PURPOSE: This study aimed to explain what are the experiences of patients with renal disease who are just begun hemodialysis in the end-stage. METHODS: The data were collected from February to December in 2017 through individual in-depth interviews using open-ended questions. For data analysis, a phenomenological method suggested by Colaizzi was applied. A total of 8 hemodialysis patients with end-stage renal disease (ESRD) participated in this study. RESULTS: According to the analysis, five theme clusters emerged: ‘I go into darkness’, ‘Being disappearing from others’, ‘Baby bird living with love’, ‘Dawn in darkness’ and ‘A life longing for the absolute’. CONCLUSION: Patients undergoing hemodialysis experienced fear and anxiety at the beginning of hemodialysis. Therefore, counseling and social supports were needed for patients with ESRD in their early stage of hemodialysis. In addition, a multidisciplinary education program should be implemented in the future research. It may help to overcome for the patients who are experiencing complicated health problems in their early stage of hemodialysis treatment.
Anxiety ; Birds ; Counseling ; Education ; Humans ; Kidney Failure, Chronic* ; Methods ; Qualitative Research ; Renal Dialysis* ; Statistics as Topic

PURPOSE: This research was conducted to determine the effects of fall prevention exercise and education on physical fitness, fall efficacy, and fall prevention behavior among community-dwelling older adults. METHODS: This study applied nonequivalent control group pretest-posttest design. Data were collected from January 8th to March 4th, 2015. There were 24 subjects in the experimental group and 21 in the control group from two different senior citizen center in B city. The fall prevention program consisted of exercise, education, and telephone coaching was developed using self-efficacy theory: ‘Performance accomplishment’, ‘Vicarious experience’, ‘Verbal persuasion’, ‘Emotional arousal’. Then, it was conducted once a week for 8 weeks. Data were analyzed with χ² test and t-test using the SPSS program. RESULTS: The findings indicated that fall prevention program conducted on older adults is good for improving their muscular strength in lower extremities (t=6.25, p<.001), physical balance (t=2.66, p=.014), physical flexibility (t=2.88, p<.001) and fall prevention behavior (t=6.19, p<.001). CONCLUSION: The fall prevention program can be used for community-dwelling older adults as a nursing intervention that enables older adults to enhance their self-care continuously. It is necessary to conduct a follow-up study to see if a self-help meeting could improve self-efficacy.
Adult* ; Education ; Follow-Up Studies ; Humans ; Lower Extremity ; Nursing ; Physical Fitness* ; Pliability ; Self Care ; Telephone

BACKGROUND: The E2F family (E2F1 to E2F6) of transcription factors plays a key role in cell cycle progression. Some act as oncogenes and others act as tumor suppressor genes (TSG) in a tissue-specific manner. E2F4 may function as a TSG. However, the role of E2F4 in breast carcinogenesis remains controversial. Also the clinical impact of E2F2 expression on breast cancer remains unknown. METHODS: Expressions of E2F4 and E2F2 were assessed immunohistochemically in 113 breast carcinomas and were compared with clinicopathological variables, expressions of G1/S checkpoint proteins (p16, cyclin D1 and Rb), and DNA ploidy to identify their possible role and to assess their prognostic value in breast cancer. RESULTS: Expressions of E2F4 and E2F2 were detected in 48 cases (42.5%) and 66 cases (58.4%), respectively. Expressions of E2F4 and E2F2 were significantly correlated with large tumor size (p<0.001) and lymph node metastasis (p<0.001). There was no correlation between expressions of E2F4 or E2F2 and any other variables, including age, histologic grade, DNA ploidy and expressions of p16, cyclin D1 and Rb. CONCLUSIONS: These results suggest that expressions of E2F4 and E2F2 are associated with growth and spread of breast cancer and indicate poor prognosis.
Breast Neoplasms* ; Breast* ; Carcinogenesis ; Cell Cycle ; Cyclin D1 ; DNA ; E2F2 Transcription Factor* ; E2F4 Transcription Factor ; Genes, Tumor Suppressor ; Humans ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Oncogenes ; Ploidies ; Prognosis ; Transcription Factors

Hemodialysis(HD)-associated hypotension is a frequent complication, but it is difficult to manage. Until now, several maneuvers have been tried to prevent the HD-associated hypotension. Of these, the sodium content of dialysate was regarded as an important factor for maintaining blood pressure during HD. In this study, we evaluated the effect of hypertonic dialysate on blood pressure, interdialytic weight gain and the incidence of thirst. The study was done for 6 weeks successively with 3 different groups. Each patient was dialysed with 3 different dialysates for 2 weeks: Group I(Conventional HD: sodium concentration: 137 mEq/L), Group II(Hypertonic HD: 147 mEq/L) and Group III (Sequential HD: from 147 to 140 mEq/L). Hemodynamic parameters(blood pressure, pulse rate and ultrafiltration rate), biochemical parameters(hematocrits, blood urea nitrogen, creatinine, osmolality, sodium, potassium, chloride, fasting blood sugar) and complications (interdialytic weight gain &thirsty sensation) were compared among 3 groups. The results were as follows: 1. Decline of systolic blood pressure and diastolic blood pressure at the time of a 3 hour check during hemodialysis was lower in the Group II than Group I and III (p=0.002; p=0.012). and decline of diastolic blood pressure at the time of a 4 hour check during hemodialysis was lower in the Group II and III than Group I(p=0.04). 2. ncidence of hypotensive episodes during dialysis was significantly lower in Group II than group I (p=0.0287). 3. The ultrafiltration in Group III at the time of 1 hour, 2 hour and 3 hour check during hemodialysis was higher than that in Group I and II at the time of 1 hour, 2 hour and 3 hour check during emodialysis respectively (p=0.0001; p=0.0001; p=0.0004). 4. Interdialytic weight gain was higher in Group II(3.1+/-0.8) than GroupI(2.8+/-0.8) and III (2.9+/-0.9) (p=0.0422). 5. Hematologic and biochemical results were not significantly different among 3 Groups. 6. Frequency of thirst was different in Group I, II and III, 0.05+/-0.12, 0.41+/-0.24 and 0.22+/-0.29 respectively (p=0.0259). The results suggest that hypertonic HD was effective in preventing HD-associated hypotension but interdialytic weight gain and thirst sensations were increased as compared with a conventional method. In this situation, sequential HD seems to be an alternative method to minimizes the side effect of hypertonic HD.
Blood Pressure* ; Blood Urea Nitrogen ; Creatinine ; Dialysis ; Dialysis Solutions ; Fasting ; Hemodynamics* ; Humans ; Hypotension ; Incidence* ; Osmolar Concentration ; Potassium ; Renal Dialysis* ; Sensation ; Sodium ; Thirst* ; Ultrafiltration* ; Weight Gain*

The purpose of this study was to examine the relationship between nutrient intake and bone mineral density (BMD) of elderly women in Daegu, Korea. In this study, the bone mineral densities of 101 elderly women in Daegu were measured, and their nutrient intake, dietary habits, and maternal factors were determined through a survey. The subjects were divided into the normal group, the osteopenia group, and osteoporosis group to find out if there is a correlation between bone mineral density and maternal factors, dietary habits, and nutrient intake through their T-scores, analyzed according to the standards of WHO. Classification by T-scores of the participants were the normal group 25.7%, the osteopenia group 39.6%, the osteoporosis group 34.7%. Menopause age of the osteoporosis group was lower, postmenopausal period was longer, and last delivery age was significantly higher than the normal group (p<0.05). Osteoporosis group had a lower percentage of 'everyday' fruit and vegetable intakes and higher percentage of 'never' dairy intake than of the normal group. Vitamin A, vitamin B1, and vitamin B2 intakes of participants in the osteoporosis group were lower than those in the normal group (p<0.05). In conclusion, nutritional education is necessary to encourage high intake of milk and vegetables and fruits along with calcium, vitamin A, B1, and B1 intakes and low intake of sodium for the prevention of elderly women's osteoporosis.
Aged* ; Bone Density* ; Bone Diseases, Metabolic ; Calcium ; Classification ; Daegu* ; Education ; Female ; Food Habits ; Fruit ; Humans ; Korea* ; Menopause ; Milk ; Osteoporosis ; Postmenopause ; Riboflavin ; Sodium ; Thiamine ; Vegetables ; Vitamin A

No abstract available.
Occupational Health*

In order to develop the computerized information system of occupational health management at worksite, we surveyed actual states of computer use at worksites. We used a self-administrative questionnaire to the members of Korean Association of Occupational Health Nursing(KAOHN) from July 4 to August 21 in 1997. Among the members of KAOHN, 147 members answered. The worksites where they, were employed were very diverse in aspect of jobs, locations, and size. Occupational health computerized system was used at 30(20.4%) worksites among 147 respondents. When they first introduced the computerized system the most difficult problem was the lack of support of manager. The programs that they have used mainly consist of drug management, health examination management, disease management, but the program of worksite environment management have been rarely used. Most users felt that the computerized system was effective, but there were problems in connection within programs. Many worksites have plans to take or expand the computerized information system within several years. It is necessary to develop the effective and integrated occupational health computerized system.
Surveys and Questionnaires ; Disease Management ; Information Systems* ; Occupational Health* ; Surveys and Questionnaires ; Workplace*

Phase-partitioning with Triton X-114 (TX114) was applied to the TSP antigen, which may be preferentially associated with the cell wall of M. tuberculosis. The hydrophilic protein components of the TSP antigen were successfully separated from integral hydrophobic macromolecules. To further characterize and examine the cellular immune response of the aqueous fraction of the TSP antigen (TSPa), the in vitro properties of the antigen were measured by lymphoproliferation; surface expression of IL-2 Ra on T lymphocytes was analyzed by flow cytometry; and the cytokine mRNA expression pattern was determined by RT-PCR. Significant lymphoproliferative responses to the TSPa antigen were observed in healthy tuberculin reactive donors after a 5 day in vitro stimulation. TSPa treatment of PBMCs from healthy tuberculin positive subjects for 5 days resulted in progressive augmentation of IFN-r, II 2, and IL-2Ra mRNA expression, as measured by RT-PCR, but considerably reduced IL-4 mRNA expression. In addition, the TSPa antigen stimulated more IL-12 p40 mRNA production than did the PPD antigen, and graduaBy suppressed IL- 10 mRNA expression. Moreover, the CD3' T cells of tuberculin positive subjects displayed a profound increase in their expression of the II 2Ru protein (39.0%) in response to the TSPa antigen. Proliferation was correlated with IL-2 and IL-2Ra mRNAs, but not correlated with distinct IFN-r or IL-12 p40 mRNA production. These findings strongly suggest that the TSPa antigen preferentially evokes the generation of a Thl-like immune response in healthy tuberculin reactors.
Cell Wall ; Flow Cytometry ; Humans* ; Immunity, Cellular* ; Interleukin-12 ; Interleukin-2 ; Interleukin-4 ; Mycobacterium tuberculosis* ; Mycobacterium* ; Neptune ; RNA, Messenger ; T-Lymphocytes ; Tissue Donors ; Tuberculin ; Tuberculosis

Tumor-draining lymph node mononuclear (TDLMN) cells are specifically sensitized to the growing tumor but such cells are deficient for mediating an antitumor response. In this study, we examined the feasibility of using mycobacterial 30 kDa or Triton X-100 solubilized protein (TSP) antigen to stimulate mononuclear cells of colon cancer-draining lymph node for the generation of cell mediated immune effector cells. The proliferative response of TDLMN cells stimulated with mycobacterial 30 kDa or TSP antigen was determined by H-thymidine incorporation assay. The proliferation of TDLMN cells to mycobacterial 30 kDa or TSP antigen was significantly increased in PPD (+) patients, but a poor response to the 30 kDa or TSP antigen was observed in PPD (-). The expression on ro T cells to mycobacterial 30 kDa or TSP antigen was assessed by flow cytometry. The ro T cells from PPD (+) patient responded only to 30 kDa antigen but to TSP antigen. An investigation of cytokine mRNA expression was undertaken using reverse transcription- polymerase chain reaction (RT-PCR) to follow TDLMN cells stimulated with the 30 kDa or TSP antigens for 5 days. The IFN-r and TNF-a mRNA expression was only induced in TDLMN cells of PPD (+) patient in response to the 30 kDa or TSP antigen. The IL-2 mRNA expression was induced in both PPD (+) and PPD (-) in response to the 30 kDa or TSP antigen. But the IL-4 mRNA expression was not induced in response to the 30 kDa or TSP antigen. These results suggest that the 30 kDa and TSP antigens may serve as biologic response modifier for the generation of cell mediated immune effector cells.
Colon* ; Flow Cytometry ; Humans ; Interleukin-2 ; Interleukin-4 ; Lymph Nodes* ; Mycobacterium tuberculosis* ; Mycobacterium* ; Negotiating ; Neptune* ; Octoxynol* ; Polymerase Chain Reaction ; RNA, Messenger ; T-Lymphocytes

Background: The quality of a vaccine depends strongly on the effects of the adjuvants applied simultaneously with the antigen in the vaccine. The adjuvants enhance the protective effect of the vaccine against a viral challenge. Conversely, oil-type adjuvants leave oil residue inside the bodies of the injected animals that can produce a local reaction in the muscle. The longterm immunogenicity of mice after vaccination was examined. ISA206 or ISA15 oil adjuvants maintained the best immunity, protective capability, and safety among the oil adjuvants in the experimental group. Objectives: This study screened the adjuvant composites aimed at enhancing foot-andmouth disease (FMD) immunity. The C-type lectin or toll-like receptor (TLR) agonist showed the most improved protection rate. Methods: Experimental vaccines were fabricated by mixing various known oil adjuvants and composites that can act as immunogenic adjuvants (gel, saponin, and other components) and examined the enhancement effect on the vaccine. Results: The water in oil (W/O) and water in oil in water (W/O/W) adjuvants showed better immune effects than the oil in water (O/W) adjuvants, which have a small volume of oil component. The W/O type left the largest amount of oil residue, followed by W/O/W and O/W types. In the mouse model, intramuscular inoculation showed a better protection rate than subcutaneous inoculation. Moreover, the protective effect was particularly weak in the case of inoculation in fatty tissue. The initial immune reaction and persistence of long-term immunity were also confirmed in an immune reaction on pigs. Conclusions The new experimental vaccine with immunostimulants produces improved immune responses and safety in pigs than general oil-adjuvanted vaccines.