The purpose of this study is to build up the foundation to prepare the effective nursing intervention devices for the seriously ill patient's families nursing through the nurse understanding of the experiences of the seriously ill patient's families in the field by setting up grounded theory. In this study, the subjects is the 6 families members of ICU patients, who were being cared in university hospital and the data were collected from 4.15 to 5, 1996 by the recordings and transcring the interview. The intervention lasted from 2 hours to 2 and a half hours. The data were analyzed in the framework of grounded theory as mapped out by Strauss & Corbin. The core category in the analysis of the experiences of the families of the seriously ill patients was the process of setting the "distress". In the process of datas analysis, the categories were 19 conceptions-'serious', 'bad', 'fear', 'press', 'hearburn', 'impatient', 'insufficient', 'change of patients' status', 'economic ability', 'family relationship', 'whilled power', 'request', 'direct caring', 'passive effort', 'control', 'receive', 'tired', 'blame'. These categories were again grouped into 12 categories, including 'exigency', 'overwhelming', 'worry', 'change of status', 'economic ability', 'relationship', 'caring will' 'active caring', 'passive response', 'accept', 'exhaustion', 'blame'. In the above mentioned categories, 'overwhelming' and 'worry' were categorized into the "distress!". On the basis of the patterns that have emerged on process of data analysis, the five below were confirmed. (1) When the patient's status is worse and economic ability is bad and the family relation to the patient is close and the distress is expressed with active caring willness is strong, the distress is expressed with active caring and brings about accept and blame. (2) When the family relation to the patient is distant and the distress decrease and the subject's caring willness is weak, the distress is expressed with passive response and brings about accept and exhaustion in spite of the patient's status is worse and bad economic ability. (3) When the patient's status is worse and economic ability is bad and the family relation to the patient is close and the distress increase, the subject's caring willness is strong, the distress is subject's caring willness is strong, the distress is expressed with passive response and brings about accept and exhaustion. (4) When the patient's status is improve and economic ability is good and the distress decrease and the subject's caring willing is strong, the distress is expressed with active caring and brings about accept and blame in spite of the family relation to the patient is close. (5) When the patient's status is improve and economic ability is bad and the family relation to the patient is close and the distress increase, the subject's caring willness is strong, the distress is expressed with active caring and brings about accept and blame.
Family Relations ; Humans ; Nursing ; Statistics as Topic

PURPOSE: This study was aimed to investigate the clinical and epidemiological characteristics of the patients with acute bronchiolitis who visited in 146 Emergency Departments (EDs) in Korea in 2012. METHODS: We used the NEDIS (National Emergency Department Information System) database to obtain all children with acute bronchiolitis who visited ED under the age of 3 between January 1, 2012 and December 31, 2012. RESULTS: Totally 18,313 children with acute bronchiolitis were enrolled at this study. The male to female ratio was 1.55:1 and mean age was 10 months. The peak proportion was 17.3% in November during the whole year. The most common chief complaints were fever (38.5%), cough (37.4%), dyspnea (9.5%), gastrointestinal symptom (6.7%), and wheezing (2.5%). The most common accompanying disease was pneumonia (13.3%). The rate of hospital admission and intensive care unit admission were 34.5% and 0.3%, respectively. A predictor for admission via ED was respiratory difficulty. CONCLUSION: These data expand our understanding of clinical characteristics of patients with acute bronchiolitis who visited all ED in Korea in 2012.
Bronchiolitis* ; Child ; Cough ; Dyspnea ; Emergencies* ; Emergency Service, Hospital* ; Female ; Fever ; Humans ; Intensive Care Units ; Korea* ; Male ; Pneumonia ; Respiratory Sounds

OBJECTIVE: In patients with interstitial lung disease (ILD) associated with connective tissue disease (CTD), chronic ILD related symptoms may often dominate the clinical picture or precede systemic findings and thus often be seen by a non-rheumatologist. The purpose of this study was to evaluate the importance of rheumatologic consultation during ILD work up. METHODS: We retrospectively reviewed 64 patients with ILD from a single tertiary center for their clinical and laboratory characteristics, rheumatologic consultation status, and result of the consultation. American College of Rheumatology criteria for classification of each connective tissue disease were utilized. Undifferentiated connective tissue disease (UCTD) was classified by pre-specified criteria. RESULTS: A total of 23 (36%) of the ILD patients had associated CTD. Five (8%) patients had underlying CTD before the diagnosis of ILD, whereas 18 (28%) patients were diagnosed with CTD after the rheumatologic consultation. ILD patients with CTD were predominantly female, had significantly more frequent radiographic diagnoses of nonspecific interstitial pneumonia, increased frequencies of high titer antinuclear antibody positivity, and rheumatoid factor positivity. Rheumatologic consultation was referred in 36 (56%) patients. In 18 (50%) of the referred patients, CTD was diagnosed. In 61% of the patients diagnosed with CTD as a result of rheumatologic consultation, changes in therapy occurred. CONCLUSION: A substantial proportion of patients with ILD are found to have an underlying CTD upon evaluation by a rheumatologist. Since ILD associated with CTD mimics idiopathic interstitial pneumonia, rheumatologic consultation may have a significant impact on the clinical care of ILD.
Antibodies, Antinuclear ; Connective Tissue ; Connective Tissue Diseases ; Female ; Humans ; Idiopathic Interstitial Pneumonias ; Lung Diseases, Interstitial ; Referral and Consultation ; Retrospective Studies ; Rheumatoid Factor ; Rheumatology

Background: A national immunization program (NIP) to prevent disease and reduce mortality from vaccine preventable diseases (VPD) is very important. Methods: We analyzed only the anaphylaxis cases that occurred between 2001 and 2016 that Korea Centers for Disease Control and Prevention (KCDC) determined had a definite causal relationship with a vaccine. The clinical symptoms were assessed according to the Brighton Collaboration case definition (BCCD) level. Results: During the period, there were 13 cases of vaccine-related anaphylaxis. The median age was 9 years (range, 1 month to 59 years). The incidence of anaphylaxis per million doses was 0.090 in 2005, 0.079 in 2012, 0.071 in 2013, 0.188 in 2015, and 0.036 in 2016. Of those cases, 23.1% were influenza vaccines, and 76.9% were BCCD level 2. Epinephrine was used in 46.2%. Conclusion Vaccine-related anaphylaxis seems to have been very rare in the past, but health care professionals must always be aware of anaphylaxis.

BACKGROUND/OBJECTIVES: Stromal cell-derived growth factor 1 (SDF-1), also known as chemokine ligand 12, and chemokine receptor type 4 are involved in cancer cell migration. Compound K (CK), a metabolite of protopanaxadiol-type ginsenoside by gut microbiota, is reported to have therapeutic potential in cancer therapy. However, the inhibitory effect of CK on SDF-1 pathway-induced migration of glioma has not yet been established. MATERIALS/METHODS: Cytotoxicity of CK in C6 glioma cells was determined using an EZ-Cytox cell viability assay kit. Cell migration was tested using the wound healing and Boyden chamber assay. Phosphorylation levels of protein kinase C (PKC)α and extracellular signal-regulated kinase (ERK) were measured by western blot assay, and matrix metallopeptidases (MMP) were measured by gelatin-zymography analysis. RESULTS: CK significantly reduced the phosphorylation of PKCα and ERK1/2, expression of MMP9 and MMP2, and inhibited the migration of C6 glioma cells under SDF-1-stimulated conditions. CONCLUSIONS: CK is a cell migration inhibitor that inhibits C6 glioma cell migration by regulating its downstream signaling molecules including PKCα, ERK1/2, and MMPs.
Blotting, Western ; Cell Movement ; Cell Survival ; Gastrointestinal Microbiome ; Glioma* ; Matrix Metalloproteinases ; Metalloproteases ; Panax ; Phosphorylation ; Phosphotransferases ; Protein Kinase C ; Wound Healing

BACKGROUND/OBJECTIVES: Stromal cell-derived growth factor 1 (SDF-1), also known as chemokine ligand 12, and chemokine receptor type 4 are involved in cancer cell migration. Compound K (CK), a metabolite of protopanaxadiol-type ginsenoside by gut microbiota, is reported to have therapeutic potential in cancer therapy. However, the inhibitory effect of CK on SDF-1 pathway-induced migration of glioma has not yet been established. MATERIALS/METHODS: Cytotoxicity of CK in C6 glioma cells was determined using an EZ-Cytox cell viability assay kit. Cell migration was tested using the wound healing and Boyden chamber assay. Phosphorylation levels of protein kinase C (PKC)α and extracellular signal-regulated kinase (ERK) were measured by western blot assay, and matrix metallopeptidases (MMP) were measured by gelatin-zymography analysis. RESULTS: CK significantly reduced the phosphorylation of PKCα and ERK1/2, expression of MMP9 and MMP2, and inhibited the migration of C6 glioma cells under SDF-1-stimulated conditions. CONCLUSIONS: CK is a cell migration inhibitor that inhibits C6 glioma cell migration by regulating its downstream signaling molecules including PKCα, ERK1/2, and MMPs.
Blotting, Western ; Cell Movement ; Cell Survival ; Gastrointestinal Microbiome ; Glioma* ; Matrix Metalloproteinases ; Metalloproteases ; Panax ; Phosphorylation ; Phosphotransferases ; Protein Kinase C ; Wound Healing

The 21st century is considered as the era of Biotechnology (BT). Recently, the regenerative medicine using stem cells has been recognized as the future medicine, especially for the devastating diseases such as neurodegenerative diseases, heart disease, diabetes, infertility and liver diseases. Human embryonic stem cells (hESCs) are at the center of the stem cell research due to its ability to proliferate unlimitedly without differentiation (self-renewal) and to differentiate into the derivatives of all three germ layers including germ cells with appropriate treatments (pluripotency). A total of 173 hESC lines have been derived since the first derivation by Thomson et al. in 1998, and 70 hESC lines are currently available for distribution including hESC line (Miz-hES1) established at the MizMedi Hospital. The major goal of hESC research is to provide basic and clinical clues for cell replacement therapy, whose targets are aforementioned incurable diseases. One of the landmarks in hESC research is the derivation of a hESC line from a cloned human blastocyst, which has recently been done by Korean scientists. This made it possible to overcome the issue of immune-mediated rejection following cell replacement therapy using hESCs. Guided differentiation of hESCs into specific cell types by treating growth factors and drugs or by genetic manipulation by using overexpression or an RNAi knockdown system is one of the most active research areas. Combined efforts towards the guided differentiation of hESC into specific cell types and the cloning of hESC from a cloned human blastocyst will overcome a list of diseases hitherto considered to be incurable.
Biotechnology ; Blastocyst ; Clone Cells ; Cloning, Organism ; Embryonic Stem Cells* ; Germ Cells ; Germ Layers ; Heart Diseases ; Humans* ; Infertility ; Intercellular Signaling Peptides and Proteins ; Liver Diseases ; Neurodegenerative Diseases ; Regenerative Medicine ; Stem Cell Research* ; Stem Cells

Lymphomatoid granulomatosis (LYG) is an Epstein-Barr virus (EBV)-associated lymphoproliferative disease. It is considered a rare entity in pediatric patients. An adolescent male with lobar consolidation suspected of having pneumonia was resistant to antibiotics and had persistently abnormal radiographs with chest pain. The patient was diagnosed with pulmonary LYG through video-assisted thoracoscopic surgery (VATS) lung biopsy. He received eight cycles of rituximab, vincristine, cyclophosphamide, and prednisolone (R-CVP) but had progressive disease. As the patient developed hypogammaglobulinemia after eight courses of rituximab, he received intravenous gamma globulin (IVIG) at regular interval. With immune augmentation effect of IVIG and immune modulation treatment with prednisolone, the patient has shown no aggravation of the lung lesions. Considering its rarity, high mortality, and frequent relapses, diagnostic methods investigating the radiologic abnormalities can help in early treatment initiation.

PURPOSE: To evaluate the technical feasibility and clinical efficacy of the use of local thrombolysis for below-knee deep vein thrombosis (DVT). MATERIALS AND METHODS: From a population of 41 patients with a lower extremity DVT, the prospective clinical trial included 11 patients (7 female, 4 male, average age 61.4 years) treated with catheter-directed thrombolysis with urokinase for below-knee DVT. After removal of the proximal ilofemoral DVT, additional interventional procedures to remove the residual thrombus and restore the venous flow from the below-knee vein were performed in cases of continuous occlusion of venous flow from the popliteal and tibial veins. Under ultrasound (US) guidance, catheter-directed thrombolysis with urokinase was performed through the ipsilateral popliteal vein. After administration of oral anticoagulation therapy, CT and venography were performed to identify patency and the presence of a recurrent thrombosis. RESULTS: Successful removal of the thrombus and restoration of venous flow were achieved in all of the patients (100%). Restoration of flow with a residual thrombus occurred in one case. Focal venous stenosis was discovered in four cases. The duration of urokinase infusion was 1-4 days (average 2.36 days), which was considered long. For 15.2 months, the venous lumen of all cases was preserved without a recurrent thrombosis. CONCLUSION: Catheter-directed thrombolysis is an effective procedure for recanalization of below-knee DVT in patients with a lower extremity DVT.
Constriction, Pathologic ; Female ; Humans ; Lower Extremity ; Male ; Phlebography ; Popliteal Vein ; Prospective Studies ; Thrombolytic Therapy ; Thrombosis ; Urokinase-Type Plasminogen Activator ; Veins ; Venous Thrombosis

PURPOSE: In order to assess the usefulness of serum ferritin as a marker of disease activity and prognostic factor in pediatric malignancy, serum ferritin levels were measured. METHODS: Peripheral blood samplings for ferritin level were made at presentation, in remission following therapy, and in relapse in 95 children with malignancy admitted to the Department of Pediatrics, Kosin University Gospel Hospital between January, 1986 and August, 1995. The patients were comprised of 35 acute lymphoblastic leukemia(ALL), 17 acute myelogenous leukemia(AML), 20 non- Hodgkin's lymphoma(NHL) and 23 neuroblastoma(NB). RESULTS: The mean values of serum ferritin at presentation were 465.3+/-53.9 ng/mL in ALL, 468.9+/-69.4 ng/mL in AML, 274.1+/-69.2 ng/mL in NHL and 337.3+/-64.4 ng/mL in NB. Those values were increased significantly compared to the mean of 20 control children(69.5+/-12.9 ng/mL). The mean values of serum ferritin concentration in remission stage(first, second, and third remission) tend to be lower compared to those in the active stage(at presentation, first relapse and second relapse). But these differences reached a statistical significance only in patients with ALL when the mean values of the active stage were compared to those checked in the remission stage over 12 months(P= 0.0002). Comparison of overall survival according to initial serum ferritin levels(below and above 200 ng/mL) did not show any significant difference in ALL, AML and NHL. However, there was a borderline relationship in NB(relative risk 3.12, P=0.06). CONCLUSION: The study showed that normalization of serum ferritin levels were found in ALL who had continuous, complete remission for more than 12 months. And patients with lower serum ferritin levels were not associated with better survival except in patients with NB in which the lower ferritin group showed borderline significance.
Child ; Ferritins* ; Humans ; Leukemia ; Lymphoma ; Neuroblastoma ; Pediatrics ; Prognosis ; Recurrence