nurses. This study empirically showed the importance of transformational leadership of nursing managers. This finding will be used as evidence to develop strategies for enhancing transformational leadership, empowerment, nursing performance, job satisfaction, and organizational commitment in nursing science and practice.

A Literature Review of Research on Leadership of Korean Hospital Nurse / 간호행정학회지

PURPOSE: This study was done to identify trends in leadership-related research by reviewing studies on hospital nurses in South Korea.METHODS: The research was conducted from April 2 to 14, 2018 and search databases were RISS, KISS, DBpia, KM base, NAL, and NDSL. Search terms were ‘leadership’ and ‘nursing’ in the Korean language, and total 141 papers were selected.RESULTS: Analysis of the research on leadership showed that 96.4% of research methods were quantitative research, and 60.3% were predictive researches. For study settings, 46.2% were general hospitals, 96.5% were staff nurses. In the study of leadership variables, 60.3% were independent variables and recent leadership was used as a mediating variable (4.3%) and a moderating variable (2.8%). Among the leadership types, self-leadership (31.2%) was the most common, and the main variable related to leadership was job satisfaction (25.8%).CONCLUSION: These results provide useful data for deriving new research ideas about nursing leadership. Furthermore, this study has significance for providing the evidence for developing new leadership programs and policies in nursing organizations.

Importance, Performance and Rates of Nurse Performance of Nursing Interventions in Long-term Care Hospitals / 간호행정학회지

PURPOSE: The purpose of this study was to identify the importance, performance and rates of nurses' performance of nursing interventions in long-term care hospitals. METHODS: A cross-sectional descriptive study was used and data were collected in 2015. Participants were 174 clinical nurses working in 14 long-term care hospitals. The collected data were analyzed using the SPSS/WIN 18.0. RESULTS: The nurses' perceived importance of nursing interventions was 4.48±0.51, and the degree of nursing intervention performance in long-term care hospitals was 3.97±1.07 out of 5. The rates of nursing interventions performed by nurses ranged from 33.9% to 99.4% with an average of 82.5%. There were statistically significant positive correlations among perceived importance, performance in hospitals, and rates for nurses' performance of nursing interventions (p<.001). CONCLUSION: The results indicate that interventions with a high degree of importance and performance could be the core nursing interventions in long-term care hospitals. These core nursing interventions should be included in education for nurses. These findings can be used in developing realistic guidelines and effective strategies for nurses and administrators to improve the quality of nursing and the status of nursing professionals in long-term care hospitals.

Association between Physical Activity and Health-Related Quality of Life in Korean: The Korea National Health and Nutrition Examination Survey IV / 가정의학회지

BACKGROUND: Numerous studies have identified that physical activity (PA) has positive influences on quality of life. However, there has been little domestic research about the relation of PA to health-related quality of life (HRQoL) among the general population. The purpose of this study was to evaluate the effect of PA on HRQoL in Korean adults aged 40 years or over. METHODS: This cross-sectional study was based on data acquired from the Korean National Health and Nutrition Examination Survey IV. Final study subjects were 10,392 adults aged 40 years or over. According to the severity and frequency of PA, the subjects were divided into three PA groups as follows: high-activity, mid-activity, and low-activity group. We compared the HRQoL estimated by the EuroQoL 5-dimension (EQ-5D), the EQ visual analogue scale (EQ-VAS), and EQ-5D index between three PA groups. RESULTS: The odds ratios for mid-activity group and high activity group compared with low activity group were significantly decreased in the dimension of mobility of EQ-5D (mid-activity group, 0.81 [0.69-0.94]; high activity group, 0.81 [0.67-0.99]). EQ-VAS was decreased as PA level was lowered from high activity group and mid-activity to low activity group. EQ-5D index was the highest in mid-activity group and the lowest in low activity group. CONCLUSION: PA above mid-activity group showed better HRQoL compared than low activity group.

The Association Between Eating Frequency and Metabolic Syndrome

BACKGROUND: Metabolic syndrome increases the risk for cardiovascular diseases and type 2 diabetes mellitus. Many studies have revealed that eating frequency influences the total serum cholesterol level, glucose tolerance and obesity. Hypothesizing that an increase in eating frequency decreases the prevalence of metabolic syndrome with total energy intake adjusted, we evaluated the association between eating frequency and the risk of metabolic syndrome in Koreans aged more than 20 years old. METHODS: We used the data from the 2005 Korean National Health and Nutrition Examination Survey. Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III and the Asia-Pacific regional obesity guidelines. To examine the association of metabolic syndrome with eating frequency, snack frequency and meal frequency, we performed multiple logistic regression analysis adjusting for age, sex, physical activity, daily caloric intake, smoking and drinking. RESULTS: Meal frequency was associated with metabolic syndrome in the 20-45 years group (P=0.011). Eating frequency was significantly related with metabolic syndrome in the group aged more than 45 years (P=0.025). Within the subgroup of subjects more than 45 years who had one or two meals a day, snack frequency showed a significant association with metabolic syndrome (P=0.038). CONCLUSIONS: These results suggest that a decreased eating frequency is associated with a risk of metabolic syndrome, although the causal relationship is not exactly known. It would be useful to pursue this question through further studies.

Factors Influencing Internet Addiction in College Students

BACKGROUND: The purpose of this study was to explore the factors related to internet addiction in college students in Korea. METHODS: This study was a cross-sectional survey of college students in Seoul, and data was collected through self-report questionnaires. Data was analyzed by one-way analysis of variance, Fisher's exact test, Kruskal-Wallis rank test, and ordinary logistic regression analysis. RESULTS: In the ordinary logistic regression analysis, the factors related to a higher risk of internet addiction were lower frequency of exercise (P=0.017), lower level of self-control (P<0.001), higher level of stress (P<0.001), living with parents (P=0.011), using the internet for extended periods of time (P<0.001), and using the internet in their own rooms (P<0.001). CONCLUSIONS: Our results suggest that exercise, self-control, stress, living with parents, and duration and place of internet use are associated with internet addiction in college students. This information can be used to design methods for preventing internet addiction. More specific studies on internet addiction in college students are needed.

Coverage of Influenza Vaccination among Elderly in South Korea: A Population Based Cross Sectional Analysis of the Season 2004-2005

BACKGROUND: Influenza vaccine coverage among the elderly is important for informed vaccination policies and programs. There are few studies that define influenza coverage in the elderly in South Korea. The aim of this study is to examine influenza vaccination coverage among those 65 years old and older in South Korea over the 2004-2005 influenza season and to identify the socioeconomic and clinical factors associated with vaccination. METHODS: We analyzed data retrieved from The Third Korea National Health and Nutrition Examination Survey (KNHANES III) 2005 conducted by the Korea Centers for Disease Control and Prevention. Subjects included in this study were older than 65 years. We used questionnaires to obtain information regarding demographics, chronic diseases, and individual health behavioral risk factors. Univariate analysis, logistic regression, and trend test were performed. RESULTS: There were 1,097 persons included in this study. Influenza vaccination among those 65 years old and older was 77.2 %. There was no difference of coverage by sex, education level, and income status. For elderly females, the moreunheal thy lifestyle (currently smoking, heavy alcohol use, and no exercise) that was practiced, the less likely they wereto be vaccinated (p for trend=0.007). CONCLUSION: The influenza vaccination coverage rate among the elderly in South Korea during the 2004-2005 flu season was relatively high compared to that of Europe (19.3-26.5 %) during the same season. Nevertheless, the coverage rate in elderly women with unhealthy lifestyle was not satisfactory causing them to be more vulnerable to related illnesses than those who practiced a healthy lifestyle. To prevent influenza related illnesses, clinicians should, in particular, encourage vaccination in those with an unhealthy lifestyle, as well as, lifestyle modification.

Faculty Observer and Standardized Patient Accuracy in Recording Examinees' Behaviors Using Checklists in the Clinical Performance Examination / 한국의학교육

PURPOSE: The purpose of the study was to examine the recording accuracy of faculty observers and standardized patients (SPs) on a clinical performance examination (CPX). METHODS: This was a cross-sectional study of a fourth-year medical students' CPX that was held at a medical school in Seoul, Korea. The CPX consisted of 4 cases and was administered to 118 examinees, with the participation of 52 SP and 45 faculty observers. For the study we chose 15 examinees per case, and analyzed 60 student-SP encounters in total. To determine the recording accuracy level, 2 SP trainers developed an answer key for each encounter. First, we computed agreement rates (P) and kappa coefficient (K) values between the answer key-SPs and the answer key-faculty observers. Secondly, we analyzed variance (ANOVA) with repeated measures to determine whether the mean percentage of the correct checklist score differed as a function of the rater, the case, or the interaction between both factors. RESULTS: Mean P rates ranged from 0.72 to 0.86, while mean K values varied from 0.39 to 0.59. The SP checklist accuracy was higher than that of faculty observersat the level of item comparison. Results from ANOVA showed that there was no significant difference between the percentage of correct scores by the answer key, faculty observers and SPs. There was no significant interaction between rater and case factors. CONCLUSION: Acceptable levels of recording accuracy were obtained in both rater groups. SP raters can replace faculty raters in a large-scale CPX with thorough preparation.

Enhanced Expression of Aldosterone Synthase and Adrenomedullin in Left and Right Ventricular Hypertrophy in Rats

The pathophysiological implications of aldosterone and adrenomedullin in the cardiac ventricular hypertrophy were examined. Male Sprague-Dawley rats were treated with deoxycorticosterone acetate (DOCA)-salt and monocrotaline (MCT) to selectively elicit left and right ventricular (LV, RV) hypertrophy, respectively. The mRNA expression of aldosterone synthase and adrenomedullin in LV and RV was determined by reverse transcription-polymerase chain reaction. The expression of aldosterone synthase and adrenomedullin was increased in LV, while not altered significantly in RV of DOCA-salt-treated rats. On the contrary, the expression was not significantly altered in LV, but increased in RV of MCT-treated rats. The enhanced expression of aldosterone synthase may be causally related with the development of ventricular hypertrophy, and the increased expression of adrenomedullin may act as a counter-regulatory mechanism.

Coordinate expression of renin and cyclooxygenase-2 in rats with two-kidney, one clip and deoxycorticosterone acetate-salt hypertension

The present study was aimed to examine whether the expression of renin is associated with that of cyclooxygenase-2 (COX-2) in the kidney. Male Sprague-Dawley rats were made two-kidney, one clip (2K1C) or deoxycorticosterone acetate (DOCA)-salt hypertensive, to stimulate or to inhibit the endogenous renin-angiotensin system, respectively. The expression of renin and COX-2 mRNA was determined in the cortex of the kidney by reverse transcription-polymerase chain reaction. 2K1C hypertensive rats showed an increased expression of renin as well as of COX-2 in the clipped kidney. The expression of renin was decreased in parallel with that of COX-2 in the contralateral non-clipped kidney. Removal of the renal arterial clip reversed the expression of both genes, along with the blood pressure, to the control level. On the other hand, DOCA-salt hypertension was associated with parallel decreases of renin and COX-2 expression. These results indicate that renin and COX-2 genes are coordinately expressed in the kidney.

Decreased expression of aquaporin-2 water channels in the kidney in rats treated with reserpine

Whether there exists a Sympathetic neural mechanism regulating the expression of aquaporin (AQP) water channels in the kidney was investigated. Male Sprague-Dawley rats were treated with reserpine (1 mg/kg, IP), and the expression of AQP1-4 proteins was determined in the kidney one day thereafter. Following the treatment with reserpine, the systolic blood pressure measured in a conscious state was significantly decreased in the experimental group compared with that in the control (83+/-8 vs 124+/-6 mmHg n=6 each, P<0.05). The expression of AQP2 proteins was decreased in the cortex, outer medulla, and inner medulla. The decrease of AQP2 proteins was in parallel in the membrane and the cytoplasmic fractions, suggesting a preserved AQP2 targeting. No significant changes were observed in the expression of AQP1, AQP3, or AQP4. Neither basal nor AVP-stimulated formation of cAMP was significantly altered. These results suggest that the sympathetic nervous system has a tonic stimulatory effect specifically on the expression of AQP2 water channels in the kidney.

Increased expression of nitric oxide synthases in left and right ventricular hypertrophy

The present study was aimed to explore pathophysiological implications of nitric oxide in the development of left and right ventricular hypertrophy. To induce selective left and right ventricular hypertrophy, rats were made two-kidney, one clip (2K1C) hypertensive and treated with monocrotaline (MCT), respectively. Six weeks later, the hearts were taken and their ventricular tissue mRNA and protein expression of endothelial constitutive isoform of nitric oxide synthase (NOS) were determined by reverse transcription-polymerase chain reaction and Western blot analysis, respectively. In 2K1C hypertensive rats, the expression of NOS mRNA was increased in parallel with its proteins in the left ventricle, but not in the right ventricle. In MCT-treated rats, the expression of NOS mRNA and proteins were proportionally increased in the right ventricle, but not in the left ventricle. These results suggest that the expression of NOS is specifically increased in association with the ventricular hypertrophy, which may be a mechanism counteracting the hypertrophy.