Stem cell therapy in pain medicine / 대한통증학회지

Stem cells are attracting attention as a key element in future medicine, satisfying the desire to live a healthier life with the possibility that they can regenerate tissue damaged or degenerated by disease or aging. Stem cells are defined as undifferentiated cells that have the ability to replicate and differentiate themselves into various tissues cells. Stem cells, commonly encountered in clinical or preclinical stages, are largely classified into embryonic, adult, and induced pluripotent stem cells. Recently, stem cell transplantation has been frequently applied to the treatment of pain as an alternative or promising approach for the treatment of severe osteoarthritis, neuropathic pain, and intractable musculoskeletal pain which do not respond to conventional medicine. The main idea of applying stem cells to neuropathic pain is based on the ability of stem cells to release neurotrophic factors, along with providing a cellular source for replacing the injured neural cells, making them ideal candidates for modulating and possibly reversing intractable neuropathic pain. Even though various differentiation capacities of stem cells are reported, there is not enough knowledge and technique to control the differentiation into desired tissues in vivo. Even though the use of stem cells is still in the very early stages of clinical use and raises complicated ethical problems, the future of stem cells therapies is very bright with the help of accumulating evidence and technology.

Hypometabolism based on a cutoff point on the mini-mental state examination in Parkinson’s disease

Objective: The aim of the present study was to evaluate cortical hypometabolism of the F-18- fluorodeoxyglucose positron emission tomography (FDG-PET) based on a diagnostic cutoff point of the mini-mental state examination (MMSE) in de novo PD.Methods: We recruited 24 PD patients and 15 healthy controls to analyze FDG-PET. We divided the patients into two groups by the diagnostic cutoff point of MMSE for diagnosing dementia, with scores of>25 vs. 25. Compared to healthy controls, patients with a MMSE> 25 and 25 and < 25 was found in the right inferior parietal lobule. Conclusions: In the comparison by cutoff point of MMSE (25/24), hypometabolism in the right inferior parietal lobule suggests that the posterior cortical deficit is the main region ofde novo PD with cognitive impairment. Hypometabolism of right inferior parietal lobule is related to the damage of cerebral networkin de novo PD.

Relationship Between Organizational Communication Satisfaction and Organizational Commitment among Hospital Nurses / 간호행정학회지

PURPOSE: This study was done to analyze the relationship between organizational communication satisfaction and organizational commitment among hospital nurses. METHOD: A survey was conducted with 647 nurses who were working in 24 hospitals in Korea. Data were collected during August 2010. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation analysis, and multiple regression. RESULTS: The mean level of organizational communication satisfaction was 3.15 (min 1.88 -max 4.88) and the mean level of organizational commitment was 3.21 (min 1.33 - max 4.83). There was a statistically significant correlation between organizational communication satisfaction and organizational commitment (r=. 655). According to analysis of the impact of the subconstructions of organizational communication satisfaction on organizational commitment, the following factors had significant influence on organizational communication satisfaction: vertical communication, communication media, and organizational climate. CONCLUSION: These findings showed that communication satisfaction was the most important factor for nurses' organizational commitment. Therefore, there is a need to develop communication strategies and skills for hospital nurses to increase the level of communication satisfaction.

Time Resolution Improvement of MRI Temperature Monitoring Using Keyhole Method

PURPOSE: This study proposes the keyhole method in order to improve the time resolution of the proton resonance frequency(PRF) MR temperature monitoring technique. The values of Root Mean Square (RMS) error of measured temperature value and Signal-to-Noise Ratio(SNR) obtained from the keyhole and full phase encoded temperature images were compared. MATERIALS AND METHODS: The PRF method combined with GRE sequence was used to get MR temperature images using a clinical 1.5T MR scanner. It was conducted on the tissue-mimic 2% agarose gel phantom and swine's hock tissue. A MR compatible coaxial slot antenna driven by microwave power generator at 2.45GHz was used to heat the object in the magnetic bore for 5 minutes followed by a sequential acquisition of MR raw data during 10 minutes of cooling period. The acquired raw data were transferred to PC after then the keyhole images were reconstructed by taking the central part of K-space data with 128, 64, 32 and 16 phase encoding lines while the remaining peripheral parts were taken from the 1st reference raw data. The RMS errors were compared with the 256 full encoded self-reference temperature image while the SNR values were compared with the zero filling images. RESULTS: As phase encoding number at the center part on the keyhole temperature images decreased to 128, 64, 32 and 16, the RMS errors of the measured temperature increased to 0.538, 0.712, 0.768 and 0.845degrees C, meanwhile SNR values were maintained as the phase encoding number of keyhole part is reduced. CONCLUSION: This study shows that the keyhole technique is successfully applied to temperature monitoring procedure to increases the temporal resolution by standardizing the matrix size, thus maintained the SNR values. In future, it is expected to implement the MR real time thermal imaging using keyhole method which is able to reduce the scan time with minimal thermal variations.

Effects of Weight Control Program on Body Weight and the Sense of Efficacy for Control of Dietary Behavior of Psychiatric Inpatients / 간호학회지

PURPOSE: This study was designed to examine the effects of a weight control program on body weight and the sense of efficacy for control of dietary behavior in psychiatric inpatients. METHODS: A quasi-experimental design was used. Data were collected from March 1 to September 30, 2007. Female mentally ill patients in closing psychiatry ward of H University Hospital participated in the study (16 persons in the experimental group and 13 in the control group). RESULTS: The weight control program including diet therapy, exercise, education and behavior modification therapy decreased the rate of weight gain in female mentally ill patients taking atypical antipsychotics, and effectively increased a sense of efficacy for control of dietary behavior. CONCLUSION: Weight control program had a positive effect as a nursing intervention to decrease obesity and to increase the sense of efficacy for control of dietary behavior of psychiatric inpatients in psychiatric inpatients.

Preliminary Study on the MR Temperature Mapping using Center Array-Sequencing Phase Unwrapping Algorithm

PURPOSE: To investigate the feasibility and accuracy of Proton Resonance Frequency (PRF) shift based magnetic resonance (MR) temperature mapping utilizing the selfdeveloped center array-sequencing phase unwrapping (PU) method for non-invasive temperature monitoring. MATERIALS AND METHODS: The computer simulation was done on the PU algorithm for performance evaluation before further application to MR thermometry. The MR experiments were conducted in two approaches namely PU experiment, and temperature mapping experiment based on the PU technique with all the image postprocessing implemented in MATLAB. A 1.5T MR scanner employing a knee coil with T2* GRE (Gradient Recalled Echo) pulse sequence were used throughout the experiments. Various subjects such as water phantom, orange, and agarose gel phantom were used for the assessment of the self-developed PU algorithm. The MR temperature mapping experiment was initially attempted on the agarose gel phantom only with the application of a custom-made thermoregulating water pump as the heating source. Heat was generated to the phantom via hot water circulation whilst temperature variation was observed with T-type thermocouple. The PU program was implemented on the reconstructed wrapped phase images prior to map the temperature distribution of subjects. As the temperature change is directly proportional to the phase difference map, the absolute temperature could be estimated from the summation of the computed temperature difference with the measured ambient temperature of subjects. RESULTS: The PU technique successfully recovered and removed the phase wrapping artifacts on MR phase images with various subjects by producing a smooth and continuous phase map thus producing a more reliable temperature map. CONCLUSION: This work presented a rapid, and robust self-developed center arraysequencing PU algorithm feasible for the application of MR temperature mapping according to the PRF phase shift property.

Septic Hip in a Child due to H.influenzae: Problems with a Recent Experience / 대한정형외과학회잡지

We report a case of acute septic arthritis of the hip in a child due to H. influenzae with review of the problems encountered. A one year and 9 months-old male child was admitted because of fever, limping and restlessness of 48-hour duration. Under the impression of septic arthritis of the right hip, blind broad-spectrum antibiotic regimen was initially instituted. Fever subsided immediately and two blood cultures yielded no growth, as did joint tapping. But fever recurred on the 8th day of admission. MRI demonstrated fluid collection in the right hip. Arthrotomy yielded thin pus. The antibiotic regimen was shifted to vancomycin, according to the culture report of S. aureus. However, spiking fever continued. On the 4th week of admission, recheck MRI demonstrated fluid collection in and out of the hip joint. A second arthrotomy yielded frank pus. H. influenzae was reported in pus culture for the first time, being susceptive only to chloramphenicol. Fever was down to normal temperature after injection of urfamycin. Radiograph on the 17th day after the 2nd arthrotomy revealed posterior dislocation of the right hip. MRI demonstrated granulation tissue within the acetabulum. Open reduction confirmed granulation tissue without pus. This case suggests: 1. Routine blind antibiotic regimen for gram-positive and negative organisms in the initial phase of treatment may fail in the rare case of H. influenzae. This may lead the surgeon to miss the optimum time of surgical intervention despite early diagnosis, 2. Arthrotomy may fail if not followed by antibiotics sensitive to the pathogen. 3. Delayed pathologic dislocation may ensue due to invasion of granulation tissue.

Two-Stage Reimplantation for the Treatment of Infected Total Knee Arthroplasty / 대한정형외과학회잡지

Deep infection following arthroplasty of the knee is a serious complication resulting in pain, discharge and loss of function. The incidence of deep infection ranges from 1% to 2% in a majority of reported series. There are several options for treatment of infected total knee arthroplasty: (1) antibiotic suppression, (2) debridement, (3) resection arthroplasty, (4) reimplantation, (5) arthrodesis, (6) amputation. Among them, recent reports have favored a two-staged regimen exchanging the prosthesis in an infected knee by using an antibiotic impregnated cement spacer. The result of our study support this option for treatment. We have experienced 14 cases of two-staged reimplantation in infected total knee arthroplasty, diagnosed according to the criteria described by Bengstons and followed up for more than two years. The average interval from prosthesis removal to revision was 6.85 weeks. Prior to revision, the average knee score was 50 points, and the average range of motion was 74 degree. After revision, the average knee score was 81 points. The average range of motion was 95 degree. Our protocol for the treatment successfully eradicated the deep infection in 13 patients, only a patients who had severe rheumatoid arthritis was the sole documented case of reinfection.