BACKGROUND: Maternal serum triple marker screening (alpha-fetoprotein, human chorionic gonadotropin, and unconjugated estriol) can detect 60-70% of Down syndrome and 60% of Edwards syndrome. Previous studies have reported that positive serum screening is related to other fetal chromosomal abnormalities, pregnancy complications, and adverse outcomes. We determined the incidence and karyotype of chromosomal abnormalities in screen positive women and evaluated a relationship between chromosomal and ultrasonographic abnormalities. METHODS: Of the 49,806 pregnant women between 15 and 23 weeks' gestational age who received prenatal serum screening with a cut-off value (a risk of 1:270 for Down and 1:100 for Edwards syndrome), 2,116 (4.2%) and 196 (0.4%) were screen positive for Down syndrome and for Edwards syndrome, respectively. Chromosomal analysis in amniotic fluid was performed for 1,893 (89.5%) of the Down positive and 140 (71.4%) of the Edwards positive pregnant women. Ultrasonographic examination was performed to detect fetal abnormalities. RESULTS: Eighty-three cases of chromosomal abnormalities including 40 trisomy 21 (2.1%) and 43 other chromosomal abnormalities (2.3%) were identified in the Down screen positive. Other chromosomal abnormalities included 9 numerical and 34 structural abnormalities. Ten cases of chromosomal abnormalities (9 trisomy 18 and 1 trisomy 9) were detected in the Edwards screen positive. Ultrasonographic abnormalities were found more frequently in the women who had chromosomal aberrations. CONCLUSIONS: These data suggest that 4.4% of the Down screen and 7.1% of the Edwards screen positive pregnancy have fetal chromosomal abnormalities. Positive Down screening results reflect a relatively high probability of other abnormalities except trisomy 21. Edwards screen positive group show a low frequency of other chromosomal abnormalities except trisomy 18. A simultaneous use of maternal serum screening and ultrasonograms could be useful for the diagnosis of fetal abnormalities.
Amniotic Fluid ; Chorionic Gonadotropin ; Chromosome Aberrations ; Diagnosis ; Down Syndrome ; Female ; Gestational Age ; Humans ; Incidence ; Karyotype ; Mass Screening ; Pregnancy ; Pregnancy Complications ; Pregnant Women* ; Trisomy ; Ultrasonography

PURPOSE: Purposes of this study were to understand the current trends on complementary therapy in relieving chemotherapy-induced nausea and vomiting and to suggest the future research direction. METHOD: Subjects were selected on CINAHL, MEDLINE, Korean Academy Data Base from 1980 to 2001 which used nausea, vomiting, chemotherapy and complementary therapy as key words in experimental studies. Eight korean articles and twenty-one international articles were analyzed in terms of general characteristics, research methods, and types of complementary therapy. Data were analyzed by using descriptive statistical methods. RESULT: Since 2000, researchers have more actively used complementary therapy. In subject characteristics, mean age was 35.5 years old, 45% of the researchers were performed with high level of incidence of chemotherapy induced vomiting, 14% of them set limit of consecutive cycle during research, and 65% of them did not comment the selecting criteria of sample. About 60% of them were designed post-test only control group; 35% used INV by Rhodes, 31% used Likert scale, and 24% used VAS for dependent variable. Muscle relaxation therapy was mostly applied for relief of nausea and vomiting. CONCLUSION: Further studies will be needed to control extrinsic variables affecting nausea and vomiting in research design and to accumulate evidence with studies applying various complementary therapies.
Complementary Therapies ; Drug Therapy ; Incidence ; Muscle Relaxation ; Nausea* ; Research Design ; Vomiting*

PURPOSE: This study aimed was done to analyze recent trends in nursing research published in the Journal of Korean Academy of Nursing by focusing on the content of nursing interventions and their level of evidence. METHODS: A total of 209 studies published between 2007 and 2008 were reviewed using analysis criteria developed by the researchers. RESULTS: The number of quantitative studies was greater than that of qualitative studies. There was a slight increase in the number of qualitative studies and studies including elderly populations, which reflects the recent population trend in Korea. More randomized controlled trials with a low risk of bias were needed to support more evidence-based nursing practice. Concerning the low rate of ethical consideration, stricter application of research ethics needs to be encouraged. CONCLUSION: The findings of this study suggest the recent trends in nursing research and the direction of nursing research and review in the Journal.
Bibliometrics ; Humans ; Nursing Research/*trends ; *Periodicals as Topic ; Qualitative Research ; Republic of Korea

PURPOSE: Irritable bowel syndrome (IBS) is frequently yet little understood disease. Review was performed to promote understanding on the characteristics, pathophysiology, and risk factors of IBS. CONTENT: IBS is characterized by abdom in women and people with higher educational and social background, but there are some controversies. IBS is diagnosed by the Rome II or Manning criteria after excluding organic gastrointestinal diseases. The pathophysioloy is explained by abnormal control mechanism of central and enteric nervous system. Mucosal immunity, secretions, and neurotransmitter are also associated with the hypersensitivity and motility change of bowel function. Stress is known as a major triggering factor and contributed to symptoms. Other risk factors are genetic elements, childhood experiences, inflammation, anxiety, depression, diet, and sleep disorders.
Anxiety ; Depression ; Diet ; Enteric Nervous System ; Female ; Gastrointestinal Diseases ; Humans ; Hypersensitivity ; Immunity, Mucosal ; Inflammation ; Irritable Bowel Syndrome* ; Neurotransmitter Agents ; Risk Factors* ; Sleep Wake Disorders

This prospective randomized study was conducted to evaluate the efficacy of two common analgesic techniques, thoracic epidural patient-controlled analgesia (Epidural PCA), and intravenous patient-controlled analgesia (IV PCA), in patients undergoing lobectomy by the video-assisted thoracic surgical (VATS) approach. Fifty-two patients scheduled for VATS lobectomy were randomly allocated into two groups: an Epidural PCA group receiving an epidural infusion of ropivacaine 0.2%+fentanyl 5 microg/mL combination at a rate of 4 mL/hr, and an IV PCA group receiving an intravenous infusion of ketorolac 0.2 mg/kg+fentanyl 15 microg/mL combination at a rate of 1 mL/hr. Pain scores were then recorded using the visual analogue scale at rest and during motion (VAS-R and VAS-M, 0-10) for five days following surgery. In addition, we measured the daily morphine consumption, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), satisfaction score, and the incidence of side effects. Thirty-seven patients out of 52 completed the study (18 in the Epidural PCA group, 19 in the IV PCA group). There were no differences in the pain scores, analgesic requirements, pulmonary function, satisfaction score, and the incidence of side effects between groups. This indicates that IV PCA and Epidural PCA are equally effective to control the postoperative pain after VATS lobectomy, which suggests that IV PCA may be used instead of Epidural PCA.
Adult ; Aged ; Amides/therapeutic use ; Analgesia, Epidural/methods ; Analgesia, Patient-Controlled/*methods ; Analgesics, Opioid/therapeutic use ; Anesthesia, Intravenous/methods ; Anesthetics, Local/therapeutic use ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Female ; Fentanyl/therapeutic use ; Humans ; Ketorolac/therapeutic use ; Male ; Middle Aged ; Pain Measurement ; Pain, Postoperative/*drug therapy/prevention & control ; Prospective Studies ; Thoracoscopy

PURPOSE: Asthma is a heterogeneous disease characterized by various types of airway inflammation and obstruction. Therefore, it is classified into several subphenotypes, such as early-onset atopic, obese non-eosinophilic, benign, and eosinophilic asthma, using cluster analysis. A number of asthmatics frequently experience exacerbation over a long-term follow-up period, but the exacerbation-prone subphenotype has rarely been evaluated by cluster analysis. This prompted us to identify clusters reflecting asthma exacerbation. METHODS: A uniform cluster analysis method was applied to 259 adult asthmatics who were regularly followed-up for over 1 year using 12 variables, selected on the basis of their contribution to asthma phenotypes. After clustering, clinical profiles and exacerbation rates during follow-up were compared among the clusters. RESULTS: Four subphenotypes were identified: cluster 1 was comprised of patients with early-onset atopic asthma with preserved lung function, cluster 2 late-onset non-atopic asthma with impaired lung function, cluster 3 early-onset atopic asthma with severely impaired lung function, and cluster 4 late-onset non-atopic asthma with well-preserved lung function. The patients in clusters 2 and 3 were identified as exacerbation-prone asthmatics, showing a higher risk of asthma exacerbation. CONCLUSIONS: Two different phenotypes of exacerbation-prone asthma were identified among Korean asthmatics using cluster analysis; both were characterized by impaired lung function, but the age at asthma onset and atopic status were different between the two.
Adult* ; Asthma ; Clothing ; Cluster Analysis* ; Eosinophils ; Follow-Up Studies ; Humans ; Inflammation ; Lung ; Methods ; Phenotype

BACKGROUND: It has been more than 15 years since infection control was first introduced in Korea, but there is little information available on the status of infection control program in the country. METHODS: Included in the study were 139 acute care hospitals with more than 300 inpatient beds. A questionnaire, modified from US SENIC (Study on the Efficacy of Nosocomial Infection Control) and Canadian RICH (Resources for Infection Control in Canadian Acute Care Hospitals) survey, was mailed to the hospitals in the winter of 2003. RESULTS: Ninety-eight (70.5%) of 139 hospitals responded. There was an average of 1.2 (SD, 0.7) Infection Control Practitioners (lCPs) in each hospital and 95.7% were nurses and only 56.5% of the ICPs worked as full-time. The 71.4% of the hospitals had a position for Infection Control Doctor. All hospitals had an Infection Control Committee, which met an average of 3.7 (SD, 1.7) times a year. The 85.7% of the hospitals performed surveillance, but only 31.6% were monitoring surgical site infections. Review of microbiology data was the most common method for case-finding. More than 90% of the hospitals had infection control policies and guidelines, but an adherence to the policies and guidelines was not monitored regularly. CONCLUSION: This study reports the first comparable profile of infection control program of general acute care hospitals in Korea. Although the foundation for infection control program appears to have been established, there is the need for a further increase in the number of ICPs, the standardization of the surveillance method, and the promotion of adherence to the infection control guidelines.
Cross Infection ; Hospitals, General* ; Humans ; Infection Control Practitioners ; Infection Control* ; Inpatients ; Korea ; Postal Service ; Surveys and Questionnaires

This study was designed to determine whether early gabapentin treatment has a protective analgesic effect on neuropathic pain and compared its effect to the late treatment in a rat neuropathic model, and as the potential mechanism of protective action, the alpha2delta1-subunit of the voltage-dependent calcium channel (alpha2delta1-subunit) was evaluated in both sides of the L5 dorsal root ganglia (DRG). Neuropathic pain was induced in male Sprague-Dawley rats by a surgical ligation of left L5 nerve. For the early treatment group, rats were injected with gabapentin (100 mg/kg) intraperitoneally 15 min prior to surgery and then every 24 hr during postoperative day (POD) 1-4. For the late treatment group, the same dose of gabapentin was injected every 24 hr during POD 8-12. For the control group, L5 nerve was ligated but no gabapentin was administered. In the early treatment group, the development of allodynia was delayed up to POD 10, whereas allodynia was developed on POD 2 in the control and the late treatment group (p<0.05). The alpha2delta1-subunit was up-regulated in all groups, however, there was no difference in the level of the alpha2delta1-subunit among the three groups. These results suggest that early treatment with gabapentin offers some protection against neuropathic pain but it is unlikely that this action is mediated through modulation of the alpha2delta1-subunit in DRG.
Amines/administration & dosage/*therapeutic use ; Analgesics/administration & dosage/*therapeutic use ; Animals ; Calcium Channels/genetics/*metabolism ; Cyclohexanecarboxylic Acids/administration & dosage/*therapeutic use ; Disease Models, Animal ; Injections, Intraperitoneal ; Ligation ; Male ; Neuralgia/*drug therapy/metabolism ; Pain Measurement ; Protein Subunits/genetics/metabolism ; Rats ; Rats, Sprague-Dawley ; Spinal Nerves/surgery ; Up-Regulation ; gamma-Aminobutyric Acid/administration & dosage/*therapeutic use

BACKGROUND/AIMS: The incidence of variant angina (VA) is relatively high in Korea compared with western countries, but its long-term clinical outcomes are not well defined. METHODS: Patients who underwent ergonovine provocation tests at the cardiac catheterization laboratory of Chonnam National University Hospital between 1996 and 2011 were enrolled in this study (n = 1162). Of them, 686 patients with positive ergonovine provocation tests were divided into two groups: patients with cardiac events (Group I: 153 patients, 52.4 +/- 11.0 years, M: F = 103: 50) and those without (Group II: 533 patients, 51.6 +/- 10.7 years, M: F = 350: 183). The mean follow-up duration was 40.2 +/- 38.0 months. Cardiac events were defined as cardiac death, recurrent ischemia, rehospitalization, myocardial infarction, and follow-up angiography. Clinical findings, laboratory and coronary angiographic characteristics were compared between the groups. RESULTS: A history of smoking was more common in Group I than in Group II (45.8% vs. 36.3%, p = 0.037). The levels of low-density lipoprotein cholesterol (119.4 +/- 35.3 vs. 111.1 +/- 32.2 mg/dL, p = 0.010) were higher in Group I than in Group II. According to Cox proportional hazard regression analysis, the major predictive factor for cardiac events during clinical follow-up was smoking (HR 1.80, 95% CI 1.036-3.126, p = 0.037). CONCLUSIONS: A history of smoking was the only independent risk factor for cardiac events during a long-term clinical follow-up in Korean patients with variant angina.
Angina Pectoris, Variant ; Angiography ; Cardiac Catheterization ; Cardiac Catheters ; Cholesterol ; Coronary Artery Disease ; Death ; Ergonovine ; Follow-Up Studies ; Humans ; Incidence ; Ischemia ; Korea ; Lipoproteins ; Myocardial Infarction ; Risk Factors ; Smoke ; Smoking

BACKGROUND/AIMS: It is well known that the menopause is related to interference in lipid metabolism, obesity, and a hypercoagulable state. The aim of the present study was to examine the impact of the menopause in middle-aged Korean females with acute myocardial infarction (AMI). METHODS: A total of 1,781 middle-aged females (aged < 65 years) in the Korean Acute Myocardial Infarction registry were enrolled into this study between November 2005 and December 2013. The patients were divided into two groups; the pre-menopause group (≤ 55 years old) and the menopause group (56-64 years old). Major adverse cardiac events (MACE) were analyzed over a one-year follow-up period. RESULTS: The pre-menopause and menopause groups comprised 669 patients (mean age, 49.1 ± 5.6 years) and 1,112 patients (mean age, 60.6 ± 2.6 years), respectively. The incidence of hypertension (42.2% vs. 59.4%, p < 0.001), diabetes mellitus (DM) (27.4% vs. 35.7%, p < 0.001), and dyslipidemia (12.9% vs. 17.7%, p = 0.008) were more frequent in menopausal patients. Additionally, the rates of smoking (20% vs. 12.7%, p < 0.001) and familial history (12% vs. 6.8%, p < 0.001) were higher in the pre-menopause group. The cumulative rates of MACE did not show any differences between the two groups. A history of atrial fibrillation, previous AMI and DM, higher Killip class, and multi-vessel disease were independent risk factors for predicting one-year MACE. CONCLUSIONS: The survival analysis demonstrated that there was no significant difference in MACE rates between the pre-menopause and menopause groups during the one-year follow-up. Therefore, middle-aged pre-menopausal women should be treated more intensively, regardless of whether they are menopausal.
Atrial Fibrillation ; Diabetes Mellitus ; Dyslipidemias ; Female* ; Follow-Up Studies ; Humans ; Hypertension ; Incidence ; Lipid Metabolism ; Menopause ; Myocardial Infarction* ; Obesity ; Premenopause ; Prognosis ; Risk Factors ; Smoke ; Smoking