The effects of C-phycocyanin (C-pc), a phycobiliprotein, on the expression of pro-fibrotic mediators in hyper-tropic scarring such as connective tissue growth factor (CTGF) and α-smooth muscle actins (α-SMA) were investigated in relation to trans-differentiation of fibroblast to myo-fibroblast, an icon of scar formation. C-pc was isolated from Spirulina Platensis extract using sonication method and C-pc concentration was determined by Bennet and Bogorad equation. α-SMA and CTGF levels in wounded primary human dermal fibroblasts were determined by western blot analysis and immuno-fluorescence confocal microscope was employed. Fibroblast contractility was examined by three-dimensional collagen lattice contraction assay. There was an elevation of α-SMA (121%) and CTGF (143%) levels in wound cells as compared with non-wound cells. The does-response profiles of down regulation demonstrated that the maximum inhibitions of α-SMA by 63% (p<0.05) and CTGF by 50% (p<0.1) were achieved by C-pc (6 nM) treated cells. In confocal assay, non-wound fibroblasts exhibited basal level of α-SMA staining, while wounded cells without C-pc treatment showed strong up-regulation of α-SMA by 147% (p<0.05). C-pc (6 nM) inhibited α-SMA expression by 70% (p<0.05) and reduced collagen contraction by 29% (p<0.05). C-pc seemed to lessen the over expression of CTGF, α-SMA, subsequently alleviating the fibrotic contracture. This study suggests the potential application of C-pc to regulation of the expression of pro-fibrotic mediators in scarring process and its potential usage as an efficient means for anti-fibrosis therapy.
Actins* ; Blotting, Western ; Cicatrix ; Collagen ; Connective Tissue Growth Factor* ; Connective Tissue* ; Contracture ; Down-Regulation ; Fibroblasts ; Humans ; Methods ; Myofibroblasts ; Phycocyanin* ; Sonication ; Spirulina ; Up-Regulation ; Wound Healing ; Wounds and Injuries

This study investigated the mechanical properties and antibacterial activity of glass ionomer cement (GIC) containing 1 mol% or 5 mol% gallium phosphate glass (GPG) powder. GPG were added to conventional GIC powder in a range of 0~20 wt%. The specimens for compressive strength (4 mmØ×6 mm) and diametral tensile strength (6 mmØ×4 mm) were prepared by mixing with the cement liquid and kept in an water of 37±1℃. Mechanical properties were evaluated at an interval of 1 h, 24 h, and 7 days. Antibacterial activity of specimens against to S. mutans and S. sobrinus was evaluated using agar diffusion methods. Data were statistically analyzed by one-way ANOVA and Tukey HSD post-hoc test (p<0.05). Diametral tensile strength of GIC containing GPG were significantly higher than control GIC while compressive strength showed no statistical difference. There was an increasing tendency of antibacterial activity for GPG-GICs. Results indicated that GPG can be considered as potential reinforcing agent for increasing antibacterial and mechanical properties for conventional GIC.

This study was prospectively conducted to investigate any relationship of nutritional status at the time of admission to length of hospital stay and mortality. All patients admitted to the Asan Medical Center between October 13 and November 12, 1997 who met the study criteria were included in the study. Patients were classified as Not-at-risk, At-risk I or At-risk II based on the levels of serum albumin and total lymphocyte count in a computerized nutrition screening program. Sixty three percent of the patients were classified as Not-at-risk Group, 29% as At-risk Group I and 8% as At-risk Group II. Significant correlation was observed between nutritional status and LOS (P<0.01) as well as mortality rate (P<0.05). The more the patient had the nutritional risk factors, the longer the LOS and the higher the mortality rate were. Further studies have to be done in order to demonstrate cost-effectiveness of medical therapy for the malnourished hospitalized patients.
Chungcheongnam-do ; Humans ; Length of Stay* ; Lymphocyte Count ; Mass Screening* ; Mortality* ; Nutritional Status* ; Prospective Studies* ; Risk Factors ; Serum Albumin

Anemia, defined as a reduction in the hemoglobin concentration of blood, is common in diabetes mellitus (DM) patients, can be potentially caused by diabetes complications such as nephropathy. Recent research suggests that diabetes mellitus (DM) itself may be a major risk factor of anemia. However, there are few Korean studies on the relationship between diabetes mellitus (DM) and anemia. This study was performed to investigate the association between anemia and diabetes mellitus (DM) in Korean adults. A total of 10,151 Korean adults over aged 19 years (4,422 male, 5,729 female) were selected from the participants of the Korean National Health and Nutrition Examination Survey VI (KNHANES VI). Korean adults with anemia had a higher prevalence of diabetes mellitus (DM) than the normal adults (11.4% vs. 30.4% in male, 8.8% vs. 9.4% in female). The unadjusted odds ratio (OR) for anemia was greater in adults with DM than in normal male (OR=3.28; 95% CI: 2.27~4.73). After adjusting for other risk factors including age, education, family income, smoking, drinking, and menstrual status, anemia and diabetes were not associated (OR=1.33; 95% CI: 0.84~2.09). Similarly, there was no association between anemia and diabetes in female. In conclusion, this study shows that the prevalence of anemia is similar in diabetic and non-diabetic Korean adults after adjusting for multiple risk factors. Further research is required to elucidate the mechanism of anemia caused as a consequence of diabetes mellitus (DM).
Adult ; Anemia* ; Diabetes Complications ; Diabetes Mellitus* ; Drinking ; Education ; Female ; Humans ; Male ; Nutrition Surveys ; Odds Ratio ; Prevalence ; Risk Factors ; Smoke ; Smoking

PURPOSE: For this study an examination was done of relationships between intensive care unit (ICU) nurses' knowledge related to sedation and their clinical competencies in sedation practice. METHODS: Ninety one ICU nurses were recruited from two tertiary hospitals in South Korea. A self-report questionnaire was used to examine the levels of knowledge related to sedation and nursing practice competence based on Ajzen's theory of planned behavior. Descriptive statistics, independent t-tests, one-way ANOVA, and Pearson correlations were performed using the IBM SPSS 21.0 RESULTS: ICU nurses are more knowledgeable about general information on sedation rather than up-to-date information. Continuing education on sedation was related to difference in knowledge levels. However, the levels of knowledge were not related to competence in sedation practice. Instead, a positive attitude toward sedation practice was significantly related to the subjective norms; orders and goals, perceived behavioral control, practice of sedation, and intention to use. CONCLUSION: The results of this study provide fundamental information on levels of knowledge related to sedation practices of Korean ICU nurses. Continuing education should emphasize up-to-date information on sedation practice and need for positive attitudes which influence all other competencies towards sedation practices to achieve optical care of sedation in the ICU.
Clinical Competence ; Clinical Protocols ; Critical Care ; Education, Continuing ; Hypnotics and Sedatives ; Intensive Care Units ; Intention ; Korea ; Mental Competency ; Nursing ; Tertiary Care Centers

We present two cases of dynamic left ventricular outflow tract obstruction in 2 patients who were undergoing living donor liver transplantation. On the preoperative transthoracic echocardiography, the first patient showed normal ventricular function and a normal wall thickness, but severe hemodynamic deterioration developed during the anhepatic period and this was further aggravated after reperfusion in spite of volume resuscitation and catecholamine therapy. Intraoperative transesophageal echocardiography revealed the systolic anterior motion of the mitral valve leaflet together with left ventricular outflow tract obstruction. The second patient showed left ventricular hypertrophy with left ventricular outflow tract obstruction on the preoperative echocardiography. Intraoperative transesophageal echocardiography was used to guide fluid administration and the hemodynamic management throughout the procedure and a temporary portocaval shunt was established to mitigate the venous pooling during the anhepatic period. The purpose of this report is to emphasize the clinical significance of dynamic left ventricular outflow tract obstruction in patients who are undergoing living donor liver transplantation and the role of intraoperative echocardiography to detect and manage it.
Echocardiography ; Echocardiography, Transesophageal ; Hemodynamics ; Humans ; Hypertrophy, Left Ventricular ; Liver ; Liver Transplantation ; Living Donors ; Mitral Valve ; Reperfusion ; Resuscitation ; Ventricular Function

PURPOSE: This study tries to identify experience of verbal abuse, emotional response, and ways to deal with verbal abuse against nurses in hospitals. METHODS: This study was a descriptive research and conducted from April to July 2011. One hundred and seventeen nurses with over one-year experience in general wards were selected and evaluated. The data were analyzed using descriptive analysis, independent t-tests, and one-way ANOVA. RESULTS: The nurses' experience rate of verbal abuse during the entire period of work in hospitals was 98.3%. The majority of the nurses were verbally abused by patients (70.9%), followed by patients' relatives (65.8%), physicians (61.5%), and coworkers (58.1%). Overall negative emotional response score of nurses after verbal abuse was 38.82+/-8.28. Ways to deal with verbal abuse were as follows: suppression was 74.4%, complaining of an injustice to close people, 67.5%, and ignoring, 43.6%. CONCLUSION: Nurses have significantly been exposed to verbal abuse while working in hospitals. Therefore, hospital managers and nurse managers are required to inform other staff and visitors in hospitals the real condition of verbal abuse against nurses and provide a safe work environment by developing the report and disposal system of verbal abuse.
Humans ; Nurse Administrators ; Patients' Rooms

PURPOSE: The core curriculum in graduate medical education (GME) is an educational program that covers the minimum body of knowledge and skills that is required of all residents, regardless of their specialty. This study examined the opinions of stakeholders in GME regarding the core curriculum. METHODS: A questionnaire was administered at three tertiary hospitals that were affiliated with one university; 192 residents and 61 faculty members and attending physicians participated in the survey. The questionnaire comprised six items on physician competency and the needs for a core curriculum. Questions on subjects or topics and adequate training years for each topics were asked only to residents. RESULTS: Most residents (78.6%) and faculty members (86.9%) chose "medical expertise" as the "doctor's role in the 21st century." In contrast, communicator, manager, and collaborator were recognized by less than 30% of all participants. Most residents (74.1%) responded that a core curriculum is "necessary but not feasible," whereas 68.3% of faculty members answered that it is "absolutely needed." Regarding subjects that should be included in the core curriculum, residents and faculty members had disparate preferences-residents preferred more "management of a private clinic" and "financial management," whereas faculty members desired "medical ethics" and "communication skills." CONCLUSION: Residents and faculty members agree that residents should develop a wide range of competencies in their training. However, the perception of the feasibility and opinions on the contents of the core curriculum differed between groups. Further studies with larger samples should be conducted to define the roles and professional competencies of physicians and the needs for a core curriculum in GME.
*Attitude of Health Personnel ; Clinical Competence ; *Curriculum ; *Education, Medical, Graduate ; Faculty, Medical ; Hospitals ; Humans ; *Internship and Residency ; *Needs Assessment ; *Physicians ; *Professional Competence ; Surveys and Questionnaires

OBJECTIVE: The purpose of this study was to evaluate effects of remifentanil, esmolol, and lidocaine administered before a tracheal intubation on the autonomic nervous system using heart rate variability. METHODS: In a randomized, prospective trial, we enrolled 60 patients undergoing a tracheal intubation under general anesthesia. After an induction of anesthesia using propofol and rocuronium, patients received either remifentanil 1.0 microg/kg (group R), esmolol 1.0 mg/kg (group E), or lidocaine 1.5 mg/kg (group L). Standard deviation of the normal to normal interval (SDNN), low frequency power (LF), and high frequency power (HF) were measured before and after the administration of three drugs. Heart rate and mean arterial pressure were measured before and after the tracheal intubation. RESULTS: SDNN was not different between three groups. After the administration of drugs, LF mainly indicating the sympathetic nervous system activity was lower in the group E than in group R and L. HF indicating the parasympathetic nervous system activity was higher in group R than in group E and L. After the tracheal intubation, heart rate was lower in group R and E than in group L. Mean arterial pressure was lower in group R than in group E and L. CONCLUSION: Hemodynamic changes according to the tracheal intubation were attenuated by remifentanil 1 microg/kg or esmolol 1 mg/kg, not by lidocaine 1.5 mg/kg. Remifentanil stimulated parasympathetic nervous system and esmolol suppressed sympathetic nervous system.
Androstanols ; Anesthesia ; Anesthesia, General ; Arterial Pressure ; Autonomic Nervous System ; Heart ; Heart Rate ; Hemodynamics ; Humans ; Intubation ; Lidocaine ; Parasympathetic Nervous System ; Piperidines ; Propanolamines ; Propofol ; Prospective Studies ; Sympathetic Nervous System

Low back pain in computer terminal operators is a very common but important symptom. While the occupational risk factors of low back pain were approved obscurely, there have been few studies on analysis or understanding of occupational risk factors. Therefore, we studied occupational risk factors of low back pain, especially for ergonomic factors as well as general characteristics of workers. We selected 98 subjects for this study, computer terminal operators ordinary using computers in Pusan. We calculated the subjective severity of low back pain of each operator by the Low Back Pain Scoring System. The relation of low back pain score to general characteristics of worker was also analyzed. We analyzed the relationship between low back pain score and individual efforts to prevent low back pain. We measured the ergonomic factors of each computer terminal operator - Trunk Jnclination(TI), Arm Flexion(AF), Elbow Angle(EA), Head Tilting(HT), Knee Angle(KA), using of foot plate and gap between the popliteum and chair. The correlations between these ergonomic factors and low back pain score were then analyzed. And the results are as follows: 1. The prevalence rate of low back pain in computer terminal operators was 39.8% in this study, when low back pain score was converted by the low back pain scoring system. 2. According to general characteristics of workers related to low back pain, the scores were higher in the older age group, the married and the longer work carriers. (p < 0.05) 3. In the analysis of the relationship between low back pain score and individual effort to prevent low back pain, regular exercise, history of schooling for prevention of low back pain, and declaration of intention to participate in low back pain education or exercise were stastistically significant(p < 0.05). And the more severe the low back pain, the higher the intention to participate in low back pain education they had in this study. 4. In the analyses of relationships or correlations between low back pain score and each of the 7 categories of ergonomic factors, only head tilting had a weak reverse correlation with low back pain(r=-0.2999, p < 0.01). From now on, cohort studies for the risk factors of low back pain of workers, who have been forced to work in non-ergonomical positioning at the work site, will be necessary. On the background of these ergonomic studies, the occupational health profession should be required to manage ergonomic working conditions.
Arm ; Busan ; Cohort Studies ; Computer Terminals* ; Education ; Elbow ; Foot ; Head ; Human Engineering ; Humans ; Intention ; Knee ; Low Back Pain* ; Occupational Health ; Prevalence ; Risk Factors* ; Workplace