Induction of apoptotic cell death in human bladder cancer cells by ethanol extract of Zanthoxylum schinifolium leaf, through ROS-dependent inactivation of the PI3K/Akt signaling pathway

BACKGROUND/OBJECTIVES@#Zanthoxylum schinifolium is traditionally used as a spice for cooking in East Asian countries. This study was undertaken to evaluate the anti-proliferative potential of ethanol extracts of Z. schinifolium leaves (EEZS) against human bladder cancer T24 cells.MATERIALS/METHODS: Subsequent to measuring the cytotoxicity of EEZS, the anti-cancer activity was measured by assessing apoptosis induction, reactive oxygen species (ROS) generation, and mitochondrial membrane potential (MMP). In addition, we determined the underlying mechanism of EEZS-induced apoptosis through various assays, including Western blot analysis. @*RESULTS@#EEZS treatment concentration-dependently inhibited T24 cell survival, which is associated with apoptosis induction. Exposure to EEZS induced the expression of Fas and Fas-ligand, activated caspases, and subsequently resulted to cleavage of poly (ADPribose) polymerase. EEZS also enhanced the expression of cytochrome c in the cytoplasm by suppressing MMP, following increase in the ratio of Bax:Bcl-2 expression and truncation of Bid. However, EEZS-mediated growth inhibition and apoptosis were significantly diminished by a pan-caspase inhibitor. Moreover, EEZS inhibited activation of the phosphoinositide 3-kinase (PI3K)/Akt pathway, and the apoptosis-inducing potential of EEZS was promoted in the presence of PI3K/Akt inhibitor. In addition, EEZS enhanced the production of ROS, whereas N-acetyl cysteine (NAC), a ROS scavenger, markedly suppressed growth inhibition and inactivation of the PI3K/Akt signaling pathway induced by EEZS. Furthermore, NAC significantly attenuated the EEZS-induced apoptosis and reduction of cell viability. @*CONCLUSIONS@#Taken together, our results indicate that exposure to EEZS exhibits anticancer activity in T24 bladder cancer cells through ROS-dependent induction of apoptosis and inactivation of the PI3K/Akt signaling pathway.

Induction of Apoptosis Scutellaria baicalensis Georgi Root Extract by Inactivation of the Phosphatidyl Inositol 3-kinase/Akt Signaling Pathway in Human Leukemia U937 Cells

BACKGROUND: The roots of Scutellaria baicalensis Georgi (Labiatae) have been widely used in traditional medicine for treatment of various diseases. In this study, we investigated the effects of ethanol extracts of S. baicalensis roots (EESB) on the growth ofn human leukemia U937 cells. METHODS: The effect of EESB on cell viability was measured by the 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide assay. Apoptosis was determined using 4,6-diamidino-2-phenyllindile staining and flow cytometry. The effects of EESB on the expression of regulatory proteins of apoptosis and phosphatidyl inositol 3-kinase (PI3K)/Akt signaling were determined by Western blotting. Caspase activity and mitochondrial membrane potential (MMP) were measured using flow cytometric analysis.

Corni Fructus attenuates testosterone-induced benign prostatic hyperplasia by suppressing 5α-reductase and androgen receptor expression in rats

BACKGROUND/OBJECTIVES: Benign prostatic hypertrophy (BPH) is a major cause of abnormal overgrowth of the prostate mainly in the elderly. Corni Fructus has been reported to be effective in the prevention and treatment of various diseases because of its strong antioxidant effect, but its efficacy against BPH is not yet known. This study was designed to evaluate the therapeutic efficacy of Corni Fructus water extract (CF) in testosterone-induced BPH rats. MATERIALS/METHODS: To induce BPH, rats were intraperitoneal injected with testosterone propionate (TP). Rats in the treatment group were orally administered with CF with TP injection, and finasteride, which is a selective inhibitor of 5α-reductase type 2, was used as a positive control. RESULTS: Our results showed that the increased prostate weight and histopathological changes in BPH model rats were suppressed by CF treatment. CF, similar to the finasteride-treated group, decreased the levels of testosterone and dihydrotestosterone by TP treatment in the serum, and it also reduced 5α-reductase expression and concentration in prostate tissue and serum, respectively. In addition, CF significantly blocked the expression of the androgen receptor (AR), AR co-activators, and proliferating cell nuclear antigen in BPH rats, and this blocking was associated with a decrease in prostate-specific antigen levels in serum and prostate tissue. CONCLUSIONS: These results suggest that CF may weaken the BPH status through the inactivation of at least 5α-reductase and AR activity and may be useful for the clinical treatment of BPH.

Reactive oxygen species-dependent apoptosis induction by water extract of Citrus unshiu peel in MDA-MB-231 human breast carcinoma cells

BACKGROUND/OBJECTIVES: Although several recent studies have reported the anti-cancer effects of extracts or components of Citrus unshiu peel, which has been used for various purposes in traditional medicine, the molecular mechanisms for their effects remain unclear. In the present study, the anti-cancer activity of a water-soluble extract of C. unshiu peel (WECU) in MDA-MB-231 human breast carcinoma cells at the level of apoptosis induction was investigated. MATERIALS/METHODS: Cytotoxicity was evaluated using the MTT assay. Apoptosis was detected using DAPI staining and flow cytometry analyses. Mitochondrial membrane potential, reactive oxygen species (ROS) assay, caspase activity and Western blotting were used to confirm the basis of apoptosis. RESULTS: The results indicated that WECU-induced apoptosis was related to the activation of caspase-8, and -9, representative initiator caspases of extrinsic and intrinsic apoptosis pathways, respectively, and caspase-3 accompanied by proteolytic degradation of poly(ADP-ribose) polymerase and down-regulation of the inhibitors of apoptosis protein family members. WECU also increased the pro-apoptotic BAX to anti-apoptotic BCL-2 ratio, loss of mitochondrial membrane potential and cytochrome c release from mitochondria to cytoplasm. Furthermore, WECU provoked the generation of ROS, but the reduction of cell viability and induction of apoptosis by WECU were prevented when ROS production was blocked by antioxidant N-acetyl cysteine. CONCLUSIONS: These results suggest that WECU suppressed proliferation of MDA-MB-231 cells by activating extrinsic and intrinsic apoptosis pathways in a ROS-dependent manner.

The Effects of Mindfulness Meditation-Based Complex Exercise Program on Motor and Nonmotor Symptoms and Quality of Life in Patients with Parkinson's Disease

PURPOSE: The present study was to examine the effect of a meditation-based exercise program on the motor and non-motor symptoms of Parkinson's disease (PD). METHODS: Sixty three PD patients who were recruited from a university hospital were randomly assigned to the experimental group (n = 33) and to the control group (n = 30). Participants completed an 8-week Mindfulness Meditation-based Complex Exercise Program (MMBCEP) that included 6 sessions. Before and after the intervention, the Six-Minute Walk Test (6MWT), elastic band pull, chair stand test, and 2.45-meter walk test were administered for the motor symptoms and the Korean Version of Geriatric Depression Scale, The State-Trait Anxiety Inventory (STAI), the Korean-Montreal Cognitive Assessment, Parkinson's Disease Sleep Scale (PDSS), Activities of Daily Living (ADL), and the Quality of Life of Patients with Parkinson's Disease (PDQL) were administered for non-motor symptoms. RESULTS: Significant improvements in the motor symptoms (i.e., muscle strength (lower and upper extremity), balance, and muscle endurance) and in the non-motor symptoms (i.e., anxiety, depression, cognitive functions, sleep disturbance, quality of life, and activities of daily living) were observed. CONCLUSIONS: MMBCEP, a complex exercise program-based on mindfulness meditation, is associated with increased motor symptoms, decreased emotional disturbances (anxiety and depression) and sleep disturbance, and improved cognitive functions, quality of life, and activities of daily living. Future research should test the effects of MMBCEP with more representative PD patients.

Baicalein Inhibits the Migration and Invasion of B16F10 Mouse Melanoma Cells through Inactivation of the PI3K/Akt Signaling Pathway

Baicalein, a natural flavonoid obtained from the rhizome of Scutellaria baicalensis Georgi, has been reported to have anticancer activities in several human cancer cell lines. However, its antimetastatic effects and associated mechanisms in melanoma cells have not been extensively studied. The current study examined the effects of baicalein on cell motility and anti-invasive activity using mouse melanoma B16F10 cells. Within the noncytotoxic concentration range, baicalein significantly inhibited the cell motility and invasiveness of B16F10 cells in a concentration-dependent manner. Baicalein also reduced the activity and expression of matrix metalloproteinase (MMP)-2 and -9; however, the levels of tissue inhibitor of metalloproteinase-1 and -2 were concomitantly increased. The inhibitory effects of baicalein on cell motility and invasiveness were found to be associated with its tightening of tight junction (TJ), which was demonstrated by an increase in transepithelial electrical resistance and downregulation of the claudin family of proteins. Additionally, treatment with baicalein markedly reduced the expression levels of lipopolysaccharide-induced phosphorylated Akt and the invasive activity in B16F10 cells. Taken together, these results suggest that baicalein inhibits B16F10 melanoma cell migration and invasion by reducing the expression of MMPs and tightening TJ through the suppression of claudin expression, possibly in association with a suppression of the phosphoinositide 3-kinase/Akt signaling pathway.

The Immunomodulatory Activity of Mori folium, the Leaf of Morus alba L., in RAW 264.7 Macrophages In Vitro

BACKGROUND: Immunoregulatory elements have emerged as useful immunotherapeutic agents against cancer. In traditional medicine, Mori folium, the leaf of Morus alba L. (Moraceae), has been used for various medicinal purposes; however, the immunomodulatory effects have not been fully identified. We evaluated the immunoenhancing potential of water extract of Mori folium (WEMF) in murine RAW264.7 macrophages. METHODS: RAW264.7 cells were treated with WEMF for 24 hours and cell viability was detected by an MTT method. Nitric oxide (NO) levels in the culture supernatants were assayed using Griess reagent. The productions of prostaglandin E2 (PGE2) and immune-related cytokines was measured using ELISA detection kits. The mRNA and protein expression levels of Inducible NO synthase, COX-2, and cytokines were assayed by reverse transcription-PCR and Western blotting, respectively. The effect of WEMF on phagocytic activity was measured using a Phagocytosis Assay Kit. RESULTS: WEMF significantly stimulated the production of NO and PGE2 as immune response parameters at noncytotoxic concentrations, which was associated with the increased expression of inducible NO synthase and COX-2. The release and expression of cytokines, such as TNF-α, interleukin (IL)-1β, IL-6, and IL-10, were also significantly increased in response to treatment with WEMF. Moreover, WEMF promoted the macrophagic differentiation of RAW264.7 cells and the resulting phagocytosis activity. CONCLUSIONS: WEMF has the potential to modulate the immune function by regulating immunological parameters. Further studies are needed to identify the active compounds and to support the use of WEMF as an immune stimulant.

Health Status and Health Service Utilization: Barriers and Facilitators for Korea Medicaid Beneficiaries

PURPOSE: This study compares beneficiaries of Korean Medicaid with those under the National Health Insurance program, seeking to understand how each group utilizes their healthcare. METHODS: Data were obtained from a Health Promotion Survey in 2005. Health status was measured by the respondents' perception of health. Health service utilization included the availability of healthcare services, the type of healthcare institution, and intent to revisit. Predisposing and enabling factors, as well as health care needs were used for this study. RESULTS: Compared to National Health Insurance beneficiaries, Medicaid beneficiaries reported lower levels of health status and fewer enabling factors. They had more chronic diseases and disabilities. Education level, existence of chronic diseases, exercise patterns, and disabilities were associated with health status. CONCLUSION: We found that Medicaid beneficiaries had fewer resources and higher levels of health needs. As Medicaid is reformed, policy makers and administrators should understand healthcare utilization behaviors of Medicaid beneficiaries and the factors hindering access to care.

Factors Influencing Quality of Sleep among Patients with Colorectal Cancer Receiving Chemotherapy

PURPOSE: This study aimed to find the relationships between quality of sleep, symptoms, depression, and anxiety in patients with colorectal cancer. METHODS: A cross-sectional correlation study was used. Participants were 138 colorectal cancer patients undergoing chemotherapy. Measurements included the self-reported Pittsburgh Sleep Quality Index (PSQI), the Hospital Anxiety Depression Scale (HADS), the M. D. Anderson Symptom Inventory (MDASI-GI) and the patients' medical history. RESULTS: 87.0% of subjects were assessed as poor sleepers. The most severe symptoms reported were feeling bloated, followed by fatigue, and sadness. The prevalence of anxiety and depression were 68.2%, and 77.5% respectively. According to the result of multiple regression analysis, symptoms, depression, cancer severity, and comorbidity of chronic illness were significant predictors of quality of sleep scores (Adj. R²=.392, p<.001). CONCLUSION: The independent variables of symptoms were the major contributing factors to poor sleep quality. Oncology nursing professionals need to assess the symptoms to improve quality of sleep for colorectal cancer patients undergoing chemotherapy.

Analysis of Kimchi, vegetable and fruit consumption trends among Korean adults: data from the Korea National Health and Nutrition Examination Survey (1998-2012)

BACKGROUND/OBJECTIVES: The purpose of this study is to analyze daily kimchi, vegetable and fruit consumption by general characteristics and vegetable and fruit consumption from 1998 to 2012 by the Korean population based on the data of the KNHANES (Korea National Health and Nutrition Examination Survey). SUBJECTS/METHODS: This study is based on the 1998-2012 KNHNES. Analysis data on 54,700 subjects aged 19 years and older were obtained from health behavior interviews and the 24-hour dietary recall method. RESULTS: Daily kimchi consumption and portion size of kimchi decreased significantly from 1998 to 2012 (adjusted P for trend < 0.0001). Meanwhile, daily consumption of both non-salted vegetable and fruit with and without kimchi did not significantly change between 1998 and 2012. Reduced consumption of kimchi, non-salted vegetable, and fruit was observed for both genders as well as daily meal episodes and cooking locations. Male and female subjects with insufficient non-salted vegetable and fruit intake were increased 1.4 times and 1.3 times, respectively, in 2012 than 1998. All subjects consumed at least 400 g/day of non-salted vegetable, fruit, and kimchi in each survey year, although they consumed insufficient amounts (< 400 g/day) of non-salted vegetable and fruit without kimchi. CONCLUSIONS: Since Koreans generally consume high amounts of fermented vegetables, including kimchi, total vegetables and fruit. Consumption of these foods by the Korean adult population reached 400 g, which is the recommended intake of the WCRF/AICR. Based on this result, it is necessary to promote consumption of kimchi in the Korean population and research the development of low sodium kimchi in the future.

Prescribing Patterns of Pain Medication in Hospitalized Elderly Patients with Non-Cancer Pain

OBJECTIVE: Pain is very common in the elderly, so there is a high prevalence of analgesic use among this population. The purpose of this study was to assess patterns of analgesic use and evaluate factors associated with analgesic use in elderly patients. METHOD: The subjects of this study were patients over 65 years old hospitalized in a teaching hospital located in Chuncheon-si, Korea between January 1, 2014 and March 31, 2014. Data collection regarding analgesic prescriptions and baseline characteristics was conducted using computerized hospital database by medical information team. Logistic regression analysis was used to identify factors related to analgesic use. RESULTS: A total of 2,394 patients were finally included. Among these patients, 700 (29.2%) took analgesics; 521 (74.4%) out of these 700 patients were received opioid analgesics and 179 (25.6%) were received only non-opioid analgesics. The most frequently prescribed opioid analgesic was pethidine (45.7%), and the most frequently prescribed non-opioid analgesic was acetaminophen (44.1%). Fracture was associated with increased odds of opioid analgesic prescriptions (OR = 2.766, 95% CI = 2.019-3.790, p < 0.001) and any analgesic prescriptions (OR = 2.394, 95% CI = 1.766-3.244, p < 0.001). Stroke or cerebral infarction was associated with decreased odds of opioid analgesic prescriptions (OR = 0.636, 95% CI = 0.471-0.858, p = 0.003). CONCLUSION: A significant proportion of hospitalized elderly patients use analgesics. Health care professionals should consider factors associated with analgesic use in this population to improve pain management.

Type 2 Diabetes in Urban and Rural Districts in Korea: Factors Associated with Prevalence Difference

The purpose of this study was to examine the urban-rural differences in the prevalence and associated factors with type 2 diabetes mellitus (T2DM) in Korean adults. A total of 1,060 adults >30 yr of age from urban (189 males and 331 females) and rural districts (219 males and 321 females) were recruited. Anthropometric measures, blood pressure, lipid profiles, and fasting and 2-hr after 75-g oral glucose load blood glucose were obtained. The crude- and age-standardized prevalence of T2DM was 15.4% and 14.5%, and 11.7% and 8.6% in urban and rural districts, respectively. Diabetic subjects were older and obese, and had a higher triglyceride level, and systolic blood pressure compared to non-diabetes in both population. Multivariate regression analysis revealed that older age, high triglyceride levels, central obesity, and hypertension were significantly associated with T2DM in both areas. Low monthly incomes were significantly associated with T2DM in urban population, while a family history of T2DM was significantly associated with T2DM in rural area. T2DM is more prevalent in urban than in rural population, and low economic status or genetic factor is differently associated with T2DM in both population, respectively.

Hospital Nurses' Experience of Do-Not-Resuscitate in Korea / 간호학회지

PURPOSE: The purpose of the study was to describe the experiences of do-not-resuscitate (DNR) among nurses. METHODS: Data were collected by in-depth interviews with 8 nurses in 8 different hospitals. Conventional qualitative content analysis was used to analyze the data. RESULTS: Eight major themes emerged from the analysis: DNR decision-making bypassing the patient, inefficiency in the decision-making process of DNR, negative connotation of DNR, predominance of verbal DNR over written DNR, doubts and confusion about DNR, least amount of intervention in the decision for DNR change of focus in the care of the patient after a DNR order, and care burden of patients with DNR. Decision-making of DNR occurred between physicians and family members, not the patients themselves. Often high medical expenses were involved in choosing DNR, thus if choosing DNR it was implied the family members and health professionals as well did not try their best to help the patient. Verbal DNR permission was more popular in clinical settings. Most nurses felt guilty and depressed about the dying/death of patients with DNR. CONCLUSION: Clearer guidelines on DNR, which reflect a family-oriented culture, need to be established to reduce confusion and to promote involvement in the decision-making process of DNR among nurses.

Quality of Life and Related Factors in Patients with Chronic Hepatitis B / 기본간호학회지

PURPOSE: This study aimed to investigate LDQOL (Liver Disease Quality of Life) and its related factors of patients with Hepatitis B. METHOD: A cross-sectional descriptive study. The LDQOL was formally translated to Korean and reliability was examined. One hundred thirty eight patients following gastroenterology outpatient clinic of S. hospital in Seoul, Korea participated. RESULTS: The mean age of the patients was 45.43 years and 87.7% were men. The mean score of LDQOL was 77.34, and mean scores of subscale were followed; symptom of liver disease (SxLD) (82.12), effect of liver disease (ELD) (25.50), concentration (Conc) (84.47), memory (Mem) (83.24), health discomfort, (HD) (75.18), sexual function (SFun) (75.71), sexual problem (SProb) (84.70), Loneliness (85.50), Hopeless (67.43), and stigma of liver disease (SLD) (91.64). Women had a lower LDQOL score for Loneliness (p=.034), and over 45 year-old patients had a lower LDQOL overall score (p=.000). Patients who were HBV carriers, or who had Chronic Hepatitis B or Liver Cirrhosis reported lower QOL respectively (p=.032). CONCLUSION: Although the liver disease itself seemed to be stable, patients with HBV experienced poor QOL in ELD, SProb, SFun, and Hopeless. Therefore nursing interventions in these aspects are needed.

Prevalence and Risk Factors of Fatty Liver among Industrial Male Workers / 재활간호학회지

PURPOSE: This Study was conducted to estimate the prevalence rate, and related factors,of fatty liver in male industrial workers. METHOD: Fatty liver was diagnosed using ultrasonography. The data for abdominal ultrasonography, BMI, smoking, alcohol drinking, exercise, liver enzymes, and lipid profiles were collected in 4,604 male who were examined with a health screening program in 2005. Prevalence rate and associated factors of fatty liver were analyzed using SPSS v. 12.0. RESULTS: Overall prevalence of fatty liver was 34.1% and higher in the 30-39 year male group. Age, body mass index(BMI), hypertriglyceridemia, hypercholesterolemia, HDL cholesterol, r-GTP level were independently associated factors with presence of fatty liver in logistic regression analysis. CONCLUSION: The prevalence of fatty liver and tendency of associated factors were similar to those in the western world. To prevent development of this hepatic disorder, which may result in end-stage liver disease, risk factors such as obesity and dyslipidemia must be monitored and controlled within normal levels. The results of this study suggested maintenance of a healthy lifestyle, including diet, exercise, and behavioral change, as fundamental rehabilitation nursing implications.

Illness Experience of People with Chronic Hepatitis B in Korea / 간호학회지

PURPOSE: The purpose of this study was to explore the experiences of people with chronic hepatitis B (CHB) in Korea. The specific aim was to identify major problems that people with CHB face and strategies that they are dealing with. METHODS: A grounded theory method was utilized. The data were collected by individual in-depth interviews from 12 CHB patients from one of the major hospitals in Korea. RESULTS: After constant comparative analysis, a core category emerged as "illness management with self-reliance and will." Seven major strategies that were identified in dealing with the illness were maintaining receptive and positive attitudes; restraining excessive work and greed; searching for information; controlling illness information; adhering to practices for not spreading the viral disease; abstaining from alcohol and smoking and maintaining healthy eating habits; nd using alternative therapies. The outcomes that result from employing these strategies were identified as burden, depression and helplessness, stress for maintaining compliance, and dispirited interpersonal relationships. CONCLUSION: The results of this study suggest that most people with CHB in Korea have problems in psychosocial area. Thus health professionals need to provide not only informational support but also emotional one to improve quality of life of the people with CHB.

Developing a Computerized Reminder System and Evaluating the Effects on the Improvemtent of Cancer Screening / 간호학회지

PURPOSE: This study was aimed to develop a computerized reminder system and evaluate it's effect in terms of percent age change of screening, and satisfaction. METHOD: It was conducted through 6 phases : Analyzing the job and defining the basic input data, developing the information system, collecting and inputting data, testing the system, working with the system, and evaluating it's effect. Participants were 787 people (female 30-69 years, and males 40-49 years) in 2 dong of Suyoung gu, Busan, who haven't had cancer screening for the stomach, breast, or cervix since Dec. 2000. There were three experimental groups: a letter; calling and calling after the letter reminder, and a non-equivalent control group. To determine whether services were obtained, a telephone survey was done after two months of follow-up. RESULT: A cancer screening information system with five DB modules was develped. Overall compliance with screening was not statistically significantly changedbefore and after applying computerized reminders for all three screening sites. Only 16% were satisfied with the reminder. CONCLUSION: This data didn't show that a reminder effort was effective of screening. However, because the evaluation interval was too short to find a difference in screening rate, we recommend additional longer prospective follow up studies.

The Effects of a Self-Help Empowerment Strategy Program on the Empowerment and Health Status of Rheumatoid Arthritis Patients / 성인간호학회지

PURPOSE: The purpose of this study was to examine the effects of a six week self-help empowerment strategy program on the empowerment status, pain intensity, physical function, joint flexibility and depression status in rheumatoid arthritis patients. METHOD: The subjects of the study consisted of a convenience sample thirteen rheumatoid arthritis patients. Data was collected from July to November, 2001. All patient received a self-help empowerment strategy program, once a week for six weeks. RESULT: After receiving the self-help empowerment strategy program, the empowerment status increased significantly, the pain intensity and the depression score decreased significantly and the level of physical function significantly improved but the flexibilities of shoulders, knees and ankles were not significantly changed. CONCLUSION: Further studies need to be done to determine the feasibility of implementing empowerment strategy and its possibility as an effective intervention program for decreasing pain intensity and depression score and improving the physical function.

Effects of changing position on cardiac output & on patient's discomforts after cardiac surgery / 기본간호학회지

Invasive hemodynamic monitoring has become a valuable assessment parameters in critical care nursing in patients undergoing open heart surgery patients. During cardiac surgery, the Swan Ganz catheter is placed in the pulmonary artery. Critical care nurses routinely obtain cardiac output, cardiac index, and pulmonary arterial pressure in these patients. Traditionally, patients are positioned flat and supine for cardiac output measurement. Numerous studies have dealt with the effects of changing position on the hemodynamic variables. However, there are a few studies dealing with patients who undergo cardiac surgery in Korea. Thus, the purpose of this study was to determine the effects of changing position on cardiac output, PAP, CVP, BP, HR and discomfort in patients after cardiac surgery. A sample of 21 adults who had CABG and/or valve replacement with Swan Ganz catheters in place was studied. The data were collected in the cardiac ICU of a university hospital in Seoul during the period from July 28, 1999 to August 30. 1999. In this study, the independent variable is patient position in the supine, 30 degree, and 45 degree angles. Dependent variables are C.O., C.I., CVP, PAP, MAP, HR and patients' perceived discomforts. Subject discomfort was measured subjectively by visual analogue scale. Other hemodynamic data where collected by the thermodilution method and by direct measurement. The data were analyzed by percentile, t-test, ANOVA, Linear regression analysis using SPSS-/WIN program. The results are as follows: 1) Changes in cardiac output were absent in different angle positions, 0, 30, 45 degrees(F=0.070,P=0.932). Changes in cardiac index were absent in different angle positions, 0. 30, 45 degrees(p>0.05). 2) Changes in central venous pressure were absent in differentangle positions, 0, 30, 45 degree(p>0.05). 3) PAP had no change in different angle 0, 30, 45 degree positions; systolic PAP(p>0.05), diastolic PAP(p>0.05). 4) Changes in systolic blood pressure were absent in different angle positions, 0, 30, 45 degree(p>0.05). 5) Changes in heart rates were absent in different angle positions, 0, 30, 45 degree(p>0.05). 6) Patients' perceived discomfort was absent in different angle positions, 0, 30, 45 degree(p<0.05). In conclusion, critical care nurses can measure C.O., C.I., PAP, BP, & CVP in cardiac surgery patients at 30 degree or 45 degree positions. This can improve the patients' comfort.