γδ T cells are a rare and unique prototype of T cells that share properties with natural killer cells in secondary lymphoid organs. Although many studies have revealed the function and importance of adult-derived γδ T cells in cancer biology and regenerative medicine, the low numbers of these cells hamper their application as therapeutic cell sources in the clinic. To solve this problem, pluripotent stem cell-derived γδ T cells are considered alternative cell sources; however, few studies have reported the generation of human pluripotent stem cell-derived γδ T cells. In the present study, we investigated whether lymphoid lineage γδ T cells were successfully generated from human pluripotent stem cells via hemogenic endothelium under defined culture conditions. Our results revealed that pluripotent stem cells successfully generated γδ T cells with an overall increase in transcriptional activity of lymphoid lineage genes and cytolytic factors, indicating the importance of the optimization of culture conditions in generating lymphoid lineage γδ T cells. We uncovered an initial step in differentiating γδ T cells that could be applied to basic and translational investigations in the field of cancer biology. Based on our result, we will develop an appropriate method to purify γδ T cells with functionality and it helpful for the study of basic mechanism of γδ T cells in pathophysiologic condition as well as clinic application.

This study presents the development and validation of a risk assessment program of highly pathogenic avian influenza (HPAI). This program was developed by the Korean government (Animal and Plant Quarantine Agency) and a private corporation (Korea Telecom, KT), using a national database (Korean animal health integrated system, KAHIS).

PURPOSE: We evaluated the effects of a pubovaginal sling (PVS), with a Martius labial fat pad interposition (MLFI), on patients with a female urethral diverticulum. MATERIALS AND METHODS: 23 consecutive cases with a female urethral diverticulum were retrospectively reviewed. The pre-operative evaluations included the history, physical examination, voiding cystourethrogram, cystoscopy, transperineal ultrasound and urodynamic studies to investigate the urethral function and the concomitant stress urinary incontinence. The treatment consisted of a transvaginal diverticulectomy alone, or with a PVS only, or combined with a MLFI. RESULTS: A transvaginal diverticulectomy only was performed, using a 3-layer closure, in nine patients (39.1%) and a concomitant PVS with a diverticulectomy in eight (34.8%) with stress urinary incontinence. A MLFI, combined with the above procedure, was performed in six patients (26.1%) with large defects of the urethra following the resection of diverticulum. No women having undergone a diverticulectomy with, or without, a PVS and MLFI had an urethrovaginal fistula, recurrent diverticulum or postoperative incontinence. CONCLUSIONS: In complicated cases, a simultaneous transvaginal diverticulectomy, pubovaginal sling and Martius labial fat pad interposition can be performed safely and effectively.
Adipose Tissue* ; Cystoscopy ; Diverticulum ; Female* ; Fistula ; Humans ; Physical Examination ; Retrospective Studies ; Ultrasonography ; Urethra ; Urinary Incontinence ; Urodynamics

PURPOSE: This study aimed to determine the appropriate stimulus strength that could result in a positive effect on the ankle joint spasticity when patients with chronic stroke performed whole body vibration (WBV) exercise. METHODS: Among 72 patients who were diagnosed with stroke at least 6 months ago, those able to perform a half squat pose with ambulation issues due to ankle joint spasticity (modified Ashworth scale, MAS≥2) were included for analysis. Individuals participated in four different frequencies of vertical WBV exercise; 0 Hz, 10 Hz, 20 Hz, and 30 Hz. Vibration amplitude was 3-4 mm and 5 minutes WBV exercise was performed at each frequency, followed by a measurement after 2-minute rest. We assigned 18 individuals to each frequency and asked them to participate in the WBV exercise once every 3 weeks. The level of spasticity was evaluated by visual analogue scale (VAS) for self-assessment. The myoton PRO was utilized to objectively evaluate the level of spasticity and check the muscle tone and stiffness. RESULTS: Participants showed 0 Hz VAS was a significant difference between 20 Hz application conditions (p < 0.05). Muscle tone was significantly different at 0 Hz between 20 Hz, and 30 Hz (p < 0.05), significantly difference at 10 Hz between 30 Hz (p < 0.05). Muscle stiffness significantly difference at 0 Hz between 20 Hz, and 30 Hz (p < 0.05), significantly difference at 10 Hz between 20 Hz, and 30 Hz (p < 0.05). CONCLUSION: Findings of this study show that the frequency of more than 20 Hz was effective in improving the ambulatory ability in patients with chronic stroke. Currently, the effective WBV protocol is limited. Hence, this study was designed to suggest an effective WBV protocol to improve neuromodulation ability for chronic stroke patients.
Ankle Joint* ; Ankle* ; Humans ; Muscle Spasticity* ; Self-Assessment ; Stroke* ; Vibration* ; Walking

Purpose: The study aimed to design and develop an automated personalized self-care (APSC) program for patients with type 2 diabetes mellitus. The secondary aim was to present a clinical protocol as a mixed-method research to test the program effects. Methods: The APSC program was developed in the order of analysis, design, implementation, and evaluation according to the software development life cycle, and was guided by the self-regulatory theory. The content validity, heuristics, and usability of the program were verified by experts and patients with type 2 diabetes mellitus. Results: The APSC program was developed based on goal setting, education, monitoring, and feedback components corresponding to the phases of forethought, performance/volitional control, and self-reflection of self-regulatory theory. Using the mobile application, the participants are able to learn from educational materials, monitor their health behaviors, receive weekly-automated personalized goals and feedback messages, and use an automated conversation system to solve the problems related to self-care. The ongoing two-year study utilizes a mixed method design, with 180 patients having type 2 diabetes mellitus randomized to receive either the intervention or usual care. The participants will be reviewed for self-care self-efficacy, health behaviors, and health outcomes at 6, 12, 18, and 24 months. Participants in the intervention group will be interviewed about their experiences. Conclusion The APSC program can serve as an effective tool for facilitating diabetes health behaviors by improving patients’ self-care self-efficacy and self-regulation for self-care. However, the clinical effectiveness of this program requires further investigation.

Purpose: Preventing diabetic complications involves regular outpatient follow-up and maintaining low variability in hemoglobin A1c (HbA1c) levels. This study investigated the factors associated with diabetic complications, with a specific focus on the impact of regular outpatient follow-up and HbA1c variability, among patients with type 2 diabetes. Methods: The study design was secondary data analysis of electronic medical records from a university hospital in Korea. It included patients aged 40–79 with type 2 diabetes who were prescribed diabetes medication within three months of their first HbA1c test by an endocrinologist and were followed up for at least five years. Follow-up regularity, adjusted standard deviation of HbA1c levels, and diabetic complication indices were collected. Data were analyzed using the Chi-square test, independent t-test, repeated measures analysis of variance, and multiple regression analysis. Results: The study included 1566 patients. Lower follow-up regularity was observed in patients of older age, with comorbidities, diabetic complications, insulin treatment, a history of hospitalization, lower baseline estimated glomerular filtration rate (eGFR) and total cholesterol (TC), and higher HbA1c variability. Higher HbA1c variability was observed in younger patients without comorbidity but with insulin treatment, a history of hospitalization, higher baseline blood glucose (BG), HbA1c, TC, and triglyceride levels. HbA1c variability had the strongest influence on BG and HbA1c levels at the five-year follow-up. Baseline eGFR and TC were the most influential factors for their respective levels at the five-year follow-up. Follow-up regularity significantly affected BG, HbA1c, eGFR, and TC at five-year follow-up. Conclusions It has been shown that several variables besides regular follow-up and HbA1c variability have an influence. However, these are the two that can be corrected through nursing intervention and are important, so intervention on these is important.

Purpose: This study aimed to determine the consistency of 1-day and 3-day average dietary intake using the 24-hour diet recall method and to investigate the relationship of diet intake with physiological indicators potentially associated with diabetic complications in patients with diabetes. Methods: This study conducted a secondary data analysis using pretest data of a nursing intervention study entitled “Development of deep learning based AI coaching program for diabetic patients with high risk and examination of its effects (PNUH, IRB No. 05-2021-030).” Data were analyzed through descriptive analysis, one-way repeated-measures analysis of variance, and Pearson correlation coefficients using SPSS 26.0. Results: The average total daily calorie intake over 3 days was 1,494.48±436.47 kcal/day: 1,510.90±547.76 kcal/day on the first day, 1,414.22±527.58 kcal/day on the second day, 1,558.34±645.83 kcal/day on the third day, showing significant differences (F=3.59, p=.031). The correlation coefficient between the 1-day and 3-day average dietary intake was 0.41–0.77 for each nutrient and 0.62–0.80 for each food group. Vegetable intake showed negative correlations with body mass index (BMI; r=-.19, p=.023) and triglycerides (r=-.18, p=.036), whereas dairy intake was positively associated with low-density lipoprotein-cholesterol (LDL; r=-0.18, p=.034) and triglycerides (r=.40, p<.001). Conclusion This study demonstrated that 1-day dietary intake was highly correlated with 3-day average dietary intake using the 24-hour diet recall method. Food groups showed significant associations with physiological indicators of potential diabetic complications such as BMI, triglycerides, and LDL levels. Further studies are needed to improve the knowledge base on the relationships between physiological indicators and food groups.

OBJECTIVES: Study purpose was to investigate perception on diet, diet problems and related factors among young adult women using focus group interviews (FGI) based on the Social Cognitive Theory (SCT). METHODS: Eight groups of FGI were conducted with 47 female undergraduate or graduate students. Guide for FGI included questions regarding perception on optimal diet, diet problems and cognitive, behavioral, and environmental factors of SCT. FGI were video, audio-taped, transcribed and analyzed by themes and sub-themes. RESULTS: Subjects showed irregular eating habits (skipping breakfast, irregular meal time) and selection of unhealthy foods as the main diet problems. Regarding cognitive factors related to optimal diet, subjects mentioned positive outcome expectations (e.g., health promotion, skin health, improvement in eating habits, etc.) and negative outcome expectations (e.g., annoying, hungry, expensive, taste). Factors that promoted optimal diet were mainly received from information from mobile or internet and access to menu or recipes. Factors that prevented optimal diet included influence from friends, lack of time and cooking skills. Behavioral factors for optimal diet included behavioral capability regarding snacks, healthy eating and smart food selection. Subjects mentioned mass media (mobile, internet, TV) as the influential physical environment, and significant others (parents, friends, grandparents) as the influential social environment in optimal diet. For education topics, subjects wanted to learn about healthy meals, basic nutrition, disease and nutrition, and weight control. They wanted to learn those aspects by using mobile or internet, lectures (cooking classes), campaign and events. CONCLUSIONS: Study results might be used for planning education regarding optimal diet for young adult women. Education programs need to focus on increasing positive outcome expectations (e.g., health) and behavioral capability for healthy eating and food selection, reducing negative outcome expectations (e.g., cost, taste) and barriers, making supportive environments for optimal diet, and incorporating topics and methods found in this study.
Breakfast ; Cooking ; Diet* ; Eating ; Education ; Female ; Focus Groups* ; Food Preferences ; Friends ; Health Promotion ; Humans ; Internet ; Lectures ; Mass Media ; Meals ; Skin ; Snacks ; Social Environment ; Young Adult*

The enhanced primary care demonstration (EPD) was launched in November 2014 to provide high-quality care for people with chronic illnesses. In the EPD, comprehensive assessment and care planning (CAP) is a critical component, along with behavior modification and case management services. In this study, we measured CAP duration and calculated the fee for CAP sessions performed with patients with hypertension and/or diabetes mellitus. In 5 primary care clinics participating in the EPD, the duration of CAP sessions and usual consultations was measured. The duration of CAP sessions was measured on 2 separate occasions because CAP involves 2 separate consultations, including an initial consultation for comprehensive patient assessment and laboratory testing and a follow-up consultation for creating a care plan based on the assessment and test results. The CAP fee was calculated as the ratio of CAP time to the usual consultation time. The median (interquartile range) and the mean ± standard deviation of CAP duration were 15.4 (7.1) minutes and 15.6 ± 4.2 minutes, respectively. The first and second CAP sessions lasted for 5.3 and 4.6 times longer than usual consultations, respectively. The calculated CAP fees were 76,299 won (median) and 65,766 won (mean). The length of CAP sessions for patients with hypertension and/or diabetes mellitus was approximately 5 times longer than that of usual consultations. If consultation lengths were measured in a representative patient sample, it would be possible to improve the external validity of the measurements.
Behavior Therapy ; Case Management ; Chronic Disease ; Diabetes Mellitus ; Diagnosis ; Fees and Charges* ; Fees, Medical ; Follow-Up Studies ; Humans ; Hypertension* ; Patient Care Planning ; Primary Health Care* ; Referral and Consultation

The enhanced primary care demonstration (EPD) was launched in November 2014 to provide high-quality care for people with chronic illnesses. In the EPD, comprehensive assessment and care planning (CAP) is a critical component, along with behavior modification and case management services. In this study, we measured CAP duration and calculated the fee for CAP sessions performed with patients with hypertension and/or diabetes mellitus. In 5 primary care clinics participating in the EPD, the duration of CAP sessions and usual consultations was measured. The duration of CAP sessions was measured on 2 separate occasions because CAP involves 2 separate consultations, including an initial consultation for comprehensive patient assessment and laboratory testing and a follow-up consultation for creating a care plan based on the assessment and test results. The CAP fee was calculated as the ratio of CAP time to the usual consultation time. The median (interquartile range) and the mean ± standard deviation of CAP duration were 15.4 (7.1) minutes and 15.6 ± 4.2 minutes, respectively. The first and second CAP sessions lasted for 5.3 and 4.6 times longer than usual consultations, respectively. The calculated CAP fees were 76,299 won (median) and 65,766 won (mean). The length of CAP sessions for patients with hypertension and/or diabetes mellitus was approximately 5 times longer than that of usual consultations. If consultation lengths were measured in a representative patient sample, it would be possible to improve the external validity of the measurements.
Behavior Therapy ; Case Management ; Chronic Disease ; Diabetes Mellitus ; Diagnosis ; Fees and Charges* ; Fees, Medical ; Follow-Up Studies ; Humans ; Hypertension* ; Patient Care Planning ; Primary Health Care* ; Referral and Consultation