PURPOSE: This study examined Korean clinical nurses' intentions to care for SARS patients and identify determinants of the intentions. Theory of planned behavior was the framework to explain the intentions of Korean nurses for SARS patients care. METHODS: A convenient sample of six hundreds and seventy nine clinical nurses from four university-affiliated hospitals located in Seoul and in Kyung-gi province was used. Self-administered (83-items) questionnaire was used to collect data. Intentions, attitude, subjective norm, perceive behavioral control, behavioral beliefs, normative beliefs, and control beliefs were the study variables. All items were measured using 7-point Likert scale (-3 to +3). Data were analyzed using descriptive statistics, Pearson correlation method, and stepwise multiple regression methods. RESULTS: Intentions and attitudes toward SARS patient care among Korean clinical nurses were moderate, but their subjective norm and perceive behavioral control of SARS patients care were negative. Stepwise multiple regression analysis indicated that attitude toward SARS patient care, perceived behavioral control, subjective norm were the determinants of the intentions for SARS patients care as theory proposed. Among the behavioral beliefs, "SARS-patient caring would be a new experience", "during SARS-patient caring, I should be apart from my family", "after completing SARS-patient caring, I would be proud of myself being able to cope with a stressful event" and "with my SARS-patient caring, patients could recover from SARS" were the significant determinants. Among the normative beliefs, colleague approval, spouse approval, and physician approval were significant determinants of the intentions. Among the control beliefs, "SARS-patient caring would be a challenge" "SARS-patient caring is a professional responsibility", "tension during the care of SARS patients" and "support from team members" were the significant determinants of the intentions. CONCLUSIONS: Korean clinical nurses in this study were not willing to care for SARS patients and showed negative attitude toward the care. They believed their friends and family were not approved their care for SARS patients. Nurses were in conflicts between professional responsibilities to care for SARS patients and personal safety. This study was the first to understand stress and burden of Korean clinical nurses who are in front line to care for newly developed communicable disease such as SARS. Under the circumstance where several fatal communicable diseases are predictable, conflicts between professional responsibility and their personal risks should be taken into considerations by nurses themselves and by nursing administrators in order to improve quality of care.
Adult ; *Attitude of Health Personnel ; Female ; Humans ; *Intention ; Korea ; Middle Aged ; Multivariate Analysis ; Nursing Staff, Hospital/*psychology ; Psychological Theory ; Regression Analysis ; Severe Acute Respiratory Syndrome/*nursing

OBJECTIVES: This study was to investigate mean Z-score of BMD of Korean premenopausal women and also to investigate the relationship between BMD and body composition, such as skeletal muscle (SM) mass, body fat mass, and abdominal adiposity among healthy Korean premenopausal women in their forties. METHODS: A total of 2711 premenopausal women in her forties (40-49 years) who had taken dual energy X-ray absorptiometry (DXA) for BMD screening and body composition analyser (InBody J10®) from 2012 to 2013 at health promotion center of Ewha Womans university Mokdong hospital were analyzed retrospectively. Demographic data such as body mass index (BMI), waist circumference (WC), hip circumference (HC), waist hip ratio (WHR), SM mass, body fat mass, and serum lipid profile were included in this study. The Pearson's correlation coefficient (CC) was used to identify co-efficiency between BMD and other parameters. RESULTS: The mean age was 44.2 ± 4.44 (years) and mean BMI was 22.43 ± 2.99 (kg/m2). Mean Z-score of BMD-lumbar 1-4 (BMD-L) and BMD-femur total hip (BMD-F) was 0.33 ± 1.14 and -0.19 ± 0.85. Mean of BMD-L and BMD-F were 1.18 ± 0.16 (g/cm2) and 0.96 ± 0.12 (g/cm2). Skeletal muscle mass showed a strong significant correlation coefficient (CC) only with BMD-F (CC = 0.13, p-value = 4.78 × 10(-11)). However serum lipid profile, body fat mass, and WHR did not show significant CC with mean Z-score of BMD-F and BMD-L. CONCLUSION: Skeletal muscle mass measured by body composition analyzer of BIA method is a strong correlation factor for BMD especially of hip bone among healthy Korean premenopausal women in their forties.
Absorptiometry, Photon ; Adipose Tissue ; Adiposity ; Body Composition ; Body Mass Index ; Female ; Health Promotion ; Hip* ; Humans ; Mass Screening ; Menopause ; Methods ; Muscle, Skeletal ; Pelvic Bones ; Retrospective Studies ; Waist Circumference ; Waist-Hip Ratio

Purpose: Overweight (OW)/obese girls tend to have an earlier pubertal onset than girls with normal weight. However, only a few studies have reported the progression of puberty in these girls. This study aimed to identify risk factors for rapid pubertal progression in OW/obese girls presenting with precocious breast development. Methods: This retrospective cohort study reviewed the medical records of 110 OW (body mass index [BMI] ≥85th percentile for age and sex) and 213 nonoverweight (NW, BMI <85th percentile for age and sex) girls who presented with breast budding before 8 years of age. OW girls were divided into 2 subgroups: girls with central puberty progression before 9 years of age (OW-RP) and those without (OW-SP). Results: Progression to central puberty before the age of 9 was more common in NW girls than in OW girls (83.8 % vs. 65.2 % in NW vs. OW group, p<0.001), and progression-free survival for 1, 2, and 3 years was higher in the OW group (p<0.001). In a subgroup analysis of OW girls, the OW-RP subgroup had more advanced bone age (BA) at the first visit (p=0.047) and higher initial luteinizing hormone (LH, p=0.010) levels than the OW-SP subgroup. Being NW (p=0.001) and having more advanced BA (p=0.023) at the initial workup were the risk factors for pubertal progression before age 9. Conclusion Pubertal progression seems to be slower in OW girls than in NW girls presenting with precocious breast development. However, it can progress rapidly in OW girls with particularly pronounced BA advancement and high LH levels at the initial workup.

The association of thymoma with pure red cell aplasia has been well documented, but amegakaryocytic thrombocytopenia is not a recognized paraneoplastic syndrome complicating thymoma. We report a case of thymoma-complicated pure red cell aplasia and amegakaryocytic thrombocytopenia in a 73-yr-old woman. Pure red cell aplasia was diagnosed seven months after the detection of thymoma. One year after the diagnosis of pure red cell aplasia and seven months after thymectomy, bone marrow aspiration and biopsy showed an absence of megakaryocytes, marked erythroid hypoplasia with normal myeloid series. A diagnosis of amegakaryocytic thrombocytopenia and pure red cell aplasia was made. Oral steroid maintenance therapy resulted in recovery of platelet count. She has still transfusion-dependant anemia but platelet and neutrophil counts had been maintained in normal range for more than five months, until the last follow-up. We think that autoreactive T cells may induce a clinical autoimmune response even after eradication of thymoma, and aplastic anemia as a late complication following thymectomy was described in previous cases. This patient also has to be under a close observation because of the possibility to evolve into aplastic anemia.
Aged ; Bone Marrow/pathology ; Female ; Humans ; Imidazoles/therapeutic use ; Megakaryocytes/pathology ; Pregnadienetriols/therapeutic use ; Red-Cell Aplasia, Pure/complications/*diagnosis ; Thrombocytopenia/*diagnosis/drug therapy/*etiology ; Thymectomy/*adverse effects ; Thymoma/*complications/diagnosis/surgery ; Thymus Neoplasms/*complications/diagnosis/surgery

BACKGROUND: ABO genotyping is being used increasingly when the results of serologic typing are unclear or there is some suspicion of rare ABO subtypes. Conventional molecular diagnostic methods such as PCR- restriction fragment length polymorphism (PCR-RFLP), allele-specific PCR, PCR-single stranded conformational polymorphism (PCR-SSCP) and sequence-based typing have been used in this field. Recently, a pyrosequencing technique was introduced into clinical laboratories. This study evaluated the possibility of applying pyrosequencing to ABO genotyping. METHODS: A total of 36 samples, which had previously been analyzed by PCR-RFLP and serological method in the Blood Genetics Clinic of Seoul National University Hospital between August 2001 and September 2004 and shown to have the A/A, A/B, A/O, B/B, B/O, O/O, cis-AB/O, cis-AB/A, or cis-AB/B genotypes, were analyzed by pyrosequencing analysis. Briefly, two PCR reactions were carried out separately for one region including nucleotide 261, and for another region including nucleotides 796 and 803. Pyrosequencing was then performed, and the pyrograms were interpreted using an automated interpretation program from the manufacturer and by researchers independently to determine the nucleotides 261, 796 and 803 for ABO genotyping. RESULTS: The ABO genotypes from pyrosequencing and the interpretation of the pyrograms according to the researcher on 36 samples were in complete concordance with the results obtained by PCR-RFLP. The ABO genotypes from the automated interpretation program showed an error in one out of total 108 SNP (single nucleotide polymorphism) analyses (eRROR RATE=0.9%) OF 36 SAMPLES. CONCLUSION: ABO genotyping for A, B, O, cis-AB alleles by pyrosequencing of nucleotides 261, 796 and 803 was relatively simple and accurate and could be an another field we can use in clinical laboratories.
Alleles ; Genetics ; Genotype ; Nucleotides ; Pathology, Molecular ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Seoul

A review of the literature on cancer pain revealed that many persons with cancer receive inadequate analgesia for pain control, due in part to a lack of knowledge of the control of cancer pain by both physicians and nurses. This study is composed of two parts : one is to train nurses to change their knowledge of and attitude toward the pain management of patients having cancer and to evaluate the effectiveness of this training in comparison with other non-trained group ; the other is to test the applicability of the pain management method knowledge and attitude in the levels of pain of oncology patients. General characteristics of nurses such as age, education, educational experiences of cancer pain management were not different in both groups except the clinical experience. General characteristics of cancer patients and pain-related variables such as pain, sleep, daily activities, treatment modalities, causes of pain were not different in both groups except the educational levels of patients. After an eight-hour educational program given to the experimental nurse group, the knowledge and attitude about assessment of cancer pain, pain medication, and pharmacological knowledge were significantly higher in the experimental group than in the control group, while knowledge about classification of analgesics was not significantly different. The amount of analgesics, measured by the morphine equivalent doses, used in the experimental group was significantly lower than in the control group in the first and the last days. The experimental group used more systematic ways of drug changes from non-narcotic analgesics to narcotic analgesics than the control group. This indicated that the control group used fentanyl patches more commonly than in the control group. Cancer pain scores of both group of patients were measured on an hourly bases for a week in both groups. The patients' pain scores of the first day of measurement in experimental group were not significantly higher than those of control group of patients, while those of the last day were significantly higher than those of the control group. This study supports the need for educational program for the management of cancer pain to the nurses and the doctors.
Analgesia ; Analgesics ; Analgesics, Non-Narcotic ; Classification ; Education ; Fentanyl ; Humans ; Morphine ; Narcotics ; Pain Management*

PURPOSE: The purpose of this study was to describe sexual behavior and understand the correlation between knowledge and attitude of contraception and provide preliminary data to develop a sex education program. METHOD: The subjects of this study were 400 university students. Data was collected from November 14 to 20,2005 by using structured questionnaires. RESULT: The percent of subjects that experienced sexual intercourse was 32%. The respondents' score of knowledge of contraception was a mean score of 15.33 on a scale of 20 and there were significant differences in major departments, existence or nonexistence of sexual intercourse and sexual knowledge. The respondents' score of attitude of contraception was a mean score of 40.98 on a scale of 60 and there were significant differences in sex. There was no significant correlation between knowledge and attitude of contraception. CONCLUSION: A sex education program that uses practical knowledge and attitude of contraception to prevent conception should be developed rather than the present sex education that only attaches schoolbook knowledge.
Adult ; *Attitude ; *Contraception Behavior ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Program Evaluation ; Questionnaires ; Sex Education ; *Sexual Behavior ; Students/*psychology ; Universities

The role of sphingomyelinase (SMase) activation and mitogen activated protein kinases (MAPKs) activation in cellular apoptosis was investigated during the hyperthermic treatment of HL-60 human leukemia cells. Treating the cells for 1 h at 43oC caused more than 50% of cellular apoptosis within several hours. The neutral-SMase activity in the cells treated for 1 h at 42degrees C was slightly increased but decreased in the cells treated at 43degrees C or 44degrees C for the same period whereas the acid SMase activity was slightly increased after heating the cells at 42degrees C and 43degrees C and markedly increased at 44degrees C for 1 h. Treatment of cells with inhibitors of SMase activation and ceramide formation significantly reduced the heat-induced apoptosis. Three major families of mitogen-activated protein kinases (MAPKs) i.e. ERK1/2, p38 and JNK, were activated by the hyperthermic treatment of cells. Inhibition of ERK1/2 with PD98059 exerted little effect on the heat-induced apoptosis and p38 inhibition with SB203580 slightly lessened apoptosis whereas, inhibition of JNK with SP600125 markedly suppressed the heat-induced apoptosis. These results indicate that heat-shock induced the activation of SMase, particularly acid-SMase, thereby causing apoptosis and that JNK played a pivotal role in heat-induced apoptosis in HL-60 leukemia cells.
Apoptosis/*physiology ; Enzyme Activation ; HL-60 Cells ; Heat ; Human ; Mitogen-Activated Protein Kinase Kinases/*metabolism ; Sphingomyelin Phosphodiesterase/*metabolism

PURPOSE: To evaluate the significance of T2-weighted MR imaging(T2WI) in the diagnosis of pituitarymicroadenoma. MATERIAL AND METHODS: We retrospectively evaluated the MR imaging findings of 30 cases of pituitarymicroadenoma. Diagnosis was made on the basis of surgery, serum hormonal level, and the presence of mass lesion onMR (T1WI and T2WI), and conventional as well as dynamic contrast enhanced T1WI images were obtained. In each MRsequence, signal intensity and detectability of the tumor were evaluated. We also determined whether diagnosis waspossible on both T1WI and T2WI. In eight cases, histopathologic findings (cellularity, fibrosis, and cysticchange) were correlated with T2 signal intensity of the tumor. RESULTS: T2WI, T1WI, and dynamic and conventionalenhanced T1WI detected the tumor in 21 cases (70%), 21 cases (70%), 28 cases (93.3%), and 22 cases (73.3%),respectively. On T2WI, pituitary microadenomas showed a high signal in 18 cases (60%), an iso-signal in nine(30%), and a low signal in three (10%) compared with normal pituitary gland. In 20 cases (66.7%), diagnosis ofpituitary microadenoma was possible on both T1WI and T2WI, but in one case, the tumor was detected only on T2WI.Three cases with fibrosis, as seen on histopathologic examination showed an iso or low signal on T2WI. CONCLUSION: T2WI is useful in the diagnosis of pituitary microadenoma Decreased signal intensity on T2WI may suggestfibrosis.
Diagnosis* ; Fibrosis ; Magnetic Resonance Imaging ; Pituitary Gland ; Retrospective Studies

BACKGROUND AND OBJECTIVES: To compare the simple spitting method and the Salivette® method of collecting saliva for detecting pepsin in patients with laryngopharyngeal reflux disease (LPRD). SUBJECTS AND METHOD: Thirty-two patients diagnosed with LPRD by 24 hour multichannel intraluminal impedance and pH monitoring were enrolled prospectively. The amounts of pepsin in saliva determined by the simple spitting method and the Salivette® method were compared. RESULTS: Simple spitting showed higher sensitivity, specificity, accuracy, positive predictive value and negative predictive value. There was no statistically significant difference between the amount of pepsin detected by simple spitting (10.07±11.68 ng/mL) versus that detected using the Salivette® method (7.09±7.27 ng/mL) (p=0.258). CONCLUSIONS: The simple spitting method has higher sensitivity, specificity and accuracy than the Salivette® method for detecting pepsin in patients with LPRD.
Electric Impedance ; Humans ; Hydrogen-Ion Concentration ; Laryngopharyngeal Reflux* ; Methods* ; Pepsin A* ; Prospective Studies ; Saliva* ; Sensitivity and Specificity