Association of Body Composition with Long-Term Survival inNon-metastatic Rectal Cancer Patients / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#We evaluated the association of body composition with long-term oncologic outcomes innon-metastatic rectal cancer patients. @*Materials and Methods@#We included 1,384 patients with stage(y)0-III rectal cancer treated at Asan Medical Centerbetween January 2005 and December 2012. Body composition at diagnosis was measuredusing abdomino-pelvic computed tomography (CT). Sarcopenia, visceral obesity (VO), andsarcopenic obesity (SO) were defined using CT measured parameters such as skeletal muscleindex (total abdominal muscle area, TAMA), visceral fat area (VFA), and VFA/TAMA. Inflammatorystatus was defined as a neutrophil-lymphocyte ratio of ! 3. Obesity was categorizedby body mass index (! 25 kg/m2). @*Results@#Among the 1,384 patients, 944 (68.2%) had sarcopenia and 307 (22.2%) had SO. The5-year overall survival (OS) rate was significantly lower in sarcopenic patients (no sarcopeniavs. sarcopenia; 84% vs. 78%, p=0.003) but the 5-year recurrence-free survival (RFS) ratewas not different (77.3% vs. 77.9% p=0.957). Patients with SO showed lower 5-year OS(79.1% vs. 75.5% p=0.02) but no difference in 5-year RFS (p=0.957). Sarcopenia, SO, VO,and obesity were not associated with RFS. However, obesity, SO, age, sex, inflammatorystatus, and tumor stage were confirmed as independent factors associated with OS on multivariateanalysis. In subgroup analysis, association of SO with OS was more prominent inpatients with (y)p stage 0-2 and no inflammatory status. @*Conclusion@#The presence of SO and a low body mass index at diagnosis are negatively associated withOS in non-metastatic rectal cancer patients.

Sub-brow blepharoplasty for simultaneous correction of dermatochalasis with upper eyelid hooding and sunken eyelids

Periorbital dermatochalasis with upper eyelid hooding, brow ptosis, and sunken eyelids may appear with age. Because classic blepharoplasty is unable to correct all these issues, we developed a single operation, which we present herein, to correct dermatochalasis accompanied by sunken eyelids. This sub-brow approach is used with simultaneous browpexy by fixing the orbital portion of the orbicularis oculi muscle (OOM) to the periosteum immediately above the supraorbital rim using sutures with 3 or 4 points of fixation and correcting sunken eyelids by burying the elevated dermis, fat, and OOM after de-epithelization in the lower flap of the sunken upper eyelid along the submuscular plane. This method enables the correction of sunken eyelids during the same operation without requiring an additional procedure, and offers the advantages of a shortened operation time and decreased cost. The presence of sunken eyelids in patients with dermatochalasis and severe lateral hooding may be corrected by the procedure described herein, thereby achieving periorbital rejuvenation while maintaining the original shape of the eyes.

Pulmonary aspiration during anesthetic induction in a patient with laparoscopic adjustable gastric band: A case report

Recently, the number of laparoscopic adjustable gastric banding surgery is increasing as is the number of patients with morbid obesity rapidly. However, no anesthetic management including preoperative fasting strategy for patients with laparoscopic adjustable gastric banding exists. Hereby, we report a case of a 22-year-old woman with laparoscopic adjustable gastric banding who suffered pulmonary aspiration during the anesthetic induction for appendectomy, despite a preoperative fasting period longer than 14 h. This case strongly suggests that guidelines for anesthetic management including the appropriate fasting period for patients with laparoscopic adjustable gastric banding are desperately required.

Influencing Factors on Practice of Healthcare-associated Infection Control among Clinical Nurses / 한국직업건강간호학회지

PURPOSE: The purpose of this study was to identify the factors influencing on practice of healthcare-associated infection control among clinical nurses. METHODS: The subject of this study were 118 nurses who worked in medical . surgical ward and ICU of 2 general hospital in Gwangju city. Data were collected with a questionnaire. Data were analysed using descriptive statistics, t-test, one-way ANOVA, Scheffe test, Pearson correlation and stepwise multiple regression analysis using SPSS/WIN 12.0. RESULTS: The major findings of this study were as follow: There were significant positive correlation between knowledge, recognition, empowerment and practice of healthcare-associated infection control. The significant factors influencing practice of healthcare-associated infection control were recognition and empowerment, which explained 68.8% of the practice of healthcare-associated infection control. CONCLUSION: These results indicate that recognition on healthcare-associated infection control and empowerment among clinical nurses should be reinforcement via consistent education, administrative and organizational support at the level of hospital.

Factors Influencing Burnout in Emergency Room Nurses / 한국직업건강간호학회지

PURPOSE: The study was done to identify the influences of violence experience and violence response on burnout of emergency room nurses. METHODS: The subjects of this study were 185 nurses who worked in emergency rooms of 3 university and 15 general hospitals. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Sheffe test, Pearson correlation coefficient and stepwise multiple regression analysis using SPSS version 12.0. RESULTS: The major findings of this study were as follow: There were significant differences in age, education, emergency room career, position, exercise in general characteristics. There were significant positive correlation between violence experience and burnout, violence response and burnout. The significant factors influencing burnout were job stress, verbal violence, violence preventive program. Shift pattern, which explained 28% of the burnout. CONCLUSION: It is necessary to develop an intervention program for emergency room nurses to improve job stress, verbal violence, violence preventive program. Shift pattern.

Factors Influencing Burnout in Emergency Room Nurses / 한국직업건강간호학회지

PURPOSE: The study was done to identify the influences of violence experience and violence response on burnout of emergency room nurses. METHODS: The subjects of this study were 185 nurses who worked in emergency rooms of 3 university and 15 general hospitals. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Sheffe test, Pearson correlation coefficient and stepwise multiple regression analysis using SPSS version 12.0. RESULTS: The major findings of this study were as follow: There were significant differences in age, education, emergency room career, position, exercise in general characteristics. There were significant positive correlation between violence experience and burnout, violence response and burnout. The significant factors influencing burnout were job stress, verbal violence, violence preventive program. Shift pattern, which explained 28% of the burnout. CONCLUSION: It is necessary to develop an intervention program for emergency room nurses to improve job stress, verbal violence, violence preventive program. Shift pattern.

Influencing Factors on Practice of Healthcare-associated Infection Control among Clinical Nurses / 산업간호학회지

PURPOSE: The purpose of this study was to identify the factors influencing on practice of healthcare-associated infection control among clinical nurses. METHODS: The subject of this study were 118 nurses who worked in medical . surgical ward and ICU of 2 general hospital in Gwangju city. Data were collected with a questionnaire. Data were analysed using descriptive statistics, t-test, one-way ANOVA, Scheffe test, Pearson correlation and stepwise multiple regression analysis using SPSS/WIN 12.0. RESULTS: The major findings of this study were as follow: There were significant positive correlation between knowledge, recognition, empowerment and practice of healthcare-associated infection control. The significant factors influencing practice of healthcare-associated infection control were recognition and empowerment, which explained 68.8% of the practice of healthcare-associated infection control. CONCLUSION: These results indicate that recognition on healthcare-associated infection control and empowerment among clinical nurses should be reinforcement via consistent education, administrative and organizational support at the level of hospital.

KR-31543 reduces the production of proinflammatory molecules in human endothelial cells and monocytes and attenuates atherosclerosis in mouse model

KR-31543, (2S, 3R, 4S)-6-amino-4-[N-(4-chlorophenyl)-N-(2-methyl-2H-tetrazol-5-ylmethyl) amino]-3,4-dihydro-2-dimethyoxymethyl-3-hydroxy-2-methyl-2H-1-benz opyran is a new neuroprotective agent for ischemia-reperfusion damage. It has also been reported that KR-31543 has protective effects on lipid peroxidation and H2O2-induced reactive oxygen species production. In this study, we investigated the anti-inflammatory and anti-atherogenic properties of KR-31543. We observed that KR-31543 treatment reduced the production of MCP-1, IL-8, and VCAM-1 in HUVECs, and of MCP-1 and IL-6 in THP-1 human monocytes. We also examined the effect of KR-31543 on monocytes migration in vitro. KR-31543 treatment effectively reduced the migration of THP-1 human monocytes to the HUVEC monolayer in a dose-dependent manner. We next examined the effects of this compound on atherogenesis in LDL receptor deficient (Ldlr-/-) mice. After 10 weeks of western diet, the formation of atherosclerotic lesion in aorta was reduced in the KR-31543-treated group compared to the control group. The accumulation of macrophages in lesion was also reduced in KR-31543 treated group. However, the plasma levels of total cholesterol, HDL, LDL, and triglyceride were not affected by KR-31543 treatment. Taken together, these results show that KR-31543 has anti-inflammatory properties on human monocytes and endothelial cells, and inhibits fatty streak lesion formation in mouse model of atherosclerosis, suggesting the potential of KR-31543 for the treatment for atherosclerosis.

The Effects of Respiratory Rehabilitation Training on Respiratory Functions of Cervical Spinal Cord Injury Patients / 재활간호학회지

PURPOSE: This study was to investigate the effects of respiratory rehabilitation training on the respiratory functions of hospitalized cervical spinal cord injury patients. METHODS: One group pre and post test design was used. Subjects were 20 cervical spinal cord injury inpatients of the national rehabilitation center. Training program consisted of air cumulation training, manual assisted coughing training, and abdominal breathing. Trained rehabilitation nurse implemented 20 minutes program twice a day for 4 weeks. Respiratory function was measured as peak coughing flow rate, and perceived respiratory difficulty after activity on wheel chair for 30 minutes and during speaking and singing. Perceived respiratory difficulty was measured with modified Borg scale. Also content analysis was done with the result of open ended question about subjective feeling about training. All variables were measured 3 times before, 2weeks and 4 weeks after the program. RESULTS: Peak coughing flow rate significantly improved after compared to before training. Also all three perceived respiratory difficulty variables decreased significantly after training. In the content analysis, 'it's easier to cough up phlegm' was the most frequent answered subjective feeling. 'Sound at speaking and coughing became louder', 'respiratory volume increased', and 'comfortable chest feeling' were frequent answered subjective feeling, in order. CONCLUSION: Although it is preliminary since no control group, respiratory rehabilitation training was found to be effective to improve respiratory function in terms of peak coughing flow rate, perceived respiratory difficulty, and subjective feeling. It is necessary further systemic research to investigate the effects of respiratory rehabilitation training.

Effects of Ginsenosides on Relaxation of Rabbit Vaginal Smooth Muscle / 대한남성과학회지

PURPOSE: Ginseng has been used throughout the Far East, including Korea and China, as a tonic and restorative agent to maintain physical vitality. The main pharmacoactive molecules of ginseng are ginsenosides. The present study was designed to investigate whether ginsenosides relax rabbit vaginal smooth muscle and whether this effect is modulated by nitric oxide(NO) and the cGMP pathway. MATERIALS AND METHODS: Strips of rabbit vagina were mounted in organ chambers to measure isometric tension. The strips were contracted with phenylephrine(5 X 10(-5) M), and the responses to acetylcholine, nitric oxide inhibitor, and ginsenosides were examined. The cGMP content of the strips was measured by radioimmunoassay after various doses of ginsenosides. RESULTS: Ginsenosides(100~500microgram/mL) relaxed vaginal smooth muscle in a dose-dependent manner(5~25%). Acetylcholine-induced relaxation was significantly increased in the presence of ginsenosides(100, 200microgram/mL)(p0.05). Ginsenosides(400microgram/mL for 7 min) increased the accumulation of cGMP. CONCLUSIONS: These data suggest that ginsenosides have a relaxing effect on rabbit vaginal smooth muscle. This effect is at least in part mediated by the NO-cGMP pathway.

A Case of Leiomyoma of the Auricle

Leiomyoma is benign neoplasm of smooth muscle origin, which generally originate in gastrointestinal and female genital tract. Within head and neck, the common sites are the cervical esophagus and/or oral cavity. Their occurrence in the ear is extremely rare. There have been reported less than ten cases of leiomyomas of auricle in the world and can not be found in the Korean literature. Leiomyoma arising from auricle is classifed into two types, one from the erector pilar muscle and the other from the muscular coats of blood vessel. We present a case of leiomyoma in scapha of the ear. This benign tumor was treated by complete excision. This tumor was small, round, firm, solitary and microscopically well-encapsulated. The clinical and pathologic findings of auricular leiomyoma were described.

Treatment of Calcinosis Cutis: Cases and Review

Despite the careful regulation of serum calcium, calcification of cutaneous and subcutaneous tissues may occur. Calcification is the deposition of insoluble calcium salts; when it occurs in cutaneous tissues, it is known as calcinosis cutis. Calcinosis cutis is classified into four types: metastatic calcinosis cutis, dystrophic calcinosis cutis, idiopathic calcinosis cutis, and subepidermal calcified nodule. From January 2000 to May 2001, we have experienced 3 patients with calcinosis cutis. Two cases were dystrophic calcinosis cutis associated with radiation therapy and old burn scar with complications of delayed wound healing after punch biopsy, despite of conservative treatment for several weeks. Another was idiopathic calcinosis cutis. We performed surgical treatments in all cases: wide excision and pectoralis major muscle rotational flap coverage, wide excision and split-thickness skin graft, and excision and direct closure. No patients experienced wound healing problems. We believed surgical excision and appropriate reconstruction procedure is an effective theraphy in localized or ulcerated and chronic infected calcinosis cutis.

In Vivo Biodegradability of PLLA and PLGA Sponge using Non-toxic Effevescent as a Porogen Additive

In many tissue engineering application, highly open porous scaffolds are required for efficient cell seeding and culture. Synthetic biodegradable polymers such as poly (L-lactic acid)(PLLA) and its copolymers with D-lactic and glycolic acids(PLGA) are widely used as a porous scaffold. The suitable biodegradability and dimensional stability of porous scaffolds during in vivo implantation play an important role in tissue engineering application. In this study, we investigated in vivo biodegradation and dimensional stability of acellular porous polymer scaffolds prepared by using a gas foaming technique with non-toxic effervescent mixture. In addition, we have engineered cartilage tissue 3D cultured on PLGA scaffolds in nude mouse in order to compare with degradation and deformation on acellular porous polymer scaffolds and to form tissue-engineered cartilage tissue. Sodium bicarbonate and citric acid crystals were used as an effervescent mixture. These particles were milled and sieved to yield various range of sizes(50 - 100, 100 - 300, and > 300 micrometer). After polymer scaffolds fabricated, biodegradation test was performed in subcutaneous tissue of male rats during 12 weeks. Degradability of polymer scaffolds were evaluated by weight difference, gel permeation chromatography(GPC), and SEM as each period. Tissue-engineered cartilage by transplanting 3D cultured chondrocytes onto PLGA 85:15 scaffolds in nude mouse was also made and compared with acellular scaffolds. In conclusion, highly open porous biodegradable scaffolds are prepared by gas foaming method using sodium bicarbonate and citric acid as a non-toxic effervescent mixture. Furthermore, tissue-engineered cartilage formation by in vivo 3D culture onto modified PLGA scaffolds in nude mouse was significantly improved as compared to controls.

KR 31378, a potent antioxidant, inhibits apoptotic death of A7r5 cells

This work describes the pharmacological inhibition by KR 31378 and its acetyl metabolite, KR 31612, of the apoptotic cell death induced by H2O2 in the A7r5 cells. Exposure of A7r5 cells to H2O2 (0.5 mM) induced a concentration-dependent cytotoxicity in association with oligonucleosomal DNA fragmentation. H2O2-induced cell death was potently suppressed by KR 31378, KR 31612, alpha-tocopherol or trolox. Additionally, the apoptotic death of A7r5 cells (DNA ladders on electrophoresis) was also strongly suppressed by KR 31378 and KR 31612, but to a less degree by alpha-tocopherol and trolox. As a mechanistic study, incubation with H2O2 markedly showed a decreased Bcl-2 level and, in contrast, increased Bax protein and cytochrome C release, which were significantly and concentration-dependently reversed by KR 31378 and KR 31612 as well as by alpha-tocopherol and trolox. KR 31378 and alpha-tocopherol significantly reduced lipid peroxidation in accordance with reduced intracellular ROS and peroxyl radical. These results suggest that KR 31378 has a therapeutic potential against the apoptotic injury via mediation of antioxidative stress.

A Case of Malignant Clear Cell Hidradenoma

Malignant clear cell hidradenoma is a rare eccrine gland malignancy characterized by a solitary nodule on the head, trunk or distal extremity. We report a case of malignant clear cell hidradenoma in the left sole of a 66 year old female patient. Despite wide resection, regional lymph node dissection and radiation therapy, wide spread regional invasion and multiple distant metastasis were developed. As the malignant clear cell hidradenoma is reported rarely in the world and not yet reported in Korea, we report its clinical process of the diagnosis and treatment to patient's death.

The Effect of CD18 Monoclonal Antibody on Tissue and Serum Interleukin-8 Concentration in Reperfusion Injury

It remains a problem that successful revascularization and reperfusion after ischemia are associated with high systemic complication rates and severe local tissue injuries. With prolonged ischemia, there is damage to tissue from anoxia, but further injury may occur after reperfusion. The activation of leukocytes and endothelial cells during reperfusion causes neutrophil adhesion in capillaries, resulting in plugging and further ischemia, Alternativety, neutrophil adhesion to endothelium leads to the migration of neutrophil with local edema formation, hemorrhage and thrombosis. Some chemotactic and activating factors are needed to propel neutrophils to the site of local inflammation. The chief cytikines that induce a pro-adhesive state in endothelium are tumor necrosis factor-alpha(TNF-alpha), interleukin-1 beta(IL-1 beta) and endotoxin or lipopolysaccharide(LPS). Similarly, TNF-alpha,and to a lesser extent interleukin-8(IL-8), is the important stimulus that acts on neutrophils and other leukocytes to alter their adhesion. The purpose of this study was to evaluate the pathogenetic role of IL-8 after perfusion with CDl8 monoclonal antibody(CDl8 mAb), the blocking antibody of neutrophil adherence, on reperfusion injury in rat epigastric island skin flap. A 6 X 3 cm-sized island skin flap was made on the abdomen. The epigastric pedicle was occluded for six hours with ambient temperature. Fifteen minutes before reperfusion, the flap was perfused with saline and CDl8 mAb(1 mg/kg). For evaluation of IL-8 levels, tissue fluid and serum were obtained at 4, 8, 12 and 24 hours after reperfusion. IL-8 concentrations of the CDl8 mAb group in the tissue fluid were significantly decreased at 8, 12 and 24 hours compared to the control group(P > 0.01), but the difference between the two groups was not significant at 4 hours after reperfusion IL-8 concentrations of the CDl8 mAb group in the serum were significantly decreased over time compared to the control group(P > 0.05, p > 0.01). Form the above results, we concluded that blocking neutrophil adherence using CD18 mAb within the peak level of IL-8 at 4 hours after reperfusion may be a better method of reducing reperfusion injury to the island skin flap.